x < • • • . . •"Sy■: THE 
AMERICAN CYCLOPEDIA 
OF 
Domestic Medicine 
AND 
HOUSEHOLD SURGERY. 
A RELIABLE GUIDE FOR EVERY FAMILY. 
CONTAINING FULL DESCRIPTIONS OF THE VARIOUS PARTS OF THE HUMAN BODY J ACCOUNTS OF THE NUMEROUS 
DISEASES TO WHICH MAN IS SUBJECT-THEIR CAUSES, SYMPTOMS, TREATMENT AND PREVENTION- 
WITH PLAIN DIRECTIONS HOW TO ACT IN CASE OF ACCIDENTS AND EMERGENCIES OF 
EVERY KIND J ALSO, FULL DESCRIPTIONS OF THE DIFFERENT ARTICLES 
USED IN MEDICINE, AND EXPLANATIONS OF MEDICAL AND 
SCIENTIFIC TERMS. 
WITH NUMEROUS ILLUSTRATIONS. 
EDITED BY 
SAMUEL PAYNE FORD, M. D., 
Ui 7 7 
GRADUATE OF THE UNIVERSITY OF TORONTO, ONT., CANADA, AND OF THE UNIVERSITY OF BUFFALO, N. Y.; 
MEMBER OF THE COLLEGE OF PHYSICIANS AND SURGEONS, ONT., AND 
LATE ACTING ASSISTANT SURGEON, U. S. ARMY. 
WITH AN APPENDIX BY 
PAAREN, M.D..V.S. 
1 'upmplete in One Vol. (Three Parts). 
Pa/t II. COCOA-NUT-LUNGWORT. 
E. P. KINGSLEY & CO., CHICAGO, ILL. 
J. HUGILL, Cincinnati, 0. J. R. SEVERNS, Atlanta, Ga. 
18 8 0. Entered, according to Act of Congress, in the year 1880, by E. P. KINGSLEY, in the office of the Librarian 
of Congress, at Washington. 
ALT. RIGHTS RESERVED. 
SKEEN & STUART, 
PRINTERS, 
CHICAGO. 
BLOMGREN BROS. & CO^ 
ELECTROTYPERS, 
CHICAGO. COCOA-NUT-COD-LIVER OIL. 
421 
COCOA-NUT. (See Cocos.) 
COCOS, kd-koze [Gr. kokkos, a kernel], a genus of palms. C. nuci- 
fera, the cocoa or cocoa-nut palm, is perhaps the most useful member 
of that great family, which may be said to yield flour, sugar, oil, wax, 
wine, thread, utensils, timber for habitations, and leaves for thatching. 
Sugar, called jaggery, is largely obtained from the juice, which flows 
out when its spathes and spadix are injured. Toddy and areca are pro- 
duced by the fermentation of this juice. The albumen of the seeds 
(cocoa-nuts) and the liquid within this (cocoa-nut milk) are important 
articles of food in many tropical regions. The cocoa-nut is also largely 
consumed in this country. It cannot be recommended for family eating, 
as it is very indigestible, being rendered so by its oily nature, and 
solidity of structure. From the albumen, or edible portion, the con- 
crete oil known as cocoa-nut oil, or cocoa-nut butter, is obtained. 
COCUM. (See Phytolacca Decandra.) 
CODEIA, ko-de-a, one of the active principles of opium, and has 
been used in the form of lozenge for the purpose of allaying irritating 
cough in cases in which it was not thought desirable to produce the full 
and characteristic effects of opium itself upon the constitution. It is 
well known that some persons cannot take opium in any shape without 
unpleasant effects, and it is to such persons that the above lozenges may 
prove valuable as a means of soothing a cough that has resisted other 
more simple methods of cure. Dose, J of a grain gradually increased to 
2 grains. (See Opium.) 
COD-LIVER OIL, kod'-liv-ur oil [Oleum Morrkuad\, is extracted 
from the fresh liver of the cod, by the application of a heat not exceeding 
180°. There are various modes of extracting the oil. That recom- 
mended is to select the best livers fresh, clean and slice them, and then 
expose them to the above heat until all the oil is drained from them, 
which is then filtered and cooled to a temperature under 50°, so as to 
congeal the more solid fat. There are three kinds of oil, the pale-yellow, 
pale-brown, and dark-brown, the last being the least pure. In addition 
to the usual components of fish oils, it appears to contain a compound of 
acetic acid with glycerine, various constituents of the bile, and minute 
portions of iodine, bromine, and phosphorus. It was formerly employed 
as medicine in England, fell into disuse, was revived as a remedy in 
Germany, and again brought into public notice in Britain, by Dr. 
Hughes Bennett, of Edinburgh, in 1841, since which time it has 
advanced rapidly and deservedly in the estimation both of the profession 
and of the public in Europe, the United States, and Canada. It had 
never, however, been entirely abandoned as a domestic remedy in 
rheumatism, and among the sailors, particularly those connected with 422 
COD-LIVER OIL-COFFEA. 
the northern fisheries, had been regularly used both internally and 
externally, in the above disease. Now, however, it is principally 
employed and celebrated for its curative powers, especially in pulmonary 
consumption, in scrofula, and in all diseases connected with the scrofu- 
lous constitution, or depending on general debility. In the atrophy or 
wasting of the flesh in young children, connected with enlarged glands 
in the belly, which is tumid and hard, feels knotty, and with the veins of 
the surface enlarged, cod-liver oil, given internally, 1 teaspoonful twice a 
day, and well rubbed into the skin of the belly two or three times a day, 
will in many cases cure, in a way which no other remedy we are 
acquainted with could do. 
For some time, the dark, heavy, strong oil was considered to be the 
most efficacious; but now, especially since more care has been bestowed 
on the manufacture, the purer and lighter oil, of the color of light 
mahogany, is as good as any that can be used. The dose for an adult is 
generally 1 tablespoonful twice or three times a day; it is, however, by 
some given much more largely. It is always advisable at first, to begin 
with smaller, such as teaspoonful doses, till the patient and the stomach 
become accustomed to the remedy, which even children quickly do, 
although sickness at the stomach is sometimes produced at first. Tastes 
differ much as to the best method of taking cod-liver oil; the dose may 
be shaken up with half the quantity of syrup of marsh mallow, and 
swallowed at once, or it may be taken in water, simple or aromatic. 
The following form of administration will suit some persons who can- 
not take the oil otherwise: Rub down 2 ounces of loaf-sugar, in a quart 
mortar, to fine powder, add the yolk of an egg, and blend thoroughly 
with the sugar, adding 3 drops of oil of cinnamon; add 2 ounces of cod- 
liver oil by small quantities, and rub with above till thoroughly incor- 
porated ; finally add, still rubbing, 1 ounce of orange-flower water. The 
dose-1 tablespoonful thrice daily, before meals. It is said that shaking 
the oil with cherry laurel-water is a good method of correcting its smell 
and taste; of course, the laurel-water is separated before taking the oil. 
With many, cod-liver oil acts slightly upon the bowels. In some cases 
of chest affection, the breathing is certainly apt to become more difficult 
for the first few days of its use, and it has been said to induce spitting of 
blood. There cannot be stronger evidence of the nutritious power of 
cod-liver oil, than the way in which its omission is felt, by patients who 
have taken it regularly for some time, neither wine nor anything else 
appears to be a sufficient substitute. Dose, 1 tablespoonful or more, 
two or three times a day. (See Consumption, Scrofula, Atrophy, etc. ) 
COFFEA, Icof-fe'-a [Sp. and Fr. cafe'], a genus of plants belong- 
ing to the Nat. order Cinchonaceoz. The species C. arabica is the COFFEA. 
423 
coffee-plant, or quhwa of the Arabs, the seeds of which, when roasted 
and ground, are used to furnish the daily and most cherished drink 
of probably more than a hundred millions of human beings. The 
plant is said to be a native of Arabia Felix and Southern Abyssinia; 
but it has been carried to various countries within the tropics, and, at 
the present time, is cultivated wherever the climate is suitable. In some 
countries it seldom attains a greater height than eight or ten feet; but in 
others, its average height, when full grown, is from fifteen to twenty 
feet. Coffee owes its valuable properties chiefly to the presence of an 
alkaloid called caffeine, and a volatile oil. It is remarkable that tea 
should contain precisely the same principle, theine and caffeine being 
identical. The sensible properties and effects of coffee, like those of tea, 
are too well known to require to be stated in detail. It exhilarates, 
arouses, and keeps awake; it counteracts the stupor occasioned by 
disease, by fatigue, or by opium; it allays hunger to a certain extent; 
gives to the weary increased strength and vigor, and imparts a feeling of 
comfort and repose. As an article of diet, coffee is for most persons 
wholesome and stimulating, but when there exists any tendency to head 
affection, or when the biliary secretion is apt to be over-abundant, it 
ought not to be used. Dr. Paris remarks, that coffee, "if taken after a 
meal, is not found to cause that disturbance in its digestion, which has 
been noticed as the occasional consequence of tea; that on the contrary, 
it accelerates the operations of the stomach;" when strong, it most 
undoubtedly exerts much influence over the brain and nervous system, 
producing watchfulness and feverish symptoms ; it is thought, too, to 
affect the skin, and the sallow hue of the Parisians has been ascribed to 
the excessive use of coffee. The nutrient power of coffee is considered 
greater than that of tea, although this cannot be great in either, irre- 
spective of the characteristic principles theine and caffeine-above- 
mentioned, which, probably, are peculiarly beneficial to those who, 
either from necessity or inclination, consume much non-azotized, or 
vegetable food. In such individuals, who are often of sedentary habits, 
a deficient consumption of animal diet, and inactivity together, render 
the biliary secretion deficient, and these principles of tea and coffee are, 
according to Liebig, "in virtue of their composition, better adapted" to 
supply the-otherwise deficient-"biliary azotized principles, than all 
other nitrogenized vegetable principles. " Coffee is more suitable, for 
most persons, for the morning meal, than tea, which is more likely to 
affect the nervous functions. A cup of strong coffee taken immediately 
after rising, is considered a good protective from the effects of malaria. 
In poisoning by opium, coffee is one of the most useful antidotes, but in 
this case ought to be fresh, pure, and strong, and taken without milk or 424 
COFFEA- COL C III CUM 
sugar. The infusion of 1 ounce taken every twenty minutes is considered 
a suitable dose. Coffee should always be infused, never boiled ; when 
made with half milk, it is more nutritious for the weak, if it agrees with 
the stomach in this form. The adulterations of coffee are numerous ; 
for that with chicory which is the most prevalent, the reader is referred 
to the article Chicory. Roasted wheat flour, and beans, mangel- 
wurzel, acorns, potato-flour, and a " coffee colorer " made with coarse 
burnt sugar, are likewise used. Coffee sold in "air-tight" canisters is 
always to be suspected. The only real security at present is, for persons 
to grind their own coffee, not too much at once, and to preserve both 
the whole berry and the powder in canisters, or wide-mouthed, well-closed 
bottles. In the West Indies, an infusion of raw coffee is used by the 
negroes, and found serviceable in promoting the flow of urine. A few 
coffee-beans thrown upon a red-hot shovel are an effective, and not un- 
pleasant, corrective of unpleasant effluvia. A strong infusion of coffee 
has been well spoken of as a useful auxiliary in the reduction of strangu- 
lated rupture. (See Rupture, Breakfast, Dinner, Food, Diet, Tea, 
Drinks. ) 
COFFEE. (See Coffea.) 
COHOSH, BLACK. (See Black Cohosh.) 
COHOSH, BLUE. (See Blue Cohosh.) 
COLCHICUM, kol'-ke-kum [after Colchis, its native country], a 
genus of plants belonging to the Nat. order Melantkaceoe. The most 
important species is C. autumnale, the common meadow-saffron, a 
perennial, growing in abundance in many parts of Europe. It blos- 
soms during the months of August and September, its flowers being 
crocus-like, and of a purple color. This plant offers a strange con- 
trast to most others in the mode of producing flowers and fruit. The 
flowers appear during the autumnal months named, rising from the 
ground without any leaves ; and, when they fade, nothing further is seen 
of the plant until the following spring, when tufts of leaves make their 
appearance, enclosing the seed-vessel or capsule, which ripens about hay- 
harvest. Both the seeds and corms of this plant are employed medi- 
cinally. They stimulate the secretions, acting as a cathartic, diuretic, 
alterative, emetic, and sedative. Used in rheumatism, gout, dropsy, 
palpitation of the heart, scarlet fever, gonorrhoea, enlarged prostate, 
and in neuralgia. In improper doses colchicum acts as a narcotico-acrid 
poison. The symptoms produced by an overdose of colchicum are, 
vomiting, purging, colic, heat in the throat and abdomen, general 
depression, headache, and stupor or delirium. The remedies to be used 
until medical assistance is procured are, diluents, such as barley-water, 
linseed tea, or thin gruel, and laudanum or opium in some form. The COL CELL CUM- COLD. 
425 
once celebrated French nostrum for gout, called Eau medecinale d'Hus- 
^on, owes its properties to colchicum. The corms are collected about 
the end of June, stripped of their coats, sliced transversely, and dried at 
a temperature not exceeding 150°. Dose: in powder, 2 to 8 grains; 
tincture, 10 to 30 drops ; wine, 10 drops to % a teaspoonful; fluid extract, 
3 to 12 drops; solid extract, £ to 2 grains. To be taken every four to 
six hours. 
COLD, kolde, is generally considered to be a negative result of the 
absence of heat, rather than an active principle; in consequence, how- 
ever, of its energetic influence upon the living body, either in health or 
disease, it is usually spoken of as an active agent. The animated human 
frame is endowed with the power of maintaining a certain average 
temperature, which-except in rare instances-is higher than that of the 
surrounding medium, and this power is adequate to resist all ordinary 
impressions of cold; but when, from great intensity, or long continu- 
ance, and especially when combined with moisture, the depressing action 
of cold is much augmented, the powers of life sink, and disease or death 
is the consequence. This power of the living body to resist cold is in a 
great measure dependent upon the supply and proper assimilation of a 
sufficiency of nourishment; the ill-fed and the dyspeptic always suffer 
most from the effects of cold. But in order that full benefit may be 
derived from the power of food to protect against low temperature, par- 
ticularly when at all severe or long-continued, it is requisite that more or 
less muscular exercise-according to circumstances-be engaged in, for 
the purpose of quickening the functions of respiration, circulation, and 
metamorphosis of tissue; in other words, for the purpose of increasing 
the supply of oxygen taken into the system, and thereby facilitating the 
consumption of internal fuel (see Animal Heat) either obtained directly 
from the food, or from the compounds carbon and hydrogen already 
existing in the body. This is no more than common experience testifies ; 
for all know, that of two men exposed to a continued degree of intense 
cold, even if equal in other respects, should one persevere in muscular 
exertion, and the other give way to indolence or torpor, the former will 
be much more likely to survive the effects than the latter. And even 
under exposure to cold, not so immediately dangerous to life, and 
especially if combined with moisture, the most ignorant are aware that 
"as long as they keep moving," there is comparatively little danger of 
those bad consequences, which almost invariably result if rest is indulged 
in. In fact, as long as the muscular movement is kept up, the circula- 
tion, respiration, and change of tissue goes on with sufficient activity to 
maintain temperature adequate to resist the cold, which, however, pre- 
vails, as soon as inactivity permits the cessation of the resisting forces. 426 
COLD. 
Thus we have a point of every day experience confirmed, and its 
rationale explained, by the researches of modern science. 
In northern latitudes, however, the internal means of resisting cold 
are of themselves insufficient for the purpose, and therefore, clothing, 
shelter, or habitations, and the production of artificial heat, are resorted 
to, and these, indeed, in some degree stand in the place of nourishment; 
for the man who is sufficiently well protected from the effects of cold, 
certainly requires a less supply of food to maintain health than he who 
is not. As regards food, habitations, and fuel, most people who have it 
in their power, are inclined to use their protecting influences sufficiently; 
it is in clothing that the chief errors and negligences are met with, and 
the reader is referred to that subject for their exposition. (See Cloth- 
ing.) There may be such over-precaution in guarding against cold, that 
it is impossible to keep up the protection on all occasions, so that an acci- 
dental omission in dress, or exposure, after being habituated to air of too 
high a temperature, at once gives rise to disease ; but the abuse is no 
argument for the non-employment of sufficient rational protection against 
the influences of weather, especially in northern latitudes in which a low 
temperature frequently prevails, and that, too, combined with moisture, 
whilst at the same time, the vicissitudes from heat to cold are often 
extreme and violent. It may safely be asserted, that a large proportion 
of the diseases to which the inhabitants of this country are liable, are, 
either directly or indirectly, the result of cold. It is sufficient to mention 
inflammatory attacks, general and local, apoplexy and paralysis, rheu- 
matism and neuralgia, scrofula with its long train of disease, and con- 
sumption, as diseases, among many others, traceable to the influences of 
low temperature, to convince the most careless of the necessity of due 
protection against an agent so potent for evil. In many warm climates, 
the principal danger from cold is incurred by exposure to the chill dews 
of evening, after hot days. 
The effect of extremely low temperature acting upon a limited portion 
of the body, is rigidity of the muscles, blistering of the skin, particu- 
larly from grasping metallic bodies with the bare hand, and frost-bite or 
death of the part affected. The general effect of extreme continued 
cold, is depression of the nervous system, of the functions of the 
respiratory organs and skin, deterioration of the blood, torpor, insuper- 
able drowsiness, and death. In case of frost-bite, as of the fingers or 
toes, although the part may appear quite lifeless, pale and shrivelled, it 
may often be saved by proper treatment, and the principal thing to be 
attended to is, that the temperature be not suddenly raised; circulation, 
nervous power, and heat, must be very gradually restored, and probably 
the method followed in countries in which this accident is common, will COLD. 
427 
be found safest and best, that is, continued friction of the part affected, 
with snow, till reaction is established, at all events friction should be 
used; after inflammation may be soothed by tepid poultices. 
When in consequence of long exposure to extreme cold, drowsiness 
comes on, both mind and body must be exerted to keep off the influence; 
to indulge it, is death ; muscular motion must be kept up; if the indi- 
vidual is alone, and has a supply of alcoholic stimulant, brandy or wine, 
it ought to be resorted to when it is felt that otherwise the powers must 
give way; then, it may give strength to reach safety and shelter, but the 
greatest caution is requisite, before those who are exposed to severe con- 
tinued cold have recourse to these stimulants ; as a last resource they are 
invaluable, but their aid must be unsought as long as possible, for if 
resorted to too soon, the after depression adds fatal facility to the further 
depressing power of a low temperature. Experience proves, that those 
who are likely to be exposed to great continued cold, should provide 
abundant nourishment, particularly of a fat or oily character; they 
should never be without a flask of spirits, but never have recourse to it, 
except as a last resource. The sudden application of cold, even if it be 
not intense, may be very serious, in case the nervous powers are at all 
exhausted; of this, the cramp to which bathers are subject is an 
example, and likewise the fatal accidents so frequent during harvest, 
from persons drinking largely of cold water. The fatal effect is usually 
ascribed to the heated state of the body, but much is also due to the 
shock communicated to the stomach and its numerous nervous con- 
nexions, while the system generally is exhausted. The effect of cold, 
not extreme, but long-continued, especially if combined with moisture, 
is one of the most fertile sources of diseases, some of which have been 
already enumerated. The young and the aged are more peculiarly liable 
to suffer, and for this reason require especial protection. The partial 
application of cold, particularly by a moving current of air, most 
generally produces disease of a neuralgic or rheumatic character, partial 
paralysis, especially of the face, or erysipelas. All these injurious 
influences are more readily exerted, if the body is at the time in a state 
of heated excitement, combined with nervous exhaustion the result of 
previous exertion, and at rest. 
The'partial application of cold and wet may produce inflammatory 
action in the immediate vicinity of the part exposed, or as in the case of 
wet feet, in some distant organ. 
The most effectual remedy for the effects of "chill," is warmth with 
moisture, in the form of bath, vapor or warm, or of hot bran bags, and 
the free use of warm diluent drinks, such as tea, gruel, etc., and in case 
of much depression, warm wine and water. 428 
COLD-COLD FEET. 
The use of cold as a hygienic agent, or in the treatment of disease, is 
invaluable. When, either as cold air or cold water, it is adapted in 
intensity and continuance, to the resisting power of the constitution, it is 
a most admirable tonic. When used to subdue certain forms of excited 
and inflammatory action, the temperature must of course be suited to 
the case, but ice-cold is most generally useful, care being taken, in the 
application of ice itself, that the part is not, as has happened, actually 
frozen or killed. Various forms of evaporating lotions, made with 
spirits, etc., are employed, but as the additions are made simply to 
increase the cold by increasing the evaporation, if a sufficient supply of 
sufficiently cold water can be procured, it is all that is requisite ; the best 
mode of application is by cloths dipped in the cold fluid, and renewed 
again and again by a careful nurse. When, from circumstances, this 
cannot be done, the next best method is, to keep up a continued system 
of irrigation, by means of a vessel of cold water placed a little higher 
than the part to be cooled, the fluid being conducted from the vessel to 
the part by bundles of woolen thread, or thin strips of flannel, care 
being taken, by means of waterproof material of some kind placed 
underneath, to carry off the superfluous water; in this way, the head, or 
a broken limb, may be kept constantly under the influence of a stream 
of cold water, without the necessity for constant attendance. Extreme 
cold, such as is produced by a mixture of equal parts of salts and 
pounded ice, may be used with safety to cause temporary loss of sensa- 
tion in minor operations. The plan is one which might frequently 
supersede the employment of chloroform. In the removal of small 
tumors, the extraction of ingrowing toe-nails, the introduction of setons, 
and such like, the author has reason to speak most favorably of the 
practice. To Dr. James Arnott is due the credit of being the chief 
promoter of "Congelation as an Anaesthetic," not only in operations, 
but also to allay the pain and promote the cure of neuralgia. (See 
Baths, Affusion, Heat, Ice, Climate. Seasons, Exercise, Circulation, 
Respiration, Catarrh or Common Cold, Inflammation, Rheumatism, 
Apoplexy, Paralysis, Neuralgia, Scrofula, Consumption.) 
COLD BATH. (See Baths and Bathing.) 
COLD CREAM, kolde kreme^ is a white ointment, commonly used as 
a lip salve, and as a healing application to chapped or abraded sur- 
faces generally. It is made in various ways, but commonly by melt- 
ing together 1 pound of almond-oil and 4 ounces of white wax, pouring 
them into a warm mortar, and adding, by degrees, 1 pint of rose-water. 
COLD FEET, Isolde feet. This may seem a trifling affair, but no 
one, a child especially, can be well, and constantly have cold feet. It is 
a very common beginning of consumption, and often ushers in sore COLD FEET-COLIC. 
429 
throat, croup, diphtheria, scarlet fever, and bronchitis (which see). 
Children should not be put off in this matter with a simple injunction to 
go to the fire and warm them, but immediate steps should be taken by 
proper clothing, warm bathing, and thorough friction to remove the 
difficulty. A state of health cannot long be maintained unless the feet 
are comfortably warm all the time. 
COLD IN THE HEAD (See Catarrh or Common Cold, Snuffles. ) 
COLD ON THE BREAST, OR IN THE CHEST. (See Bronchitis, 
Pneumonia.) 
COLDS. (See Catarrh or Common Cold ; Snuffles ; Catarrh, 
Chronic; Cough; Influenza; Bronchitis,Acute ; Bronchitis, Chronic; 
Pneumonia. ) 
COLD WATER. (See Water, Baths and Bathing, Hydropathy, 
Affusion. ) 
COLD WET-SHEET, OR THE WET-SHEET BATH. (See Baths 
and Bathing.) 
COLIC, kol'-ik [Gr. kolon, the colon], is a painful spasmodic con- 
traction of the muscular fibres of the bowels, particularly of the colon. 
Causes.-It is caused by the presence of an undue amount of wind, 
or of some irritating matter, such as accumulated feces, undigested food, 
acrid bile-when it is termed "bilious colic," overdoses'of strong pur- 
gatives, or poison; it may also be brought on by exposure to cold. 
Symptoms.-The pain of colic comes on and goes off suddenly, is of 
a rolling or twisting character, is referred chiefly to the umbilical or navel 
region, and is relieved by pressure; there may or may not be vomiting. 
In some cases of colic, the spasmodic contraction of the bow'el is so 
complete and permanent, that inverted action takes place, and the ftecal 
contents are vomited; to this form, the name of ileus, or iliac passion, 
has been given. The above symptoms distinguish colic from inflamma- 
tion, the pain of which is of a more persistent burning character, and is 
aggravated rather than relieved by pressure; in the latter case, too, 
febrile symptoms are present from the commencement. The distinction 
is, of course, requisite for active medical treatment, but many remedies, 
which may be used safely and effectually to relieve the one, will also be 
beneficial in the other, and, indeed, in other spasmodic or inflammatory 
attacks within the abdomen, which might be mistaken for colic. (See 
Enteritis, Peritonitis.) 
Treatment.-The sudden accession of an attack of colic, its peculiarly 
painful character, and the danger, that if continued, it may pass on to 
one of inflammation, renders immediate relief imperative. The first 
remedy is heat, either locally to the abdomen by bran bags or similar 
applications, as hot as they can be borne, or by the hot bath of the 430 
COLIC. 
temperature of 100°, if not undesirable on other accounts. The use of 
heat if promptly and effectually carried out, will often of itself relieve 
the attack at once, particularly if it is the result of cold, but even should 
it do so, it will be well to give a dose of castor-oil, or rhubarb and 
magnesia, to insure the freedom of the bowels from irritating matter ; a 
few drops of laudanum being added to either medicine should the spasm 
show a tendency to return. Should the pain not be relieved by the 
employment of external heat, as recommended, a warm injection, 
temperature 102°, sho'uld be administered, and a cup of tea or of some 
unstimulating fluid, taken as hot as it can be swallowed. If the pain still 
remains, 10 drops of laudanum must now be given, and repeated every 
quarter of an hour, until relief is obtained, or until 40 drops, or even 
more, have been administered. If the case is violent, an injection con- 
taining 20 drops of laudanum may be given. These means, if thoroughly 
carried out, will scarcely fail to afford relief until the arrival of medical 
assistance, which should always be procured, if the case is at all severe 
or continued ; it may depend on causes which a medical man alone can 
discover or remove. Alcoholic stimulants are scarcely to be recom- 
mended for use in non-medical hands, not because they are not service- 
able in colic, but because, should the case be mistaken, and prove one of 
inflammation, they would prove most injurious, which the remedies 
above prescribed could not. Still, in a case in which no doubt could 
exist, a tablespoonful of undiluted tincture of rhubarb, or a glass of hot 
brandy and water, with or without laudanum, are either of them good 
remedies. 
Painter's colic, or dry bellyache, is a disease to which persons are 
subject who work much among lead ; it is said also to be occasioned by 
new cider, etc. It is severe colic, accompanied with obstinate constipa- 
tion. The disease, either in itself or from concomitant constitutional 
affection, may prove fatal, and should always be treated by a medical 
man if possible. The treatment is much the same as that for common 
colic as far as allaying pain goes, but the obstinate constipation which 
accompanies it, requires the laudanum and other means to be combined 
with active purgatives, castor-oil, senna, compound colocynth pill, etc. 
Alum has been strongly recommended as a remedy in painter's colic. 
Much might be done by those engaged in employments connected with 
lead, to avoid, not only this, but other bad effects, by due attention to 
cleanliness, particularly of the hands at meal times. The use of lemonade, 
acidulated slightly with sulphuric acid in water, would probably be 
additional protection. Lead colic has been induced in whole families, 
by the use of water, which acted strongly upon leaden pipes or cisterns. 
It should be remembered that this affection may arise from the gradual COLIC-COLLIERS, DLSEASES OF. 
431 
introduction of lead into the system by means little suspected. A case 
has been narrated to the author, where one person was fatally affected, 
and another nearly so, by the long-continued and profuse use of snuff, 
which was imported, and kept for a considerable time in coverings made 
of thin sheet-lead. Many are unaware that a very pure water is more 
dangerous when conveyed through lead, than one which contains a toler- 
able amount of saline impregnation. Those who have once suffered from 
an attack of colic should pay particular attention to the bowels. A pill 
composed of 1 grain of extract of henbane, with 2 of compound colocynth 
and rhubarb pill, will be found a most valuable aperient. (See Alum, 
Lead, Sulphuric Acid, Gregory's Powder, Dioscore a Villosa.) 
COLIC ROOT. (See Dioscorea Villosa.) 
COLLAPSE, koi-laps' [Lat. collapsus, from collabor^ I shrink down,] 
is a wasting or shrinking of the body, or of a part of it, or a sudden and 
extreme depression of its strength and energies. 
COLLAR-BONE. (See Clavicle.) 
COLLEGE. (See School.) 
COLLIERS, DISEASES OF, kol'-yurz. Miners, as a class, are 
short-lived and unhealthy, breaking down prematurely from a variety of 
diseases, but principally from those engendered by the circumstances 
under which their work is carried on. Light and fresh air are both 
essential to health; and if many have sufficient difficulty in preserving 
vigor " with all appliances and means to boot," what must be the disad- 
vantage under which the collier labors when deprived of both essentials? 
Robert Stephenson thought that 100 cubic feet of air per man per 
minute would not be enough. This includes, of course, all the air 
wanted in the mine for horses, lights, etc. Miners suffer much from the 
inhalation of particles of carbon, coal, charcoal, or dust in the pursuit of 
their occupation. These being swallowed, produce dyspepsia, or still 
worse, and, as is more frequently the case, being inhaled, and becoming 
lodged in the lungs and air-passages, give rise to bronchitis and inflam- 
mation of the lungs, and to a peculiar disease now well known as 
"miners' lung," in which innumerable atoms of charcoal are incor- 
porated with the substance of the lung itself, the epithelium of which 
has actually grown over them. The collier also suffers much from the 
damp, and from the constrained position in which he is often obliged to 
work for whole days together. The grand remedy is efficient ventilation 
of the mines, which is at once a preventive of the sudden explosions and 
of the continued deterioration of health to which colliers are ever sub- 
jected. In addition, it is of great impartance that employers should 
endeavor by all means in their power to elevate the moral and social char- 
acter of those who, being debarred from the employments and enjoy- 432 
COLLIERS, DISEASES OF-COLLODION. 
ments of open day, are too apt in times of recreation still further to 
enfeeble their health by debauchery and excess of all kinds. 
COLLINSONIA CANADENSIS, kolAinso'-ne-a kan-Orden sis, a 
perennial plant belonging to the Nat. order Lamiacea. It is found grow- 
ing in rich, moist woods, from Canada to Florida, and is known in dif- 
ferent parts of the country as stone-root, horse-weed, hardback, and 
knot-grass. It is tonic, astringent, diaphoretic, and diuretic, and has 
been found beneficial in chronic catarrh of the bladder, whites, gravel, 
and dropsy. As a stimulant it has been employed in colic, headache, 
cramp, etc. The root is the part used in medicine. Dose: of the 
infusion, to 2 fluid ounces; fluid extract, 20 to 60 drops, every three or 
four hours. (See Infusion.) 
COLLIQUATIVE, koldik' -wartiv, a term applied to any profuse 
exhausting evacuation, more particularly the diarrhoea and perspirations 
of pulmonary consumption. 
COLLODION, kol-lo'-de-un [From Gr. kolla, glue], is made by dis- 
solving 2 scruples, or 40 grains of gun cotton, in 3 ounces of ether, and 1 
ounce of rectified spirit. It is a very useful application to cuts, small 
wounds, and abrasions, chapped hands, or chapped nipples, etc. It should 
be gently applied by means of a hair pencil. The ether evaporates, and a 
thin layer of cotton is left as a covering, which is not removed by washing 
in water. Collodion may also be applied to leech-bites, or small wounds 
of any kind, to stop the bleeding, which it does, owing to the contraction 
of the film of cotton constricting the vessel of the bleeding part. 
A mixture of 2 parts of glycerine, to 100 of collodion, makes an 
excellent protective application to chilblains, burns, bed-sores, etc. It 
has also been applied as a protective covering in many cases of disease 
of the skin, accompanied by great pain, itching, or irritability. It forms 
a good covering for pills, the unpleasant taste of which it conceals, with- 
out in any way interfering with their action. 
One of the best known ways of applying a liquid blister, is to paint 
the surface of the skin .over with collodion, in which cantharides or 
cantharidin, the active principles of the fly blister is dissolved. It may 
be applied with a brush directly, which saves the trouble of spreading a 
blister, and vesication is as quickly produced as with the ordinary 
plaster, while it is much less bulky, and more convenient in every way 
for general use. 
Collodion is a very good application to small cuts after they have 
been strapped or stitched up, when it is desirable to exclude the air, and 
to let them heal, if possible, by what is called "the first intention." It 
causes a little smarting for a few seconds, but this soon passes off, and a 
pellicle is left which forms an admirable protective covering for the Collinsonia Canadensis. (Stone-Root.) COLL ODLON- COL ON. 
433 
wound, and allows the healing process to go on below undisturbed. 
Collodion is best kept in a stoppered bottle, the stopper of which may 
be fitted with a camel's hair pencil, to allow of its ready application. 
(See Wounds, Bruises, etc.) 
COLLYRIUM, kol-lir'-e-um [Gr. kollurion\^ was formerly applied 
to any medicament employed to restrain defiuxions ; but it is now con- 
fined to topical remedies for disorders of the eyes-an eye-salve, or eye- 
wash. Collyria are of various kinds; stimulating, as weak solutions of 
sulphate of zinc or copper; astringent, as alum, or tannin; sedative, as 
warm or tepid lotions, containing opium, henbane, or belladonna; 
escharotic, as nitrate of silver in solution. (See Eye, Diseases of the.) 
COLOCYNTH, koi'-o-sinth [Gr. kolokunthis^ the bitter cucumber 
or bitter apple, a well known drastic hydragogue cathartic. It is the 
fruit of the Citrullus coloeynthus, a plant belonging to the Nat. order 
Cucurbit aceue^ and supposed to be the ' ' wild vine ' ' of the Old Testa- 
ment. The seeds possess the purgative property to a slight extent; but 
the pulp is by far the most active part of the fruit. In large doses, 
colocynth is an irritant poison. It owes its properties to a peculiar bitter 
principle, which has been named colocyntkin. The pulp is light, spongy, 
white or yellowish-white in color, without odor, but intensely bitter in 
taste. It is employed in passive dropsy, in cerebral derangements, and 
for the purposes of overcoming torpid conditions of the biliary and 
digestive system. Its irritant effect upon the rectum may influence the 
uterus by sympathy of contiguity, and thus provoke menstruation. It 
may be used in moderate doses in all diseases where cathartics are 
indicated. The addition of extract of hyoscyamus will deprive it of its 
harsh and griping effect. Dose, of powder, 2 to 8 grains. The com- 
pound extract is formed by macerating, for four days, 6 ounces of the 
pulp in 1 gallon of proof spirit, pressing out the tincture, and distilling 
off the spirit; then adding 12 ounces socotrine aloes, 4 ounces of resin 
of scammony, 3 ounces of hard soap, in powder, and evaporating until 
of a consistence for making pills, adding 1 ounce of cardamom seeds; 
dose, 3 to 10 grains. The compound pill is made by mixing 1 ounce of 
the pulp, in powder, 2 ounces each of Barbadoes aloes and scammony, 
in powder, J ounce of sulphate of potash, in powder, with 2 fluid drams 
of oil of cloves, adding a sufficient quantity of distilled water to form a 
mass of the proper consistence; dose, 5 to 10 grains. The C. and 
Ilyoscyamus pill is made of 2 ounces of compound pill of C., and 1 
ounce of extract of hyoscyamus; dose, 5 to 10 grains; dose of the fluid 
extract of colocynth, 5 to 15 drops. 
COLOMBO. (See Calumba.) 
COLON, ko'-lon [Gr. kolon, a member, or limb], in Anatomy, is the 434 
COLON-COLOR BLLNDNESS. 
largest of the intestines, or, rather, the largest division of the intestinal 
canal. This canal is divided into the small and great intestines, the 
former consisting of the duodenum, jejunum, and ileum; the latter of 
the caecum, colon, and rectum. The great intestine commences in the 
right iliac fossa, in a dilatation of considerable size, called the caecum. 
The colon ascends through the right lumbar and hypochondriac regions, 
to the under surface of the liver; passes transversely across the abdo- 
men, on the confines of the epigastric and umbilical regions, to the left 
hypochondriac region; descends through the left lumbar region to the 
left iliac fossa, where it becomes convoluted, and forms the sigmoid 
flexure, from which the rectum extends to the anus. It is thus divided 
into four parts-the ascending, transverse, descending, and the sigmoid 
flexure. The colon, in man, averages from 4 to 5 feet in length, and 
about 2 inches in diameter, being about a fourth part as long, and twice 
as wide, as the small intestine. The canal is not smooth and uniform, 
as in the small intestine, but bulges out between the bands of muscular 
fibre into various prominences, more or less regular in their form, in 
which the faeces lodge for a time, and become deprived of much of their 
moisture as they are rolled onwards by the peristaltic action to the 
rectum and anus. The colon is enveloped in the serous membrane called 
the peritoneum, which forms the external covering of all the abdominal 
viscera. (See Intestines, Alimentary Canal, Abdomen, etc.) 
COLOR. (See Complexion.) 
COLORADO, CLIMATE OF. (See Climate.) 
COLOR BLINDNESS, kul'-lur hlind'-nes [Lat. color, and Ang.-Sax. 
blindnes]. It was discovered by the late Dr. George Wilson, the dis- 
tinguished Professor of Technology, in the University of Edinburgh, 
that this is a much more common affection than is generally supposed. 
He proved conclusively from his experiments that a large number of 
persons were unable to distinguish the different colors, and also, that 
these same persons were quite unaware of the fact themselves. It fol- 
lows that railway companies should be exceedingly careful with regard 
to this particular in the selection of their employes, as it is easy to sup- 
pose how accidents might arise from the wrong interpretation of signals. 
A remarkable form of temporary color blindness is produced by the 
administration of santonine, for long, round worms. Patients taking 
this drug complain that they see everything colored green or red, and 
they are often afraid that the condition may continue, whereas it always 
ceases when the medicine is left off for a few days. It colors the urine 
of a deep citron yellow tinge, and this is at once changed to a brilliant 
scarlet on adding a few drops of solution of caustic potash to it, hence 
we may easily understand how the tissue of the eye may be acted upon COLOR BLINDNESS-COMA. 
435 
to cause the above-mentioned effects. Santonine has even been tried as 
a remedy in some cases of blindness, but without much success as yet. 
In some cases, color blindness is complete, and in others it only 
exists to a slight degree. The following table of Dr. Wilson's will show 
how frequent this defect is: 
1 in 55 confound red with green. 
1 in 60 " brown " 
1 in 46 " blue " 
Hence, one in every 17'9 persons is color blind. Most persons will 
be surprised to learn from the above table what a large proportion of 
people are unable to distinguish colors ; but it is not after all so astonish- 
ing when we reflect how many people have peculiarities as to their other 
senses of taste, smell, touch, and hearing. Dalton, the celebrated 
chemist, was color blind, and hence the affection is often called 
"Daltonism." (See Blindness.) 
COLORED CONFECTIONERY. (See Confectionery.) 
COLOSTRUM, ko-los'-tram [Lat.] A name given to the first milk 
secreted in the breasts after childbirth. It has been a general belief, 
that this early milk is purgative, and destined to carry off the meconium; 
an opinion which rests on no sufficient evidence, and is probably errone- 
ous. 
COLTSFOOT. (See Tussilago Farfara.) 
COLUMBA. (See Calumba.) 
COMA, ~kd-ma [Gr. koma^ from keo, I lie down], is used to denote a 
diseased condition of the brain, manifesting itself in a state of insensi- 
bility resembling sleep, from which the patient cannot be aroused, or 
only in a very partial degree. Coma may result from congestion or 
hemorrhage in the brain, or from any abnormal pressure on that organ; 
from the agency of narcotic poisons or alcohol; from exhaustion arising 
from the loss of blood, or from the actioji on the blood of various morbid 
products generated within the system. Slight coma differs but little 
from profound sleep; but in complete coma the patient is entirely shut 
off from the external world, and is quite dead to all external impressions. 
Medical writers distinguish several varieties of coma, the chief of which 
are the coma vigil and the coma somnolentum. The former is charac- 
terized by a constant disposition to sleep, without falling into a quiet, 
sound, or natural slumber, accompanied by delirium, muttering, and 
agitation; the latter is marked by profound sleep, without the power of 
awakening spontaneously, and, if roused, almost immediately sinking 
into the same state. Any of the forms of coma may come on suddenly, 
and terminate speedily in death; or it may come on gradually, and be 
of short duration; sense and voluntary motion as slowly returning. 436 
COMA- COMPLEXION. 
When its accession is slow, it often commences with drowsiness or head- 
ache. The causes and characteristics being so various, its treatment 
must also necessarily vary: generally, the object is by means of stimu- 
lants and counter-irritants to arouse the patient to consciousness. (See 
Apoplexy. ) 
COMFREY. (See Symphytum Officinale). 
COMMON COLD. (See Catarrh or Common Cold.) 
COMMON COLD OF INFANTS. (See Snuffles.) 
COMMON ELDER. (See Sambucus Canadensis.) 
COMPLEXION, kom-plek'-shun [Lat. complexion the hue of the 
face. Much information may frequently be obtained of the existing con- 
stitutional condition, by observation of the complexion ; but in judging, 
it is requisite to consider the original temperament, and the family 
descent of the individual. In fair races, such as the Anglo-Saxon, a 
certain amount of color is usually associated with our ideas of health, 
and in some respects truly so; the reverse, a perfectly pallid face, can 
scarcely be consistent with a sound bodily condition. But color may be too 
high at all times, and the capillary vessels of the face, partaking of the 
fulness of those of the body generally, may indicate that from some 
cause, such as overfeeding, or indolence, combined with good digestive 
powers, the system of the individual is too full of blood; for the color 
is not confined to the parts naturally tinged, but it is diffused over the 
face generally, and even the white of the eye is covered with distended 
vessels. Such a state is one of danger, it is often accompanied with 
headaches, giddiness, confusion of thought, sleepiness, and when these 
occur, apoplexy may be dreaded. A high or brilliant color, also, may 
accompany the consumptive constitution, but in this it is very generally 
associated with a fine skin, and often with light or red hair, with freckles, 
and also with a pearly or bluish appearance of the white of the eye. 
This appearance of high health is apt to deceive the inexperienced; but 
the color is generally not equal or persistent, it varies much, being easily 
heightened by excitement, or depressed by the reverse, and it continues 
to add beauty even to the last stages of the hectic consumption. In the 
dark-hair, and dark-complexion, color is less commonly developed. 
The complexion of disorder or disease is very varied, it may be muddy, 
pallid, pasty, white, sallow, cachectic, yellowish green, and purple. 
The muddy complexion may be the natural one of the skin, but it 
frequently accompanies dyspeptic ailments, and is directly dependent on 
depressed nervous power, and languid circulation of blood; it is most 
strongly marked in the dark depressions underneath the eyes. What- 
ever lowers or exhausts the nervous power, will produce this complexion, 
which may be seen in perfection, when the light of morning shines in, COMPLEXION-COMPTONIA ASPLENIFOLIA 
437 
either upon the votaries of a too protracted dance, or upon the weary 
watcher beside the bed of sickness. Sleep is the best restorer of the 
exhaustion of nervous power, indicated by this condition of complexion ; 
but if rest is impossible, it is one of those cases in which stimulant, 
hot tea or coffee first, and then alcoholic stimulant, is requisite. The 
pallid complexion is often the result of too close confinement to the 
house, and especially of deficient exposure to diffused daylight-it is 
well marked in miners. The pasty complexion accompanies the lym- 
phatic constitution, and general laxity of the solids; the subjects of it 
require a good allowance of animal food, in preference to milk and grain 
preparations, puddings, etc., of which they are often too fond. They 
almost invariably derive benefit from preparations of iron. A marked 
white complexion not natural to the individual, is often indicative of 
serious disease, probably of the kidneys or heart, and when it appears 
in persons advanced in life, the cause ought most certainly to be investi- 
gated by a medical man. The sallow complexion is very generally a 
natural one. The cachectic accompanies a diseased state of the system, 
and often of the abdominal organs-it is muddy, and accompanies 
emaciation of the features. The yellow complexion may be the bright 
hue of jaundice, or the muddy yellow associated with malignant disease, 
especially cancer. In the greenish yellow skin of chlorosis or green 
sickness, there is also extreme pallor of parts usually colored-such as 
the lips. A purple complexion is indicative of deficient oxygenation of 
the blood, either from disease of the heart or lungs; generally of the 
former. The bronzed complexion is one which of late years has attracted 
attention among medical men, as indicative of a peculiar disease, called 
Addison's disease. (See Addison's Disease, Skin, Countenance, Cos- 
metic, Temperament.) 
COMPLICATION, leomple-lea'-shun [Lat. complicatio\. In medi- 
cal language, any disease or anomalous symptoms which are co-existent 
with, and modify another disease, without being inseparable from it, is 
called a complication. 
COMPRESS, leone pres [Lat. comprimo^ I press together], is formed 
of soft linen, lint, or other substance folded together into a sort of pad, 
and applied to a part where pressure is required. The "wet compress" 
consists of two or three folds of thin flannel or calico wrung out in cold, 
tepid, or warm water, and laid upon the part and covered with gutta- 
percha or oil silk. 
COMPRESSION OF THE BRAIN. (See Apoplexy.) 
COMPTONIA ASPLENIFOLIA, leomp-to'-ne-q as-ple-ne-fo'or 
sweet fern. A shrubby perennial plant belonging to the Nat. order 
Myricaceai. It grows in thin, sandy soils, or dry, rocky woods, in 438 
COMPTON 1 A ASPLENIFOLIA-CONCUSSION. 
the Northern and Middle States. It has a spicy, aromatic odor, and 
an astringent, bitter taste. Sweet fern is also known by the common 
names of sweet bush, fern gale and sweet ferry. It is tonic, astringent 
and alterative, and has been used with success in diarrhoea, dysentery, 
bleeding of the lungs, the whites, debility succeeding fevers, and in 
the summer complaint of children. Dose of the infusion, 1 to 4 fluid 
ounces (see Infusion); of the fluid extract, 20 to 60 drops; and of the 
syrup, made by adding 2 ounces of the fluid extract to 14 ounces of 
sugar, 2 to 4 teaspoonfuls, to be taken three times a day. 
CONCRETION, kon-kre-shun [Lat. concresco, to grow together], is 
a term applied to the unusual aggregation of any substance or substances 
within the body, most generally to intestinal concretions. Persons who 
have been in the habit of taking large and repeated doses of magnesia, 
have not unfrequently suffered from its concretion into hard lumps or 
balls in the stomach or intestines. Any substance which possesses the 
power of felting or matting together, is liable to form a concretion in 
the bowels; one has been found of the ends of thread matted together, 
which the female had been in the habit of biting off and swallowing 
when at work; but perhaps the most common cause of the intestinal 
concretion is the felting of the bran of the oatmeal, as used in Scotland, 
when too exclusively employed as food, and in too dry a state. Well 
boiling and diluting, and mingling with other articles of food, particu- 
larly of an oily nature, is the best preventive. (See Oatmeal, Mag- 
nesia, etc.) 
CONCUSSION, kon-kusK-un [Lat. concutio, to shake together], is 
applied to a violent commotion or shock communicated to the brain, or 
the whole nervous system, by collision of the body with some external 
object. 
Symptoms.-In its slightest form a stunning sensation is merely 
communicated, which passes away in a few minutes; in its severest 
form, death rapidly ensues. In the severer cases the patient becomes 
immediately pale and insensible; the breathing sometimes natural, but 
frequently slow and feeble; the pupil rather contracted; the pulse usu- 
ally slow and weak, but sometimes natural; the extremities become cold, 
the secretions are suspended, and there is frequently nausea and vomit- 
ing. 
Treatment.-In the treatment of concussion great caution is neces- 
sary. The patient at first should be kept warm in bed, with bottles of 
hot water, hot bricks, etc., till consciousness is restored, when wine or 
other stimulants may be cautiously administered. If he seem to be 
sinking, stimulants should at once be had recourse to ; but so long as he 
remains stationary, no active means should be employed. Afterwards CONCUSSION-CONCUSSION OF THE BRAIN. 
439 
bodily rest, and quiet, cessation from all mental occupation, a mild 
unstimulating diet with gentle bitter aperients, are the means to be 
adopted in restoring the patient. When there is also extravasation of 
blood upon the brain the symptoms will take the form of apoplexy. 
(See Apoplexy.) The symptoms in the two cases, however, are so 
similar, that it is frequently a very difficult matter to distinguish them. 
Severe concussion of the chest affecting the heart, or over the region of 
the stomach, may prove fatal immediately, or at least produce much 
alarming faintness and collapse; in the latter case, the use of stimu- 
lants, such as ammonia or spirit internally, or stimulant injections, and 
the dashing of a pitcher of cold water over the chest and face, imme- 
diately following it by hot applications, mustard, etc., would be the most 
appropriate treatment. (See Concussion of the Brain, Accidents, 
Shock. ) 
CONCUSSION OF THE BRAIN, one of the most frequent in- 
juries to which the brain is exposed, is concussion. 
Symptoms.-Either in consequence of a fall or a blow, a person be- 
comes stunned; the effect may be but momentary, there is transient 
unconsciousness, and the individual " comes to himself, " without further 
symptom ; but if the concussion be severe, the state of unconsciousness 
continues, the power of motion is almost or entirely lost, the breathing 
is slow and quiet, the pupils frequently contracted, but sometimes dilated, 
and very generally there is vomiting; the pulse is small and weak. 
This condition may continue for a longer or shorter period, according to 
the violence of the shock, and may terminate in death; but if it be simple 
concussion, there is generally a restoration of the usual condition of 
health, permanent or otherwise. 
Treatment.-In some cases of simple concussion of the brain, but 
little active interference is required; the patient should, if possible, be 
put in bed, and the warmth of the surface, particularly of the feet, 
attended to ; if there is extreme depression, a little sal-volatile orbrandy 
and water may be given, but sparingly, on account of the subsequent 
reaction. The chief danger to be apprehended after concussion of the 
brain, is inflammation affecting either the organ itself or its covering 
membranes, and on this account the sufferer from the accident ought to 
be extra careful for at least ten days or a fortnight after the receipt of 
the injury. All alcoholic stimulant is to be avoided, and rest both of 
body and mind submitted to; the bowels being kept relaxed by the use 
of gentle aperients. If the immediate reaction is great, that is, if a few 
hours after the accident, there is much pain in the head, shivering, fol- 
lowed by heat, quickened pulse, vomiting, the case demands the most 
serious attention, and should be seen by a medical man as soon as 440 
CONCUSSION OF THE BRAIN-CONTINENTS. 
possible. In such a case as this occurring-and they frequently do 
occur-at a distance from medical aid, an unprofessional person who 
could bleed would be quite justified in abstracting from a man of full 
habit, from 12 to 20 ounces of blood, and in applying 12 or 18 leeches 
about the head, either with or without the general blood-letting; or 8 or 
10 ounces of blood might be taken from the nape of the neck by cup- 
ping. The hair must be cut or shaved off, and the head kept cool with 
cold or iced applications; the most perfect quiet in a dark situation, 
observed, and active purging with calomel and colocynth, jalap and 
calomel, or the most active aperient at hand. The diet is to be reduced 
to the very lowest ebb. Such cases are generally so urgent, and their 
cause and nature so palpable, that they not only require the most active 
treatment, but also render that treatment justifiable in the hands of the 
unprofessional, in the absence of, or during a lengthened interval of the 
non-arrival of medical assistance. Symptoms, similar to those detailed 
above, though not directly referable to reaction, may, coming on some 
days after a concussion of the brain, indicate the commencement of 
inflammatory action. In such a case, bleeding must be more cautiously 
resorted to, but the other measures should be carried out. It ought to 
be known, that direct violence to the head is not always requisite to pro- 
duce concussion ; a heavy fall on the feet may equally cause it, by the 
shock conveyed through' the spine to the brain. But violence may go 
beyond the production of mere concussion-there may be rupture of the 
substance of the brain, or . of a single vessel, causing effusion of blood. 
In such a case, the individual may never rally from the first condition of 
unconsciousness, or he may rally only partially, to sink again as reaction 
conies on into a state of apoplectic stupor, or become the subject of those 
symptoms of inflammation of the brain already described ; in which 
case, of course, the same treatment is to be pursued. If the case runs on 
to a fatal termination, there is generally apoplectic stupor, paralysis, con- 
vulsions, one or all of them. (See Concussion, Shock, Accidents, Brain. ) 
CONCUSSION OF THE SPINAL CORD. (See Spine, Diseases 
and Injuries of the. ) 
CONDIMENTS, kon-de-ments [Lat. condimentum; condio^ to make 
savory]. Condiments are substances which are not of themselves nour- 
ishing, but which are taken along with food as seasoning, and to pro- 
mote its digestion. Salt is the most extensively used, and also the most 
wholesome condiment; to civilized man its use is second nature, and 
very many of the lower animals are not only fond of it, but seek it 
instinctively as a necessity, and improve in health and appearance when 
they have access to it. The vegetable acids, vinegar, etc., are useful 
and wholesome in moderation, particularly with oily food. The aro- CONDIMENTS- CONFECTIONER Y. 
441 
matics and spices, such as cayenne, white or black pepper, ginger, etc., 
can scarcely be called injurious, if used in moderation, to healthy 
individuals; in debility of the stomach they are often of service, and 
they seem especially adapted to counteract the effects of a warm climate 
upon the digestive organs, and also to the constitution, acquired or 
otherwise, of the inhabitants. They are, however, generally used along 
with vegetable productions. (See Salt, Vinegar, Mustard, Piper 
Nigrum, Aromatics, etc.) 
CONDY'S DISINFECTING FLUID. (See Permanganic Acid.) 
CONFECTION, kon-fek'-shun [Lat. conflow, to make up]. A term 
applied to medicinal preparations generally made with sugar. The most 
useful are almond confection, aromatic confection, cassia, rose and senna 
■confections. Of these, the aromatic confection is the most us 
generally used preparation. It is thus made : 
Take of Cinnamon Two ounces. 
Nutmeg Two ounces. 
Saffron Two ounces. 
Cloves One ounce. 
Cardamoms Half an ounce. 
Prepared chalk Sixteen ounces.-Mix. 
Reduce these materials when dry, to a fine powder, and keep in a close 
vessel. Sugar to the extent of six ounces, may or may not be added to 
the preparation. 
CONFECTIONERY, kon-fek'-shun-er-e, literally, "things made up," 
or candies, sweetmeats, sweet-cakes, etc. They are not necessarily 
unwholesome, if used in moderation, but should, as a rule, be avoided 
by those of weak digestive powers. Cakes and sweetmeats are too 
often deleterious, if made with much butter, when made of bad materials, 
■or mingled with poisonous ingredients. Baked confectionery, in which 
the butter or grease is rendered empyreumatic and acrid by the heat 
employed in its preparation, is always liable to disagree, and especially 
so when, as often happens, bad materials are made up and disguised 
with flavors of various kinds, which are often in themselves unwhole- 
some, particularly those so largely used, such as the oil of bitter 
almond, peach kernel, and laurel flavoring, which are actual poisons, 
when taken even in not very large quantity. Another flavoring ingredi- 
ent, recently introduced, but already largely used, called " jargonelle 
pear," is not devoid of danger, and has been known to produce dangerous 
head symptoms in a child. It is made from the fusel oil obtained in 
distillation from grain, potatoes, etc. But perhaps the most numerous 
cases of injury have arisen from colored confectionery and sweetmeats, 
a large proportion of which are tinged with deleterious substances ; the 
greens with arsenite of copper or Scheele's green, verdigris, or a 442 
CONFECTIONER Y- CONIUIf. 
mixture of chrome and Prussian blue ; the yellows by chromate of lead; 
the reds by vermillion, a compound of mercury, or by oxide of iron ; and 
the whites by carbonate of lead, oxide or carbonate of zinc, chalk, or 
sulphate of baryta. The frosting of cakes, and the white sugar comfits, 
often contain a large per-centage of plaster of Paris. These facts ought 
to be sufficient to make people very cautious in the use of such articles, 
particularly with children ; and in case of sudden unaccountable illnesses, 
they should not forget the possibility of such causes. The color of a 
sweetmeat would afford some clue to the nature of the poison, and 
reference to the article Poisons and their Antidotes, will show the 
measures proper to be adopted, in the interval of procuring medical 
assistance. (See Pastry, etc.) 
CONFECTIONERY, COLORED. (See Confectionery.) 
CONGESTION, con-jest'-yun [Lat. congestion from congero, I amass], 
is a term employed to denote an unnatural accumulation of blood in 
the capillary vessels of any part, accompanied with disordered functions 
of the organ in which such accumulation takes place. The organs most 
liable to congestion are the brain, lungs, and liver; but other parts are 
also subject to it. It is usual to distinguish two kinds of congestion-a 
passive and an active. In passive or simple congestion there is merely 
an accumulation of blood arising from distention and diminished vital 
energy in the capillaries ; in active congestion, on the other hand, the 
blood-vessels are in a state of inordinate activity, and a preternatural 
quantity of blood is determined to them. Anything may be the cause 
of congestion which diminishes the vital energy of the capillaries or 
which increases the quantity of blood which they contain. (See Inflam- 
mation. ) 
CONGESTION OF THE BRAIN. (See Congestion.) 
CONGESTION OF THE LIVER. (See Congestion.) 
CONGESTION OF THE LUNGS. (See Congestion.) 
CONGRESS WATER. (See Mineral Waters.) 
CONIUM, ko'-ne-um, a genus of plants belonging to the Nat. order 
Umbelliferce. The most important species is C. maculatum, spotted 
hemlock, or poison hemlock, a European plant, which is extensively 
employed in medicine to relieve pain, relax spasm, and compose 
general nervous irritation. It is also used as an alterative and de- 
obstruent in glandular and other swellings. It owes its properties 
chiefly to the presence of a colorless oily liquid, with a penetrating 
mouse-like odor, to which the name of Conia has been given. In 
improper doses, hemlock is a powerful poison, and many fatal accidents 
have arisen from its having been mistaken for harmless umbelliferous 
plants. It is used to promote sleep, and will be found efficacious in C0N1UM-CONSTITUTION, BREAKING OF. 
443 
allaying excessive action of the heart. All affections attended with an 
excited or excitable condition of the nervous or vascular systems, will be 
benefited by its use. It is highly recommended in chronic rheumatism, 
secondary syphilis, in scrofulous tumors, and ulcers. Fothergill strongly 
recommends this drug in the treatment of neuralgia and rheumatism. 
It has been used with decided advantage in gonorrhoea, in various 
diseases of the skin, in the complicated derangements of health attend- 
ant upon secondary syphilis, in excessive secretion of milk, whooping- 
cough, menorrhagia, asthma, chronic catarrh, and consumption, and in 
various other disorders connected with a general depraved state of the 
health. Conium, unquestionably, proves useful in the treatment of 
cancer, mitigating pain, checking the progress of the disease, and some- 
times effecting a radical and permanent cure. The less malignant may, 
with safety, be said to be under its control. Dr. Waring says the 
internal and external application of this medicine is attended with excel- 
lent effects in syphilitic ulcerations. Hemlock poultice is formed by 
mixing 1 ounce of the leaf in powder, and 3 ounces of linseed-meal, and 
gradually adding them to 10 fluid ounces of boiling water constantly 
stirred. The tincture is formed from the dried ripe fruit, bruised and 
macerated, 2^ ounces in 1 pint of proof spirit for 48 hours in a closed 
vessel, then percolated and filtered. Dose: 20 to 60 drops ; fluid extract, 
5 to 20 drops. Vinegar is recommended as an antidote. The stomach 
to be properly evacuated before administering it. (See Poisons and 
their Antidotes.) 
CONJUNCTIVA, kon-junti -te-va [Lat. congungo, to unite], is the 
membrane which lines the eyelids, and is folded from them upon the 
fore part of the eyeball, which it covers, extending over both the white 
and the clear portion, or cornea. In its ordinary healthy condition, 
the conjunctiva is a transparent membrane, with perhaps one or two 
tortuous vessels seen upon it. (See Eye.) 
CONSTIPATION. (See Costiveness.) 
CONSTITUTION, kon-ste-tu-shun [Lat. constituo, to dispose]. The 
general condition of the body, as evinced by the peculiarities in the 
performance of its various functions; such are the peculiar predisposition 
to certain diseases, or liability of certain organs to disease ; the varieties 
in digestion, in muscular power and motion, in sleep, in the appetite, 
etc. Some marked peculiarities of constitution are observed to be 
accompanied with certain external characters, such as a particular color 
and texture of the skin and of the hair, and also with a peculiarity of 
form and disposition of mind ; all of which have been observed from the 
earliest time, and divided into classes. (See Temperament, Complexion.) 
CONSTITUTION, BREAKING OF. (See Climacteric Disease.) 444 
CONSTEICTOE MUSCLES-CONSUMPTION, ETC. 
CONSTRICTOR MUSCLES, kon-strik'-tur mus'-slz, those muscles 
which contract any opening of the body. 
CONSULTATION, kon-sul-ta'-shun [Lat. consultation a meeting of 
physicians in any case of disease. 
CONSUMPTION, PHTHISIS PULMONALIS, OR PULMON- 
ARY CONSUMPTION, kon-sum-shun, ti'-sis [Lat. consumo, to waste 
away], as its name implies, is a disease of the lungs, or at least one 
in which the lungs are more prominently affected than any other 
organ. Its fatality and frequency render it but too familiar, as year by 
year it numbers for its victims the young, the good, and the fairest in 
the land. 
Consumption is a portion only of a constitutional malady, which very 
frequently develops its intensity in the organs of respiration, but may 
do so in other modes, and in other organs of the body. Its constitu- 
tional nature requires to be impressed upon the mind of the people in 
general; for regarded only as a disease of the lungs, alarm is not taken, 
nor are remedies generally resorted to, until its effects upon these organs 
become manifest, the antecedent period, in which the constitution is 
giving way, is overlooked, and that time is lost in which the first indica- 
tions of disease might have been successfully attended to. 
Causes.-The causes of pulmonary consumption are all those which 
occasion debility generally, not excepting the most frequent of all, her- 
editary predisposition, that tendency to the disease which exists so 
strongly in some families, that no care or precaution can ward it off, nor 
prevent it seizing in succession member after member of a household. 
Fortunately, this intensity of hereditary transmission is not so very fre- 
quent, but there are few families in this country in which the tendency 
does not more or less exist; there are few which cannot number amid 
their deceased relatives some victim of consumption. With a suscepti- 
bility so widely diffused, it becomes a serious consideration with all by 
what this tendency is encouraged, and how it may be diminished. The 
first consideration that presents is marriage. There can be no question, 
that from errors in the contraction of this great engagement of life, 
much of the hereditary tendency to consumption is developed, and 
especially when the union is between parties nearly related by blood; 
doubly so if the predisposition already exists in the family. Delicacy of 
either parent, particularly of the father, is very apt to entail consump- 
tive tendencies upon the children; and the same follows if the parents 
are either too young, or if the father be advanced in life. The mistake 
is a very common one, that marriage and child-bearing act as a check 
upon the progress of consumption, and the step is often advised, even 
to the comparatively young, with this view. The error is a serious one ; CONSUMPTION, ETC. 
445 
nothing can be more trying even to a healthy female, in this country, 
than having a family before the constitution is formed; and most cer- 
tainly it is so to the weak. It is true, apparent temporary amendment 
of consumptive symptoms sometimes occurs, but the powers of life are 
sapped by the too early call on their exertions. 
In the management of the children of even the most healthy parents, 
doubly so of those who are the reverse, much may be done either to 
weaken or to fortify the constitution, to pull down the one to the level of 
the scrofulous diathesis, which ripens into consumption, or to infuse 
into the other such strength and vigor that it may resist during a long 
life any development of the disease. For information respecting the 
management of children, the reader is referred to the article itself. (See 
Children. ) 
As the period of puberty approaches, care is required with all, but 
doubly so in the case of those who have displayed any scrofulous or 
consumptive tendency. The development of the body which is going 
on, requires a full supply of the most nutritious food, animal food par- 
ticularly. The secretions should, if possible, be kept in healthy activity, 
and, more especially, all sources of exhaustion most strictly avoided ; 
youths especially must be warned against the evil of prolonged physical 
exertion; and not less so against the mental efforts, which those, 
especially, who partake of the nervous and excitable constitution of the 
hereditary consumptive, are apt to give way to in competitions at school 
or college. 
At any period of life, mental anxiety or over-exertion, intemperance, 
or dissipation, the habitual breathing of vitiated air, low, damp situation, 
insufficient clothing, and exposure to the weather, or peculiarity of 
employment, particularly that which necessitates the inhalation of irri- 
tating matters, or any continued drain upon the powers of the constitution, 
such as suckling, may any of them develop or induce consumption. 
We can here only take a hasty glance at those circumstances of life 
which seem to endanger a predisposition to consumption. Foremost 
among these must be ranked poverty; for, though this disease attacks all 
ranks and conditions of men, the cause now stated is admitted by all to 
play an important part. (See Poverty.) Poverty, however, seldom, if 
ever, occurs alone ; exposure, anxiety, bad nourishment, and the inhala- 
tion of an impure or confined atmosphere, accompany it; and, while the 
single influence of each cannot be correctly calculated, the potency of their 
combined operation it is impossible to overestimate. Lombard informs 
us that in Geneva the proportion of deaths from consumption among 
those living upon their incomes is only fifty in one thousand, while the 
average deaths from the disease in all classes is one hundred and fourteen 446 
COBBCUPTIOE, ETC. 
in one thousand. Sedentary habits, too, exercise a pernicious influence, 
more especially the sitting constantly with the body leaning forward; 
both respiration and digestion are thus interfered with. Violent exercise, 
if followed by marked depression, acts deleteriously; while moderate 
exertion has quite the opposite tendency. The inhalation of various 
substances, gases and vapors, exerts a very injurious action on the sys- 
tem generally, while some act more decidedly on the lungs themselves. 
Climate and season, no doubt, play a part in the development of con- 
sumption ; but upon this subject professional opinion has undergone a 
considerable change since our knowledge became more extended and 
precise. The disease occurs in all latitudes, in temperate as well as in 
tropical climates. Some situations there are, unquestionably, freer from 
it than others, but none appear to be wholly exempt. Every one knows 
the fearful ravages consumption makes in this country; in Britain it 
seems to be equally formidable; Italy, and the most southern parts of it 
particularly, is no freer from the disease. As we shall have occasion to 
observe when mentioning the proper treatment of consumption, there is 
no doubt that a dry atmosphere and an equable climate are two most 
favorable circumstances, and in a preventive as well as a curative 
capacity both act. (See Climate, Health Resorts.) 
Bad and imperfect nourishment exercises a most injurious influence 
in this disease. In proof of this, nothing can be more striking than the 
amelioration, even in very advanced cases of consumption, which results 
when patients who have thus suffered are received into hospitals and 
supplied with wholesome food in sufficient quantity. Intemperate habits 
exert an injurious influence; not so much perhaps, it may be allowed, 
the actual abuse of intoxicating drinks, as the exposure, and deprivation 
of suitable nourishment, which, to a certain extent, always accompany 
that lamentable vice. 
Irritant substances applied directly to the lungs themselves may set 
up an unhealthy action, and tend to arouse the disease in persons by 
nature predisposed to it, but are not in any way capable of causing the 
deposition of tubercle. Such occupations as those of stone-masons, 
miners, and knife and razor-grinders, ought to be avoided, or wholly 
given up by persons of this diathesis. 
Is Consumption contagious? Nearly every author agrees that con- 
sumption does not spread by contagion; but, of course, the room in 
which a patient is lying in its later stages is rendered very unhealthy 
for any other person to inhabit. No one should be allowed to sleep in 
the same bed, or occupy the same chamber in which such a patient is 
lying. There are a few points of great interest as well as of importance 
in connection with the deposition of tubercles in the lungs, to which a CONSUMPTION, ETC. 
447 
brief reference may here be made. In the great majority of instances, 
tubercles are first deposited in the upper parts or apices of the 
lungs; in these situations the softening change first occurs, and 
there also cavities or vomicae are first formed. In consumption, 
though both lungs usually suffer, the left lung is the one most frequently 
and seriously affected. This has been established by the careful inquiry 
of M. Louis of Paris. This distinguished physician met with seven 
cases in which one lung alone was affected: in five, the left; in two, the 
right. In thirty-eight cases in which the disease existed in a very 
advanced degree in the upper parts of the lungs, twenty-eight were on 
the left, only ten on the right side. Not unfrequently, in the course of 
consumption, the windpipe and vocal cords become affected, tubercles 
are deposited there, and ulcers form, giving rise to many most distress- 
ing symptoms. Other parts and organs of the body are, moreover, apt to 
become involved; they rarely altogether escape; the liver too becomes 
variously affected; so do the kidneys, and not unfrequently the brain. 
Duration of the Disease.-The duration of consumption varies very 
considerably, so much so as to have led to the adoption of the terms 
acute and chronic in relation to it. There is the case of extremely rapid 
progress, in which a person, almost invariably young, apparently in the 
enjoyment of health, though undoubtedly manifesting in greater or less 
degree those features which mark the scrofulous constitution, is suddenly 
affected with cough and febrile excitement; in whom, very shortly, some 
of the other symptoms become developed, and death, within a period 
of a few weeks, occurs. Such is appropriately enough named galloping 
consumption. On the other hand, and in marked contrast, there is the 
case of very slow progress-and those who thus linger are often of a more 
advanced age-in which cough and expectoration, with perhaps certain 
other symptoms, have lasted for months, it may even be years. The 
medium between these two extreme cases includes by far the larger 
number of the sufferers from consumption. And in order to give a just 
notion of the average duration of the disease, the following table, con- 
taining the results of Bayle and Louis's observations, may be consulted. 
Of 314 cases: 
24 died within 3 months. 
69 " between 3 and 6 months. 
69 " " 6 " 9 " 
32 " " 9 " 12 
43 " " 1 year and 18 months. 
30 " " 18 months and 2 years. 
12 " " 2 and 3 years. 
11 died between 3 and 4 years. 
5 " " 4 " 5 « 
1 " " 5 " 6 " 
3 " " 6 " 7 " 
X " " 7 " 8 " 
3 " "8 " 10 " 
11 " " 10 " 40 " 
Thus, more than one-half died within nine months from the time when 
the disease declared itself. 448 
CONSUMPTION, ETC. 
Symptoms.-Two very opposite conditions of physical development 
are found to exist along with the consumptive tendency; in the one, 
there is the fair fine skin and bright red complexion, the fair hair, the 
light eye, with its pearly-looking white, and the tapering fingers ; in the- 
other, the dark hair and skin, the latter almost dirty-looking, and the 
swollen-looking upper lip. Pulmonary consumption creeps upon a 
patient very insidiously; he begins to feel weak and languid, his appetite 
fails him, and his digestive organs are out of order; he has slight 
cough, which is only occasional, occurring principally in the morning- 
when he gets out of bed; it is usually dry at first, but soon becomes 
attended with expectoration of mucus. As the disease advances these 
symptoms increase, and the expectoration becomes altered in character, 
being frequently streaked with or composed of pure frothy blood, due te 
the giving way of small vessels at various stages of the disease. It 
becomes more purulent, and formed into gray, globular, flocculent 
masses, having the appearance of wool, and when spat into an empty 
vessel, it assumes the circular and flattened form of pieces of money, 
and hence called by the French nummular sputa. This kind of expectora- 
tion, and that consisting of pure, frothy, bright red, arterial blood, are 
most characteristic of this frightful malady, providing there be no disease 
of the heart obstructing the flow of blood through the lungs, the uterine 
function be healthy, and there be no blow upon the chest causing hemor- 
rhage by mechanical injury to the lung itself. A great deal of faith is 
placed by patients upon the degree of buoyancy of the expectorated 
matters when placed in water; thus they suppose if the matter floats 
that the disease from which they are suffering is of a harmless character; 
but if it sinks, that their case admits of little or no hope. The truth is 
this, that the matter if raised with difficulty, is mixed with a large pro- 
portion of air, and will be more buoyant than that which is easily 
expectorated and unmixed with air. Many years ago, it was thought 
that the expectoration of this disease could be distinguished by its con- 
sisting of puriform matter; but since then it has been most clearly 
proved that the mucous lining of the air passages may secrete pus itself 
under the influence of the inflammatory process. Besides cough and 
expectoration, we soon get difficult and hurried breathing; the pulse 
becomes permanently quickened, and the temperature of the body, as 
measured by the thermometer, has been proved by Dr. Ringer to be 
elevated in proportion. The patient begins to waste and suffer from 
hectic fever and night sweats, the tongue becomes morbidly red, and the 
bowels much purged. In a large proportion of cases, ulceration goes on 
in the organs of speech, as may be readily detected by means of the 
laryngoscope, an instrument consisting of two plane mirrors, one of Under250 in 10.000 
from- 250to 550 
, 550.900 „ 
„ 900,1^00 „ 
„ mo.moo , 
over2000 „ 
DEATHS from CONSUMPTION. 
Compiled from U.S.Census. 
Drawn by A.deWitzleben. CONSUMPTION, ETC. 
449 
which is fastened on to the forehead to reflect the light into the patient's 
mouth, and the other attached to a handle is placed against the back 
part of the throat, and draws an inverted representation of the upper 
part of the organs of respiration and the vocal cords, by the vibration of 
which we are enabled to speak and make ourselves understood. At 
various periods of this disease a stitch or pain in the affected side is 
caused by inflammation lighted up in the serous membrane covering the 
diseased part of the lung. The disease having reached its last stage, 
the patient has become much emaciated ; his bones seem in danger of 
pricking through his skin, swelling of the legs and puffiness of the hands 
and face often set in, the teeth are dry and black, the lips and tongue 
parched, and the patient gradually sinks under the weakening power of 
this dreadful disease. During the later stages the monthly periods 
cease to recur in women, the hair falls off, and the eye becomes less 
sensitive. In many patients of consumptive habit the ends of the fingers 
are more rounded and clubbed, and the nails small, flattened, triangular, 
and bent inwards. The late Dr. Theophilus Thompson, of England, 
describes a festooned line of redness as occurring on the edges of the 
gums of such patients. 
Prognosis.-As regards the prospect of recovery from consumption 
-for recovery does undoubtedly take place-much depends upon the 
original and existing constitution and the habits, past or present, of the 
individual, and the worldly means within his power. If the disease has 
become established in an individual of strong hereditary tendency to it, 
or in one who has broken down his constitution by dissipation or intem- 
perance, or who is the subject of some other debilitating disease, hope of 
amendment can be but small; if, on the contrary, the affection is more 
probably induced, rather accidental than the result of original constitu- 
tional tendency, the probability is, that under proper management, and 
with the aid of the great curative powers of cod-liver oil, not only 
amendment, but permanent recovery, may be obtained. 
Treatment.-Threatened consumption is no disease for domestic 
treatment. On the first suspicion of its presence, the person should at 
once be examined medically; the above symptoms may excite alarm, 
may afford most grave ground for suspicion, not only to the friends, but 
also in the mind of any medical man, but their certainty cannot possibly 
be pronounced upon, without the physical examination of the chest, 
which well-educated medical practitioners only can conduct. By that 
the case may very generally be pronounced upon, groundless fears dis- 
pelled, or just apprehensions confirmed and acted upon, while yet there 
is time to save or prolong life. One of the most important points to be 
attended to in the treatment of consumption, and one which should 450 
CONSUMPTION, ETC. 
never be lost sight of as a means for preventing the development of the 
disease, is the inhalation of & pure atmosphere. 
Persons affected with or threatened by consumption, should spend as 
much time as possible in the open air-as long a portion of each day as 
their own strength and the state of the weather will allow. The really 
great advantage which consumptive patients derive from a residence in a 
mild climate, consists in the greater opportunity which is almost 
invariably thereby afforded for occupation in the open air. 
In all cases of consumption a strict regard must be paid to the con- 
stitution, habits, and special circumstances of the patient, whatever these 
may be. Though consumption does not, in all cases, result from 
inflammatory action, there is good reason to believe that, in the progress 
of the disease, tubercular deposition not unfrequently gives rise to inflam- 
mation. A case may occur in which a full and generous diet will be for 
a time well borne, but anon symptoms indicative of inflammatory excite- 
ment come on; to persevere then with the former plan would be worse 
than foolish; it must be suspended, and to a lower diet, with perhaps 
some remedy against inflammation in addition, will be the appropriate 
change. 
The hygienic treatment of consumption is, then, always to be 
regarded as of the greatest possible importance. Diet should consist of 
what is the most nutritious and most easily digested. (See Food, Diet.) 
Meals should be taken at regular intervals, and there should always be 
the most careful regulation of the digestive organs. Exercise in the open 
air, whenever practicable, is to be recommended. It may be active or 
passive ; that is, walking on foot, or borne in a carriage or on horseback. 
Sponging of the surface of the body, and more especially of the chest, 
with cold or tepid water, over front and back, besides being very refresh- 
ing, is often -directly salutary, and should never be neglected; for in 
this, as well as in many other diseases, it is of much consequence to main- 
tain a proper exercise of the cutaneous function. Stated exercise of the 
respiratory muscles-as by making deep inspirations in the open air, or 
by gentle gymnastics-should be practised. A due amount of sleep 
should be indulged in; it is most consistent with health to go early to 
bed and to rise early in the morning. A change of occupation is to be 
counselled in the instance of those whose labor is heavy, or mental 
occupation great, for both of these should be avoided. 
The great desideratum for the consumptive patient in the way of 
climate is one at once dry, mild, equable, with as little as possible 
variation between day and night, and least of all liable to sudden alter- 
nations. There can be no question that many cases of consumption are 
much ameliorated by a change of climate. That good effects may follow, CONSUMPTION, ETC. 
451 
it is, however, essential that the change be made at an early period of 
the malady. When the disease has become far advanced, and the 
system exhausted, then the fatigue of a long journey, and almost neces- 
sary discomfort entailed by a residence from home, do much more harm 
than good. A judicious change, practised early, seems in some to have 
completely arrested the disease; in many, without effecting so much, 
life has, apparently through its means, been greatly prolonged ; in certain 
other cases the most unfavorable symptoms have been subdued, and the 
termination of life smoothed and rendered infinitely more comfortable. 
What is of far greater consequence, however, than any mere change of 
climate, is the influence of apure, fresh atmosphere. Very special care 
should be taken that the sleeping apartment occupied by a consumptive 
patient is duly ventilated-that in it, to as complete an extent as pos- 
sible, there is a free circulation of pure air. Of course due provision 
must be made against the introduction of a cold or chilly atmosphere: 
but the "night air" has been regarded too much in the light of a bug- 
bear, for not only can the temperature of the bed-room, with sufficient 
care, be properly maintained while the pure air is permitted to enter, 
but the probability is, that the night air as such, never injured any one; 
it is only impure or chill air that does so. (See Air, Climate.) 
As to the various special remedies which have been employed in the 
treatment of consumption only a few can be mentioned here. Foremost 
among these is cod-liver oil, an oil obtained from the fresh livers of 
several fishes, the ling and the skate, as well as the cod. Strong 
testimonies have been borne to its efficacy by the most eminent 
physicians of both Europe and America, and there are probably few 
medical men who have seen much of this sad disease who would hesi- 
tate to concur in the opinion of an eminent London physician, that 
" cod-liver oil is more beneficial, in the treatment of pulmonary con- 
sumption, than any other agent-medicinal, dietetic, or regiminal-that 
has yet been employed." Here it need only further be observed, that, 
while cod-liver oil is being taken, it is of the greatest importance that 
the general hygienic means already referred to should not be relaxed; 
specially should care be taken that all heavy articles of food are 
avoided, the diet being, as indeed it always should be, plain but 
nutritious. And still more imperative is it that, if possible, regular 
exercise in the open air, at all events the inhalation of a pure atmos- 
phere, be practised. It is the neglect of this that often leads to the 
assumption that the oil has disagreed; or, perhaps, that it will never 
agree. Let attention also be paid to the condition of the skin. By 
ablution and gentle friction its function is best maintained. Notwith- 
standing, however, a strict attention to all these particulars, cases will 452 
CONSUMPTION, ETC. 
occur in which cod-liver oil does undoudtedly not agree ; and there are 
certain articles, one or other of which may, in such circumstances, be 
substituted for it. Of these, cream, fat of meat, olive-oil, almond-oil, 
glycerine, are the chief. (See Cod-Liver Oil.) 
Phosphate of lime, hypophosphites of lime and soda, iodine, chlorine, 
arsenic, and iron in various forms, have all been recommended, but 
there is not much confidence to be placed in the power of any one of 
them to cure. The best form to use the iron is in the form of natural 
iron waters, the best in this country, probably, being the red sulphur 
spring of Virginia. Counter-irritation to the chest with croton-oil 
liniment, in the early stages of the disease, is beneficial, but later on, 
when the patient's strength is much exhausted, it only does injury by 
increasing prostration. The diet in consumption should be as nutritious 
as possible. Milk, cream, sugar, eggs, and strong animal broths, are 
all very beneficial. More or less milk should be taken at every meal. 
Coffee and chocolate are recommended instead of tea. 
Exercise is also of prime importance. Prof. Flint, of New York, 
says, "I would rank exercise and out-door life far above any known 
remedies for the cure of this disease. There are grounds for believing 
that the advantage of a change of climate mainly consists in its being 
subsidiary to a change of habits as regards exercise and out-door life; 
exercise in the open air should be accompanied by either mental 
recreations or occupations which interest the mind." (See Exercise.) 
Ln the endeavor to relieve the cough of consumption which often 
proves severe, causing much pain, preventing sleep, and (what must 
always be attended to when possible) perhaps preventing other patients 
sleeping, no remedy is superior to opium. With consumptive patients 
it seldom disagrees. For this purpose one or other of the preparations 
of opium may be employed. The dose, in the first instance, need not 
be otherwise than small. A few drops (5 to 15) of the solution of the 
muriate or acetate of morphia, alone or combined with an equal amount 
of antimonial wine, or 3 to 5 grains of the compound ipecacuanha powder 
(Dover's powder), given at intervals, three or four times in the day, 
often do good. Dr. Prout, of England, speaks highly of the aniseed in 
affording relief to the cough; the oil of aniseed {oleum anisi) may be 
given in doses of 5 to 10 drops in water. Of other remedies, hydro- 
cyanic acid (prussic acid) in doses of 2 drops every four or six hours, 
may be mentioned; also chlorodyne, 5 to 10 drops whenever necessary. 
When these means fail, the application of a leech or two leeches over 
the upper part of the breast-bone may succeed in removing the cough; 
but if the patient be weak, this expedient must not be had recourse to. 
When there is much difficulty of breathing, a degree of relief may some- CONSUMPTION, ETC. 
453 
times be obtained by the administration of 5 drops of chloroform, or 10 
to 15 drops of chloric ether, or from the very cautious inhalation of a 
small quantity of the former. When the expectoration is very difficult, 
giving rise to urgent and distressing cough, its greater freedom may be 
encouraged by the use of a little antimony, ipecacuanha, or squill. On 
the other hand, the expectoration may be excessive, wearing out the 
patient's strength, and requiring to be controlled; in such circum- 
stances, opiates may be given, or acetate of lead, in doses of 2 to 5 
grains ; or of gallic acid, 3 to 5 grains, alone or with opium; also naphtha. 
For the relief of the perspiration, oftentimes so distressing to the 
patient, no remedy is more effectual than the sponging of the body with 
vinegar and cold or tepid water. This expedient should be practised 
twice daily, morning and evening; and if the patient be weak, a nurse 
or attendant should undertake the duty. While this is not to be neg- 
lected, it may be necessary to administer some astringent medicine; 
and for this purpose there is the diluted sulphuric acid, in doses of 10 to 
15 drops in water, three or four times a day. Or the following pill, 
highly recommended by Dr. Barlow, may be taken: 
Take of Sulphate of zinc Six grains. 
Extract of henbane Twenty-four grains.-Mix. 
Divide into 6 pills, 1 to be taken each night at bed-time. 
The diarrhoea, which frequently becomes very troublesome, must be 
checked by the ordinary chalk mixture, or a pill containing sulphate of 
copper or nitrate of silver combined with opium. 
Take of Prepared chalk Two drams. 
Powdered gum acacia Two drams. 
Tincture of catechu One and a half drams. 
Laudanum One dram. 
Pure water Six ounces.-Mix. 
Take 1 large tablespoonful every three or four hours. Or, 
Take of Sulphate of copper Three grains. 
Powdered opium Three grains. 
Extract of gentian Twelve grains.-Mix. 
Make 6 pills, 1 to be taken three times a day. 
When there exists irritation of the throat, and when there is reason 
to believe that tubercular deposition has taken place in the upper part of 
the air-passages (larynx and trachea), some relief may be obtained from 
the inhalation of steam, or of a very weak chlorine vapor. When so 
affected, the application of a weak solution of caustic (nitrate of silver) 
may also be practised. 
When bleeding from the lungs has occurred-and more particularly 
if the amount of blood passing is considerable-there are certain simple 454 
CONSUMPTION, ETC. 
but important rules to observe. Let the patient's head be kept high ; 
in other words, favor the occurrence of a feeling of faintness, which 
often leads to the arrestment of hemorrhage. Let the air about the 
patient be kept cool; open a window in the room if the weather be 
mild ; let the clothes upon him be light; let there be perfect quietness 
and silence. Cold should be cautiously applied over the chest; a piece 
of ice placed in the mouth ; the limbs kept warm. If the action of the 
heart be excited, a little ipecacuanha or antimony, so as to induce 
nausea, should be administered. The administration of a cooling laxa- 
tive is also called for. If the hemorrhage have been so profuse as to 
bring life immediately into jeopardy, or if it have occurred in the case 
of a patient already greatly reduced, then such remedies as those now 
mentioned are wholly inadmissible. Astringents must be given. Acetate 
of lead (3 or 4 grains) in solution, with a little acetic acid and laudanum, 
may be given every half hour; or gallic acid, in similar doses, to the 
extent of 30 grains in twelve hours. The most efficacious remedy which 
we at present possess for controlling hemorrhage is ergotine, which is 
best used in doses of 3 to. 5 grains injected under the skin, or, better, 
into the substance of a muscle. Stimulants, moreover, may be required; 
they are best administered cold. Digitalis is sometimes found useful. 
% a teaspoonful of common salt may be given to the patient if no other 
remedy is at hand, and repeated at intervals of half an hour till other 
means are procured. 
Preventive treatment.-The prevention of so fatal a disease as con- 
sumption is a more important subject in a work like the present than its 
treatment; and in those predisposed, the preventive or "prophylactic" 
system must be continued life through, even to old age. It is a popular 
error that by the time middle life is reached, the liability to consump- 
tion is over. Such is not the case, for even the "threescore and ten" is 
sometimes terminated by the disease. According to the tables of Sir 
James Clark, it appears "that the greatest number of deaths from 
phthisis (consumption) happens between the ages of twenty and thirty; 
the next greatest number from thirty to forty; the next from forty to 
fifty, and many even up to seventy years of age; more women than 
men, on the average, dying from the disease. It has already been 
remarked what a potent influence hereditary predisposition towards con- 
sumption exerts, and how strongly this predisposition may be developed 
or increased in a family by marriage union. People will marry, what- 
ever their constitutional predisposition; but if either their own constitu- 
tion or that of their family generally is at all consumptive, it ought to 
be a very weighty consideration with them, that the union should be 
with one as little inclined towards the disease as possible. When the CONSUMPTION, ETC. 
455 
children in a family evidently inherit or display consumptive tendencies, 
in addition to the precautionary measures already enumerated in the 
article Children, it should become a question, how far permanent 
removal to a more genial and drier climate might be desirable. To 
the rich, who have it in their power to change their residence as 
and when they may, the consideration is perhaps of less immediate 
consequence; but to the laborer, the mechanic, or the man of small 
income, it must be a question of paramount importance, whether, by 
emigration to such a climate, he may not only save himself the 
constant sorrow, actual and anticipated, of seeing his family drop 
one by one into their early graves, but also save the constant pull- 
back upon his exertions, and drain upon his resources, which a sickly 
family necessary entails. But, indeed, in any condition of life, the 
question of tendency or not to consumptive disease, should always influ- 
ence the choice of field for exertion, and not only of field, but also of the 
nature of the business of life. 
To those who may be able to go abroad, we would say, choose the 
sunny shores of the Mediterranean, but if you would expect to reap any 
benefit therefrom, go in time, before the system has become exhausted, 
and travel a weariness instead of a recreation. The island of Madeira 
is, in the equability of its temperature, one of the most desirable places 
known for the consumptive, where the necessary comforts can be ob- 
tained. The summer and winter being mild, it is peculiarly suited for 
the permanent residence of the patient. The climate of the Canary 
Islands resembles Madeira, but is not quite as equable. 
For those who do not wish to leave the shores of America, there 
remain several places nearer home, where the climate is especially favor- 
able. Among these is Florida, which seems to be-the southern por- 
tion especially-a model climate, having an equable temperature, mod- 
erate moisture, moderate and regular winds, and comparative freedom 
from local diseases. Minnesota, Colorado, and California also possess 
an atmosphere peculiarly favoring the restoration of consumptive pati- 
ents. Many have gone thither, with the incipient symptoms of the dis- 
ease, and after a residence of some time there, have come home, either 
completely restored in health, or vastly improved. Dr. Hatch, of 
Sacramento, Secretary of the California State Board of Health, says 
"that for the majority of invalids seeking a change of climate in consump- 
tion, the mountains-preferably the coast range-offer advantages, during 
the summer and early autumn months, superior to those of any other por- 
tion of the State; and that a certain proportion may find the eastern slope 
of the coast agreeable and beneficial, even during the winter seasons; and 
that for a large proportion of consumptives, some point on the southern 456 
CONSUMPTION, ETC.-CONTAGION. 
coast seems eminently suitable as a winter residence." Dr. Hatch also 
entertains the opinion that a large proportion of those suffering from the 
first stages of consumption, are benefited by a residence in California; 
some cases of the second, but no very strong inducement could be 
offered to those who have passed into the third stage. The point of 
great importance in this matter of a change of climate is not pro- 
crastinating until too late. 
Any occupation which renders the inhalation of irritating substances 
unavoidable, is to be eschewed by the consumptively inclined man, and 
not less so, that which involves confinement in a constrained position, or 
in a close room. Of the former class, grinding or polishing of metal 
or stone, especially if dry, flour-grinding, etc., are examples; of the 
latter, the occupation of the tailor, the shoemaker, the seamstress, or 
the compositor. The most eligible employments are those which require 
muscular exertion of not too exhausting a.kind, and without too great 
exposure to the weather; the gardener, the carpenter, the butcher, the 
farmer, are all less likely to be the victims of the disease. In whatever 
situation or grade of life, however, a person may be placed who is pre- 
disposed to consumption, much may be done to keep up the powers of 
resistance, by keeping up the general health to the highest possible 
standard, by diet, early hours, attention to the skin, and avoidance of 
all kinds of dissipation and intemperance; smoking tobacco should be 
shunned as particularly injurious. Regular exercise is to be taken- 
the chest and shoulders should be bathed every morning with cold 
salt water, and rubbed afterwards to promote reaction. Cheerfulness of 
mind, and moderate mental exertion are important, whilst perfect tem- 
perance in the use of alcoholic stimuli is indispensable, but any change 
to their total disuse cannot be made in many cases without danger. All 
the usual sources from which "cold is taken" are to be shunned, par- 
ticularly wet feet, sitting in damp clothes, crowded ball-rooms. andpublic 
assemblies ; and lastly, when exposure to cold air, especially to east 
winds, or to the foggy atmosphere of night, is unavoidable, the protec- 
tion of a respirator of some description should be resorted to. (See Air, 
Ventilation, Houses, Climate, Madeira, Canaries, Health Resorts, 
Mineral Waters, Cold, Damp, Cold Feet, Clothing, Ablution, Baths 
and Bathing, Atomizer, Inhalation, Hemorrhage, Cod-Liver Oil, 
Hypophosphites, Digestion, Diet, Food, Meals, Drinks, Sleep; Stimu- 
lants, Alcoholic; Excitants, Regimen, Exercise, Health, Sanitary 
Science, Auscultation, Stethoscope, etc.) 
CONTAGION, kon-ta'-gun [Lat. contagio, from con, and tango, I 
touch], is sometimes used to express the actual agent by which disease 
is propagated; but more generally the propagation itself. Properly CONTAGION. 
457 
speaking, the term ought to be confined to the propagation of disease 
by actual contact, in contradistinction to infection ; but it is now used in 
the more extended sense of "infection" likewise. Contagious diseases 
may be communicated only by actual contact of individuals, as in the 
case of itch, etc. ; by inoculation, as in the case of cow-pox; or in addi- 
tion to both or either of these modes of transmission, through the 
atmosphere*by infection, as in the case of small-pox, etc. 
This power of propagation through the atmosphere, however, does 
not, independent of epidemic and endemic influences, extend far from 
the patient. Certain circumstances influence the extent of contagious 
diffusion. Of these, the most distinctly ascertained are atmospheric 
impurities ; for it is ever observed, and we believe it may be predicated 
of every disease possessing the property of remote contagion, that its 
contagious matter is propagated to greater distances in a dirty, crowded, 
and ill-ventilated apartment, than in one of which the air is pure. The 
same principle applies to articles of dress and furniture; those which 
are contaminated by animal secretions and effluvia, being much more 
readily impregnated with contagious matter than those which are clean. 
Peculiar atmospheric conditions certainly, also, favor the propagation of 
disease by contagion; sometimes these conditions are inappreciable, at 
others they are evidently connected with a superabundance of warmth 
and moisture; and also we have good reason to conclude, with certain 
states of electrical disturbance. The discovery of the new agent, or 
modification of the known existing agent oxygen-named ozone-may 
probably shed some new light upon the subject of contagion. Actual 
contact, however, or even immediate vicinage, to a person laboring 
under a contagious disease, is not requisite for its propagation to others ; 
this may be affected by means of substances to which the contagious 
matter clings; these substances, which go by the name of fomites, are 
more generally clothing and stuff furniture which have been about or 
near the bodies of those laboring under the disorder. These fomites are 
apt to be impregnated with the poison in a very concentrated condition, 
and are capable, not only of retaining it for a long period, but of tran- 
sporting it from place to place. A sofa on which a patient laboring 
under scarlet fever had lain, has been known to propagate the disease 
six months afterwards ; and clothes which have been about the sick are 
constantly ascertained to have been the media of conveying fever, etc., 
to distant localities. Wool and cotton seem particularly apt to attract 
and retain contagious emanations ; but, indeed, all loose textures appear 
to have the property, whilst on the other hand, polished and hard sur- 
faces and substances, are much less likely to act as fomites, if they do 
so at all. Everything of unnecessary drapery or clothing should be 458 
CONTAGION. 
removed from the chambers of those sick of contagious maladies, or, 
indeed, of any malady; for a sick chamber must always, in a lesser or 
greater degree, have an atmosphere containing unhealthy emanations,, 
which it is expedient, both for the good of the patient and of others, 
should find no unnecessary attractions or lodgments. Further, it is 
advisable to have the furniture as much as possible of hard and polished 
substances; and the dresses of those in attendance upon the sick, 
especially if habitually so, might with advantage be made with a glazed 
surface. Those substances which have necessarily become the fomites 
of contagious matter, ought to be scrupulously freed from it by com- 
plete and lengthened exposure to the open air, by washing, or by 
exposure to the fumes of chlorine in a close apartment; or by all three, 
the chlorine fumigation being first resorted to. Indeed, those persons 
under whose management a case of contagious disease has occurred, 
ought, as a Christian duty, to make sure that every article of stuff, furni- 
ture, clothing, etc., has been fully and carefully purified before others, 
either in the way of social intercourse, or in occupation, particularly that 
of the washerwoman, come into contact with them. The following is 
the most systematic course of action when the generation of contagious 
matter has ceased in an apartment, either by the death or recovery of 
the patient, premising of course, that throughout the illness measures 
have been, or ought to have been resorted to, to preserve purity. During 
the day, the door being shut, the windows should be open to their full 
extent, and the infected articles freely exposed to the air; during the 
night, the windows and door being closed, chlorine should be well 
diffused through the apartment; this having been repeated, if possible, 
for two days and nights, all textile fabrics and the like should be 
removed; those that are capable of being washed put into cold water, 
others placed in the open air. All articles of furniture left in the room, 
also the floor and oil-painted wood-work, should be well scoured. If the 
chamber be a white-washed or colored one, it should be "re-done ; " if 
papered, it is only a safe precaution to re-paper it. The bed requires 
the greatest amount of care ; if of wool, it is better destroyed altogether; 
if of hair or feathers, these should be exposed to the heat of re-baking, 
that is, at least to a temperature of 210° Fahr. ; and the ticking either 
thoroughly fumigated and washed, or entirely renewed. These direc- 
tions may appear minute and troublesome, but they are far from being 
too much so when put in comparison with the fearful scourge of a con- 
tagious disease which has established itself in a household or community,, 
and which perhaps might have been checked at the outset by the 
adoption of prompt and vigorous measures. The poorer classes and 
the ignorant cannot or will not adopt, in most instances, effective pre- CO NT A GION- CONVALESCENCE. 
459 
cautions ; it remains for the rich, for the well-informed, to point out their 
necessity, and lend a helping hand to their fulfilment, not only as an act 
of Christian charity, but as a means of safety for themselves; the 
disease which takes its origin in the cellar of Lazarus, not unfrequently 
ends by establishing itself in the mansion of Dives. It is not a neces- 
sary character of contagious disease that it has itself sprung from con- 
tagion-some of the most virulent and spreading fevers, such as those 
of the ship, or of the old jails, had no such commencement; but had 
their origin in the decomposing emanations from the bodies of numbers 
of individuals confined in unventilated and insufficient spaces. In addi- 
tion to the disinfectants already mentioned-air, water, and chlorine- 
many others are and have been used, such as the vapor of vinegar, of 
pitch, or of tobacco or camphor; large fires also used to be a favorite 
method ; none of these last-mentioned are to be depended upon. The 
vapor of muriatic acid, and the absorbing properties of newly-slaked 
lime may be resorted to in the absence of chlorine with advantage.. In 
many instances, particularly in the case of clothes, and other textures 
which will not wash, heat might be used more extensively than it is at 
present as a disinfectant. The experiments of the late Dr. Henry, of 
Manchester, England, proved that whilst the various textile fabrics 
might be exposed to a heat of at least 212° Fahr, without injury; their 
power as fomites, or of propagating contagious disease, after having 
absorbed the emanations, is destroyed by the high temperature. (See 
Disinfectants, Air, Bed-room, Chlorine, Bromo-Chloralum, Chloride 
of Lime, etc.) 
CONTAGIOUS DISEASES. (See Contagion.) 
CONTINUED FEVER. (See Fever.) 
CONTUSION. (See Bruises and Contusions.) 
CONVALESCENCE, kon-va-les'-sense, is the transition period be- 
tween the cure or cessation of severe disease, whether acute or chronic, 
and the re-establishment of health. The commencement of convales- 
cence, or the point at which the characteristic symptoms of disease 
cease, is sometimes distinctly marked, more especially after acute dis- 
orders; frequently, however, the tendency towards health, particularly 
after chronic disease, is much more insensibly established ; in the latter 
case, too, the progress of the convalescence is slower than it is in the 
former. Its rapidity or protraction, moreover, is much influenced by 
age, and the nature and treatment of the previous malady. Children 
convalesce rapidly, old people the reverse; but in all cases the natural 
power or resiliency of the constitution exerts much effect. In no case, 
perhaps, is convalescence more tardy and unsatisfactory than after ill- 
ness in which much loss of blood, or of its constituents, has taken place, 460 
CONVALESCENCE. 
either as a consequence of the disease, or of blood-letting in the treat- 
ment of it. Since, however, the practice of abstracting blood in large 
quantity by the lancet has been modified, there are fewer cases of pro- 
tracted convalescence from this cause. 
When convalescence from acute disease commences, the previously 
quick pulse falls to the natural standard, the tongue begins to clear, the 
skin becomes cool, sleep is refreshing, the mind acquires a more healthy 
and hopeful tone, and the person looks better. There is nothing which 
more assures a medical man of the condition of his patient, than the 
look, the expression of the countenance, to which the first glance, as he 
enters the room of sickness, is almost instinctively directed. The look 
of convalescence is tranquil, placid, not the heightened color and bright 
eye of hectic, which so often deceives the inexperienced with delusive 
hopes. When the brain has been much affected, however, the condition 
of the mind, and consequently the countenance, assumes its natural look 
more slowly. 
The management of convalescence is extremely important; errors in 
this respect frequently expose the already weakened patients to attacks 
of other disorders, or induce relapses to the diseased actions which had 
just been cast off. The convalescence after some particular diseases is 
more liable to such accidents than it is in others. That after fever is 
peculiarly so, and after scarlet fever, the tendency to cold and its conse- 
quences, dropsical swelling, and affection of the kidneys, is so very 
common, and so frequently fatal, that the greatest possible care is requi- 
site. During convalescence from acute disease, and especially of an 
eruptive character, many of the disorders characteristic of the scrofulous 
constitution show themselves : the eyes become the seat of chronic 
inflammation, purulent discharge from the ears occurs, and chronic 
eruptions show themselves upon the skin, of the head especially. More- 
over, these disorders, now, perhaps, for the first time apparent, are apt 
to continue even after convalescence, properly so called, is over. Fur- 
ther, relapse in convalescence often occurs from too soon employing 
actively the previously affected organ; the liability to this mishap must 
be evident to the common sense of every one. In the case of the eye, 
it is evident to the senses, after inflammation of that organ, its undue 
exercise, or even its exposure to full daylight, will often be followed by 
a return of the disease. Such is the case elsewhere, and whether it be 
the eye, or the brain, or the stomach, which has been affected, return to 
the ordinary exertions of health must be made with the greatest caution. 
The clothing of a convalescent patient requires particular attention; 
there is much susceptibility to cold, and to atmospheric vicissitudes. 
For the requisite information, the reader is referred to the article Cloth- CONVALESCENCE. 
461 
ing. General exercise is to be resumed cautiously, and should never be 
carried to the extent of fatigue. Diet, however, is tire great source both 
of error and mischief-the greatest difficulty which the medical man 
has to contend with; that is, in getting it properly attended to, and his 
orders properly carried out. Whilst disease is in progress and alarm is 
felt, directions are tolerably well, or indeed strictly obeyed; but no 
sooner does the patient begin to get better, than irregularities commence. 
The popular idea seems to be that convalescence must advance in pro- 
portion to the amount, and often to the stimulant qualities of the food 
given; and many a hopeful case sinks back into fatal relapse, from the 
wilful and injudicious kindness of friends. The point is one which 
requires to be strongly enforced on the minds of people generally, that 
in diet, as in everything else, convalescence must be gradual, and that 
nothing is more dangerous, more likely to induce relapse, than the 
injudicious use of solid animal food, or of stimulants. Milk, and the 
various farinaceous preparations with which it is usually combined, such 
as arrowroot, sago, rice, bread, etc., is-perhaps the most generally useful 
article of diet in convalescence; next come the teas made from fowl, 
mutton, veal, or beef-alone, or mixed with some of the farinacea; next 
in succession, eggs lightly boiled; and lastly, solid meats, of which ten- 
der mutton is probably the best, are to be permitted. Ripe fruits in 
their season, if not contra-indicated by the nature of the previous dis- 
ease, and if they do not occasion flatulence or diarrhoea, are both grate- 
ful and serviceable. If alcoholic stimulants can be dispensed with, it is 
the safer plan, and when requisite, the time of their employment and 
the kind used, is best left to a medical attendant. A good deal must 
depend upon the previous habits of the person. Gin, in cases in wdiich 
the urinary secretion is deficient, is most suitable; or light sherry, if the 
circulation is excitable; and port wine or porter in extreme debility. 
One of the most useful of the alcoholic stimuli, in convalescence, is the 
bitter India beer or pale ale; the amount of alcohol it contains is not 
large, its bitter exerts a beneficial tonic effect upon the stomach, whilst 
the narcotic principle of the hop tranquillizes the nervous system, often 
so painfully irritable. In whatever form nourishment is given to the 
convalescent, it should be in small quantity at a time, but as frequently 
repeated as natural appetite requires. 
The atmospheric purity of the chambers occupied by persons recover- 
ing from sickness requires great attention, and the temperature ought 
to be kept as nearly as possible about 58° Fahr. Lastly, when con- 
valescence has reached a certain point, there is no remedy which so 
surely promotes perfect recovery, and confirms health, as change of air. 
Almost any change is beneficial, but in many cases much more advan- 462 
CONVALESCENCE- CONVOL VUL US. 
tage would be derived, if persons thus seeking health acted upon com- 
petent medical advice. It is to be regretted, that so many of the 
accessories which promote speedy and certain convalescence, have 
hitherto been unattainable by the poorer classes. Care, and good 
nursing, and the highest medical skill in the country are bestowed upon 
the poor inmate of the hospital up to a certain point, and convalescence 
is barely established, when too often the patient has, in order to make 
room for others, to leave the comfortable home of his sickness, with all 
its nourishing food, and its comforts, and return to scanty nourishment, 
exposure to weather, and to an unhealthy home. In a climate like that 
of the United States, the point is one which requires more attention than 
it has hitherto received. Proposals for the establishment of con- 
valescent villages have been made in England, and some steps have 
been taken towards providing convalescent stations; but an immense 
deal requires to be done before the want is supplied, and charitable 
bequests and donations might be worse directed, than into such a 
channel. (See Air, Bed-Room, Sick-Room, Clothing, Health Exercise, 
Climate, Cookery for the Sick, Diet, Health Resorts, Mineral 
Waters, etc.) 
CONYALLARIA MULTIFLORA, kon-vql-la'-re-q mul-te-jlo' -Ta, 
Solomon's seal, or Giant Solomon's seal, a perennial plant belonging 
to the Nat. order Liliacece, It grows on the sides of meadows, high 
banks, woods and mountains, in the Northern and Eastern States and 
Canada. The root is the part used in medicine. It is tonic, mucilagi- 
nous, and mildly astringent, and is valuable in the whites, excessive 
menstruation, female debility, pectoral affections, and piles. It has 
been found beneficial in erysipelas and cutaneous affections. A large 
dose will produce vomiting, and act as a cathartic. Dose: of the infu- 
sion, 1 to 4 fluid ounces; fluid extract, 2 to 6 teaspoonfuls, three or four 
times a day. (See Infusion.) 
CONVULVULUS, kon-vol'-vu-lus, bindweed, a genus of plants 
belonging to the Nat. order Convolvulacew. The C. Scammonia, 
a native of Asia Minor, is a valuable medicinal plant, being the 
source of the purgative gum-resin called scammony. This is obtained 
from the fresh root, by cutting the top obliquely off, and allowing the 
milky juice which exudes to be collected in shells or other vessels. 
Scammony is a drastic purgative, somewhat of the nature of jalap, but 
less active. Dose, 5 to 10 grains. The resin of scammony is obtained 
by digesting the root in coarse powder, in a covered vessel with recti- 
fied spirit. Then pass through a percolator, adding more spirit until the 
root is exhausted: add water, and distill off the spirit, and when cool 
pour off the supernatant fluid from the resin. Dose, 3 to 8 grains. CONVOL VUL US- CONVULSIONS. 
463 
The confection consists of 3 ounces of scammony in tine powder, 3 fluid 
ounces of syrup, ounce each of clarified honey and ginger in fine 
powder, 1 fluid dram of oil of carraway, and fluid dram of cloves. 
Dose, 10 to 30 grains. The compound powder contains 4 ounces of 
scammony in powder, 3 ounces of jalap in powder, and 1 ounce of ginger 
in powder. Dose, 10 to 20 grains. The of a grain of podophyllin, 
mixed with 2 grains of scammony, makes a good and safe purgative for 
a child of three years of age. 
CONVULSIONS, kon-vul'-shum [Lat. convello, I pull together], is 
a state of alternate violent contraction and relaxation of the muscles, 
independent of the influence of the will; those under its direct control 
are most frequently affected, but not invariably so; the muscular fibres 
of the stomach, and other involuntary muscles, are often the seat of con- 
vulsion, but in this case the term spasm is generally applied to the dis- 
order. Convulsions are classed by medical men as "tonic," or those 
in which the state of contraction is maintained for a considerable period 
without alternation with relaxation, and as "clonic," or those in which 
the two states succeed one another with more or less rapidity. When 
the relaxations and contractions are very slight, and very rapid, the 
condition is tremor. The first of these, or the tonic convulsion, occurs 
in lock-jaw in its most perfect form; the second, or clonic, in hysteria; 
the third is seen in the persons of hard drinkers when not under the 
influence of their stimulant. 
Convulsions may be either general or partial, affecting only the 
muscles of the eyes or eyelids, of the face, or of one of the extremities, 
or of one side of the body, or they may shake the whole frame in con- 
vulsive agitation, such as occurs in epilepsy. Some of the most charac- 
teristic local convulsive actions occur in the muscles of the face, causing 
squinting, etc., or the peculiar "sardonic smile" or grin, which is 
caused by forcible retraction of the corners of the mouth, exposing the 
teeth. 
Sometimes an attack of general convulsion is pre-warned by a local 
affection, the eye is unnaturally turned, or the thumbs, as often occurs 
in children, drawn across the palm of the hand; or hiccup, which is a 
convulsive affection of the diaphragm, precedes the more widely diffused 
affection. In partial convulsion, the mind is probably unaffected; but 
when the affection is widely distributed, or general, there is frequently 
no outward sign of consciousness, and when the convulsion ceases, and 
consciousness does return, there is no recollection of the past paroxysm. 
Causes.-Convulsions are the result of a great variety of causes. 
The brain itself may be the organ primarily affected; there may be dis- 
ease of its structure, or pressure or irritation exerted upon it, by disease 464 
CONVULSIONS. 
or accident; there may oe too great determination of blood to the head, 
or the reverse condition may exist, and the supply of stimulant blood to 
the brain may be inadequate. But convulsions quite as frequently arise 
from irritation of distant organs affecting the brain and spinal cord ; in 
childhood, the irritation of teething is a most prolific source of convul- 
sions, and perhaps not less so, irritation of the stomach and bowels; 
causes which might, in the adult, produce transient headache, in the sus- 
ceptible nervous system of the child may cause convulsion. In females, 
irritation connected with the generative system is a frequent source of 
convulsive action, and, indeed, one of the most formidable phases of the 
disorder occurs in the process of childbirth. Strong mental emotion of 
any kind, such as joy, fear, etc., are apt to cause convulsion. Suppres- 
sion of accustomed discharges likewise are often followed by an attack 
of the malady. Worms in the intestinal canal cause it; and the onset 
of acute disease, small-pox in particular, but also febrile disease of any 
kind is, in many instances, heralded by an attack. In fact, with those 
who are susceptible, there is scarcely an agent, from a carious tooth or 
the scent of a flower upwards, which has not the power of exciting con- 
vulsive action-or something nearly approaching it-of the human 
frame. 
Symptoms.-An attack of convulsions may come on suddenly, with- 
out any previous warning, but more generally it is preceded by symp- 
toms. If in a child, there has probably been disturbed and moaning 
sleep, starting, screaming, grating of the teeth, peevishness, heaviness 
about the eyes, or squinting, or rolling of the ball in sleep, and a dis- 
ordered condition of the bowels; if in an adult, dreaming and unsettled 
sleep have occurred, headache, noises in the ears, disturbed and clouded 
vision, giddiness, nervous fears, loss of memory, and confusion of mind, 
have accompanied disorder of the digestive organs, a tendency to vomit 
without obvious cause, or colicky pains in the bowels, hiccup, and 
cramps in the hands or feet, have been the premonitors, and just before 
the accession of the paroxysm, a creeping sensation or "aura" is often 
felt to extend gradually from an extremity up to the head. In one of 
the most terrible and protracted successions of convulsive attacks the 
author ever witnessed, each paroxysm could be distinctly traced, com- 
mencing in one toe, gradually extending up the limb and trunk, until 
the whole frame was fearfully agitated. In such cases the convulsive 
movements of the limbs, and the distortion of the features are truly ter- 
rible to witness; but there is every reason to suppose that in many 
instances, and it is a great consolation to do so, the trial is to the spec- 
tators, and that the cerebral disorder which causes such violent commo- 
tion of the body, extinguishes for the time any consciousness of suffer- CONVULSIONS. 
465 
ing. Of course when the mind is unaffected, as it is in lock-jaw or 
tetanus, or in hydrophobia and other cases, the pain of the convulsion 
is severely felt. The length of time a convulsion continues, may vary 
from a few minutes to many hours, but generally the period is short, the 
paroxysms returning after intervals of cessation. The fit of convulsions 
may terminate in apoplectic stupor, in a state of extreme nervous exhaus- 
tion, in lethargy, or in prolonged sleep. For some time after, there is 
usually much languor, both physical and mental, and the faculties of 
the mind are confused and incapable of being exerted. There may 
remain permanent lesion of the nervous functions, such as paralysis, or 
disordered nervous action, such as St. Vitus's dance; a squint often 
dates from an attack of convulsions in childhood. In some cases bleed- 
ing from the nose or ears, or vomiting, or diarrhoea appear to terminate 
the attack. 
Treatment.-Some persons are much more liable to be affected than 
others, and children, as a general rule, especially so; it is therefore very 
important, that the premonitory symptoms, either in them or in individ- 
uals of excitable temperament, should be carefully noted and attended 
to, and the exciting cause, if possible, discovered and removed. In 
children, the state of the gums, and of the secretions from the bowels, 
are especially to be watched; the first may require lancing, or the 
second clearing out by an active purgative, such as calomel and scam- 
mony; but when, from the occurrence of warning symptoms, and 
especially if the child, or any other member of the family, have pre- 
viously suffered from convulsions, an attack is supposed to be impend- 
ing, medical advice should be procured. A point of great importance 
to be determined is, whether the disordered condition is connected with 
excess or deficiency of circulation in the vessels of the head and spine; 
for if the former, it is evident that the lowering treatment which it 
requires, must be injurious should the latter condition prevail, for this 
must be corrected by tonic medicines, or even by the exhibition of stimu- 
lants such as sal-volatile, or brandy in minute quantity. It must be 
clear to all, how important it is, either in the prophylactic or in the 
actual treatment of convulsions, whether in children or adults, that this 
point should be clearly ascertained. And as it is one which sometimes 
requires considerable medical acumen and experience satisfactorily to 
determine, it must be equally clear, that it must render non-professional 
interference in such cases a matter of hazard, and not lightly to be 
undertaken; at the same time, the sudden and alarming nature of con- 
vulsive attacks, renders it necessary that some means of discrimination, 
and some safe rules of treatment, should be known to all who are likely 
to be appealed to in such cases, particularly if resident in places far 466 
CONVULSIONS. 
removed from immediate medical assistance, and it is reiterated that the 
two opposite states must be kept in mind, the one arising from excess, 
the other from deficiency of circulation, and the treatment modified 
accordingly. 
If convulsion be threatened in a child of full habit, with firm flesh 
and good color; if teething is going on, the gums must be looked to, 
and lanced if requisite, the bowels may be freely purged with calomel 
and scammony, or with gray powder at night, followed by senna in the 
morning, the diet being at the same time reduced; and should there be 
much heat about the head, and the symptoms remain unabated, leeches- 
one, two, or more, according to age-may be applied to the temples, and 
cold to the head generally. If, on the contrary, the child, even though 
fat, be pale, and the flesh loose, and if it is of feeble habit, anything like 
lowering must be avoided ; the gums ought, of course, to be attended to, 
and if the bowels are disordered, the secretions must be gradually 
corrected by 2 grains of gray powder, given every night at bedtime, and, 
if requisite, a small dose of castor-oil in the morning; likewise, in either 
of the above cases, an antacid will probably be of service, such as 3 or 4 
drops of potash solution, or 1 teaspoonful of fluid magnesia, in the milk- 
food, given twice a day. In judging of the energy or weakness of the cere- 
bral circulation in infancy, as long as the opening of the head is unclosed, it 
affords a guide to judgment. When at this point, the scalp and sub- 
jacent parts appear depressed, the condition is one in which anything 
like lowering measures are inadmissible. Keeping the already given 
cautions in view, and remembering how often, both in child and adult, 
convulsion is threatened in consequence of irritation, not in the brain or 
spine, but at a distance from them, when it is suspected that an attack 
is impending, and when medical assistance cannot be at once procured, 
attention should be directed to any possible source of irritation, and 
should any such be found, its removal should, if possible, be effected. 
If no appreciable source of irritation is discovered, to which symptoms 
of threatened convulsion can be referred, and if the brain itself be sus- 
pected to be in fault, the same cautions respecting excess or deficiency of 
vascular action must still be remembered. If plethora is undoubted, if 
the individual is of full habit, florid, and with a strong pulse, leeches and 
cold to the head, and free purging, with low diet, may be resorted to 
with every prospect of advantage ; on the contrary, if the habit is feeble, 
the more negative system will be most safely pursued; the bowels must 
be regulated but not purged, the diet attended to as regards digestibility, 
not lowered, and every source of nervous exhaustion, either fatigue of 
body or mind, or of sexual character, most scrupulously avoided. If 
the extremities are cold, as they often are, their warmth must be pre- CONVULSIONS. 
467 
served; if the head is hot, the moderate use of cold will allay nervous 
excitement, as well as vascular action. Provisional measures like the 
above, will, if used with judgment, be most valuable even in unprofes- 
sional hands, but they are not to supersede medical examination, which 
must be submitted to. 
In the treatment of an attack of convulsion the above directions must 
equally be borne in mind and acted upon. When a child is seized with 
convulsions the most generally available remedy is the warm bath, and 
if used with judgment it is a good one. The temperature should be 98°; 
if the child is strong and plethoric, it should not be immersed above the 
waist, and while in the bath, cold should be applied to the head; if the 
child is weak, it may be put in the water above the shoulders, in either 
case the immersion is to be continued for twenty minutes. The gums 
are to be lanced if requisite, and leeches applied to the head under the 
cautions already given as to the abstraction of blood, and under the same 
cautions, purgatives are to be resorted to, either the more powerful ones 
of calomel and scammony, or calomel and jalap, or senna, or indeed the 
first efficient medicines of the class at hand, or the milder agency of 
castor-oil; in addition, an aperient injection may be administered with 
advantage. When the child is taken out of the bath, it should at once 
be wrapped up in warm blankets, and laid in its cradle, or in bed, and 
cold used to the head, or not, as thought well, and if the fits still con- 
tinue, mustard plasters made with half linseed-meal may be applied to 
the legs, but must be removed as soon as the skin is well reddened. 
When an adult is seized with convulsions, the treatment, conducted 
upon the same principles, must be very similar to that recommended 
for a child, with exception of the bath, which cannot be conveniently 
used ; in its stead, a warm bed, with hot applications to the feet, limbs, 
etc., must be substituted, and mustard plasters may be used more freelv. 
If there is much heat or excited action about the head, it should be 
shaved, or the hair cut close off, and cold or iced applications freely 
employed. In following out these directions, the non-professional will 
be doing much, indeed all they can legitimately, to relieve during the 
longer or shorter interval that must necessarily elapse before the case is 
seen by a medical man. Lastly, it must be borne in mind that convul- 
sions are not unfrequent in extreme intoxication, and also in poisoning 
from narcotics, such as opium, their occurrence from such causes would 
of course materially modify the treatment. In children particularly, 
they are unquestionably the frequent result of the administration of 
laudanum, and more frequently still of quack soothing and carminative 
medicines and elixirs. Whether in child or adult, if there is any sus- 
picion that the stomach itself is loaded or irritated by injurious food, an 468 
CONVULSIONS-COOKERY FOR THE SICK 
emetic is of course indicated ; mustard will often be the readiest, but 
ipecacuanha is preferable for children, in an average dose of 5 grains for 
a child of four years of age. (See Apoplexy, Baths, Child, Clyster, 
Croup, Dentition, Lock-Jaw, Spasm, Saint Vitus's Dance, Worms, 
Etc.) 
COOKERY FOR THE SICK, Tcook'-ur-e. It seems almost unneces- 
sary, and yet is of such importance that we will not offer any excuse for 
commencing this article by stating, that as a general rule, no cooking of 
any kind whatsoever should be done in the sick chamber, and it cannot 
be too much insisted upon that all cookery for the sick must be simple. 
The best methods of preparing suitable nourishment for the sick is a 
matter of so much consequence, that its consideration here cannot be 
out of place. Its importance is, perhaps, scarce sufficiently appreciated 
by any, and with a large class almost total ignorance prevails respecting 
it. Even when the needful materials are abundantly provided, still, 
things are prepared in such a barbarous and uninviting fashion, that the 
fastidious appetite of an invalid turns loathing from them; and this, 
simply from lack of knowledge, or of attention in preparing. Constantly 
is the medical man told-" I could eat, but I cannot fancy such food as 
we have here"-and this, when material is amply provided, but nicety 
wanting. The reader is referred to the separate articles which treat of 
the various forms of food for further information; but the following 
recipes are a few of the most directly useful sick-room articles of diet- 
and here, it may just be hinted, that neatness in serving up, as well as 
care and perfect cleanliness in preparing, makes sick-room cookery more 
likely to be attractive to an easily-offended appetite. 
Arrowroot.-Not quite 1 tablespoonful of arrowroot powder is to be 
mixed slowly and smoothly in a basin with a little cold water-and when 
done, 1 pint of boiling water added; it should then be sweetened to 
taste, and put on the fire to boil for five minutes, stirring well the whole 
time. If wine is permitted, it should be put to it after the arrowroot is 
poured into the basin. The same quantity of arrowroot is a proper one, 
when it is prepared with milk instead of water. 
Sago requires thorough washing in cold water, to take away its 
earthy taste; after doing so-1 tablespoonful will be a sufficient quan- 
tity-put it in 1 pint of milk, and boil it slowly till it is quite soft and 
has thickened the milk-ten minutes or a quarter of an hour is sufficient 
time-sweeten to taste, and add wine, or flavor with lemon-peel accord- 
ing to circumstances. Some invalids prefer tapioca to sago. It is pre- 
pared in the same quantity as the other, but does not require the previous 
washing, and takes only half the time for softening on the fire. 
In all preparations for the sick, let the constant stirring whilst on COOKER Y FOR THE SICK 
469 
the fire be attended to, whether directed or not. A taste of burn 
renders sick-cookery perfectly abominable. 
Macaroni.-To 1 ounce of macaroni add a little cold water, boil for 
a few moments and pour oft*, then add £ a pint of milk, grate in cracker 
crumbs and add a little nutmeg. Vermicelli may be made in the same 
way. 
Corn Starch.-Add to 1 pint of boiling milk, 3 tablespoonfuls of 
corn starch, mixed with milk into a thin paste, add 1 egg, a little pinch 
of salt, and sufficient white sugar to sweeten. Stir to prevent burning, 
and boil until thick, then turn into molds to cool. 
Cracker Pudding is made by pouring on 4 or 5 crackers rolled fine, 
1 pint of boiling milk, adding a piecS of butter the size of a walnut, 
and 2 eggs, and baking for half an hour. It may be eaten with wine 
sauce. 
Rice Pudding.-Take 2 tablespoonfuls of rice, sugar to suit the 
taste, 1 egg. Butter size of a walnut, 1 pint of milk. Mix thoroughly 
and bake. 
Ground Rice Milk.-One tablespoonful of ground rice, 1^ pints of 
milk, and £ ounce of candied lemon-peel. Mix the rice very smoothly 
with the milk, then add the lemon-peel cut into very small pieces; boil 
for half an hour; and strain as soon as off the fire. This is an excellent 
nutritious beverage for the sick when strict abstinence is not required, 
and for early convalescence. 
Calf's Foot Custard.-Take 1 calf's foot, put it into 1 quart of new 
milk, let it simmer till reduced to 1 pint, beat up the yolk of 2 eggs with 
a little pounded sugar, mix all together, boil it for a few minutes, let it 
stand, and skim well. It should have the chill taken off before eating it. 
Milk Toast is made by toasting a slice off a loaf uniformly brown, 
then laying it on a plate and pouring on it as much boiling milk as will 
thoroughly soak it. A little butter, a few grains of salt, or finely 
pulverized white sugar may be added according to taste. 
Simple Bread Panada.-Put a moderate quantity of grated or soft 
stale bread into enough boiling water to form a moderately thick pulp; 
cover it up, and leave it to soak for an hour-then beat it up with 2 or 3 
tablespoonfuls of milk, and fine sugar to sweeten-boil the whole for 
ten minutes. This preparation is occasionally acceptable to the invalid, 
when milk dietary alone is rejected. 
Oatmeal Gruel.-One dessertspoonful of meal must be mixed 
smoothly with two of cold water-1 pint of boiling water poured on, 
and the whole boiled on the fire for ten minutes, well stirring for the 
time, then strain and add sugar, or pepper and salt, as may be agreeable 
to or proper for the sick person. 470 
COOKERY FOR THE SICK 
Milk for Infants.-Take of cow's milk and water equal parts, loaf 
sugar as much as may be agreeable. It is necessary, when children are 
to be raised by the hand, to dilute the milk. These proportions may be 
altered, as the child advances in age. The object is to make a diet as 
near the qualities of the maternal milk as possible. 
Suet Ptisan.-Take of sheep's suet 2 ounces, milk 1 pint, starch % 
ounce. Boil slowly for half an hour. This may be used as a common 
drink in dysentery. 
Boiled Flour.-Take of fine flour 1 pound, tie it up in a linen cloth 
as tight as possible, and ufter frequently dipping it in cold water, dredge 
the outside with flour till a crust is formed round it, which will prevent 
the water soaking into it while boiling. It is then boiled about three 
hours, when it becomes a hard, dry mass. 2 or 3 teaspoonfuls of this 
may be grated and prepared with 1 pint of water or milk in the same 
manner as arrowroot, for which it forms an excellent substitute. 
Diet for Diarrhcea and Dysentery.-The following is a useful pre- 
paration : Gum arabic, tragacanth, arrowroot, sago, tapioca, of each 2 
drams. Mix them well together, and boil in 1 pint of milk, flavored 
with nutmeg or cinnamon. Used as a diet in dysentery, diarrhoea, etc. 
Carrageen Moss.-One ounce of it, boiled in 1| pints of water, is 
sufficient to form a semi-transparent, moderately consistent, nearly 
tasteless jelly. This may be sweetened and acidulated with juice of 
lemon, or it may be eaten with milk. It forms an excellent diet for 
invalids who require to have the strength supported. The gelatine, now 
so commonly used, is a very palatable preparation, combined with either 
water or milk, and may be taken dissolved in tea, coffee, or broth, 
without impairing the flavor of one or other. 
Iceland Moss.-Wash 2 ounces of the moss in some cold water, 
then boil slowly in 1 quart of water until it becomes thick, adding white 
sugar to suit the taste. Strain through a cloth and eat cold. Irish moss 
may be used in the same way. 
Gelatine with Milk.-One ounce of gelatine is to be soaked in 
pint of cold milk; when softened, 1 pint of boiling milk stirred well 
with it, till it is quite dissolved, it may be sweetened to taste, and put 
upon the fire to boil up altogether. It may be flavored with lemon-peel, 
or cinnamon, or brandy, as is most liked, or most suitable. It will be 
quite solid when cold. 
Jelly from Gelatine.-To rather more than 1 ounce of gelatine add 
% pint of cold water to soften it, then pour over 1 pint of boiling water, 
and stir till the gelatine is dissolved; pare very thinly the rind of 1 
lemon, and add, with the juice of 3 or 4-if acids are permitted-1 pound 
of loaf sugar, the whites and shells of 3 or 4 eggs, thoroughly well COOKERY FOR THE SICK 
471 
whisked together, and stirred into the whole; let it come to the boil 
upon the fire without more stirring-if wine is ordered with it, it should 
be added after coming off the fire ; pour it through a thick flannel jelly 
bag-what runs through at first will not be clear, and should be returned 
to the bag again; let it stand till cold, and you will have a clear, spark- 
ling jelly, which few invalids will refuse. 
Port Wine Jelly.-Port wine may be given in the form of a jelly, 
according to the following excellent form: Take 2 ounces of isinglass, 
1 ounce of gum arabic, 1 bottle of port wine, loaf sugar and spices 
according to taste. Let it simmer until it is perfectly dissolved. Then 
put it in a shape. To be eaten when cold, two or three times a day, in 
cases of great debility where port wine is ordered. 
Gloucester Jelly.-Take 1 ounce of sago, 1 of rice, 1 of pearl 
barley, and 1 of candied eryngo root; put them into a small pan, with 
2 quarts of water; let it boil till it is reduced to 1 quart; strain it 
through a sieve, and give the patient 1 teacupful three or four times a 
day, with wine and lemon-peel if desired. 
Strengthening Jelly.-Take 2 calf's feet, well cleaned; put them 
into a jar; to which add 1 ounce of isinglass, 2 ounces of sugar candy, 
with 2 quarts of new milk. Then bake it with some bread over the jar. 
When done, strain it off, and take 1 teacupful, just warmed before the 
fire, twice or three times a day. 
Hartshorn Jelly.-Take of hartshorn shavings, 4 ounces; water, 
1 quart; boil over a gentle fire until 1 pint of the water be dissipated. 
Strain, and add lemon-juice, sugar, and wine. This forms, either with 
or without the last-named ingredients, a very nourishing diet for con- 
valescents ; and, when mixed with an equal portion of milk, is well 
adapted to the bowel complaints of children. Isinglass or fish glue 
may be used instead of the hartshorn shavings, if preferred. 
Calf's Foot Jelly.-Take 2 calf's feet and add to them 1 gallon 
of water, which reduce by boiling to 1 quart. Strain it, and when cold, 
skim the fat entirely off. Add to this the white of 6 or 8 eggs well 
beaten, 1 pint of wine, pound of loaf sugar and the juice of 4 lemons, 
and let them be well mixed. Boil the whole for a few minutes, stirring 
constantly, and then pass it through a flannel strainer. This forms a 
very nutritious article of diet for the sick and convalescent. The wine 
may be omitted or added at option. 
Mucilage of Gum Arabic.-As an article of diet, the proper pro- 
portions are 1 ounce of gum arabic to 1 pint of boiling water. The 
solution is allowed to cool before it is used. Gum arabic is very nutri- 
tive, and life can be sustained on it alone for some time. 
Wine Whey is prepared by adding to 1 pint of fresh milk, as soon as it 472 
COOKERY FOR THE SICK 
reaches the boiling point, as much good Madeira or sherry as will coagu- 
late it. The mixture is then strained and sweetened, or flavored for use. 
Vinegar Whey.-Take of milk, 1 pint; vinegar, | ounce ; boil for a 
few minutes, and separate the curd. 
Tartar Whey.-Take of milk, 1 quart; cream of tartar, ounce ; 
boil until the curd separates. 
Rennet Whey.-Take of new milk, 1 quart; rennet, 1 large spoon- 
ful ; heat the milk and then add the rennet. Boil until the curd 
separates and is all taken off. To many persons this forms a very 
agreeable nutriment. 
Milk Punch is made by mixing good brandy or whiskey with cold, 
fresh milk, in the proportion of about 1 ounce, or 2 tablespoonfuls of the 
spirit to | pint of the milk. Sugar and nutmeg may be added to make 
the mixture palatable. 
Egg-nog consists of 1 egg, the white and yolk of which are beaten 
up separately; pint of cold water or milk with a little loaf sugar is 
then added, together w'ith 2 tablespoonfuls of brandy or whiskey. 
Lemonade.-The juice of 2 lemons, the rind of 1, added to 1 quart 
of boiling water, sweetened moderately, and kept in a covered jar, is a 
useful drink for those suffering from cold or slight fever. 
Infusion of Malt.-Take of ground malt, 1 pint; scalding water, 3 
pints; infuse for two hours, and strain off the liquor, to which may be 
added sugar or lemon-juice, if required. This was a favorite preparation 
with the late Dr. Jos. Parrish, in inflammatory fevers. 
Milk and Soda-Water.-Heat, nearly to boiling, 1 teacupful of 
milk; dissolve in it 1 teaspoonful of fine sugar, put it into a large 
tumbler, and pour over it two-thirds of a bottle of soda-water. This is 
an excellent mode of taking milk when the stomach is charged with 
acid, and consequently feels oppressed by milk alone. 
Toast-Water.-This simple beverage is seldom well prepared. Let 
the water with which it is made have been boiled and become cold. 
Toast thoroughly of a fine deep brown, but not black, a slice of bread 
about six inches square ; put it into a pitcher, and pour 1 quart of the 
water over it; let it stand one hour, and decant the water from the 
bread. A small piece of either orange or lemon-peel added with the 
bread is an improvement to toast-water. 
Linseed-Tea.-One ounce of linseed, not bruised, two drams of 
liquorice-root, bruised; pour over 1 pint of boiling water; place the 
pitcher-covered pitchers with perforated spouts should always be used 
for drinks for sick people-near the fire for three or four hours, then 
strain off. When linseed-tea is ordered to be continued, it should be 
made fresh every day. COOKERY FOB THE SICK 
473 
Sage Tea.-Take of dried leaves of sage, £ ounce ; boiling water, 1 
quart; infuse for half an hour and then strain. Sugar and lemon-juice 
may be added in the proportion required by the patient. In the same 
manner may be made balm and other teas. These infusions form very 
agreeable and useful drinks in fever, and their diaphoretic powers may 
be increased by the addition of the sweet spirits of nitre or antimonial 
wine. 
Decoction of Bran.-Take of fresh wheat bran, 1 pint; water, 3 
quarts; boil down one-third, strain off the liquor, and add sugar, honey, 
or molasses, according to the taste of the patient. Bran tea may be 
made by using boiling water, and suffering the mixture to stand in a 
covered vessel for three or four hours. 
Decoction of Barley, or Barley-Water.-Take of pearl barley, 2 
ounces; boiling water, 2 quarts. Before adding the boiling water, let 
the barley be well washed. Then boil it to one-half and strain the 
liquor. A little lemon juice and sugar may be added if desirable. To 
be taken at pleasure in inflammatory diseases. (See the article Barley: 
W ATER.) 
Rice Water.-Take of rice, 2 ounces, let it be well washed, and add 
to it, water, 2 quarts. Boil it for an hour and a half, and then add sugar 
and nutmeg as much as may be required. To be taken at pleasure. 
Chocolate.-Chocolate should be suffered to stand until cold, after 
having been made in the usual way. The oily parts thus collect on the 
surface and should be taken off. The liquid should then be boiled again, 
and sugar, etc., added. 
Essence of Beef.-Take 1 pound of lean beef, free from skin and 
fat; chop it up ; put it into a glass fruit jar with a cover; plunge it into 
a saucepan, and let it boil for two hours; then pour off the liquid 
essence; and the coagulated muscle, which has been made to shrink 
and express its juice by the heat, will be found below in a state useless 
for food ; let the essence stand till cold, and skim off the fat. This will 
be found most palatable and supporting, and will be retained by the 
stomach when almost everything else is rejected. It may be eaten cold, 
in a jellied state, with chicken, etc. It is invaluable in cases of intense 
debility, in chronic vomiting, sea-sickness, and every ailment where it is 
desirable to supply nutriment in the most concentrated and digestible 
state. Any other meat, fowl, or game may be treated in the same way 
as above. 
Another excellent method, though inferior to the above, is as follows: 
Take 1 pound of lean beef, mince it fine, and add to it 1 pint of cold 
water. Place it in a pot by the side of the fire, so that it may heat very 
slowly. Let it stand two or three hours before it is even allowed to sim- 474 
COOKERY FOR THE SICK 
mer, and then let it boil gently for fifteen minntes. Skim off all the fat. 
Mutton or veal broth may be made in the same way, and to all of these, 
if desired, a few ounces of rice or arrowroot may be added as thickening. 
There is a good method of making essence of beef with vegetable 
juice: Take slices of lean beef, free from fat and skin, and slices of 
turnips pared. Lay them alternately in a glass fruit jar, so as to exclude 
water and air; then put the jar into a large vessel full of water, and let 
it boil two or three hours. Half a cupful of this very strong essence 
may be given at a time to a delicate person, or a smaller quantity of it 
may be given to a child. 
Beef-Tea.-Take of lean beef, cut into shreds, 1 pound; water, 1 
quart. Boil it for twenty minutes, taking off the scum as it rises. 
After it grows cold, strain the liquor. This preparation is more nour- 
ishing than ordinary broths, and very palatable. For Prof. Liebig's, 
and other methods of making beef-tea, see the article Beef-Tea. 
Strong Veal Broth.-Take 2 pounds of veal, free from fat, and | 
pound pearl barley. Boil them till they become like a cream, and can 
pass through a sieve. It may be taken warm or cold, with salt. 
Chicken Broth, with every particle of fat or grease carefully taken 
off by blotting paper when hot, may be drank cold or iced, and will at 
times be retained when the stomach rejects everything else, especially in 
sea-sickness, or the sickness of pregnancy. It should be seasoned with 
a little salt, and taken from a glass feeder, when the patient is lying 
down. It is a refreshing and supporting drink even in cases of fever, 
and should be given quite cold or iced, not lukewarm. 
Mutton Broth.-Take 1 pound of lean mutton, put it into 1 quart 
of water; salt to taste: boil over a slow fire to half the quantity, skim- 
ming well; put in a little pearl barley or rice. May be given with dry 
toast, or the toast may be broken in. Veal, beef, chicken, or any other 
broth may be made in same way. 
Concentrated Fowl.-Take an old fowl, split it, and wash it 
thoroughly till all traces of blood have disappeared, then put it into a 
stewpan, add 3 pints of water, let it stew in the pan till the meat comes 
off the bones, and the water is reduced to 1 quart. 
Chicken Panada.-Cut up a chicken or young fowl, take off the 
skin, put it into a stewpan with 1 tablespoonful of water, and cook on a 
slow fire. When the chicken is hot through, put in a teacupful more 
water. Stew it for half an hour or longer, till quite tender. Take the 
meat off the bones, pound it well in a mortar, and rub it through a 
sieve. Use the gravy to moisten the meat in the mortar. 
Toasted Mutton.-Cut slices as thin as possible from the prime of a 
fresh loin of mutton, toast them with a toasting-fork before the fire. COOKERY FOR THE SICK-COPPER. 
475 
It is very light of digestion when prepared after this most simple 
fashion. 
Pounded Meat.-Take a piece of raw mutton, quite free from skin 
and fat; cut it into small pieces, and pound it in a mortar. Then put it 
into a saucepan, and warm it over the fire for ten minutes or less in its 
own gravy (of course without water). If too dry, add 1 spoonful of 
clear gravy (not stock), or a little beef-tea. It should be served very 
hot. 
(See Convalescence, Diet, Food; Bed, Bed-Room, Sick-Room, Sago, 
Beee-Tea, Barley Water, etc.) 
COPAIBA, OR COPAIVA. (See Balsam of Copaiba, Copaifera.) 
COPAIFERA, kopa -fe-ra [from copaiba, the Brazilian name, and 
Lat. fero, I bear], a genus of plants belonging to the Nat. order 
Leguminosoi. The species are natives of tropical America, and several 
yield the valuable oleo-resin which is used in medicine under the name 
of balsam of copaiba. This is obtained by making incisions into the 
stems of the trees. Most of the copaiba of commerce is brought from 
the Brazils, a very little being imported from Guiana and the West 
Indian islands. This is about the consistence of olive-oil, light yellow, 
transparent, with a peculiar odor, and an acrid aromatic taste. It is used 
as a stimulant of mucous surfaces generally, particularly of the urinary 
passages. It is a valuable remedy in gonorrhoea. Dose, from 10 to 30 
drops. The oil of copaiba, obtained by distillation from copaiba, is 
given in doses of 5 to 20 drops. (See Balsam of Copaiba.) 
COPPER, Icop'prur [Lat. Cuprum, from Cyprus, Gr. Kupros, the 
name of the island where it was first worked on an extensive scale], in 
Chemistry, symbol Cu, equivalent 31.75, specific gravity 8.921 to 8.952. 
It was called Venus by the alchemists, who gave to it the symbol of that 
planet. Copper is a hard, sonorous, ductile, and malleable metal, of a 
characteristic reddish-brown color. Very thin films have been obtained, 
which were of a beautiful green color by transmitted light, although of 
the natural color by reflected light. It is one of the best conductors of 
heat and electricity, and expands one part in 582 between the freezing 
and boiling points of water. The melting point of copper is 1996° 
Fahr.; and by exposing it to a very intense heat, it boils and volatilizes, 
burning with a brilliant green flame. Heated to redness in the open air, 
copper combines rapidly with oxygen; but even moist air at ordinary 
temperatures has but little effect on it. In sea-water it becomes gradu- 
ually corroded by the formation of an oxychloride of copper. The uses of 
copper are very important. With zinc it forms brass, and with different 
proportions of tin it forms bronze, bell-metal, gun-metal, and speculum- 
metal. Its oxides and salts are largely used as pigments and in phar- 476 
COPPER. 
maceutical preparations. Copper unites with oxygen in four pro- 
portions : 1. The svb-oxide or dinoxide, Cu2O. 2. The protoxide or 
Hack oxide, CuO. 3. The Hnoxide, CuO2. 4. Cupric acid, the com- 
position of which is not known. The salts of copper are characterized 
by their green or blue color. They are nearly all soluble, and have a 
strong, disagreeable, metallic taste, acting as poisons on the human 
system. In Medicine, sulphate of copper (better known by the name 
of blue vitriol) strongly resembles that of zinc in its action. Internally 
it acts as an astringent, tonic, and antispasmodic in doses of J to 2 
grains; and is used in dyspepsia and in Asiatic cholera. In doses of 
from 5 to 10 grains it acts as an emetic. It is also used as an outward 
application to wounds which present the granulated appearance known 
as "proud flesh." A mild solution of it is also used externally as an 
astringent lotion. The symptoms of poisoning by copper are violent 
and irrepressible purgings and vomitings, cramps in the limbs and 
severe pain in the bowels, followed by exhaustion and death. The 
matters ejected are tinged with the blue color of the poison. The best 
antidote is albumen, or white of egg, with which they form an insoluble 
and almost inert compound. In a case of poisoning by a salt of copper, 
the object must, of course, be to get the stomach freed from it as quickly 
as possible. Its own emetic action should be assisted by warm drinks, 
warm water, or milk, or mucilaginous drinks of some kind, such as 
linseed-tea, or barley-water; sugar has been found useful in these cases 
as an antidote, and should be added in good quantity to the fluids which 
are administered. After the stomach has been well cleared by the 
vomiting, raw eggs should be given largely, and if vomiting does not 
recur, which it probably will, it should be re-induced by putting a 
feather down the throat, or by the administration of a scruple of white 
vitriol in a little water. Of course medical assistance should be obtained, 
but the above measures may advantageously be had recourse to in the 
interval. When poisoning by copper occurs in consequence of its 
presence in food which has been prepared improperly, or in badly cleaned 
copper vessels, the amount of* the poison may not be sufficient to 
occasion death, but it produces severe symptoms similar to those above 
detailed. Copper vessels, unless protected by tinning, and even then, 
unless the protection is in a perfect state, cannot be considered desirable 
cooking utensils, and wffien they are used, the strictest cleanliness is 
requisite for safety; even if water is allowed to stand in a copper pan 
for any length of time, a poisonous salt is formed, but if the water con- 
tains an acid of any kind, such as vinegar, if it holds common salt in 
solution, or if there be oily or fatty matter present, poisonous com- 
pounds are quickly formed, consequently, food which contains any of Coptis Trifoliata. (Gold Thread.) COPPER- CORDIALS. 
477 
these ingredients should never be prepared in copper vessels; the same 
objection, of course, holds good as regards preserving fruits, which all 
contain more or less acids, and are therefore liable to act upon copper. 
There is, however, less danger as long as the active operations of cook- 
ing are going on, than there is from allowing the article^ above 
enumerated to stand for any length of time in a copper utensil, freely 
exposed to the air. Many of the cheaper green pickles contain copper, 
which is added to them to make the color appear finer. Its presence 
may be readily detected by burning the suspected article, washing the 
ashes in water, and filtering. If, on the addition of liquid ammonia, the 
solution strikes a deep blue color, copper is present. It may be also 
detected by introducing a perfectly clean plate of iron-a table knife- 
into the suspected article ; if copper is present, it will be deposited upon 
the surface of the former metal, in the form of a fine metallic film or 
coating. It should be remembered that the majority of the green color- 
ing matters and paints at present in general use, are compounds of 
copper, and, therefore, care should be observed in permitting children 
to have access to them. A child has been poisoned by a cake of green 
paint from a toy color-box. Copper coins are sometimes swallowed by 
children, and may pass awray by stool without any apparent bad conse- 
quences ; but this is not always the case, and severe epileptic fits have 
ensued in consequence of the accident. In the event of a child being 
known to have swallowed a piece of copper; salt, acids, and fatty matters 
should be excluded from its food, wdiich ouglit to consist of thick milky 
preparations, such as hasty pudding and the like, well sweetened with 
sugar ; gentle doses of aperients being administered. The thickened 
food should be given as soon as possible after the accident. 
COPPERAS, kop-pur-as [from German kupper-wasser, copper- 
water]. This term is applied w'ith the prefixes blue, green, and white, 
to the sulphate of copper, iron, and zinc respectively; also called blue, 
and green, and white vitriol. 
COPTIS TRIFOLIATA, kop-tis tri-fo-le-a-tq, gold thread, a small 
evergreen plant, belonging to the Nat. order Ranunculaceae. It grows 
in wet, boggy situations, in the Northern and Middle States and Canada. 
The root is the part used in medicine. It is a pure, bitter tonic, very 
much resembling quassia in its properties, and is used when a simple 
bitter tonic is required. It is also used with benefit as a local applica- 
tion in aphthous sore mouth, and as a gargle in ulcerated sore throat. 
Dose: of the fluid extract, to 1 teaspoonful; decoction, 1 to 4 fluid 
ounces, to be taken three or four times a day. (See Decoction.) 
CORDIALS, kord-yalz [Fr. and Sp. cordial, from Lat. cor, the 
heart,] are stimulants generally of an alcoholic nature ; the name is 478 
CORDIALS- CORNS. 
derived from the old idea that they "strengthened the heart." They 
certainly stimulate the circulation, and are useful in cases of depression 
from any cause, where such an effect is required. Brandy is, perhaps, 
as good and as generally attainable a cordial as any; the compound 
tincture of cardamoms, and the aromatic spirit of ammonia, constitute 
two of the best medicinal cordials. (See Excitants ; Stimulants, Alco- 
holic. ) 
CORIANDER. (See Coriandrum.) 
CORIANDRUM, ko re-an'-drum [from Gr. koris, a bug, in allusion 
to the smell of the leaves], in Botany, a genus of plants belonging to 
the Nat. order Umbdliferaz. The species C. sativum, the coriander, 
has long been cultivated for its fruits, improperly called seeds, which 
are used in the East for flavoring dishes and curry powder, and in 
Europe for the purposes of the distiller, confectioner, and pharmaceutist. 
They have a peculiar odor and warm aromatic taste, due to the presence 
of a yellowish-colored volatile oil, and are stimulant, carminative in their 
nature, but are chiefly employed as an adjunct to other medicines, as in 
tincture and syrup of rhubarb, tincture and confection of senna, etc. An 
oil is distilled from the fruit, called oil of coriander. Dose: of the fluid 
extract, to 1 teaspoonful; oil, 10 to 20 drops. 
CORNEA, kor'-ne-a [Lat. cornu, a horn], is a name given to one of 
the coats of the eye, from its being of a horny consistence. (See Eye.) 
CORN-MEAL, CORN-BREAD, korn-meel [Ang.-Sax.] Corn-meal 
is a popular article of diet In this country. It is very wholesome, either 
used as corn-bread or porridge. It possesses both aperient and fattening 
properties, and no fermentation is required to make good bread. It is 
not, however, so easily digested by some as wheaten bread. (See Food, 
Bread, etc.) 
CORNS, korm [Ang.-Sax.], are certain small, hard, troublesome 
excrescences on the feet, arising from a thickening of the cuticle or epi- 
dermis, and owing generally to irritation, caused by excessive pressure 
or friction on the part. Corns are of two kinds, hard and soft, the latter 
being situated between the toes. Frequently a bursa or bag is formed 
beneath the corn, which is apt to inflame and cause great pain and irrita- 
tion. In the treatment of corns, the great object is to remove all undue 
pressure or friction; and for that purpose the boots or shoes should be 
easy and pliant. This will be still further effected by protecting the 
corn with a small piece of thick soft leather, spread with diachlyon or 
other emollient plaster, and having a hole in the centre corresponding 
with the size of the corn. The feet should also be frequently bathed 
with warm water, and as much as possible of the corn carefully pared 
away, care being taken not to wound the more sensitive part. If the Cornus Florida. (Dogwood.) CORNS- CORNUS FLORIDA. 
479 
corn is very sensitive, it ought to be occasionally touched with lunar 
caustic; and if much inflamed, a warm bread poultice should be applied 
to it. Tight shoes are undoubtedly the most general originators of 
corns, but badly-made, ill-fitting ones, also give rise to the affection- 
not by pressure but by friction. Soft corns generally form between the 
toes, and are very troublesome and painful: they are kept soft by the 
continued perspiration of the part. 
The most efficient cure for corns is, of course, to get rid of the cause 
-the offending boot or shoe-but as some persons are so liable to the 
affection, or have their feet so formed, that if they wear boots or shoes 
at all they must suffer from corns; the best palliative is keeping the 
hardened mass well pared down in the centre. Vinegar, or strong 
acetic acid, applied to a corn every evening, will sometimes effect a 
cure, a little olive-oil being smeared over every morning. Various corn- 
plasters are used, the most effective and rational are those which are 
made thick, and have a hole cut in the centre for the corn, which is thus 
preserved from pressure. Soft corns should be cut with scissors; a 
piece of linen should be worn between the toes, and the strictest cleanli- 
ness observed. A peculiar kind of corn occasionally forms under the 
corner of the nail of the great toe, and causes much pain and irritation, 
if discovered by slightly elevating the nail, the thickened mass may be 
turned out. 
The following recipe makes a good corn-plaster: £ pound of yellow 
wax, £ ounce of Burgundy pitch, 1 ounce of turpentine, and ounce of 
powdered verdigris. Mix these over the fire; spread the composition 
upon linen or leather, and when cold, cut off the plasters the size 
required. 
We also add a corn solvent (Sir Humphrey Davy's recipe): 2 parts 
potash, 1 salt of sorrel. Mix these in a fine powder; cover the corns 
with some of the powder for four successive nights, binding it on with 
rag. (See Foot.) 
CORN-STARCH. (See Cookery for the Sick.) 
CORNUS FLORIDA, kor'-nus flor'-e-da, dogwood, boxwood, a 
small tree belonging to the Nat. order CornacecB. It grows in swamps 
and moist woods in various parts of the United States and Canada. 
The bark, which is the part used in medicine, has an astringent and 
slightly aromatic taste. It is a tonic, astringent and stimulant. It in- 
creases the force of the pulse, and elevates the temperature of the body. 
It has been successfully used as a substitute for cinchona in the treat- 
ment of intermittent fever, and may also be used with advantage in 
typhoid and typhus fevers. Dose: powdered bark, 20 to 30 grains; 
infusion, 1 to 2 ounces (see Infusion); fluid extract, to 2 teaspoonfuls. 480 
CORNUS FLORIDA-CORPULENCE. 
The doses may be given every three or four hours. A solid extract may 
be made by boiling the bark in water and evaporating to the proper con- 
sistence, 5 to 10 grains of this may be given three times a day. The 
ripe berries made into a tincture with brandy or whiskey is a popular 
bitters in many families. The flowers are sometimes used in the place 
of chamomile. The cornus circinata, or round-leaved dogwood, and the 
cornus sericea, or swamp dogwood, are used in the same cases, but their 
properties are not so powerful as the Cornus Florida. 
CORPULENCE, kor'-pu-lense [Lat. corpulentia, from corpus, the 
body], is an undue bulkiness or size of the body, arising from an exces- 
sive accumulation of fat in certain parts. It is impossible to define 
exactly the limit beyond which the body can be said to be corpulent, 
depending as it does, very much upon the general habit and the state of 
health of the individual. It most commonly takes place after the age of 
forty, but is not confined to any particular period of life, being to be 
found also in childhood and youth. The causes of corpulence are both 
natural and acquired. There are some persons who have a natural 
tendency to corpulence ; in others it may be induced by modes of life, 
indolent and sedentary habits, and the use of certain kinds of food. 
The undue accumulation of fat produces a variety of effects, interfering 
with the vital energies of the body, and incapacitating for exertion. The 
chances of life are not so great among persons of a corpulent habit as- 
among those of a normal condition. All sudden or violent measures to 
get rid of corpulence are attended with harm; and not the least 
dangerous is the popular remedy of vinegar, which has the effect of 
destroying the digestive powers. Attention to diet, and the avoidance 
of such articles as tend to generate fat, together with active exercise, 
and the counteracting of indolent habits, are among the best means that 
can be employed. Dr. Chalmers, in his small treatise " On Corpulence," 
gives a variety of cases in which liquor potasses, was used with great 
effect, in doses of to 1 teaspoonful, three times a day in milk and 
water, but this remedy should not be resorted to without the sanction of 
a medical adviser. Mr. Banting has published an interesting pamphlet 
on this subject, in which he records the beneficial effects which he 
experienced from the following course of diet: Breakfast, 4 or 5 ounces 
of beef, mutton, kidneys, broiled fish, bacon, or cold meat (except pork) ; 
a large cup of tea without milk or sugar, a little biscuit, or 1 ounce of 
dry toast. Dinner, 5 or 6 ounces of any fish except salmon, any meat 
except pork, any vegetable except potato, 1 ounce of dry toast, fruit out 
of a pudding, any kind of poultry or game, and 2 or 3 glasses of good 
claret, sherry, or madeira; champagne, port, and beer forbidden. Tea, 
2 or 3 ounces of fruit, 1 or 2 rusks, 1 cup of tea without milk or sugar.. CORPULENCE- COSMETIC. 
481 
Supper, 3 or 4 ounces of meat or fish, and 1 or 2 glasses of claret; 
bread, butter, milk, sugar, beer, soup, potatoes, and beans were for- 
bidden. The result of this was a gradual reduction of weight from 202 
to 156 pounds. There are numerous very remarkable cases of corpu- 
lence on record. Of modern instances was Bright, of Maldon, in Essex, 
England, a respectable tallow-chandler and grocer, who died on the 12th 
of November, 1750, in the twenty-ninth year of his age. He weighed 
616 pounds, and it is said that seven persons of ordinary size could be 
enclosed in his waistcoat. Daniel Lambert, who is supposed to have 
been the heaviest man that ever lived, died at Stamford, in Lincolnshire, 
England, at the age of forty, on the 21st of June, 1809. lie is said to 
have weighed 52 stone 12 pounds, or 740 pounds. (See Fucus Vesicu- 
losus, Fat, Food, Diet, Exercise, Regimen, etc.) 
CORPUS, kor'-pus [Lat. body], is a term applied in Anatomy to 
certain parts of the animal structure ; as the corpus callosum, the corpora 
quadrig&mina. (See Brain.) 
CORPUSCLES OF THE BLOOD. (See Blood.) 
CORROSION, kor-ro'-zkun [Sp. and Fr. corrosion], The term, 
when applied to the living body, means the gradual destruction of any of 
its tissues by chemical action. 
CORROSIVE SUBLIMATE. (See Mercury.) 
CORSETS. (See Education, Chest, etc.) 
CORSICAN MOSS. (See Gracillaria.) 
CORYDALIS FORMOSA, kor-e-daV-is for-md-sg, Turkey corn, 
a perennial plant belonging to the Nat. order Fumariaceoe. It 
grows from six to ten inches in height, in rich soils, all over the 
Middle States, and is known by the common names Turkey-pea, fumi- 
tory, and stagger-weed. The root is the part used in medicine, and it 
owes its activity to the presence of a principle called corydalin. It pos- 
sesses tonic properties similar to the columbo and gentian, and is a valu- 
able remedy in syphilitic and scrofulous affections, and in many cutane- 
ous diseases. It is also reported very serviceable in dropsy, gravel, 
catarrh of the bladder, and incontinence of urine. Dose: of the fluid 
extract, 10 to 40 drops; corydalin, | to 1 grain, three or four times a 
day. It may also be used in decoction, 1 to 2 ounces, three times daily. 
(See Decoction. ) 
CORYZA, OR COMMON COLD. (See Catarrh, or Common Cold.) 
COSMETIC, kos-met-ik [Gr. kosmeo, I adorn], is a preparation 
used to whiten or soften the skin, or otherwise to beautify and improve 
it. With the ancient Romans the term cosmetoc was applied to those 
slaves who were employed to dress and adorn their mistresses. Cos- 
metics are indirectly injurious, by leading the mind from the only true 482 
COSMETIC-COSTIVENESS, OR CONSTIPATION. 
cosmetics, obedience to the laws for the maintenance of physical health, 
which the Almighty has linked with our existence. Cleanliness, tem- 
perance, abundant fresh air and exercise, and early hours, and the cheer- 
fulness which results from the healthful occupation of the mind in legiti- 
mate pursuits, are cosmetics which no art can imitate or supply. If, as 
is too often the case, mineral and metallic substances form the bases of 
them, they cannot fail to be attended with harm to the skin, in the first 
instance, and afterwards to the general health. Vegetable preparations 
are the least injurious; but even these, if used at all, must be used with 
moderation. The following makes a good cosmetic: Pound a lump of 
benzoin and put it into a decanter, which fill with spirits of wine 60° 
above proof; as soon as the balsam is dissolved, add more, until the 
alcohol is fully saturated. A few drops of this tincture, in either pure 
water or rose-water, make an admirable wash for the face. (See Com- 
plexion. ) 
COSTIVENESS, OR CONSTIPATION, kos'-tiv-nes [From Lat. 
constipo^ to press closely together], is undue retention of the faecal con- 
tents of the bowels, and their evacuation in a harder and drier condition 
than natural. The state is one, in great degree dependent upon habit 
and constitution, for that which would be considered constipation in one 
person, would not be so in another, and vice versa. As a general rule, 
however, the bowels ought to relieve themselves thoroughly, once in the 
twenty-four hours, when such is not the case, the condition may be said 
to be one of costiveness. 
With some individuals, a single evacuation of the bowels, once every 
three or four days, and even less often, seems to be sufficient, and 
perfectly compatible with their enjoyment of perfect health, and when 
such is the case, it is of course superfluous to endeavor to correct it, and 
it is better to let well alone. If, however, in conjunction with this 
condition of the bowels, the person suffers from headache, from languor, 
from distention of the abdomen, if the breath is disagreeable, and the 
tongue furred, the state is not compatible with health, and should be 
corrected. 
Causes.-The causes of costiveness are very numerous, the nature of 
the food, as might be expected, exerts considerable influence ; bread badly 
made, and especially if alum be mixed with it, cheese, milk with some 
persons, farinaceous articles such as arrowroot or ground rice, and food 
of too concentrated a character, all tend to constipate. Deficient exer- 
cise, particularly if combined with much exertion of mind; any drain 
upon the system as in suckling, abundant perspirations, loss of nervous 
power, and old age, have the same effects. Pregnancy, and tumors in 
the abdomen, constipate by mechanical obstruction, and in the same COSTIVENESS, OR CONSTIPATION 
483 
way, contraction of any portion of the alimentary canal. The colon or 
large bowel is very frequently the seat of the constipation, it loses tone, 
allows itself to be distended, sometimes to an enormous extent, or con- 
tracts to a very narrow calibre in some portion of its course. Lastly, a 
very common inducing cause of costiveness, particularly in females, is 
inattention to the intimation of nature to relieve the bowels. 
Treatment.-As, except in the case of a few persons of constitutional 
peculiarity, confined bowels cannot be compatible with health, comfort, 
or activity of either mind or body, the state must be rectified, and that 
in a proper manner, not as it is usually attempted. Perhaps there is no 
ailment to which the human body is subject, which is more frequently 
mismanaged than constipation. Every effort should be made to correct 
the disorder without the aid of medicine. In the food, all those articles 
which have been enumerated, or which are known to constipate, must 
be avoided; the bread used should be made of coarse flour; if vege- 
tables and fruits agree in other respects they may be freely consumed, 
and cocoa substituted for tea or coffee; food is not to be taken in a state 
of too great concentration, but so that by the bulk of its refuse it may 
afford substance to stimulate the action of the bowels. In addition, 
there are various articles of diet which exert an aperient effect, and 
which may be used or not according to the taste of the person, such as oat- 
meal in the form of porridge, honey, prunes, etc. Exercise, whether on 
foot or horseback, is another valuable aid in the removal of the costive 
state ; it not only quickens all the functions, but it assists by the mechanical 
motion it communicates to the intestines; a similar effect may, in some 
cases, be produced by friction or kneading the abdomen with the hand ; 
the practice is scarcely so much resorted to as it might be. Another 
very important point is regularity in the time of evacuating the bowels; 
not waiting for the urgent sensation, but retiring for the purpose at one 
set period of the day, when time can be given. Persons who are liable 
to costiveness should give themselves at least a quarter of an hour, or 
even longer for the daily evacuation of the bowels. Lastly, as constipa' 
tion is so frequent an attendant upon the sedentary life of the student, 
and upon the anxious-minded man of business, a holiday both from 
books or desk, and change of air and scene, is both a good and pleasant 
remedy. 
When neither diet nor regimen will effect the cure, other means must 
be had recourse to. If there is simple costiveness, without disorder of 
the digestive functions, the best remedy will be the regular use of some 
simple clyster or injection; if on the other hand, furred tongue, with 
acidity of stomach, flatulence, pain between the shoulders, headache, 
etc., betoken deranged digestion, medicine will be required, at all events 484 
COSTIVENESS, OB CONSTIPATION 
in the first instance; the liver is probably at fault, and 5 or 6 grains of 
blue pill, or of compound colocynth and calomel pill, followed in the 
morning by the black draught, or by castor-oil, will be requisite to com- 
mence the treatment. When the stomach, liver, and upper bowels have 
been well cleared by the above medicines, it is requisite to keep the 
bowels open, otherwise a few days will see all the symptoms returned, 
and, in fact, such is too often the case ; persons are content with taking 
a dose of strong opening medicine every few days, or once a week, as 
the case may be, and rest content with thus, as it is called, having a 
good clearing out-albeit they are under the necessity of increasing the 
strength of the doses. The practice is one incompatible with sound 
health, and is most injurious to the stomach and bowels themselves; 
many cases of obstruction, and even inflammation of the bowels are 
produced by it. The principle to be proceeded upon in the treatment of 
costiveness is, that it is more easy to keep the bowels in action than to 
excite them to it W'hen they have become thoroughly torpid, and there- 
fore the individual should not rest content without the daily evacuation. 
As has been said above, if simple constipation, depending upon inaction 
of the lower bowel, exists, the use of the injection will in all probability 
be sufficient; but medicine may be required, perhaps daily, for some 
time ; or it may be used alternately with the clyster or injection. Some 
medicines are more than others adapted to the treatment of habitual 
costiveness, and of these castor-oil, aloes, alone or in its combinations, 
senna, and ipecacuhana are the principal, their great advantage is not 
losing their effect by continued use. When castor-oil can be taken 
regularly, in most cases it answers extremely well, and if taken regularly, 
the dose requires rather diminution than increase; it is a medicine, 
moreover, which never seems to injure the tone or the mucous coat of 
the bowels. In the constipation of pregnancy, castor-oil is so well 
known as the best and safest aperient that it scarcely requires mention. 
Aloes is peculiarly well adapted to relieve certain forms of costiveness, 
particularly that of the sedentary, and may be taken in the form of pill, 
in combination with soap, in the compound rhubarb pill or compound 
colocynth pill; any of these are most excellent combinations. If there 
is debility of stomach, the addition of £ or £ grain of quinine to each 
pill increases the efficiency of the medicine and gives tone to the 
stomach. The quinine must not be continued for more than a fortnight 
at a time. The dose of aloes when regularly taken does not require to 
be augmented. When quicker action is required, the compound decoc- 
tion of aloes may be taken with advantage instead of pills. The prin- 
cipal objection to the use of aloes is the occurrence of piles, which, if 
inflamed, or if the dose be too strong, are apt to be aggravated by the COSTIVENESS, OR CONSTIPATION. 
485 
medicine, in this case, castor-oil, or infusion of senna, or the injection, 
should be substituted, for a time at least. In some cases, on the other 
hand, when the piles are not inflamed, aloes taken regularly in small 
doses, seems to exert a beneficial and curative action upon them; 
probably in consequence of keeping the intestinal veins from becoming 
overloaded with blood. Senna, either in infusion or electuary, is a 
medicine well adapted for the relief of costiveness-, it is perfectly safe, 
and does not seem soon to lose its effect. Ipecacuanha, not alone, but in 
| or £ grain doses, especially when added to the aloetic pills, exerts a 
most beneficial effect in cases of habitually confined bowels. A weak solu- 
tion of Epsom salts, 1 dram to the | pint of water, with or without the 
addition of 5 or 10 drops of dilute sulphuric acid, when taken on first 
rising in the morning, will prove effectual with some, and forms a change 
from the use of the other aperients. Again it is repeated; keep the 
bowels free, by food, by exercise, by habit, if possible, by injections or 
medicines, if necessary; but do not let them become costive. 
In some individuals, in whom the walls of the abdomen are very 
flaccid, and do not afford sufficient tonic support to the contained bowels, 
costiveness frequently exists, and is much remedied by the use of an 
elastic or other belt, worn to support the entire belly. 
The medical students of Paris were recently not a little surprised to 
receive a lecture from Professor Trousseau, one of the most distinguished 
medical men in the world, upon such an ordinary and commonplace sub- 
ject as constipation of the bowels. The learned professor gave it as the 
result of his extended experience, that costiveness was a habit which 
could in nine cases out of ten be entirely overcome by the practice of 
evacuating the bowels every day at the same hour, and he maintained 
that he had cured numerous cases, simply and solely by directing atten- 
tion to be paid to this particular. There can be very little doubt of the 
truth of this axiom, and, indeed, it has been proved in the experience of 
many, that they could distinctly refer the occurrence with them of a consti- 
pated condition of the bowels, to something which has interfered with the 
daily custom or habit. Hence it is a point of great importance to attend 
to in the construction of dwelling-houses, that there should be no hindrance 
or difficulty experienced by even the most sensitive in these respects. 
In the treatment of costiveness the following pill is often especially 
useful, but it should not be persevered in for more than ten days at a time, 
and its use not renewed until after an interval of ten days. During this 
interval, the ordinary colocynth, or compound rhubarb pill may be taken. 
Take of Extract of nux vomica Two grains. 
Compound colocynth pill Forty grains.-Mix. 
Divide into 12 pills, and take 1 or 2 at bedtime. 486 
COSTIVENESS, OR CONSTIPATION-COUGH. 
The following electuary was recommended by the late Dr. Graves, 
and would, probably, suit persons of weak habit: 
Take of Senna confection Two ounces. 
Cream of tartar Half an ounce. 
Carbonate of iron Quarter of an ounce. 
Syrup of ginger sufficient to make an electuary.-Mix. 
Dose, 1 small teaspoonful at midday and bedtime. In some cases £ 
ounce of sulphur may be added. Podophyllin is a valuable addition 
to our remedies in the treatment of costiveness. (See Alimentary 
Canal, Mineral Waters, Aloes, Clyster, Podophyllum, Cathartics, 
Diet, Health, Exercise, Digestion, Dyspepsia, etc.) 
COTO BARK, ko'-to. This is a new remedy lately introduced from 
Bolivia. It is said to be almost a specific in the various forms of 
diarrhoea, and is highly recommended in dysentery, cholera morbus, 
colic, gastric catarrh, rheumatism and gout. Dose, of the fluid extract, 
1 to 3 drops, from four to six times a day. 
COTTON, kot'-tn, is a soft downy fibre obtained from the seed cap- 
sules of the cotton-plant, a species of gossypium. In its manufactured 
state, as calico, it is useful for many purposes, such as bandages, etc., in 
medical practice. The use of cotton cloth in the treatment of sores is 
generally considered to be more likely to irritate than linen, but the 
difference, if there is much, is greatly exaggerated. The cause has been 
said to be in the different form of the constituent fibre; that of the cot- 
ton, as seen under the microscope, being flat; that of the lint round. 
Much of the manufactured lint consists of cotton alone or mixed with 
flax. It has been thought that the flat sharp (?) edges of the cotton 
fibre were the irritating agents. The use of the sheet cotton in the form 
as used for wadding dresses, is a most invaluable application in burns. 
It is also sometimes used to dress blisters. (See Lint, Burns, etc.) 
COTTON-ROOT. (See Gossypium.) 
COUCH GRASS. (See Triticum Repens.) 
COUCHING, koutsh'-Ing, is an operation performed upon the eye, 
by which the lens, when it has become opaque from disease, is shifted 
or depressed to another part of the interior of the eyeball, and thus 
removed from the axis of vision, which it obstructs. (See Eye.) 
COUGH, kof, consists in the violent expulsion of air from the 
lungs through the air-passages. In most cases it must be regarded 
rather as a symptom of disease than as a disease itself. It may be a 
symptom of bronchitis, catarrh, croup, influenza, whooping-cough, laryn- 
gitis, consumption, pleurisy or pneumonia (all of which see). 
Causes.-Cough may arise from a great variety of causes. From 
direct irritation of the air-tubes themselves by the inhalation of cold and COUGH. 
487 
damp air, or of irritating vapors, by the mechanical irritation of foreign 
substance accidentally introduced into them, by the pressure of tumors, 
or by irritation of the throat and fauces, particularly when there is relax- 
ation of the uvula, and also in consequence of disease, inflammatory or 
otherwise, of the lungs themselves. Further, cough maybe sympathetic 
with disorder in the stomach, or liver, or with irritation in the bowels, 
occasioned by worms or other irritant agents; or it may be the result of 
nervous derangement, such as hysteria; or be spasmodic, like whooping- 
cough. So numerous are the ailments and diseases of which cough is a 
symptom, that it frequently requires considerable discrimination to 
determine the real cause of the irritation. Many of the acting causes 
are undoubtedly trivial, but many are deeply seated and fatal diseases, 
and therefore, whenever an individual becomes the subject of cough, 
which cannot be readily accounted for by cold or some other direct 
cause, a medical examination ought to be submitted to, and even if the 
cough has been in the first instance the result of cold, should it 
continue "hanging about" a person, without obvious reason, medical 
advice ought to be taken; mischief may be brewing, and be the cause.of 
the irritation, or the cough excited by some trivial and easily remedied 
cause, may itself be causing disease in the lungs of a predisposed per- 
son. 
Cough is spoken of, both medically and popularly, as dry and moist. 
A dry cough may be the result of direct temporary irritation of the air- 
passages, but more generally it is symptomatic either of incipient dis- 
ease connected with the chest, or of sympathetic nervous irritation prob- 
ably connected with the abdominal viscera. Moist cough is generally 
connected with direct affections of the chest, such as common catarrh, 
and with inflammatory affections, or with asthma or consumption. 
Treatment.-It has already been said, that a cough should never be 
allowed to continue for any length of time without the cause being ascer- 
tained by medical examination; till this is done, it can scarcely be ex- 
pected that the proper remedy can be applied. In the first instance, 
however, simple remedies may be tried. If the cough be clearly trace- 
able to cold or catarrh, it may be treated according to the directions 
given under these heads; if it be very dry, demulcent medicines, such 
as the mucilage and tolu mixture, or barley-water, or linseed-tea, may 
be taken freely, with from 5 to 10 drops of ipecacuanha wine two or 
three times a day, to which may be added 15 or 20 drops of tincture of 
henbane to allay irritation. Opium and its preparations are not gener- 
ally desirable in dry cough-unless, indeed, it be spasmodic-as the 
drug itself exerts a drying effect upon the mucous, membrane of the 
lungs. The inhalation of the steam from boiling water is sometimes 488 
COUGH. 
highly beneficial. In dry, and also in moist cough, counter-irritation 
by blisters, on the anterior part of the chest, or between the shoulders, 
is often of much service. The surface of the chest should be well pro- 
tected by flannel next the skin, by a dressed hare-skin, or by a warm 
plaster, either in front or behind. In moist coughs, the amount of 
fluids, and of demulcents, must be somewhat more restricted than in 
the above. The preparations of opium may be given in small quantity, 
either alone or in cough mixtures, but none answers better than pare- 
goric, taken in 1 or 2 teaspoonful doses in water; this allays the irrita- 
tation and teazing frequency of the cough; and to each dose, if expec- 
toration is difficult, 5 or 10 drops of ipecacuanha wine, and the same of 
tincture of squill may be added. The author has found the following 
pill most extensively useful in coughs depending upon irritation in the 
bronchi or air-passages: 
Take of Powdered opium Five grains. 
" squill Sixteen grains. 
" ipecacuanha Twelve grains. 
" camphor Eighteen grains. 
" gum ammoniac Twenty-four grains. 
" rhubarb Twelve grains.-Mix. 
Make into a mass with syrup, and divide into thirty pills: of these, 1 or 
2 may be taken for a dose. 
The foregoing remarks apply only to chronic or continued cough; of 
course the treatment of the affection as it arises in connection with other 
disease, either acute, such as inflammation of the lungs; or chronic, falls 
under the general management of these disorders. When feverish 
symptoms occur along with cough, all stimulation, either in diet, or by 
stimulant expectorants, is to be avoided; indeed, as a general rule, 
when cough exists, the diet should be as little stimulating as circum- 
stances will permit, and the usual allowance of animal food curtailed; 
but in old people, and those who have lived freely, the lowering system 
must not be carried too far; it may be requisite even, at times, to stimu- 
late, and to support strength by strong meat soups. 
Again it is repeated, a cough ought not to be allowed to continue; if 
not relieved by some of the simple remedies mentioned above, medical 
advice should be sought, particularly in the case of the aged, and if there 
is much secretion of phlegm or mucus, the least continued impediment 
to the expectoration of which, in an old person, may rapidly induce 
dangerous or fatal embarrassment of the lungs, often most unexpectedly. 
The possibility of a relaxed or elongated uvula being the cause of 
cough must not be forgotten; an examination of the throat will detect 
it, and the state may be relieved by the use of some astringent gargle, 
by a small fragment of catechu allowed to dissolve in the mouth, or by CO UGH- CO UNTENANCE. 
489 
touching the uvula once or twice a day with a camel's hair brush dipped 
in tincture of iron. 
COUGH MIXTURES. 
1. Take of Syrup of ipecacuanha One ounce. 
Syrup of squill One ounce. 
Syrup of tolu One ounce. 
Tincture of blood-root One ounce. 
Camphorated tincture of opium.. .One ounce.-Mix. 
Give from | to 1 teaspoonful whenever the cough is severe. 
2. Take of Oil of anise .One ounce. 
Oil of sweet almonds One ounce. 
Tincture of tolu... One ounce. 
Canada balsam One ounce. 
Madeira wine One ounce.-Mix. 
Give from 10 to 20 drops in a little slippery elm or flax-seed infusion. 
3. Take of Syrup of senega Five drams. 
Syrup of ipecac Two and a half drams. 
Syrup of rhubarb Five drams. 
Muriate of morphia Fifteen grains. 
Simple syrup Nineteen ounces. 
Oil of sassafras Half a dram.-Mix. 
Give 1 or 2 teaspoonfuls three or four times a day. 
4. Take of Syrup of squills Two ounces. 
Peppermint water Two ounces. 
Ammoniated tincture of opium....Half an ounce. 
Compound spirit of lavender Half an ounce. 
Simple syrup One ounce.-Mix. 
Give 1 teaspoonful three or four times a day. 
5. Take of Syrup of wild cherry bark One ounce. 
Syrup of tolu.. One ounce. 
Syrup of blood-root One ounce. 
Fluid extract of stillingia One ounce.-Mix. 
Give 1 teaspoonful every three or four hours. 
6. Take of Syrup of squills Half an ounce. 
Wine of ipecac Half an ounce. 
Tincture of hyoscyamus Half an ounce. 
Simple syrup Two and a half ounces.-Mix. 
Give 1 dessertspoonful every four hours. 
(See Asthma; Bronchitis, Acute; Bronchitis, Chronic; Catarrh 
or Common Cold ; Catarrh, Chronic ; Consumption, Croup, Influenza, 
Laryngitis, Pneumonia, Pleurisy, Whooping-Cough, Cold, Counter- 
Irritation, Balsam, Mustard, Blisters, Expectorants, Lungs, etc.) 
COUNTENANCE, koun-te-nanse [Lat. continentia^ a holding in]. 
The expression and aspect of the human face is much and peculiarly 
affected by the various diseases which affect the body, and the first view 490 
CO ENTENANCE- CO ENTER-IRRITATION. 
of a countenance often conveys to a physician who has studied the sub- 
ject, immediate, valuable, and certain prescience as to the nature of the 
disease for which his patient is about to ask advice. The indications are 
partly due to the changes of complexion which are associated with 
different forms of disease; but expression is equally significant. The 
physiognomical evidences have been classed by a writer, Mr. Corfe, who, 
enjoying abundant scope in such observations, has made them an object 
of special attention. The following is a summary of Mr. Corfe's arrange- 
ment : 
Countenance in- 
A.-Brain Affections.-1. Lethargic, in disease causing insensibil- 
ity. Example : Apoplexy. 2. Livid, in disease causing deficient change 
in the blood. Example : Suffocation and coma. 3. Distressed, in dis- 
ease causing mental disturbance. Example: Paralysis and fever. 
B.-Chest Affections.-1. Dusky, in disease interfering with blood 
changes. Example: Bronchitis. 2. Anxious, in disease impeding 
respiration. Example: Croup. 
C.-Abdominal Affections.-1. Pinched, in painful seizures. Ex- 
ample : Colic and cholera. 
D.-Nutrition Affected.-Emaciation General.-1. Wan, in dis- 
eases of debility. Example: Consumption and cancer. 2. Hue peculiar, 
in diseases affecting the blood. Example: Heart disease and jaundice. 
E -Enlargement of Organs, Glands, etc.-1. Disturbed, in dis- 
eases causing continued uneasiness. Example: Sore throat, rheuma- 
tism, etc. 
F.-Vascular Disturbance.-1. Flushed, in febrile disease. Ex- 
ample : Inflammatory fever. 2. Pale and languid. Example: Hemor- 
rhage, etc. (See Complexion.) 
COUNTER-IRRITATION, houn -ter-ir-re-ta'-shun [Lat. contra, 
against], is irritation or excited action in one portion of the body, which 
counteracts or withdraws analogous action going on in another portion. 
It may be naturally or artificially established, and it may be called into 
action within the body, as well as without; but the term is now gener- 
ally applied solely to counter-irritant action artificially excited upon the 
skin. There are many various modes of exciting counter-irritation: 
some may be, and are used, popularly, with perfect safety, others are 
only admissible in medical hands. 
Counter-irritants may simply produce reddening of the skin, or they 
may blister, or they may cause discharge of purulent matter, or even 
mortification of the surface. Heat, according to the temperature at 
which it is used, may give rise to any or all of these effects: mustard 
will redden smartly, and may blister; ammonia will do the same. CO ENTER-IRRITATION. 
491 
according to strength; camphor in solution, either in spirit or oil, will 
redden. Of the blistering counter-irritants the Spanish fly is the best, 
and almost universally employed. Boiling water, or its steam, or metal 
heated in boiling water, have all been used for the purpose, and might 
be, on emergency. Counter-irritation by tartar emetic, or tartarized 
antimony, takes the form of pustules or pimples. The salt is applied 
either in the form of ointment, or as a saturated solution, used as hot as 
can be borne, and rubbed upon the skin by means of a piece of flannel. 
The pustules formed by the latter mode are said to heal speedily, and to 
leave no scar, which sometimes happens after the ointment. When a 
common blister is irritated, "kept open," secretion of purulent matter 
takes place; but the system is a bad one, and is productive of much 
unnecessary pain and irritation. 
Issues and setons cause discharge of matter. Counter-irritation, by 
means of galvanic agency, has recently attracted notice. 
Iron heated to a red or white heat, moxas, and other applications 
which destroy the texture to which they are applied, fall under the head 
of cauterants, and can never be used as domestic remedies. There is, 
however, one application of the hot iron, introduced by Dr. Corrigan, of 
Dublin, which might safely be used by the non-professional, and as the 
instrument can be made by any blacksmith, might prove a valuable 
resource in remote districts, for the relief of nervous and rheumatic pains, 
such as lumbago, sciatica, etc., in which it is often of essential service. 
The instrument consists of an iron portion about four inches and a 
half long, which ends in a disk half an inch in diameter, end quarter of 
an inch thick, and a wooden handle. The disk is to be introduced into 
the flame of a spirit-lamp, or of a piece of burning paper, and held till 
the metal becomes uncomfortably hot; the handle is then to be grasped, 
and the disk applied lightly, and momentarily, and at short intervals, to 
the skin over the affected part. Each touch of the disk produces a 
shining mark on the skin, and very shortly the whole surface becomes 
reddened and slightly inflamed. 
As regards the use of counter-irritants generally, it is often service- 
able to excite the skin by friction, or heat, before using them. When 
fever is present and inflammation going on, non-professional persons will 
do quite as much, if not more good, and be much less likely to do 
harm, by using the mild counter-irritation of moist heat, than by apply- 
ing blisters, mustards, etc., particularly close upon the seat of the dis- 
ease. If a blister is put on in these cases, it should be a large one. 
For further information respecting the counter-irritants individually, the 
reader is referred to the various articles. 
An excellent counter-irritant liniment is made by mixing 1 dram of 492 
CO UNTERMRRITATION- CRAMP. 
croton-oil with 7 drams of soap liniment. A teaspoonful rubbed on the 
skin quickly brings out a crop of eruption. The person who rubs it on 
should wash the hands at once. (See Mustard, Croton, etc.) 
COUNTRY AIR. (See Air.) 
COUP DE SOLEIL, OR SUNSTROKE. (See Sunstrokes.) 
COURSES. (See Menstruation.) 
COWHAGE. (See Mucuna. ) 
COW-POX. (See Vaccination.) 
CRACKED WHEAT, krakt hweet. A very wholesome, nutritious, 
laxative diet. (See Food.) 
CRADLE, krd-dl [K^.-^WL.cradel, cradV}. The old form of child's 
bed, is now nearly superseded by the more convenient bassinet. Either, 
if well arranged, should have a tolerably firm mattress^ a firm pillow, a 
piece of protective waterproof cloth over the mattress, and soft blankets, 
but no curtains, which are incompatible with the health of the child. 
Rockers beneath, if they allow only very gentle motion, are admissible, 
but not otherwise. (See Child, Children.) 
CRAMP, kramp [Ang.-Sax. hramma, Du. kramp}, is a spasmodic, 
involuntary, and painful contraction of the muscular fibres. The term 
is generally applied to the affection of the voluntary muscles, in contra- 
distinction to spasm, applied to that of the involuntary. Any muscles 
may become affected with cramp, but those of the legs and arms, of the 
former especially, are most liable to be so, doubtless from the greater 
liability of the nerves supplying the lower extremities, to irritation and 
pressure, two great exciting causes of the disorder. The cramp may be 
confined to one or two muscles, such as those of the calves of the legs, 
or may be more general, as happens in cholera. The affected fibres are 
drawn in hard knotty contractions, and maintain this condition for a 
longer or shorter time. The most frequent causes of cramp, are the 
presence of indigestible food in the stomach, or of acid in the bowels, or 
the pressure exerted on the nerves by overloaded bowels. A similar 
acting cause in pregnancy and labor, the weight and pressure of the 
child, also occasions painful and troublesome cramp. The disorder is 
often associated with the presence of worms. When cramp affects the 
arms and fingers, it may be connected with disease of the heart and 
great blood-vessels of the chest. The power of the application of sudden 
and prolonged cold in producing cramp, is often sadly exemplified in the 
case of bathers. 
The best immediate remedy for cramp is friction with the hand, or 
better still, with the soap and opium liniment. When the legs are 
affected, it is always expedient to take medicine, rhubarb and magnesia, 
with 1 teaspoonful of sal-volatile, or 15 grains of carbonate of soda, CRAMP-CREAM OF TARTAR. 
493 
with sal-volatile, or a little ginger; and afterwards to clear out the 
bowels with some active aperient, such as castor-oil, especially if there is 
any existing constipation, or a possibility of their being loaded. Any 
other disorder of the digestive organs ought of course to be attended to. 
Some persons find relief to the immediate attack of cramp, by tying a 
band of some kind tightly round the limb, between the affected part and 
the body, whilst others are in the habit of standing upon some cold sub- 
stance. The first process is perfectly safe, and may be tried; the second 
certainly is often effectual, but it is not devoid of danger. Active friction 
is quite the best temporary remedy. Cramp affecting the arms is always 
to be regarded with suspicion, if it recurs, a medical opinion should be 
taken. (See Convulsions, Spasm, etc.) 
CRAMP-BARK. (See Viburnum Opulus.) 
CRANBERRY, kran -ber-re, a very wholesome red berry, of acid 
taste, much used as a sauce. The species most commonly found in the 
United States, is the Oxy coccus macrocarpus. 
CRANESBILL. (See Geranium Maculatum.) 
CRANIOTOMY, kra-ne-ot'-o-me^ a desperate resource of the accou- 
cheur in those cases where, from deformity of the pelvis, the head 
cannot pass through it, even with the assistance of forceps, and where, 
the child being dead, the Caesarian section cannot be employed. It is 
done with a perforator, cautiously introduced during an interval from 
pain. The point of the instrument is directed so as to enter a fontanelle 
or suture, and, being introduced, the handles are opened, and the 
instrument rotated so as to break up the brain. 
CRANIUM, kra'-ne-um, the skull containing the brain. (See Skull, 
Anatomy, Brain.) 
CREAM, kreme [Lat. cr&mor\ is that bland oily portion of the milk 
which separates and floats on the top; its composition is very nearly 
that of fat. It is a constituent of the milk of all animals. As the amount 
of cream, contained in cows' milk especially, varies considerably, the 
proportion may be ascertained by allowing the milk to repose in tall 
cylindrical glasses. Zinc pans have been recommended for use in 
dairies, as exerting some chemical action upon the milk, and causing the 
more abundant separation of cream. If there is chemical action, there 
must be danger of impregnation from the metal, and though it may be 
slight, it is better avoided. Cream is nourishing, but not suited for 
weak stomachs, except in small quantity, mixed with other articles of 
diet, such as arrowroot mucilage, when it may sometimes be advantage- 
ously substituted for a larger proportion of milk. (See Milk.) 
CREAM OF TARTAR, in Chemistry, bitartrate of potash. (See 
Potash. ) 494 
CREASOTE- CRISIS. 
CREASOTE, lere'-a-8ote [Gr. kreas, flesh; sozo, I preserve], a fluid 
containing oxygen, hydrogen, and carbon, first found by Reichenbach, 
in the heavy oil obtained by the distillation of wood-tar. When pure, it 
is a colorless oily liquid, of high refractive power, boiling at 398°. It 
has a burning taste, and its odor is peculiar. It is sparingly soluble in 
water, to which it gives its odor and taste, is freely soluble in acetic 
acid, alcohol, ether, benzole, and tersulphide of carbon. It coagulates 
albumen immediately, and is one of the most powerful antiseptics 
known. Meat that has been plunged into a solution containing only one 
per cent, of this substance becomes dry and hard on exposure to the air, 
and does not become putrid. Creasote given internally acts as a seda- 
tive, and is very useful in certain disorders of the stomach, especially in 
allaying severe vomiting. Dose, 1 to 3 drops. Applied externally, it 
serves to allay rheumatic and neuralgic pains, and will frequently remove 
toothache. It is also useful in inducing a healthy action in indolent 
sores. Creasote ointment consists of 1 fluid dram of creasote, and 1 ounce 
of simple ointment thoroughly mixed. Creasote mixture consists of 16 
drops each of creasote and glacial acetic acid, % teaspoonful of spirit of 
juniper, 1 fluid ounce of syrup, and 15 fluid ounces of distilled water. 
Dose, 1 to 2 fluid ounces. Creasote is also sometimes inhaled by mix- 
ing 12 drops with 8 fluid ounces of boiling water, in an apparatus so 
constructed that air may pass through the solution and be afterwards 
inhaled. 
CREATINE, kre-a-tin, is a crystallizable substance, existing in the 
flesh of animals. 
CREPITATION, Icrep-e-td-skun ^from crepito, to make a crashing 
or crackling noise]. 1. The peculiar sound or sensation occasioned by 
pressure between the fingers, in cellular tissue filled with air: as the 
lungs in their natural state, or a part affected with emphysema or gan- 
grene. 2. The grating of the ends of broken bones. 
CRESSES, kres'-ez, in the various forms of land and water-cresses, 
are wholesome salads, but like other vegetables which are eaten un- 
cooked, are not likely to agree with those of weak digestion. Water- 
cresses, so famed popularly, for their effect in purifying the blood, prob- 
ably owe their beneficial influence to the presence of a small portion of 
iodine. 
CRETA, kre-ta^ Lat. for chalk. (See Chalk.) 
CRISIS, kri'-sis [Gr. krino., I decide], in Medicine, denotes the 
decisive period or event of a disease-a sudden and considerable change 
of any kind, o«curring in the course of its progress, and producing an 
influence upon its character. Among ancient physicians, it was applied 
to that tendency which fevers were supposed to possess, of undergoing CRISIS- CR OTON. 
495 
a sudden change at particular periods of their progress. Hence there 
were what were called critical days-certain days in the progress of an 
acute disease on which a sudden change, either favorable or unfavorable, 
would take place, the seventh, fourteenth, and twentieth or twenty-first 
days, were regarded as eminently critical. In the course of acute 
diseases, and particularly of fevers, there usually occurs, after a certain 
time, some abundant excretory discharge, perspiration, diuresis, or 
purging, attended by a sudden fall in the temperature of the body. The 
term crisis is applied to this period of the disease, and the particular day 
on which it happens, counting from the day of seizure, is called the 
critical day, from which dates the period of convalescence, the patient 
having then got what, in common language, is called the "turn." 
CROCUS SATIVUS, kro'-kus sa-ti'-vus, saffron. A perennial plant 
belonging to the Nat. order Iridacea. It is a native of Greece and Asia 
Minor, and is much cultivated in many parts of Europe. The stigmas 
of the flowers are the parts used in Medicine. The dried stigmas, with 
the top of the style constitute hay-saffron, or when pressed together 
cake-saffron. Saffron is emmenagogue and diaphoretic, and has been 
used with benefit in chlorosis, hysteria, and suppression of the menstrual 
discharge. It is a well-known domestic remedy in the jaundice of new- 
born infants, and in promoting the eruption in scarlet fever and measles. 
Dose: of the infusion, 2 to 4 ounces; fluid extract, 20 to 60 drops; 
tincture, to 2 teaspoonfuls, to be taken three or four times a day. (See 
Infusion. ) 
CROTON, kro'-tun [Gr. kroton, the dog-tick, in reference to the 
resemblance of the seeds to that vermin], a genus of plants belonging to 
the Nat. order Euphorblacem. The seeds of the species C. Tiglium, 
and probably also those of C. Parana, constitute the croton, or tiglium 
seeds, of the materia medica. They yield, by expression, an oil called 
croton-oil, of a brownish-yellow color, slightly viscid, of an acrid taste, 
and with a faintly nauseous odor. In doses of 1 to 3 drops, it is a 
powerful drastic cathartic, and, when applied externally, acts as a rube- 
facient and counter-irritant. The croton-oil liniment of the Pharma- 
copoeia is composed of 1 fluid ounce of croton-oil, and 3| fluid ounces 
each of oil of cajeput and rectified spirit, and is very useful as a counter- 
irritant in subacute inflammation of the chest, bringing out an eruption 
of pustules in a few hours. The seeds are used without preparation, in 
India, as purgative pills. C. Eleut&ria and Cascarilla, natives of the 
Bahama Islands and Jamaica, yield the aromatic tonic bark commonly 
known as cascarilla or eleutheria bark. It is warm and bitter to the 
taste, and emits a fragrant odor when burned. It is aromatic and tonic, 
and is employed when a pleasant and gently stimulant tonic is desirable; 496 
CROTON-CROUP. 
as in dyspepsia, chronic diarrhoea and dysentery, flatulent colic, and 
other cases of debility of the stomach and bowels. It is sometimes 
advantageously combined with the more powerful bitters. Cascarilla 
counteracts the tendency of cinchona to produce nausea. The infusion, 
1 ounce of the powdered bark to 10 fluid ounces of boiling water, is 
given in doses of 1 to 2 fluid ounces ; the tincture, 2| ounces of bark, 
bruised, to 1 pint of proof spirit, in doses of | to 2 teaspoonfuls; the 
fluid extract is given in doses of 20 to 60 drops. 
CROTON-OIL. (See Croton.) 
CROUP, kroop [Ang.-Sax. hreopan\. Croup consists of inflamma- 
tion of the mucous membrane of the windpipe, which is a continuation 
downwards of the larynx. It occurs most frequently in male children, 
and the second year is the usual period for its attack. It is essentially 
a disease of infants, as inflammation of the larynx is peculiar to adults. 
Why inflammation should be generally found in the one case in the 
larynx and in the other in the windpipe it is difficult to say; for, 
although croup may affect the larynx in some cases, still it has its origin 
in the windpipe. Croup is peculiar, too, in another respect, viz.: that, 
contrary to the usual process of inflammation affecting mucous tissues, 
there are false membranes formed resembling those produced by the 
serous membranes under the action of inflammation, but differing from 
them in being more albuminous, more brittle, and less fibrous, and in 
not becoming organized and developed into permanent structures of the 
organism. 
Causes.-The causes of croup are almost invariably connected with 
cold and moisture, particularly during east winds; but it may also be 
occasioned by the removal of wrappings from the throat, and exposure 
to a cool air, when a child is heated. Children liable to croup are still 
more so after attacks of acute or debilitating disease. 
There are certain families the members of which are more subject to 
croup than others. Dr. Wood of Philadelphia speaks of the disease as 
running in families. All the children of certain parents suffer from it, 
while those of others escape. Haase mentions the death of four children, 
the offspring of one mother, within six weeks, from this disease; and 
there are probably few persons who, within the circle of their own 
acquaintance, have not heard of a similar though not so harrowing 
a domestic calamity. 
The occurrence of croup is, to a very considerable extent, influenced 
by climate and locality. Certain climates and localities there are 
which, to all appearance, favor its origination. It is more common in 
northern than in southern countries. Dr. Alison considers croup to be 
generally produced by a combination of cold with moisture; hence it is CROUP. 
497 
observed to be remarkably more frequent in low moist situations than in 
higher grounds, and in wet weather than in cold. 
Symptoms.-Croup comes on with the ordinary symptoms of catarrh: 
the child is said to have a "cold," he begins to sneeze and cough, the 
eyes and nose pour out abundant secretions, and the voice becomes 
gruff and hoarse, and this is a symptom which should always arouse 
suspicion on the part of the anxious mother; the little patient is fever- 
ish, his tongue is white and furred, the pulse becomes frequent and 
hard, and the breathing more and more difficult, and attended with a 
"crowing" inspiration; the face is flushed, and the skin hot and dry. 
The cough is of a ringing, brassy, metallic character, adding to the dis- 
tress caused by the above-detailed symptoms. As the disease makes pro- 
gress-as it rapidly will do unless cut short by active antiphlogistic treat- 
ment-the child's powers begin to fail, his skin becomes cold and blue, 
his face livid and expressive of great anxiety and distress; the cough 
loses its metallic character and becomes much less noisy, and the voice 
ceases to be audible. As it is drawing to its close, the little patient 
thrusts his head back, the eyes become prominent and staring, and the 
pupils dilated, the nostrils are widely opened, drowsiness supervenes, 
and the child struggles for his breath, and gradually sinks, being ex- 
hausted by this slow progress of strangulation, and narcotized by the 
circulation of non-aerated blood. 
This affection usually comes on in the middle of the night: the child 
is put to bed apparently in good health, but wakes towards morning 
with the characteristic inspiration. It resembles inflammation of the 
larynx in running a very rapid course, being sometimes fatal within the 
twenty-four hours. 
Treatment.-Every case of this disease requires treatment the most 
active, efficient, and energetic. In cases where an attack is merely 
apprehended, in which such symptoms as feverishness, a dry, with per- 
haps slightly ringing cough exist, care should be taken that the child so 
affected is watched night and day. For the relief of such symptoms, 
the warm bath should be resorted to, or what will in the author's opinion 
answer equally well, large poultices of hot moist bran should be placed 
over the upper part of the chest and fore-part of the throat, whilst tho 
child is kept in a sufficiently warm situation. In the habitations of the 
poor, especially, the latter mode of treatment is certainly preferable to 
the bath, which cannot always be procured without delay, nor managed 
without danger of after chill. Confinement to bed, at all events to one 
room, and spare diet, should be ordered. In such circumstances the 
employment of an emetic, the wine of ipecacuanha, or antimony (for a 
very young child, the former), often brings relief. Ten or 15 drops of 498 
CROUP. 
the wine or syrup of ipecac, may be given with a little warm water every 
ten minutes till vomiting occurs ; this effect being produced, it may be 
well, by smaller and less frequently repeated doses, to keep up for a 
short time the nauseating action of the ipecacuanha or antimony; while 
a little saline medicine to 1 teaspoonful of sulphate of magnesia) is 
given to act upon the bowels. It is very necessary to attend to the regu- 
lation of the temperature of the room occupied by the child; it should be 
both warm and moist-not lower than 65° Fahr. To convey some moist- 
ure into the air of the apartment, the steam from a boiler or kettle on the 
fire may be directed through a simple roll of paper. Care must also be 
taken that there is no draught of cold or cool air. By attention to these 
simple instructions attacks of croup may be warded off; and their appli- 
cation is specially important in the case of children who have either pre- 
viously suffered from the disease or belong to a family the members of 
which are subject to it. 
There are a few other points to which it is of great consequence to 
attend in the treatment of croup, as well as of threatened croup: 1. 
See that, for the purpose of enabling the breathing to be as free as 
possible, the little patient is placed with the head a little higher than 
the body. 2. Let there be no external circumstances tending to obstruct 
the breathing, no pressure of the bed-clothes on the chest or neck. 3. 
Let the child drink freely of bland fluids (water, milk, toast and water, 
barley-water); this for two reasons-to prevent the throat getting dry, 
and to supply the fluids of the system which are deficient. 
If the disease sets in violently, more energetic remedies must be 
used, and that promptly. Vomiting must be excited as soon as possible, 
and a state of nausea hept up. This may be accomplished by the 
administration of 20 to 30 drops of wine or syrup of ipecac, given every 
ten or fifteen minutes until vomiting ensues, and then every hour or two 
until recovery takes place. One-sixth or one-eighth of a grain of tartar 
emetic dissolved in hot water and given every few minutes, will some- 
times answer better than the ipecac. If these remedies are not at hand, 1 
teaspoonful of powdered alum, in some thin syrup, will very promptly pro- 
duce vomiting. The child affected with violent croup should be placed 
for several minutes in the hot bath ; and, after removal from it, a sponge 
dipped in hot water should be closely applied to the neck, the applica- 
tion being renewed from time to time as the sponge cools. The late Dr. 
Graves, a distinguished Dublin physician, bore a high testimony to the 
value of the hot sponge. If the disease has advanced to a further stage, 
and there exists prostration to any extent, then such remedies as those 
now mentioned, which are depressing, must be considered as inadmis- 
sible ; and while it is, in such circumstances, still desirable to produce CROUP-CROUP, FALSE, ETC. 
499 
vomiting, that must be accomplished, not by the exhibition of antimony 
or ipecacuanha, but by sulphate of copper, of which to grain may be 
given in water every ten minutes till vomiting occurs. 
When an appearance of sinking is visible, stimulants, wine, and 
strong beef-tea, must be administered ; and while all such cases must be 
regarded as fraught with danger, there is yet often room for hope ; for 
even in circumstances apparently the most desperate, and when medical 
appliances have been abandoned, a sudden improvement has taken 
place, a portion of the false membrane obstructing the air-passages 
expectorated, and ultimate recovery occurred. 
Tracheotomy, or making an artificial opening into the windpipe, is 
not so successful in this disease as in laryngeal inflammation, for false 
membranes are formed the whole way down the windpipe; but in a few 
cases it has been successful, when there were either no adventitious 
membranes produced, or where they were limited to the upper part of 
the windpipe and larynx. 
Prevention.-The prevention of croup is, of course, of the highest 
importance, and, therefore, the causes of it enumerated in the first part 
of this article must be avoided in every way; slight colds should never 
be neglected in children of families predisposed, but should be treated 
by confinement to the house, or to bed if requisite, by milk diet, diluent 
drinks, and by the tolu cough mixtures with the addition of ipecacuanha 
wine (see cough mixtures in article Cough) ; paregoric should also be 
given to allay troublesome cough, and, in fact, those measures recom- 
mended in the subjects Catarrh or Common Cold, and Snuffles, carried 
out. The susceptibility may also be lessened, by not clothing the throat 
too warmly, and by the regular practice of bathing the throat and chest 
well with cold water every morning, rubbing afterwards with a rough 
towel till thorough reaction ensues. This practice is, of course, better 
commenced in warm weather, and not too soon after an attack of the 
disease. Flannel should always be worn next the skin, and care taken 
particularly, that bed-chambers, and rooms children habitually live in, 
are not too warm, and never occupied whilst the floors are wet after 
washing. A residence at a distance from water is to be preferred. (See 
Croup, False ; Antimony, Ipecacuanha, Baths and Bathing, Cough, 
Child, Larynx, Trachea, Climate, Cold, Cold Feet, Damp, Houses, 
Walls and Wall Papers, Flannel, Clothing, Barley-Water, Beef- 
Tea, Atomizer, Inhalation, Catarrh or Common Cold, Snuffles, etc.) 
CROUP, FALSE; SPASMODIC CROUP, OR CHILD-CROW- 
ING. 
Causes.-The occurrence of this disease is, to a considerable extent, 
under the influence of climate and season. In dry and warm climates 500 
CROUP, FALSE, ETC. 
it is little known, hence it is not familiar to many German and French 
writers. Damp situations and seasons predispose to, as well as act 
directly in exciting the disease; it is also aggravated by the changes of 
temperature. Let it be borne in mind, that indiscretions in the matter 
of diet very clearly predispose to it. Children of the scrofulous consti- 
tution (for description of what is thus meant, see Scrofula), and especi- 
ally such as suffer from enlargement of the cervical glands, are subject 
to this disease. The great majority of patients affected with this disease 
are very young children. Among those causes which seem to act most 
powerfully in directly exciting the affection, are the irritation in the 
gums during teething, the presence of worms in the bowels, or of indi- 
gestible articles of food in the stomach, and also eruptions on the scalp, 
and exposure to cold and damp. Paroxysms of the disease are apt to 
be excited by violent muscular movements, by crying, cough, sudden 
awakening from sleep, or sudden application of cold. 
Symptoms.-This is a disease of a nervous character, closely resem- 
bling in its symptoms and mode of attack the true form of croup (see 
Croup.) It occurs quite suddenly during the night, the child wakes up 
and is unable to inspire, it struggles for breath, and at last the act of 
inspiration is performed with a whistling or crowing sound. It has been 
variously named by different writers: some call it spasmodic croup, 
others child-crowing, and still others false, or bastard croup, and Dr. 
Mason Good gave it the pedantic title of laryngismus stridulus. This 
affection is due to the spasmodic contraction of the small muscles guard- 
ing the entrance of the larynx and windpipe, and unless this spasm be 
in due time overcome, the little patient falls lifeless upon its nurse's 
lap, but more commonly the spasm, after lasting for a few seconds, 
relaxes, and the child is released from its sufferings and danger. This 
spurious affection may be distinguished from true croup by the absence 
of ah inflammatory and feverish symptoms. 
Treatment.-What is the proper treatment to be pursued in this 
affection? First, what is the plan to adopt when the child is suddenly 
seized? Let him be placed as quickly as possible in a warm bath (see 
Baths and Bathing.) While this is being prepared, let a sponge, pre- 
viously dipped in hot water, be applied over the throat; and as the 
sponge cools, let the reapplication be continued. A sudden clap on the 
back, or the dashing of a little cold water over the face and body, may 
suffice to undo the spasm, and these simple means should not be 
neglected. Under all circumstances let an emetic be immediately 
administered; this can be done while the patient remains in the bath. 
For this purpose, the safest and best remedy is the wine or syrup of 
ipecac, in doses of 15 drops to % a teaspoonful, every ten or fifteen CP O UP, FALSE, ETC.-CP YSTALLINE LENS. 
501 
minutes, until vomiting ensues. A bottle of either the wine or syrup 
should always be at hand in every house where there is a sufferer from 
false croup. In cases where the ipecac is not at hand, a teaspoonful of 
mustard, stirred up in water, will meet the emergency. If these means 
are insufficient to reduce the spasm, there are still others in the hands 
of the physician, but he must be present to execute them. 
Preventive treatment.-But something more is required than atten- 
tion to the paroxysm itself. The tendency to it may continue. It 
then becomes a matter of importance to determine whether any cause, 
distant it may be (that is, in a remote part of the body), exists; if 
dentition is painful and difficult, the gums must be lanced; if worms are 
present, some suitable vermifuge remedy must be administered, say 2 
grains of santonine in thin syrup, at intervals of six hours, until three doses 
have been taken, followed by a dose of castor-oil or infusion of senna; 
and if there be an irritating scalp eruption, those appliances must be 
used which tend to soothe or entirely remove it. If the child suffer 
from enlargement of the cervical glands, or present other manifestations 
of the scrofulous constitution, the general health must, if possible, be 
improved, by such means as a nourishing diet, taking care that the 
child's supper is plain and light, and remedies such as cod-liver oil, or 
phosphate of lime, in doses of 5 to 10 grains, administered in chalk 
mixture thrice daily, as suggested by Dr. William Budd; the syrup of 
the iodide of iron in 5 drop doses, three times a day, etc. Lastly, and 
very important in the treatment of this disease, change of air, specially 
from an impure or damp to fresh and more bracing air, is oftentimes a 
potent remedy; it may always be regarded as a powerful adjuvant in 
every tedious case. Nor need the removal be to a great distance. (See 
Croup, Spasm, Scrofula, Dentition, Worms, Ipecacuanha, Santonine, 
Flannel, Clothing, Climate, Baths and Bathing, Houses, Damp, Cold, 
Cold Feet, Child.) 
CROW CORN. (See Aletris.) 
CRY OF CHILDREN, kri tshiV-dren [Goth, greitan^ Ang.- 
Sax. graetan}. The principal distinctive difference in the cry of chil- 
dren is, whether it be that of expiration from, or inspiration into, the 
lungs. The cry of a strong child, suffering pain, is more of the expira- 
tory; that of a weak, exhausted child of the inspiratory, or sobbing 
character. (See Children.) 
CRYSTALLINE LENS, kris'-tal-line [Lat. cry st alius, a crystal; 
lens}, is the lens of the eye, a lentiform pellucid substance, enclosed in a 
membranous capsule, and situated in a depression in the anterior part 
of the vitreous humor. Opacity of this substance is the disease known 
as cataract. (See Eye, Couching.) 502 
CP YSTALLIZATION- CUPPING. 
CRYSTALLIZATION, kris-tql-le-za-shun, may be defined as the 
spontaneous assumption of well-defined geometrical forms by bodies in 
passing from the fluid or aeriform state to the solid condition. Bodies 
not capable of assuming the crystalline form are termed amorphous, or 
colloid; those -which form crystals, crystalloid. When a substance 
crystallizes in two distinct forms, which cannot be derived from the same 
original, it is said to be dimorphous. Sulphur, for instance, will crys- 
tallize in octahedra, or prismatic crystals. Some substances are even 
trimorphous. Sulphate of nickel crystallizes in light rhombic prisms, 
square-based octahedra, and oblique rhombic prisms, according to the 
temperature at the time of evaporation. Bodies crystallizing in similar 
forms are called isomorphic. Crystallization may be effected in several 
ways-by evaporation, by sublimation, by fusion, or by slow electrical 
action. 
CUBEBA, ku-be-bq [Arab. cubabaK\, a genus of plants belonging 
to the Nat. order Piper aceoe. The species C. officinalis, or Piper 
cubeba, a native of Java and Prince of Wales' Island, yields the 
berries called cubebs, which are extensively employed in medicine 
for their peculiar power of arresting excessive discharges from the 
urethra. Cubebs resemble black pepper, but may be distinguished by 
the network of raised veins on their surface, also by the short stalks 
which they possess. Cubebs is a well tried remedy in the treatment of 
gonorrhoea. It is aromatic, pungent, stimulant, and purgative, and acts 
as a specific in arresting gonorrhoeal discharges. It has also been given 
in the whites, abscess of the prostate gland, piles, chronic bronchial 
inflammation, and incontinence of urine. The use of cubebs is contra- 
indicated during a high inflammatory condition, and is advised to be 
used in gonorrhoea only when the inflammation is confined to the mucous 
membrane of the urethra. Dose of powder, 30 to 120 grains, three 
times a day. The oil of cubebs is obtained by distillation, and is given 
in doses of 5 to 20 drops. The tincture, 2^- ounces in powder to 1 pint 
of rectified spirit, is prescribed in doses of % to 2 teaspoonfuls. Dose of 
fluid extract of cubebs, $ to teaspoonfuls. To be taken three or four 
times a day. (See Gonorrhcea.) 
CUBEBS. (See Cubeba.) 
CUCKOO-PINT. (See Arum.) 
CUCUMBER, ku'-kum-bur [Lat. cucumis], a pleasant article of diet 
for the strong, but a very unwholesome one for invalids. 
CULVER'S ROOT, OR CULVER'S PHYSIC. (See Leptandra 
VlRGINICA.) 
CUPPING, kup'-ping [from the cup-like form of the glasses em- 
ployed], is a process of blood-letting, by which blood is drawn from CUPPING. 
503 
wounds made for the purpose, by the agency of suction, exerted by a 
cup or other vessel exhausted of air, or nearly so. • It is a very old 
surgical expedient, and in former times it was, and, indeed, among 
uncivilized nations at the present time, it is still effected by the primitive 
agency of a sharp flint or knife, and a cow's horn with the tip removed, 
suction being made by the mouth of the operator. In modern surgery, 
cupping, when w'ell performed, is at once one of the most elegant and 
most useful of our methods of treatment. For the purpose of wounding 
the skin, a metallic box, containing a set of lancets, varying in number, 
is provided; in this box, which is called the scarificator, the lancets are 
so fixed as to be discharged, when set or cocked, by a trigger and spring, 
which cause them to pass rapidly through the skin in a semicircular 
sweep, so rapidly indeed, that the usual sensation of cutting is not felt. 
The most convenient number of lancets is twelve, and the depth of the 
wound made by them can be increased or diminished by turning the 
screw; this must be done while they are fixed at half-cock, and protrud- 
ing from the instrument. The only other essentials for cupping are, a 
vessel from which the air can be exhausted, and kept so when it is 
applied to the skin, and a flame of some kind, or some other means, for 
exhausting the air. There are, however, sundry other little requisites 
convenient for the operation, to be mentioned hereafter. 
Cupping is applicable in most instances where local abstraction of 
blood is called for, and may often be substituted for leeches, and even 
for general bleeding; it is a safe operation when used in proper situa- 
tions, and one may be taught its performance by a few practical lessons; 
it is, moreover, a most useful accomplishment for persons who are far 
removed from medical assistance. It is hoped that the following details 
may be sufficiently clear, to enable even those who have never seen 
cupping performed to effect it in case of need; but by all means, let 
every one who contemplates the possibility of such a requirement get 
practical instruction, which there can be no difficulty in doing. 
Cupping glasses of various kinds are, and have.been used, but the 
most general is the bell-shaped form of various sizes; some of these are 
made with brass fittings at the top for the attachment of an exhausting 
syringe ; but the most useful form of all, and that most easily applicable 
by an unpracticed or an unprofessional hand, is the leech cupping-glass. 
When this is used, the lamp or torch is not required as it is for the 
application of the bell-shaped glass; the torch is simply a lamp made 
for burning spirits of wine, by means of a wick which will afford a large 
flame. 
Cupping may be performed in most situations on which it is possible 
to fix a glass, by a proficient, but the range of the unprofessional operator 504 
CUPPING. 
must be much more limited, partly on the score of safety, but also for 
the reason, that in some situations they are not likely to draw blood 
sufficient to effect any good object. As a general definition, an unpro- 
fessional person may cup anywhere upon the back of the trunk of the 
body, from and including the nape of the neck, to the bottom of the 
spine, and also on the forepart of the chest. In selecting a place 
within the above limit, it should always be ascertained that there is 
room for the rim of the glass to be in contact with the skin throughout 
its entire circle. It being pre-supposed that the abstraction of blood is 
called for, and it being also pre-supposed that the intending operator is 
provided with the necessary instruments, he should also have some 
warm water, a good-sized piece of sponge, or, in lieu of it, a piece of 
flannel, a light, and some plaster. 
The person to be operated upon being conveniently placed, and the 
skin bared, it should be moistened with warm water, or the circulation 
of the part excited by means of hot water fomentation applied for some 
time; an exhausted glass is then to be applied for a few minutes, 
removed, the scarificator placed upon the portion of skin which had 
been drawn up by the glass, and the lancets, which have been put on 
full cock, discharged. The scarificator being removed, the exhausted 
glass is again to be applied over the wounds made by the lancets; the 
blood ought immediately to comlnence flowing. If the bell-shaped glass 
is used, when applied, one edge should be made to rest upon the skin, 
the flame of the spirit-torch passed rapidly under it, and withdrawn, and 
the glass at the same instant pressed entirely down upon the skin. This 
is the point of the operation most difficult to perform well and efficiently 
by the unpractised; for if the exhaustion is incomplete, suction, and con- 
sequently the abstraction of blood, are so likewise; and in endeavoring 
to make the movements quickly, there is a liability of burning the skin. 
Fortunately, an individual can practice the manoeuvre upon the skin of 
his own thigh at any time. Much of this is avoided by the use of the 
leech cupping-glass, from which the air is exhausted by simply putting 
into it a small fragment of paper, half an inch square, dipped in spirits 
of wine, or spirit of some sort. A short piece of wire, with a small por- 
tion of tow tied to the end of it, and dipped in the spirit, is used to 
ignite the paper in the glass, the latter being applied to the skin the 
moment this is done, and the wire withdrawn; the confined air ex- 
tinguishes the lighted paper in the cupping-glass at once. 
In addition to simplicity in application, the leech-glass has also the 
advantage of taking at once a considerably larger quantity of blood than 
the other form, and thus of requiring to be less frequently re-applied; 
moreover, the blood, as it flows, gravitates to the bottom of the glass, CUPPING. 
505 
and does not clot over the wounds, as it does with the bell-shaped in- 
strument. These remarks do not refer to the quick, elegant, and effici- 
ent manipulation of a professed cupper, but as the operation must be in 
the hands of the unskilled. When an applied cupping-glass is to be 
removed, it must be done by pressing down a portion of the skin at its 
■edge with the point of the finger, so as to admit the air, which enters 
with a hiss. If, after a cupping-glass has been on some time, the blood 
does not flow freely, but clots upon the wounds, and if it is desirable 
that more blood be drawn, the glass should be taken off, and-when 
the wounds have been cleansed with warm water-re-applied. When 
the operation is concluded, it is only necessary to cleanse the wounds, 
which will not continue to bleed in the situations indicated for cupping 
in this article, and to put a little adhesive plaster upon them. 
Such is the operation, under the pre-supposition that the operator is 
provided with the requisite instruments, but in the absence of these, very 
good substitutes may often be made. To make the incisions, which 
should be about the eighth of an inch in depth, any sharp instrument 
will suffice; for the cup, a tumbler or any similar vessel with a uniform 
rim will do; and to exhaust the air, whatever will blaze freely. In 
cases of poisoned wounds, the application of a cupping-glass, where it 
can be done, either with or without enlargement of the original wound, 
is a good precaution, and will retard the absorption of the poison, dur- 
ing the interval of procuring medical assistance. 
Dry cupping is a most useful remedy, perhaps too little used; it is 
the application of the cupping-glass for from ten to twenty minutes, 
without any previous scarification. The blood is thus withdrawn from 
parts in the vicinity of that operated on; and relief afforded, without 
weakening by actual abstraction of blood. In local congestions of blood, 
in local pain, etc., it is often of much service. The principle of dry cup- 
ping has been brought forward as a remedial measure on a large scale 
by M. Junot, who, by means of vessels capable of being exhausted 
after the manner of a cupping-glass, and which are made sufficiently 
large to include a whole limb, thus draws temporarily a great mass of 
blood-from three to four pounds-out of the current of the general 
circulation, and produces the effect of a large bleeding, without its 
weakening results. The method is said to be successful, but it has not 
been much employed in this country. 
Cupping is certainly a most useful accomplishment for the emigrant. 
It is a safe method, and when once practised, an easy one, of blood- 
letting ; but, by all means, let it be practically learned if possible, and 
then the above, though meant for all, will be more certainly useful in 
bringing back to the memory the minutiae which so aptly escape it. The 506 
CUPPING- CURRANTS. 
chief inconveniences of the leech cupping-glass are its greater bulk and 
liability to fracture than the bell-shaped form. (See Leech, Bleeding, 
Scarificator, etc.) 
CURARI, ku-ra'-ri, a violent poison used by the South American 
Indians to poison weapons. It is supposed to be obtained from a 
strychnos, and contains an alkaloid (curarine) of a yellowish amorphous 
form, which is very active. 
CURCUMA, kur-ku'-ma [Arab. curkum\ a genus of plants belong- 
ing to the Nat. order Zingiberacece. The rhizomes of O. angustifolia, 
contain much starch, which, when extracted, forms East Indian arrow- 
root, or curcuma starch. The dried tubers or rhizomes of C. Tonga, 
constitute the turmeric of the shops. It is extensively cultivated in 
almost every part of India, being employed as a condiment by the 
natives. It forms the principal ingredients of curry-powder, giving to 
that compound its peculiar odor and bright yellow color. As a medi- 
cinal agent, turmeric is a stimulant aromatic tonic, and is used especially 
in jaundice and the itch ; also employed in debilitated states of the 
stomach, intermittent fever, and dropsy. Dose: of the fluid extract, 2- 
to 3 teaspoonfuls ; infusion, 2 to 4 ounces. (See Infusion.) 
CURD. (See Cheese.) 
CURE BY NATURAL MEANS. The natural or hygienic means 
of cure are fully treated under various headings in this work. (See 
Digestion, Diet, Food, Breakfast, Luncheon, Dinner, Supper, Meals, 
Drinks ; Stimulants, Alcoholic ; Exercise, Air, Ventilation, Houses, 
Drainage, Sanitary Science, Climate, Health Resorts, Mineral. 
Waters, Ablution, Baths and Bathing, Cold, Damp, Cold Feet, Heat, 
Light, Clothing, Sleep, Disease, Life, Poverty, Riches, Marriage, 
Regimen, Occupation ; Rule, Living by ; Health, Longevity, Elec- 
tricity, Movement Cure, etc.) 
CURRANTS, kur'-ranz [from Corinth, where they were originally 
grown], the well-known fruit, either black, red, or white, are extremely 
wholesome, disagree with few, and are particularly well adapted, either 
fresh or cooked, to form part of the cooling diet requisite for health in 
very hot weather. Moreover, the mechanical action of their seeds has 
a most beneficial effect in exciting the bowels. Some bilious persons, 
say they find benefit from eating a few ripe red currants a short time 
before breakfast, and that the practice tends to keep off the increased 
liability to bilious attacks during the hot weather, when currants are in 
season. The black currant possesses more astringency than the other 
varieties, and when preserved, is much domestically used in sore throats,, 
etc.; it also acts upon the bowels. Boiling water poured upon a portion 
of currant preserve, and the infusion allowed to cool, forms one of the CUTE ANTS- CYANOSIS, ETC. 
507 
pleasantest and most useful of our fever beverages. Black currant 
leaves are used in infusion, as a domestic diuretic. What usually goes 
by the name of the dried black currant, is no currant at all, but a species 
of small grape. It is brought almost solely from the islands of the 
Levant. It is a favorite domestic aperient-particularly in the lying-in 
chamber-mixed with gruel. It probably acts mechanically. 
CURRY, kur'-re, is food of any kind prepared with the well-known 
condiment, curry-powder, which is composed of turmeric, cayenne and 
black peppers, mustard, ginger, and other spices. The preparation is 
not adapted for invalids, and should only be used sparingly by those in 
health, especially if they have any tendency to irritation of the stomach 
and bowels, or to head affections. It is probably better adapted, as 
regards wholesomeness, to give requisite stimulating power to the rice 
and other foods of hot climates, than as an addition to an animal diet. 
CURVATURE OF THE SPINE. (See Spine, Diseases and In- 
juries OF THE.) 
CUSPARIA BARK. (See Angustura Bark.) 
CUSSO, OR KOUSSO. (See Kousso, Brayera.) 
CUTANEOUS DISEASES. (See Skin, Diseases of the, etc.) 
CUTICLE. (See Skin.) 
CUTS. (See Wounds, Collodion.) 
CUT-THROAT, kut-throte . In this horrible casualty two dangers 
chiefly threaten life immediately: the one, death from immediate bleed- 
ing, if any of the large vessels have been divided, or if this has not 
been the case, death from blood finding its way into the windpipe. In 
the first, few unprofessional persons pould possess on the instant either 
sufficient knowledge or presence of mind to render much efficient assist- 
ance-certainly not in the case of the large arteries ; but bleeding from 
a small branch might be arrested by the means suggested in article 
Artery. Should a superficial vein be wounded, and pouring out dark 
blood, gentle pressure in its course, between the wound and the head, 
might be of service. To prevent the danger of suffocation, when the 
windpipe is opened, and when the bleeding does not immediately 
threaten life, the position of the person is the principal thing to be 
attended to; this should be either on the side, or on the face, in which- 
ever situation fluids may most easily run off without entering the tube. 
This being done, and some light gauze material thrown loosely over the 
wound, nothing more should be attempted before the arrival of that 
medical assistance which must as speedily as possible be procured. 
Above all things, no attempt should be made to close the wound. (See 
Wounds, Accidents.) 
CYANOSIS, OR BLUE DISEASE, si-amo'-sis [Gr. kuanos, blue], 508 
CYANOSIS, ETC-CYTISUS SCOPARIUS. 
is a diseased condition of the system arising from a malformation of the 
heart, which allows the intermixing of the venous with the arterial 
blood; in consequence of which the former is not properly oxygenized, 
and a blueness is imparted to the skin, whence the disease takes its 
name. It usually manifests itself soon after birth; and those affected 
by it generally die at a very early age, but occasionally they reach 
mature life. Little can be done in the treatment of this disease beyond 
the adoption of palliative measures. The avoidance of fatigue or mental 
excitement, nourishing diet, warm clothing, and a pure mild air, include 
probably all that can be done for the patient. 
CYNANCIIE, si-nang'-ke [Gr. kuon, a dog, and agcho, I strangle, 
from dogs being said to be subject to it], is used in Medicine to denote 
sore throat. (See Quinsy, Laryngitis, Croup, Diphtheria.) 
CYPRIPEDIUM PUBESCENS, sip-re-pe -de-um pudes'-sens, ladies' 
slipper. A perennial plant belonging to the Nat. order Orchidaceoe. It 
grows in most parts of the United States and Canada, and is known in 
different localities as nerve root, moccasin root, Indian shoe, bleeding 
heart, and American valerian. The roots are the parts used in medicine, 
and they contain a principle called Cypripedin. The root is tonic, nerv- 
ine, and antispasmodic. It is employed in nervous headache, nervous 
excitability, hysteria, neuralgia, and other morbid conditions of the 
nervous system. Dose: fluid extract, to 1 teaspoonful; infusion, 
1 to 4 ounces (see Infusion) ; solid extract, 5 to 15 grains ; cypripedin, 
2 to 4 grains; syrup, made by adding 4 ounces of the fluid extract to 
12 ounces of syrup, 2 to 4 teaspoonfuls. 
CYST, sist [Gr. kustis, a bladder], in Anatomy, is applied to the 
urinary bladder, gall bladder, and similar vessels in the human body; 
but it is also applied to morbid growths within the body, having the 
form of a bag or bladder, and enclosing morbid matter. 
CYSTITIS. (See Bladder, Diseases of the.) 
CYTISUS SCOPARIUS, sit'-e-sus skopa -re-us, common broom. 
A tree belonging to the Nat. order Leguminosoe^ common to Europe, 
and cultivated in the United States. It flowers in May and June. The 
tops, with the buds, are the officinal parts. In large doses, emetic and 
cathartic; in small ones, diuretic; used in dropsy; also to increase the 
flow of urine; and is said to be especially beneficial in dropsy of the 
chest, combined with diseased lungs. Dose: fluid extract, 20 to 30 
drops ; infusion, 1 ounce ; decoction, 1 ounce ; to be taken three or four 
times a day. (See Infusion, Decoction.) . DAMIANA-DAMP. 
509 
DAMIANA, dq-me-an'-q \Turnera Aphrodisiaca.^ Fluid extract 
of the plant. A Mexican drug, with strong aphrodisiac powers, for 
which is claimed great efficacy in sexual debility, or lethargy of the sex- 
ual organs, whether the result of abuse, or senility. Many cases of total 
or partial impotence have been cured by the use of this drug, where the 
usual remedies have given no relief. Used in the form of fluid extract. 
Dose : from to 1 teaspoonful three or four times a day. 
DAMP, damp. Moisture is one of the most prolific and most gener- 
ally acknowledged sources of disease; in whatever way applied to the 
body, whether in atmosphere, or clothing, or bed, it is alike apt to be 
productive of bad consequences, often of the most serious character. 
When combined with decaying vegetable matter, and more especially 
when favored by heat, fever and ague are the results of undue moisture ; 
when cold and damp unite their depressing influences, colds of every 
kind, inflammatory attacks, scrofula and consumption, rheumatism and 
neuralgia ensue. 
Dampness, or injurious excess of moisture, may depend upon the 
natural formation of the country, or character of the soil, or upon a 
superabundant growth of timber, which obstructs the drying effect of 
the sun's rays, and of a free circulation of air. The effects of these' con- 
ditions are evinced by the agues of the marsh districts, the cretinism, 
of the low, dark, damp valleys of the Alps, the fevers of the tropical 
forests and African rivers, or in a lesser degree by the relaxing effect of 
a damp and somewhat mild climate. The advance of the improvements 
of civilization does much, if it cannot do all, to rectify these sources of 
disease; the cutting of water courses, the clearing of timber, are for the 
most part attended with increased salubrity of the district. The latter, 
of course, requires circumspection; for much harm may be and has been 
done by the injudicious removal of protecting belts of trees; neither 
must it be forgot, as mentioned in article Ague, that the intervention of 
a wood may prevent the extension of the malaria of a marsh. But the 
shelter of trees is a different thing from closely encircling a house with 
them; they will retain moisture around, more or less according to the 
nature of the soil and the denseness of their growth, and in a way which 
is not compatible with health, 
Dampness and moisture in excess, cannot of course be prevented, 510 
DAMP. 
when owing to the vicinity of large bodies of water, but in such a case 
the chief evils to be dreaded are the cold winds which "come off the 
water" laden with vapor, and which, as happens in many situations, are 
liable to produce croup in children, and catarrhal affections in the pre- 
disposed. If these influences cannot be guarded against, of course re- 
moval is the only remedy. 
Damp houses must be unwholesome; if occupied too soon after 
building, disease, especially of a rheumatic character, is the frequent 
consequence. Most generally, insufficient drainage, particularly in the 
country, is the cause of dampness, and it is moreover, after a house has 
been built, one difficult to rectify, but it should be done as far as pos- 
sible ; even houses, which apparently stand high, are damp from this 
cause, especially if the ground slopes to, as well as from them. If no 
other remedy is available, nothing is so effectual as covering the damp 
floor with sheet lead, which effectually excludes the moisture, if it does 
not do away with the cause. 
If all houses were built as they should be, with hollow walls, and 
the walls lathed before being plastered, there would be few or no com- 
plaints of damp walls, which are so conducive to rheumatism and other 
diseases. 
Damp clothes and beds are so generally recognized as causes of 
disease, that the fact scarcely requires to be insisted on, or indeed the 
additional one, that when the former are unavoidable, the danger is 
much if not wholly done away with by continued active motion, which 
keeps up the animal temperature, and it is probable that this preventive, 
not being available in the case of the latter, renders a damp bed almost 
synonymous with disease and death. 
Damp, in most instances, acts, undoubtedly, by abstracting, either 
by evaporation or otherwise, the natural temperature of the body; but 
as dry cold does this likewise without producing the same certain 
injurious consequences, it is probable that moisture also calls into action 
changes connected with the electrical conditions of the body, of the 
precise nature of which we are not at present cognizant. One thing is 
certain, that moisture is always more apt to act injuriously upon the 
system when the nervous power is either depressed, or not in its full 
state of activity, as it is during sleep, or for the first hour or more in the 
morning, after rising, and before food of some kind has been taken; 
hence it is always found that fogs and moisture are much more likely to 
injure during the first morning period, and that the best protection is 
some warm food or drink, which may support or gently stimulate the' 
system. (See Ague, Neuralgia, Rheumatism, Catarrh, Consump- 
tion, etc.) Datura Stramonium. (Thorn-Apple.) DAMP AIR-DATURA STRAMONIUM. 
511 
DAMP AIR. (See Air, Damp.) 
DAMP BEDS. (See Damp.) 
DAMP CLOTHES. (See Damp.) 
DAMP HOUSES AND WALLS. (See Houses, Walls, Damp.) 
DANCING. (See Exercise.) 
DANCING MANIA, dan'-sing ma'-ne-q, an epidemic disorder 
among susceptible subjects, in which imitation is brought about under 
high excitement. It is closely allied to hysteria, and principally occurs 
among persons who are desirous of notoriety or sympathy. During the 
Middle Ages, epidemics of this class were common in Germany; and in 
Italy they were ascribed to the bite of the tarantula spider. Towards 
the close of the fourteenth century, a number of men and women 
appeared at Aix-la-Chapelle, on the festival of St. John, dancing and 
screaming in a frantic manner in the streets. Many foamed at the 
mouth, and danced till they fell down insensible; others dashed their 
brains out against the walls. While dancing they were unsusceptible of 
■outward impressions, but were haunted by visions. The epidemic spread 
over the Low Countries, and bands of wretched, ignorant people 
traversed the country, and, excited by wild music, danced themselves 
into convulsions, singing all the time in derision of the priests. At the 
beginning of the seventeenth century, St. Vitus's dance, as it was then 
called, was on the decline, and is now only heard of in isolated cases. 
(See Saint Vitus's Dance.) 
DANDELION. (See Taraxacum Dens Leonis.) 
DANDRIFF, DANDRUFF, OR SCURF, dan'-drif, dari-druf, are 
white scales or flakes which occur on the head, sometimes in great num- 
bers. It is a natural discharge of the skin, and only troublesome when 
excessive, but not in any way dangerous. Frequent washing of the head 
with soap and water, and the application of an alkaline or spirituous 
lotion, as 2 ounces of solution of caustic potash to 1 pint of water, or 
rum and water will generally serve to remove it. 
DATE, date. The fruit of the date palm constitutes a considerable 
portion of the food of the people of Egypt and Northern Africa, Arabia, 
and Persia. The nutritive material is chiefly sugar. As imported into 
this country, dates are not a digestible article of diet. 
DATURA STRAMONIUM, da-tu-rq strarmo'-ne-um, a perennial 
plant belonging to the Nat. order Solanaceae. It is commonly called 
thorn-apple and Jamestown-weed or jimpson, and is found growing in 
various parts of both Europe and America. The dried leaves and the 
ripe seeds are the parts used in medicine, and they owe their activity to 
tho presence of an alkaloid called datura or daturina. Stramonium 
possesses powerful narcotic properties, and is used by physicians as an 512 
DATURA STRAMONIUM-DEAFNESS. 
anodyne and antispasmodic. In large or long-continued doses it pro- 
duces dilatation of the pupil, disturbance of the functions of the brain, 
coma, delirium, and death. The leaves are often smoked in a pipe, and 
the fumes inhaled-10 to 30 grains are sufficient for this purpose-but if 
dizziness, dryness of the throat, and dilatation of the pupil are produced, 
its use must be immediately discontinued. It sometimes acts as an 
anodyne when opium and belladonna fail. It is employed in spasmodic 
asthma, lockjaw, various forms of mania, epilepsy, chorea, neuralgia, 
rheumatism, and in acute uterine diseases. It is also used with success 
as a local application in piles. It must always be used with extreme 
caution. Dose: of the fluid extract, 2 to 10 drops ; tincture, 10 to 30 
drops; wine, 16 to 60 drops; solid extract, J to 1 grain; powdered 
leaves, 1 to 3 grains. 
DAUCUS, daw-kus, a genus of plants belonging to the Nat. order 
Umbdlifera. D. Carota, variety satira^ is the cultivated or garden 
carrot, so much esteemed for its esculent roots. Those roots are occa- 
sionally used in medicine as a poultice, for their moderately stimulant 
properties. The carrot is nourishing, and contains a considerable pro- 
portion of saccharine matter, but it is not easily digested by weak 
stomachs, and requires thorough boiling to make it wholesome for any. 
In the experiments of Dr. Beaumont, carrot was found to take three 
hours and fifteen minutes of the healthy digestive process, for its solu- 
tion. 
DAY BLINDNESS. (See Blindness.) 
DEAD, DISPOSAL OF. (See Death.) 
DEADLY NIGHTSHADE. (See Ateopa Belladonna.) 
DEAFNESS, def'-nes, or deficiency in the sense of hearing, may 
be either partial or complete, and it may be accompanied with dumb- 
ness. 
Causes.-The causes of deafness may be temporary or permanent, 
and the affection may be due to disorder in the brain and nervous sys- 
tem, to disease and disorganization of the essential portions of the 
organ of hearing itself, or to causes which interfere with the transmis- 
sion of sound. 
The temporary causes of deafness may be such as have their origin 
in temporary disorder of the brain, resulting from external violence, or 
from disorder either local or general-more particularly some forms of 
fever, of which deafness is a frequent concomitant. Some drugs, quinine 
particularly, given in too large doses, also give rise to the affection. 
Temporary deafness is frequently occasioned by common cold, which', 
seems to cause tumefaction of the membranes lining the passage of the 
external ear, or when the throat is affected, obstruction of the eustachian DEAFNESS. 
513 
tube-which extends between the internal ear and the throat-either by 
swelling, or accumulated mucus. These causes often continue in action, 
and keep up the deafness, long after the cold has disappeared. 
Permanent deafness may result from disease of the brain, such as 
paralysis, or from violence, such as severe blows or falls upon the head. 
Disease of the ear itself, or its eifects, can scarcely fail to cause deafness. 
The internal portions of the ear are liable to a variety of disorders or 
diseases. Many of these take their origin during attacks of acute dis- 
ease-particularly measles or scarlet fever-in scrofulous individuals. 
Discharges occur from the ears, and the minute bones contained in the 
cavity are sometimes discharged. To allow of this, of course, the 
membrane of the tympanum, or drum of the ear, must be wholly or 
partially destroyed. This important membrane of the ear being dis- 
eased, is often the occasion of deafness. As mentioned above, the 
obstructions, either in the outer ear-passage, or in the eustachian tube, 
first arising from common cold, may become permanent; in the case 
of the latter, when the swelling subsides, thick mucus may block it 
up; in that of the foYmer, hardened wax, or cerumen. This last-men- 
tioned cause of deafness is very frequent, is easily discoverable, and 
no less easily removed, affording most striking relief to an almost total 
defect of hearing. It is perhaps the only affection of the organ causing 
deafness, which is likely to be well or safely treated domestically. (See 
article Cerumen.) 
The subject of deafness and of diseases of the ear generally, was for- 
merly greatly neglected by medical men, and consequently fell into the 
hands of quack aurists. Of late years, however, it has been taken up by 
many medical men-among whom may be found quite a number of dis- 
tinguished members of the profession-and promises fair to take the 
place its importance demands. 
Treatment.-A person affected with temporary deafness, if it is trace- 
able to an assignable cause, such as cold, should wait the effect of time for 
its alleviation. A blister applied behind the affected ear, or, better still, 
an eruption brought out just below the ear, by tartar emetic or croton-oil, 
may probably give some relief. If wax be suspected or ascertained to 
have accumulated, it should be removed, as directed under article Ceru- 
men, but never by ear-picks or such-like dangerous weapons. When no 
assignable cause for the deafness, whether permanent or temporary, can 
be discovered, a medical man should be consulted, who, if he cannot 
give relief, will always refer his patient to a medical man who has given 
special attention to aural surgery; but unqualified quacks with nostrums 
and never-failing cures must be shunned, especially the traveling im- 
postors who style themselves aurists. No one, surely, can be so credu- 514 
DEAFNESS. 
lous as to believe that any application, or variety of applications, put 
into the outer ear-and strong stimulants are often used in this way, 
can be remedial for a symptom owing to causes so varied. Some varie- 
ties of deafness are alleviated by appliances to the external ear-passage, 
and some remarkable cases have been published of great improvement 
in hearing resulting from small pellets of cotton wool, or other sub- 
stances, moistened and introduced so far into the ear, as £o be in contact 
with the tympanum membrane, which had been perforated by disease. 
For moistening these, and indeed for moistening the passage of the 
external ear, when too dry-an occasional cause o>f deafness-or for 
moistening hardened wax previous to syringing, glycerine is better 
adapted than the oil generally in use. For information concerning the 
use of the ear syringe, the reader is referred to the article, Eak 
Sykinge. 
Various modes of treating deafness, with reference to its various 
causes, have been and are employed. Its dependence upon destruction 
of the eustachian tubes, has originated the practice of passing an instru- 
ment, or eustachian catheter, up these passages for the purpose of clear- 
ing them. The operation is one which requires both practice and tact 
for its safe and efficient performance. 
When deafness is confirmed, and cure cannot be obtained, relief must 
be sought in the various artificial methods-ear cornets, and the like- 
for collecting and conveying to the ear as large a body of sound as pos- 
sible. The remarkable power of gutta-percha in the conveyance of 
sound, has afforded many facilities for adding comfort to the deaf, and 
improving their means of hearing, and many instruments for the pur- 
pose are now manufactured. 
With respect to the deaf and dumb, or "deaf-mutes f as they are 
now called, whatever the cause, whether congenital deficiency, or com- 
plete deafness brought on by disease or accident before the power of 
speech had been thoroughly acquired, the education should be conducted 
in an establishment for the purpose. It cannot be done at home, but 
much maybe done by the philanthropic and earnest endeavors which have 
devised, and are now daily devising new methods for imparting to these 
unfortunate individuals the blessings of knowledge. It has probably 
been an error in the education of the deaf-mutes hitherto, that they have 
been brought up in establishments by themselves, a plan it would seem 
less likely to fit them for mingling usefully with the world in general in 
after-life, than commingling them with children who have the power of 
speech. 
Dumbness is known usually to proceed from deafness, either existing 
from birth, or arising early in life. The exceptions to this are very rare, DEAFNESS-DEA TH. 
515 
and occur only from defective formation of the organs of voice and 
speech, or from disease of the brain. In the case of dumbness arising 
from total congenital deafness, sounds can never be associated with 
ideas, and consequently feelings, emotions, actions, and the names of 
objects or description of their qualities and states, must find a language 
in natural gesture, or in conventional written and manual signs. In the 
second case, that, viz., of total deafness coming on later in life, even if 
speech shall already have been acquired, it may be gradually lost, in 
consequence of the want of habit to associate sounds with speech. This 
occurs, however, only in early life, when the habit of speech has not been 
fully impressed on the memory. It rarely happens that dumbness is 
entailed by deafness so late as the tenth or eleventh year, and the extent 
to which this may occur will depend very much on the circumstances in 
which the individual is placed. In those who become only partially 
deaf, but to such an extent as to incur the risk of becoming also mutes, 
it seems probable that much of the power of retaining voice and speech, 
or of regaining it, may depend on a very small difference in the amount 
of hearing. (See Ear; Ear, Diseases of the; Cerumen, Dumbness, 
ETC.) 
DEATH, deth [Ang.-Sax.], in common language, is opposed to life, 
and is considered as the cessation of it. It supervenes as the necessary 
termination of all that long succession of phenomena of which life con- 
sists. Death may result either from the general failure of the vital 
powers, as in old age, or from some disease or injury in some of the 
vital organs, ■which extends itself to the organism in general. 
Die signs of approaching death are necessarily various, and depend, 
in a great measure, upon the nature of the disease. In some cases there 
is a dullness of the senses, inactivity of the muscles, vacancy of the 
intellect, and extinction of the sentiments, as in death resulting from old 
age. There is, also, frequently some degree of delirium, which is often 
of a most interesting and pleasing character, resembling dreaming more 
than any other form of derangement; sometimes, again, the dying 
fancies of the individual are of the most dreadfully distressing character; 
but it is presumptuous, as many do, to hazard much upon the various 
modes of terminating the career of life. In the delirium the reproduc- 
tion of visual sensations often bears a considerable part; and frequently 
the victim of typhus is seen catching at something in the air, or picking 
at it on the bedclothes. The sense of hearing is frequently also affected, 
and imaginary voices, and sounds of tolling bells, etc., are heard. 
Dementia, or mental debility, sometimes comes on shortly before death, 
and for the most part manifests itself in an incapacity of concentrating 
the ideas upon one object, or by an all but total failure of the memory ; 516 
DEATH. 
this mental weakness often painfully manifests itself in the apparent 
pleasure which the sufferer takes in some of the most childish amuse- 
ments. The voice generally becomes low and weak as death approaches; 
but sometimes it has a shriller pitch than natural; sometimes it is husky 
and thick; and not unfrequently it dwindles to a mere whisper. The 
muscular system generally becomes feeble and relaxed; the pulsations 
of the heart gradually feebler, but more frequent; the respiration some- 
times hurried and panting, sometimes ceasing gradually; and sometimes 
slow, laborious, and stertorous. There is frequently, also, an accumula- 
tion of fluids-mucous, serous, or purulent, in the bronchial tubes. 
What is known as the " death-rattle " is produced by the passage of the 
air from the lungs through the fluid collected in the trachea and upper 
respiratory passages. The dying are often impatient of any kind of 
clothing, throwing off the bedclothes, and lying with chest bare, and 
arms extended and the neck as much exposed as possible. The nose 
and lips are very characteristic in the dying; the lips become pale, the 
nostrils dilated and dark-looking, and the hairs about the lips seem more 
than usually apparent; the teeth look like pieces of ordinary bone, and 
the eyes seem to shadow through the eyelids, or are partially turned 
under the lids; the nails look dark, and the end of the fingers sodden. 
Finally, convulsive twitchings often show themselves in the face, with 
singular elevations of the eyebrows, and staring of the eyes. A gaping 
attempt to breathe terminates the struggle. When coma is present a 
mucous rattle is of fatal import; on the contrary, when the lungs are 
affected, the supervention of coma is equally to be dreaded. 
When fluids taken by the patient flow back from his mouth, or fall 
heavily down his throat, as if poured into an ordinary tube, death is 
soon to be expected. 
In young children a curious playing with the bedclothes often attends 
fatal affections of the brain. I remember a little child, who had her 
handkerchief in her hand, which she spread out repeatedly with appar- 
ent care and in a fantastic manner that would have been amusing, but 
for its fatal import. The picking of bedclothes, and catching of the 
hands as if at imaginary objects, are well known as terrible indications. 
Among the other signs of approaching dissolution are the sunken 
eye, the hollow temple, the sharpened nose, the forehead dry, tense, and 
harsh, the complexion shallow, livid, or black, the lips cold, flaccid, and 
pale, or of a leaden hue. We believe that the opinion that generally 
prevails of the great amount of suffering that immediately precedes 
death, and which is expressed by such words as the death struggle or 
agony of death, is very erroneous. There is every reason to believe 
that as death approaches, the sensibilities are gradually deadened, and DEATH. 
517 
that in most cases consciousness has ceased before the struggle com- 
mences. Those who have made the nearest approaches to actual death, 
as in drowning, have described their feelings as being of an extremely 
pleasurable kind. 
The possibility or the probability of illness having a fatal termination, 
devolves a great responsibility, and much anxiety upon the mind of a 
medical man, as regards the patient more particularly. There is the 
preparation of the mind for the great change to be considered; the 
settlement of worldly affairs on which may depend the future welfare of 
others to be thought of; but there is also the effect of the announcement, 
nay, of the slightest hint of danger upon some individuals, to be duly 
pondered, lest the mental shock may put the finishing stroke to what 
disease has begun, and extinguish the last faint chance of recovery. 
It may be requisite on the first symptoms of danger occurring in some 
diseases, particularly in those likely to affect the powers of the mind, 
to make the announcement early, in others it may be delayed for some 
time after the physician has decided in his own mind that the case can 
have none but a fatal issue, till, indeed, the idea, without being actually 
imparted, has gradually dawned upon, or been gently awakened in the 
mind of the patient, and has by degrees ripened into conviction. 
Too frequently it happens, that whilst a medical man is examining 
the patient, or still within hearing, questions relative to that patient's 
state are put, whether "there is any danger?" whether the person v411 
"get better?" and other interrogatories, which he can scarcely either 
answer or refuse to reply to, without conveying to the patient informa- 
tion he may not wish to communicate. Every medical man must have 
felt himself at times thus unfairly embarrassed. 
The influence of season in causing death is well marked. According 
to Quetelet's tables of mortality in Belgium, the greatest number of 
deaths among individuals above twenty-five takes place in February, and 
the smallest number in July. Other researches as regards Berlin, show 
that the greatest number of children die in summer and the fewest in 
winter, whilst with adults the case is exactly reversed. It has also been 
observed that more deaths on the average occur between six a.m. and 
noon, than at any corresponding period during the twenty-four hours. 
(See Climacteric Disease.) 
One word as to the treatment of the dying; let quiet, attention to 
every sign, the moistening of the lips, the gently shifted position, be the 
attentions ; but who can tell how painful the disturbance of the forced 
stimulafit or medicine, the noisy lamentation, or the pulling about or 
pulling away of pillows which nurses are apt to practice, may be to the 
last moments. 518 
DEATH. 
In persons found dead, or apparently so, the first thing is, of course, 
to ascertain the real state of the case. If death is doubtful, the first 
object must be to ascertain, if possible, the cause of the condition which 
so nearly approaches to it; this must be the first step, but it must be 
taken with all possible speed, in order that proper measures for resusci- 
tation may be adopted. The causes may either be natural or violent; of 
the former, apoplexy, sudden fainting, or suffocation from internal 
affections, may be in operation; of the latter, suffocation from unnatural 
causes, poison, wounds, burns, cold, starvation, lightning, include the 
most probable influences. Some of these, such as burns, wounds, the 
action of lightning, cold, and many of the usual modes of suffocation, 
such as hanging, drowning, etc., are too evident, either in themselves or 
from concomitant circumstances, to be overlooked; but others, particu- 
larly those cases of apparent death resulting from natural causes, from 
some forms of suffocation, and from poisons, are almost beyond the 
power of the unprofessional to investigate. For the mode of distinguish- 
ing, and for the subsequent treatment, the reader is referred to the 
articles devoted to these subjects. It is repeated, when a person is 
found apparently dead, do not let the fact be assumed without investiga- 
tion ; the spark of life may yet linger in its earthly tenement, may yet 
be not past recall, beyond which, the loss of even a short time, or the 
tofal abandonment of care may quickly place it. If there is the faintest 
hope that life is not quite gone, whilst the causes of the mishap are 
investigated, means, such as are recommended under the peculiar cir- 
cumstances, should be at once adopted, and vigorously-no half-measures 
will turn the scale between life and death. These things are peculiarly 
important, for often it can only be a fortunate chance that places a 
medical man on the spot where cases such as the above have occurred. 
Of course, where it is possible, medical assistance ought to be as quickly 
procured as may be, but time may or must necessarily elapse, and while 
it slips by, life slips away, which might be preserved by the knowledge 
possessed by some intelligent bystander, which might lead him to think 
that there was still hope-often too readily given up by the crowd-and 
lead him to direct the adoption of rational and really efficient measures, 
instead of the useless, or worse than useless, treatment followed, where 
there is no information to guide, or head to direct. 
When persons are found who are undoubtedly dead, there yet remains 
something to be done, for the cause may be natural, or unnatural, and in 
the latter case the ends of justice may either be forwarded or retarded 
by those who first discover the body. The exact position should be 
noted. The stiffening or not of the limbs. The presence or absence of 
warmth about the chest or abdomen particularly. The state of the DEATH. 
519 
clothes. Whether there are signs of vomited or other matters discharged 
from the body. Wounds noticed, and the state of the blood upon them, 
whether fresh, coagulated but yet soft, or hardened. And, indeed, 
whatever the circumstances connected with the finding of the body can 
suggest to the intelligent mind, should be written down. On the arrival 
of the judicial and medical authorities, there are other matters of course 
to be investigated, which only they can undertake, but as most of those 
above-mentioned are evanescent, the persons first on the spot can best, 
or only, testify to them, and facts which may appear trivial to note at 
the moment, may, in criminal cases, be the turning-point on which con- 
viction hinges. 
As it is a well-known fact that all the usual signs of death occasion- 
ally fail, and, at long intervals we read the account of some one, 
supposed to be dead, having been interred alive, the question is often 
asked, "Is there any positive sign of actual death?" Of course decom- 
position is an unfailing sign, an absolute test of death. Science, how- 
ever, says there are others just as certain. It is a well-known 
circumstance that the liquid preparations of the deadly nightshade or 
belladonna, when applied to the ball of the eye during life, produce an 
enlargement of the pupil, owing to the contraction of the muscular 
fibres of the iris. After death the muscle fails to respond to the appli- 
cation of the irritant. This is known as the eye-test. A red-hot iron 
applied to the skin during life, produces a blister; after death, the sur- 
face is charred, but no blister is formed. This is known as the blister- 
test. A third test is formed by plunging a polished needle into the 
body. If life still is there, the needle will be tarnished, but if life be 
extinct the needle will remain bright. It is known as the needle-test. 
After death the body should be, as soon as compatible with decency, 
disposed of in the most suitable manner. One or two days in summer, 
and two or three days in winter, is as long a time as a body can with 
safety remain unburied. By the ice-box, or by the use of disinfectants, 
or by embalming when circumstances demand it, the body may be pre- 
served for a much longer time. Wooden coffins are better than metallic 
ones, unless apertures are left in the latter for the escape of the gases, 
which result from decomposition. It is a fact that contagious diseases 
may be communicated by dead bodies, therefore, the practice of relatives 
and friends kissing the lips of the dead, should be deprecated; also the 
practice of carrying the corpse through our most crowded thoroughfares 
on its way to its last earthly resting-place-the cemetery-which should 
never be in the city or town, as is too often the case, but some distance 
in the country. (See Apoplexy, Accidents, Disinfectants, Bromo- 
Chloralum, etc.) 520 
DEATH-DEBILITY, OR WEAKNESS. 
Causes of unexpected death are treated of in various articles of this 
work. 
DEBILITY, OR WEAKNESS, <7e-^7'-6-^[From Lat. debilis^ weak], 
is a falling off from the usual power of the individual to perform those 
exertions, whether of duty or pleasure, in which he has habitually 
engaged, and which, judging from the constitution, mode of life, etc., 
he might naturally be expected to perform. 
Illness and debility may be said to be synonymous, for it is difficult 
to imagine the former unaccompanied or not followed by weakness, 
except in the few exceptional instances, in which apparent debility, 
caused by the presence of morbid matter in the blood, is relieved by the 
disorder which carries off the cause of the depression. Such is seen to 
be the case in mild attacks of bilious diarrhoea, which do not go far 
enough to affect the general strength, and which are immediately fol- 
lowed by relief to the feelings of languor and weakness which preceded 
them; indeed, unwonted discharges of any kind, whether in the urine, 
or from the skin, or even of blood in small quantity, if they do not go 
too far, are often followed by feelings of strength rather than of 
debility. In these cases, however, the debility was apparent, not real; 
that of oppression rather than of depression. 
Causes.-To the foregoing and similar sources, then, may be referred 
all those causes of apparent debility, or in other words, of languor or 
torpor, which arise from impurity of the blood, consequent upon the 
retention of noxious matters in that fluid, which are from some cause 
unremoved as they ought to be, by the agency of eitner lungs, liver, 
kidneys, bowels, or skin, or which have been absorbed into the vital 
fluid from without. 
As apparent debility is referred to impurity of blood, so the cause 
of real debility must be looked for, in many cases, in its deterioration 
or deficiency. The vital fluid, which is the medium for supporting our 
animal temperature, and for supplying plastic elements to the ever- 
wearing textures of the body, may be deficient in all or any of the 
elements required for these purposes, or it may itself have been drained 
away by hemorrhage. The first office of the blood, the maintenance of 
animal heat, is so essential, that it seems arranged by the Author and 
Supporter of our life, that to carry on this, the soft constituents of the 
body may be sacrificed almost to the extreme limit; but this very 
circumstance must be a cause of debility during illness, when to obtain 
fuel as it were, muscular substance is consumed away, whilst muscular 
motion is unexercised. Again, whatever plastic elements the blood may 
be deficient in, the organs to which those elements should be supplied 
become debilitated. This is most strikingly exemplified in the case of DEBILITY, OB WEAKNESS. 
521 
the bones in childhood, where food is deficient, which become soft- 
rickety-for want of the due supply of earthy matter; still more 
generally is it exemplified, in those cases so often quoted, of animals 
fed, or rather starved, upon certain kinds of food, such as arrowroot, 
white sugar, bread made of fine flour, etc., which, however wholesome 
as articles of diet in themselves, do not contain plastic elements for the 
building up or sustaining the bodily tissues in strength and healthy 
active operation; to deficiency, therefore, of the blood, as regards those 
elements required in the unceasing operations of the living frame, must 
we look for the most generally operating and palpable cause of debility. 
But this cause is itself only an effect of other causes. If the blood is 
to nourish well, it must be nourished well itself; the supplies it is ever 
yielding to the system must be rendered to it from without; the food 
must not only be in quantity and quality sufficient to preserve the 
balance of nutrient materials in the blood, but it must be properly 
digested, properly fitted for its commixture with the vital fluid; if 
cither food or digestion be deficient, debility, more or less, must be the 
result. 
In the healthy constitution, and sufficient nutriment of the organic 
■constitution of the body, and of the nervous system, lies the true ele- 
ment of strength, or the real seat of weakness. To use a simile, the 
machine must be strong in all its parts, and its moving power ade- 
quate to its requirements to constitute real well-balanced strength. 
When the central organ of the nervous system, the brain itself, becomes 
debilitated, the condition may be manifested by affections of the body, 
partial or general, or by disorders of the mind. The brain may be 
debilitated or exhausted by the excessive stimulation of alcohol, opium, 
and other agents which act upon it peculiarly, also by sensual excesses, 
over-nursing and the like; but perhaps the most frequent source of 
weakened brain in this country, is undue exertion of it as the agent of 
the mind; it is tasked till it gives way, is used up. This is not a figur- 
ative expression, it is the actual truth, that the substance of the brain is 
actually consumed by the process of intense thought, the amount of 
consumption, probably, being in proportion to the exertion the mind is 
put to. In persons of irritable and nervous temperament it is not 
uncommon to find deposits of phosphatic salts in the urine after the 
mind has been strained, and we can only look to the nervous system and 
brain as the most probable source of the additional excretion of phos- 
phorus. The subject is undoubtedly an obscure one at present, but it is 
deserving of notice, from bringing directly and sensibly to the mind, 
and in a physical point of view, the possible and probable manner in 
which this wonderful agent of man's intellect may be, and is, exhausted. 522 
DEBILITY, OB WEAKNESS. 
Having then seen, that debility may either be apparent or real, and 
that in the latter case it may depend upon deficient nutriment or defi- 
cient healthy supply of nervous power, it remains to consider the causes 
which most generally tend to bring about these conditions. 
Debility has been divided into original and acquired. The former 
is witnessed in the children of parents whose constitutions have been 
weakened by any cause, such as dissipation, advanced life, etc., and also 
in the children of scrofulous families. The latter or acquired debility, may, 
of course, be caused by whatever lowers the standard of health. As 
already mentioned, insufficient nourishment is one great source of debility; 
likewise, the absence of the usual stimuli of solar heat and light, defi- 
ciency of fresh air and exercise, and of stimulation to the mind by a proper 
amount of healthy active exertion. Again, there is the debility pro- 
duced by the direct action of injurious agents, a continued damp climate, 
either warm or cold, poisons gradually absorbed in necessary employ- 
ment, or accidentally but continually taken into the system, and such 
like; and also by depressing passions of the mind, such as anxiety, 
fear, etc. 
Lastly^ there is debility, the result of direct abstracting and exhaust- 
ing influences. Any habitual loss of blood, or draining discharge of any 
kind, over-nursing, or sexual excesses. One especial cause of debility 
requires notice, it is that occasioned in young children or people who 
sleep with the aged; for the fact is an undoubted one, that the practice 
has an extremely debilitating effect upon the former. It is one which 
should never be followed or permitted. The withdrawal of accustomed 
excitements often occasions debility of an alarming and even fatal char- 
acter. The debilitated drunkard or the opium eater cannot without dan- 
ger be deprived of his usual stimulant, and even the man who has lived 
in the most perfect moderation, cannot always, without danger of induc- 
ing great debility, leave off an accustomed stimulus. It is not said that 
in many instances this may not be done with impunity, or even benefit, 
but there are cases in which it is hazardous. 
Treatment.-In the treatment of debility, whether simple or com- 
plicated with disease, it must be obvious to all that it must be adopted 
with due reference to the cause. This must, if in continuance, be 
removed or rectified as quickly as it may be; if the mischief, as occurs 
in original debility, or in that produced by causes which have ceased to 
operate, cannot be prevented, of course nothing remains but to build up 
or restore strength by nourishment, tonic medicines, change of air and 
scene, especially to the sea-side when that is practicable. In every case, 
however, of marked debility, the medical man should be consulted; he 
only is likely to detect with certainty the cause or causes, and to direct DEBILITY, OR WEAKNESS-DECAY. 
523 
the adoption of appropriate remedies. It is repeated, in the treatment 
of debility, whatever may be the cause, if still in operation, that must 
be rectified, but the weakness itself is only to be repaired by a 
sufficiently ample supply and circulation of healthy blood. The latter 
must be procured by every means which tend to enrich and purify the 
vital fluid; good food well digested, air, exercise, and the use of all 
accessories to health, and assisted when suitable by such regular and 
regulated exercise of the debilitated parts themselves, as will increase 
the circulation of blood through them, without exhausting either their 
constituent tissues or nervous power; but it is useless, and worse than 
useless, to load a stomach which cannot digest it, with food and drink, 
in the vain hope of giving strength, as people too often do, or wish to 
do, in cases of febrile or other disease. To use the simile of a steamer, 
although the seasoned wood-work within may be broken up to feed the 
engine, and to carry the vessel safely into port, it would be no slight 
hindrance, and no small aggravation of her danger, were she to be 
loaded with water-logged or green wood, which would not burn when 
it was wanted; so it is with the body in fever; the already prepared 
and digested components stored up in its tissues, though not perhaps 
accumulated for the special purpose, will yet answer well to keep its 
works in movement; but crude food is like the green wet wood, useless 
for good, and fitted only to overload and retard. When increase of 
nourishment is called for in cases of debility, care must always be taken 
to adapt it to the condition of the digestive organs ; these are generally 
weakened, and while the food given contains much nutriment, it should 
be as easily soluble in the stomach as possible. For information on this 
head, however, the reader is referred to the articles on Digestion, Food, 
Diet, etc. (See Animal Heat, Bilious Cholera, Blood, Fever, Nerves, 
Nervous Disease, Starvation, etc.) 
DECAY, de-ka'. After the sixtieth year in men, and somewhat 
earlier in women, as a general rule, the period of old age or of decay 
commences, the descent has begun, imperceptibly perhaps at first, but it 
is progressive. There may be no positive disease, but the circulatory 
powers fail, the arteries lose their elasticity and tone, and in this, 
perhaps, lies one great cause of the decay of the body generally, the 
deficient circulation of blood; the brain, the muscles, the whole body 
becomes smaller, shrinks, and if there is no disease, the powers of 
material life are gradually extinguished, a few degrees fall in the 
thermometer may be all that is required to put out the flickering 
flame. For the management of this stage of life the reader is 
referred to the article on Age, Old. (See also Climacteric Disease, 
Debility.) 524 
DECID UO US MEMBRANES-DEEO EMIT Y. 
DECIDUOUS MEMBRANES, de-sid'-u-us, are those which line 
the uterus during pregnancy, and which are cast off shortly after the 
birth of the child. 
DECLINE. (See Consumption.) 
DECOCTION, de-kok'-shun [Lat. deco quo, I boil], in Chemistry, the 
extraction of the soluble portion of plants by boiling. It should be 
performed in a covered vessel. When the menstruum is valuable, as 
alcohol, a retort and a receiver, or the common still, may be used, to 
condense and preserve the vapors that would otherwise escape. It is 
more powerful than infusion by reason of the increased temperature ; 
and is employed to extract the mucilaginous parts of plants, their bitter- 
ness, and other vegetable principles. It is not suitable, however, where 
the virtues of the plants depend wholly or in part on the essential oil or 
volatile principles which they contain. As a general rule, and unless 
stated differently, the decoctions mentioned in this work, contain 1 
ounce of the drug to 1 pint of water. (See Drug, Infusion.) 
DECOMPOSITION, de-kom-po-zish'-un [Fr. decomposer, to decom- 
pose, from Lat. compono, compositus~\, is the separation of the constitu- 
ents of a body during putrefaction. In Chemistry it is applied to any 
process during which a compound substance undergoes the separation or 
re-arrangement of its elements. (See Putrefaction.) 
DECREPITUDE, MEANS OF PREVENTION. (See Longevity, 
Health, etc.) 
DECUBITUS, de-ku-be-tus [from decumbo, to lie down], the atti- 
tude or disposition of the body of a patient when in the horizontal 
posture. This forms an important feature in some diseases. (See 
Position. ) 
DEFORMITY, de-form'-e-te [Lat. deformitas, from de, and forma, 
a form], is the want of that regularity of form necessary to constitute 
the beauty or symmetry of an object. In the human subject deformities 
may be either congenital or acquired; i.e., occurring before or after 
birth. 
Causes.-Deformities are frequently produced by physical injuries 
suffered by the mother during pregnancy; and hence a strong mental 
impression may so affect the mother physically as to transmit its effects 
to the foetus. Of the other class of deformities, or those which are 
acquired after birth, they may arise from various causes, from accident, 
from bad habits, or from debility (which see), and may occur in almost 
any part of the body. They commonly receive the name of distortions, 
and are frequently occasioned by affections of the muscles or nerves, as 
in various kinds of lameness, wry neck, squinting, etc. The most com- 
mon cause of distortion, however, is disease of the bones. These are DEFORMITY-DEL I RIEM. 
525 
sometimes deficient in the earthy matter which gives them hardness and 
rigidity, and thus are incapable of supporting the weight of the parts 
which they are designed to bear, or of sustaining the muscular action, 
without becoming bent and distorted. From this arises the disease 
known as rickets (which see). The distortion known as lateral curvature 
of the spine arises from weakness in the vertebral muscles, inducing a 
habit of resting the weight of the body more on one side than the other. 
Angular curvature of the spine differs entirely from the above, and is 
occasioned, for the most part, by the ulceration of the body of one or 
more of the vertebrae. 
Treatment.-Perfect rest in the horizontal position, issues and setons 
in the neighborhood of the diseased bone, and attention to the general 
health, is the treatment to be adopted in the last mentioned case. Dis- 
eases of a similar kind frequently occur in the bones and joints of other 
parts of the body, and require similar treatment. Distortions may also 
arise from a variety of other causes; as rheumatism, gout, burns, and 
various chronic and local affections ; but these come more properly for 
consideration under their own heads. Much can now be effected in the 
way of the cure of deformities, whether congenital or acquired; the 
means will necessarily differ according to the nature of the case. In 
general, nourishing diet, iron, cod-liver oil, phosphate of lime, cold 
bathing, sea air, and the like will be attended with marked benefit. In 
many cases properly directed muscular exercises or. movements with a 
view to strengthen the relaxed muscles will effect a cure. A good 
account of various mechanical contrivances for the relief or removal of 
deformities will be found in a work on deformity by Dr. Sayre, of New 
York. (See Club Foot.) 
DEGLUTITION, degdu-tisK-un. [Lat. deglutition from deglutio, 
I swallow], is the act of swallowing, or the passing a substance, either 
solid, liquid, or gaseous, from the mouth to the stomach. It is divided 
into three stages. In the first, the food passes from the mouth to the 
pharynx; in the second, it passes the opening of the glottis, and of the 
nasal organs, and arrives at the oesophagus; and in the third it passes 
through this tube and enters the stomach. The first of these is purely 
voluntary; the second is an action of the reflex function; the third is 
altogether involuntary, being due to the irritability of the oesophagus, 
which, by a series of musclar contractions and expansions, forces the 
substance downwards. 
DELIRIUM, de-lir'-e-um [Lat. from deliro, I rave or am furious], is 
a confusion of ideas, which occurs in the progress of certain diseases, 
from disturbed function of the brain. Sometimes the term is employed 
to include every form of mental alienation; but generally a distinction 526 
DELIRIUM-DELIRIUM TREMENS. 
is made between insanity and delirium, the latter occurring principally 
in fever and inflammatory diseases, while the former is unattended by 
these disorders. (See Insanity.) The insane usually display all the 
external appearances of health, and have the digestive and nutritive 
functions in a sound state. In the delirious, on the other hand, all the 
cerebral functions are severely affected; there are no correct sensations, 
connected ideas, or passions; no regular voluntary motions; little or no 
intelligence or recollection. The patient is almost a stranger to every- 
thing that surrounds him, as well as to himself. Delirium may be either 
violent and frantic {delirium ferox\ as in acute inflammation of the 
membranes of the brain, or low and muttering {typkomanid), as in 
low fever. It supervenes on fever during any part of its course. It 
occurs in the hot state of some intermittents, but rarely makes its 
appearance in typhoid or continued fever until the disease has reached 
its height. It sometimes occurs suddenly, without any previous indica- 
tion ; but more frequently it is preceded by headache, throbbing of the 
temples, a flushed and oppressed countenance, etc. The patient is at 
first delirious during the short and imperfect periods of sleep, or imme- 
diately after he is roused, becoming, wdien fully awakened, more clear 
and comparatively collected. By degrees this lucid interval becomes 
less perceptible; the individual becomes more and more incapable of 
reflection and mental exertion, and gradually loses the power of recog- 
nizing the persons and objects which surround him. When delirium is 
about to terminate fatally, sensibility becomes more and more impaired, 
until all conscious feeling seems to be lost. Inarticulate moaning succeeds 
to delirious incoherence, the patient loses in a great measure sight and 
hearing; the mouth and tongue are dry, yet the patient no longer com- 
plains of thirst; the pupils become scarcely contractile; black spots, like 
flies, appear before the patient's eye, and the evacuations escape with- 
out consciousness. As delirium is rather a symptom of disease itself, 
its treatment necessarily forms part of that of the disease on which it 
supervenes and will therefore fall to be noticed under these heads. (See 
Delirium Tremens.) 
DELIRIUM TREMENS, de-lir'-e-um tre-mem, is a disease of the 
brain. It is usually caused by an abuse of spirituous liquors, but some- 
times also by great mental anxiety and loss of sleep; or it may result 
from bodily injuries or accidents, loss of blood, etc. Delirium some- 
times makes its appearance in consequence of a single debauch; but more 
frequently it is the result of protracted or long-continued intemperance. 
It usually supervenes on a fit of intoxication; but it not unfrequently 
occurs, also, when the habitual drunkard omits his accustomed draught. 
Symptoms.-The approach of an attack is almost invariably preceded DELIRIUM TREMENS. 
527 
by the patient being remarkably irritable, with a fretfulness of mind 
and mobility of body. lie becomes very nervous and uneasy; is startled 
by any sudden noise, the opening of a door or the entrance of a visitor; 
is restless; the hands and tongue are tremulous ; he complains of inabil- 
ity to sleep, and if he dozes for a moment, he is awakened by frightful 
■dreams. Soon delirium manifests itself; if questioned, the patient often 
answers rightly enough; but if left to himself, he begins to talk or mut- 
ter ; he is surrounded by frightful or loathsome animals; is pursued by 
some one who has a design upon his life; has terrible and ghastly visions. 
Though most commonly of a frightful or terrifying character, the delirium 
is not always so: occasionally the appearances are droll and ludicrous, 
and the patient seems amused by them; at other times it turns on some 
matter of business, as settling of accounts or telling of money, and the 
patient is in a perpetual bustle, and his hands are constantly full of 
business. The predominant emotion w'ith the delirious patient is fear, 
and in his efforts to escape from an imaginary enemy, he may be guilty 
of a murderous assault, or, as is more frequently the case, may take 
his own life; and hence he requires to be very carefully watched. "The 
strong features of this complaint," says Sir T. Watson, "are sleepless- 
ness, a busy but not angry or violent delirium, constant chattering, a 
trembling of the hands, and an eager and fidgety employment, of them. 
. . . The tongue is moist and creamy; the pulse, though frequent, is 
soft; the skin is perspiring and most commonly the patient is drenched 
in sweat." The delirium continues until the patient sinks into a sleep, 
from which he awakes comparatively rational, or dies from exhaustion. 
In such cases death is often sudden, the patient rising for some trivial 
purpose and falling in a faint, from which he never recovers; or at length, 
after passing nights without sleep, he sinks into a state of coma, which 
terminates in death. This disease, however, is rarely fatal, unless where 
the strength of the patient has been seriously impaired by long con- 
tinued excesses. 
Treatment.-The great remedy is sleep, and the best means of induc- 
ing this is by opium, which is to be given in large doses, and frequently 
repeated, until the desired effect follows. Sometimes it is necessary, in 
order to procure sleep, if the patient is in a very exhausted state, or if 
the disease has been brought on by the cessation of an accustomed 
stimulus, to allow the patient a certain quantity of his ordinary bever- 
age ; but this should not be continued longer than he can do without it. 
Chloroform has also been recommended as a means of procuring sleep 
when opium fails, or better probably than either will be found to be the 
hydrate of chloral (see Chloral). Powdered capsicum in 30 grain doses, 
repeated in three or four hours, if necessary, will often procure sleep 528 
DELIRIUM TREMENS-DENGUE, ETC. 
under such circumstances. Some medical men recommend large doses 
of digitalis, but the nature of this renders it unad visable in the hands of 
any but a medical man. The strength should also be supported by beef- 
tea, milk, raw eggs, etc., and sometimes a cold shower bath affords great 
relief. This disease is to be carefully distinguished from inflammation 
of the brain, with which it has many symptoms in common for bleeding, 
which is resorted to in the latter disease, would be of the utmost danger 
in this. (See Delirium, Opium, Chloroform, Digitalis, Capsicum.) 
DELIVERY. (See Childbed, Parturition.) 
DELPHINIUM, del-jin'-e-um, a genus of plants belonging to the- 
Nat. order Danunculacece. The flowers and the root of the Delphinium 
Consolida^ or larkspur, are diuretic, emmenagogue, and vermifuge. 
One dram o£ the flowers placed in 1 pint of hot water, and boiled down 
to a pint, is an excellent remedy for cholera morbus. It may be 
sweetened and given in teaspoonful doses every hour or two until relief 
is obtained. The seeds of the Delphinium Staphisagria, or stavesacre, 
are cathartic, emetic, and anthelmintic. They are seldom used inter- 
nally ; the bruised seeds externally, are used to destroy vermin. Del- 
phinium owes its active properties to the alkaloid delphinia. It has 
obtained some repute as a remedy in neuralgia and rheumatism. It is 
used both externally and internally. Dose of delphinium, from £ to 1 
grain, three or four times a day. 
DEMENTIA. (See Insanity.) 
DEMULCENTS, de-mul'-sents [Lat. demulceo^ I soften], is a name 
given to such medicines as are especially useful in obviating the action 
of acrid and stimulating matters, and that not so much by correcting or 
changing their nature as by involving them in a mild and viscid fluid, 
which prevents their acting, or by covering the surface exposed to their 
influence. They are generally divided into two classes, mucilages and 
expressed oils. In the former are almonds, coltsfoot, Arabic and several 
other gums, linseeds, mallows, liquorice-root, barley, oats, wheat, sago, 
and starch; in the latter, most European and many foreign oils, fat, 
and other animal substances, including hartshorn-shavings, gelatine, and 
isinglass, spermaceti, and wax. They are principally used in catarrh, 
diarrhoea, dysentery, gravel, and a few other complaints. 
DENGUE, OR BREAK-BONE FEVER, den-ga, is the name of a 
disease that has, on several occasions, made its appearance in the 
Southern States, and the East and West Indies, and is characterized as 
a severe inflammatory fever, accompanied with rheumatic pains in the 
joints and muscles, and a cutaneous eruption that usually makes its 
appearance upon the third or fourth day. Though very severe, it is not 
often fatal, and usually terminates in a few days with a copious discharge DENGUE, ETC.-DENTITION 
529 
of perspiration. It is regarded as scarlet fever, combined with severe 
rheumatic pains in the limbs and joints. It demands no special treat- 
ment beyond opiates to relieve the pain, and purgatives, or an emetic, 
to subdue the fever. 
DENS, denz, is the Latin term for a tooth; in the plural, dentes ; 
whence come such English words as dentist, dentition, dentifrice, etc. 
(See Teeth.) 
DENTIFRICE, den'-te-fris [Fr.], a substance, usually in the form of 
a powder, used as an aid in cleaning the teeth. Camphorated chalk is 
one of the most generally used dentifrices. Cuttle-fish shell and char- 
coal, reduced to fine powder, are extremely useful as detergents. 
Pumice-stone is also employed when the teeth have become dark-colored. 
Catechu, cinchona, and rhatany are used in order to give astringency; 
myrrh to give odor, and bole Armenian to impart color to various tooth- 
powders. The following is a most excellent dentifrice for preserving the 
teeth, and it is especially useful when the teeth and gums are tender: 2 
ounces of borax, 3 pints of water, 1 teaspoonful of tincture of myrrh, 1 
tablespoonful of spirit of camphor. Mode: Dissolve the borax in the 
water, and before it is quite cold add the myrrh and spirit of camphor. 
Bottle this mixture for use. Wash the teeth daily with a soft brush, with 
this mixture diluted, in the proportion of 1 wine-glass of the mixture 
to | pint of tepid water. (See Teeth.) 
DENTIST, den'-tist [Itai, and Sp. dentista, Fr. dentiste], one who 
devotes himself to the study of the diseases of the teeth and their treat- 
ment ; called also surgeon dentist and dental surgeon. (See Teeth.) 
DENTITION, den-tisK^un^ is one of the most important processes of 
infantile life; for during its course the little patient is subject to many 
trying diseases, such as convulsions, cough, eruptions upon the skin, 
and disordered bowels; and great care and attention will be necessary at 
this period. Children cut their teeth at different ages, the most com- 
mon time at which this process begins being at the end of the seventh 
month; but instances have been placed on record in which children 
have been born with teeth already through the gums, others have 
cut them at the age of three months, while in some cases teeth have not 
appeared till the second or third year, and in rare instances, adults have 
been met with who have never had any. The first set of teeth, or the 
temporary or milk teeth, are twenty in number, and are generally pro- 
duced in the following order-those in the lower jaw being a little in 
advance of those of the upper: the two lower front teeth are the first to 
be produced, then the two upper, and these are soon followed by the 
remainder of the lower and upper front teeth; and in the course of a few 
months the lateral and posterior grinders of both jaws make their 530 
DENTITION. 
appearance. When the gums are hot, tender, red and swollen, and the 
child is cross and fretful, the part affected should be lanced over the 
protruding tooth, which is evidently pushing its way to the surface with 
great difficulty, and may, if not assisted, give rise to a severe attack of 
infantile convulsions; and in some cases, this operation will have to be 
repeated from time to time, as circumstances may require. Should the 
little patient become convulsed from the irritation thus set up, cold water 
should be freely dashed upon his face, and his body should be immersed 
for ten minutes or a quarter of an hour in a hot bath, or one containing 
hot water mixed with mustard, so as to bring the blood as much as pos- 
sible to the surface and relieve internal congestion. Mustard poultices 
may be applied to the nape of the neck, or to the calves of the leg, and 
the following aperient powder should be given:- 
Take of Scammony powder Three grains. 
Calomel Three grains.-Mix. 
Let it be taken immediately in a little preserve. 
(The above prescription is intended for a child a year old, and must 
be varied in strength according to the age of the infant.) 
The surgeon should be summoned at once, and he will examine the 
sufferer's gums, and if necessary, relieve the local irritation by gently 
incising them with an ordinary gum lancet, and in many cases of this 
kind, the convulsions cease at once upon the performance of this simple 
operation, thus plainly showing that all the irritation was caused by the 
difficult advance of the protruding tooth. After the child is taken from 
the warm bath, its trunk and extremities should be gently rubbed, and 
he must then be placed in a warm blanket near a small fire. About the 
end of the seventh year of childhood, the temporary or milk teeth begin 
to loosen and drop out, and are gradually replaced by the second, or 
permanent teeth. The former arc* twenty in number; but the latter, 
including the wisdom teeth, which are cut later in life, consist of thirty- 
two. The process of second dentition is easily accomplished, and is not 
attended by any diseases as in the case of the cutting of the milk teeth. 
When the child is feverish, the warm bath and a small dose of min- 
dererus spirit will be useful. The heat of the child's mouth may induce 
the desire for the breast too frequently, in order to obtain the grateful 
relief of moisture: in this there is need of caution; a little lime-water or 
barley-water may at times be given instead. 
The best articles of diet for the weaned child during the active pro- 
gress of dentition are arrowroot made with water, a little sweet milk 
added; and isinglass dissolved in equal parts of milk and water, so as 
to resemble arrowroot in consistence. 
If the bowels are disordered, as they are apt to be, let a gentle laxa- DENTITION-DEOB STR VENTS. 
531 
tive be first administered-less than a teaspoonful of castor-oil: after its 
operation a little lime-water may be given-a teaspoonful repeatedly. 
To a child under a year, £ grain of Dover's powder may be administered 
night and morning; to one older, 1 grain. 
If the child have difficulty in making water, the warm bath often 
brings relief; and in addition, a few drops of the wine or syrup of 
ipecacuanha, and 1 or 2 drops of the liquor potassse may be given. 
When the gum is exceedingly red and swollen, a leech may be 
applied at the angle of the jaw, as in such a condition the employment 
of the lancet would be extremely painful, and unhealthy action in the 
gums might follow its use. 
During the progress of teething, certain forms of scalp eruption are 
very prone to appear, more particularly one which, in the first instance, 
consisting of minute vesicles, is afterwards, by their rupture and the 
escape of their watery contents, converted into a thin scab; which scab, 
becoming dry, in time separates: fresh vesicles, however, appear, and 
the head is at one part and time dry, at another moist. The ears gen- 
erally are swollen, and behind them there are cracks with watery fluid occu- 
pying them. In another form of eruption the scab over the scalp is much 
denser, from the rupture of little pustules. The hair, in both forms, 
assumes an unhealthy appearance, lying matted on the head, and often 
dropping out. These eruptions almost invariably disappear in course of 
time, and while teething progresses they should be very Cautiously inter- 
fered with. When very dry, a little glycerine will relieve the disagree- 
able irritation they occasion. When, on the other hand, they are moist, 
a little flour or violet puff may be dusted behind the ears and over the 
neck, down which they are apt to creep. Should they continue after 
dentition is complete, and the means now mentioned prove ineffectual, 
an alkaline lotion (carbonate of soda or baking soda, dram to 1 dram, 
in*8 ounces of water) may be alternated with the glycerine; the former 
when the head is moist, the latter when dryness of the scalp exists-the 
head being at the time protected from the atmosphere by a covering. 
While the changes taking place in the mouth of the child during the 
second dentition are not attended by an equal or the same constitutional 
affection as so often occurs in that of the infant during the first, there 
is often room, while it continues, for increased watchfulness and care. 
In those who are predisposed, various nervous affections, as Saint 
Vitus's dance, and epilepsy, are not unapt to be developed; and unless 
care be exercised, the general health may become more or less de- 
praved. (See Child, Teeth.) 
DEOBSTRUENTS, de-ob'-stru-ents [Lat. de, and obstruo, I obstruct], 
is a term applied to such medicines as have the property of removing 532 
DEOBSTE UENTS-EESQ VACATION. 
obstructions in any part of the body, especially in the lymphatic system. 
Mercury, iodine, bromine, and podophyllin are the principal deob- 
struents. 
DEODORIZER, de-o'-dur-ize-ur [Lat. de, from, and odor, an odor], 
is a term applied to such substances as have the power of destroying 
foetid smells. One of the most common and valuable of these is 
chloride of lime. (See Disinfectants.) 
DEPILATORY, de-pil'-ctrtur-e [Lat. de, from, and pilus, a hair], is 
a term applied to certain chemical substances employed for removing 
hair from the skin. Formerly it was usual to apply pitch to the part to 
be denuded, and then to pull it forcibly away; but this rude practice is 
now discontinued. Most of the depilatories to be purchased contain 
orpiment, and as this is an arsenical preparation, its employment is 
dangerous. One part of quicklime and two parts of carbonate of soda 
or baking soda, mixed and formed with water into a paste, and then 
applied to the part, will be found to be a good depilatory. 
DEPRESSANTS, OR CONTRA-IRRITANTS, de-pres'-sants, a 
general term applied to certain medicines which have the power of sub- 
duing excessive action. Thus sedatives and refrigerants are employed 
to subdue excessive action in the blood; narcotics and antispasmodics 
to subdue and soothe nervous excitement, or pain. 
DERBYSHIRE NECK. (See Goitre.) 
DERIVATIVE, de-rir'-a-tiv. The term, as used in Medicine, 
signifies whatever tends to withdraw diseased action from any part of the 
body, by means of action-not necessarily diseased-set up in some 
other part. Thus, bleeding from the lungs may be stopped by the 
derivative action exerted by the flow of blood from a vein opened in the 
arm, or inflammation affecting the eyes may be relieved by a blister, or 
a seton, at the back of the neck. Derivatives may be either natural or 
artificial. The principal natural derivatives are, either the discharge of 
blood, or the increase eof natural secretions; thus, bleeding from the 
nose may act derivatively, as regards the brain, or the bleeding from piles 
as regards the liver, or parts within the abdomen; or an attack of 
diarrhoea may also act in the same way. Boils, cutaneous eruptions, 
ulcers, etc., also act as derivatives, but in many cases approach the class 
of counter-irritants. Artificial derivatives, such as blood-letting, blisters, 
etc., may be referred to under their proper heads. 
DESPAIR. (See Passions.) 
DESQUAMATION, des-kwa-ma'-shun, is the separation, in scales or 
flakes, of the outward or scarf skin. Strictly speaking, desquamation is 
constantly going on on the surface of the body, and scales or scurf are 
constantly being separated in small and almost insensible quantity; but DESQ VARIATION-DIABETES. 
533 
after some inflammatory diseases, particularly those of an eruptive char- 
acter, such as scarlet fever, measles, etc., a much more copious desqua- 
mation takes place, and the scarf skin separates in large pieces. The 
same thing occurs after irritants, such as mustard plasters, blisters, etc., 
have been applied to the skin. Desquamation, whether natural or the 
consequence of disease, is always facilitated by the use of the tepid or 
warm bath. (See Skin ; Skin, Diseases of the.) 
DETERGENTS, de-ter'-jents [Lat. detergo, I wipe away], is a name 
given to,such medicines as cleanse and remove viscid humors adhering 
to and obstructing the vessels; also such applications as cleanse foul 
ulcers. 
DETERMINATION, de-ter-min-a-shun, is applied to the excessive 
flowing of the blood to any part, as a determination of blood to the 
head, etc. 
DIABETES, di-a-be-teez [Gr. dia, through, and bainomai, I pass], in 
Medicine is a disease characterized by an inordinate flow of urine. Medi; 
cal men recognize two distinct kinds of diabetes-the diabetis insipidus, 
or diuresis, in which there is merely a greatly increased flow of urine; 
and diabetes mellitus, in which the urine is found to contain a large 
quantity of saccharine matter. The former is ah uncommon disease, 
and differs from the latter in presenting no saccharine traces. Persons 
of a debilitated constitution and in the decline of life, are most subject 
to this disease. It commonly comes on slowly and imperceptibly, with- 
out any apparent disorder of the system, and may exist for considerable 
time before it attracts any notice. 
Causes.-Of the causes or treatment of this disease, unfortunately, 
little is satisfactorily known. Some refer it to a diseased state of the 
kidneys or liver, others of the lungs, stomach, or nervous system. It 
maybe produced by intemperate habits, or whatever tends to impair the 
system and produce debility^ and there is believed to be a predisposition 
to it in certain constitutions. 
Symptoms.-One of the most constant symptoms of this disease is 
an inordinate degree of thirst; and yet the quantity of urine passed daily 
is usually much greater than that of the liquids drunk. A voracious 
appetite is also a usual characteristic of this disease. After a time the 
constitution manifestly suffers; the body becomes emaciated, the strength 
and vigor fail, the pulse is frequent and small, a slight degree of fever 
prevails, and the skin is dry and rough. There are also usually aching 
pains in the back and loins, and uneasy sensations along the urinary 
passages. Although too often a fatal malady, it is not necessarily so, 
and cases have been known of a perfect recovery after the disease has 
been well established. In other cases it goes on by slow or rapid steps, 534 
DIABETES-DIA GNOSIS. 
sometimes extending over years to a fatal termination. In this last case 
the symptoms gradually become more and more intense, until at length 
the patient sinks from exhaustion, or is cut off by dropsy, consumption, 
or some other incurable disease. 
Treatment.-The measures resorted to in its treatment are rather of 
a palliative than a remedial nature. It is possible, however, by judicious 
treatment, if not to remove, at least to mitigate the symptoms and to 
ward off the issue for a number of years. The regulation of the diet 
constitutes by far the most important part of' the treatment, care being 
taken to exclude, as far as possible, all articles of food that contain sugar, 
or are readily converted into saccharine matter. Animal food ought, 
therefore, to constitute as large a portion of the diet as possible. All 
kinds of fruit must be avoided, as well as vegetables, as much as pos- 
sible, particularly such as contain a large quantity of starch, as potatoes. 
Bread, too, should be used very sparingly, and should be well fermented 
and somewhat stale. Bran-bread is preferable to the common kind. 
Beyond this, the treatment should be principally directed to restoring 
and strengthening the tone of the system by abundant exercise in the 
open air, and the use of tonics and such medicines as tend to soothe the 
nervous system. Opium in large and continued doses is said to have a 
very beneficial effect in this disease, and an exclusively milk diet, methodi- 
cally persevered in, is said to have been successsul in effecting cures in 
several cases. The state of the skin is particularly to be attended to, 
and daily ablution of the whole body in warm or cold water is recom- 
mended. The Turkish bath, it is believed, might possibly prove useful 
in this disorder. Flannel should also be worn next the skin. (See Diet, 
Exercise, Tonics, Milk, Ablution, Baths and Bathing, Flannel, 
Debility, etc.) 
DIACHYLON, OR LEAD PLASTER, dl-oK-edon [Lat. Emplas- 
trum Plumbi], is composed of oxide of lead in fine powder 4 lb., olive-oil 
1 gallon, and water 3^ pints, boiled gently together, and kept simmering 
for four or five hours, constantly stirring. It forms an excellent defen- 
sive, or strapping plaster, for protecting or keeping together the edges 
of wounds, but is chiefly used as a basis for other plasters. (See Plas- 
ters. ) 
DIAGNOSIS, di-ag-no'-sis [Gr. diagignosko, I discern, or distin- 
guish], is the art of discovering the nature of a disease, and of 
distinguishing it from other diseases of a similar nature. Much depends 
upon a correct diagnosis of disease, and the minute characteristics that 
frequently distinguish one disease from another render it often a matter 
of great skill and delicacy. If the true nature of a disease be not ascer- 
tained, a course of treatment may be pursued that may be followed by DIA GNOSIS-DIAPHORETICS. 
535 
very serious results. Nothing will compensate for a hasty and imperfect 
diagnosis, and evils innumerable spring from it. It is essential-in 
many cases at least-either to facilitate or enable the formation of an 
accurate opinion of a case of disease, that there should be perfect candor 
on the part of the patient towards the medical man consulted ; and 
not only candor, but thoughtful consideration and communication of 
every circumstance which is, or may appear to be, connected with the 
illness. Whether it be hereditary predisposition, or personal transgres- 
sion, nothing should be concealed. Females often permit prudery or 
mistaken feeling to interfere with their communications with a medical 
adviser; but one thing can be said upon this matter, if they cannot con- 
fide in him on these points, he is unworthy of their confidence at all, 
but the same resolution which induces the consultation, ought at the 
same time to give this resolve, to leave nothing untold connected with 
the state of health. 
When it is reflected how strict an investigation is required at the 
hands of those whose lives are, and have been devoted to the subject, it 
ought to make unprofessional persons doubly cautious in dealing with 
disease. Either our physicians, most of them men of character and of 
high honor, make a parade of their diagnosis of disease, and devote 
their lives of labor to deceive the public, or are themselves deceived, or 
quackery and quack medicine must be impudent lies and wicked deceits. 
The individual who purchases a quack nostrum, can either have no idea 
of the disease-if he has one-under which he- is suffering, or only 
the crude idea-diagnosis-of his own judgment, and upon the faith of 
this, he prescribes for himself the unknown compound of an unknown-■ 
to him at least-individual, on the faith of some lying advertisement. 
(See Medical Advice ; Opinion, Medical ; Prognosis, Physician, Sur- 
geon, Symptoms, Disease ; Quack, Quackery, etc. ) 
DIALYSED IRON. (See Iron.) 
DIAPHORETICS, di-a-fo-re^-iks [Gr. dia/phoreo, I carry through], 
are agents used in the practice of Medicine which "determine to the 
skin," or produce perspiration or sweating. The most useful diaphor- 
etics for domestic purposes are: 
Ammonia.-In the form of carbonate, when stimulation is required at 
the same time, and in the form of acetate or spirit of mindererus, 
which is one of our most certain and safest diaphoretics. (See Ammonia.) 
Antimony : In the form of the tartrate of antimony, in small doses, 
when fever is excessive, and the true James's powder, which is the 
safest form for children. (See Antimony.) 
Bath-Tepid, warm or vapor, or used as in hydropathic establish- 
ments, by means of the wet sheet and blankets. (See Baths and Bathing. ) 536 
DIAPHORETICS-DI API!RA GAL 
Ipecacuanha.-In any of its combinations. (See Ipecacuanha.) 
Opium.-Particularly in its combination with ipecacuanha, named 
Dover's powder. (See Dover's Powder, Opium.) 
To the above may be added, sweet spirit of nitre, gin, and diluent 
drinks of all kinds, sometimes cold, but generally warm, and exercise. 
There are many other agents employed in medicine as diaphoretics. 
(See Sweet Spirit of Nitre, Gin, Exercise.) 
As there is always a degree of uncertainty, especially in some consti- 
tutions, in the action of diaphoretic medicines, when they are taken, 
every means should be used to assist and promote the desired effect. 
Confinement to bed is absolutely necessary, and before retiring there, it 
is always well to put the feet in hot water for twenty minutes ; the dia- 
phoretic medicine should be used on getting into bed, and nothing more 
for three quarters of an hour, when the warm diluent drinks are to be 
commenced with, and may after that be taken very freely, and continued 
as long as the sweating process is kept up. If the warm diluent drinks 
are taken too soon after the medicine, vomiting will probably ensue, and 
so the object in view be defeated. Purgative medicine, which is likely 
to act during the operation of a diaphoretic, should be avoided ; for the 
disturbance occasioned thereby will not only effectually counteract the 
desired process, but may, by checking it, aggravate the disease it was 
intended to benefit. Some persons promote the action of sweating by 
cold instead of warm drinks. In cases of much febrile heat and excite- 
ment, they may be useful; but, as a general rule, it is the safer plan to 
keep to the warm fluid. When sweating is produced, the person should 
always have flannel next the skin, never linen ; and of course there must 
be sufficient covering to maintain the requisite temperature. If the per- 
son is laboring under infectious disease, additional care is of course 
requisite in the after disposal and purification of the woolen clothing. 
When it is thought desirable to check the sweating process, every source 
of chill must be avoided, the skin is to be dried with warm towels, and 
fresh clothing previously slightly warmed, put on, the coverings light- 
ened, and the hands and arms gradually exposed. There is sometimes 
great difficulty in producing perspiration in certain constitutions. When 
such is the case, the medicines should be given, and other means re- 
sorted to, towards four o'clock in the morning-that is, just previous to 
the time in the four-and-twenty hours, when the body, either in health 
or disease, appears most liable to perspiration. (See Skin, Perspira- 
tion. ) 
DIAPHRAGM, di'-arfram [Gr. diaphragm^ a partition], is the 
name given to that transverse muscle which separates the thorax or chest 
from the abdomen or belly. The diaphragm is largely engaged in laughing, DIAPIIRA GAL-DIARRIICEA. 
537 
sneezing, sighing, sobbing, and other affections of the respiratory- 
organs. Whatever occasions stoppage of the action of this muscle 
speedily proves fatal. It is subject to inflammation, called diaphragma- 
titis; but as this is rarely confined to the organ itself, but communicated 
either to the pleura or peritonaeum, its symptoms and mode of treatment 
correspond with inflammation of these parts. (See Pleurisy, Periton- 
itis.) 
DIARRHOEA, di-q-re-q [Gr. dia, and rheo, I flow]. The term diar- 
rhoea is in very general use both amongst professional men and their 
patients, to signify a certain state of the system in which the action of 
the bowels is much perverted and increased, the evacuations being 
loose, liquid, and frequent, and attended with griping pains in the 
abdomen; the tongue is white and furred, the breath offensive, and there 
is no appetite; the patient is troubled with nausea and vomiting, and 
flatulent distension of the abdomen; the temperature of the body is not 
heightened, nor is the pulse increased in frequency. 
Diarrhoea has been divided into several different species from the 
nature and appearance of the alvine discharges; thus in bilious diarrhoea 
the excreta are of a bright yellow color, and in the mucous form of the 
disease are freely mixed with mucus. When blood passes away with the 
feces, it is called dysenteric diarrhoea; and in another species the food 
escapes from the bowels in the same state as it entered the stomach, 
having passed all the various secretions of the alimentary canal unacted 
upon. This affection is due to an increased action of the bowels, brought 
on by some foreign matter irritating their mucous lining and muscular 
coat. 
Causes.-Diarrhoea has been traced to a great many different causes ; 
it may be due to exposure to heat or cold, and it most frequently occurs 
during the hotter weather of summer and autumn. It is often caused 
by over-feeding, and the use of acrid indigestible food, such as shell fish, 
salads, cucumber, and various kinds of fruit. Sometimes it is the result 
of mental emotion, and at others of an impure atmosphere: thus medical 
students frequently suffer from this malady when their daily avocations 
in the pursuit of scientific knowledge render their regular attendance in 
the tainted air of the dissecting room absolutely necessary. Diarrhoea 
is a symptom attending many important diseases; it is very trouble- 
some in pulmonary consumption, typhoid fever, and malignant disease 
of the bowels. 
This affection is distinguished from dysentery by the absence of 
inflammation and ulceration of the mucous lining of the intestines, by 
there being less griping, and by the absence of blood in the liquid dis- 
charges. 538 
DIARRTI(EA. 
Treatment.-The method of treatment will depend essentially upon 
the cause; if the disease be due to exposure to heat or cold, it will work 
its own cure, and all the interference from us that will be necessary is to 
restrict the diet, give diluents freely, and to keep the patient in an equa- 
ble temperature. When the bowels are thus affected from over-feeding 
and other errors in diet, nature is trying by this means to effect a cure, 
and consequently we should be wrong in giving any astringent form 
of medicine, but must first order a mild aperient to correct the faulty 
condition of the stomach and act gently on the bowels, carrying off the 
irritating substance; for this purpose, no drug is so well suited as the 
best East India rhubarb, for after its purgative effects have passed away, 
the medicine does not cease to be active, but exerts then a slightly 
astringent action upon the bowels; it should be given thus, in the form 
of a draught: 
Take of Powdered rhubarb, East India Twenty to thirty grains. 
Carbonate of magnesia Twenty grains. 
Peppermint water Two ounces.-Mix. 
Give the draught immediately. Next to rhubarb, probably the best 
aperient for this purpose is the old fashioned castor-oil. A tablespoon- 
ful may be given in these cases conjoined, if there is a good deal of pain, 
with 10 or 15 drops of laudanum 
When the bowels have already been assisted in their action of trying 
to rid themselves of the offending substance, should the purging still go 
on, a little astringent medicine may be given, thus : 
Take of Prepared chalk, in powder Two and one-half drams. 
Powdered gum acacia Three drams 
Laudanum. Eighty drops. 
Tincture of catechu One ounce. 
Pure water Eight ounces.-Mix. 
Give 2 tablespoonfuls every four hours till the purging ceases. 
Diarrhoea due to mental emotion will soon pass away when the ex- 
cited mind is at rest. When the purging is caused by a tainted atmo- 
sphere, the invalid should be removed for a time from its noxious influ- 
ence, and should be allowed plenty of fresh air and healthy exer- 
cise. 
When diarrhoea occurs as a symptom of other more important diseases, 
it must be met by general principles, according to the morbid condition 
giving rise to it. Thus in consumption and gastric fever, it is the result 
of an ulcerated and irritated state of the mucous membrane of the 
bowels, and is then very difficult to check. Chalk mixture may be tried 
in vain, and opium prove itself useless ; and should this actually be the 
case, we must resort to small doses of sulphate of copper, or nitrate of DIARRII(EA. 
539 
silver. These may be given in J or % grain doses, combined with bis- 
muth and confection of roses, every three or four hours, thus: 
Take of Nitrate of silver or sulphate of copper. .Three grains. 
White bismuth Twenty grains. 
Confection of roses sufficient to make six pills.-Mix. 
One to be taken every four hours until the purging ceases. 
The mineral acids are very useful in cases of simple diarrhoea when 
astringents are required. 
Take of Dilute sulphuric acid Two drams. 
Laudanum One dram. 
Infusion of gentian Six ounces.-Mix. 
Take 2 tablespoonfuls every four hours. Dilute nitric acid may be sub- 
stituted in the above prescription. 
In the diarrhoea of children, during dentition, the following powders 
are useful: 
Take of Gray powder Ten grains. 
Carbonate of magnesia Ten grains. 
Dover's powder Five grains.-Mix. 
Divide into 10 powders, 1 to be given every four or 6 hours. 
Chronic Diarrhoea-Diarrhoea may occur as a chronic, or long-con- 
tinued affection, lasting for months or years ; but these cases depend on 
such a variety of causes and influences, and require so much care in 
treatment, that they can only be advantageously managed by a medical 
adviser, and ought as soon as possible to be put under the care of one. 
In these and in all cases of bowel complaint, diet exerts great influence; 
generally speaking, the preparations of milk and of the grains are most 
suitable, such as arrowroot, sago, tapioca, rice, etc. When broth is 
given, it should be in small quantity and of tolerable strength; it is 
improved by the addition of gelatine, and of well-boiled rice. Alum 
whey is sometimes found useful in these cases. In chronic diarrhoea, 
ipecac, in doses of 2 or 3 grains, three times a day, has often effected a 
cure. In the absence of medical aid, the patient should try the decoction 
of blackberry (Pubus Villosus\ made by steeping a handful of the 
smaller roots, or the bark of the larger ones, in a pint of boiling water. 
(See Kubus.) Of this, 3 or 4 fluid ounces may be taken every three or 
four hours. From to 1 teaspoonful of the fluid extract of blackberry, 
when it can be procured, is better still. Fluid extract of logwood, in 
similar doses, will also be found useful, and also the fluid extract of 
cranesbill (Geranium Maculatum) in same doses. 
Preventive treatment.-As diarrhoea is frequently the result of eating 
unripe or impure fruit, great care should be taken, especially in the hot 
weather, to eat only fruit that is wholesome and ripe, and vegetables 540 
DIARRHEA-DIET. 
that are unirritating. Green corn and beans, when they come in season, 
should be partaken of cautiously, and green cucumbers be avoided as the 
essence of trouble. A chill often causes diarrhoea, therefore, some cover- 
ing should be used at night, even in the very hottest weather, and, in 
persons disposed to this trouble, it is a good plan to wear flannel next 
the abdomen at all times. If pure water cannot be procured, it should 
be filtered or boiled before using. Bathing the chest and abdomen daily 
with cold water, or water and vinegar, lessens the tendency to this 
disease. There is, probably, no disease that is more under control, by 
the observance of care in eating and drinking, and the other rules noted 
above. (See Dysentery, Bilious Cholera, Autumnal Complaints, 
Summer Complaint, Cholera, Chlorodyne, etc.) 
DIASTOLE, di-as'-to-le [Gr. dia, and stello, I stretch], is the dilating 
action of the heart, or that by which its cavities are opened to attract 
and receive a portion of the current of blood, after a previous portion 
has been expelled by the systole or contracting action of the organ. 
(See Circulation of the Blood, Heart. ) 
DIATHESIS, di-ath'-e-sis [Gr. diatithemi, I dispose], is a term used 
in medicine to indicate states of constitution peculiarly predisposed to 
certain diseases, such as scrofula, cancer, gout, etc. Peculiar diathesis 
is for the most part hereditary. 
DIEKVILLA CANADENSIS, di-ur-vil'-la can-a-den'-sis, or honey- 
suckle bush, a shrub belonging to the Nat. order Caprifoliaceoe. 
It grows in hedges and thickets throughout the United States and 
Canada. The leaves, twigs and roots are the parts used. It is diuretic, 
astringent and alterative. A cold infusion, taken freely has been found 
very useful in inflammation of the bladder and in gonorrhoea. The 
bruised root and leaves applied to the surface in the inflammation caused 
by the poison ivy soon relieves the pain and the burning. It may be 
taken without stint. (See Infusion. ) 
DIET, di'-et [Gr. diaita, regimen]. The diet of the infant, Nature, 
with unerring wisdom, has provided; and she has indicated, by those 
remarkable changes in the mouth, when it is that other articles of food are 
to be employed. These should, in the first instance, be farinaceous alone, 
rusl*, arrowroot, sago, rice, being the chief and most suitable; and with 
such and such like, cow's milk being substituted after weaning for the 
mother's or nurse's, may the child during the first two or three years of 
life be fed. There may occur circumstances rendering the occasional- 
even frequent-employment of other articles (animal soups, for example) 
requisite; but in the case of a healthy child the former restricted plan is 
vastly preferable. While yet a child-in other words, during the first 
seven years-unless to meet certain indications, it is well to permit the DIET. 
541 
farinaceous articles to enter largely into the diet as a whole: these, 
including bread, with well-cooked vegetable broth, animal soup, the 
lighter vegetables and the gravy of roasted meat, should be the staple; 
tender chop and steak, or fowl, the occasional, or even frequent varieties. 
There conies a time-and the occurrence of the second dentition must 
be regarded as marking it-when the regular use of more substantial 
food is required; and, after the sixth year, it is probable that the due 
admixture of animal and vegetable food is the most suitable and appro- 
priate diet. An early hour of the day is best suited for the principal 
meal of children. The growing youth, with keen appetite, often requires 
to be repressed rather than encouraged, in respect to food, though there 
is no doubt that at such a time, a liberal allowance of what is nourish- 
ing is demanded. 
Of ordinary animal food, beef and mutton are the most nutritious; 
and, when well cooked-particularly roasted-may be considered as 
easily digested as any other. Old meat is certainly preferable to young 
in both respects-beef to veal, mutton to lamb. Roast surpasses boiled 
and stewed is inferior to both. Steak and chop, with roast beef and 
mutton, form the very best varieties. White flesh (fowls and game) is 
an excellent occasional substitute for so-called butcher's meat; so, also, 
is white fish. 
It is undoubtedly easier for the stomach, and generally speaking, a 
better plan, to partake in moderation at dinner, of a few different arti- 
cles rather than to be restricted to one.* A dinner composed of a little 
soup, followed by a moderate allowance of beefsteak, mutton or beef, 
roasted or otherwise cooked, or one composed of white fish, with any of 
the articles named, is better than if the whole repast had consisted of 
beefsteak, which under such circumstances, with a good appetite, would 
be likely to be taken in too large amount. While beef and mutton are 
specially referred to, a variety may be secured from time to time by 
substituting pork, veal, lamb, venison, etc. 
A well-cooked pudding is a wholesome addition to dinner; pastry and 
apple dumplings should be moderately and only occasionally indulged 
in. Fruits, as dessert, are not merely agreeable, but in the case of many 
persons exert a salutary effect; strawberries, gooseberries, currants, 
raspberries, etc., in summer; figs, prunes, apples, oranges, etc., in 
winter. 
That element of food required to sustain life and impart strength is 
called albuminate. It has been ascertained that an able-bodied man 
weighing one hundred and forty pounds must have at least one quarter 
of a pound of this substance each day to keep his system in repair. 
Some kinds of food contain very much of this albuminate, others very 542 
DIET-DIGESTION. 
little. Lean meat and fish, and pease and beans belong to the first class, 
fruits and vegetables to the latter. They contain, however, a great deal 
of the warming element, which is just as necessary. To furnish this 
quarter of a pound of strength-giving element a man would require to 
eat five pounds of a mixed diet of meat, bread and vegetables, but he 
would at the same time furnish himself with a pound and a quarter of 
warming element. 
It will follow from this, that a different diet is needed in summer 
than in winter. When the hot weather begins to come on, the system 
does not need as much of those substances that give heat, such as fat, 
and fat meats, sugar, starch, butter, etc., therefore those should be, to a 
great extent, given up, and instead the cooling vegetables; the melon, 
in moderation, when it agrees; the berry, spinach, etc., should be eaten. 
Due regard to these facts would save a great deal of summer disease. 
(See Cookery foe the Sick, Food, Aliment, Albumen, Digestion, 
Dyspepsia, Acidity of the Stomach, Flatulence, Costiveness, Sleep, 
Exercise, Health, Starvation, Tbaining; Rule, Living by; Regimen, 
etc.) 
DIETETICS, di-e-tet'-iks [Gr. diaitetike], is that department of 
medical science which relates to the diet or ordinary food. (See Food, 
Diet. ) 
DIET FOR THE SICK. (See Cookeey fob the Sick.) 
DIFFICULT MENSTRUATION. (See Menstruation. ) 
DIGESTIBILITY OF FOOD, TABLE OF. (See Food.) 
DIGESTION, de-gest' -yun [Lat. digestio, from digero, I carry to 
different parts, or dissolve], is the process by which food is fitted for 
the nourishment of the animal body. The whole process may be 
divided into : 
The mastication or chewing of the food, and its mingling with the 
saliva or spittle. 
The swallowing of the food. 
The digestion of the food in the stomach, by means of the gastric 
juice. 
The mixture of the food with the bile and juice from the pancreas, 
and its conveyance through the small intestines. 
The passage of the remains of the food into and through the large 
intestine, or colon, during which it becomes acid, and mixed with the 
faeculent excretions from glands of that bowel. 
The discharge of the remnants of the food from the body along with 
other excrementitious matters. 
To the above may be added the passage of the digested and nutritious 
part of the food into the blood. DIGESTION. 
543 
The first process of digestion, the mastication or breaking down of 
the food by the teeth, and its mixture with the saliva, is one of extreme 
importance. The teeth of man are evidently adapted for the two pro- 
cesses of cutting and bruising; the front or incisor teeth being con- 
structed for the former purpose, the back, or molar, for the latter. These 
adaptations are well seconded by the action of the powerful muscles of 
the lower jaw, which give it a direct cutting, and a side to side or grind- 
ing motion ; the morsel of food submitted to this mechanical action 
being at the same time kept admirably under it by means of the 
extraordinary mobility and sensibility of the tongue, whilst it is at the 
same time thoroughly moistened by the saliva or spittle, which is poured 
out abundantly from the salivary glands, which lie imbedded around 
the mouth and jaws ; the same mechanical action which grinds the food, 
serving at the same time to press out the secreted saliva. This fluid, 
however, does not act simply as a moistener of the food, it exerts a dis- 
tinct chemical or digestive power upon its starchy components, convert- 
ing them into sugar, in which state they become fitted for absorption into 
the blood, a capability which starch does not possess. When the food 
morsel has been masticated, and moistened sufficiently-at least such 
ought to be the case-it is collected by the action of the tongue into a 
ball, and conveyed to the back of the throat or fauces, where it is con- 
signed to the care of involuntary muscles, and passes for the most part 
from under man's direct control. Passing from the throat into the 
gullet, it is carried by the wave-like action of that tube into the stomach. 
This action is not, as some might imagine, a simply mechanical one; 
that is, the food does not drop into the stomach as it would into a bag, 
by means of its own weight, but it is carried thither by the muscular 
movements of the oesophagus, or gullet, by the same power that water 
is conveyed upwards through the gullet of the drinking horse or cow, or 
indeed in ourselves, as any one can testify who has drunk from a spring 
by stooping down to the water. The entire process of swallowing, par- 
ticularly that part of it by which the top of the windpipe is protected 
during the passage of the food over it, is a series of beautifully con- 
nected actions. 
When the food has been passed down the gullet, and has reached the 
stomach, it lodges in its left or larger extremity. As soon as the lining 
membrane of the organ feels the contact of nutriment, it becomes 
reddened, there is evidently increased flow of blood to it, and quickly, 
its peculiar secretion, the gastric juice, or solvent fluid of the 
stomach, begins to be poured out. This fluid is "clear, transparent, and 
viscid, without smell, slightly saltish, and very perceptibly acid," its 
characteristic power being that of dissolving the chief components of 544 
DIGESTION. 
the food, and reducing the varied ingredients of a common meal to one 
homogeneous, gray-looking, pulpy, acid mass, which is called the 
chyme. This uniform mass, when formed, varies but slightly in 
perceptible character; when the food has been farinaceous, it is like 
gruel, but when much oily or fat nutriment is mixed with it, it has more 
of a creamy appearance. 
The solution, of the food, and its formation into chyme by the powers, 
of the gastric juice, is much assisted by the muscular movements- 
alternate contractions and relaxations-of the stomach, which turn the 
mass over and over, and thoroughly incorporate it with the solvent fluid. 
When the chyme is fully formed, it is probable that the gelatine com- 
ponents of the food have been dissolved, and what are called its 
albuminous components, such as the curd of milk, or cheese, or the 
muscular flesh of meat, or- the gluten of grain, have for the most part 
been reduced to the condition of a soluble albumen, fitted for absorption 
into the system. The action of the acid gastric juice, however, puts a 
stop to the conversion of the starchy ingredients of the food, into sugar, 
by the saliva; but this is resumed in the small intestines, when the 
acidity of the chyme has been neutralized by the alkalinity of the bile 
and juice of the pancreas or sweet-bread, with which it becomes mingled, 
immediately after it passes or is passed through the opening at the right 
or smaller extremity of the stomach, into the duodenum, or first portion 
of the small intestines. This passage of the chyme from the stomach 
into the intestines, is effected as each successive portion is perfectly 
formed, that is, has become of semi-fluid, perfectly smooth consistence; 
for in a healthy condition of the digestive organs, should a portion of 
solid food attempt to pass the muscular valve at the pylorus, or place 
of exit, it is immediately closed against it, and the morsel passed back 
into the stomach. As already mentioned, the chyme has no sooner 
passed from the stomach into the small intestines, than it becomes 
mingled with the bile, which is continually distilling into them from the 
liver, and with the juice from the pancreas or sweet-bread. The effect of 
this admixture is to neutralize the acidity of the chyme. The action of 
the saliva in converting the starchy matters into sugar is now resumed, 
and is probably assisted by the fluid from the pancreas, and the oily 
principles of the food are converted into a milky-looking emulsion, in 
which state they are fit for absorption into the system. The digested 
and altered food mass is now passed slowly through the small intestines- 
by their muscular, vermicular, or wave-like movements; during this 
passage, the nutrient portions are absorbed, partly by the blood-vessels, 
and partly-more particularly the oily emulsion portion-by the lacteal 
absorbent vessels, until the now almost exhausted food reaching the DIGESTION. 
545 
valve-like opening into the large bowel, or colon, is discharged into it. 
Here the food mass again becomes acid, and this change is supposed by 
some, and not improbably so, to be of the nature of a second digestion, 
to ensure the perfect solution of any matters which may have escaped 
the first acid digestion in the stomach. A more striking change, how- 
ever, is effected, for here the contents of the bowels assume their natural 
faecal or excrementitious character, and acquire their characteristic odor 
from being mingled with used-up matters thrown out or excreted from 
the system at large, from the small glands with which the lining mem- 
brane of the large bowel is studded. The absorption of the nutrient 
matters from the chyme requires a little explanation. 
The process is now considered to he largely shared in by the blood- 
vessels^ but much of it is doubtless effected by the lacteal vessels, which, 
indeed, were at one time considered to be the sole agents for the purpose. 
These little vessels are abundantly distributed over the small intestines. 
By the lacteals, the chyle, or milky-looking fluid absorbed from the 
intestines, is conveyed through a set of small glands-the mesenteric- 
after passing through which, the chyle, this extract from dead food, 
seems-if we may so speak-to become in some degree vitalized; it 
acquires power of coagulating, and assumes a red tinge when exposed to 
the air. The chyle from the various smaller lacteal vessels is now col- 
lected in the larger trunks, which coalesce at one point, and from one 
main vessel, the thoracic duct, which runs up and lies close upon 
the spine, till, arriving at the neck, it turns down and opens to discharge 
its contents into the general current of the circulation at the junction of 
the large veins of the head and neck with that from the arm. 
Such is the marvellous process by which man's material body is daily 
nourished, and its strength preserved and renewed. 
One of the most frequent causes of disorder of the digestive func- 
tion is insufficient mastication, either from want of teeth, from a habit of 
hurried eating, or from carelessness; many persons but half, or indeed 
scarcely at all, chew their food, which is swallowed in lumps, and of 
course, not being broken down, is unmixed with the due proportion of 
saliva. Fortunately, the solvent powers of the gastric juice are suf- 
ficiently active to compensate in the course of time for the imperfect per- 
formance of the first of the digestive operations; but it must be evident 
to all, how much longer and more laborious the process must be of dis- 
solving a solid lump of meat or potato, than of one well broken up and 
opened up to the operations of the gastric juice; it must also be evident, 
that in the case of farinaceous and vegetable food, insufficient admixture 
of saliva must occasion insufficient digestion or conversion of the starchy 
matter into sugar, and that, therefore, a portion of the food consumed 546 
DIGESTION. 
may become useless. Another evil resulting from imperfect mastication, 
is the rapidity with which food is introduced into the stomach, so that, 
probably, the organ is overloaded before the natural sensation of 
appeased hunger can make itself felt. 
Many persons again hurry over their meals, with minds intently 
engaged on something else; the food is swallowed as quickly as possible, 
and the scarcely interrupted mental effort or business anxiety is resumed; 
or it may be active exertion at once engaged in. Now, it is a law of the 
animal economy, that all the functions of the living body, and those 
which are only periodically called into exercise more than others, require 
for their perfect performance, some additional access of nervous power, 
and some increase in their usual supply of blood, whilst the peculiar 
function is in active operation. With the stomach this is peculiarly the 
case; the disinclination for exertion, and the slight sensation of cold 
which generally follow a full meal, are the results of the call made upon 
the nervous energies and upon the circulating blood by the stomach, 
during the first stages of digestion. These sensations are more felt if 
the individual remains quiet after a meal, less so or not at all, if active 
exertion, either of mind or body, is at once engaged in, and the reason 
for this is evident; in the first instance, the person who remains quiet 
permits the nervous power and the blood to be,- as they ought, directed 
to the performance of the digestive function, and, consequently, their 
supply to the other portions of the body being diminished, incapacity for 
exertion, both of mind and body, is experienced; if, however, before the 
nervous and circulating energies have become fully directed towards the 
stomach, (or, indeed, if after they have, exertion is made by a strong 
effort of the will,) they are attracted by a still stronger power, either 
of muscular movement or mental exercise, the inclination for rest is not 
experienced; but this is attained at the expense of the stomach and of its 
digestive powers, the food is more slowly and perhaps imperfectly, 
digested. It is true that many persons go on for a great length of time, 
without apparent bad results, violating the laws of their own constitution, 
snatching hurried meals, and running off to business, or study, or exer- 
tion, immediately after; but the practice tells, in the course of time, and the 
extreme prevalence of disorder of the digestive organs, especially among 
the commercial and professional classes in this country, is evidence suffici- 
ent of the hurtful tendency of such practices. There is, of course, much 
variation in the injury which the digestive powers sustain, for some have 
these naturally much more active than others, and can with much more 
impunity impose upon them, but as a general rule, moderate rest, both 
of body and mind, is requisite for a short period after a full meal has 
been taken, to ensure the perfection and the continued healthy operation DIGESTION 
547 
of the' digestive powers. If exertion is requisite, the meal should be 
made a light one, and the full supply of food delayed till rest can be 
taken. Somewhat similar consequences and enfeeblement of the func- 
tion of digestion are apt to occur if an individual makes a hearty meal 
when in a state of fatigue or exhaustion from exertion previous to the 
taking of food, even though quiet is observed after it; the nervous 
power being exhausted, cannot be sufficiently supplied to the stomach to 
support its efficient action. 
Another f requent cause of disordered digestion is excess of food, 
either at once, or by its too frequent repetition. It would seem that the 
healthy digestive power, and secretion of the gastric juice, is dependent 
in some degree upon the requirements of the system, and as the gastric 
juice can only dissolve a certain proportionate quantity of aliment, if 
more is taken than there is gastric juice to act upon it, it must be imper- 
fectly or not all digested, and if it is not, it becomes subject to the same 
chemical laws as if exposed to heat and moisture out of the living body; 
fermentation, and, it may be, putrefaction, take place; gas-"wind"- 
is generated, acids are formed both in the aliment itself, and thrown out, 
probably by the efforts of the irritated stomach, and heart-burn, pain, 
and the many other uneasy sensations connected with indigestion are 
developed. Many of the causes of indigestion are undoubtedly trace- 
able to other sources, but the consideration of those will be taken up in 
the article devoted to the subject. The digestive power of the stomach 
is remarkably interfered with, or even negatived, in many diseases, 
especially those of an acute or febrile character; it seems to lose almost 
entirely its power of secreting the gastric juice, and with it, of course, 
all power of digesting; if food is put into it, it is unacted upon, and is 
probably vomited after many hours, almost unchanged. There can be 
no question that this instinctive sympathy, as we may call it, of the 
stomach with the constitution at large, is wisely intended to prevent 
nutriment being introduced into the system, and into the blood, when it 
would either only tend to embarrass the curative powers of nature, or 
to aggravate the disease. 
It may, perhaps, have puzzled the unprofessional reader that at 
times the digestive operations have been alluded to as if they had 
actually been witnessed by the eye, and such is the fact; for it happened 
that between thirty and forty years ago, an American physician-Dr. 
Beaumont-enjoyed the rare opportunity of experimenting upon, and 
witnessing with his eyes, the results of his experiments upon the healthy 
stomach of a living healthy man. 
The subject of Dr. Beaumont's experiences was Alexis St. Martin, a 
young Canadian of good constitution and robust health, who was acci- 548 
DIGESTION-DIGITALIS PURPUREA. 
dentally wounded by the discharge of a musket, which carried away a 
portion of the skin and muscles covering the stomach, and perforated 
the organ. By good treatment, St. Martin recovered from the injury, 
but the opening into the stomach never closed. The case coming under 
the notice of Dr. Beaumont, he, fortunately for science, availed himself 
most fully and intelligently of the unique opportunity it afforded, and, 
by numerous well-conducted and accurately-recorded experiments, he 
cast light upon many unascertained points connected with the process of 
digestion, to some of which allusion will be made in future articles, par- 
ticularly in that upon food. 
For Dr. Beaumont's table, containing a long list of articles of food, 
and the time consumed in digesting each, see Food. (See also Diet, 
Animal Chemistry, Animal Heat, Dyspepsia, Alimentary Canal, 
Stomach, Acidity of the Stomach, Flatulence, Physiology; Bule, 
Living by; Regimen, Exercise, Health, etc.) 
DIGITALIS PURPUREA, dij-e-td-lis pur-pu-re-a^ or foxglove, a 
biennial plant belonging to the Nat. order Scrophulariacew. It is a 
native of Europe, but is cultivated in this country, both as an orna- 
mental plant and for medicinal purposes. The leaves are the parts 
employed in medicine ; and they owe their activity to a principle known 
as digitalzne. 
Digitalis is narcotic, sedative and diuretic. Administered in quanti- 
ties sufficient to bring the system decidedly under its influence, it is apt 
to produce a sense of tightness, or dull weight in the head, vertigo, dim- 
ness or other disorders of the vision, and more or less confusion of 
thought. It sometimes also disturbs the bowels, and excites nausea, or 
even vomiting. Another and highly important effect is an augmented 
flow of urine. Besides these effects, digitalis has a remarkably sedative 
action upon the heart. This is exhibited in the reduction both of the 
force and frequency of the pulse, which sometimes sinks to fifty, forty, 
or even thirty strokes in a minute. In some instances, however, it 
undergoes little change; in others, only becomes irregular, and in 
some cases, it is said, it has occasioned an increase in frequency. An- 
other peculiarity of digitalis is, that after having been administered in 
moderate doses for several days, without apparent effect, it sometimes 
acts suddenly, with an accumulated influence, even endangering life. It 
is, moreover, very permanent in its operation, which, having once com- 
menced, is maintained for a considerable period, without fresh acces- 
sions of medicine. It is prescribed as a sedative in hypertrophy or 
enlargement of the heart, and'in aneurism of the large vessels proceed- 
ing from it; in inflammatory diseases; in dropsy, on account of its 
great diuretic power; in hemorrhage, as a sedative. Digitalis is a DIGITALIS PURPUREA-DINNER. 
549 
violent poison, and is one of those remedies which should never be 
administered without an accurate knowledge of their medicinal prop- 
erties. Dose: of the fluid extract, 1 to 10 drops; solid extract, 
to 1 grain; tincture, 10 to 30 drops; digitaline, ± to ~ of a grain. 
(See Poisons and theik Antidotes.) 
DILATATION, dil-add-shun [Lat. dllatatio\ is the expansion or 
enlarging of bodies after a state of contraction or compression. It dif- 
fers from extension, as the latter is properly applied only to lines and 
surfaces, the former to bodies that spread open or enlarge in all direc- 
tions. 
DILL. (See Anethum.) 
DILUENTS, dil'-u-ents [Lat. diluo, I wash away], are liquids ad- 
ministered to increase the fluidity of the blood, and render certain of 
the secretions and excretions less viscid. They likewise promote the 
operation of more active medicines, especially aperients and diuretics. 
Water is the simplest, and frequently the best diluent; or it maybe 
made more agreeable by the addition of acid or other substances, or in 
the form of toast and water. Gruel, infusion of tea, mutton and chicken 
broth, beef-tea and such-like, come under this designation. Diluents 
are of great use in allaying the thirst of patients affected with fever or 
other inflammatory complaints, and are often very useful in subduing 
the more violent symptoms of the disease, and relieving the system by 
means of perspiration. The excessive use of fluids at meals, however, 
is hurtful to digestion. (See Drinks.) 
DIMNESS OF SIGHT. (See Amaurosis.) 
DINNER, din'-nur [Ang.-Sax. dynan, to dine], is the meal of the 
twenty-four hours, the principal occasion on which the daily waste of 
the body is restored by food. At dinner, for the most part, the articles 
either of food or drink taken, are stronger and more stimulating than 
at any other meal, consequently its disposal makes the greatest de- 
mand upon the digestive powers. It matters not that what some 
persons call dinner, others would call supper, for by the designation 
is here meant the principal meal of the day. 
The regulation of the meal as to time and circumstances, often 
requires more attention and care in relation to health than is bestowed 
upon it, either by medical men or the public. In more primitive 
times, and where primitive habits prevail at the present day, the 
timing of this principal meal, must obviously be very different from 
what it should be when taken in connection with the habits and modes of 
life of many in this country, particularly in our large cities. When per- 
sons, such as those engaged in country and agricultural work, rise very 
early, and are engaged in active muscular exertion in the open air, there 550 
DINNER. 
can be no question, that by the time of noon, the system is ready for, 
and requires a full supply of good nourishment; and the powers of diges- 
tion are fully equal to the task, even though the interval of rest be not 
very great, and that, further, half-a-dozen hours' work afterwards, pave 
the way for another substantial meal-such being the case with our agri- 
culturists, the healthiest and strongest, probably, of our population-and 
people seeing this, have jumped somewhat hastily to the conclusion that 
the early dinner is the secret of health, forgetting the other accessories 
of fresh air and exercise, and in the case of the laborer, not over active 
minds. The case of mechanics and artizans generally, who begin the 
day early, is nearly, but not quite similar to that of the laborer; they 
require a good meal tolerably early in the day, but not having the advan- 
tage in many cases of the fresh air of the agriculturist, many of them 
might with advantage divide the meals a little more equally, diminish 
the dinner, and add to the meal made after work is concluded, more par- 
ticularly when the dinner hour is short, or shortened by the necessity of 
walking home from the place of employment to the meal. 
When the case of the professional and business classes is considered, 
it must be evident how completely the time for their principal meal must 
be altered by circumstances; beginning the day for the most part, some 
hours later than the operatives, making, generally, much less physical 
exertion, and working the head more, there is not the necessity for the 
principal meal being early in the day; moreover, the employments gen- 
erally of the class in question, being more of the mind than of the body, 
and often of an anxious and thought-engrossing nature, they cannot in 
the midst of them cast loose the mind, or place it in the same careless 
ease as the physical laborer can do, consequently the digestive powers 
are interfered with. If these observations are taken in connection with 
those upon digestion in the article devoted to that subject, their force 
will be seen. (See Digestion.) 
Undoubtedly, modern habits and luxury tend frequently to make 
even this principal meal, a much too abundant one, chiefly by tempting 
the appetite with a variety of food, and it is impossible to lay down any 
set rules on this head beyond that which every rational man must be 
well aware of, that none can perseveringly transgress the bounds of 
temperance, either in eating or drinking, without sooner or later, disease 
being the result. 
Sleeping after dinner may suit a few persons, but it is not advisable 
for those of full habit of body. For the reasons already mentioned, the 
time immediately succeeding dinner should be one of easy relaxation, to 
the man of mental toil in particular. The use of wine, beer, or any 
stimulant, falls of course to be considered under the other articles more DINNER-DIOSPYROS VIRGINIANA. 
551 
directly bearing on these subjects. A cup of coffee is sometimes taken 
shortly after dinner; opinions differ as to the propriety or not of the 
practice; it will probably be found to be best regulated by individual 
experience; the practice, however, of taking tea or coffee two or three 
hours after the meal, is unquestionably a serviceable one amid the usages 
of civilized life, and assists the perfection of the latter stages of digestion. 
These diluents, however, ought not to be taken too strong, or too late in 
the evening, otherwise their effect upon the nervous system will inter- 
fere with sleep. 
Some individuals of weak digestive powers are in the habit of taking 
a "dinner pill," for the purpose either of exciting the appetite, of stim- 
ulating the digestion, or of both. As a habit, the practice is bad, 
because it must be a substitute for more efficient and permanent means 
of improving appetite and digestion; occasionally, however, in some 
cases the dinner pill is useful as a temporary remedy. Eighteen grains 
of compound rhubarb pill, 6 grains of cayenne pepper, and 12 
grains of extract of gentian, made up into twelve pills, of which 1 or 
2 may be taken a quarter of an hour before dinner, will be found use- 
ful. The practice of taking spirits, or stimulant cordials or bitters before 
dinner, is highly injurious to the stomach, exhausting and irritating in a 
way that must interfere with digestion. A draught of cold waiter is a 
much better preparative; with persons of very weak powers, however, 
cold water either before or during the meal, depresses too much. (See 
Breakfast, Luncheon, Supper, Meals, Digestion, Dyspepsia, Diet, 
Food, Exercise, Drinks, Ale, Wine, Brandy; Stimulants, Alco- 
holic ; Regimen ; Rule, Living by, etc. ) 
DINNER PILL. (See Pills, Dinner.) 
DIOSCOREA VILLOSA, di-os-kd-re-a vil-ld-sa, or wild yam, a deli- 
cate twining vine belonging to the Nat. order Dioscoreacea. It grows 
from Canada to the Gulf of Mexico, and in many parts it is known as 
colic-root, china-root and devil's bones. It owes its activity to an active 
principle named dioscorein. It is an excellent antispasmodic. In bili- 
ous colic it has considerable reputation ; by some considered a specific ; 
in cramp of the stomach or painful spasmodic affections of the bowels ; 
in flatulence, and in nausea and vomiting of pregnant women, it is par- 
ticularly recommended. Dose: of the fluid extract, 5 to 30 drops, 
repeated every hour, if necessary; infusion, 1 to 2 fluid ounces; dios- 
corein, 1 to 4 grains. (See Infusion.) 
DIOSPYROS VIRGINIANA, di-os-pi'-rus vir-jin-e-a'-na^ or per- 
simmon, the bark and fruit of an indigenous tree growing all over the 
United States, but reaching its greatest proportions in the South. It is 
tonic and astringent, and has been used with success in intermittent 552 
DIO SPYROS VIRGINIAN A-DIPHTHERIA. 
fever, dysentery and hemorrhage from the womb. An infusion of the 
bark or fruit may be made by adding an ounce of either to a pint of 
water. (See Infusion.) Dose: of the infusion or syrup, for adults, a 
fluid ounce ; for infants, 1 teaspoonful. 
DIPHTHERIA, dif-tke'-re-a [Fr. diptkerite, from Gr. dipkthera^ a 
skin or membrane], may be defined as epidemic sore throat, depending 
upon the presence of a blood poison in the system, accompanied with 
the exudation of a leathery-looking membrane or skin upon the throat, 
attended by great prostration of vital power, and not unfrequently fol- 
lowed by a remarkable form of paralysis of certain muscles, of which 
more will be said hereafter. It may occur more than once in the same 
individual-that is to say, that though, depending upon the presence 
of a fever poison as distinct as that of typhus or scarlet fever, yet one 
attack does not afford immunity from a second. 
Symptoms.-The disease frequently commences with a feeling of 
languor and debility, sickness, headache, and not unfrequently shiverings 
or chilly sensations. It is very remarkable that, in a short time after 
the commencement of the symptoms, the strongest man may feel as 
weak as a child, and require to be supported in walking to his bed-room. 
The throat affection comes on in different ways. Some patients awake 
in the middle of the night, and find the throat sore for the first time. In 
others it is preceded by a slight feeling of stiffness in the neck, and gen- 
eral uneasiness in the region of the throat. The tonsils and glands of 
the neck become tender and inflamed ; there is difficulty of breathing; 
and soonfer or later there appears the leathery membrane spoken of 
above. This does not, of course, present itself fully formed all at once, 
but in the form of little patches, which coalesce to form one continuous 
skin or membrane, which certainly resembles damp white leather. It is 
this skin or membrane which is so eminently characteristic of diphtheria, 
whether it occurs in the throat, or, as it sometimes does, in other parts 
of the body. In bad cases of the disease, the membrane increases in 
extent, and spreads to the surrounding parts-to the palate, uvula, gul- 
let and nostrils, the cheek and gums, or even-in which case it is of 
course extremely perilous-to the larynx and windpipe. In cases where 
there is much of this membrane about the throat or mouth, there is 
always a great amount of sloughing, accompanied with fetor of the 
breath, while the membrane is being detached and separated, leaving a 
raw, ulcerated substance underneath, which is often very painful during 
swallowing, especially if any irritating substance is used with the food 
which the patient takes. The pulse is generally quick and very feeble, 
and the skin dry and hot. The tongue is generally furred ; and there is 
great disinclination to take food, both on account of the difficulty of DIPHTHERIA. 
553 
swallowing, and the want of appetite. In very bad cases, occurring for 
the most part in those who live in dark and damp, ill-ventilated and ill- 
drained dwellings, the patient very soon sinks into what is called a 
typhoid state; mortification sets in in the affected parts; and there is 
not unfrequently hemorrhage, which may cause death to those already 
weakened by the disease. Most commonly, death takes place from ex^ 
haustion. It may, however, take place suddenly, owing to the format 
tion of clots of the diseased blood in the heart or large blood-vessels. 
It not unfrequently happens, too, that the patient is choked by the mem- 
brane extending down into and blocking up the air-passages; death 
being either gradual or sudden from this cause. 
Treatment.-The treatment of the disease must be divided into that 
necessary for the throat itself, and that required to support the system 
under the violence of the disease, assist the elimination of the morbid 
poison, and ensure a good recovery of the patient. Numerous sub- 
stances have been applied to the throat in the shape of caustics, washes, 
gargles, etc. If a caustic be used, it is probably best to pencil the throat 
over with nitrate of silver, or with a solution of 2 scruples of this salt 
in 1 ounce of nitric ether. Chlorine water, or solution of chlorinated 
soda, may be used in the proportion of one part to eight parts of water, 
either as a gargle or as a wash, to be pencilled over the throat; or borax 
.and water may be tried, or a gargle or wash made by adding 3 drams of 
tincture of the muriate of iron to a tumblerful of water. 
It may be stated generally as an axiom, that all internal remedies of 
a depressing character, are to be avoided in this disease. Ten to 15 
grains of chlorate of potash may be given in water to an adult every 
three or four hours; or, if there is a tendency to sloughing and to hem- 
orrhage, 15 drops of the tincture of the muriate of iron, and 15 
dlops of the dilute hydrochloric acid may be added to this. Strong 
beef-tea and wine should be given at regular intervals, according to 
the patient's state; and in cases of great depression, brandy must be 
given instead of wine. Where there is inability to swallow, injections 
of brandy, beef-tea and quinine, should be administered. Dr. Lewis 
Smith, Clinical Professor of Diseases of Children at Bellevue Medical 
College, uses the following formulae in the treatment of this disease : 
Take of Sulphate of quinine Thirty grains. 
Compound elixir of taraxacum Two ounces.-Mix. 
Give one teaspoonful every 2 hours, and 1 teaspoonful of the following 
between each dose : 
Take of Tincture of iron Two drams. 
Chlorate of potash Two drams. 
Simple syrup Four ounces.-Mix. 554 
DIPHTHERIA. 
Tlie citrate of iron and ammonia alone, or combined with carbonate of 
ammonia, may be given in 2 grain doses, in syrup, instead of the above, 
when the inflammation in the throat has considerably abated, or is 
moderate. 
Dr. Smith also objects very strongly to the forcible removal of the 
false membrane, and also to the use of irritating applications. The use 
of the sponge or other rough instrument should be avoided, as likely to 
do harm. The local applications should be made with a camel's hair 
brush, or with the atomizer. 
He recommends the local use of one or the other of the following 
mixtures: 
1. Take of Salicylic acid Half an ounce. 
Glycerine Two ounces. 
Lime water Six ounces.-Mix. 
2. Take of Carbolic acid Thirty-two drops. 
Glycerine Two ounces. 
Lime water Six ounces.-Mix. 
3. Take of Carbolic acid Thirty-two drops. 
Chlorate of potash Three drams. 
Glycerine Three drams. 
Water Five ounces.-Mix. 
Half a dozen compressions of the back of the hand atomizer cover the' 
surface of the throat more effectually than can be done by several appli- 
cations of the brush, and it is usually not dreaded by the patient. In 
the absence of an atomizer, the following mixture may be applied 
with a camel's hair brush: 
Take of Carbolic acid Eight drops. 
Solution of sub-sulphate of iron Two drams. 
Glycerine One ounce.-Mix. 
When the membrane of the nose becomes affected, the best method of 
treatment consists in injecting into the nostrils with a small glass syringe, 
every third or fourth hour, 1 or 2 teaspoonfuls of the following 
mixture: 
Take of Carbolic acid Thirty-four drops. 
Glycerine Two ounces. 
Water Six ounces.-Mix. 
It should be used about the same temperature as the blood, the head 
being thrown back and the eyes covered with a cloth. 
Carbolate of soda has also been used successfully in this disease, as 
well as a new remedy named diphtherine, manufactured by Tilden 
& Co. 
Preventive treatment.-All classes are liable to diphtheria where it 
is prevailing, but those suffer most severely who live on low, wet DIPHTHERIA-DIPSOMANIA. 
555 
grounds; in houses with imperfect drains, or surrounded by offensive 
matters, as privies, decaying animal or vegetable refuse; in damp rooms, 
as cellars; in overcrowded and unventilated apartments. 
Diphtheria is not affected by either heat or cold, drought or rain. 
Cleanliness in and around the dwelling, and pure air in living and 
sleeping rooms, are of the utmost importance wherever any contagious 
disease is prevailing, as cleanliness tends both to prevent and mitigate 
it. Every kind and source of filth around and in the house should be 
thoroughly removed; cellars and foul areas should be cleaned and dis- 
infected; drains should be put in perfect repair; dirty walls and ceilings 
should be lime-washed, and every occupied room should be thoroughly 
ventilated. Apartments which have been occupied by persons sick with 
diphtheria should be cleansed with disinfectants; ceilings lime-washed and 
wood-work painted; the carpets, bed clothes, upholstered furniture, etc., 
exposed many days to fresh air and the sunlight; and all articles which 
may be boiled or subjected to high degrees of heat, should be thus 
disinfected. 
When diphtheria is prevailing, no child should he allowed to kiss 
strange children, nor those suffering from sore throat, nor should it 
sleep with or be confined to rooms occupied by, or use articles, as toys 
taken in the mouth, handkerchiefs, etc., belonging to children having 
sore throats, croup, or catarrh. If the weather is cold, the child should 
be warmly clad with flannels. 
When diphtheria is in the house or in the family the well children 
should he scrupulously kept apart f rom the sick, in dry, well-aired rooms, 
and every possible source of infection through the air, by personal con- 
tact with the sick and by articles used about them or in their room 
should be rigidly guarded. Every attack of sore throat, croup, and 
catarrh should be at once attended to. The feeble should have invigo- 
rating food and treatment. 
Sick children should he rigidly isolated in well-aired unlighted rooms, 
the outflow of air being, as far as possible, through the external win- 
dows by depressing the upper and elevating the lower sash. All dis- 
charges from the mouth and nose should be received into vessels con- 
taining disinfectants, or upon cloths which are immediately burned, or 
if not burned, thoroughly boiled, or placed under a disinfecting fluid. 
(See Atomizer, Air, Bromo-Chloralum, Children, Cold Feet, Damp, 
Disinfectants, Drainage, Health, Sanitary Science, Ventilation, 
etc.) 
DIPSOMANIA, dip-so-ma-ne-a [Gr. dipsa, thirst; mania, madness], 
a term lately applied to an inordinate or insane craving for alcoholic 
stimulants. It is a remarkable and at the same time a most melancholy 556 
DIPSOMANIA. 
reflection, that those persons who have for a length of time indulged a 
craving for intoxicating drinks, sooner or later, are apt to lose all power 
of control over themselves, and, in fact, so conscious are they of this, 
that many of them would willingly submit to any kind of restraint which 
would deprive them of all opportunities of indulging in a vice, the per- 
nicious consequences of which they are too well aware of. Continuance 
in such a degrading vice as drunkenness cannot fail to be followed by 
punishment, and those who are ignorant on the subject should not be 
left uninformed that the disease, if we may so call it, dipsomania, is a 
consequence of vicious habits unchecked; that it is one of the most 
dreadful punishments with which a poor human creature can be visited, 
so dreadful, that the sufferer is often only too anxious to put himself 
under voluntary restraint, making the humiliating confession that his 
reason-that proudest faculty of man-has lost its ascendancy over his 
evil passions, and that he has indeed sunk into a lower condition than 
the brutes that perish! It must, however, be distinctly understood that 
there is no such disease as dipsomania, which has not been self-acquired 
or hereditarily transmitted; that is, there is no disease of the brain 
known to physicians which causes this morbid craving for drink that has 
not itself followed as a consequence of indulgence in the evil habit. In 
connection with this, it may be well to remark that there is in the pres- 
ent day too great a readiness on the part of the public mind to attribute 
the commission of the most revolting crimes to insanity, and to regard a 
drunkard as an irresponsible being, a tendency which is as much against 
common sense as it is detrimental to public safety. 
Treatment.-Proper treatment consists in the entire removal of stim- 
ulants, and the substitution of good nourishing food, exercise in the open 
air, and healthful occupation both of body and mind. Medicine is only 
of use in so far as to correct that derangement of the digestive organs 
which almost invariably is present in the debauchee. Mineral acids, 
quinine, iron, etc., may be given to restore the tone of the system. 
Aerated waters of various kinds, either alone, or with the addition of 
some agreeable fruit syrup, lemonade, soda water, potash water, etc., 
may be taken as drinks at meals. 
Bitter tonics, such as a strong infusion of Peruvian bark or quassia 
chips, should be taken at the same hours when it was usual to take the 
alcoholic stimulant. Dilute sulphuric acid, 10 to 15 drops three or four 
times a day; sulphate of quinine, 3 grains, morning and evening, and 
sulphate of iron, 1 grain thrice daily, may be given to restore the system. 
Coffee in the morning, and milk taken freely through the day, with 
abundance of animal food in the shape of fresh beef or beef-tea, will sup- 
ply the place of the stimulant, and soon recuperate the debilitated body DIPSOMANIA-DISEASE. 
557 
and the enfeebled mind. The welfare of society demands that there 
should be institutions throughout the country for the voluntary or com- 
pulsory restraint of habitual drunkards, where they might be subjected 
to proper treatment, under the care of duly qualified medical attendants. 
A number of these establishments already exist in this country, known 
as inebriate asylums ; and so far, the results of the treatment have been 
eminently satisfactory. (See Stimulants, Alcoholic ; Intoxication, 
Delirium Tremens, Tonics, Diet, Food, Exercise, Recreation, Regi- 
men, Health,Longevity, etc.) 
DIRCA PALUSTRIS, dur'-kq pq-lus'-tris, moosewood or leather- 
wood, a perennial shrub belonging to the Nat. order ThynLodacece. It 
grows all over the United States and Canada. The bark is the part used 
in medicine; it is acrid, emetic and cathartic. The decoction, in doses 
of 1 to 4 fluid ounces, may be used intsead of senega; but the latter is 
preferable. The steam from the boiling decoction is sometimes inhaled 
in pectoral or lung troubles, and not without considerable benefit. 
(See Decoction.) 
DISCHARGE, dis-tsharje', used as a medical term generally; means 
anything cast out from the body. It is often applied, however, in a more 
restricted sense, to the excretion of purulent matter solely. 
DISCHARGE FROM THE EAR. (See Ear, Diseases of the.) 
DISCUTIENT, dis-ku -shent [Lat. discutio, I destroy], is a term 
applied to remedies that discuss or disperse morbid matter. 
DISEASE, diz-eez [Ang.-Sax.], is a departure from the state of 
health in which the due balance between the several parts or proper- 
ties of the animal frame is maintained. It is "a changed condition or 
proportion, in function or structure, in one or more parts of the body.'' 
Diseases of function are deviations from a standard furnished by physiol- 
ogy, and disease of structure a departure from a standard supplied by 
anatomy. These, however, are usually combined ; for there is seldom 
structural disease without some disorderof function, andinmany instances 
functional diseases are, or ultimately will be, accompanied by change of 
structure. The causes of the disease may be either intrinsic, existing 
within the body, or independent of any obvious external influence ; or 
they may be extrinsic, having their origin without the body. The latter 
embrace all the external agencies that can operate either on body or 
mind-as temperature, air, food, poison, sensual impressions, and the 
like. Causes of disease, however, are often present without disease en- 
suing, some frames being less susceptible to particular causes of disease 
than others. Hence physicians distinguish two kinds of causes-predis- 
posing and exciting ; the former being circumstances which so influence 
the functions or structures of the body as to render it unusually suscep- 558 
DISEASE. 
tible to the influence of particular exciting causes-that is, of such 
circumstances and agents as seem to more immediately operate in pro- 
ducing disease, especially when in a state of predisposition. 
The predisposing causes of disease are said to be : 1, Debilitating in- 
fluences ; 2, excitement; 3, previous disease ; 4, present disease ; 5, 
hereditary constitution ; 6, temperament; 7, age ; 8, sex; 9, occupa- 
tion. The exciting causes are so termed because the diseases seldom 
make their appearance unless they have been present ; and hence they 
have come to be regarded in the light of excitements to it. They are 
divided into cognizable and non-cognizable agents ; the former compre- 
hending those physical and mental influences of whose existence we can 
take cognizance independently of their operation in producing disease; 
the latter such as elude our senses, and whose existence we only infer 
from their morbific effects. 
The cognizable agents are: 1, Mechanical influences; 2, chemical 
influences ; 3, bodily exertion; 4, mental emotion; 5, excessive evacua- 
tion ; 6, suppressed or defective evacuation ; 7, defective cleanliness, 
ventilation, or drainage ; 8, excess and changes of temperature. 
The non-cognizable facts are : Endemic, epidemic and infectious poi- 
sons, and are sometimes termed zymotic [Gr. zuma, a ferment.] The 
classification and arrangement of diseases according to their external 
characters, is termed nosology; and that branch of science which more 
particularly regards the nature and progress of disease with a view to 
its cure, is called pathology. References from this article must be made 
to the work at large, for it bears upon the whole. 
Perfect health consists in the uninterrupted action and perfect 
balance of all the functions of the body-this involving, of course, per- 
fection of structure. The slightest pain or ache must be indicative of a 
hitch somewhere in the machinery. In this view, perhaps, none are 
free from disease for a day ; for few can boast of such perfect, undevi- 
ating health, as to pass four-and-twenty hours without some slight 
twinge of pain, without some ache or weariness to remind them that 
their bodies are mortal; and from this slightest passing uneasiness, to 
the confirmed and fatal malady, disease passes through every gradation. 
Again, it must be remembered that constitution and other causes oc- 
casion so much variation in the actions of the body, that what would be 
disease in one man, is health in another. For instance, one man's pulse 
may average sixty in a minute, another's eighty; and it is certain that 
the former could not rise to the level of the latter, or the latter sink 
to that of the former, without disease or disorder being present. Such 
considerations are important in judging of the real state of a person 
laboring under disease ; to judge accurately of disorder, we must know DISEASE. 
559 
the whereabouts of the level of health, and in this consists the great 
advantage of the regular medical attendant over one who is casually 
consulted, and who first sees the patient when suffering under illness. In 
popular language, the regular attendant " knows the constitution " of 
his patient; the other has it in many respects to learn. 
Tendency to health.-Many of the most painful and deadly disor- 
ders are not more felt at their commencement than as a slight sense of 
discomfort, and perhaps numbness of the lesser pains felt during what 
is considered health, might pass on to real disease, were it not for the 
natural tendency to cure with which our bodies are endowed ; that 
which is called the vis medicatrix naturae-the same tendency which 
restores the fractured bone to soundness, and heals the wound. There 
can be no question that, but for this tendency towards health, this 
power of resisting and casting off disease, our bodies would quickly suc- 
cumb to the innumerable causes of disorder to which they are hourly 
exposed. This power of resisting disease is without doubt much greater 
in some persons than others, and even in the same person at different 
times, often without any perceptible reason why it should be so. The 
power of the system in casting off disease, when forming or formed, is 
for the most part more plainly exercised. 
When disease has established itself in the constitution, were it not 
for the " tendency to health,"- it must run on to a fatal termination ; the 
wound would remain unhealed, the inflammation would extend, or its 
effects remain unrepaired, were it not for these curative powers existing 
in the constitution itself. If, then, whatever tends to lower the standard 
of health, favors the inroad of disease, so the preservation of that stan- 
dard, as far as may be consistent with the safety of the patient and the 
reduction of his malady, ensures a more certain and speedy throwing off 
of the effects of the disorder, or, in one word-convalescence. 
Moreover, during the progress of disease, nothing assists more the 
powers of the constitution, which tend towards health, and to throw off 
the enemy, than a cheerful and hopeful mind; as the people call it, a 
"good spirit;" it may make all the difference between recovery or the 
reverse ; indeed every medical man must have met with cases of illness, 
in which the patient seemed as it were resolved not to give in-seemed, 
even under unfavorable circumstances, determined not to die, if they 
could help it-and did not die; even when physical powers tended to 
death, the mind tended to life, and the mind succeeded. Were it not 
for the tendency to health, or to cure, existing in the body, our medi- 
cines would be in vain, and he is the best physician who can detect those 
tendencies to recovery, permit them to act when they seem strong enough 
and assist them when they do not. The patient in the lowest stage of 560 
DISEASE. 
fever, still has the tendency to health existing and acting within, and 
battling with the disease; the powers of a good constitution may of 
themselves be sufficient to conduct him over the crisis; but they may 
not, and unassisted, the patient must sink ere the tendency to throw off 
the disease gets the mastery; but the physician steps in, he gives his 
help to the constitution; his wine, and bark, and nourishment, and regu- 
lation of the functions, support the frame till the struggle is over, and 
the disease is vanquished. This power of throwing off disease, this 
tendency to health with which the living body is endowed, requires to be 
impressed upon the mind of people generally, for they are too apt to 
attribute that to the action of medicine, which medicine only gives its assis- 
tance to, and to despise the simpler modes of treatment, which place the 
natural powers in the most favorable position for curing. The vulgar 
attribute the healing of the wound to the plaster which merely holds it 
together, and consider cold water too simple to do good. 
The aggravation of existing disease, both by physical influences and 
mental emotions, is one of the most serious enemies the physician has to 
contend with. The subject is sufficiently entered into in the various 
articles of this work. 
In the treatment of disease very different methods have to be pur- 
sued ; the one is that which exerts itself directly to cure by the direct 
action of certain medicines. Of this, the cure of ague, of neuralgia, 
and other periodical diseases, by quinine or iron, is an example; 
experience has unfolded to us, that in these and similar cases, the 
medicine has the power of curing by some relation established between 
it and the disease, by the Author of all things, and in nothing is His 
mercy more strikingly exemplified. But, why quinine should cure 
neuralgia, why opium should allay pain, we cannot tell, at least in the 
present state of our knowledge; the only approach to any explanation 
being one given by Liebig. The other method in the treatment of dis- 
ease is not so much of the active as of the expectant or passive character. 
There are many-perhaps the majority belong to this class-forms of 
disease, for which we know of no cure, such as quinine is to ague; the 
throwing off the malady must be by the natural powers, and our only 
resource consists in putting and keeping those natural powers in as 
favorable a state for this purpose as possible. Of this, many forms 
of fever are examples; we cannot hope to cure, we can only hope to 
pilot the body through the rocks and untoward currents which arise in 
the course of the disorder, to allay secondary diseases which show them- 
selves, to alleviate painful symptoms, and to support the constitution. 
These facts should be made plain to the minds of unprofessional persons 
generally, for the most erroneous notions prevail upon the points just DISEASE-DISINFECTANTS. 
561 
alluded to, and often lead to dissatisfaction with medical men. (See 
Symptoms, Convalescence, Health, Hereditary Tendency, etc.) 
DISEASE, GEOGRAPHICAL DISTRIBUTION OF. (See Geo- 
graphical Distribution of Disease.) 
DISEASES AND INJURIES OF THE SPINE. (See Spine, Dis- 
eases and Injuries of the.) 
DISEASES, FEIGNED. (See Feigned Diseases.) 
DISEASES OF THE BLADDER. (See Bladder, Diseases of the; 
Urine, etc.) 
DISEASES OF THE BRAIN. (See Brain, Diseases of the; etc.) 
DISEASES OF THE DIGESTIVE ORGANS. (See Gastritis, 
Peritonitis, Enteritis, Cholera, Bowel Complaints, Dyspepsia, etc.) 
DISEASES OF THE EAR. (See Ear, Diseases of the; etc.) 
DISEASES OF THE EYE. (See Eye, Diseases of the; etc.) 
DISEASE OF THE HEART. (See Heart, Diseases of the; etc.) 
DISEASES OF THE KIDNEY. (See Nephritis, Bright's Disease, 
etc.) 
DISEASES OF THE LIVER. (See Hepatitis, Biliary Disorders, 
Biliousness, etc.) 
DISEASES OF THE LUNGS. (See Pneumonia, Bronchitis, 
Pleurisy, Consumption, etc.) 
DISEASES OF THE SKIN. (See Skin, Diseases of the; etc.) 
DISINFECTANTS, dis-in-fekt'-ants, are any agents which destroy 
the power or means of propagation of diseases which spread by infection 
or contagion. Purification of every kind, therefore, either by fresh air 
or by water, is disinfecting, these agents acting by dispersing or diluting 
the morbific germs, whatever these maybe. A high temperature, doubt- 
less, acts as a disinfectant, by destroying their chemical composition, 
and chlorine and muriatic acids probably exert a similar influence. 
Quicklime and charcoal, on the other hand, most likely owe their disin- 
fecting properties to their power of absorbing various gases. These 
chemical agents are all useful, but cleanliness and ventilation are disin- 
fectants in the power of all, and their operation is both continued and 
conducive to comfort. Many new agents have come into general use 
lately, as disinfectants, owing to the increased amount of attention which 
has very properly been paid to the subject. 
It must be patent to the observation of every one, that it is desirable 
to have a disinfectant which can be of general use; one adapted for the 
private house as well as for the public institution. Nothing can be more 
important, for instance, in the case of an outbreak of fever or some other 
contagious disorder in a private family; for it is not always possible, nor 
even always desirable, that all the members of the family should remove 562 
DISINFECTANTS. 
themselves from the source of the contagion, and abandon their rela- 
tions to a trained nurse. By all means, then, let them take every pre- 
caution. Independently, too, of their real value, disinfectants, when 
used, give confidence to those who are needlessly afraid of infectious 
disease and enable them better to perform their duties. Besides being 
valuable as disinfectants, many of the following articles are exceedingly 
useful as deodorizing agents, even in cases when there may be no dan- 
ger of directly infectious or contagious effect; and it should not be for- 
gotten that all disagreeable odors and emanations from the sick, are 
more or less hurtful in their effects, and ought to be guarded against as 
much as possible by a diligent use of the means which are now so numer- 
ous and so simple of application as to be placed within the reach of all. 
Amongst the most important uses also, of disinfectants, may be men- 
tioned the advantage to be derived by those who are engaged in work- 
ing amongst materials which have an offensive smell upon the hands. 
This is at once removed by washing the hands with the prescribed fluids, 
in a proper state of dilution. Perhaps one of the most suitable for this 
purpose is Condy's patent disinfecting fluid, which is a solution of per- 
manganate of potash, of a beautiful purple color. It has not the objec- 
tion which many have, of being disagreeable when used with a lather of 
soap. Sir Win. Burnett's fluid, which is a solution of chloride of zinc, 
is an admirable disinfectant, and has the advantage of being cheap. 
For the sick-room, rags maybe dipped in it (properly diluted) and sus- 
pended on strings, at various parts of the room. Both the above named 
fluids may also be used in the night-chairs, water-closets, etc. It is often 
desirable in cases where the noxious vapors are very penetrating and per- 
sistent (as in the case of a patient dying from mortification of the lung, 
which is always accompanied by the most intolerable odor), to have 
recourse to several deodorizing agents at the same time. While the 
above are freely used, plates containing charcoal are to be- distributed 
over the room; a few grains of iodine may be put on a plate and vapor- 
ized by gently heating the under surface of the plate with a lighted can- 
dle ; or some chloride of lime may be placed in a bowl, and a few drops 
of sulphuric acid, or oil of vitriol cautiously added to it from time to 
time, which will cause it to give off fumes of chlorine gas, than which 
there is probably no more powerful disinfectant. Sir Wm. Burnett's 
fluid also acts by evolving chlorine, Condy's by giving off oxygen, which 
it contains in great quantity, and charcoal, by the absorption of noxious 
materials. 
Creasote and the liquor carbonis deter gens, or concentrated solution 
of the active principles of coal-tar, are also useful disinfectants, though 
probably inferior to those above named. Solutions of chlorinated lime, DISINFECTANTS. 
563 
or chlorinated soda (Labarraque's fluid), are also among the very best 
disinfectants and deodorizers. Many others might be mentioned, as 
well as several powerful methods of fumigating, but they are scarcely 
suitable for non-professional hands. Leydoyen's fluid is a solution of 
nitrate of lead, but is not much used in this country. It is made by dis- 
solving 1 pound of litharge in about 7 ounces of strong nitric acid, and 
2 gallons of water. A little of the water is mixed with the litharge ; 
the acid is gradually added, and then the rest of the water. This quan- 
tity will deodorize a moderate-sized cess-pool. 
Heat is often used as a means of disinfecting clothing, and should be 
employed in the case of clothes used by patients suffering from scarlet 
fever, typhus, etc. Exposure to a heat of 212° Fahrenheit, has been 
found quite effectual, and it is probable that a long exposure to a moder- 
ate heat would be sufficient. 
When no others can be had, dried earth, lime or soot, may be used 
as disinfectants, and are quite effectual in removing the unpleasant and 
unhealthy vapors of cess-pools, etc. Dried earth immediately destroys 
the odor of excrement covered by it, and prevents unwholesome emana- 
tions from it. 
Carbolic acid is one of the most recent and effectual. (See article 
Carbolic Acid.) 
Carbolates of lime and magnesia are also used, but their effects have 
not yet been much tested by experience. 
Permanganate of soda is stated by Hofmann to destroy the odor of 
tobacco instantly when taken into the mouth. 
In addition to the means recommended above for using iodine and 
chlorine vapors as disinfectants, nitrous acid and sulphuric acid gas may 
be employed. The former is probably the most powerful of all known 
gaseous disinfectants, and may be evolved simply enough when required, 
by putting a piece of copper in a jar with nitric acid in a little water. 
As, however, the gas is very irritating to the lungs, the rooms should 
be cleared before using, or it must be produced very sparingly, which 
can be effected by diluting the nitric acid. Sulphurous acid gas is 
evolved simply by burning sulphur. Vinegar is not of much, if any use, 
as a disinfectant. It seems almost unnecessary to say that no kind of 
disinfectants, or no combination of them, should ever be allowed to take 
the place of free ventilation. As regards their application to special 
diseases, Dr. Parkes seems to place most reliance upon the fumes of 
nitrous acid, continuously diffused, in cholera, in typhus fever, and in 
yellow fever; and upon fumigations of chlorine to destroy the emana- 
tions from the stools in case of dysentery. (See Air, Bromo-Ciiloralum, 
Burnett's Disinfecting Fluid, Carbolic Acid, Chloride of Lime, 564 
DISINFECTANTS-DISL 0 CA TIONS. 
Chlorine, Coal Tar, Condy's Disinfecting Fluid, Contagion, Labar- 
raque's Disinfecting Fluid, Charcoal, etc. 
DISLOCATIONS, disdo-kd-skunz [Lat. disloco, I put out of place], 
are the displacement out of their natural positions of bones articulated 
together or forming joints. They are usually occasioned by external vio- 
lence, but may also, in some cases, result from diseases of the joints. 
Dislocation is either complete or incomplete; being incomplete when 
the articular surfaces remain partially in contact, and complete when 
there is an entire separation. It is simple when there is no wound and 
the skin remains unbroken; compound when there is a wound, by means 
of which the external air may communicate with the joint. When, be- 
sides the dislocation, there are fractures of the bones, or laceration of 
important organs, then it is termed a complicated dislocation. Disloca- 
tions are named either from the joint or the bone that is chiefly dis- 
placed ; and various terms are likewise employed to indicate the direction 
-as upward, downward, forward, backward, etc. Nearly all the bones 
of the human body are liable to displacement; but some are much more 
so than others; as those of the shoulder, hip, elbow, ankle, etc. Gen- 
erally, those joints are the most liable to dislocation that admit of the 
greatest extent of motion. Dislocation is in most cases easily observ- 
able; but in some parts it is extremely difficult of detection. It is 
attended with loss of power and motion in the part, with more or less of 
swelling and pain, which is increased on moving the part; the patient 
feels sick and faint, and there is a sensation of numbness in the part. 
Dislocations should be reduced as soon as possible after their occur- 
rence ; for the longer it is delayed, the more difficult will be the 
operation. 
The particular dislocations most likely to be recognized and to be 
remedied by unprofessional persons, are those of the small joints, such 
as fingers and toes; of the wrist and ankle; of the elbow, shoulder and 
lower jaw. 
Dislocations of fingers or toes may generally be made out by most 
people, and should, if possible be reduced at once; the dislocated bone 
being grasped and forcibly pulled into place; or the clove hitch noose, 
made with a piece of tape, may be used. Dislocation of the thumb, it 
should be known, is extremely difficult of reduction, and should this not 
be effected at once, the attempt ought to be given up till the surgeon's 
arrival; it is moreover, one of the dislocations which may be left unre- 
duced with less subsequent inconvenience than many others. Disloca- 
tion of the ankle is very generally accompanied with fracture, but the 
distortion is often so great and evident, and the suffering so severe that 
when the accident does occur far from proper aid, some attempt ought DISLOCATIONS. 
565 
to be made to put the displaced parts in better position; for this pur- 
pose, whilst one individual grasps the leg firmly, another, putting one 
hand on the heel and the other on the instep, should endeavor, whilst 
steadily pulling downward, to bring the joint into its natural position. 
Dislocation of the wrist is reduced by the fore-arm being tightly 
grasped by one individual, the surgeon laying hold of the patient's hand 
in his, and endeavoring by steady traction downwards, and slight up 
and down movement, to bring the joint into its proper condition. 
Dislocation of the elbow, if attended to quickly after the accident, 
may often be easily reduced by seating the person in a chair, carrying 
the arm well behind the back, and pulling, not very forcibly, from the 
sore arm. This dislocation, like the preceding, is extremely apt to be 
confounded with fracture of the bones close to the joint, and great cau- 
tion is necessary in ascertaining the nature of the injury. 
Both these dislocations-of the wrist and elbow-may be suspected, 
when, after violence, particularly such as is calculated to push either the 
hand or lower arm upwards, inability to use the limb below the seat of 
the injury, and distortion and impaired motion of the joint, are unac- 
companied with any grating sensation, such as occurs when bone is 
fractured. 
Dislocation of the shoulder is most generally occasioned by violence 
applied to the elbow, or by falls, whilst the arm is not close down to the 
side of the body. Sometimes the exact discrimination of an injury to 
the shoulder-joint is a matter of much difficulty ; for fractures alone, or 
fractures with dislocation, may occur. At other times, particularly in 
thin persons, it is tolerably easy to make out, more so if the examination is 
made before swelling comes on. In addition to the general symptoms 
of dislocation already enumerated, the injured shoulder will be percep- 
tibly altered in shape; it will appear more depressed and flatter than 
the sound one, and if the hand is placed on the spot which ought to be 
occupied with the round head of the arm-bone-and this may be discov- 
ered by examination of the uninjured shoulder-it will be found hollow; 
and further, if the arm be now gently moved about, and its bone traced 
up towards the shoulder, it will be found moving in some unusual posi- 
tion, most probably in the arm-pit. Supposing, therefore, that the case 
is sufficiently clear, and that the sufferer from the accident, in the absence 
of proper surgical assistance, is content to risk the matter upon non- 
professional judgment, or that from having been the subject of the acci- 
dent on some previous occasion, he is tolerably certain of its pres- 
ent nature, the means for the reduction ought to be set about as speedily 
as possible, if it can be, whilst faintness from the injuries continues. 
These means vary considerably. Hanging over doors or gates, the arm- 566 
DISLOCATIONS. 
pit being placed on the edge, have been employed and recommended; 
and in persons who have been the subjects of frequent dislocations in 
the same shoulder, may be efficient, but in a first dislocation should 
never be resorted to. One frequently-used method of reducing disloca- 
tion of the arm-bone into the arm-pit, is for both patient and surgeon to 
lie down upon the ground side by side, but with their heads different 
ways, and so that the surgeon, having previously taken off his boot, can 
place his heel in the arm-pit of the patient, whilst he grasps the hand, 
or a towel fixed to the arm of the affected side. In this way, whilst the 
heel is used to push against the displaced bone in the arm-pit, it, com- 
bined with the traction exerted by the surgeon upon the limb of the 
patient, tends to give a leverage by which the bone is so placed that it 
can be drawn into the socket by the muscles. This method may be a 
convenient one when only one person is in company with the individual 
to whom the accident has happened. The following is the most gener- 
ally useful and most resorted to mode of reducing dislocation of the 
shoulder: The patient being seated on a chair, a large towel or a table- 
cloth, folded broad, is to be passed round the chest, close under the 
arm-pit of the affected side, crossed over the opposite shoulder, and held 
either by a strong assistant or fastened to some fixed point. By this 
application, the shoulder-blade is fixed; the arm itself is then to be 
pulled, chiefly in the direction in which it has been fixed, firmly, steadily 
and slowly, this being done, either directly by the hands of assistants, or 
by a towel fastened round the arm by the hitch-noose. If when this steady 
pull has been persevered in for some time, the displaced bone does not get 
into place, the effect of suddenly taking off the attention of the patient 
may be tried, either by some sudden exclamation or by dashing a little 
cold water in the face. By such a proceeding, the muscles which re- 
sist the reducing or pulling force applied to the arm are, for a moment, 
so to speak, thrown off their guard, and that moment may suffice to 
permit the bone to pass into its socket. 
Dislocation of the lower jaw is not a very unfrequent occurrence, and 
happens from persons opening the mouth very wide, either in laughing 
or gaping ; the jaw slips, and its joint portions or articulations on both 
sides are drawn forward ; the person cannot close the jaws, but remains 
with the mouth wide open, a most inconvenient position should skilled 
assistance be far distant. The accident, however, can scarcely be mis- 
taken, and maybe rectified without much difficulty by a bystander. For 
this purpose, the thumb or thumbs, according to whether the joint is 
entirely dislocated or only on one side, are to be placed by the acting 
party upon the upper portions of the back teeth, and strong pressure 
exerted downwards, whilst the chin is drawn upwards by the fingers at DISL 0 CATIONS-DISTILLATION. 
567 
the same time. As the jaw returns to its place, its powerful muscles 
draw it upwards with a sudden snap ; and if the fingers of the operator 
are not covered with a handkerchief, or some other material, they may 
get smartly bitten.' 
After dislocation of any part has occurred and been reduced, a band- 
age or some application which will confine the injured members should 
be worn for some days, not simply from fear of the accident recurring 
at the time, but to keep the parts, which must have been more or less 
lacerated, quiet, and to permit the internal traces of the injury to be as 
much as possible obliterated. In conclusion, although the subject of 
dislocation has been dwelt upon at some length, it is chiefly for the 
reason that these accidents, painful at the time, and, if unremedied, 
productive of deformity and impaired usefulness for the future, are 
often overlooked, or are apt to occur at great distances from skilled 
assistance. In such cases, the information given in the foregoing 
article may, either by directing attention to the importance of the 
injury and its speedy rectification, or, if acted upon with care and 
prudence, by pointing out the most effective treatment, prove a 
useful guide. (See Accidents, Ankle, Fractures, Joints, Bandages, 
etc.) 
DISPENSARY, dis-peri-sa-re [Lat. dispensarium, from dispendo, I 
distribute], denotes, properly, the shop or place in which medicines are 
made up and distributed, but it is now more commonly applied to a 
charitable institution for supplying medical advice and medicines gratui- 
tously to the poor. These vafuable institutions are only of recent origin 
but they are now to be met with in every city of any importance either 
in this country or in Europe. Attached to each are generally one or 
more physicians and surgeons, who, besides attending at the institution, 
visit at their own houses those that are too ill to attend personally. There 
is also a resident medical officer for dispensing the medicines. 
DISPENSATORY, dis-peri-sa-to-re, is a book containing the method 
of preparing the various kinds of medicine used in pharmacy. 
DISPLACEMENT OF THE WOMB. (See Womb.) 
DISSECTION, dis-sek'-shun [Lat. dis, and seco, I cut], is applied to 
the cutting or dividing of the different parts of the body in Anatomy. 
(See Anatomy.) 
DISTILLATION, dis-til-la'-shun [Lat. distillo, from dis, and stillo, I 
drop], the process of evaporating a fluid by means of heat, and after- 
wards condensing it into a liquid. Its object is to separate the one sub- 
stance from others with which it maybe mixed; and the possibility as to 
whether a substance can be distilled depends upon the temperature at 
which it evaporates. 568 
DISTILLATION-DIURETICS. 
In chemistry, distillation is performed by means of a retort, or 
flask, and a receiver. 
DISTILLED WATER, dis-tild'. When water is subjected to the 
process of distillation, the result is a fluid without odor or color, with an 
insipid taste. In this form it is called distilled water, and if evaporated 
to dryness, ought to leave no residue. Distilled water, in its purest pos- 
sible form, is absolutely necessary to the chemist in his laboratory. 
Pure soft water, or rain water, is a very good substitute for the domestic 
preparation of medicine, etc. (See Aqua, Water.) 
DISTORTION. (See Deformity.) 
DISTURBED SLEEP. (See Sleep, Dreaming.) 
DIURETICS, di-u-rei-iks [Gr. diouretikos], in Medicine, those 
agents which have the power of augmenting the secretion of urine. 
Their action is beneficial whenever the system is troubled with an excess 
of fluids or of salts and nitrogenous substances derived from effete tis- 
sues. 
There are some diuretics, such as saltpetre, which act primarily 
upon the urinary organs; others, as the mercurials, which act prima- 
rily on the kidneys; and others, again, which act directly on the 
stomach or system generally, and indirectly on the urinary organs. 
Stimulant and tonic medicines have generally a diuretic action in cases 
of debility. The action of these remedies is promoted by drinking freely 
of mild diluents. 
As diaphoretics (which see) and diuretics are naturally opposed 
to each other, whatever promotes perspiration in general is opposed 
to the large secretion of the urine. Thus, in order to the latter, 
the skin should be kept cool and the patient out of bed. Diuretics are 
chiefly employed to restore the healthy action of the kidneys, to promote 
the absorption of dropsical effusions, to eliminate poisonous agents from 
the system, and to relieve inflammatory action. The diuretics are very 
various in their nature, they belong to all the three kingdoms, and are 
all very uncertain in their action. They include mercurials, the dilute 
mineral acids, and some mineral waters, digitalis, colchicum, buchu, 
copaiba, juniper, cantharides, broom, dandelion, parsley, cream of 
tartar, saltpetre, carbonate of potash, liquor potassae, carbonate of 
soda, sweet spirit of nitre, squill, turpentine, spirituous liquors, beer, 
wine, infusion of raw coffee-berry, etc. It sometimes happens that diur- 
etics which would not act before, act after the administration of an active 
purgative. Similar effects are found in the hands of medical men before 
and after bleeding. 
Mental emotion such as fear, and nervous disorders such as hysteria, 
it is well known, give rise to great increase in the flow of urine. DI EEETICS-D OSE. 
569 
(See the various individual articles, for the uses, etc., of the diuretics 
mentioned.) 
DIZZINESS. (See Giddiness.) 
DOCK. (See Rumex.) 
DOGBANE.' (See Apocynace^e.) 
DOGS, BITES OF. (See Bites and Stings; Hydrophobia.) 
DOG'S GRASS. (See Tkiticum Repens.) 
DOGWOOD. (See Cornus Florida.) 
DOMESTIC MEDICINES. (See Household Medicines.) 
DOMINION OF CANADA, CLIMATE OF. (See Climate.) 
DONOVAN'S SOLUTION. (See Solution Iodides of Arsenio 
and Mercury.) 
DORSAL, dor'-sal [Lat. dorsalis, from dorsum, the back], denotes 
something appertaining to the back, and in Anatomy it forms part of the 
name of ligaments, arteries, etc., belonging to that region. 
DORSTENIA CONTRAYERVA, dor-ste-ne-a kon-tra-yer'-va, a 
perennial plant belonging to the Nat. order Urticaceos. It is a native of 
the Southern States and the West India Islands. The root is the part 
used in medicine. It is a good aromatic tonic and has been considered 
anthelmintic. The infusion makes a good gargle for malignant sore 
throat. Dose of the powder, 20 to 40 grains; infusion, 1 to 4 fluid 
ounces. (See Infusion.) 
DOSE, dose [Gr. dosis, from didomi, I give]. Almost every article 
in the Materia Medica operates differently when given in a small and 
in a large dose. Tartar emetic, for example, in doses of from ~ to | 
of a grain acts as a diaphoretic and expectorant ; in doses of from £ to 
of a grain, as a nauseant; and if carried to the extent of 2 or 3 grains, 
it proves powerfully emetic. A very similar series of effects is pro- 
duced by graduated doses of ipecacuanha. The neutral salts are aperient 
in large doses, and diuretic in small ones. Opium is a stimulant in small 
and a narcotic in large doses; and the oil of turpentine, in doses of 1 
to 2 grains, acts as an irritant of the kidneys and urinary organs ; 
whilst in doses of an ounce, especially if combined with castor-oil, it 
operates freely on the bowels, without producing irritation of either 
bladder or kidneys. 
These are but a few examples, but most of the medicinal sub- 
stances whose operation is mild and beneficial in small doses, may 
be converted into powerful poisons by being administered in large 
quantities. 
A mistake is frequently made by considering the minim and drop 
as identical, both being regarded as the one-sixtieth part of a dram. 
The following table will show how erroneous is such a conclusion: 570 
DOSE. 
TABLE OF THE NUMBER OF DROPS OF DIFFERENT LIQUIDS EQUIVALENT 
TO A FLUID DRAM. 
Drops. 
Acetic acid 120 
Hydrocyanic acid 45 
Muriatic acid 54 
Nitric acid 84 
Sulphuric acid 90 
" dilute 51 
Alcohol 138 
Arsenic (Fowler's solution) 57 
Sulphuric ether 150 
Oils of aniseed, cloves, cinnamon, 
peppermint, almonds, olives.... 120 
Drops. 
Tinctures of assafcetida, opium, digi- 
talis .. 120 
Tincture of iron 132 
Vinegar 68 
Vinegar of squill 78 
Water, distilled 45 
Wine (Teneriffe) 78 
Antimonial wine 72 
Wine of colchicum 75 
Wine of opium 78 
Tincture of guaiacum 120' 
The minim, as a standard of measurement, should be employed in 
preference to the drop; still, as a matter of convenience, doses are pre- 
scribed in drops, teaspoonfuls, tablespoonfuls, etc., throughout this work. 
The dose of any given medicine, particularly of narcotics and purga- 
tives, should be regulated rather in accordance with the effect it pro- 
duces in each individual case than from published or written directions- 
on the subject; they should be looked on as guides to the dose gener- 
ally required rather than as applicable to every instance. It is impos- 
sible, in many instances, to lay down any positive rules as to the quan- 
tity of a certain medicine to be given. Take cancer of the womb, for 
example. Here opium is the sheet-anchor as a palliative; and the dose 
which at first will afford relief and induce sleep, soon fails to produce 
these effects, and the quantity requires to be increased almost daily 
until enormous doses are required to give the same amount of ease and 
sleep which were originally produced by comparatively small ones. 
Iodine, in scrofulous cases, is another example. The tolerance of this 
medicine varies much in certain individuals, without any peculiar idio- 
syncrasy existing with respect to it; and a dose which will act benefici- 
ally in one case will be productive of great irritation in another. The 
same remark applies to mercury and many other medicines. 
The following is another circumstance which requires notice in regard 
to the regulation of the dose : A scrofulous patient, for example, comes 
under treatment, and iodine is administered. For a time, the patient 
improves rapidly, ulcers heal, glandular enlargements diminish in size, 
the appetite increases, and the constitution gains tone and vigor. Sud- 
denly, however, from no apparent cause, the repairing process ceases, 
and the patient, perhaps, retrogrades. Under such circumstances, the- 
dose requires either to be greatly decreased, or, what is still better, 
the medicine should be discontinued for a few days or weeks, when it 
may be resumed with the original benefit. DOSE. 
571 
Wherever doses are mentioned in this work-unless otherwise specified 
-they are the average for an adult. 
The following table is generally considered a sufficient guide in the 
apportionment of the doses to the different ages. For an adult, sup- 
pose the dose to be 1, or one dram: 
Under 1 year the dose will be I = 5 grains... .gr. v. 
"2 " % = 8 grains... .gr. viii. 
" 3 •* % = 10 grains... .gr. x. 
"4 " % = 15 grains... .gr. xv. 
"7 " % = 1 scruple... 9 i. 
"14 " M = /^ dram .... 3 ss. 
" 20 " % = 2 scruples.. 9 ii. 
" 21 to 60 years 1 dram .... 3 i. 
Above sixty, that is, in old age, the dose gradually diminishes. 
Although the above table is, and may be, accepted as an average 
rule, it must not, by any means, be adopted as an invariable one in 
practice, without reference to the constitution, state of health, etc., of the 
individual. A strong child at three years of age may require, and may 
tolerate better, a much stronger dose than a weaker or weakly one two 
years older. Moreover, in the case of many aged persons, purgative 
medicines especially, will often require to be used as actively as in the 
young. Again, in such a medicine as opium, the proportions given 
in the table would give rather large doses for children, whilst, on the 
other hand, in the administration of mercurials, such as calomel or 
gray powder, they would reduce them too greatly. These observations 
are made as qualifications to what some might regard, from its being in 
the tabular form, as a complete guide in all cases. 
As a general rule, women require smaller doses of medicine than 
men, and at the same time, it is always requisite to keep in view the 
peculiarities, periodical and otherwise, of their constitutions; and in the 
case of matrons, the possibility of pregnancy. It is better to avoid the 
use of strong purgatives, and of astringents, during the healthy men- 
strual period. In some cases, all relaxing remedies, such as warm bath- 
ing of the feet, and diaphoretic medicines, are inadmissible during the 
same event. Temperament, in all cases, requires to be considered in 
the administration of medicine. 
^Ledicines used as tonics and alteratives, are usually administered 
three or four times a day. 
For the proper preparation and administration of medicines, every 
family should be provided with a graduated measure, indicating tea- 
spoonful and tablespoonful doses, and small druggists' weights and 
scales, both of which may be procured at any drugstore at a trifling cost. 
(See Household Medicines, Weights and Measures, etc.) 572 
DOUCHE BATH-DEAINAGE. 
DOUCHE BATH. (See Baths and Bathing.) 
DOVER'S POWDER, dd-vera, is a compound of 1 grain of opium, 
1 of ipecacuanha, and 8 grains of sulphate of potash, powdered well 
together; 10 grains consequently, contain 1 of opium. It is much used 
as a remedy to produce perspiration, in which, however, it often fails. 
It is used, also, in cases generally where opium is requisite. The ipecac- 
uanha may occasion vomiting. From 10 to 20 grains of Dover's pow- 
der taken at the beginning of a severe cold will often promptly break it 
it up. (See Diaphoretics.) 
DRACHM OR DRAM. (See Weights and Measures.) 
DRAGON'S BLOOD. (See Calamus.) 
DRAINAGE, dra/ne-gf is the important process by which super- 
fluous moisture is removed from the soil, through the soil itself, or by 
means of channels made in or through the earth. It may be either 
natural or artificial; to carry off* the simple excess of fluid resulting from 
atmospheric moisture, such as rain, or to remove the impure and dete- 
riorated fluids, which more or less result where man and the domestic 
animals are congregated. 
The salubrity of a district is always closely connected with its natural 
drainage; whenever moisture accumulates, either from position, that is, 
want of inclination or slope to run it off, or from the nature of the soil, 
disease is apt to prevail, There can be no doubt that the district where 
sand and gravel allow the water to drain off at once beneath the surface, 
and that where hard and impermeable rock permits the rain to escape 
readily into the nearest running stream, will be on the whole the most 
healthy; while, on the other hand, that in which the tough clays retain 
the water in ponds on the surface will be exposed to marsh fevers and 
various disorders affecting the throat and lungs. These remarks apply 
chiefly to temperate climates, but when the conditions of vegetation are 
taken into account, they are no less true than important for warm 
countries, where the rankness of the vegetation must no doubt be con- 
nected with the nature of the sub-soil over which it grows. 
The drainage of houses or collections of houses, where day by day 
there must be removed the excretions, both solid and fluid, of man 
and animals, is one of the most important points connected with the 
preservation of health-it might almost be added, and one of the most neg- 
lected ones. Both in town and country, the necessity for sufficient drain- 
asfe. whether of the natural moisture of the soil, of the results of animal 
life, or of domestic habits, has been, if not entirely overlooked, most 
insufficiently provided for. 
It is generally thought that in the country less necessity exists for 
perfect drainage than in large towns, and to some extent the idea D RAINA GE-DREAMING. 
573 
may be correct in so far as the less number of individuals col- 
lected in a given spot, and the freer circulation of air, must tend to 
preserve greater purity of atmosphere ; but the idea, by lulling suspi- 
cion, has proved a dangerous one, and the single homestead, or small 
isolated hamlet, has been desolated by the scourge of fever, which a 
little precaution might have prevented. 
It is not fever, however, as generally so-called, which alone occurs 
in consequence of deficient drainage, but bad health generally; and 
whatever case of disease or accident may remain within the tainted lo- 
cality, acquires a certain unfavorable tendency and type ; even recov- 
ery from childbed is affected by it, and perhaps more cases of childbed 
fever and death than would be imagined, might be traced to the 
unhealthy influences originated by habitations situated in a badly-drained 
locality. Surely this last consideration, if no other, might rouse men to 
act; the point touches the wealthy citizen as well as the poor one. 
Inflammation of the eye, or rather of its covering membrane, the 
conjunctiva, has been found occurring commonly in particular locali- 
ties, no cause being assignable beyond that of stagnant and putrefying 
ditches or unwholesome drains. The contamination of wells which sup- 
ply water used for drinking and cooking, by badly-arranged or imperfect 
drainage, is a very fertile source of disease; many of the worst invasions 
of fever and cholera also, have been traced to this disgusting source. 
(See Houses, Sanitary Science.) 
DRAM. (See Weights and Measures.) 
DRASTICS, dras-tiks [Gr. drastikos, active, brisk, from draco, I 
effect], is a term generally applied to such medicines as are very violent 
in their action, particularly as purgatives; such as croton-oil, jalap, etc. 
(See Cathartics.) 
DRAUGHT, draft [Lat. haustus], is a liquid form of medicine 
intended to be taken at once, or at a draught, whence its name. 
DREAMING, dreme-ing, is the wakeful and sentient condition of 
some of the faculties of the mind, whilst the others are asleep. The whole 
subject of dreaming is highly interesting in a psychological point of view; 
but it is only in connection with the body that we have here to do with 
it. Some persons naturally dream more than others; but there is no 
question that the occurrence and more particularly the nature of dreams 
are both much influenced by the condition of the body. Few are so for- 
tunate as to have escaped an attack of incubus or nightmare, arising from 
disordered digestion; and all who have been much with children, know 
well how liable they are to suffer from disturbing dreams, whenever the 
stomach and bowels are disordered. It may be safely asserted, that a 
large proportion of uncomfortable dreams are connected with disorder 574 
DREAMING-DRESSING. 
of the digestive functions-generally over-loading, but sometimes the 
reverse. Some people always dream if they do not take some slight 
refreshment just before retiring to rest. Mental excitement during the 
previous day is of course a frequent cause of dreaming. Organic dis- 
eases, .which give rise to oppression within the chest, such as diseases of 
the heart, are peculiarly liable to occasion uncomfortable dreams and 
nightmare. 
Uneasy and powerful sensations excited upon any portion of the 
body occasion what are called suggestive dreams, that is, the sensa- 
tion seems to start some thought in relation to itself from which a 
train of incongruities, such as occurs in dreams, appears to arise; a blis- 
ter is the foundation for some dream of torture; or a loud sound for one 
of tumult. 
Although made the subject of much credulity, dreaming, not only in 
its general character, but as regards the nature of the dreams, is not to 
be altogether disregarded with respect to the indications it affords of the 
bodily condition. When natural sleep is thus disturbed, particularly by 
dreams which cause alarm and uncomfortable sensations, or which occa- 
sion children to start and scream, the cause should be investigated; 
some error, simply as regards diet, either as to time, quantity, or quality, 
may be the reason: or disease may be forming. One or two smart 
purges will frequently remove the symptom. Whether in child or adult, 
should much mental exertion be going on, and sleep become unusually 
disturbed by dreaming, mental relaxation, and a greater amount of 
physical exercise should be combined with attention to all the functions. 
The shower bath, either generally or as a local application to the head 
alone, will be useful in such cases. 
Those who are much disturbed by dreams should avoid lying upon the 
back as experience tells that dreaming is more frequent in that position 
than in any other. (See Sleep, Diet, Dyspepsia, etc.) 
DRESS. (See Clothing.) 
DRESSING, dres'-ing. As the treatment of and mode of dressing 
burns, wounds, etc., is entered into in the articles on these and similar 
subjects, it is unnecessary to reiterate them here, and for what is requi- 
site respecting the application of bandages, the reader is referred to the 
article itself. Here it is proposed to give more the principles on which 
dressings should generally be conducted, than its details. 
The first essential in dressing is gentleness and lightness of hand. 
Parts which require the process are generally in a state of greater or 
less inflammation, and consequently of increased sensitiveness ; and the 
patient too, owing to the weakness which accompanies or follows disease or 
accident, is most probably in an irritable or nervous condition. For these DRESSING. 
575 
considerations, if for no other, the dressing, which is so often dreaded, 
should be conducted with the utmost gentle care. The next essential is 
to have at hand whatever is likely to be wanted-warm soft water with 
sponge, or in its place some soft material, scissors and lint, or linen. A 
piece of water-proof material, to draw under the part, is often useful. If 
plasters, bandages, etc., are required, they should not have to be sought 
for or cut when the wound is exposed and the patient waiting. If the 
old dressings have become in the least hard or adherent, or if plasters 
form part of the applications, they should all be well softened by 
warm water before the attempt is made to remove them; they should 
not require pulling away. When plasters are to be taken off a wound, 
the lips of which they hold together, they should be lifted at both ends 
so that the detaching process meets just at the wound; the object of this 
proceeding is to prevent the newly-healed and adhering surfaces being 
torn asunder, which they are more likely to be if the plaster is pulled 
off from end to end. For taking dressings off wounds, a pair of for- 
ceps will be found useful. When the old dressings have been removed, 
the parts around the wound should be gently but thoroughly cleansed. 
If there are any loose, mortified, or "sloughing" substances upon the 
wound, they may be lifted off, but its surface must not-as is too fre- 
quently done, even by medical men-be washed and swilled over with 
water. The matter which covers the surface of a wound is the protec- 
tive covering provided for it by nature, and if this be removed, it is 
much more likely to become irritable and painful, and to be longer in 
healing. When the proper cleansing has been effected, the requisite 
dressings should be put on without delay, leaving room, if there is likely 
to be much formation of matter, for its due discharge, and so placing the 
part when the dressing is finished, that the discharge can easily escape. 
The various dressings requisite for injuries will be mentioned in their 
proper places and articles; but one often recommended in this work 
requires notice here: it is the simple water dressing; which is at once the 
most convenient, agreeable, and universally applicable application to 
wounds of every kind. The popular fallacy that the applications have in all 
cases something to do with the healing of wounds, is very apt to make 
people look suspiciously on so simple an agent as pure water. It is true, the 
interference of art is frequently requisite either to stimulate or to repress 
action whilst wounds or diseases are in process of cure ; but in the major- 
ity of instances, the cure is the work of the natural powers alone: all that 
has to be done is to place these in as favorable a position for exerting their 
agency as possible, and nothing answers this purpose so well as pure soft 
water. The application is made either by linen or lint soaked in the 
water-warm, tepid, or cold, as most agreeable to the sensations of the 576 
DRESSING-DELNES. 
patient, and is in most cases covered over with some material which will 
prevent evaporation. Oiled silk has generally been used for the pur- 
pose, and oiled calico where economy is an object, but latterly thin sheet 
gutta percha has been employed and answers extremely well. If linen or 
common lint is used, it will require at least double, to enable it to retain 
moisture sufficient. As a dressing, Taylor's new patent lint is a much 
thicker and more spongy, and for this purpose, better adapted material 
than the others. Water dressing is not necessarily covered with water- 
proof material; if the part requires keeping very cool, it is better not so; 
but then it will require much more frequent wetting, either by a nurse or 
by the system of irrigation recommended under article Cold. When 
water-proof material is put over the wet linen or lint, it of course prevents 
evaporation, and keeps in heat; it should always be larger than the lint. 
A mistake is very commonly made in this matter ; a great piece of linen 
or lint is put on with its edges sticking out beyond the oiled silk, or 
whatever is used; and these edges, or even a very slight protrusion, are 
sufficient to drain off the entire moisture, leaving what ought to be a 
most soothing dressing, a dry and irritating one. (See Wounds, Burns 
and Scalds, Bites and Stings, Bruises and Contusions, Ulcers and 
Ulceration, Poultice, etc.) 
DRINKS, drinks [Aug.-Sax]. In order to dilute our food and 
repair the constant waste of fluids that is taking place in the body, a 
certain quantity of liquid must be taken into the system; and so neces- 
sary is this that one can bear hunger better and longer than he can do 
thirst. Water is, undoubtedly, the natural drink of man, and, in a per- 
fectly healthy condition, is preferable to any other. The injurious effects 
of the use of impure water are manifest in the extraordinary augmenta- 
tion of the liability to attacks of such zymotic diseases as may be 
prevalent. For the purification and preservation of water, numerous 
ingenious methods have been adopted ; and one of the most approved is 
by means of patent filters, in which the water is passed through alter- 
nate layers of sand and charcoal. Where there is reason, however, 
to suspect much injurious contamination, the process of boiling should 
never be omitted; after which it may be strained and filtered, and, 
lastly, agitated in contact with the atmosphere, in order to restore 
to it its natural proportion of air. The quantity of drink required varies 
according to the climate, the nature of the solid food taken, and indi- 
vidual peculiarities. Most persons generally consume too much of 
liquids; and this is to be particularly guarded against during meals, as 
by diluting the gastric juice, it prevents the food from being properly 
acted upon. Perhaps the l^est time for taking drinks of any kind is an 
hour or two after meals, as is shown by the degree of thirst which is DP INKS-DP OPSY. 
577 
then felt. The instinctive desire for fluid in cholera, and in diseases 
generally which are attended with fever, ought not to be neglected. 
There appears to be almost a superstitious fear with some, of allowing 
the sick to drink cold water, and many a sufferer regards most gratefully 
the unlimited permission of the medical attendant to take it freely, after 
it had perhaps been begged for, but withheld by mistaken friends. 
There are few safer prescriptions, none perhaps which may be more 
freely carried out by unprofessional persons, than the unrestricted allow- 
ance of simple, unstimulating drink, in all acute diseases in which thirst 
exists, and especially if fever be present. One dram of chlorate of pot- 
ash added to 1 pint of water, makes a good drink in all cases of fevers. 
A very refreshing drink may also be made by adding 2 drams of 
dilute phosphoric acid to 1 pint of barley water. Drinking large 
quantities of water is sometimes employed with beneficial effects in the 
cure of certain diseases. By exciting the vascular system and its con- 
nected secreting organs, it tends to remove from the blood various effete 
or noxious matters. On the other hand, a total abstinence from drink 
for two or three days is recommended as a mode of stopping fluxes and 
of relieving catarrhs, inflammations, and congestions. (See Catarrh, 
or Common Cold ; Cold, Cookery, Diluents ; Stimulants, Alcoholic ; 
Ale, Wine, Heat, Water, Mineral Waters. ) 
DROP. (See Minim.) 
DROPSY, drop'-se [Gr. hudrops, from hudor, water, and ops, 
aspect or apppearance], is the effusion or accumulation of the serous or 
watery portion of the blood-such as we see thrown out in a blister-in 
any of the tissues or cavities of the body. Thus the watery effusion may 
take place in the cellular tissue, which connects the various portions of 
the body, and fills up their interstices, in which case it will show itself 
in the eyelids and other portions of the face, or swell the feet and legs, 
hands and arms, or the body generally. This form of dropsy is called 
by medical men anasarca. The effusion on the other hand, may be 
into some of the larger cavities, as into the abdomen, when it is named 
ascites; or into the cavity of the chest, between the lungs and ribs, when 
it is known as hydrothorax, or water in the chest. Again, effusion may 
take place into some of the smaller cavities, or rather sacs, as into the 
bag which surrounds the heart. Whenever it occurs, dropsy is always 
to be regarded seriously. It is not, as the unprofessional generally 
regard it, a disease in itself, but is almost invariably a symptom of 
disease, either constitutional or local, existing in the system. 
Anasarca, or effusion into the cellular tissue, may be simply the result 
of general constitutional debility, of which the blood-vessels, both large 
and small, and the heart partake ; this form of dropsical swelling usually 578 
DP OPS Y 
shows itself in the feet or ankles towards night, especially after long 
standing; many delicate persons are subject to it as a temporary ailment, 
when from cause the general health has become impaired. Local 
anasarca, or dropsical swelling, may arise from any cause which impedes 
the return of the blood through the veins ; and is a very common accom- 
paniment of disease of the liver or heart, or tumors which press upon the 
great veins; of this, pregnancy, which often occasion^ swelling of the 
legs during its continuance, is an example, the effect passing off as soon 
as the cause is removed. The lower limbs are the most frequent seat of 
anasarcous, or as it is often called, oedematous swelling; but the hands, 
face, etc., are also occupied by it; indeed, swelling of the eyelids in the 
morning, with stiffness on first trying to open them, is often one of the 
first symptoms of the tendency to dropsical effusion, whatever the cause. 
Again, anasarcous dropsical swelling may be occasioned by affection of 
the kidney which cannot carry off the fluid from the body with sufficient 
rapidity. 
The above are all instances of what are called passive dropsies; 
the cause generally acting slowly, and unaccompanied with a marked 
feverish state of the system ; there are, however, forms of dropsy which 
are attended with this feverish state, and in which the watery effusion 
takes place rapidly, sometimes surprisingly so. The best instance of 
this is the acute form of dropsy, which is apt to happen to convalescents 
from scarlet fever, and which is traceable to cold. Whatever occasions 
anasarca, or effusion of watery fluid into the cellular substance of the 
body generally, may also cause its occurrence in the cavities, as of the 
abdomen or chest; but it may also take place both in the large and small 
cavities, as a consequence of local inflammation. Their lining serous 
membrane becomes inflamed, and pours out a watery secretion in greater 
or less abundance. It is matter of popular information, that dropsy in 
the belly is apt to follow inflammation, and that water in the chest 
results from pleurisy. 
Whatever form dropsy assumes, however, the case should at once be 
put under medical superintendence. As temporary palliative measures, 
the bowels should be kept either simply open or actively purged, accord- 
ing as the patient is of weak or strong habit of body; and the effusion 
of water may be kept in check by the use of diuretic remedies. Of 
these the patient may safely use the infusion of broom in doses of 2 or 
3 ounces three times a day; sweet spirit of nitre, 30 drops in water, 
every four hours; saltpetre, 5 grains, three or four times a day; infusion 
of dwarf-elder, 3 or 4 ounces, three times daily. Partial relief may be 
found by acting upon the skin by some active diaphoretic. The follow- 
ing will frequently accomplish the object: DROPSY-DRO WNING. 
579 
Take of Spirit of mindererus Two drams. 
Sweet spirit of nitre One and a half drams. 
Compound tincture of lavender One dram. 
Camphor water Six ounces.-Mix. 
Give 2 tablespoonfuls every three or four hours. 
With the same object in view, the bowels may be freely acted upon 
by brisk purgatives: 
Take of Cream of tartar Half an ounce. 
Powdered scammony Twenty grains.-Mix. 
Divide into 4 powders, and take 1 every morning. 
When there is great debility, iron may be given with salicine. 
Take of Ammonio-citrate of iron One dram. 
Salicine Two scruples. 
Compound spirits of ammonia One dram. 
Pure water Six ounces.-Mix. 
Take 2 tablespoonfuls three times during the day. 
The diet must be liberal, consisting of meat and all kinds of deli- 
cacies. Wine may be allowed, and, in many cases, gin in small quan- 
tities benefits the sufferer, keeping up his system, and acting at the same 
time as a diuretic. After these remedies have received a fair trial, and 
found to fail, if the breathing be getting much embarrassed, and the 
heart's action interfered with, the patient will require to be tapped, and 
the surgeon's aid should be sought to let out the accumulated fluid. This 
operation must be resorted to only after all the other methods have 
failed, for the fluid will gradually accumulate again, and require another 
operation in a short time, because the morbid condition of the liver 
giving rise to the liquid effusion is beyond all cure. (See Dwarf Elder, 
Colciiicum, ETC.) 
DROP-WRIST, OR WRIST-DROP, drop'-rist^ as it is often called, 
is an affection frequently accompanying lead poisoning, and depending 
upon paralysis of the muscles which extend the hand, so that it falls, or 
drops. Galvanism of the muscles twice a day, besides kneading, sham- 
pooing, and rubbing them with flower of sulphur, are useful as local 
remedies. Hot baths, with sulphur, or with the addition of a handful of 
sulphuret of potassium may be given every other day. These means, 
it is scarcely necessary to add, will be of little avail without the admin- 
istration of medicines to aid in the elimination of lead from the system, 
and this should only be followed out under medical advice. The affec- 
tion is common among painters and all tradesmen who use lead (see 
article Lead) such as plumbers, workers in glass and putty powder, 
makers of brass taps, especially the manufacturers of sugar of lead, white 
and red lead, etc. 
DROWNING, droun'-ing [Dan. drugner, to drown], is suffocation 580 
DEO WNING. 
produced by the immersion of the body under water, or according to 
some, by the exclusion of atmospheric air from the lungs by any liquid. 
The necessity of air to life is well known, and any exclusion of it, for 
even a few minutes, produces death. When a human being unable to 
swim, falls into the water, if it is not of great depth, he first goes to the 
bottom; but on account of the air in the lungs rendering the specific 
gravity of the body lighter than the water, he immediately rises again to 
the surface. The efforts made by him to maintain himself at the sur- 
face diminish the quantity of air in the lungs, and he again sinks to the 
bottom, but soon rises again; and this alternate rising and sinking may 
occur several times in succession. The air which is expelled from the 
lungs is seen to rise to the surface in the form of bubbles, and with every 
expiration the specific gravity of the body is increased ; the powers of 
sensation and voluntary motion rapidly diminish, and the body settles at 
the bottom. A feeble motion may still be perceived in the chest for a 
short time, but that, too, ceases, and death ensues. In drowning, death 
is effected by the impure condition of the blood. The impure or venous 
blood of the system is converted into pure or arterial blood by being car- 
ried to the lungs, where it is brought into contact with the air, and its 
impurities carried off. 
, When, by any means, as in drowning, the lungs are shut out from 
communication with the external air, this operation cannot be carried 
on, impure instead of pure blood is carried through the system, the 
brain is immediately affected, sensation and volition rapidly diminish, 
and at length cease. 
The period during which life may continue in submersion varies in 
different persons. In some instances bodies submerged but one minute 
have been found to be lifeless; and in many cases recovery has taken 
place after a submersion of eight or ten minutes. Occasionally, anima- 
tion has been restored after a submersion of fifteen or twenty minutes, 
or even of half an hour. In general, if the body has not been in the 
water longer than from five to eight minutes, the prompt use of the 
proper means will restore animation. When the body is recovered after 
drowning, the skin is cold and pale, presenting sometimes patches of 
livid discoloration. The expression is usually placid, the eyes half-closed, 
the pupils dilated, the tongue swollen and pressed forward, and the lips 
and nostrils covered with a mucous froth. The fingers are sometimes 
found torn and abraded, and the hand grasping gravel or other sub- 
stances, which have been seized in a convulsive struggle at the bottom 
of the water. Internally, the epiglottis is found to be raised; bloody 
foam appears in the windpipe and bronchial passages; the lungs are 
soft and distended ; a large quantity of black fluid blood is collected in DRO WNING. 
581 
the right, and less in the left cavity of the heart; and the vessels of the 
brain are swollen and filled with impure blood. 
The following plan of treating a drowned person was proposed by 
the late Dr. ^Marshall Hall: 1, Treat the patient instantly, on the spot, 
in the open air, except in severe weather, freely exposing the face, neck, 
and chest, to the breeze ; 2, send with all speed for medical aid and for 
articles of clothing, blankets, etc. ; 3, place the patient gently on the 
face, with one arm under the forehead, so that any fluids may flow from 
the throat and mouth, and without loss of time. I. To excite respira- 
tion', 4, turn the patient on his side and (a) apply snuff or other irritant 
to the nostrils; (6) dash cold water on the face, previously rubbed 
briskly until it is warm. If there be no success, again lose no time, but, 
II. To imitate respiration ; 5, replace the patient on his face (when the 
tongue will then fall forward, and leave the entrance into the windpipe 
free); then, 6, turn the body gently, but completely, on the side and a 
little beyond (when inspiration will occur), and then on the face, making 
gentle pressure along the back, when expiration will take place, alter- 
nately. These measures must be repeated deliberately, efficiently, and 
perseveringly, fifteen times in the minute only. Meantime, III. To 
induce circulation and warmth, continuing these measures, 7, rub the 
limbs upwards with firm pressure and with energy, using handkerchiefs, 
etc., for towels; 8, replace the patient's wet clothing by such other 
covering as can be instantly procured, each bystander supplying a coat, 
waistcoat, etc. "These rules," says Dr. Hall, "are founded on physi- 
ology; and whilst they comprise all that can be done immediately for 
the patient, exclude all apparatus of galvanism, the warm bath, etc., as 
useless, not to say injurious, especially the last of these, and all loss of 
time in removal, etc., as fatal." 
Treatment after natural breathing has been restored. To promote 
warmth and circulation, commence rubbing the limbs upwards, with 
firm grasping pressure and energy, using handkerchiefs, flannels, etc., 
by this measure the blood is assisted along the veins towards the heart. 
The friction must be continued under the blanket or over the dry cloth- 
ing. Promote the warmth of the body by the application of hot flannels, 
bottles, or bladders of hot water, heated bricks, etc., to the pit of the 
stomach, the arm-pits, between the thighs, and to the soles of the feet. 
If the patient has been carried to a house after respiration has been 
restored, be careful to let the air play freely about the room. 
On the restoration of life, 1 teaspoonful of warm water should be 
given; and then, if the power of swallowing have returned, small quan- 
tities of wine, warm brandy and water, or coffee, should be administered. 
The patient should be kept in bed, and a disposition to sleep encouraged. 582 
DR 0 WNING-D UAID NESS. 
General observations.-The above treatment as presented by Dr. 
Hall, should be persevered in for some hours, as it is an erroneous 
opinion that persons are irrecoverable because life does not soon make 
its appearance, persons having been restored after persevering for many 
hours. 
Appearances which generally accompany death.-Breathing and the 
heart's action cease entirely; the eyelids are generally half-closed; the 
pupils dilated; the jaws clenched; the fingers semi-contracted; the 
tongue approaches to the under edges of the lips, and these, as well as 
the nostrils, are covered with a frothy mucus. Coldness and pallor of 
surface increase. 
Cautions.-Prevent unnecessary crowding of persons round the 
body, especially if in an apartment. 
Avoid rough usage, and do not allow the body to remain on the back 
unless the tongue is secured. 
Under no circumstances hold the body up by the feet. 
On no account place the body in a warm bath, unless under medical 
direction, and even then it should only be employed as a momentary 
excitant. (See Accidents, Asphyxia, etc.) 
DRUG, drug, is the general term applied to medicinal agents used 
in the treatment of disease; it is, however, more generally employed 
with reference to the crude or commercial substances; after these have 
undergone preparation, they are usually called medicines. 
DRUM OF THE EAR. (See Ear.) 
DRUNKENNESS AND ITS TREATMENT, ETC. (See Dipso- 
mania, Delirium Tremens, Intoxication; Stimulants, Alcoholic; etc.) 
DRY AIR. (See Air, Climate, etc.) 
DRY CUPPING. (See Cupping.) 
DUCK. (See Poultry.) 
DUCT, dukt [Lat. duco, I lead or conduct], is used in Anatomy to 
denote the vessels which convey the different fluids in the body; as the 
thoracic duct, which receives the contents of the different absorbents, 
and discharges itself at the angle formed by the junction of the subcla- 
vian and jugular veins. 
DULCAMARA. (See Solanum Dulcamara.) 
DUMB AGUE, dum, a common name for one of the forms of ague, 
hence the treatment is the same as presented in the article Ague (which 
see). 
DUMBNESS, dum'-nes, or inability to utter articulate sounds, may 
arise from absence of the tongue, or from defect .in the formation of the 
organs of voice; probably, also, from causes affecting the nerves which 
supply the organs of speech; but most generally, from complete deaf- D UN BN ESS-D YSENTER Y. 
583 
ness, either congenital, that is dating from birth, or as the result of dis- 
ease before the power of speech had been acquired and fixed in the 
memory. (See Deafness.) 
DUODENUM, duro-de'-num [Lat. duodenus, consisting of twelve), 
in Anatomy is the name given to the first portion of the small intestines, 
and was' so called by the ancients because it was supposed not to exoeed 
the breadth of twelve fingers; but as they dissected only animals, this 
does not hold true in the human subject. It is from eight to nine inches 
in length, and commences at the pyloric end of the stomach. It first 
inclines upwards, backwards, and to the right, and having arrived near 
the neck of the gall-bladder, it bends vertically downwards, and again 
changes to a transverse direction; thus forming two curves or angles. 
It is in this intestine that chylification of the food takes place. (See 
Digestion, Intestines.) 
DURA MATER. (See Brain.) 
DWALE. (See Atropa Belladonna.) 
DWARF ELDER. (See Aralia. 
DWELLINGS. (See Houses.) 
DYSENTERY, dis'-en-ter-e [Gr. dusenteria^ from dus, with diffi- 
culty, and enteron, intestine], or as it has been popularly called bloody 
flux, is a disease characterized by severe diarrhoea, fever, etc., the accom- 
paniment of a peculiar inflammation of the mucous membrane lining the 
large intestines. It is frequent in tropical climates and marshy districts. 
Causes.-Dysentery appears to be engendered by exposure to cold, 
wet, and to privations connected with food; hence it has been one of the 
greatest scourges of armies. The same causes and its connection with 
variations in climate, particularly with a hot one, must render dysentery 
a disease respecting which the emigrant ought to possess information; 
for it may happen, and it often does, that the disorder attacks those far 
removed from medical aid, and it is not one which brooks much delay in 
treatment. 
Dr. Parkes says: "We may admit as both predisposing and exciting 
causes, according to circumstances, the following agents: 
"1st. All acrid agents, whether produced by irritating ingesta, or 
secretions: as bad or too rich food, bad water, fruits, or retained excre- 
tions, or derangement of the biliary secretions, etc. 
"2nd. Suppression of secretions rapidly accomplished: as that of the 
skin by cold, wet, sudden changes of temperature from hot to cold, etc. 
' ' 3rd. Epidemic states of the atmosphere, and probable alteration of 
the blood, either from food or its digestion." 
The power of these causes to produce dysentery should be well fixed 
in the minds of all those whose lot it may be to be exposed to their 584 
DYSENTERY. 
influences; for by their avoidance the disease may probably be escaped; 
and there can be few misfortunes greater than for a new settler, whose 
welfare, and that perhaps of a family, depends upon his health and 
strength, to be attacked with dysentery. 
Symptoms.-Dysentery commences either gradually or suddenly; 
the general commencement is, however, by diarrhoea. 
"First, as to the kind of stools. 
"These are, first, simply numerous, perhaps feculent, in a few very 
rare instances, scybalous.-[That is, containing hard black-looking 
lumps about the size of beans or nuts, called by medical men scybalae.J 
" After this the stools become numerous, slimy, gelatinous, bloody; 
blood in streaks, or mixed with a dark watery fluid; in another form 
pure, perhaps clotted. Afterwards, stools watery, muddy, like the wash- 
ings of meat, or gelatinous-looking, shreddy, offensive in odor. Some- 
times after this the stools present an appearance something like pus 
(matter), or this is mixed with mucous slime and blood, in such a way 
as to form a variously-colored stool, which causes great griping and 
tenesmus when passed." 
Treatment.- The treatment of dysentery which may most safely be 
practised by an unprofessional person, in the absence of a medical man, 
would be, in the first instance, if they were procurable, the application 
of leeches to the belly, a dozen or more at once, and repeated according 
to the strength of the patient, if the symptoms remained unrelieved. 
Should leeches not be obtainable, and even if they are, a warm bath 
once or twice-if it did not exhaust too much-in the twenty-four hours, 
would be found useful; and probably the hot bran poultice to the bowels. 
To allay pain and relieve the disease generally, opium is the most valu- 
able remedy; but as there may be irritating matters in the bowels, they 
must not be confined, which the opium alone might do, and thus, though 
relieving apparently for a time, aggravate the disease ultimately. To 
avoid this, the opium should be combined with castor-oil, or olive-oil, 
either simply or in emulsion with yolk of egg; 5 to 10 drops of 
laudanum to 1 dessertspoonful of castor-oil, repeated four or five times 
at intervals of four or six hours. If castor-oil is procurable, it should be 
trusted to; if not, Epsom salts, in teaspoonful doses, each dissolved in 
from a pint to 1 pint of gruel or barley water, or some other demul- 
cent, with 4 or 5 drops of laudanum added, may be given every four 
or five hours. Ten grains of Dover's powder, given once or twice in the 
twenty-four hours, may probably be of service, or a pill composed of £ a 
grain of opium, 1| grains of blue pill, and J a grain of ipecacuanha, may 
be given every six or eight hours. The safest course, however, will be die 
treatment by the oily aperients and laudanum. In addition, injections, DYSENTERY. 
585 
containing from 10 to 20 drops of laudanum, will give much relief. 
Sometimes the lower bowel is too irritable to bear the injection, in which 
case, a suppository, or pill, made with a grain of opium, mixed with a 
little flour and water, may be passed into the bowel. The food requires 
much attention, and should be of the mildest character: milk, and pre- 
parations of the grains, and sago, arrowroot, etc., combined with gela- 
tine or isinglass, will be most suitable. If the strength is much reduced, 
strong concentrated animal soup will perhaps be required. 
Of course so serious, and it may be fatal, a disease as dysentery,1 
should be put under medical care as soon as possible; in the meantime 
the above directions may be of much service. 
"The first appearance of recovery is evidenced by the stools becom- 
ing less slimy, perhaps copious and feculent, or bran-like, or dark and 
slightly beaten up; or while one part of the stool is slimy, the remainder 
consists of natural feculence." A person convalescent from dysentery, 
wTill of course require the greatest possible care in diet; and also with 
respect to all exposure to the causes which originated it. 
Chronic Dysentery.-The acute affection now briefly described shows 
in some instances, a tendency to pass into the chronic disease. The 
latter is distinguished by the absence of all febrile symptoms, and by the 
long continuance of a condition of relaxation of the bowels, the dis- 
charges containing blood mixed, to a greater or less extent, with fecu- 
lent matter. The belly, in such cases, is sometimes distended, at others 
relaxed; there is apt to be great emaciation and general feebleness; the 
tongue becomes red, smooth and glazed; great thirst is also a symp- 
tom. In such case, change of air often does good. Great attention 
must be paid to the food of the patient. Indeed the original cause of 
the disease is very generally a long-continued irregularity in the matter 
of diet. Diet, in chronic dysentery, should be nourishing, but not in any 
degree stimulant, consisting of farinaceous articles, and mutton or beef- 
tea. Milk boiled with flour, raw eggs, ripe grapes, cream and rice, are 
all useful articles of food in this form of disease. Such astringent reme- 
dies as logwood, in doses of from to 1 teaspoonful of the fluid extract, 
repeated every four or six hours, fluid extract of blackberry, or fluid 
extract of cranesbill, in similar doses, are the remedies indicated. Tinc- 
ture of iron, in doses of 10 drops, three times a day in sweetened water, 
is often beneficial in completing a cure when the remedies have already 
begun the good work. In case a stimulant is needed, port wine is the 
best. 
Preventive treatment.-When dysentery is prevalent, or after a per- 
son has had an attack, great care should be exercised in the matter of 
eating and drinking. Avoid all unwholesome and unripe fruits; eat only 586 
D YSENTEP Y-D YSPEPSI A. 
those vegetables which are easily digested, and drink no impure water. 
Even though the weather be warm, wear flannel next to the bowels, 
sponging them daily with water or vinegar and water, with the chill 
taken off. Be very careful, if possible, to avoid exposure to damp and 
cold. Many a severe attack of this disease has been contracted by a 
severe chill from improper exposure, while insufficiently clothed, to the 
damp night air. (See Autumnal Complaints, Bilious Cholera, Diar- 
riicea, Chlorodyne.) 
DYSENTERY WEED. (See Eciiinospermum Virginicum.) 
DYSMENORRHCEA. (See Menstruation.) 
DYSPEPSIA, dis-pep'-se-q [Gr. duspepsia, from dus, bad, and pepto^ 
I concoct or digest], is a bad or difficult digestion. It is by means of diges- 
tion that the food which is taken into the stomach is converted into nutri- 
tive matter for supplying the waste that is constantly going on in the 
system; hence anything that interferes with the due supply of nutritive 
matter materially affects the system, and may introduce a long series of 
ills. The complicated series of operations by which digestion is carried 
on, renders indigestion one of the most prevalent of the ills to which 
human flesh is subject-it is the prevailing malady of civilized life. (See 
Digestion. ) 
Causes.-Anything which tends to weaken the system, and the 
stomach in particular, will lead to dyspepsia, such as the use of tobacco- 
in excess, snuff-taking, spirit-drinking, long-continued abstinence; imper- 
fect mastication, and bolting the food, eating in a hurried manner and in 
too great quantity; an indolent and sedentary life, intense study; exces- 
sive labor will cause it, and it is sometimes due to disease of the liver, 
and at others depends upon an inflamed state of the stomach itself 
Indigestion is constantly met with in the different stages of Bright's dis- 
ease. Some of the retained excreta being got rid of by the mucous: 
membrane of the stomach, give rise to constant vomiting; nothing can 
be kept down, and the patient soon becomes much reduced. Another 
very powerful cause of this disease is not allowing sufficient time to 
elapse between the end of one meal and the beginning of another; but 
before one lot of food has been thoroughly digested and passed on into- 
the bowels, another hearty meal is partaken of, and more food is 
crammed down into the stomach; this organ becomes dilated, there is 
not sufficient gastric juice secreted to act upon so large a collection of 
food, and the digestive process either goes on slowly, giving rise to all 
kinds of morbid feelings, such as are described below, or Nature works 
her own cure by a circuitous route, for by setting up a reversed action in 
the stomach and the upper part of the small intestines, the overloaded 
organ is soon relieved of its burden by the act of vomiting. During the DYSPEPSIA. 
587 
course of pulmonary consumption dyspepsia presents itself as a very 
prominent symptom, and «so also in most cases of diabetes, or saccharine 
urine, the patient suffering from enormous appetite and intense thirst. 
Symptoms.- The chief symptoms of dyspepsia or indigestion are 
pain and sense of oppression at the pit of the stomach, increased by 
meals, sour eructations, irregular action of the bowels, white and furred 
tongue, offensive breath, capricious or no appetite, flatulence and belch- 
ing, nausea and vomiting, headache and palpitation of the heart, sallow 
complexion and depression of spirits. The patient is languid, weak and 
debilitated, incapable of any bodily or mental exertion, and is very 
fidgety and irritable. 
Treatment.-In attempting to cure this troublesome affection, depend- 
ing as it does upon so many different morbid conditions, our great object 
is to find out its exciting cause, and if possible to relieve it. The treat- 
ment may then be divided into two parts-the dietetic and medicinal, 
and the strictest attention must be paid to the regimen ; the patient must 
eat and drink sparingly, and allow four or five hours to elapse between 
the several meals. The diet should consist of the most digestible kind 
of food, and should be partly vegetable and partly animal. Mutton and 
poultry are very easy of digestion; but all kinds of cured meat, as ham, 
sausages and tongue, must be carefully avoided; the use of tobacco should 
be prohibited, tending to hurry the action of the heart and disarrange the 
digestive organs; the snuff-taker, too, should relinquish his dirty and 
injurious habit; all sedentary occupations must be given up, and healthy 
exercise sought in the pure, dry, open air of the country; walking or 
horseback exercise should be daily resorted to, and cheerful company 
must be sought to keep up the spirits. Veal has been recommended to 
their patients by some physicians as being very digestible, but we think 
it more apt to lead to this complaint than good mutton or a tender 
chicken. Fish is generally considered to be easy of digestion; but there 
is not much nutrition in it, and it is not well suited for persons troubled 
with dyspeptic symptoms. All kinds of slop food should be avoided, 
for the stomach is often unable to digest them when in a state of health, 
and in its present weak state they always give rise to a severe attack of 
this affection; so that soups, stews, hashes, and meat cooked the second 
time, must be shunned. Cocoa or chocolate made with milk or water, 
will be found very nutritious, and to agree with the patient better than 
tea or coffee. New bread and hot rolls must not be partaken of, and all 
kinds of pastry and sweets must be left for those of stronger digestive 
powers. If the patient indulge in any supper, it must be of the lightest 
character, and very small in quantity. 
In the treatment of indigestion, the proper regulation of the bowels 588 
DYSPEPSIA. 
is of the utmost importance; they should be gently relieved every day; 
but on no account should purging be resorted to. When aperient medi- 
cine is absolutely necessary, it may be taken in the form of a dinner pill, 
and the best form is 5 or 6 grains of the compound rhubarb pill, 
swallowed immediately before the meal, or mineral water, German bit- 
ter water, or some other aperient water may be used at night or before 
breakfast. Flatulence may be relieved by the use of the following 
aromatic stomachic: 
Take of Tincture of ginger Forty drops. 
Tincture of cardamoms Twenty drops. 
Peppermint water Two ounces.-Mix. 
Make a draught to be taken immediately. 
Cayenne pepper, mustard, and other condiments of a warm character, 
are generally recommended to relieve this unpleasant and painful symp- 
tom. The writer has been in the habit for some time past of recom- 
mending his patients to mix as much powdered ginger as they can con- 
veniently take with a cup of hot tea, to relieve this distension of the 
stomach and bowels ; and in the greater proportion of cases, this homely 
remedy acts remarkably well. For nausea and vomiting the following 
may be given with good effect: 
Take of Compound spirit of ammonia Two drams. 
Hydrocyanic acid Sixteen drops. 
Pure water Eight ounces.-Mix. 
Give 2 tablespoonfuls every four hours. 
Granulated citrate of magnesia, 1 teaspoonful every four or six 
hours, taken during effervescence, frequently succeeds in allaying the 
distressing irritability of the stomach. Should the sickness become very 
obstinate, a blister or mustard poultice may be placed over the pit of the 
stomach. Some physicians have thought that this symptom depends 
entirely upon a low tone of the coats of the stomach, and have given 
strychnine as follows, and with decided advantage: 
Take of Strychnia Quarter of a grain. 
Dilute acetic acid Two drams. 
Pure water Eight ounces.-Mix. 
Give 2 table spoonfuls every four hours. 
Dr. Watson thinks that vomiting is often due to morbid irritability 
of the stomach, and recommends hydrocyanic acid and lime water as 
follows: 
Take of Hydrocyanic acid Ten drops. 
Lime water Six ounces.-Mix. 
Give 2 tablespoonfuls every four hours. 
At other times solution of potash in 20 drop doses, will be found to DYSPEPSIA. 
589 
have a direct sedative effect on the stomach. A few drops of chloroform 
will often relieve it. Creasote is highly recommended, and may be 
taken thus: 
Take of Creasote Six drops. 
Carbonate of magnesia Forty-eight grains. 
Mucilage of acacia sufficient to make twelve pills.-Mix. 
Two of these may be taken three times a day. 
Should the appetite become much impaired, bitter tonics combined 
with the mineral acids are of much service. One of the best forms is 
as follows: 
Take of Dilute nitro-muriatic acid One dram. 
Infusion of calumba Six ounces.-Mix. 
Give 2 tablespoonfuls three times a day half an hour before eating. 
When there is much debility present, the calumba, which is a very 
pleasant bitter, may be combined with the ammonia-citrate of iron as 
follows: 
Take of Ammonia-citrate of iron Half a dram. 
Compound spirits of ammonia Two drams. 
Infusion of calumba Half a pint.-Mix. 
Give 2 tablespoonfuls half an hour before each meal. 
On the supposition that indigestion may often be due to absence or 
deficiency of some of the ingredients of the gastric juice, either the 
lactic, or hydrochloric acids, or the pepsine, these substances have been 
prescribed either alone or combined, and in many cases with very good 
effect. A preparation called lactopeptine, combining all the elements of 
the gastric juice in, as near as possible, the proportions they are found 
in the stomach, has lately been introduced, and in doses of 5 to 8 
grains, three times daily, has certainly been productive of very much 
good. If the secretion of the stomach be defective, ipecacuanha may 
be given thus: 
Take of Ipecacuanha in powder Twenty grains. 
Extract of gentian One dram. 
Carbonate of iron Two drams--Mix. 
Make 60 pills, of which 2 may be taken three times during the day. 
Five grains of the compound rhubarb pill, given morning and evening, 
will answer the same purpose. 
Heartburn is frequently a concomitant of dyspepsia. It may be 
relieved by 1 teaspoonful of lemon juice, 1 wine-glassful of lime-water, 
or 1 teaspoonful of baking soda in 1 wine-glassful of water. (See Heart- 
burn. ) 
Water-brash may be removed by 10 to 15 grains of subnitrate of 
bismuth, taken three times during the day, alone or with a few drops of 
oil of cajeput three times a day, or, what is often more convenient, 20 590 
DYSPEPSIA. 
or 30 drops of essence of peppermint; 3 grains of asafoetida pill (sugar- 
coated) three times a day, will afford relief also. (See Water-Brash.) 
When the spirits become much dejected and the hypochondriacal 
state is arrived at, great patience will be demanded in the treatment; 
the sufferer becomes anxious about his own welfare, and fancies that 
every little ache and pain will be followed soon by death; his confidence 
must be gained, and his disease, which is a species of insanity, pre- 
scribed for. If we treat persons of this temperament in an off-hand 
manner, telling them that there is nothing the matter, and hold their 
anxious thoughts and cares up to ridicule, they soon lose all confidence 
in themselves and domestic remedies, and perhaps apply to some quack, 
who works not only upon their mind, but upon their pocket also. The 
kindest treatment should be exercised in this kind of cases; the invalid 
should be advised to travel, to get change of air and scene, to mix in 
pleasant and cheerful society, and his attention must be turned, if pos- 
sible, from his own fancied ailments to things more intellectual and 
more profitable to himself. (See Melancholia, Hypochondriasis.) 
Many of the most distressing symptoms of this disease are very 
much ameliorated or disappear under the use of chalybeate or slightly 
purgative mineral water. Vichy or Saratoga seltzer, or the celebrated 
German bitter water, are among the most suitable. 
Preventive treatment.-This is the disease, perhaps more than any 
other, in which "an ounce of prevention is better than a pound of 
cure. ' ' Those at all disposed to dyspeptic symptoms should take plenty 
of outdoor exercise. By so doing, even those who are compelled to 
pursue sedentary avocations may remain in perfect health to advanced 
years. The food should be perfectly masticated, not hurriedly swal- 
low'ed in a half-chewed state, as is so often the case in this country. At 
least five hours should elapse between meals, as many substances take 
that long to digest, and one meal should not be partaken of until its 
predecessor is out of the way. The stomach, like every other organ, 
must have rest. The use of very hot or very cold articles, such as 
boiling hot tea, or ice water, should be avoided. Digestion takes place 
at a certain temperature, and if this be raised or depressed, usually the 
process stops. Avoid the use of tobacco and ardent spirits, if you 
would remain free from dyspepsia. Excessively hard labor should be 
avoided if possible, and to those who must earn their bread by the 
sweat of their brow, we would say, take a few moments' rest before 
and after participating in any meal. Be always employed about some- 
thing. The worst sufferers from the disease are those who have noth- 
ing to do. The vast quantity of patent medicines swallowed annually 
is one of the most common predisposing causes. They produce, taken D YSPEPSIA-EAR. 
591 
wholesale, the very conditions they are advertised to cure. Dys- 
pepsia is very seldom prevented by the taking of medicine. When 
the disease has been contracted, the treatment is necessarily partly 
medicinal, but prevention is always hygienic. In short, eat slowly, 
not too often, not too much; eat simple food, neither too hot nor 
too cold; take rest at stated times, and always before eating; take 
plenty of outdoor exercise, taken after eating, it should be gentle ; and 
under all circumstances be cheerful. The discontented grumbler is 
almost invariably a dyspeptic. In the article Food the reader will find 
a classification of the various articles of diet-for the convenience of 
dyspeptics-and Dr. Beaumont's table, showing the length of time 
required for the digestion of each article of food; also a table from Dr. 
Letheby's work on Food, giving a comprehensive idea of the nutritive 
value of different articles of diet. (See Digestion, Food, Diet, Exer- 
cise, Health, Air, Animal Heat, Baths, Mineral Waters, Sleep, 
Costiveness, Cathartics, Acidity of the Stomach, Atrophy, Emacia- 
tion, Colic, Biliary Disorders, Biliousness, Flatulence.) 
DYSPHAGIA, dis-fa'-je-q, difficulty in swallowing. 
DYSPHONIA CLERICORUM, OR CLERGYMAN'S SORE 
THROAT. (See Clergyman's Sore Throat.) 
DYSPNCEA, disp-ne'-q [Gr. dus, with difficulty, and pneo, I breathe], 
is an embarrassed or laborious breathing. It is owing to a disturbance 
of the natural and healthy relation that ought to subsist between the 
blood and air in the lungs. 
DYSURIA, dis-u'-re-q, difficulty in passing water. (See Bladder, 
Diseases of the ; Urine.) 
EAR, eer [Ang.-Sax.], the organ of hearing consists of three parts- 
the external ear, the middle ear or tympanum, and the internal ear or 
labyrinth. The external ear consists of an expanded trumpet-shaped 
cartilaginous structure, called the pinna, or auricle, which collects the 
sounds, and a tube which conveys these sounds to the internal ear. The 
pinna or auricle consists of an uneven piece of yellow cartilage, covered 
with integument and fixed to the margin of the auditory canal. This 
canal, the 'meatus auditorius externus, or tube by which sound is con- 
veyed from the pinna to the internal ear, or tympanum, is about 
inches in length, and is formed partly by cartilage and membrane. The 
middle ear, tympanum, or drum of the ear, is an irregular cavity situated 592 
EAR-EAR, DISEASES OF THE. 
within the petrous bone, and interposed between the meatus auditorium 
and the labyrinth or inner ear. It is filled with air and communicates 
with the pharynx by the eustachian tube. It is traversed by a chain of 
small movable bones, which connect the membrana tympani with the 
labyrinth, and serve to convey the vibrations communicated to the mem- 
brana tympani across the cavity of the tympanum to the internal ear. 
The inner and fundamental portion of the organ of hearing is called from 
its complexity, the labyrinth, and consists of three parts-the vestibule, 
the semicircular canals and the cochlea. The vestibule is the common 
central cavity of the osseous labyrinth, and is placed behind the cochlea, 
but in front of the semicircular canals. These are three bony canals 
situated above and behind the vestibule, measuring about one-twentieth 
of an inch in diameter, and opening at both ends into the vestibule. 
The cochlea, so called from its resemblance to a snail's shell, is conical 
in form, and placed almost horizontally in front of the vestibule. Its 
length is about a quarter of an inch, and its width at the base about the 
same. It consists of an axis or centre; of a canal winding spirally 
round it for two turns and a half from the base to the apex; and of a 
delicate lamina contained within the canal, which follows its windings, 
and subdivides it into passages. The auditory nerve, which is dis- 
tributed over the different parts of the labyrinth, enters by the meatus 
auditorius internus and divides into two branches-viz., an anterior for 
the cochlea and a posterior for the membranous labyrinth. (See Ear, 
Diseases of the ; Cerumen, Deafness. ) 
EARACHE. (See Ear, Diseases of the). 
EAR, DISEASES OF THE, the disorders to which the organ of 
hearing is most liable, are loss of function, or deafness, noises in the ear, 
neuralgia, or affection of its nerves, abscess within the meatus, or in the 
cavity of the tympanum, chronic discharges, polypus; and further, the 
meatus in children is very apt to be chosen as the receptacle for peas, 
small buttons, or indeed anything they can poke in easily, but which are 
often extremely difficult to get out again, and usually require the aid of 
the surgeon. 
The subject of deafness has been already treated of, but the attention 
of the reader is again called to the many causes which may produce the 
one effect. The malformation at birth of the inner ear, as a cause of 
complete deafness, is also connected with dumbness: or accident may at 
any time of life injure the delicate structures contained within the cover 
of bone. The passage of the air through the external ear-passage may 
be obstructed or prevented by an accumulation of wax or other matters; 
the membrane of the drum may be perforated ; the bones may have been 
discharged by disease; or the eustachian tube blocked by swelling EAR, DISEASES OF THE. 
593 
temporarily, or permanently by thickened mucus. There are no diseases, 
perhaps, which require-as must be evident to all-more tact in their 
discovery and in their treatment, than those of the ear, and yet, till 
lately, they have been almost entirely left in the hands of ignorant 
assumers, and the name of aurist has almost been synonymous with 
quack. The anomaly is now passing away, and the labors of the talented 
and scientific are placing the knowledge and treatment of these dis- 
orders upon a more rational and scientific basis. 
We would caution our readers to avoid quacks, and especially travel- 
ing impostors, who assume the name of "aurist." In cases of threat- 
ened deafness, or any serious trouble in the ears, no time should be lost 
in consulting the family physician, who, if he cannot grant relief, will 
refer his patient to a medical man who has given special attention to 
aural surgery. 
Noises in the ears, such as singings, ringing of bdls, roaring as of 
the sea, etc., are often extremely troublesome, and may arise from 
many and different causes. Mere temporary derangement of the diges- 
tive organs will in some persons produce them ; they are often indicative 
of determination of blood to the head, and, when accompanied with 
symptoms of this tendency, ought not to be neglected. Partial obstruc- 
tion of the eustachian tube by cold, or accumulation of wax in the exter- 
nal ear-passage, is apt to occasion these noises, and they are accom- 
panied with some degree of deafness. Of course the remedy must vary 
with the cause ; if the digestive organs are deranged they must be regu- 
lated ; if cold be the cause, the symptoms may be left to pass away with 
the temporary ailment. In some cases of chronic, or continued noise 
in the ears, regularly bathing the head with cold water every morning 
will, after a time, remove it. For further advice regarding the accumvr 
lotion of wax in the ear, the reader is referred to the subjects Cerumen 
and Deafness. 
Earache, or otalgia, is a neuralgic affection of the ear, characterized 
by fits of violent pain, generally coming and going capriciously, and with- 
out fever. It is distinguished from otitis, or inflammation of the ear, 
by the pain being of a shooting and not of a throbbing nature, and by 
its coming on or departing suddenly, or reaching at once its maximum 
of intensity. The causes of earache are the same as those of neuralgic 
affections generally, and it requires a like mode of treatment. (See 
Neuralgia.) It frequently arises from toothache, and may likewise be 
occasioned by foreign bodies in the ear. Gentle rubbing with the chloro- 
form liniment in the immediate neighborhood of the pained part; or 
warm poultices, especially the chamomile poultice; or a soft warm poul- 
tice made of white bread, over the wdiole ear; or a fomentation of 594 
EAR, DISEASES OF THE. 
•chamomile and poppieswill generally afford relief. (See Fomentation.) 
Immediate relief is often afforded by warming some laudanum-which 
is most conveniently done by placing the bottle in a vessel containing 
warm water-and filling the ear with the warm laudanum, which is 
retained by inserting a plug of cotton-wool. This is free from danger or 
injurious effects. Laudanum or paregoric taken internally, will often 
prove useful in aiding the treatment. (See Laudanum, Paregoric.) 
M. Duval says that he has, in person, found relief in severe earache, 
after other means had been tried in vain, from the use of a mixture of 
equal parts of chloroform and laudanum, a little being introduced on a 
piece of cotton-wool. Chloric ether, used in the same manner, will often 
afford relief. A mixture of equal parts of laudanum and sweet oil, 
introduced into the ear in the same way, will also often relieve the 
pain. The heart of a roasted onion applied warm to the external orifice, 
will sometimes be sufficient treatment. The constitutional treatment 
consists of a smart purgative to be followed by tonics, as quinine and 
iron. (See Quinine, Iron.) 
In children, during dentition, lancing the swollen gums will often 
give relief, especially if an aperient be given, such as rhubarb and mag- 
nesia, combined with a little ginger, as in Gregory's powder (which see). 
Inflammation of the ear, or otitis, is often called earache. It is one 
of the most painful disorders, and is generally the result of cold. It is 
characterized by intense throbbing pain in the ear, with, frequently, 
perceptible swelling externally, and more or less fever. There is no 
relief to pain till the abscess bursts, and this result is to be encouraged 
by the assiduous use of fomentations, poultices, etc. After the matter 
has discharged, the ear ought to be gently syringed out three or four 
times a day with warm water, till the discharge ceases. It will be 
advisable to give a few doses of aperient medicine during the progress 
of the case. 
The abscess may form within the tympanum, and the membrane be 
perforated in giving exit to the matter. Inflammation of the ear ending 
in abscess differs from true earache, or neuralgia, in the pain being com- 
paratively slight at first, and gradually increasing in intensity as the dis- 
ease progresses ; whereas in neuralgia it commences with full severity. 
When the discharge after an abscess does not disappear, or when 
running from the ears shows itself after acute diseases, such as measles, 
scarlet fever, etc., the symptom must not be neglected, and should be 
examined into by a medical man. 
Bodies of various hinds are apt to be thrust into the external ear- 
passage by children, or to find their way there by accident; and farm 
laborers sometimes get grain, peas, etc., projected in during threshing. EAR, DISEASES OF THE-EARLY RISING. 
595 
If the introduced body is much smaller than the passage, its removal 
may be attempted by syringing freely, and with a strong syringe; but 
if the body fills up the meatus, or nearly so, this will not succeed ; and 
in the event of its being a pea, or anything that will absorb fluid, and 
swell, will do mischief. Neither, in case of a large body, which the 
syringe will not disengage, is it well for friends to attempt the removal 
in any other way; they never do any good, and only push the obstruc- 
tion further in, rendering its extraction by the surgeon more difficult, par- 
ticularly if it has passed beyond the middle and narrowest portion of 
the canal. 
In purulent discharge from the ear, which is induced by any cause, 
a lotion made with 2 drams of solution of chlorinated soda to 6 ounces 
of rose, or elder-flower water, should be injected, but not with any 
force; the best method is to let it flow into the ear, held so as to receive 
it fairly, from a small sponge saturated with the lotion. 
Counter-irritation will sometimes have a good effect on purulent dis- 
charges from scrofula or other causes; a small blister behind the ear is 
the best application, but it should not be kept open for any length of 
time, or it will weaken the system too much. When the discharge is 
the result of active inflammation, and is attended by febrile symptoms, 
a spare diet and aperients must be the treatment; but weakly scrofulous 
systems require a generous diet and tonic medicines. (See Scrofula.) 
Polypus of the ear is by no means an uncommon form of the fun- 
goid growth which sometimes occurs in several of the internal tissues. 
It is of a jelly-like consistence, and a whitish-yellow color, and is 
attached to the membraneous lining of the ear; there are also granula- 
tions of fungus which sometimes shoot up from the membrane, and are 
distinguished by their reddish hue from polypi; these may generally be 
removed by the surgeon, by being held firmly with a pair of forceps and 
then gently twisted and pulled at the same time; this should only be 
done by a properly qualified person, as much mischief may result from 
the unskilful application of the forceps to so delicate a part; sometimes 
when the polypus is in the external passage, and not far up, it may be 
destroyed by astringent applications, such as the muriatic tincture of 
iron or burnt alum, applied with a camel's hair brush. (See Ear, 
Cerumen, Deafness, Ear Syringe.) 
EAR, FOREIGN BODIES IN. (See Ear, Diseases op the). 
EARLY RISING, er'-le rize-ing. There can be no question, as a 
general rule, that the habit of early rising is conducive to health; but, 
like many other similar matters, the general application would, by many, 
be converted into a universal law, and much fallacy and no little mis- 
chief has been done by the propagation of the dogma. 596 
EARLY RISING. 
It is generally said that all those who have attained great and green 
old age have been early risers; therefore, say others, early rising is a 
promoter of health; therefore, it might be whispered, those whose con- 
stitutions have carried them through a long life have been able to be 
early risers. As in many other things, the truth probably lies between 
the two, there have been good vital powers on the one hand, and good 
habits, of which early rising is often an indication, on the other. The 
wrong deduction, however, that early rising is an unmixed good, has 
occasioned much erroneous practice, and many delicate persons, either 
in consequence of the false idea, or badly advised by others, have injured 
their health, materially, by perseverance in the practice; this, however, 
is more common among the young than among the aged, who require 
less sleep. . 
There is no question, but that the bodily powers and constitution 
undergo marked and regular changes during the twenty-four hours, 
changes which are probably influenced by electrical and other causes 
not at present understood. At all events, in diseases, evening brings 
fever if it is present at all, and towards morning, excitement abates if 
it does so at all; further, in health, the body, it is well known, is 
more obnoxious to the causes of disease in early morning than it is at 
other times; and lastly, persons of weak nervous power generally feel 
better towards evening than they do in the morning, even when the 
refreshment of a night's rest might be expected to have given strength. 
The reason of these differences it is perhaps not possible fully to explain, 
but we may reasonably conclude that the same influence which causes 
or aggravates the evening fever, and abstracts excitement towards 
morning, may also act as the elevator or depressor of the constitution 
generally, although only felt when it is not in full vigor; it may, or 
it may not, be owing to the presence or absence of solar influence, but 
still it is so, and the fact is one of general experience. The fact, too, 
explains why early rising is not only not good for all persons, but why to 
some it is positively hurtful, and why those who are able to practice it, 
are generally of strong and good constitution. Moreover, the fact tells 
that the person who cannot rise early with full impunity is not in full 
vigor, but requires means for attaining a better state of health; when 
the powers of life are raised to the proper level, then, by all means, 
let them be kept to it, and early rising used as one of the preserva- 
tive means. 
What is meant by early rising is getting up from rest before the sun 
has exerted some power upon the earth; the exact period to suit the invalid 
it is impossible to specify, it ought to be matter of experience. That 
is to say, retiring to rest at a reasonable, early hour, such as ten o'clock, EARL Y RISING-EC HALLUX OFF I GIN AR UX. 
597 
the person should rise as early as can be done without feelings of sleepi- 
ness, languor, etc., supervening during the day. There are certainly 
evils consequent upon continuance in bed in the morning, such as per- 
spiration, etc., but they may be greatly obviated by the non-use of 
feather beds, or too much clothing; they are less, however, than those 
which result from a nervous system exhausted, at a period of the day 
before it had come into full activity. The same arguments which apply 
to early rising also do so to exertions, or continuance without food by 
weak individuals in the first part of the morning; they can practice 
neither with impunity. There is no time of the day so pleasant, and 
the hale and strong can enjoy it to perfection, and gather health in its 
fresh breezes, and their description will often tempt the unwary invalid 
to leave his couch and follow the example, and he really does enjoy, for 
a short time, the novelty; but shortly, languor creeps over him; the 
breakfast which disappears before the appetite of the strong morning 
walker has no charms for his exhausted weaker companion, who pays 
with a day of listless languor for this ill-advised attempt. These hints 
will, it is trusted, not be taken as an encouragement to laziness, but as 
pointing out a very common error in popular belief and popular 
practice. 
It may be said, as a general rule, that for a healthy adult eight 
hours' sleep-equivalent to one-third of human life-are required. (See 
Bed, Sleep, Breakfast.) 
EAR SYRINGE, eer sir'-inj. This instrument is made of different 
materials. In using it, great care must be taken not to thrust the point 
in too far. Some ear syringes are so constructed as to prevent this, and 
these should always be selected, especially for domestic use. The liquid 
should be thrown in quite gently, and if it causes great pain, should 
be stopped for a time; a towel or basin should be held under the ear 
while the syringe is being used. (See Ear; Ear, Diseases of the.) 
EARTH-CLOSET, erth'-kloz-et. A closet, so arranged, that the 
evacuations from the bowels, as soon as they are dejected, are immedi- 
ately covered with a layer of dry earth, thereby effectually destroying 
all odor, and rendering their presence in the sick chamber, for a reason- 
able time, perfectly innocuous. The contents may be removed at any 
time without creating any stench whatever. Any ordinary carpenter 
can easily construct one, and no invalid-room should be without one. 
EAR-WAX. (See Cerumen, Deafness.) 
EATING. (See Breakfast, Luncheon, Dinner, Supper, Meals, 
Diet, Food, Digestion, Dyspepsia.) 
EAU DE COLOGNE, o'-de-ko-lone, a perfumed spirit of lavender. 
ECBALIUM OFFICINARUM. (See Momardica). 598 
ECHINOSPERKUK VIRGINICUM-EDUCATION 
E CHINO SPERM UM VIRGINICUM, e-ki'-no-sper'-mum vir-jin'-e- 
kum, or hound's tongue. An annual plant belonging to the Nat. order 
Boraginacew, and commonly known as dysentery weed. It is found 
growing on rocky ground throughout the United States. The root is the 
part used in medicine ; it is mucilaginous and astringent, and has proved 
very useful in dysentery and diarrhoea. Dose: of the powder, 10 to 20 
grains; of the infusion, 2 to 4 fluid ounces, three times a day. (See 
Infusion. ) 
ECTHYMA, ek'-the-mg^ a disease of the skin in which pimple-like 
pustules containing matter are developed. (See Skin, Diseases oe the.) 
ECZEMA, ek'-ze-mg [Gr. ekzeo, I boil out], is a disease characterized 
by an eruption of small vesicles on various parts of the skin, crowded 
closely together and often running into each other. These often burst, 
discharging a thin acrimonious fluid, leaving the surface very tender and 
painful. It is not contagious, and generally passes away after a week 
or ten days. There are several varieties, the most important being the 
E. rubrum proceeding from mercurial irritation. It is to be treated by 
warm bathing and fomenting with decoction of poppies, together with 
mild aperients and diaphoretics, and afterwards with cinchona bark. 
Some recommend the application of glycerine to the parts, or a lotion 
composed of water and glycerine in equal portions. Cod-liver oil will 
also be of service. 
EDUCATION, ed-u-ka'-shun [from Lat. educo^ educat us, to lead 
forth], as applied to man, means literally the bringing forward, or 
encouraging and regulating the qualities or properties of which his whole 
being is capable. The natural division of the process is into mental 
and physical; the education of the mind and of the body. 
So much that is applicable to the subject of physical education is 
said in the article Children, and also in the various articles on Air, 
Clothing, Food, Exercise, Health, etc., that it leaves but little to 
be added here, and to the above-mentioned articles, and to those bear- 
ing upon sanitary measures generally, the reader is referred for informa- 
tion. 
The great difference between the physical education of the male and 
female sex, commences when children leave the nursery. The boy, 
much less hampered by the mode of clothing, and permitted much 
more freedom in physical exertion than the girl, has, as far as these are 
concerned, a better chance of attaining his full measure of health, pro- 
vided the mind be not overworked, and the constitution and surrounding 
circumstances are not absolutely deficient or adverse. The girl, on the 
other hand, is submitted to many artificial restraints and modes of edu- 
cation which militate strongly against the chance of her making a EDUCATION-EFFERVESCENCE, ETC. 
599 
perfectly healthy woman. The diffusion of a knowledge of these prin- 
ciples on which health depends has, of late years, tended to ameliorate 
many of the most injurious practices connected with the bringing up of 
girls, but many yet require to be corrected. 
The bad results which are often brought about by the use of stays or 
corsets, have been so often exposed and condemned, that the subject 
has become almost hackneyed, and yet by a majority of the female sex 
the practice is still followed to an injurious extent. It seems as if 
people imagined that the Creator had made the body of the adult female 
so weak that it cannot support its own weight; for either on this 
account, or without reason, they case it up in artificial supports. Even 
among the poorest the abuse extends, and girls of ten or twelve are 
kept from bending naturally by the use of corsets. True, these articles 
of dress do at last become indispensable, but it is only after the muscles 
of the frame have been weakened, in consequence of not being per- 
mitted to exert their appointed and regular action. Any muscle or set 
of muscles of the body, if not regularly exercised, become diminished 
both in substance and power ; the human framework or skeleton is so 
constructed, that the muscles with which it is furnished, and particu- 
larly those connected with the spine, preserve its equilibrium; supersede 
these muscles by artificial support, and they become weakened; but as 
their artificial substitutes cannot act with the perfection of the natural 
supporters, the defect sooner or later shows itself; the unsupported 
spine gives way somewhere, and curvature, more or less, ensues. It 
would astonish most persons, were they made aware of how many 
curved spines there are, in how many, who even do not themselves sus- 
pect it, the deviation exists, and how often it is the occasion of impaired 
health, palpitation of the heart, hysterical and other affections. More- 
over, the above spinal weakness is not the only evil consequence, for it 
is too often mixed up with disorders of the digestive and circulatory 
organs, originated by their compression by the clothing. The too pro- 
longed hours of study inflicted upon girls are unquestionably a great 
evil, but they would be less so, were the hours of relaxation and 
exercise more rationally conducted. No exercise can be beneficial unless 
the mind be actively interested, or at least pleasantly occupied during 
the time of exertion; but little good can result from demure walks, 
taken without interest, and almost without enjoyment. (See Chest.) 
EDUCATIONAL INSTITUTIONS. (See School.) 
EEL, eel, is one of the oily fishes, and is peculiarly indigestible. 
EFFERVESCENCE, OR EFFERVESCING DRAUGHTS, ef-fer- 
ves'-sense, is the rapid extrication of gas or vapor from a liquid, hence 
boiling is effervescence: medically, however, the term is generally applied 600 
EFFERVESCENCE, ETC. 
to the extrication of carbonic acid gas solely. Many mineral waters 
such as Seltzer water, are effervescing, from containing the gas natur- 
ally ; soda water and other effervescing drinks are impregnated with it 
by mechanical means, whilst in fermented liquors it is generated in the 
process of fermentation. In the practice of medicine, effervescing 
draughts are most frequently, perhaps, formed by the direct separation 
of the gas from one of the alkaline carbonates, such as the carbonate or 
bicarbonate-which latter contains the gas in greatest abundance-of 
potash, soda, or ammonia; the solution of bicarbonate of magnesia, or 
fluid magnesia, is also used for the purpose. In many forms of illness, 
particularly those attended with thirst, no kind of medicine is so grateful 
to the patient, or so readily taken, as that which is given in a state of 
effervescence; if the stomach is irritable, and a tendency to vomiting 
present, medicines given in this way are more likely to be retained, the 
carbonic acid apparently exerting a quieting and soothing effect upon 
the organ; at the same time, the taste of medicine is considerably 
obscured by its administration by this method. When the tongue is 
much furred, and particularly in cases of sore throat, when medicine in 
any effervescing form can be swallowed, none appears to exert a more 
cleansing effect, in removing thick mucus and incrustations, and if it 
does this for the mucous membrane of the mouth, it must probably have 
the same effect on that of the stomach. 
Some persons who are liable to suffer from difficulty of breathing, 
whether from asthmatic or other causes, and those who do not easily get 
rid of flatulence, cannot take effervescing drinks without inconvenience ; 
this, too, occurs if patients to whom they are administered are confined 
to bed, and lie down too soon after taking the dose. A minute or two 
ought always to be allowed for the eructation of the gas, before a patient 
who has taken an effervescing draught resumes a recumbent position. 
One of the alkaline carbonates above mentioned being made the 
effervescing agent, many medicines may of course be given in combina- 
tion. The acids most generally and beneficially used to combine with the 
alkali, and set free the gas, are lemon-juice, citric acid, and tartaric 
acid; they ought to be used in the following proportions: To 30 
grains of bicarbonate of potash, a small tablespoonful of lemon juice, or 
20 grains of either tartaric or citric acids. To 30 grains of bicar- 
bonate of soda, about one-fifth more of the above acids. To 6 grains 
of carbonate of ammonia, 2 teaspoonfuls of lemon juice, or about 8 
grains of either citric or tartaric acids. 
So common has the use of effervescing draughts become, that the 
materials, soda and tartaric acid, and a measure for the purpose, are 
kept in many houses. The practice is not free from danger or injury; EFFERVESCENCE, ETC.-EGGS. 
601 
the continued use of soda being apt to impoverish the blood. To the 
weakly it is of course more likely to prove hurtful than to the strong. 
The mode of mixing effervescing draughts which is commonly recom- 
mended, is a bad one. The two powders are generally ordered to be 
quite dissolved in separate portions of water before mixing; the conse- 
quence is, the gas is extricated all at once; the violence of the efferves- 
cence-unless the glass is a very large one-is very liable to carry up 
and spill over a portion of the liquid, and the action subsides before the 
person can drink. All this may be avoided if the acid and alkali, in fine 
powder, are put dry in the glass, and the water poured slowly upon 
them from some little height. In this way the gas is more slowly extri- 
cated ; there is no spilling, and, if properly done, full solution of the 
powders ought to be effected. If lemon-juice is used, it should be mixed 
with the water, and poured upon the alkali in the same way. Of course 
when the draught is a very small medicinal one, the same precautions 
are not required. The use of effervescing forms of medicine has of late 
years become much more prevalent than formerly, and as a consequence 
we find many improvements introduced, by which various drugs are 
rendered not only more palatable if taken in the above state, but also 
more likely to sit easily upon the stomach. Thus, we have effer- 
vescing magnesia, iron, quinine, lithia, bismuth, etc. The process of 
granulating is now applied to many medicines, and consequently, we 
have such medicines as the granulated effervescing citrate of magnesia, 
and others, which are found so convenient and so comparatively agree- 
able. (See Ammonia, Carbonic Acid, Citrate of Magnesia, Potash, 
Soda.) 
EFFLUVIUM, ef-fid-ve-um [Lat.] is a gaseous emanation or exhala- 
tion, from any body, generally of an offensive or noxious character. 
Effluvia is the plural. (See Contagion, Disinfectants). 
EFFUSION, ef-fu-zhun [Lat. effuslo, from ejfiundo, I pour out or 
forth] in Medicine is applied to the escape of any fluid out of a vessel or 
viscus naturally containing it, and its lodgement in another cavity, in the 
cellular substance, or in the substance of parts. It also sometimes sig- 
nifies an oozing or morbid secretion of a fluid from vessels that have not 
been ruptured; thus surgeons often speak of coagulable lymph being 
■effused on different surfaces. 
EGG-NOG. (See Cookery for the Sick). 
EGGS, egz. Ovum [Latin for egg], is a body produced by the 
females of birds and certain other animals, containing an embryo of the 
same species. The eggs of the common domestic fowl are a favorite 
article of food, and are nutritious and easy of digestion when lightly 
cooked. Beat up in a cup of tea, coffee, or chocolate, or a glass of 602 
EGGS-ELBOW. 
wine, it is well adapted to invalids with weak digestion. The white of 
egg, from the quantity of albumen which it contains, is one of the best 
antidotes in poisoning by corrosive sublimate, the salts of copper or 
zinc. The yelk is used in making emulsions, etc. The shell, being 
composed chiefly of carbonate and phosphate of lime, may be used, 
finely powdered, as a substitute for chalk or lime, in poisoning by min- 
eral acids, when these are not to be had. 
In the preparation of medicines of an oily character, the yelk of egg 
is often advantageously employed, forming with them an emulsion which 
is mixable with distilled or rain water. Castor-oil and turpentine are 
both advantageously given by this method. 
Heat first coagulates and then hardens albumen, thus impairing its 
digestibility; a reason for avoiding over-cooked eggs, as well as meats. 
The egg should be boiled just sufficient to set the albumen or white, 
but not to make it hard. 
In an address lately read by M. Genin before the Academie des 
Sciences, he affirms that the sex of eggs may be accurately determined; 
all eggs having the germs of males have wrinkles on the smaller end, 
while the female eggs are smooth at both extremities. (See Food, 
Emulsion. ) 
ELASTICITY, e-las-tis-e-te, is the power possessed by various bodies 
of returning quickly to the form from which they have been forcibly 
altered. India-rubber, both in its natural and in its vulcanized condition, 
presents one of the most familiar and best examples. The elastic prop- 
erties of this most useful product of nature, have been'abundantly taken 
advantage of in the formation of appliances of various kinds for the 
treatment of disease, and for the relief of suffering. The elastic band- 
ages, cushions, stockings, and supporters of various kinds, are among the 
most valuable additions to the modern practice of medicine; and with 
them may be classed elastic pads, which, whilst they exert a sufficient 
amount of pressure, yield, when, from counter pressure such as that 
caused by swelling of the part to which they are applied, inelastic hard- 
ness would prove injurious. (See Caoutchouc.) 
ELASTIC PADS, BANDAGES, CUSHIONS, ETC. (See Elas- 
ticity. ) 
ELATEBIUM. (See Momardica.) 
ELBOW, eT-l)o [Sax. elneboga}, is the joint of the arm formed by the 
lower end of the humerus and the upper end of the radius and ulna. 
The lower end of the humerus is received into the hollow of the ulna, 
so as to produce a hinge-like arrangement, and the upper end of the 
radius forms also a small part of the joint. The surface of the hu- 
merus in contact with the ulna is limited, internally and externally, by a ELBOW-ELECTRICITY. 
603 
prominent ridge, and is hollowed out in the centre ; that in contact with 
the radius is a small rounded eminence which moves in the cavity of the 
latter. On front of the humerus, above the articular surface, are two 
depressions that receive the coronoid process and the head of the radius 
during flexure ; and behind is a large fossa for the reception of the ole- 
cranon, or large process of the ulna, in the extension of the fore-arm. 
Where the bones touch, their surfaces are covered with cartilage, and 
their articular ends are kept in place by a number of ligaments. (See 
Dislocations. ) 
ELBOW, DISLOCATIONS OF. (See Dislocations.) 
ELDER. (See Sambucus Canadensis.) 
ELDER, DWARF. (See Aralia.) 
ELECAMPANE. (See Inula Helenium.) 
ELECTRICITY, e-lek-tris'-e-te [Gr. elektron^ amber]. This agent is 
used as a remedial power in three principal forms, closely allied to each 
other, and yet differing somewhat in their special uses and action. They 
all act as stimulants to the nervous system, and unlike other remedies 
of the class, the stimulation they produce is not followed by subsequent 
depression. 
1. Common or Frictional Electricity. This may be obtained for 
medical purposes from the ordinary electrical machine, in which it is 
produced by the friction of a glass plate or cylinder on a rubber. A 
common mode of using it is as follows: The patient is placed upon an 
insulating stool and made to take hold of the prime conductor of the 
electrical machine. Sparks are then drawn from the body, either by the 
hand of the operator or by metallic conductors. In some constitutions 
there is a peculiar susceptibility to its action, and as there are no means 
of distinguishing beforehand those with whom it disagrees, it is always 
advisable to use it in the first instance cautiously, commencing with 
slight shocks. It is, as a rule, a purely chronic remedy, applicable 
only to chronic diseases, and required to be used for several weeks in 
succession. It should be used with caution in inflammatory states of the 
body, and in pregnancy a miscarriage might be produced. 
In paralysis and paralytic affections generally, electricity, if em- 
ployed with due care, proves highly serviceable. In lead palsy, or 
drop-wrist, it is especially beneficial. In aphonia, or loss of speech 
from sudden fright, cases of twelve years' standing have been cured. 
Its emmenagogue properties are certainly very powerful, and many 
cases of amenorrhoea have been cured by its use. In epilepsy the 
results are not so satisfactory. Constipation, depending upon paralysis 
of the muscular fibres of the intestines, has frequently yielded to the 
use of this wonderful agent. 604 
ELECTRICITY-ELEPHANTIASIS, ETC. 
2. Faradization, Electro-Magnetism and Magneto-Electricity.- 
This is the second form in which electricity is used in therapeutics. In 
the magneto-electric machine the fluid is generated by turning a crank, 
while in the electro-magnetic machines it is generated by the chemical 
action of two plates of metal immersed in an acid solution. Faradiza- 
tion, so named after Prof. Faraday, has proved very useful in chronic 
rheumatism and rheumatic paralysis. In neuralgia, the result of acci- 
dent; in recent cases of dropsy of the scrotum or hydrocele; in indolent 
ulcers and wounds. In a case of suppression of the milk, by passing it 
in various directions through the breast by means of moistened sponges 
applied to the ends of the wires, its effect was almost instantaneous. 
3. Voltaic Electricity or Galvanism.-In mercurial and lead palsy, 
galvanism has proved highly serviceable; paralysis and catarrh of the 
bladder, and also incontinence of urine in children have been materially 
benefited by its use. Several cases of impotence cured by its use are 
also on record. In spasmodic asthma, by transmitting the current from 
the nape of the neck to the pit of the stomach, almost immediate relief 
followed. Several cases of indigestion have been helped in the same 
way. 
In poisoning by opium, chloroform, etc.; in drowning and other 
forms of asphyxia, galvanism is a most valuable means of stimulating 
the patient and restoring respiration and circulation. 
ELECTRO-MAGNETISM. (See Electricity.) 
ELECTUARY, e-lek-tu-a-re [Lat. elajo. I make choice], in Medi- 
cine is a form of preparing certain remedies, such as dry powders, by 
forming them into a soft mass by means of a syrup or honey, so as to be 
easily taken off a teaspoon or the point of a knife without their naturally 
unpleasant taste being perceived. 
ELEMI, eV-e-me. A concrete, resinous exudation, the source of which 
is not exactly known, but is generally believed to be from the Canarium 
commune. It is of a yellowish-white color, with a fennel-like odor, soft, 
unctuous and adhesive, and about the consistence of thick honey, but 
becoming harder and more resinous by age. It is chiefly imported from 
Manilla. It is used as a stimulant in the form of ointment. The oint- 
ment of elemi is composed of £ ounce of elemi and 1 ounce of simple 
ointment. 
ELEPHANTIASIS, OR BARBADOES LEG, el-e-fan-ti'-a-sis [Gr. 
from elephas, an elephant], is the name of a disease common in the East 
and West Indies, and so called from the skin of the afflicted limb becom- 
ing rough, scaly, and enormously thickened, so as to resemble the leg 
of an elephant. It generally comes on with great heat of the skin, 
alternating with profuse perspiration and ardent thirst. The part ELEPHANTIASIS, ETC.-EMACIATION. 
605 
becomes red, hot, swollen, and painful, increases to great size, and 
becomes a burden to the patient. Though it is the leg that is generally 
affected by this disorder, other parts of the body are liable to its attack; 
but it is not usual for more than one part to be morbidly enlarged in the 
same individual. In the treatment of this disease in its earlier stages, 
the use of laxatives and diaphoretics is recommended, together with the 
application of iodine ointment to the part, and firm bandaging. In the 
latter stages, little can be done for its alleviation, and amputation of the 
part is generally discountenanced. 
ELETTARIA, edet-td-re-q, the name of a genus of plants of the Nat. 
order Zingiberacem. The most important species is the E. carda- 
momum, or the Malabar cardamum, a native of Malabar. The seeds 
are officinal, and are aromatic and carminative. Cardamoms are seldom 
given alone, but as an adjunct to other remedies. They are best given 
in the form of compound tincture of cardamum, in doses of to 2 tea- 
spoonfuls. 
ELIXIR IODO-BROMIDE OF CALCIUM COMPOUND. (See 
Calcium, Compound Elixir Iodo-Bromide of.) 
ELIXIR OF VITRIOL. (See Sulphuric Acid.) • 
ELIXIRS, edik'-surz [Lat. elixo, I extract by boiling], is a name 
given to various medical preparations, consisting of wine, or spirits of 
wine, and various aromatic and bitter vegetable substances. Some of 
the most elegant preparations of the pharmacopoeia are now in the 
shape of elixirs. Among them may be mentioned, elixir of valerianate 
of ammonia; valerianate of ammonia and quinine; calisaya; calisaya and 
iron ; calisaya, iron and bismuth ; gentian and chloride of iron ; iodide 
of lime and protoxide of iron ; phosphate of iron and quinine ; rhubarb 
and magnesia; iodo-bromide of calcium; pyrophosphate of iron; and 
a great many others. 
ELM. (See Ulmus Fulva.) 
EMACIATION, e-morshe-a'-shun, is wasting of the tissues so that 
the body becomes thin. The process of emaciation, however, is very 
different from simple diminution of bulk; the latter may take place 
whilst the appearance of health is still retained; but with true emacia- 
tion, the skin and aspect generally, present an unhealthy appearance. 
There are few diseases which are not accompanied with loss of flesh or 
emaciation, and it is not unfrequently the first observable symptom. 
Dr. Watson remarks: "It occurs in complaints that are not commonly 
dangerous-as in dyspepsia, and in hypochondriasis, which is often con- 
nected with dyspepsia-and when it does occur, it marks the reality of 
the disease. This wasting happens in many fatal maladies-in pulmo- 
nary consumption, for example-and in dropsy, although the dropsical 606 
AMA4CYJ TION EMETICS. 
enlargement sometimes masks it. It accompanies many acute diseases, 
and is reckoned an unfavorable symptom; for it shows that the body is 
not properly nourished. Sometimes the emaciation is so extreme that 
the integuments give way-the bones of the patient are said to come 
through his skin. 
Galvanism prevents the wasting of limbs which are paralyzed, as 
well as restores action to parts in which the nerves have been impaired 
by injury, such as fracture, dislocation, bruises, etc. Apparently hope- 
less cases have been recovered after the ordinary means failed, by trans- 
mitting the galvanic current through needles stuck in the nerve of the 
part, or as near it as possible. This process is called local Faradization, 
after the celebrated Faraday. (See Atrophy, Electricity.) 
EMBROCATION, em-bro-ka'-shun [Gr. embroche, a moistening], a 
term originally applied to those external applications used for softening 
or dissipating swellings. The word has, however, extended beyond its 
primary meaning, and is applied to oleaginous and spirituous compounds 
which incite the surface of the skin to increased action, and produce all 
the effects of counter-irritants, or which, by their influence on the 
extremities of the nerves, assist in resolving spasm ; thus acting as anti- 
spasmodics. 
EMBRYO, em'-bre-o [Gr. embruon, from embruo, I bud forth], is the 
rudimentary state of any organized body. In Physiology it is applied to 
the fetus in the womb before the fifth month of pregnancy, from its 
growth resembling the budding of a plant. Hence we have embryology, 
a description of the embryo; embryotomy, or the extraction of the 
embryo piecemeal in delivery. 
EMETICS, e-met'-iks [Gr. emetika\, are substances which excite vomit- 
ing. Many agents are capable of exciting vomiting, which are not classed 
as emetics, such as nauseous tastes or smells, swinging motions, such as 
that which causes sea-sickness, mechanical irritation of the throat, etc.; 
but these causes are very different from the specific action of a true emetic, 
which acts independently of taste or smell. Emetics constitute a class 
of our most valuable remedies, although not so indiscriminately and 
extensively used as they were formerly. The most generally used, and 
most useful emetics are, alum, antimony, chamomile, ipecacuanha, 
lobelia, mustard, sulphate of zinc, or white vitriol. Salt is sometimes 
used as an emetic ; and the mechanical irritation of the throat is often 
resorted to with benefit for the purpose of exciting vomiting. The 
reader will find further information respecting the above emetics under 
their individual articles. 
When an emetic is given, it should be mixed in the first place with 
a small quantity of water. Except in the case of sulphate of zinc-and EMETICS. 
607 
some other mineral emetics, not adapted for domestic use-some little 
time will elapse before the effects of the emetic are experienced, longer 
if the stomach be full of food, and vice versa. The first sensation is one 
of nausea, accompanied with flow of the saliva, slight faintness, and cold 
perspiration ; at last the effort of vomiting supervenes, and the contents 
of the stomach are ejected. As soon as actual vomiting commences, as 
a general rule, but not before, some tepid fluid-water, gruel, chamo- 
mile tea, or such like-should be given in moderate quantity, not exceed- 
ing a pint at a time. A slight caution is requisite upon this head ; for 
occasionally individuals under the action of an emetic, are encouraged 
to drink very freely of fluid and to distend the stomach. This is not 
well, for it not only embarrasses the action of the organ, but might cause 
its being lacerated or burst. It is also requisite to caution against giving 
the diluent fluid too soon, that is before the specific power of the emetic 
substance has come into action; if this is done, the dilution will either 
delay, or altogether prevent the desired effect. When there is much 
debility of the stomach, it is better to choose for the diluting fluid, a bit- 
ter, such as chamomile tea, which has the additional advantage of being 
itself emetic. As a general rule, the mineral act more quickly and vio- 
lently than the vegetable emetics ; for this reason the former are gener- 
ally selected in cases of poisoning, such as that by opium, in which there 
is some difficulty in rousing the stomach to action at all, and in which 
it is important that it should be relieved of its contents as speedily as 
possible. In such cases, medical men may give the sulphate of copper; 
but for the unprofessional, the sulphate of zinc, or white vitriol, is the 
safest, and is a nearly equally efficacious remedy. 
When there is much fever, and in some forms of inflammation, the 
salts of antimony, particularly tartar emetic, are most generally used if 
emetic action is desirable. As a simple emetic to relieve the stomach, 
and also in cases of chest affections, ipecacuanha will be found the best. 
In diseases of depression, mustard is most useful; and carbonate of 
ammonia may also be employed alone, or combined with ipecacuanha. 
In cases where the power of swallowing is lost, medical men can excite 
vomiting by the injection of emetic substances into the veins ; this 
practice of course cannot be followed by the unprofessional, yet they 
may safely, and with much certainty of success, have recourse to 
mechanical irritation of the back of the throat, either by the finger or by 
a feather. A few individuals possess the power of spontaneous vomiting, 
or at least of exciting regurgitation of the food from the stomach into 
the mouth ; a process somewhat analogous to the rumination of animals. 
Such persons usually suffer from dyspepsia, and have recourse to the 
operation to free the stomach from food it cannot digest. 608 
EMETICS. 
The evening is generally the most suitable time for administering an 
ordinary emetic, as the stomach has time to recover itself during the= 
night, and the uncomfortable nausea which often follows is less felt. 
Emetics are used to fulfill various indications; the most direct and 
obvious being the emptying of the stomach of any noxious substances, 
either formed within the body, such as bile; or taken in by the mouth, 
as indigestible food or poison. Fortunately, these matters often of them- 
selves excite vomiting, but in many instances, they do not sufficiently 
empty the stomach, in which case the action must be kept up, or re-ex- 
cited, either by a diluent or by some emetic medicine. It must be 
remembered, however, that in the case of some poisons it is not desirable 
to dilute largely. In addition to their power of emptying the stomach, 
emetics are valuable from the mechanical effects, both general and local, 
which they exert upon the body. Formerly, the general mechanical 
effect, or "shock," of an emetic, was believed to have the power of 
checking fever and other diseases at their outset; it is not now, however, 
much trusted to by medical men, and if it does not do good, is apt to 
prove injurious, by causing an irritable condition of the organ, which 
may continue throughout the disease. In many cases of incipient dis- 
ease, however, characterized by depression, coldness of the skin, etc., 
the mechanical action of a smart emetic of ipecacuanha, either alone, or 
with 5 to 8 grains of carbonate of ammonia, is most beneficial, by 
rousing the system, and removing the tendency to internal congestion, 
or accumulation of blood. 
Another, and most beneficial, mechanical emetic, is in the case of 
children suffering from affections of the chest, with accumulation of 
mucus, or phlegm. Children cannot expectorate, and are liable to be 
suffocated if the phlegm is in large quantity and cannot be removed; 
nothing ensures its removal so effectually as an emetic, or rather emetics 
repeated from time to time-every few hours-according to circum- 
stances. In cases of jaundice and overloaded liver, the mechanical 
action of emetics is often beneficially had recourse to. In consumption, 
the periodical exhibition of emetics has been recommended. In spas- 
modic diseases-either general, as hysteria-or local, as in spasms of the 
stomach-emetics are beneficial; in the latter case, often, of course, by 
freeing the stomach from the offending cause of the disorder. In 
asthma, they often relieve when nothing else will. 
Emetics are not always safe remedies; in pregnancy, in persons of 
very full habit, particularly if there is determination to the head, in rup- 
ture, in falling down either of the bowel or of the womb, vomiting 
should, if possible, be avoided. The ancients held the opinion that 
emetics strengthened the stomach, and they were even used in the EMETICS-EMPYEMA. 
609 
training of the athletae; modern experience certainly does not uphold the 
fact, for the habitual use of these agents assuredly injures the tone of 
the organ, and weakens its power. 
An error is frequently committed in using antimonial wine, as an 
emetic; it is far too depressing for general purposes. For these ipecac- 
uanha is quite the safest agent of the class; it should be given in pow- 
der mixed with water, and not in the form of wine, if the former is 
procurable. (See Antimony, Chamomile Ipecacuanha, Lobelia Inflat a, 
Tartar Emetic, etc.) 
EMETIC, TARTAB. (See Antimony.) 
EMETINE, em-e-tin, the active principle of ipecacuanha. 
EMIGRATION. (See Acclimatization, Climate.) 
EMMENAGOGEES, em-men-a-gogz [Gr. emmenia, the menses, and 
ago, to induce], are medicines which exert, or are supposed to exert, 
their action upon the womb, and to promote the menstrual discharge. 
(See Menstruation.) 
EMOLLIENTS, e-mol'-gents [Lat. mollis, soft], a term employed to 
denote those substances which are used externally for the purpose of 
softening the part of the body to which they are applied. They are the 
expressed oils, poultices and fomentations of various kinds, liniments, 
ointments, and embrocations. 
EMPHYSEMA, em-fe-se'-mq [Gr. emphysao, to inflate], is a medical 
term applied to two very different disorders. In one case it denotes a 
state if coalescence and unnatural distension of the air-cells of the lungs. 
(See Lungs.) In the other, it is applied to the distension or blowing 
up of the cellular or areolar tissue of the body by air. This latter form 
of emphysema, sometimes follows upon the accident of fractured rib, 
when a point of the bone penetrates the lung. In this case, with every 
breath drawn in, air passes from the lung into the cavity of the chest, 
from whence it finds its way through the wound made in the walls of the 
cavity, and by this means becomes diffused through the cellular tissue; 
the features and the whole body become greatly swollen, and when the 
surface is indented by the finger, a crackling sensation is experienced. 
The mere distension of the cellular tissue is not a circumstance of so 
much importance as the accident which gives rise to it, but in those 
perfectly unaware of the possibility of such an occurrence, the appear- 
ance presented by the affection would cause much alarm; of course the 
broken rib itself should be attended to; the emphysema may be relieved 
by punctures made in the skin by a lancet, and by the application of 
bandages. (See Fractures, etc.) 
EMPYEMA, em-pe-e-mq [Gr. em, within, pyom, pus], is a collection 
of matter in the cavity of the chest, between the lung and the ribs. 610 
EMPYREUMA-ENTERITIS, ETC. 
EMPYREUMA, em-pe-ru-ma [Gr. empyreuo^ to set on fire], is the 
peculiar and often offensive smell which many substances acquire after 
exposure to considerable heat in close ovens or vessels. The fact of an 
article of diet becoming empyreumatized renders it unwholesome and 
irritating to the stomach; on this account baked meats, pastry, etc., are 
more apt to disagree than the same articles properly roasted or boiled. 
(See Roasting, Boiling.) 
EMULSION, e-mul'-shun [from Lat. emulgeo^ emulsus, to milk out], 
is a mixture of oil with water by the intervention of a third substance. 
This may be effected by means of gum mucilage, syrup, etc., but per- 
haps the best agent for forming emulsions is the yelk of egg. The oil 
must first be rubbed up with the yelk, and then distilled rain, or per- 
fectly soft water added gradually. Milk, which is itself a natural 
emulsion, is also a very good agent for uniting some oily, or such like 
matters resembling the oils in composition, with water, particularly 
camphor. (See Camphor, Castor-Oil, Turpentine.) 
ENAMEL OF THE TEETH. (See Teeth.) 
ENCEPHALITIS, en-sef-adi'-tis. Inflammation of the brain. (See 
Brain, Diseases of the.) 
ENCYSTED, en-sist'-ed [Gr.], is applied to tumors consisting of a 
fluid or other substance enclosed in a cyst, bag, or sac. 
ENDEMIC, en-dem'-ik [Gr. endemikos^ from en^ among, and demos, 
the people], in Medicine, is a term employed to designate diseases 
peculiar to a certain class of persons, or to a particular district. Thus 
ague is an endemic disease in low marshy countries; the goitre in the 
Alps. They differ from epidemic diseases, which, without reference to 
locality or class, attack many persons at the same time in the same place, 
and are contagious; as influenza, scarlet fever, etc. 
ENDERMIC, en-der'-mik [Gr. en, in, and derma, the skin], is the 
transmission of medicinal actions to the constitution through the skin. 
(See Skin.) 
ENDOCARDITIS. (See Heart, Diseases of the.) 
ENEMA. (See Clyster.) 
ENLARGEMENT OF THE HEART. (See Heart, Diseases of 
THE.) 
ENTERITIS, OR INFLAMMATION OF THE BOWELS, en-te- 
ri'-tis [Gr. enteron, the intestines]. 
Causes.-Inflammation may be lighted up in the substance of the 
bowels by anything which impedes the passage of their contents. Some- 
times the canal of the bowel is closed by adhesion and bands of mem- 
brane, the morbid results of previous inflammatory attacks. There is a 
peculiar condition of the bowels, sometimes causing a firm obstruction ENTERITIS, ETC. 
611 
to the faeces, and finally setting up acute inflammation, called intussus- 
ception, consisting of one part of the bowel slipping into another which 
is below it-like putting a finger into a glove. This state of things is 
frequently met with in children who have suffered during the last few 
hours of their life from acute scrofulous inflammation of the brain. The 
obstruction to the bowels may be due also to thickening of their coats, 
to tumors pressing upon them from without, or some morbid accumu- 
lation within. Various substances may accumulate within the bowels, 
giving rise to obstruction, as hardened faeces; and patients in the con- 
stant habit of taking carbonate of magnesia or chalk as medicinal agents 
are in danger of suffering from intestinal concretions, as these drugs 
have a great tendency to remain in the bowels and accumulate. In rare 
instances cancerous growths affect the bowels and stop up their chan- 
nel, giving rise to congestion and inflammation. 
Symptoms.-The symptoms of inflammation of the bowels resemble 
very closely those of inflammation of the serous membrane in which they 
are packed, known as peritonitis (which see). There is pain in the 
abdomen, increased by pressure, movement and inspiration. The pulse 
is quick, hard and resisting, afterwards growing small and thready. The 
skin is hot and dry, the tongue furred, and the bowels obstinately con- 
stipated. There are distinct chills, thirst is urgent, and nausea and 
vomiting distress the patient. Should the disease advance, typhoid 
symptoms Set in; the extremities grow cold, the belly distended, and 
the features sharp and ghastly. The tongue becomes red and dry, and 
sordes appear on the teeth. The pain ceases, and the countenance no 
longer wears the anxious expression it did in the earlier stage of the 
disease, but has now a dull aspect, and the surface of the body is bathed 
in cold perspiration. The head is generally unaffected, the intellect 
remaining clear to the last, but in some cases delirium forms a trouble- 
some symptom. Inflammation of the bowels is difficult to diagnose, from 
the same condition affecting the peritoneum covering them; for the symp- 
toms of the two diseases are much alike, the only difference being, that 
when the bowels themselves are inflamed their function is necessarily inter- 
fered with and there is nausea and vomiting, with obstinate constipation. 
But, as previously stated, the bowels are generally confined also in 
inflammation of the serous membrane covering them ; but not necessarily 
so. The treatment of the two diseases is almost the same. (See Peri- 
tonitis.) Inflammation of the bowels must be carefully distinguished 
from colic, which has been already described as consisting of acute pain 
in the abdomen, especially about the navel, coming on in paroxysms, and 
not increased by pressure or attended with much fever although vomiting 
and constipation are its most troublesome symptoms. When the intestines 612 
ENTERITIS, ETC. 
are inflamed, the pain is intensely acute and much increased by pres- 
sure. But that of colic is oftentimes relieved by firm support to the 
abdomen, and the sufferer of his own accord places himself upon his 
stomach as he lies in bed. But patients suffering from inflammation of 
the bowels assume a very characteristic posture in bed, lying upon their 
backs, with their knees drawn up; and their abdominal muscles are not 
moved as they ordinarily are in the process of respiration for fear of 
increasing the pain, but the functions of inspiration and expiration are 
carried on solely by the muscles of the chest; and the respiration is said 
to be thoracic. As the pain of colic is not increased by pressure, the 
respiratory process is carried on as usual; and thus this becomes a 
diagnostic character of great value. Enteritis is generally ushered in with 
shivering and distinct rigors; the mouth is parched, and thirst urgent. 
The skin is hot and dry, and the pulse quick and resisting; but in some 
cases its onset is more insidious, and differing in no particulars from that 
of simple colic. 
Treatment.-The patient must be confined to bed, and kept in the 
horizontal posture. The diet should be nutritious, but not stimulating, 
consisting of milk, eggs, beef-tea, broth, and all kinds of farinaceous 
food, sago, gruel, arrowroot, rice, or tapioca. A few Jeeches may be 
applied to the abdomen, and a linseed poultice placed over their bites, 
which may be allowed to bleed freely into this soothing application. 
In former days bleeding and mercury were freely resorted to, and 
the antiphlogistic method of treatment rigidly adhered to. But such 
lowering remedies as these are quite unnecessary; and some practitioners 
of the present day object even to the use of leeches. Purgatives are 
inadmissible, as they tend, not to lessen the inflammation, but on the 
contrary, to increase it, by exciting the vermicular contraction of the 
bowels. The lower part of the intestines may be emptied by warm 
injections; and these will act at the same time as a kind of internal 
fomentation. (See Clyster.) Opium should be freely given, and will be 
found an invaluable remedy in this disease. 
Take of Laudanum One dram. 
Sweet spirits of nitre One and a half drams. 
Solution of the acetate of ammonia Two drams. 
Camphor water Six ounces.-Mix. 
Give two tablespoonfuls every four hours. 
The following pills may be given; but the above mixture is to be pre- 
ferred, as the stomach may not be able to bring the solid form into solution: 
Take of Powdered opium Four grains. 
Sulphate of quinine Eight grains. 
Confection of roses Twenty grains.-Mix. 
Divide into 8 pills, 1 of which may be taken every four or five hours. EE TEE ITTS, ETC-EPIDEMIC. 
613 
Some practitioners give Battley's solution of opium instead of 
laudanum. 
Take of Battley's solution of opium One dram. 
Nitrate of potash One scruple. 
Bicarbonate of potash Half dram. 
Pure water Eight ounces.-Mix. 
Give 2 tablespoonfuls every four hours. 
When the inflammatory symptoms have passed away, mild purga- 
tives may be given, and a more generous diet allowed. Should there 
be any tendency to fainting or collapse, stimulants may be ordered, not- 
withstanding the inflammatory character of the affection. 
When the disease is met with in children, leeches and hot fomenta- 
tions may be applied to the abdomen ; but opium must be given with 
great care, as it acts so much more powerfully upon them than upon 
adults. It may be given thus to a child three or four years old:- 
Take of Laudanum Ten drops. 
Mucilage of acacia Two drams. 
Syrup. One dram. 
Pure water One ounce.-Mix. 
Give a small teaspoonful every four hours. 
Should the disease assume a more chronic form, a blister may be 
applied to the abdomen; but should on no account be resorted to during 
the acute stage. (See Colic, Peritonitis.) 
ENTOZOA, en-to-zo'-q [Gr. entos, within, and zos, life], are parasitic 
animals which are found in a living state within the body. The most 
common entozoa in man are the various forms of worms. (See Worms). 
ENURESIS, en-u-re'-sis, incontinency of urine. (See Urine ; Blad- 
der, Diseases of the; Bed-Wetting.) 
EPIIELIS, e-fedls [Gr. epi, upon or for, and dios, the sun]. The 
term denotes not only freckles, and the larger brown patches, which like- 
wise arise from exposure to the direct rays of the sun, as the name 
imports, but also those large dusky patches, which are very similar in 
appearance, but occur on other parts of the surface which are constantly 
covered. The best applications to such blemishes are very dilute alco- 
hol, mineral acids, and potash, so dilute as just to be sensible to the 
tongue. One form of diffused ephelis is of a brownish color, and fol- 
lowed by desquamation of the skin, and is symptomatic of uterine and 
intestinal disturbance. (See Freckles). 
EPHEMERA, e-fem'-e-rq, a fever which does not last more than 
twenty-four hours. 
EPIDEMIC, ep-e-dem'-ik [Gr. from epi, upon, and demos, the peo- 
ple], is a general term applied to diseases which prevail among a large 
portion of the people of a country or place for a certain time, and then 614 
EPIDEMIC-EPILEPSY, ETC. 
gradually disappear. The causes assigned for the prevalence of epidemic 
diseases are very various, and are by no means determined. The most 
generally assigned causes are a peculiar state of the atmosphere or 
climate, the seasons, etc. Defective ventilation or drainage, and 
unwholesome food or drink, are also among the causes that induce 
epidemics. Most epidemic diseases are likewise contagious, and thus, 
when once induced, spread with great rapidity. During the prevalence 
of an epidemic, it is proper to take particular care of the health ; attend- 
ing to cleanliness and ventilation, as the best means of resisting its 
influence. 
EPIDEMIC CATARRH, OR INFLUENZA. (See Influenza.) 
EPIDERMIS, ep-e-der'-mis [Lat.], the outer or scarf skin, or cuticle. 
(See Skin). 
EPIGyEA REPENS, ep-efie-q re'-penz, or trailing arbutus, a 
perennial plant belonging to the Nat. order Ericaceae, and commonly 
known as gravel plant, ground laurel, may flower, and winter pink. It 
grows in sandy woods and rocky soils throughout the Middle and North- 
ern States. The leaves are the parts used in medicine. It is diuretic 
and astringent, and is by many preferred to uva ursi and buchu, in 
gravel and other diseases of the urinary organs. Dose: of the infusion, 
1 to 2 fluid ounces; of the fluid extract, 1 to 2 teaspoonfuls, three times 
a day. (See Infusion.) 
EPIGASTRIUM, ep-e-gas' -tre-um [Gr. epi, upon, and gaster, the 
belly], denotes that part of the body immediately over the stomach; 
epigastric is used to denote what appertains to this part. (See Abdomen). 
EPIGLOTTIS, ep-e-glot'-tis [Gr. epi, upon, and glotta, the tongue], 
is a cartilage of an oval or heart-shaped figure, situated at the root of 
the tongue, which falls upon and covers the glottis or opening into the 
larynx, so as to protect it, particularly during the passage of food, in 
the act of swallowing. (See Larynx, Deglutition, etc.) 
EPILEPSY, OR FALLING SICKNESS, ep'-e-lepse [Gr. epilepsis, 
from epi, and lambano, I seize], is one of the very afflicting maladies to 
which man is subject, belonging to the class of convulsive diseases. It 
is also one of the most eminently characteristic, and at the same time 
terrible to witness, when it occurs in its severer forms. 
The fits, or convulsive seizures, of epilepsy, are most varied as to 
occurrence; occasionally an individual has suffered from one paroxysm, 
and one only, the disease never again returning; in other cases, years 
have intervened; frequently the interval is one of months, but again, 
daily fits, or even two or three times a day, are the rule in the worst 
cases. 
Causes.-Epilepsy may be induced by causes affecting the nervous EPILEPSY, ETC. 
615 
system; the excitement of joy or passion, or the depression of grief, 
intoxication, and sexual excesses, are the most frequent, not only actual 
exciters, but also predisposers, to the attack of epilepsy. 
Of the predisposing causes there is no question that hereditary 
tendency is a powerful one, and especially if the constitution of the 
family be scrofulous. Epilepsy in the offspring has been traceable 
to no other cause than dissipated, and especially drunken, habits in the 
father. It is frequently observed to be concomitant with malformation, 
or at least mis-shape, of the head of the sufferer. 
Epilepsy may he a conyenital disease, that is, the child is born with 
the tendency, and becomes subject to the fits, either with or without 
apparent cause, early in life; indeed, many of the convulsions of children 
occasioned by teething, etc., are in fact epilepsy, but as they arise from 
causes irritating the brain, and not from affection of the organ itself, 
they are possibly not repeated when the cause of irritation has subsided. 
If, however, the tendency exists strongly in the constitution, and has not 
developed itself before puberty, it is very apt to do so at that period, and 
more especially if favored by circumstances which lower the tone of the 
body generally, or of the nervous system in particular; but no period of 
life is exempt from becoming the period of epileptic development, even 
to old age. 
A person may die in an epileptic fit, even in the first, hut this is sel- 
dom the case; more generally the disorder does not immediately threaten 
life, but the individual goes on from year to year, suffering more or less, 
and still lives; even when the fits occur daily, or two or three times a 
day, this is the case. When death does occur early in the disease, it is 
more probably due to suffocation arising from the spasm of the muscles 
of the throat and neck, than to the brain affection. But if life is con- 
tinued to the confirmed epileptic, too often intellect becomes affected. 
Certain precautions are always requisite with those who suffer from 
epilepsy, and as a general rule it may be laid down that they should 
never, if possible, place themselves, or be placed, in situations in which 
a sudden seizure will expose them to danger. Thus, employments 
which necessitate riding on horseback, ascending heights, etc., ought 
never to be engaged in; neither such as those in which even momentary 
unconsciousness may involve the lives of others in danger. Many, it is 
true, have sufficient warning to enable them to prepare for the attack, 
and to withdraw from danger, but this is not always possible; the worst 
case of burning-or rather roasting-the author ever witnessed, was in 
consequence of a fall into the fire, in an epileptic paroxysm: when 
means will allow of it, the epileptic ought to have an attendant con 
stantly with him. When an individual is seized with a fit of epilepsy, 616 
EPILEPSY, ETC. 
but little can be done for its immediate relief; the chief thing is to pre- 
vent the patient inflicting injury upon himself, by striking against sur- 
rounding objects, and also to protect the tongue. Those who are much 
in attendance upon the epileptic, ought always to have on hand a piece 
of india-rubber, or a thick india-rubber ring-such as is used for children 
teething-to insert between the teeth. All fastening about the body, 
such as the neckcloth, etc., ought to be loosened, and air freely admitted ; 
the head should be raised, and cold wet cloths may be applied to it if 
there is much heat. It has been advised to cram the mouth full of salt 
as soon as the fit comes on. Dr. Watson, who had the plan tried in 
hospital, thought it seemed to curtail the duration of the convulsion. 
Symptoms.-The attack of epilepsy is for the most part sudden; the 
individual in the midst of some accustomed occupation, or whilst hold- 
ing active communion with persons around, suddenly utters a loud-a 
fearful-cry, and, if unsupported, falls to the ground; the eyes are star- 
ing or rolling, the head, or rather chin, is drawn towards one shoulder, 
the color becomes dark or livid, the veins of the face and temples turgid 
with blood, and the features are thrown into convulsive movement; 
there is froth at the mouth, whilst a kind of choking noise is often made 
in the throat; the limbs are also more or less convulsed, and the 
excretions are often expelled involuntarily. The tongue very often 
suffers from being bitten, and the teeth have even been fractured during 
the fit. Gradually, these convulsive movements diminish, and the per- 
•son awakes to consciousness, with a heavy stupid look, or falls into a 
deep lethargic sleep which continues for some hours; but even when 
this is roused from, there often remains slight temporary suspension of 
the activity of the mental functions. Such are the phenomena of a 
severe epileptic paroxysm; the disease, however, occurs in much milder 
forms, even in those who at other times suffer from it in greater 
intensity. 
The attach in many cases appears to bystanders to come on suddenly, 
and without warning; but most epileptic patients are sensible for some 
time previously of the approach of the paroxysm, and even for twenty- 
four hours are always aware that a fit is at least probable, although its 
direct accession may not be certainly known until just previous to its 
occurrence. It may, however, happen that these symptoms will pass off 
without a fit, either independent of any effort of the patient to ward off 
the attack, or in consequence of some of those measures found to be 
efficacious and adopted by epileptic patients for the purpose. 
The premonitory symptoms vary greatly: low spirits, or unusual 
irritability, sometimes an increased energy, dizziness, noises in the ears, 
floating specks before the eyes, and many other signs connected with EPILEPSY, ETC. 
617 
■disorder of the nervous system, are the precursors of the epileptic 
paroxysm; but the most generally marked, and remarked, precedent, is 
the epileptic aura, a sort of creeping sensation, which is described by 
the patient as arising at some particular part of the body, such as the 
extremity of a limb, and gradually ascending upwards to the trunk or 
head, till the individual loses his consciousness in the convulsions. 
Epileptic seizures are very frequent in the night-time, just as the 
person is falling asleep ; but they may occur at any period of the twenty- 
four hours. 
Treatment.-Many drugs have been said to alleviate this disease, 
and may be tried with advantage during the intervals, but our hopes 
will often be disappointed; several of these medicines act as nervine 
tonics, as the salts of silver, zinc, and iron. When a patient has 
received a warning of the fit approaching, it may be warded off by the 
timely administration of chloroform, or by the following antispasmodic 
draught: 
Take of Sulphuric ether Twenty drops. 
Compound tincture of lavender, Fifteen drops. 
Camphor water One and a half ounce.-Mix. 
When the disease is due to emotional influences, great benefit will be 
derived from opium or morphia given at bedtime. 
Take of Laudanum Twenty drops. 
Water .'One and a half ounce.-Mix. 
Let it be taken every night at bed-time. 
When the patient's blood is impoverished, and his countenance pale, 
some tonic must be given. 
Take or Sulphate of zinc Twenty grains. 
Pure water Six ounces.-Mix. 
Take 2 tablespoonfuls three times a day. Or if iron be preferred as a tonic: 
Take of Ammonio-citrate of iron One dram. 
Compound spirits of ammonia Two drams. 
Distilled water Eight ounces.-Mix. 
Let 2 tablespoonfuls be taken every six hours 
Of all remedies which have been employed in the treatment of 
epilepsy, the most valuable is the bromide of potassium, which may be 
given in 10 to 30 or 40 grain doses three times a day. In many instances 
it diminishes the tendency to the fits, and in some no fit occurs while 
the medicine is being used. It appears to act by diminishing the nerv- 
ous excitability. Bromide of ammonium acts in the same way in 
similar doses. The anti-epileptic remedy of the celebrated Brown- 
Sequard was composed of these two bromides in con junction with iodide of 
potassium, bicarbonate of potash and infusion of calumba. He insisted, 
however, on a course of twelve or eighteen months of the medicine. 618 
EPILEPSY, ETC.-EPISPASTICS. 
Preventive treatment.-From what has now been said, it must be 
evident that epilepsy is no disease for domestic management in a cura- 
tive point of view, but that it affords much room for preventative and 
other means. 
In families in which a tendency to epilepsy is known to exist, the 
greatest care should be taken to guard the nervous system from all causes 
either of irritation or exhaustion. In infancy, the period of teething and 
the condition of the bowels will require especial attention, and the tone 
of the system to be maintained as directed in article Children. The 
physical strength and health are to be cultivated in early life, even at 
some sacrifice of educational advancement; at puberty, the strictest eye 
must be kept upon the habits and tendencies, and whilst the constitution 
is developing and growth going on, all exhausting exercises prevented ; 
indeed, during life the suspicion of a tendency to so terrible an affliction 
as epilepsy should be a never-forgotten check upon excess in every way 
-a check upon the man who consumes his energies in the exertions of 
business or of study, as well as upon those who waste them in the pur- 
suits of vice or sensualism. In addition to passive preventive means, 
all those measures which are fully laid down throughout this work for 
the preservation of health should be well attended to, particularly the 
use of cold water to the head, spine and surface generally, if there is 
sufficient reaction to bear the application. 
Care must be taken in the curing or suppression of long accustomed, 
continued discharges, such as habitual diarrhoea, bleeding from piles, etc.; 
at the same time it must be borne in mind, that the discharge by weaken- 
ing the system, may be itself the cause of the disease; but this is a point 
the medical man must determine. The use of alcoholic stimulants and of 
tobacco, engagement in exciting work or recreation, should all be scru- 
pulously avoided by those having a tendency to this disease. Diet 
should be non-stimulant, the articles of food being well-cooked and taken 
at regular intervals, while sufficient time for thorough mastication and 
for digestion must be allowed. (See Brain; Stimulants, Alcoholic; 
Tobacco, Children, Health, Aura Epileptica.) 
EPILOBIUM ANGUSTIFOLIUM, ep-e-lo'-l)e-um an-gus-te-fo'-le-umr 
or willow herb, a perennial plant belonging to the Nat. order Onagrace^. 
sometimes known as rosebay. It grows on waste lands in most of the 
Northern States. The leaves and the roots are the parts used in medi- 
cine. They are tonic, demulcent, and astringent, and are used in 
chronic dysentery and diarrhoea, the whites, profuse menstruation, and 
in ulcerations of the throat and mouth. Dose of the infusion, 3 to 
fluid ounces three times a day. (See Infusion.) 
EPISPASTICS, ep-e-spas'-tiles [Gr. epi, and spao, to draw], are EPISPASTICS- EPSOM SALTS. 
619 
substances used medicinally for producing inflammation of the skin, 
which may be followed either by blistering or by the formation of 
matter. (See Blisters, etc.) 
EPIZOOTIC, ep-e-zo-ot'-ik [Gr. epi, upon, and zoon, an animal]. 
When a disease prevails among the inferior animals in the same manner 
as an epidemic does among men, it is said to be epizootic. 
EPSOM SALTS, epsum salts, are a compound of magnesia and sul- 
phuric acid-sulphate of magnesia-and derive their name from having 
been first obtained by the evaporation of the water of a spring, situated 
near Epsom, in England, which contains the salt in large quantity. 
They are now prepared largely by manufacturing chemists from magne- 
sian limestone, and also from sea-water. They are sold in the form of 
small, pure wdiite, needle-like crystals, and from their cheapness are 
extensively, indeed too much so, used among the poor as a general aperi- 
ent, and not unfrequently by all classes. Epsom salts are tolerably cer- 
tain in their action, do not gripe much, and produce free 'watery evacua- 
tion of the bowels; on these accounts the medicine is a most valuable 
one in many diseases, particularly in persons of a full habit, but, as gen- 
erally employed, it is not suitable for a common or frequently-repeated 
aperient. From its being in many instances taken in a state of too 
concentrated solution, it induces a discharge of the watery part of the 
blood into the bowels, and thus seriously debilitates; moreover, after 
the action of a dose of Epsom salts, the bowels in those liable to 
habitual constipation, are very apt to be left with a greater tendency 
to inaction than before; nevertheless, in persons of full strong habit, 
an occasional dose of the medicine is, without question, beneficial, but 
it should be taken in smaller quantity and much more largely 
diluted than is usually done. The question of dilution is a very 
important one in the administration of this salt, and if attended to, 
renders it safe and efficient, even for the comparatively delicate. 
From to 1 teaspoonful should be dissolved in at least 6 ounces or 
a pint of cold or tepid water, and taken on first rising in the morning, 
when the dose should be followed by the fluid breakfast; many persons 
liable to constipation find this method a simple and effectual remedy 
which may be used for weeks together. From 5 to 10 drops of dilute sul- 
phuric acid are often a good addition to the dose, and one which at the 
same time corrects in some degree the bitterness of the salt. If there is 
debility, either of the stomach, or generally, from a | to a grain, either 
of quinine or of some salt of iron may be added. The quinine appears 
to increase the aperient power. The most convenient method of taking 
Epsom salts in this form is to dissolve 1 ounce in 1 pint-16 ounces-of 
water, adding the acid or other ingredients in proper proportions. Of 620 
EPSOM SALTS-EPODIUM CIOUTAPIUM. 
the solution, from a j to 1 whole wine-glassful may be taken the first 
thing in the morning, diluted with the proper quantity of water before 
taking, or if preferred, by the latter being drank immediately after the 
medicine. 
The combination of Epsom salts with infusion of senna, constituting 
the common black draught, is one of the best forms of active occasional 
purgative in common use. It is well to bear in mind, that there is con- 
siderable resemblance between oxalic acid in its crystalline commercial 
form and Epsom salts, and that in consequence, fatal mistakes have 
occurred. The intensely acid taste of a single crystal of the former would 
at once clear up any doubt; perhaps it might be well always to use so 
simple a test. (See Oxalic Acid, Cathartics, Senna.) 
EQUISETUM HYEMALE, ek-we-se-turn Ki-e-mE-le, a perennial 
plant belonging to the Nat. order Equisetacece^ and commonly known as 
horsetail, scouring rush, and shave-grass. It grows in wet grounds in 
the Northern and Western States. It is diuretic and astringent; may be 
used freely in dropsy, suppression of urine, gravel and other affections 
of the kidneys. No nicety need be observed in the dose. 
ERECIITHITES HIERACIFOLIUS, e-rek-tM-tes hi-e-ras-e-fo'-le-vs, 
qt fire weed, a perennial plant belonging to the Nat. order Aster aceoe. 
It is found growing in recent clearings, especially those that have been 
burnt over. The leaves and the root are both employed medicinally. 
It is tonic, astringent, and alterative, and has been used in diseases of 
the lungs, stomach, and bowels; in cholera and dysentery, and in sum- 
mer complaints of children. Dose : of the infusion, 1 to 2 fluid ounces; 
fluid extract, £ to 1 teaspoonful, three or four times a day. (See Infu- 
sion. ) 
ERGOTINE, er'-got-in, the active principle of ergot. (See Secale 
CORNUTUM.) 
ERGOT OF RYE. (See Secale Cornutum.) 
ERIGERON, e-rij'-e-ron, or flea-bane. There are several varieties of 
this plant, including the Canada flea-bane, growing together and having 
similar properties, and therefore described as one. They belong to the 
Nat. order Compositce, and grow abundantly in various parts of the 
United States and Canada. The whole herb is used. It is diuretic, 
astringent, and tonic, and is used in affections of the bladder and kid- 
neys, and also in dropsy, gout, and diabetes. Dose: of the fluid extract, 
1 to 2 teaspoonfuls; of the infusion, 1 to 2 fluid ounces, three or four 
times a day. The volatile oil is powerfully astringent, and is used as a 
topical application in piles, and in doses of 4 or 5 drops in uterine 
hemorrhage, and bleeding from the lungs. 
ERODIUM CICUTARIUM, e-ro'-de-um sik-u-ta'-re-urn, or storks- Erigeron. (Canada Fleabane.) ER ODIUM CICUTARIUM-ERYSIPELAS. 
621 
bill, a small tree belonging to the Nat. order Balsaminacecs^ and found 
growing in the Northern States. A decoction of the dried bark, in 
doses of 2 fluid ounces, three times a day, has been found very useful in 
dropsy. (See Decoction.) 
ERUPTION, e-rup'-shun, a diseased appearance on the skin. (See 
Skin, Diseases of the.) 
ERYNGIUM AQUATICUM, earin'-je-um Urkwat'-e-kum^ or water 
eryngo, a perennial herb belonging to the Nat. order UmbelliferoB. It 
is found growing in wet lands, from Virginia to Texas. It is diuretic, 
stimulant, diaphoretic, expectorant, and, in large doses, emetic. It has 
been found useful in dropsy, scrofula, pulmonary affections, and gonor- 
rhoea, and externally is said to be efficacious as an antidote in snake bites. 
Dose: of the powder, from 20 to 40 grains; of the decoction, 1 to 4 
fluid ounces, three or four times a day. (See Decoction.) 
ERYSIPELAS, er-e-sip'-e-las [Gr., fromezw, I draw, and pdas, near 
or adjoining], sometimes called St. Anthony's fire, or the rose. 
Symptoms.-When occurring in its most distinct form, as affecting 
the head and face, the disease comes on in much the same way as other 
febrile disorders. There is a day or two during which the patient feels 
languid and out of sorts, and very frequently has some amount of sore 
throat; after which a shivering attack occurs, followed, perhaps, by 
vomiting, or slight diarrhoea; and then the blush of erysipelas becomes 
visible on some part of the face, usually in the neighborhood of the 
nose. The part so affected is red, hot, and painful; it is also swollen, 
and has a hard feeling to the touch. The tendency of the inflamma- 
tion is to spread, and very generally it does so till the whole face and 
the greater part of the head, including both ears, become involved, caus- 
ing the greatest degree of deformity: the lips become enormously 
swollen; the eyelids so filled with serous fluid as completely to close the 
eyes. Commencing on one side of the face, in some cases, instead 
of passing to the other, the blush extends upwards to the scalp, or it 
may creep along to the ear, and over the neck. ' Sometimes regular 
blisters appear over the part most inflamed. In the course of three or 
four days the redness and swelling subside, and then a drying separation 
-what is called desquamation-of the cuticle or scarf-skin occurs; 
while, in the loose cellular tissue of the eyelids under the skin, and at 
different parts of the scalp, matter is very likely to form, and, after a 
time, to require free vent by the use. of the lancet. 
The affection, thus briefly described, varies very greatly in its degrees 
of severity: it may be a comparatively trivial disorder; and, on the 
other hand, accompanied from the outset by marked constitutional dis- 
turbance, it is often a dangerous disease, terminating not unfrequently 622 
ERYSIPELAS. 
in death. In violent cases the fever is high, and there is much wander- 
ing of the mind, or delirium ; while, before the fatal event, there usually 
occur the symptoms of effusion in the brain, and the patient lies in an 
insensible state or coma. The affection of the throat may, in some 
instances, become a source of danger; and, in all cases of erysipelas, 
the condition of the throat should be observed. 
Medical opinion is divided as to the contagious property of this dis- 
ease : It is not improbable that, in circumstances the most favorable for 
its propagation, it is communicable. Very frequently it occurs in an 
epidemic form; while there are varieties of the disease, which need not, 
however, be particularly insisted upon here. The surgeon is apt to find 
erysipelas, in certain seasons, attacking wounds and sores; and more 
especially is this the case when patients are from necessity crowded 
together in badly-ventilated wards or apartments, and damp as well as 
low-lying localities. The accoucheur meets with erysipelas in circum- 
stances bearing a close resemblance to the experience of the surgeon, 
and looks upon the disease as one of the greatest dangers to the lying- 
in woman, for in an intimate manner is the affection of the skin and 
mucous membrane connected with the form of fever incidental to such 
patients, known as puerperal fever. 
The unfavorable termination of attacks of erysipelas are most to be 
apprehended in persons of debilitated frame of body, and very specially 
in those who have led dissolute and intemperate lives. 
Treatment.-Rest, saline laxatives, cooling drinks, and low diet, are 
the elements of treatment in mild and simple cases. A dessertspoonful 
of effervescent citrate of magnesia, or 5 grains of calomel, followed 
by a dose of castor-oil, will speedily relax the bowels. Ten grains of 
Dover's powder may be taken at night, and if there be much fever, a 
draught composed of a dessertspoonful of spirit of mindererus, and 
a teaspoonful of sweet spirit of nitre, in a wineglassful of water, may 
be given every three or four hours, until the fever subsides. Tincture 
of iron, in doses of from 10 to 20 drops, four or five times a day, is a 
very efficient remedy. It should be given in sweetened water and 
sucked through a straw, so that the acid will not injure the teeth. If 
symptoms of depression ensue, wine, beef-tea, quinine, and carbonate 
of ammonia should be given. Nitric acid, as follows, may be given 
where there is much weakness : 
Take of Dilute nitric acid One dram. 
Syrup of ginger Half an ounce. 
Pure water Five and a half ounces.-Mix. 
Give a tablespoonful every four hours. 
Local applications to the reddened surface either do a great deal of AA YSEPELAS-ESSENCE. 
623 
good or a great deal of harm. They should be used with great caution 
until medical aid arrives. Dry flour, or rye-meal may be dusted over 
the surface from a flour dredge, or light muslin cloths, steeped in thick 
linseed tea may be spread over the diseased parts. These can do no 
harm, and they are very soothing to the hot inflamed skin. 
The lead and opium wash, made by dissolving an ounce of sugar of 
lead and 30 grains of powdered opium in 2 quarts of water, frequently 
gives almost immediate relief. Nitrate of silver, 20 grains to 1 ounce 
of water, with 10 drops of dilute nitric acid added, painted over the 
surface twice a day, is also an efficient remedy. Tincture of iodine, 
mixed with an equal quantity of alcohol, or tincture of iron, applied with 
a camel's hair brush, generally succeed in arresting the spread of the 
disease. It should be painted, not only on the inflamed surface, but a 
little space beyond, on to the sound skin. In the violently inflammatory 
form of the disease, when the tissues beneath the skin become filled with 
matter, free incisions must be made to give it vent. Erysipelas is no 
disease to be experimented on with domestic remedies. Many cases, 
mild in the beginning, result fatally, and medical aid should be sum- 
moned early in the disease. (See Erythema.) 
ERYTHEMA, er-e-the-ma [Gr. eruthros, red], is a more superficial 
and evanescent inflammation of the skin than erysipelas. The most 
familiar instance of it is the inflammation produced by the chafing which 
occurs in stout children, or adults, between the folds of the skin, and which 
has a tendency to spread from its point of origin. The application of 
cloths dipped in tepid water, or in the sugar of lead and opium wash 
recommended in erysipelas, will allay the burning sensation. A few 
grains of gray powder should be given at bed-time, followed by castor- 
oil or senna in the morning, and then quinine administered in doses 
suited to the age of the patient. Rapidly spreading erythema, even in 
an infant, quickly yields to small doses of quinine. (See Erysipelas.) 
ERYTIIROXYLON COCA, e-re-throks'-e-lon ko'-ka, coca leaves, a 
powerful nervous excitant. It is said to give great vigor to the muscular 
system, sustaining the human frame under extreme physical exertion 
and fatigue. Dose of the fluid extract, from 2 to 4 teaspoonfuls. 
ESCIIAR, es'-kar [Lat. eschara], is the portion of killed animal tissue 
which separates from the living body after the application of a caustic 
or cauterant. 
ESCIIAROTICS, es-ka-rot'-iks [Gr. eschareo, I form an eschar], is a 
name given to those substances of a caustic nature which destroy the 
vitality of the part to which they are applied by burning. (See Caustic, 
Cautery. ) 
ESSENCE, es'-sense [Lat. essentia], properly that part of anything 624 
ESSENCE-ETHER, SULPHURIC. 
upon which its most remarkable qualities depend. The term is usually- 
applied to the mixture of a volatile oil with alcohol, as essence of pepper- 
mint. They are strictly speaking, tinctures. 
ESSENCE OF BEEF. (See Cookery for the Sick.) 
ESSENTIAL OILS, es-sen-shal [Lat. essentialis^ in Chemistry, a 
term applied to the odorous principles of plants. They are also called 
volatile oils to distinguish them from the fixed oils. They are extracted 
from different parts of plants, some plants yielding two different essen- 
tial oils. Thus the orange yields two distinct essential oils, one from 
the flower, the other from the peel of the fruit. The principal use of 
essential oils, is in perfumery; but certain of them are used for flavoring, 
and in medicine. 
ETHER, e'-ther [Lat. (Ether}, a limpid, colorless, volatile liquid, 
obtained by the distillation of alcohol, with different acids. (See 
Chloric Ether; Ether, Sulphuric, Etc.) 
ETHER, CFILORIC. (See Chloric Ether.) 
ETHER, COMPOUND SPIRITS OF. (See Hoffman's Anodyne.) 
ETHER, NITROUS OR NITRIC, OR SWEET SPIRIT OF 
NITRE, e'-ther, is prepared by the action of nitric acid upon alcohol. 
It is one of our most valuable diuretics, being also stimulant and dia- 
phoretic, and is much used domestically as a remedy in common colds, 
etc., and to increase the flow of urine. The dose is from % to If tea- 
spoonfuls, and given either in water or gruel. When badly made, or 
too long kept, sweet nitre is apt to contain much acid, which may cause 
pain at the stomach; the fact may be known by the ether effervescing 
with carbonate of soda. 
ETHER, SULPHURIC, which is more generally known as "aether," 
is procured by the action of sulphuric acid on alcohol, and by distil- 
lation. It is a perfectly colorless limpid fluid, of very light specific 
gravity, and very volatile : its odor, peculiar and penetrating, is usually 
called the aetherial odor. It is chiefly employed in medicine as a 
diffusible stimulant, that is, it acts very rapidly and energetically as 
a stimulant when taken into the stomach, and on that account is pecu- 
liarly valuable in some diseases, such as angina, spasms, etc., attended 
with sudden violent symptoms; it is also a powerful restorer in the 
depressed conditions of the system, such as faintness, etc. For the 
above purposes, sulphuric ether is given in doses of 20 drops in water. 
A more convenient form, however, is the spirit of sulphuric ether, which 
consists of one part of the ether mixed with two parts of alcohol; it 
acts in the same way as sulphuric ether-the dose about 40 or 50 drops 
in water. The transient effect of ether renders it in many cases less 
valuable than sal-volatile, or the spirits, such as brandy. Its antispas- Eupatorivm Perfoliatum. (Boneset.) ETHER, SULPHVRIC-EUPATORIUH, ETC. 
625 
modic power is increased by the addition of opium. When bottles con- 
taining this ether are opened at night, its highly inflammable character, 
even in liquid, but especially in vapor, ought to be borne in mind, and 
care taken that lighted candles are not too nearly approached. In giving 
ether, it is not to be forgotten that it floats on the top of the water, and 
thus, that if a bottle containing three or four doses of medicine, of which 
ether forms an ingredient, be not shaken before each dose is poured out, 
more than the proper proportion of ether will be poured out first. 
Ether, from its extreme volatility, evaporates rapidly in the ordinary 
atmosphere, and in doing so occasions a considerable amount of cold; 
of this, advantage is sometimes taken in medical practice when such an 
effect is required. The power of ether, when inhaled, to cause anaes- 
thesia, or insensibility to pain, is the characteristic which has excited 
most attention of late years. Inhalation of ether is a proceeding which 
should never be tampered with by unprofessional persons. (See Chloral, 
Chloroform. ) 
EUCALYPTUS GLOBULUS, yvrka-lip'-tus glob'-u-lus, a native 
Eastern tree now acclimatized in Southern Europe, belonging to the 
Nat. order Myrtacea. The leaves are the part used in medicine, and 
they are said to have extraordinary curative powers in malarial fevers, 
croup, diphtheria, catarrh, and bronchitis, and also to be valuable as an 
antiseptic wash in offensive discharges from the vagina and womb, and 
in ulcers. Dose: of the fluid extract, 15 to 60 drops, three or four 
times a day. 
EUGENIA PIMENTA. (See Allspice.) 
EUONYMUS ATROPURPUBEUS, yu-on'-e-mus at-ro-pur-pu'- 
re-us, or wahoo, a small bush belonging to the Nat. order Celastraceaz. 
It is found growing in woods and thickets in many parts of the United 
States. The bark of the root is the part used in medicine. It is tonic, 
laxative, alterative, diuretic, and expectorant, and has been successfully 
used in ague, dyspepsia, torpidity of the liver, constipation, dropsy, and 
pulmonary affections. Dose: of the fluid extract, 1 to 2 teaspoonfuls ; 
of the infusion, 2 to 4 fluid ounces, three or four times a day. (See 
Infusion. ) , 
EUPATORIUM PERFOLIATUM, yupa-to'-re-umper-fo-le-a'-turn, 
or boneset, a perennial plant belonging to the Nat. order Asteraceaz. It 
abounds in most parts of the United States, and is known by the com- 
mon names, thoroughwort, crosswort, Indian sage, and feverwort. The 
tops and the leaves are the parts used medicinally. They are tonic, 
diaphoretic, and in large doses, emetic and aperient. It contains an 
active principle called Eupatorin, which is a powerful diuretic in doses 
of from 1 to 2 grains. Boneset is a common and useful remedy in colds, 626 
EUPATORIUM PERFOLIATUM-EXACERBATION. 
catarrh, remittent and intermittent fevers, dyspepsia, and general debility. 
Dose: of the fluid extract, 1 to 2 teaspoonfuls; solid extract, 5 to 20 
grains; of the infusion, 2 to 4 fluid ounces, every three or four hours. 
(See Infusion.) 
EUPATORIUM PURPUREUM, yupa-to'-re-um pur-pu-re'-um, or 
queen of the meadow, a perennial plant belonging to the Nat. order 
Asteracea. It grows in low places throughout the Northern, Middle, 
and Western States and Canada. It is known by the common names of 
gravel root and trumpet weed. The root is the part used, and con- 
tains an active principle called eupurpurin. Queen of the meadow is 
bitter, astringent, stimulant and powerfully diuretic. It is useful in all 
diseases of the urinyy organs, dropsy, rheumatism, gout, and female 
weaknesses and obstructions. It is thought by some to be a solvent of 
the stone, and esteemed an unfailing remedy in gravelly complaints. 
It has also been employed in incontinence of urine, especially in 
children, with good effects. Dose of the fluid extract, 1 to 3 teaspoon- 
fuls; eupurpurin, 3 to 4 grains; the decoction, 2 to 3 fluid ounces, to be 
taken three or four times a day. (See Decoction.) 
EUPHORBIA, yu-for'-be-q, the typical genus of the Nat. order 
Euphorbiaceoe^ consisting of about three hundred species, many of which 
have valuable properties. The acrid resin, commonly known as gum 
euphorbium, is the produce of certain undetermined species. It is a 
dangerous emetic, cathartic and rubefacient, and produces severe inflam- 
mation of the nostrils if those who powder it do not guard themselves 
from the dust. It is produced from the wounded stems and collected in 
leather bags. 
EUPHORBIA IPECACUANHA, yu-for'-be-q ip-e-kak-u-an'-q^ or 
ipecacuanha spurge, a perennial plant, Nat. order Eupkorbiacece. It grows 
in all parts of the United States. The dried root in doses of 10 to 20 
grains is emetic and cathartic, and is used in the same cases as ipecac. 
EUPHRASIA OFFICINALIS, yu-froi-se-q of-fis-in-a'-lis, or eye- 
bright, a plant belonging to the Nat. order Scrophulariaceoz. It is a 
native of both Europe and America. The leaves are tonic and astrin- 
gent, and are used in infusion to cure coughs, hoarseness, earache, and 
headache, arising from catarrh. (See Infusion.) Four fluid ounces 
every morning on an empty stomach, continued for some time, is said to 
have been effectual in curing many cases of epilepsy. 
EUSTACHIAN TUBE. (See Ear.) 
EUSTACHIAN VALVE, yu-sta'-ke-qn [after Eustachius, the cele- 
brated anatomist], is a membranous semilunar valve, separating the 
right auricle of the heart from the inferior vena cava. 
EXACERBATION, egz-as-er-ba'-shun [Gr. exacerbo, I become violent], EX A CEE BA TION-EXCITANTS. 
627 
denotes an increase of intensity in the symptoms of a disease recurring 
at intervals. 
EXANTHEMA, ex-an-tke-ma [Gr. exantkeo, I effloresce], is a gen- 
eral term denoting an eruption of the skin, or rash, and comprehends 
measles, scarlet fever, nettle-rash, etc. 
EXCISION, eks-sizk'-un [Lat. excisio', ex, from, and caedo, to cut]. 
The cutting out of parts, as tumors, etc., which are not sufficiently large 
or prominent to be amputated. We do not say the penis was excised, 
but a tumor was excised. 
EXCITANTS, ek-si'-tants [Lat. excito, to stimulate.] To excite, to 
stimulate, is either to originate action where no action previously 
existed, or to give increased energy to powers already in active opera- 
tion. Excitants or stimulants, therefore, are agents which are capable 
of producing such effects, and excitement is the effect produced. 
Excitants may be artificially divided into- 
I. Ordinary excitants.--The regular unceasing action of which is 
necessary for the preservation of sound health, both of mind and body. 
II. Extraordinary or occasional excitants, which produce a certain 
amount of temporary exalted action of mind or of body, or of both. 
III. Superflnous excitants, which are generally those comprised in the 
second division abused. 
Under the head of ordinary excitants, we have the following: 
A.-Physical Excitants.-I. Heat; 2. light; 3. electricity, mag- 
netism; 4. atmospheric air; 5. aliment; 6. muscular action, exercise. 
B.-Mental Excitants.-1. Occupation of the mind with some defi- 
nite object. 
Under the head, of extraordinary excitants we have : 
A.-Physical Excitants.-1. Alcoholic excitants; 2. excitant ingesta 
generally: tea, coffee, spices, drugs, etc.; 3. atmospheric changes. 
B.- Mixed Excitants.-1. Sexual stimuli; 2. extra exercises: dan- 
cing and athletic sports; 3. traveling and exciting or novel scenes. 
C.-Mental Excitants.-1. Hope, joy, etc.; 2. love, anger, etc.; 
3. social intercourse; 4. argument, politics, etc.; 5. music; 6. eloquence- 
written or spoken; exciting literature; 7. religion. 
For the more particular consideration of the above cited agencies, 
both as excitants and otherwise, the reader is referred to the various 
articles in which they are treated of in this work. From these it will be 
seen that certain ordinary physical stimuli, or excitants, are necessary 
for the sustenance of human health and life, and that equally important 
for the preservation of vigor, not only of mind, but of body, is the 
stimulus resulting from the ordinary but regular action and reaction of 
the mind of man, originating either in daily intercourse with his fellows, 628 
EXCITANTS-EXER CISE 
or in pursuits which continuously engage the mental powers. And fur- 
ther, that the mental and bodily functions are at intervals acted upon by 
occasional or extraordinary stimuli, which temporarily occasion their 
exalted and increased action; not only without actual injury, but with 
positive benefit. And lastly, that these extraordinary stimuli are not 
liable to lose their power of beneficial stimulation, unless exerted in a 
disorderly and unrestrained manner. (See Heat, Light, Electricity, 
Air, Aliment, Food, Exercise, Occupation, Mental Exercise, Stimu- 
lants; Stimulants, Alcoholic; Tea, Coffee, Tobacco, Sexual Exces- 
ses, Travelling, Health Resorts, Recreation, Pleasure, Passions, 
etc.) 
EXCORIATED NIPPLES. (See Nipples.) 
EXCORIATION, eks-ko-re-d-shun [Lat. excorio, I take off the skin], 
denotes an abrasion of the skin. 
EXCREMENT, eks'-kre-ment [Lat. excerno, I separate from], is 
applied to any useless matter ejected from the body, but generally to 
that which is discharged from the bowels. (See Stools.) 
EXCRETORY DUCTS, eks-krd-to-re or eks-kre-to-re, is a term 
applied to the ducts or vessels which convey the secreted fluids from 
the glands. 
EXERCISE, eks-er-size [Lat. exercitiurn\. The constitution of 
external nature shows that man was destined for an active existence, as, 
without labor, scarcely any of the gifts of Providence are to be made 
available. In perfect harmony with this character of the material 
world, he has been furnished with a muscular and mental system, con- 
structed on the principle of being fitted for exertion, and requiring exer- 
tion for a healthy existence. Formed as he is, it is not possible for him 
to abstain from exertion without very hurtful consequences. 
With regard to merely bodily exercise, it is to be observed, in the first 
place, that we have no fewer than four hundred muscles, each designed 
to serve some particular end in locomotion, or in operating upon exter- 
nal objects. A sound state of body depends very much upon every one 
of these muscles being brought into action, in proper circumstances, to a 
suitable extent. There is even a law operating within a certain range, 
by which each muscle will gain in strength and soundness by being 
brought into a proper degree of activity. 
The process of renovation may be said to be always going on in the 
body, but it does not go on with permanent steadiness unless the muscu- 
lar system be exercised. Whenever one of the organs is put into exer- 
tion, this process becomes active, and the two operations of which it con- 
sists maintain a due proportion to each other. A greater flow of blood 
and of nervous energy is sent to the organ, and this continues as long as EXERCISE. 
629 
it is kept in activity. When one state of action follows close upon 
another, the renovating part of the process rather exceeds the waste, 
and an accretion of new substance, as well as an addition of fresh power, 
takes place. On the contrary, when an organ is little exercised, the 
process of renovation goes on languidly, and to a less extent than that 
of waste, and the parts consequently become flabby, shrunken, and weak. 
Even the bones are subject to the same laws. 
That motion is the tenure and condition of the safety and preservation 
of the whole of animate and inanimate nature, every portion of organ- 
ized matter affords incontestible proofs. The solar system affords us a 
useful lesson of the advantages of activity ; the earth and all the planets 
keep their constant motions-the air is tossed by the winds-the waters 
are ebbing and flowing; and all this change and motion is, no doubt, 
for the safety and preservation of the system. By a similar law of 
physics, the animal machine, to be preserved in a healthy tone, must be 
employed and kept in a state of activity. 
And this primary and indispensable condition extends not only to the 
machine itself, but also to all its various component parts; no axiom in 
physiology being more clearly and better established, than that the 
exercise of the functions of an organ is necessary to the health and well- 
being of that organ, and that, in proportion to the local injury sustained 
by the decay of the particular organ, the constitution suffers more or 
less. Thus if a limb is not used, the muscles shrink, and the bone be- 
comes soft, and, by an analogous law of nature, if the functions of the 
brain are suffered to remain in a state of inactivity, sottishness is the con- 
sequence ; and in either case, the organ ceasing to perform its functions, 
an unpropitious influence is necessarily produced on the general health 
and vitality of the frame. 
But though motion is the tenure and condition of life, exercise should 
not be used immediately after eating; inattention to this rule has proved 
fatal to many persons. 
Remember, also, that the exercise of any particular limb does little 
besides improving the strength of that limb; and that, in order to in- 
crease our general strength, the whole frame must be brought into exer- 
cise. The blacksmith, by wielding his hammer, increases the muscular 
volume and strength of his right arm only, or, if the rest of his body 
derives any advantage from his exercise, it is through the general move- 
ment which the wielding of a hammer occasions. One whose profession 
consists in dancing or leaping, for the same reason, chiefly improves the 
muscles of his legs. The right hands of most persons, by being more 
frequently employed than the left, become sensibly larger as well as 
stronger. 630 
EXERCISE. 
A striking illustration of the principle was remarked, years ago, in 
a personal peculiarity in the inhabitants of Paris. 
Owing to the uneven nature of the pavement of the city at that time, 
the people were obliged to walk in a tripping manner on the front of 
their feet; a movement which calls the muscles of the calves of the legs 
into strong exertion. It was accordingly remarked, that a larger propor- 
tion of the people of Paris than of other cities, were distinguished by an 
uncommon bulk in this part of their persons. 
In order, then, to maintain in a sound state, the energies which 
nature has given us, and, still more particularly, to increase their amount, 
we must exercise them. If we desire to have a strong limb, we must 
exercise that limb; if we desire that the whole of our frame should be 
sound and strong, we must exercise the whole of our frame. It is mainly 
by these means that health and strength are to be preserved and im- 
proved. There are rules, however, for the application of these laws of 
our being. 
1. In order that exercise may truly he advantageous, the parts must 
be in a state of sufficient health to endure the exertion. A system 
weakened by disease or long inaction must be exercised very sparingly, 
and brought on to greater efforts very gradually; otherwise the usual 
effects of over-exercise will follow. In no case must exercise be carried 
beyond what the parts are capable of bearing with ease; otherwise a loss 
of energy, instead of a gain, will be the consequence. 
2. Exercise, to be efficacious even in a healthy subject, must be ex- 
cited, sustained, and directed by that nervous stimulus which gives the 
muscles the principal part of their strength, and contributes so much to 
the nutrition of parts in a state of activity. In order to obtain the 
advantage of this powerful agent, we must be interested in what we are 
doing. A sport that calls up the mental energy, a walk towards a place 
which we are anxious to reach, or even an exercise which we engage in 
through a desire of invigorating our health and strength, will prove ex- 
ceedingly beneficial, when more of actual motion, performed languidly, 
may be nearly ineffectual. 
3. The waste occasioned by exercise must be duly replaced by food ; 
as, if there be any deficiency in that important requisite, the blood will 
soon cease to give that invigoration to the parts upon which increased 
health and strength depend. 
Exercise is usually considered as of two hinds-active and passive. 
The active consists in walking, running, leaping, riding, fencing, rowing, 
skating, swimming, dancing, and various exercises, such as those with 
the poles, ropes, etc., prescribed in gymnastic institutions. The passive 
consists in carriage riding, sailing, friction, swinging, etc. EXEEC ISE. 
631 
Walking is perhaps the readiest mode of taking exercise, and the 
one most extensively resorted to. If it brought the upper part of the 
body as thoroughly into exertion as the lower, it would be perfect, for it 
is gentle and safe with nearly all, except the much debilitated. To ren- 
der it the more effectual in the upper part of the body, it were well to 
walk at all times, when convenient, singly, and allow the arms and trunk 
free play. It is best to walk with a companion, or for some definite 
object, as the flow of nervous energy will be by these means promoted, 
and the exercise be rendered, as has already been explained, the more 
serviceable. 
Very long or rapid walks should not be attempted by individuals of 
sedentary habits, nor by weakly persons. Their frames are totally un- 
prepared for such violent exertion. Every summer, many youths from 
ignorance do themselves much injury by undertaking pedestrian excur- 
sions much beyond their strength. Serious consequences-consumption 
not unfrequently-follow such ill-advised efforts. 
With respect to very rapid walking, Dr. Johnson records some effects 
from it, of a remarkable nature, as occurring in his own case. "In my 
own person," says he, "I had some years ago, a very severe and alarm- 
ing instance of the bad effects of too great muscular action, occasioned 
by a habit of walking very fast. After a day and night of unusual 
fatigue and rapid pedestrian exercise/ together with considerable mental 
anxiety, I was suddenly seized with an intermission of the pulse at irregu- 
lar periods. (See Pulse.) During each intermission, I felt the heart 
give a kind of struggle as it were, and strike with great violence against 
the ribs, accompanied by a peculiar and most distressing sensation in 
the cardiac region, which I cannot describe." 
These symptoms became aggravated, and lasted eight weeks, "dur- 
ing which time," he continues, "I used horse-exercise, and kept, 
when at home, in a horizontal position. At length the heart lost its 
morbid irritability; and at the end of fourteen or fifteen weeks, I could 
walk as well as ever." 
Walking is the natural exercise of man, and for the strong and 
healthy it is the best. Even in the case of the debilitated and of the 
aged, it should not be neglected : no other mode of exertion diffuses the 
blood and accelerates its circulation so thoroughly throughout the body. 
The principal caution required for such persons is not to continue their 
exercise till exhaustion occurs. Children are not unfrequently injured 
and weakened in constitution by their daily exercise being a walk, too 
often carried to fatigue, especially in summer. (See Child.) When 
attainable, a play-ground in which rest and exercise can be taken alter- 
nately, and at will, is much preferable to the former. Any unusual 632 
EXERCISE. 
peculiarity in walking, especially in children or young people, should 
not be permitted to pass unnoticed; it may be the first indication of 
spine or hip disease. 
Running is an exercise which is intermediate between walking and 
leaping; it consists, in fact of a series of leaps performed in progression, 
from one foot to another, and the degree of its rapidity bears a con- 
stant proportion to the length of the individual and successive leaps. 
Although this and other gymnastic exercises, such as wrestling, throwing 
heavy weights, etc., may, when judiciously had recourse to, invigorate 
the body, yet, from apprehension of the evils and accidents which may be 
so occasioned, young persons ought not to be permitted to engage 
extensively in such exercises, except under the care of some one well 
acquainted with gymnastics. 
Fencing is, of all active exercises, that which is the most commend- 
able, inasmuch as it throws open the chest, and at the same time calls 
into action the muscles both of the upper and lower extremities. Add 
to this, that it improves very much the carriage of the body; for which 
reason it may be reckoned a branch of polite education. The salutary 
effects of the other exercises which are taught in gymnastic institu- 
tions, such as exercise with the ropes, pulleys, etc., increasing the 
strength of the body, cannot be denied. 
Riding is generally classed among the passive exercises, but in 
reality it is one which involves much action of the whole frame, and as 
such is very useful for health. Pursued solitarily, it has the drawback 
of being somewhat dull; but, when two or three ride in a company, a 
sufficient flow of the nervous energy may be obtained. 
Rowing is good exercise for the development of the muscles of the 
arms and chest, but not for the lower extremities. 
Swimming is useful and beneficial, but not devoid of danger. Those 
with weak lungs and diseased heart, should not engage in it. 
Quoit-playing, curling, skating, croquet, base-ball, cricket, and tennis 
are all exercises in which nearly all of the four hundred muscles are 
brought into active exertion, and therefore, if not unduly indulged in, are 
highly beneficial. 
With regard to extra exercises, such as dancing and athletic sports, 
which are only engaged in at intervals, it is certain that whatever 
their beneficial effect upon the functions and health may be, depend 
quite as much upon the excitement of the mind, as upon that of the 
body, and every one's experience must tell him how much his favor- 
ite exercise owes its renovating influence to the mental stimulation which 
accompanies it. It must be evident to every person, that dancing, when 
associated with heated rooms and late hours, is decidedly injurious. EXER OISE-EXH A VST ION. 
633 
The amount of bodily exercise which should be taken, must vary 
according to the habits, strength and general health of the individual. 
It was an aphorism of Boerhaave " that every person should take at 
least two hours exercise in the dayf and this may be regarded as a good 
general rule. (See Aik, Blood, Circulation of the Blood, Excitants, 
Food, Gymnastics, Mental Exercise, Movement Cure, Recreation.) 
EXERCISE, MENTAL. (See Mental Exercise.) 
EXFOLIATION, eks-fode-a -shun [Lat. exfolio, I cast the leaf], is 
the separation of a dead piece of bone from the living. 
EXHALATION, eks-ha-la'-shun [from Lat. exhalo, to exhale or fly 
off ], applied to the body, means an excretion in a state of vapor, such as 
that from the lungs. 
EXHAUSTION, egz-haust'-yun [from Lat. ex, from, and haurio, to 
draw], is the diminished or almost extinguished power, either of the body 
generally, or of one or more of its organs, to continue its natural active 
operations, until it has been recruited by a period of repose. Exhaus- 
tion may arise from two principal causes-failure of the nervous power, 
and deficiency of organized materials fitted to support the requirements 
of the living body. 
If every thought, every exertion of the will upon the body, occa- 
sions the consumption of nervous matter, exhaustion of nervous 
power must in all probability be due to using up of nervous substance. 
Sooner or later, according to circumstances, every exertion must come 
to an end, and repose must be taken, that the exhausted brain and 
nerves may be recruited, and if man acts wisely, he will, if possible, 
stop exertion, either of mind or body, at the first point of exhaustion. 
It is true that powerful exercise of the will can and does compel exertion 
beyond the point at which nature says stop; but the effort is not made 
with impunity, and the after exhaustion is proportionally increased. No 
permanent injury probably arises from those occasional exhaustions, 
either mental or physical, which all have at times to undergo; but no 
man can habitually go on exhausting his nervous power, whether in the 
direct service of the mind, in the labors of the body, or in the less excu- 
sable requirements of vicious excess, without suffering eventually. The 
«arly paralysis and softened brain of the mental, the premature old age 
•of the physical laborer, the wretched decrepitude of the debauchee, are 
all the results of continued nervous exhaustion. It is not, however, 
simply the brain and nervous system which suffer, but the other organs 
of the body, particularly those of nutrition, suffer also, if the supply of 
nervous power, which ought to sustain their healthy actions is with- 
drawn to support the exhausting efforts either of mind or muscle. 
Those, therefore, who can, will do wisely to avoid the cause of these 634 
EXH A USTION-EXPECTORATION. 
evils. (See Brain, Mental Exercise, Nervous System, Excitants, 
Exercise, Health, Etc.) 
EXOSTOSIS, eks-os-to'-sis [Gr. out of, and osteon, a bone], is 
a term applied to a morbid enlargement or hard tumor of a bone. (See 
Bone. ) 
EXPECTATION OF LIFE. (See Mortality.) 
EXPECTORANTS, eks-peki-to-rants [Lat. ex, out of, and pectus, the 
chest], is a term applied to such substances as promote the expulsion of 
mucus, or other matters, from the air-passages of the throat and chest. 
The agents that are used with this view are very different, and act in 
different ways. Vapors are the only agents that can act directly upon 
the organs affected; those that are taken into the stomach being only 
capable of acting in an indirect manner. The inhaling of the vapor of 
warm water, simple or mixed with certain medicinal substances, as vine- 
gar, is very useful in this way. Most medicines which, taken in large 
doses, act as emetics, are used as expectorants; as squill, ipecacuanha, 
gum ammoniacum, etc. The expectorant most commonly used in ordi- 
nary cases is the syrup of squill. All substances, also, which excite 
irritation at the upper part of the windpipe, and produce coughing, act 
as expectorants. The most useful expectorants are acids which astringe 
and stimulate; ammonia, which stimulates; ammoniac, which stimulates; 
antimonials, which relax; ipecacuanha, which relaxes; squill, which 
stimulates; stramonium, or thorn apple; tolu, which stimulates; vapor, 
either simple or medicated. 
In whatever way these medicinal substances exert their action upon 
the body, the most important practical point is the division into relaxing 
and stimulant. In the first stages of affection of the bronchi with cough, 
when there is fever and probably inflammation present, the relaxing 
expectorants only should be used, either antimony or ipecacuanha; the 
former may be given with solution of acetate of ammonia, the latter with 
carbonate of potash; when there is much debility, ammonia combined 
with camphor is generally employed, and probably squill added. In 
chronic cough, with difficult expectoration, the same combination may 
be used, and when there is a relaxed state of the system, with copious- 
expectoration and tendency to perspiration, the acids, either vegetable 
or mineral, alone or combined with squill, are most serviceable. (See 
Expectoration. ) 
EXPECTORATION, ekspek-to-ra -shun, is the term applied either 
to the act of coughing up matters from the lungs, or to the matters so 
coughed up. These vary greatly in consistence and appearance, and 
consequently are valuable guides in the investigation of disease affecting 
the chest; indeed, until the physical examination of the chest by the EXPECTORATION-EXTRA CTS. 
635 
ear was introduced into practice, the expectorated matters were the 
most distinctive evidences attainable. Expectoration may be thin and 
frothy, as it is when the lining membrane of the air-tubes is suffering 
from irritation or inflammation, or thick and almost solid, as it becomes 
in the last stages of a cold ; it may be ropy, as it often is in old people, 
or viscid in infiammation of substances of the lungs, when it generally 
becomes of a dull reddish-brown or rust color; it may consist more or 
less of purulent matter; or be tuberculous and semi-solid, as in pulmon- 
ary consumption; it may be mixed more or less with blood, or pure 
blood may be expectorated ; of it may be what is called the prune juice 
expectoration from its color, as happens in mortification of the lungs. 
Generally, expectoration is inodorous, but sometimes it is abominably 
foetid, the odor being mostly but not invariably indicative of mortifica- 
tion of the lung itself: other matters, such as bile, etc., are occasionally 
coughed up. (See Expectorants.) 
EXPIRATION, eks-pe-ra'-shun [Lat. expiro, to breath], is the act of 
expelling air from the chest after it has been inspired. (See Respira- 
tion.) 
EXTRACTS, eks'-trakts [Lat. extraho, to draw out], are medicinal 
preparations made by separating the active portions of various drugs 
from the inert ones, this being effected by dissolving out the former, 
either by water, alcohol or ether, and evaporating the superfluous fluid, 
until a tolerably firm consistent mass of extract is left. Formerly, heat 
was used in the evaporation; but as this destroys in some measure the 
activity of the preparation, the best extracts are now all prepared with- 
out any heat whatever; and these should always be purchased in 
preference. 
Solid or pilular extracts should represent all the active medicinal 
principles of the plant from whence they are derived. They may be of 
the pilular consistence, or by further drying, brought to a powdered state, 
and in that form present all the active medicinal or positive medicinal 
constituents of the plant in a very concentrated form. 
Fluid extracts vary from the preceding class in degree of concentra- 
tion. The general principles observed in their preparation are the same, 
but the process by which the medicinal properties of the plant are ex- 
hibited in the fluid form, admits of the preparation being made of any 
required standard of strength, definite and uniform as regards the amount 
of active medicinal principles represented by any given quantity, held 
in solution so as to form clear preparations. The physician is enabled 
to regulate the dose with greater ease and certainty, and for convenience 
in calculating doses, they are generally made of the strength of 1 
pound of the drug to 1 pint of the fluid-are capable of ready 636 
EXTRA GTS-EYE. 
combination, or of converting into tinctures, syrups and infusions for 
purposes of further combination. 
EXTRAVASATION, eks-trav-a-sa'-shun [from extra, without, and 
vas, a vessel], is a term applied to fluids which are out of their proper 
vessels or receptacles. Thus, an extravasation of blood takes place 
when an artery or vein is injured, and the blood escapes into the cellular 
membrane; and an extravasation of urine, when, in consequence of a 
wound or ulceration, that fluid makes its way into the cellular substance, 
or among the abdominal viscera. Extravasation is distinguished from 
exudation, in that, in the latter case, the walls of the vessels remain 
entire, and the fluids escape by secretion. 
EYE, i [Aug.-Sax.], the organ of vision, is one of the most wonder- 
ful and delicate portions of the human body. It is placed within a bony 
cavity, termed the orbit, pyramidal in form, with the base anteriorly, 
and directed a little outwards, and the apex backwards and inwards. 
The orbit contains the globe of the eye, with numerous muscles, nerves, 
vessels, fat, etc. The external appendages of the eye are the eyebrows, 
eyelids, and lachrymal apparatus. The eyebrows, or supercilia, are 
arches of hair covering the supra-orbital ridge of the frontal bone on 
each side, and extending from near the root of the nose to a little beyond 
the outer canthus of the eye. The eyelids, or palpebraz, are two thin 
curtains which cover the eye, the one being inferior, and the other 
superior. Where they join outwardly is called the external and inwardly 
toward the nose, the internal canthus. Along the margin of each eyelid 
is a row of stiff hairs, termed cilia, or eyelashes, and which serve to 
keep external bodies out of the eyes and moderate the influx of light. 
The lachrymal gland is situated in a small depression of the frontal bone 
near the external canthus, and from it seven or eight canals issue, called 
the lachrymal ducts, opening on the internal surface of the upper eyelid. 
The lachrymal sac is a membranous receptacle, situated in the internal 
canthus of the eye, which communicates with the nose by means of the 
nasal duct. The globe, or ball of the eye is composed of membranes or 
coats, humors, vessels and nerves. The membrana conjunctiva, or con- 
junctiva membrane, is a delicate mucous membrane, lining the internal 
parts of the eyelids, and covering the whole of the anterior part of the 
globe of the eye. The outermost coat of the eye is the sclerotic [Gr. 
skleros, hard], so called from its hardness. It is a strong, dense, white, 
fibrous structure, covering about four-fifths of the ball, and leaving a cir- 
cular deficiency in front, which is occupied by the cornea. The latter, 
so named from its horny appearance, is the transparent covering in front 
of the eye, its edges being slightly overlapped by the sclerotic coat. 
The choroid membrane is of a black color, and covers the internal surface EYE-EYE, DISEASES OF THE. 
637 
of the sclerotic coat with which it is loosely connected. The retina, or 
inner coat of the eye, consists of three layers of membranes. The iris 
[Lat., a rainbow], so called from its variety of color in different indi- 
viduals, is a thin, flat, circular, membranous curtain, hanging vertically 
in the aqueous humor and having a central orifice, termed the pupil, 
for the transmission of light. It divides the space between the cornea 
and the lens into two chambers, communicating freely with each other 
through the pupil. The iris is muscular in structure, and has great 
power of contracting or exposing the pupil, so as to admit more or less 
light into the interior of the eyeball. In the anterior and posterior 
chambers is the aqueous humor of the eye. The crystalline lens is a 
transparent body, situated behind and opposite to the pupil. In form it 
is double convex, the posterior surface being more convex than the ante- 
rior; and it is invested by a transparent membrane, called the capsule, 
which contains also a small quantity of fluid, called the liquor Morgagni. 
The eyeball is moved about in its orbit by six muscles, four of which are 
straight {recti'), and two oblique-the superior and inferior. The optic 
nerves, or second pair, after uniting to form the optic commissure, in 
which some of the fibres of each nerve cross to the opposite side, sepa- 
rate and enter the optic foramen at the apex of the orbit. They pass 
through the sclerotic coat on the inner side of and below the axis of the 
eye, then through the choroid, and, spreading themselves out, are lost or 
terminate in the retina. (See Blindness, Color Blindness ; Eye, Dis- 
eases of the; Vision.) 
EYE, BLACK. (See Bruises.) 
EYEBRIGIIT. (See Euphrasia Officinalis.) 
EYE, DISEASES OF THE. We shall first give an account of 
cataract. It is derived from the Greek verb katarasso, I disturb 
or confound, and is usually defined to be a weakness or interrup- 
tion of sight produced by opacity of the crystalline lens or its capsule. 
Sometimes it is applied to every perceptible obstacle to vision situated 
in the posterior chamber, between the vitreous humor and the uvea. 
When the disease is situated in the lens or its capsule, it is called a true 
cataract; but when it consists of opaque matter deposited in front of 
the lens, it is termed spurious. The latter arises from inflammation, 
and is to be treated by the usual means employed for allaying inflamma- 
tion ; but no operation can be of use in such a case. Of true cataract 
three kinds are distinguished: lenticular, affecting the-lens alone; cap- 
sular, affecting the capsule; and capsulo-lenticular, affecting both lens 
and capsule. Lenticular cataracts are of two kinds-hard and soft; the 
former being the more common, especially among elderly persons, and 
is usually of an amber color, or brownish tint, and generally deep in 638 
EYE, DISEASES OF THE. 
proportion to its firmness. Soft cataract prevails in childhood and 
middle life, and occurs more frequently single than the other. A cata- 
ract may be occasioned by active inflammation or external violence, or 
it may arise from internal or unknown causes. Frequently it is heredi- 
tary. The habitual examination of minute objects in a depending 
position of the head, by which an undue proportion of blood is thrown 
upon the organ, is said frequently to bring on cataract. It comes on 
without pain, and the symptom flrst perceived is a dim haziness of sight, 
as if a mist or thin film were interposed between the object and the eye. 
The obscurity is greatest in direct vision, the opacity being almost 
always first noticed in the centre of the pupil. Hence the sight is better 
in a weak than in a strong light, because in the former case the pupil is 
enlarged and admits the passage of the rays through the less opaque 
edge of the lens. Hence, too, the remarkable effect produced by the 
application of belladonna to the eye, which has the power of dilating 
the pupil, and producing a temporary improvement in the sight-a 
means sometimes had recourse to by quacks, who profess to be able to 
cure this disease. There is no medicinal remedy that is known to have 
any effect upon this disease, nor is it at all likely, from the structure of 
the parts, that any such remedy exists. All palliative measures, there- 
fore, are confined to attention to the general health of the patient, and 
the removal of any inflammatory symptoms that may exist along with 
it. The only mode of cure is actual removal by an operation; but so 
long as one eye remains unaffected, the operation may be delayed. 
There are three modes of operation employed, each of which has its 
advocates, and any one of which may be best, according to circum- 
stances. The first is by extraction, or the removal of the lens, and is 
effected by making an incision through the cornea, as near the iris as 
possible, and then, by means of a needle, opening the front of the 
capsule, and gently removing the lens. The second method is the dis- 
placement of the lens from the axis of vision by what is called couching 
[Fr. coucher, to lie down] or depression. A needle is inserted through 
the fore part of the white of the eye, and is brought to bear upon the 
lens, pressing it back and down into the vitreous humor; and the 
opaque body being thus removed, sight is restored. The third method 
by absorption, is effected by puncturing the front of the capsule, and 
thus admitting the aqueous humor to act upon the cataract; by which 
means it is absorbed. All these operations require great care and skill 
in the operator, and the setting in of inflammation has to be specially 
guarded against. 
The membrane, or conjunctiva, which covers the inside of the lids 
and white of the eye is, from its exposed situation, liable to become EYE, DISEASES OF THE. 
639 
inflamed from various causes. Minute particles of dust, or other sub- 
stances, getting into the eye, and becoming fixed in the lining of the 
upper eyelid, between it and the globe, cause an amount of pain and 
irritation which could scarcely be credited from their size, but which is 
well accounted for by the accurate opposition of the two surfaces 
between which they lie. A particle so situated may be discovered, with- 
out much difficulty, by a second party examining the sufferer with the 
head thrown back, whilst he slightly averts the upper lid with the thumb 
and finger. The slightest speck of foreign matter must be removed, 
and no better instrument can be employed for the purpose than a piece 
of not over-stiff writing paper, twisted like a match. Those who work 
in metals are apt to get minute scales imbedded in the fore part of the 
ball; they cause much irritation, and are often so extremely difficult to 
remove, that a surgeon's assistance is required. The effect of these 
mechanical irritations is to cause inflammation of the conjunctiva; this, 
however, may often arise, and frequently does, from cold, from disorder 
of the digestive organs, etc. The first symptom of inflammation is a 
sensation as if a particle of some kind had lodged in the eye, and if an 
examination be made, there will be seen, not only an enlargement of 
any small blood-vessels that may be generally visible on the white 
of the eye, but a new development of others, the appearance varying 
from the slightest apparent increase of vascularity, to the most in- 
tensely red inflammation; at the same time there is considerable increase 
in the mucous secretion-not in the tears, as is often supposed-and in 
bad cases this becomes purulent or mixed with matter. There is, some- 
times, considerable swelling of the surface usually distinguished as the 
white of the eye. 
The above is the most superficial form of inflammation to which the 
eye is subject; if neglected it may extend itself over the cornea and 
produce permanent blindness. It is distinguishable from the next form 
or inflammation of the sclerotic coat by the size and winding character 
of the small blood-vessels, and by their being slightly movable along 
with the conjunctiva itself when the lids are drawn down. It is import- 
ant that these distinctive characters should be attended to, in the first 
place that no error may be committed between this form and a more 
serious and deep-seated inflammation of the eye, but also that proper 
treatment may be used. A great error is committed in treating this 
form of inflammation by means of warm fomentations, etc., applications 
tending rather to keep up than to cure the disease, which is generally 
quickly removed by astringents. A drop of laudanum or of Battley's 
solution in the eye, repeated two or three times, will often cure the dis- 
order, or a lotion of sulphate of zinc, from 1 to 3 grains to 1 ounce of 640 
EYE, DISEASES OF THE. 
water, will be found efficient, but the best of all is the solution of nitrate 
of silver, or lunar caustic, of the strength of 4 grains to 1 ounce of dis- 
tilled water, as recommended by Dr. Mackenzie. Of this, a single drop 
may be introduced into the inflamed eye twice or three times in the twenty- 
four hours. The eye, of course, should be exercised as little as possible, 
and if the bowels are confined, or the stomach disordered, a few doses of 
the blue pill and colocynth will be found useful. If the disease is 
obstinate, a blister to the back of the neck may be applied with advan- 
tage. 
The disease which has just been treated of, is a comparatively mild 
disorder, but under certain circumstances it becomes much more viru- 
lent ; the secretion of matter is very great, and acquires the power of 
propagating the disease by contagion from one person to another. The 
well-known Egyptian ophthalmia is of this nature, and is carried from 
individual to individual by the flies, which, according to travelers, seem 
to have acquired an instinctive tendency to fly towards the eyes in that 
country. Newly-born and young infants frequently suffer from a severe 
form of this ophthalmia, which often shows itself within three days after 
birth. The inflammation is intense, and the matter often accumulates 
largely between the lids, gushing out when they are separated; in 
scrofulous children especially the affection is often obstinate. The 
nitrate of silver solution is the best application, and small doses of 
quinine the best internal remedy. Syringing between the lids with a 
solution of alum-4 grains to 1 ounce of water, six or eight times a day, 
is also recommended ; a little lard should be used on the edges to pre- 
vent sticking together. 
In inflammation of the sclerotic or outer coat of the ball itself,, 
there is more actual pain, it is more deeply seated, the redness seen on 
the white of the eye is more of a pink hue than in the conjunctival affec- 
tion, the vessels appear much smaller and straighter, radiate as it were 
from the cornea, and are not movable: the affection is, moreover, gen- 
erally a more serious one than the other. The more interior structures 
of the eye may also become inflamed, and especially the iris; in all 
these cases of deep inflammation of the eye, the constitution is much 
affected, there is shivering, followed by thirst, fever, etc.; the pain in 
the organ itself is often most severe, and extends to the forehead ; 
light cannot be borne. If the iris is the part affected, its color is changed, 
and often becomes of a dirty brick red; the pupil at the same time is 
irregular. 
In these, and indeed in all affections of so precious an organ as the 
eye, proper medical treatment should be taken advantage ef. In some 
eye affections the lids are apt to become glued together during sleep by EYE, DISEASES OF THE. 
641 
the secretion; this is best prevented by smearing the edges with some 
simple oil or ointment. The edges of the lids, likewise, are apt to 
become affected with a succession of small pustules, or abscesses, which 
often continue to form in spite of treatment, depending probably on 
some disorder of the digestive organs, which should be attended to; 
local treatment seems to do but little for their amendment. 
The lachrymal sac, or some of its ducts, are apt to become the seat 
of inflammation and to be blocked up in consequence; the tears not 
escaping by their natural outlet run over the cheek, causing painful ex- 
coriation, and the corresponding nostril is dry. The disorder is not only 
troublesome to bear, but often to manage, and should be seen by a 
surgeon. 
A sty in the eye, or rather eyelid, is a small abscess, and often gives 
great pain; it is best treated by fomentations. (See Fomentation.) 
Blows on the eye frequently give rise to effusion of blood beneath 
the conjunctiva, which occasions the white of the eye to become of a 
deep, almost black, red color, and to present a very alarming appearance. 
The state of matters may be distinguished from inflammation by the 
uniformity of the redness, and by the absence of those characteristic 
symptoms enumerated above. (See Bruises and Contusions.) The 
eyes frequently assume an injected or blood-shot appearance in affections 
of the brain. 
Disordered vision may be the result of causes, such as cataract, etc., 
which interfere with the transmission of the rays of light; it may also 
arise from disorder of the digestive organs, and not unfrequently from 
incipient disease of the brain. Persons who become suddenly and unac- 
countably affected with disordered vision, should manage themselves as 
directed in article Amaurosis, and get medical advice as speedily as 
possible. 
Preventive treatment.-The eye is such an important organ, and the 
eyesight so necessary to our happiness, that no one can be too careful in 
avoiding all causes of disease, and preserving as long as possible the 
faculty of seeing. In accomplishing this purpose there are certain 
things which we must avoid doing, and other things which we must be 
careful to do. 
The eyes should never be exposed suddenly to a very bright light. 
They should never be rubbed when irritable, but gently bathed with 
a wet cloth. 
They should never be exposed, while working, to a steady glare of 
light. The desk, or the bench should not be in front of a large window, 
exposed to the direct rays of the sun. 
In reading, avoid a position in which a bright light falls directly on 642 
EYE, DISEASES OF THE-FACE. 
the page. If possible, let the light strike the book at an angle of forty- 
five degrees. 
Never attempt to read in twilight; in a railway car, or carriage, or 
any time when there is much shaking or insufficient light. 
If necessary to work or read, or write, in a very bright light, always 
use a shade for the eye. 
Avoid as much as possible exposing the eye to high winds or a dusty 
atmosphere. 
Never attempt the dangerous practice of looking for a length of time 
at bright polished objects. 
Among the things to he done may be mentioned the following: 
Bathe the eyes every morning and evening with pure cold water and 
wipe them dry with a soft towel. 
Give the eyes rest the moment they begin to show symptoms of 
being overtaxed. 
Do not, from motives of false pride, unduly postpone the use of spec- 
tacles, and be exceedingly careful in purchasing, to secure the number 
exactly fitted to the eye. 
If the eye is suffering, consult only a first-class oculist, and avoid 
making use of the thousand and one cures recommended by sympathiz- 
ing friends. (?) 
We would warn our readers to shun every appearance of quackery, 
and particularly that numerous class of traveling impostors who assume 
the name of oculist, and in all cases of serious trouble in the eye, to consult 
your physician, who, if he cannot grant relief, will refer you to a medi- 
cal man who has given special educated attention to ocular surgery. 
(See Eye, Amaurosis, Blindness, Color Blindness, Ophthalmia, 
Vision, etc.) 
EYE, FOREIGN BODIES IN THE. (See Eye, Diseases of the.) 
FABA, fa'-ha [from Gr. phago, I eat], the bean, a genus of the Nat. 
order Legurninosw. From the species F. vulgaris, all the cultivated varie- 
ties of the broad bean have been produced. The garden beans form an 
important article of human food, and are very nutritious. (See Bean. ) 
FACE, fase [Lat. facies\ is the lower and anterior part of the head. 
It comprises the organs of the three senses-sight, taste, and smell, the 
organs of mastication, and the opening to the respiratory and digestive 
canals. The bones of the face are usually divided into those of the upper FACE-FAINTING, OR SYNCOPE. 
643 
and lower jaw. The former comprises fifteen bones, besides the teeth, 
the latter consists of only one bone besides the teeth. The muscles of 
the face are numerous, and to these we are indebted for that infinite 
variety of expression that characterizes the human countenance. (See 
Anatomy, Complexion, Countenance, Caput.) 
FACE-ACHE. (See Hemicrania or Brow Ague, Neuralgia.) 
FACIAL ANGLE. (See Angle, Facial.) 
faeces,/?-seez [Lat., plural of fax, dregs], the excrement from the 
bowels. (See Stools.) 
FAGOPYRUM, fa-go'-pe-rum, a species of the genus Polygonum, 
yielding the common buckwheat, so largely used in some parts of the 
country as an article of food. The continuous use of buckwheat cakes 
almost invariably gives rise to an intolerable itching of the skin not 
accompanied with any eruption, and not very amenable to treatment. 
The only specific is to stop, for a time, at least, the use of this substance 
as an article of food. Pancakes of all kinds are unsuitable for those of 
weak digestion. (See Food.) 
FAHRENHEIT, fa-ren-hite', the German inventor of the thermome- 
ter which bears his name. 
FAINTING, OR SYNCOPE, faint'-ing, sing'-lco-pe [Irish, faine, 
a weakening; Gr., from sun, with, and kopto, I fall down], is a state of 
partial, or of total unconsciousness, in consequence of diminished circu- 
lation of blood through the brain, the result of depression of the heart's 
action. 
A person about to faint becomes affected with ringing in the ears, 
the sight fails, the ideas are confused, and the mind incapable of exer- 
tion, the countenance becomes deadly pale, cold sweat breaks out over 
the forehead, the power over the limbs either becomes very unsteady or 
fails altogether, and if actual fainting happens, the individual sinks 
down, and is really in a condition which much resembles death, and 
might pass into death. 
As said above, the direct cause of fainting is diminished circulation 
of blood through the brain; it must be obvious, that in the endeavors 
to restore a person who has fainted, this condition must be altered as 
quickly as possible ; and for this purpose, the individual should be laid 
quite flat down, the head on a level with the body, so that the feebly 
acting heart may not have to propel the blood upward, but horizontally. 
The neck and chest should be exposed, fresh air admitted freely, a little 
water sprinkled on the face, and stimulant vapors, such as ammonia, 
held to the nostrils at intervals. Sal-volatile or a little spirit, or wine 
and water may be given at the same time. Friction over the region of 
the heart with the hand or with a stiff brush is useful in stimulating the 644 
FAINTING, OF SYNCOPE-FAT 
action of the flagging organ, and ought at once to be vigorously em- 
ployed, in conjunction with other means, when there is any difficulty in 
restoring animation. It must be remembered that the first period of 
some apoplectic or paralytic seizures is one of faintness; and also, that 
where the affection is the consequence of loss of blood, its continuance 
to some extent may be the safety of the patient. In either case the use 
of stimulants must be a very cautious one. (See Apoplexy, Hemor- 
rhage, etc.) 
FALLING OF THE BOWEL. (See Prolapsus Ani.) 
FALLING OF THE WOMB. (See Womb.) 
FALLING SICKNESS. (See Epilepsy.) 
FALLOPIAN TUBES, fal-lo'pe-an, so called after the anatomist 
by whom they were first described, are slender tortuous canals, about 
four inches in length, proceeding from the upper angles of the uterus, 
and terminating in the ovaries, to which they serve as ducts. (See 
Womb.) 
FALLS. (See Bruises, Concussion, Shock, Dislocations, Frac- 
tures, Accidents, etc.) 
FALSE BITTER-SWEET. (See Celastrus Scandens.) 
FALSE CONCEPTIONS. (See Moles.) 
FALSE CROUP. (See Croup, False.) 
FALSE PREGNANCY. (See Pregnancy.) 
FALSE WINTERGREEN. (See Pyrola.) 
FAMILY MEDICINES. (See Household Medicines.) 
FAMINE. (See Starvation.) 
FAMINE FEVER, fava'-in, a form of typhus. (See Typhus Fever.) 
FARADIZATION. (See Electricity.) 
FARCY. (See Glanders.) 
FASCIA, fash'-e-a [Lat. fastis, a bundle], is .a term applied to cer- 
tain membranous expansions existing in various regions of the body, 
and forming coverings to particular parts. They are composed either of 
cellular tissue more or less condensed, or of fibrous tissue. 
FASTING. (See Abstinence, Starvation; Rule, Living by; Diet.) 
FAT, fat [Ang.-Sax. fwtt, fett}, is a compound of three principles, 
stearine, margarine, and oleine, which at the temperature of the living 
animal body are fluid; but when, as after death, the temperature falls, 
the two former become solid. The fluid fat is contained in simple cells 
of a spherical form, which prevent its being diffused, or falling to the 
most dependent portions of the body. The uses of fat are evidently, 
partly to form a soft pad or cushion for various parts ; but there can be 
no question, that it also constitutes a store of fuel, or combustible ma- 
terial, for aiding the purposes of animal heat. This is palpable in the FAT-FEBRILE. 
645 
case of hybernating animals, which are usually very fat before taking to 
their winter sleep, but the reverse on waking from it. A certain amount 
of fat, as a constituent element of the body, is requisite for health, and 
desirable for appearance; but its accumulation may become so great as 
to amount to disease, and may become an impediment to the perform- 
ance of the duties of life as well as a cause of its shortened duration. 
(See Corpulence, Fucus Vesiculosus, Adipose Tissue, Starch, etc.) 
FATIGUE. (See Exhaustion.) 
FATTY DEGENERATION OF THE HEART. (See Heart, Dis- 
eases OF THE.) 
FAUCES, faw'-seez [Lat. plural of/aw?], is the gorge, or back part 
of the mouth, terminated by the gullet. 
FAVESj/b'-ws [Lat., honey-comb], a peculiar skin disease, generally 
developed on the head, but occasionally elsewhere, and remarkable from 
the yellow-capped scabs, being the site of development of a minute 
fungus. Medical advice should always be sought in this disease. (See 
Scald Head ; Skin, Diseases of the. ) 
FEAR, feer, is one of those depressing agents which always acts 
unfavorably in cases of confirmed disease, and lays the person open to 
the attacks especially of contagious or epidemic maladies. Sudden fear 
has sometimes acted beneficially, and paralytics have been known to 
recover the use of their limbs in their efforts under a paroxysm of terror; 
more generally, however, its operation is the reverse, and many cases of 
epilepsy, mania, heart disease, etc., date from fright. In children, par- 
ticularly of a nervous temperament, the influence of fear, either in jest 
or earnest, is most sedulously to be avoided. Above all things, care 
should be taken, that circumstances in which children may be placed 
accidentally, or individuals with whom they may necessarily have to 
come in contact, are not made sources of terror. This is too often prac- 
tised, and threats of what the doctor will do, so terrify a child, that 
when visited in illness, fright quickens the pulse, the tongue will not be 
shown, and the sounds of the chest are so obscured by sobs, that it is 
next to impossible to arrive at an accurate judgment of the case. Fur- 
ther, if a child has been systematically frightened about the dark, etc., 
it may, if accidentally placed in it, suffer serious injury from fright. 
(See Passions.) 
FEBRIFUGE, feb'-re-fuje [Lat. febris, a fever, and fugo, I drive 
away], is a general term applied to medicines which are believed to pos- 
sess the power of curing or alleviating fever, more particularly to such 
as are used against ague, as quinine. 
FEBRILE, fe'-bril, or feb'-ril [Lat. febrills ; febris, fever], relating 
to, or indicating fever. (See Fever.) 646 
FECULA-FERMENTED LIQUORS. 
FECULA. (See Starch.) 
FEET. (See Foot, Deformity, Club-Foot.) 
FEET, BLISTERED. (See Blistered Hands or Feet.) 
FEET, COLD. (See Cold Feet, Clothing, Cold, etc.) 
FEET, OFFENSIVE SWEATING OF. (See Alum, Carbolic 
Acid, Clay.) 
FEET, WET. (See Cold, Clothing, Damp.) 
FEIGNED DISEASES, fund [Fr. feindre, to feign], are diseases 
which certain persons pretend to be afflicted with, in order to avoid some 
duty, or in the hope of gain. The soldier to escape the performance of 
duty, the mendicant to impose on public or private beneficence, the 
criminal, to avoid the infliction of punishment, most frequently have 
recourse to these pretences. They are sometimes, however, had 
recourse to, when no adequate motive can be assigned, and are difficult 
of detection in proportion to the skill with which they are simulated. 
The diseases most commonly feigned are epilepsy, catalepsy, convul- 
sions, blindness, deafness, palsy, insanity, indigestion, neuralgia, rheu- 
matism, palpitation of the heart, ulcers, etc. Vomiting, spitting of 
blood, diarrhoea, and ophthalmia, are also often simulated. It frequently 
demands very considerable ingenuity on the part of the physician to 
detect the knavery of such persons. 
FEL BOVINUM PURIFICATUM, OR PURIFIED OX BILE. 
(See Ox-Gall.) 
FELON. (See Whitlow.) 
FEMORAL ARTERY, fem'-o-ral [Lat. femur, the thigh], the great 
artery of the thigh. (See Artery.) 
FEMUR, fe'-mur [Lat.], the thigh bone. (See Thigh, Anatomy.) 
FENCING. (See Exercise.) 
FENNEL. (See F<eniculum.) 
FERMENTATION, fer-men-ta'-shun [Lat. fermentation in Chem- 
istry may be defined as a decomposition undergone by organic matter, 
through the influence of a small portion of organized matter which is in 
itself in an active state of alteration. In all cases of fermentation cer- 
tain extraneous conditions are necessary; for instance, the presence of 
water and a moderately warm temperature. There are three princi- 
pal kinds of fermentation-alcoholic or vinous, lactic or butyric, and 
viscous fermentation. When the juices of plants or fruits containing 
sugar are kept at a temperature of seventy degrees for several hours, 
the liquor becomes turbid, and small bubbles of gas make their appear- 
ance ; in common language, it has begun to work or ferment. (See 
Alcohol, Vinegar, Yeast, Carbonic Acid, Fermented Liquors.) 
FERMENTED LIQUORS, fer-ment'-ed lilc-urz^ that is, beverages FERMENTED LIQUORS-FEVER. 
647 
which have undergone the process of alcoholic fermentation, may almost 
be considered a natural product of warm climates, from the readiness 
with which vegetable juices take on the process in these situations. The 
pure juice of the grape, if left to itself in a suitable temperature, will 
ferment in a few hours, and the palm-juice of Africa and other tropical 
countries, and the pulque of Mexico, are instances of the same thing. 
In the present day, the principal fermented liquors in use are-1. Grape 
wines; 2. domestic or home-made wines, which are for the most part 
rendered fermentable by the addition of sugars; 3. liquor made from the 
fermented juice of the apple or pear; 4. malt liquors from various grains, 
principally barley. (See Wine, Ale, Porter; Stimulants, Alcoholic; 
Fermentation. ) 
FERMENTING, OR YEAST POULTICE. (See Poultice.) 
FERN GALE. (See Comptonia Asplenifolia.) 
FERN, MALE. (See Aspidium.) 
FERN, SWEET. (See Comptonia Asplenifolia.) 
FERRATED WINES, fer-rate-ed, wines containing some prepara- 
tion of iron. 
FERRUM. (See Iron.) 
FETID BREATH. (See Breath.) 
FETID PERSPIRATION OF THE FEET AND ARM-PITS. 
(See Alum, Carbolic Acid, Clay.) 
FETOR, fe-tor [Lat. foetor}, is a bad odor of any kind. In many 
cases it is the result of the process of putrefactive decomposition or fer- 
mentation, and may be developed either on the external or internal parts 
of the body. The use of chlorine, or of chloric ether or carbolic acid in 
various ways, is the best corrective. The mercurial fetor is a peculiar 
odor, always acquired by the breath when the constitution is sensibly 
affected with mercury. (See Chlorine, Disinfectants, Mercury, Car- 
bolic Acid. 
FEVER, fe'-vur [Lat. febris^ from ferveo^ I am hot], is that con- 
dition of the body in which the pulse is quickened, the skin hotter than 
natural, thirst present, and the functions generally disordered. This 
feverish state of the system may arise from, and be the concomitant of 
various local and other affections, but it may also constitute a disease.in 
itself, and it is to it in this light that the present article applies. 
Fever, properly so called, naturally divides itself into intermittent 
fever or ague, eruptive fever, such as small-pox or measles, hectic fever, 
and remittent and common continued fever. It is with the last only that 
we have to do at present, the others will be considered under their own 
heads. 
Remittent fever may be regarded as an aggravated form of intermittent 648 
FEVER. 
fever or ague; it has the regular succession of hot, cold and sweat- 
ing stages, but the interval between the paroxysms is not characterized 
by the return to comparative health as it is in the latter. Through most 
tropical countries, the principal type of fever is the remittent; but the 
complications of the fever, and consequently its management, vary 
according to locality. (See Remittent Fever.) 
Common continued fever is an affection of the whole system; as 
described by a medical author of eminence, "It affects the head, the 
trunk of the body, and the extremities; it affects the circulation, the 
absorption, and the nervous system; it affects the skin, the muscular 
fibres, and the membranes; it affects the body and likewise the mind." 
By medical men this serious disease is subdivided into different varieties 
and types; but it would serve no good purpose to enter into these here. 
The management of a disease so gravely important as fever, can never 
be legitimately undertaken by unprofessional persons if medical assist- 
ance is procurable, and as a provision in circumstances when this is 
absent, the less complicated, both the account of the disease and of its 
treatment, the more likely is it to be managed with advantage domes- 
tically. The first symptoms of incipient fever are usually displayed 
through the nervous system. The individual feels an unaccountable 
languor, and complains of headache and shivering, cannot exert the pow- 
ers either in the duties or pleasures of life, is easily tired, sleep is dis- 
turbed, the appetite is impaired, the skin looks dusky and the eyes heavy, 
the pulse quickens, and at length the feeling of general illness drives 
the patient to bed. The attack, however, may commence much more 
suddenly, a shivering, or, as the.people in many places call it, an "ague 
fit," may be the first symptom; or severe headache, or vomiting, or 
fainting, or even convulsion may be the first symptom of the impending 
malady. When fever is fairly established, the pulse ranges above one 
hundred, the tongue is furred, probably brownish and dry, sleep is dis- 
turbed or supplanted by delirium, the muscular power is diminished and 
diminishing, and the mind indifferent to passing circumstances; dark 
incrustations collect about the teeth, the patient sinking down in bed, 
and perhaps passing the natural evacuations unconsciously, displays the 
most evident signs of debility. This condition may increase till it ter- 
minates in death, or tends towards recovery, either by some marked 
crisis, such as profuse perspiration, or by an almost imperceptible 
amendment. Tranquil sleep, improved aspect of the countenance, the 
skin cooler and with more tendency to moisture, the tongue cleaning at 
the edges, and a natural desire for food, all give sign that the disease is 
passing away; on the other hand, if a fatal issue is approaching, the 
general weakness increases, the patient slips down in the bed in conse- FEVER. 
649 
quence, and lies in a state of dreamy muttering, there is convulsive 
starting of the fingers or other parts of the body, picking at the bed- 
clothes, the insensibility to external impressions increases, and probably 
stupor closes life. 
Such are the general features of fever, whether simply continued, or 
when it runs on to the more serious formsof typhoid, or low, or nervous, 
■or malignant fever. There are many other indications which occur, but 
which it would serve no good purpose to detail here ; all that is required 
is, that the disease should be recognizable, so that its general manage- 
ment may be properly and intelligently conducted, when it falls to the 
lot of an unprofessional person to have the direction. 
In the first place it must be remembered, that for continued fever 
we have no cure, that is, we have no medicine which we can give with 
the tolerable certainty of removing the disease, as quinine removes 
ague; it must be vanquished by the powers of the constitution, by the 
tendency to health (see Disease), and our endeavor must be to place these 
powers in the most favorable condition possible for the struggle, and, 
where they appear to be insufficient, assist. Sometimes the constitutional 
power will throw oft* fever at the very onset. A person attacked with 
fever ought to be placed in as roomy and well-aired a situation as pos- 
sible, better even in a barn than in a close or crowded room; the greatest 
cleanliness as regards everything around must be observed, and perfect 
quietude; if thirst is present, it should be liberally indulged with simple 
diluents, such as barley-water, rice-water, or lemonade; if nourishment 
is taken, it should be given in moderate quantities, and consist princi- 
pally of milk and farinaceous preparations; grapes, oranges, and ripe 
fruits, if they do not create flatulence or diarrhoea, are allowable. If 
the skin is hot and dry, it should be sponged daily, or oftener, with 
water, and, indeed, this practice is beneficial, more or less, in most 
cases. By these simple means of management, almost without medicine, 
beyond some gentle aperient at intervals to keep the bowels perfectly 
free of their necessarily depraved contents, many a case of fever may 
be well conducted to a favorable issue, with much more certainty than 
under a more meddlesome treatment, care being taken when signs of 
amendment show themselves, that there is not too great hurry in giving 
or permitting strong nourishment. 
In more serious forms of fever, the same principle of treatment must 
be kept in view, but more urgent symptoms may call for more active 
interference; delirium may require the treatment pointed out under the 
individual articles devoted to the subjects, Typhoid Fever, Typhus Fever, 
and the various diseases in which delirium occurs; difficulty of breathing 
and cough may render a blister on the chest desirable, or tenderness of the 650 
FEVER. 
bowels on pressure, particularly in the right iliac region (see Abdo- 
men) may call for the application of half a dozen leeches. Diarrhoea 
may require to be checked (see Diarrhcea), or constipation removed by 
gentle aperients; castor-oil or rhubarb or senna will generally be found 
safest and best, or by injections. Sleeplessness at night, with con- 
vulsive starting of the fingers, may require opium, or the general 
sinking of the powers, the pulse becoming feeble and easily extin- 
guished, may call for the careful and measured administration of wine or 
brandy, or of camphor in milk (see Camphor), with strong meat broth, 
or gravy, in frequently repeated small quantities. At this time care 
must be taken to observe whether urine is passed; if there seems to be 
difficulty, a bag of hot bran on the lower part of the body will possibly 
make it easier; if it dribbles away, means should be taken to protect the 
back and hips of the patient from being wetted with it. This may be 
done in various ways, either by water-proof material, or by constant 
renewal of dry cloths; it is much better effected, however, by bags of 
bran so placed as to absorb the urine as it comes away. If with every 
quart of bran, four ounces of the diluted sulphuric acid be mixed, it will 
neutralize the ammoniacal emanations which so quickly arise wherever 
urine collects. Very recently, bags filled with the powder of peat char- 
coal have been recommended for the same purpose, and where this arti- 
cle can be procured, it will probably be superior to any other. 
All patients who lie long in fever become liable to bed-sores, or 
ulcerations on the prominent parts of the body, which are subject to pres- 
sure as they lie; these are, especially, the back and hips, points of the 
shoulder blades, back of the head, tips of the ears, etc. When these 
ulcerations form, they not only add materially to the suffering of the 
patient, but may become the cause of a fatal termination to a case that 
might otherwise have recovered. They should, if possible, be pre- 
vented. The parts named above should be frequently examined, and on 
the slightest appearance of redness, the skin at the spot should be 
rubbed with spirit, brandy, or a solution of camphor in spirit. When 
the skin has actually broken, it may be dressed with simple spermaceti 
ointment spread on linen; lead plaster spread on soft leather is often 
useful, or the white of egg beat up with alum. (See Alum.) Both as a 
preventive and as a remedy after the sores have formed, the parts should 
be relieved from pressure as much as possible by various arrangements 
of cushions, etc., the elastic ones made for the purpose being the most 
suitable. (See Bed-Sores.) 
The simplest, and in every respect, the best method, of treating 
troublesome bed-sores, is to smear a little simple ointment, or fresh lard 
over one of the india-rubber water-beds or cushions, and lay the sore upon FEVER-FEVER, TYPHOID. 
651 
it, without the intervention of any kind of dressing or non-elastic material 
whatever. Care must be taken to keep the sore and the pillow quite 
clean, and the lard quite fresh. 
Such are the general principles on which a case of fever is to be man- 
aged ; by attention to them an unprofessional person will be much more 
likely to do good than by meddlesome interference. Attention to the 
ventilation of the room, to the perfect cleanliness of the patient and of 
everything around; a free supply of simple drinks and care that the 
bowels are duly, but not forcibly relieved, of their always depraved con- 
tents, ought to constitute the chief resources of the domestic manage- 
ment of fever. 
Again it is repeated, fever is not a disease to be cured, but to be 
guided to a safe termination. If many of the symptoms which arise, or 
may arise, in fever, or if minutiae of treatment are here omitted, it is 
because either their enumeration would have been useless, or that a 
judicious reference to various parts of this work will furnish adequate 
guidance. As regards the causes of the fever, first, Contagion, has 
been fully treated of in its special article, and the rest are so fully pointed 
out in the various sanitary articles, such as Air and Ventilation, Bed- 
room, Disinfectants, Drainage, etc., that it would involve needless repe- 
tition to go over them here. They may be summed up: Predisposing- 
whatever lowers, either temporarily or permanently, the standard of the 
general health; and direct-contagion and the products of animal or 
vegetable decomposition. 
Fever in children in this country is more generally of a remittent 
character than it is in adults. 
The article cannot be closed without reference to the employment of 
fresh yeast in cases of fever, particularly of a low, malignant or putrid 
tendency, in which it is most useful. It is given in tablespoonful doses, 
repeated every three or four hours. (See Remittent Fever, Typhus 
Fever, Typhoid Fever, Scarlet Fever, Ague, Bed-room, Contagion, 
Delirium, Bed-Sores, Carbon, Cold, Disinfectants, Disease, Debility, 
Convalescence, Cookery for the Sick, etc.) 
FEVER AND AGUE. (See Ague.) 
FEVER-BUSH. (See Benzoin Odoriferum.) 
FEVER, CAMP, a form of typhus. (See Typhus Fever.) 
FEVER, CONTINUED. (See Fever.) 
FEVERFEW. (See Pyrethrum Parthenium.) 
FEVER POWDER. (See Antimonial Powder.) 
FEVER-ROOT. (See Triosteum Perfoliatum. ) 
FEVER, SCARLET. (See Scarlet Fever.) 
FEVER, TYPHOID. (See Typhoid Fever.) 652 
FEVER, TYPHUS-FILTER. 
FEVER, TYPHUS. (See Typhus Fever.) 
FEVERWEED. (See Gerardia.) 
FEVERWORT. (See Eupatorium Perfoliatum. ) 
FIBRINE, fi'-brin [from Lat. fibra, a thread], one of the constitu- 
ents of the blood, and of muscular tissue. It is contained in blood in 
a liquid state, in the proportion of 2'5 parts to 1,000, and coagulates in 
a very short time after the exposure of blood to the air. It constitues 
a large portion of muscle, arranged in bundles of fibres; whence its 
name. 
FIBROUS TISSUE. (See Muscle.) 
FIBULA, fib'-u-la, the small bone of the leg. (See Leg, Anatomy.) 
FICUS, fi-kus [Lat., a fig], in Botany, a genus of the Nat. order Mora- 
cece, consisting of trees and shrubs abounding in a milky juice. The 
most important species is AI Carica, the fig tree, supposed to be a native 
of Asia Minor, but now found in all the southern countries in Europe. 
The fruit is eaten green, and dried as a luxury in some countries, and as 
a common article of food in others. The finest dried figs are imported 
from Turkey. In consequence of their nutritive, emollient, demulcent, 
and laxative properties, they are frequently employed in medicine. 
When heated and split open, they form a useful application in promot- 
ing the suppuration of tumors, or boils, particularly in the mouth or 
gums. The fig contains a wholesome and somewhat aperient pulp, but 
the thick rough rind is indigestible and should not be eaten. 
FIGS. (See Ficus.) 
FILARIA, fe-la'-re-q [Lat. filum, a thread], a genus of parasitic en- 
tozoa, common to large and small animals, and infesting even certain of 
the mollusca. Of this family the most inimical to the comfort of man 
is the Guinea-worm {Filaria medinensis)^ which, in hot climates, insin- 
uates itself under the skin of the lower members, causing excruciating 
pain. It has a slender and thread-like body, and sometimes attains a 
length of six feet. It is met only in certain portions of the torrid and 
temperate zones in Africa and Asia, and is especially frequent on the 
African coast. It is extracted by tying a thread round the head when it 
protrudes, and rolling it round a small stick, drawing the worm gradually 
out day by day, and rolling it round the stick till it is extracted, great 
care being necessary not to break it in the process. 
FILBERTS, fil'-burts, are liable to the objection to nuts generally, 
and are difficult of digestion. 
FILTER, fil'-tur [Fr. filtre\ an apparatus by which fluids are sepa- 
rated from any solid matter held in suspension. They are of various 
kinds, and for different purposes, being used in straining chemical 
liquids; in purifying water for household use; or on shipboard for changing FILTER-FISH. 
653 
salt water into fresh. Household filters for purifying water, either 
for drinking or culinary purposes, are made in various forms. Any com- 
mon vessel with a hole below, such as a flower pot, may be used. Its 
lower portion is to be filled with coarse pebbles, over which is placed a 
layer of finer ones, and on these a layer of clean coarse sand; on the 
top of this, a piece of burnt clay, perforated with small holes, should be 
put, and on this a stratum, three or four inches thick, of well-burnt 
pounded charcoal. A filter thus formed will last a long time, and not 
only separates solid impurities, but purifies the water, by means of the 
charcoal, from the putrescent and other noxious substances held in solu- 
tion, which cannot be separated by ordinary filtration. (See Sanitary 
Science, Water.) 
FINGERS, fing'-gerz [Ang.-Sax.], from their constant exposure, 
are liable to many accidents and diseases; fractures, dislocations, whit- 
low, separation of the nail, all which are treated of under their respec- 
tive articles; there is, however, one mishap which does not fall under 
any particular head. 
A ring which cannot he removed.-When this occurs, the use of 
cold to the finger and hand; the hand and arm being elevated at the 
same time, may cause sufficient shrinking to permit of the removal; if 
this does not succeed, the following may: a piece of fine packthread, or 
linen thread, is to be wrapped evenly and firmly round the finger, from 
the tip as far as the ring, through which its end is to be inserted, which 
being done, the packthread must be gradually unwound by means of the 
end thus placed. If this process does not succeed, the ring should be 
filed off. It cannot remain without risk. (See Anatomy, Fractures, 
Dislocations ) 
FIRE-DAMP. (See Coal-Gas.) 
FIRE-PLACE. (See Chimney, Stoves.) 
FIRE, ST. ANTHONY'S. (See Erysipelas.) 
FIREWEED. (See Erechthites Hieracifolius.) 
FISH, fish [Ang.-Sax. fisc], as an article of diet, generally is whole- 
some ; it is neither so nutritive nor so heating as animal food, and on 
these accounts is often to be permitted when the latter is not. 
Fish are classed as fresh water, salt water, and shell fish. Dr. Paris 
remarks, "Turbot, cod, whiting, haddock, flounder, and sole, are the 
least heating of the more nutritive species; and the flakiness of the fish, 
and its opaque appearance after being cooked, may be considered as true 
indications of its goodness, for when the muscles remain semi-transpa- 
rent and bluish, after sufficient boiling, we may reject it as inferior in 
value and not in season. When fish is in high perfection, there is also a 
layer of white curdy matter resembling coagulated albumen, interposed 654 
FISH- FISTULA. 
between its flakes. The whiting-' the chicken of the sea '-is well 
adapted for weak stomachs, on account of the little viscidity which 
it possesses; it is at the same time tender, white and delicate, and con- 
veys sufficient nutriment, with but little stimulus to the system. The 
haddock is firmer in texture. Cod is not quite so digestible as the two 
former, but it is nutritious. Turbot is wholesome, without lobster sauce. 
Sole is tender, and yet sufficiently firm; it is, therefore, easy of digestion, 
and affords proper nutriment to delicate stomachs. Salmon is very nutri- 
tious, but, being one of the oily fishes, is less digestible than many 
others; vinegar in some degree corrects the fault. Eels are always 
indigestible." Firmness of texture, whiteness of muscle, and the ab- 
sence of oiliness and viscidity, are the circumstances which render fish 
acceptable to weak stomachs. Shell fish may, without exception, be 
considered as indigestible. Oysters eaten raw are undoubtedly nutritive, 
but by some they are not easily digested. Many persons are liable to 
cutaneous eruptions after the use of some descriptions of shell fish, and 
some suffer from diarrhoea. 
In those places, as the coast of Norway and Sweden, where a diet of 
fish alone is habitual, the people are very liable to chronic cutaneous 
disease. 
The most wholesome method of cooking fish, is by boiling; frying 
is not suitable for the invalid. It is well known that certain species of 
fish are poison at all times, others appear to be so only occasionally, and 
under peculiar circumstances. The oily fishes also, such as salmon, 
herring, etc., when too long kept, have also given rise to symptoms of 
irritant poisoning. (See Food, etc.) 
FISTULA, fist'u-la [Lat., a pipe or reed], is a long and sinuous 
ulcer, having a narrow opening, sometimes leading to a larger cavity, 
and which has no disposition to heal. The most common form of 
this disease is the fistula in ano, the sinus extending into the cellular 
substances about the anus, or into the rectum itself. This disease is com- 
monly attended with intense pain, especially when passing the faeces, and 
there is an irregular discharge of purulent matter, which is sometimes 
mixed with blood. Sometimes a cure will be effected by attending to 
the general health, and the injection of some astringent lotion, as solu- 
tion of sulphate of zinc (40 grains to 1 pint of water.) Failing this, it 
will be necessary to make a complete division with the knife of the whole 
of the parts between the fistula and the bowel, and the edges of the 
wound kept apart by lint, in order to allow the cavity to fill up by gran- 
ulation. Fistula lacrymalis is a disease of the lachrymal sac, caused by 
an obstruction to the flow of tears along the nasal duct. The symptoms 
of this disease are a watering of the eye, with a dryness of the FISTULA-FLATULENCE. 
655 
corresponding nostril, a distension of the lachrymal sac, and a discharge of 
muco-purulent fluid mixed with tears, from the puncta lacrymalia, when 
the sac is compressed. Salivary fistula is a fistulous aperture in one 
of the salivary ducts, opening externally, and through which the saliva 
escapes. It is generally caused by a wound, and if this be reached, a 
cure may be effected by merely bringing together and uniting the edges 
of the wound; but if of some standing, a free canal ought to be formed 
for the discharge of the saliva into the mouth. 
FISTULA IN ANO. (See Fistula.) 
FITS. (See Apoplexy, Convulsions, Epilepsy, Hysteria, etc.) 
FIXED AIR, fikst are, the name given by Dr. Black to carbonic 
acid gas. (See Carbonic Acid.) 
FLAG, BLUE. (See Iris Versicolor.) 
FLANNEL, flannel [Fr. flanelle\, a woolen texture, is an article of 
clothing which should be worn next the skin by every man, woman and 
child. Under the head flannel is included, of course, woolen clothing 
generally. Wool being a bad conductor of heat, is, in consequence, the 
best protection against sudden vicissitudes of temperature, such as occur 
in this climate, and also against chills which may supervene upon the 
profuse perspiration of a warmer one. Of course the thickness of the 
woolen material worn next the skin may and ought to be varied, but wool 
it ought to be, if of not stronger texture than gauze. The experience of 
our military and naval surgeons all tends to prove that there is no 
greater preservative from the dysenteric and febrile affections of hot 
climates than woolen clothing next the skin, and every medical man's 
experience in this country confirms the fact of its protective power. 
Notwithstanding, it is astonishing how many carelessly neglect this 
indispensable article of clothing. Some few persons with extremely 
irritable skin cannot wear flannel next it; in such cases, a dress of thin 
cotton should be worn, and flannel over, or a woven silk texture is a 
good substitute. Flannel should be worn in summer, but not of too 
heavy a texture: still, if a tendency to rheumatism exists, it should not 
be too thin. 
Underclothes become impregnated with perspiration, the exhalations 
of the body, dust, etc., during the day. They should therefore be 
changed at night. No garment should be slept in that has been worn 
during the day. Underclothing should be washed frequently, at least 
once a week. (See Clothing.) 
FLATULENCE, flat'-u-lense [Lat. flatus, a blast], is one of the 
most common, as it is often one of the most distressing, symptoms of indi- 
gestion. Gas, which is normally formed, and is, therefore, always to 
be found in the stomach and bowels, has been evolved in too large 656 
FLATULENCE. 
amount; or, owing perhaps to some spasmodic affection of the bowels,, 
or it may be to the simple abeyance of the ordinary movement in the 
bowels necessary for the passage of their contents, whether gaseous or 
solid, flatus has collected to an unusual extent in one part. 
The most distressing feeling arising from flatulence is the sense of 
distention ; and this may be experienced in the stomach itself, or in 
some part of the intestinal track. This painful sensation is, sooner or' 
later, followed by the passage of the gas upwards or downwards-sud- 
denly, it may be, like an explosion, or more gradually and favored by 
movements which the patient has it in his power to make. If the air 
passes upwards, the patient is said to belch-an act which, for a time, 
seldom fails to bring relief. When the attack is a very severe one, and 
the amount of distention of the stomach great, there frequently occur 
pains, not only in the neighborhood of that organ, but shooting up to 
the chest, even to the throat and head. Owing to the distended 
stomach-and the same applies, though less markedly, to the bowels' 
when they alone are the seat of the flatulent collection-pressing against 
the midriff or diaphragm, the breathing becomes considerably embar- 
rassed. In connection with flatulence, unless merely accidental in its 
occurrence, there is usually found derangement of the function of the? 
bowels, very often a confined condition or obstinate constipation; while, 
in some cases, the same cause which determined the flatulence-some- 
marked error in diet-gives rise to a condition of looseness or diarrhoea. 
The habitual sufferer from flatulence should exercise very great cau- 
tion in regard to both regimen and diet; walking immediately after 
making a hearty meal, or the sitting down to some laborious mental 
occupation whenever food has been swallowed-these are fruitful sources 
of flatulence, as well as of other distressing symptoms. Not less mis- 
chievous is the rapid bolting of the food itself, which men of business 
and students are so apt to persevere in. The neglect of regularity in 
the function of the bowels is another great cause of flatulence; the proper 
adjustment of diet and regimen, favored, if necessary, by some gentle 
laxative medicine, should, by those who are apt to suffer, be carefully 
attended to. 
When a severe attack of flatulence has occurred, the patient, no 
doubt, has at once loosened his clothes, and so doing, has felt a little 
relief; let him then take a little of one or the other of the following sim- 
ple medicines-antispasmodics, carminatives, they are called; of these 
peppermint, as best known for the purpose, maybe named first; 1 ounce 
(2 tablespoonfuls) of peppermint water, or 30 to 40 drops of the spirit of 
peppermint, or 2 drops of its oil in warm water, may be given for this 
purpose. Cardamomsis another favorite remedy; the simple tincture or FLATULENCE-FL O UE. 
657 
the compound tincture (containing caraway and cochineal, among other 
ingredients), in doses of 1 or 2 teaspoonfuls, may be given also in 
warm water. If these remedies are not at hand, a little ginger (5 to 20 
grains) may be administered in warm water, or a teaspoonful of its tinc- 
ture, or a little black pepper (5 grains) after the same fashion. Mean- 
time the application of warm fomentations or a mustard poultice over 
the belly will be useful; and, after the patient has recovered from the 
more serious uneasiness, a good prescription is a laxative combined with 
an anodyne. A full dose (if for an adult, 2 teaspoonfuls) of Gregory's 
mixture, with 20 or 25 drops of the solution of the muriate of morphia, 
or 1 tablespoonful of castor-oil, with 10 drops of laudanum. (See Dys- 
pepsia, Digestion, Diet, Food, Regimen, etc.) 
FLAXSEED. (See Poultice, Linseed.) 
FLEABANE. (See Erigeron.) 
FLESH, flesh [Ang.-Sax. flcec\ a compound substance, constituting 
a large portion of every animal, and consisting of the softer solids, as 
distinguished from the bones and fluids. Chemically considered, flesh 
consists of fibrine in a coagulated form, permeated by at least three times 
its weight of water and fluid, consisting partly of blood and partly of 
substances secreted from it. The soluble matters consist chiefly of 
albumen, the soluble salts of the blood, two animal principles, called krea- 
tine and inosite, and phosphoric, lactic, butyric, acetic, and formic acids. 
The salts consist of the phosphate of potash, magnesia, and lime, and a 
small quantity of chloride of sodium. (See Beef, Mutton, Fibrine, 
Muscle. ) 
FLESH BRUSH, is a brush used for rubbing the surface of 
the body in order to excite the cutaneous circulation. Its use is very 
advantageous where the circulation is languid. 
FLIES, flize. A strong decoction of quassia chips well sweetened 
w'itli brown sugar or molasses, makes a safe and effectual fly-destroyer, 
and much preferable to the poisonous articles used for this purpose. 
(See Decoction, Simaruba Excelsa.) 
FLIES, SPANISH. (See Cantharides. ) 
FLOCCILATION, flok-sil-la'-shun [Lat. floceilatio, from floccus, a 
lock of wool], in Medicine, is a term applied to the picking the bed- 
clothes, which is sometimes observed in the last stages of fever and 
other violent complaints, and which is always regarded as a symptom of 
great danger. 
FLOODING. (See Hemorrhage, Childbed, etc.) 
FLORIDA, CLIMATE OF. (See Climate, Health Resorts.) 
FLOUR, flowr, [originally flouer, Fr. fleur\ the finely-ground meal 
of wheat, and of any other corn or cerealia which has been reduced to 658 
FL O UR-FOMENTATION. 
powder in a mill. There are several varieties of flour, depending upon 
its fineness, or the amount of bran which it contains. (See Bread.) The 
component parts of flour are starch, gluten, sugar, gum, bran, and 
water, the prime element being starch. No substance is more adul- 
terated than wheat flour; and there are several modes of detection, the 
best of which is the specific gravity test, as a vessel which contains one 
pound of wheat flour will contain nearly a pound and a half of any other. 
(See Bread, Food, Cereals.) 
FLOWERS OF SULPHUR. (See Sulphur.) 
FLUCTUATION, flukt-yu-a'shun [Lat. jluctuo, to flow, or rise and 
fall, like the waves], in medical language, is the movement given to 
fluids in cavities-either natural or diseased-by the fingers of the 
medical man whilst at the same time he endeavors to make himself 
acquainted wfith the various peculiarities which characterize the collec- 
tion. (See Abscess.) 
FLUID EXTRACTS. (See Extracts.) 
FLUOR ALBUS. (See Whites. ) 
FLUX, fluks [Lat. fluxus, from fluo, I flow], is applied to any pre- 
ternatural fluid evacuation from the body, but more especially to those 
that proceed from the bowels. It is frequently applied to diarrhoea, and 
dysentery was long known as the bloody flux. (See Diarrhoea, Dysen- 
tery. ) 
FLUX, BLOODY. (See Dysentery.) 
FLY. (See Flies.) 
FLY-TRAP. (See Sarracenia Purpurea.) 
FCENICULUM, fe-nik'-udum [from Lat./^nw, the fennel], a genus 
of the Nat. order Umbellifera. There are two species-namely, F. 
vulgare the common fennel, and F. dulce, the sweet fennel. The fruit 
of the F. dulce is officinal, and is imported from Malta. It is stimulant, 
carminative, and is sometimes employed in flatulence, dyspepsia, colic, 
etc. Fennel water is made by taking 1 pound of the fruit bruised and 
2 gallons of water, and distilling 1 gallon. 
FCETID SORES. (See Clay, Sores.) 
FCETUS, fe'-tus [Lat. from feo, I bring forth], is applied to the child 
in the uterus from the fifth month of the pregnancy to the time of birth. 
Previous to that time, it is commonly called the embryo ; but these terms 
are rather arbitrary, and the one is frequently used for the other. (See 
Embryo, Pregnancy). 
FOMENTATION, fo-menda'-shun [Lat. foveo, to keep warm], is a 
method of applying heat and moisture to any portion of the body-a 
most useful remedy, if well done, but so often badly performed, as to do 
more harm than good; for this reason, a bran-bag poultice, properly FOMENT A TION-FO OD. 
659 
made (see Bean) is in most cases preferable. When fomentation is to 
be performed, the bed or clothes should be guarded by some water-proof 
material if possible. Two good-sized pieces of coarse flannel are to be 
employed, one being in preparation whilst the other is in use. The flan- 
nel being wrung out of hot water, should be shaken up loosely, and laid 
upon the part under treatment. The size of the flannel must of course 
be proportioned to the case, but it should be ample. Simple warm water 
is generally sufficient for fomentation; but in some cases, the decoction 
of poppy capsules may be more soothing. Other additions are of no 
service beyond ensuring the greater attention and confidence of many 
ignorant persons, who will not use, either with care or confidence, so 
simple an application as water. (See Bran, Heat, Poultice.) 
FOMITES, fom'-ites [Lat. fames, fuel], is a term applied to such 
substances as are believed to be capable of receiving, preserving, and 
conveying contagious affluvia, as wool or woolen clothes. 
FOOD, food [Ang.-Sax. foda or fode\, that by which the living body 
is nourished, in its widest sense, comprehends both liquid and solid 
aliment. 
Water is not only the medium by means of which most of the opera- 
tions which go on in living bodies are conducted, but it also enters so 
largely into the composition of these bodies, that it must be regarded as 
one of the alimentary principles, a due supply of wrhich is necessary not 
only for health, but for life; and this supply must be constant, in order 
to compensate for the loss of moisture which is continually going on 
from the surfaces, exterior and interior, of the living body. 
The food-taken by man and animals, has, or ought to have, reference 
in its composition to two distinct ends-the nourishment of the bodily 
tissues, and the maintenance of animal temperature. 
Milk is the only single article of diet which in itself contains this 
essential combination in properly balanced proportion. In addition to 
water and saline ingredients, milk contains three distinct sets of princi- 
ples: the albuminous, represented by the curd; the saccharine-in which 
is included the farinaceous-represented by the sugar, and the oleagin- 
ous, or fatty, by the cream. Of these, the albuminous principles and 
salts are requisite for building up of the frame; the saccharine and olea- 
ginous for, so to speak, supplying it with fuel; they are what has been 
called respiratory food, because they chiefly furnish materials, carbon 
and hydrogen, which may combine with the oxygen taken in from the 
air by the lungs, and burn as it were, within the body by a slow and 
gentle process. It must not, however, be imagined that the saccharine 
and oleaginous principles are solely devoted to purposes of fuel; they 
also serve important ends in the nutrition of the body, but as they contain 660 
FOOD. 
no nitrogen, it is evident they cannot afford proper nutriment to tis- 
sues of which this element forms an essential component; they cannot, 
therefore, form muscle', but they can form fat which contains no nitrogen 
and requires none. In truth, the sugar, starch, and probably the fibre 
and gum of vegetables, must constitute the chief sources for the forma- 
mation of fat in graminivorous or vegetable feeding animals. 
The albuminous, the saccharine, and the oleaginous principles must 
each be taken as the representatives of a peculiar class of substances. 
Under the head of albuminous principles, falls the caseine, or curd of 
milk; albumen, as we see it in the egg; and fibrine, as it coagulates from 
blood, or forms part of animal muscle. These are principles all identical, 
or nearly so, in composition, but in different states of vital organization; 
they are composed of carbon, hydrogen, nitrogen, and contain phospho- 
rus and sulphur in small proportions. They are, therefore, adapted to 
afford due nourishment to such portions of the living animal body as are 
similarly constituted: the milk curd is the only substance contained in 
that fluid from which the young animal can form its blood and its 
muscle; from the albumen of the egg alone all the tissues of the chick 
are constructed; and the carnivorous animal subsists upon the muscle- 
flesh-of its victims; these principles are therefore in themselves capa- 
ble of sustaining life; not so the oleaginous and the saccharine, which 
represent, the one the fats and oils, and the other the starch, the sugar, 
and the gum. These being deficient in nitrogen, in sulphur, and phos- 
phorus, cannot yield them, and therefore an animal fed upon them alone, 
will die of starvation-as regards certain essential components of its 
body at least. 
What is applicable to the food of animals is also to that of man, as 
regards the nutrient principles; the bodies of both stand upon the same 
level, but man has the will and the power to consume both vegetable 
and animal food, either mixed or singly, as may suit his habits. 
Existence upon animal flesh alone is not common, but it is practica- 
ble and practised by the Indians of the South American Pampas, and by 
many people who live by hunting; but all these, like the carnivorous 
animal, make long-continued muscular exertion, without which, indeed, 
under the peculiar diet, they could not preserve health. 
Existence upon vegetable food alone is much more common than that 
upon animal food alone, and indeed, is the rule with many nations and 
people, who unquestionably maintain high strength and vigor upon it; 
it is, in fact, only requisite to look at the grass-eating bull to feel con- 
vinced of the possibility of the fact, and did space permit, it would be 
easy to cite abundant confirmatory examples'; but if man lives on vege- 
tables he must, like the vegetable-eating animal, consume a comparatively FOOD. 
661 
large bulk to obtain sufficient nutriment; and so it is, the Hindoo 
must eat seven or eight pounds of rice at a meal. The cereal grains and 
pulses possess albuminous principles largely-the gluten of the former 
corresponding to the animal iibrine, and the caseine of the latter to the 
curd of milk. Those persons, therefore, whose vegetable food is com- 
posed chiefly of the above, require, of course, to consume less, and there 
cannot be the slightest doubt that man may lead the most active and 
healthy life upon a grain diet alone, and especially if it be combined with 
milk. But what is possible may not always be expedient, nor suited to 
man's circumstances. The healthy active countryman constantly exer- 
cised in the open air will do well on a vegetable diet, under which the 
city artizan or man of business, the delicate female, the pale, perhaps 
scrofulous, child would become diseased, or sink and die. Their organs 
of digestion and assimilation cannot extract from the vegetable mass suf- 
ficient blood-nourishment, neither do they receive sufficient stimulation 
from it. Climate has a remarkable effect in modifying the rule as to a mix- 
ture of animal and vegetable food. The former has most of a stimula- 
ting quality, and this quality is greater in beef and flesh in general than 
in fowl or fish. Now, the inhabitants of torrid countries are in their 
ordinary condition least in need of stimulus; hence they find a simple 
diet of rice and sago sufficient for them. Those, on the contrary, who 
dwell in cold countries, need much stimulus: hence they can devour vast 
quantities of flesh and blubber, with scarcely any mixture of vegetable 
food. The nutritious character of any substance, or its value as an article of 
food, does not depend simply upon its containing either of the alimen- 
tary substances in large quantity, but upon its containing them mingled 
together in such proportions as is requisite for the healthy nutrition of 
the body. The total quantity of food required by man has been variously 
estimated. It will necessarily vary, indeed, not only with the constitu- 
tion and habits of the individual, but also with the quality of the food 
employed, since some articles, such as corn and meat, contain very much 
more alimentary material in the same bulk than fresh fruits or vegeta- 
bles. Prof. Dalton, of New York, says that from experiments per- 
formed while living on an exclusive diet of bread, fresh meat and butter, 
with coffee and water for drink, it has been found that the entire quan- 
tity of food required during twenty-four hours by a man in full health, 
and taking free exercise in the open air, is as follows: 
Meat 16 ounces or 1.00 lb. avoirdupois. 
Bread 19 " or 1.19 " " 
Butter or fat 3% " or 0.22 " " 
Water 52 " or 3.38 " " 
That is to say, rather less than 2| pounds of solid food, and rather 
over 3 pints of liquid food. 662 
FOOD. 
Then, again, from experiments of some of the highest authorities, 
tne following deduction has been made, namely: that a strong healthy man 
requires 300 grains of nitrogen and 4,600 grains of carbon to make up 
the waste which daily takes place in his system ; and here it would not 
be out of place to insert a table from Dr. Letheby's work on food, giving 
a comprehensive idea of the nutritive value of different articles of diet, 
and, keeping in mind the daily waste of the body, a simple calculation 
will enable us to see how much of each article one would require to take 
before getting enough of both the carbon and the nitrogen. 
Nutritive value of food.-The quantity of food required to furnish 
300 grains of nitrogen, together with the amount of carbon contained in 
that quantity. 
Lbs. 
Nitrogen or 
Flesh producer. 
Grs. 
Carbon or 
Warmth 
producer. 
Grs. 
Bread 
3% 
30625 
691145 
Wheat Flour 
2% 
31955 
7424-72 
Oatmeal 
2% 
298-57 
601345 
Rice 
4M 
303-55 
12272-45 
Peas 
1M 
309-75 
337312 
Arrowroot 
Potatoes 
14 
No Nitrogen 
302-80 
35711-20 
New Milk 
7 (5% pts.) 
308-70 
4189-50 
Cream 
10 
29440 
225190 
Butter-milk 
7 
30170 
2709-70 
New Milk Cheese (Cheddar) 
1 
305-90 
3343 90 
Skim Cheese 
10 oz. 
301-87 
121712 
Lean Beef. 
1M 
311-85 
1362-90 
Fat Beef 
2 
31920 
4198 95 
Lean Mutton . 
1M 
296-10 
1464 75 
Fat Mutton 
2M 
300-82 
6351-97 
Veal 
1M 
31115 
3089 45 
Fat Pork 
214 oz. 
303 85 
4637-58 
Tripe 
22 oz. 
303-32 
3625 55 
Poultry 
25 oz. 
296-70 
226463 
White Fish 
29 oz. 
30953 
1273-12 
Eels 
2M 
294-52 
4086 52 
Salmon 
1M 
303-80 
16610 
Entire Egg 
2 
302-40 
2545 20 
White of Egg 
1M 
293-5 
885-73 
Yelk of Egg 
1M 
301-35 
5089-87 
Beer and Porter 
220 (22 gals.) 
3080 
603680 
Red Herrings 
16 oz. 
298-30 
1973T1 
Cocoa 
12 oz. 
297-5 
8359-75 
Bullock's Liver 
1M 
305-55 
1400-70 
Although a strong healthy man consumes 4,600 grains of carbon, 
and about 300 grs. of nitrogen, it has been found in times of famine, and 
in workhouse and prison diet, that an average woman can live on daily: 
grs. 3,900 carbon, grs. 180 nitrogen, equal to 2 lbs. bread. 
A man on: 
grs. 4,300 carbon, grs. 200 nitrogen, equal to 2X lbs. bread. 
This amount barely sustains life, and is only suitable for idleness. FOOD. 
663 
To yield 300 grains of nitrogen it would only be necessary to 
eat 1^ lb. (in round numbers) lean beef; but to yield enough car- 
bon it would be necessary to eat lbs. daily. Therefore, bread, 
potatoes, or other farinaceous or oily food, rich in carbon, must be eaten 
with beef. To get enough nitrogen from bread (baker's) 3£ lbs. would 
have to be eaten; of potatoes, 14 lbs.; and of turnips, 23 lbs. But 
the 3| lbs. bread would yield 6,912 grains of carbon, or one-third more 
than is required ; the 14 lbs. potatoes 10,Y66 grains, or nearly two-thirds 
more than necessary. 
From the above table we find that the food which is richest in nitro- 
gen is cheese made from skim milk, 10 oz. being sufficient to furnish 
300 grains, but that quantity only yields 1,217T2 or about a fourth of 
the carbon or heat-producing element. Cocoa is the next in order, 1 lb. 
2 oz. only being required, but this gives nearly double the carbonaceous 
matter necessary. The relative proportion is : 
1 part nitrogenous to 7 carbonaceous 
or 
1 part nitrogen to 22 available carbon. 
In order, then, to get a correct proportion of both elements, a 
mixture of two or more kinds of food is required. In the case of a few 
substances, as bread, oatmeal, or milk, one could live entirely on either 
of these, as the proportions of carbon and nitrogen are in nearly proper 
ratios. If one were to drink about three quarts of new milk daily, 
enough nourishment would be supplied to the body to keep it in work- 
ing order. But as by-and-by there might be difficulty in digesting such 
a large quantity of fluid taken daily, the body would come to be badly 
nourished. The same would take place in the solitary use of any one 
article, even bread; there would be first a disgust, then a waste. Com- 
bining oatmeal and milk, a most nourishing diet is obtained ; chemistry 
and experience alike prove this. Many of the Scotch plowmen live from 
week's end to week's end almost entirely on that, and maintain fine 
physiques. Ten prisoners in Bridewell, Glasgow, were put on the fol- 
lowing diet for two months, at the end of which all except one man 
gained in weight more than four pounds. 
Breakfast, 8 ounces of oatmeal made into porridge, and 1 pint of 
butter-milk. 
Dinner, 3 lbs. boiled potatoes, with salt. 
Supper, 5 ounces oatmeal made into porridge, with half a pint of 
butter-milk. 
The cost, including cooking, 2^d. per diem. This is worth knowing 
during hard times; though the cost would be considerably higher in this 
country. 664 
FOOD. 
On another occasion five young men and five women lived on a sim- 
ilar diet for several months, only for the pint of butter-milk at breakfast, 
one-third pint of skim milk was substituted. Each increased on the 
average four pounds. 
In that diet there were: 
Nitrogen Two hundred and sixty grains. 
Carbon Five thousand, five hundred and thirty grains. 
If the potatoes were baked, the prisoners lost in weight, and did not 
like them so well. 
A mixture of animal and vegetable diet is undoubtedly the best; 
there is a saving both pecuniarily and physically, and physiology, anat- 
omy, and experience prove it to be the best. 
Livingstone said, ' ' The Makololo, who live on vegetable diet, soon 
tire and die if on a long journey; but those who live on fiesh scorn the 
idea of ever being tired." 
Cases are on record where people have lived for years on much smaller 
quantities of food than that indicated as necessary. Thus Cornaro is 
said to have lived for fifty-eight years on 12 ounces of vegetable 
matter and 14 ounces light wine daily. And a miller of Billericay 
lived on sixteen ounces of flour daily, made into a pudding with water 
only. On the other hand, there are cases of extraordinary eaters. Cap- 
tain Parry tells of a young Esquimaux who consumed at one meal thirty- 
five pounds of various kinds of food, including tallow candles! Also a 
Hindoo who could eat a sheep at one meal. These are exceptional cases. 
The ultimate object of all food is the production of carbon to warm, 
and nitrogen to make flesh. The substance which does not contain 
nitrogen in some form, cannot add one particle of permanent strength to 
the system. Pure alcohol being almost wholly carbon, is not food. 
In the preparation of food for eating, much depends upon the way 
in which it is cooked. As all the nutritious juices of meat are soluble 
in cold water, it is necessary, when preparing boiled food, to place the 
meat in boiling water in the first place. This coagulates the albumen on 
the surface; and forms a crust or shell, which prevents the escape of the 
nutritious juices. If, however, the object is to make soup, the meat 
should be put into cold water, and gradually raised to the boiling-point. 
In roasting or broiling meat, the first application of heat should be vig- 
orous and rapid, in order to coagulate the albumen and form a crust, so 
as to retain the juices, as in boiling. (See Boiling.) In the process 
of roasting, the cellular tissue is converted into soluble gelatine, and the 
fat is melted out of its component cells. Baked meat-or meat cooked 
in unventilated ovens-is less digestible than that which is properly 
roasted before a fire, or in a ventilated oven, or boiled, as it contains FOOD. 
665 
more empyreumatic oil. Frying is the most unwholesome form of cook- 
ing, as it is mostly performed with the assistance of heated oil or fat, 
which is decomposed during the operation. Smoking, pickling and salt- 
ing meat, not only harden the animal textures, but, in the case of 
salting, the food is rendered less nutritious, as a large quantity of 
albumen, soluble phosphates, lactic acid, potash, creatine, and creatin- 
ine, are abstracted in the brine. Very few vegetables are roasted; 
they are, as a general rule, boiled. Those which contain saccharine 
matter, such as carrots, beetroot, parsnips, etc., are best cooked 
by steam, as boiling water dissolves out a large quantity of their nutri- 
tious ingredients. Vegetables, however, which contain much starch, as 
potatoes, should be boiled. By boiling, the granules of the starch are 
ruptured and partially dissolved, and any volatile oils which may be 
present are expelled. All kinds of flesh are not equal with regard to 
their nutritive value. Veal, for instance, is totally different from beef. 
It contains a smaller quantity of the alkalies, and there is fifteen per 
cent, more phosphoric acid than is necessary for the formation of salts; 
it contains, also, little of the fibrine of flesh, and proportionately more 
of the fibrine of blood, which is less digestible than the former. Veal 
is rich in gelatine, which is not nutritious, and seldom contains any 
quantity of fat; it also contains very little iron. In all these points it 
is the reverse of beef. Hard-boiled eggs have little or no nutritive power, 
and the same may be said of boiled fish, the soup of which is generally 
thrown away. In order to make up the necessary deficiency of nutritive 
matter in veal, eggs, and fish, vegetables should be taken with them. 
Celery contains eighteen per cent., salad twenty-four per cent., and 
cabbage sprouts, ten per cent., of their dry weight of salt, alkalies, 
and alkaline earths. Vegetable food in general contains a large pro- 
portion of iron. In the human body, iron is present in the blood, the 
bile, and other places. When the blood is deficient in iron, the phy- 
sician prescribes either iron, or chalybeate waters. The presence 
of this metal is therefore necessary in food. Prolonged abstinence 
from fruits and succulent vegetables brings on scurvy. The absence 
of the acids which they contain produces this effect; thus lime-juice 
is used by sailors with good effect on long voyages. Amongst the 
condiments used for flavoring food, are mustard, cayenne pepper, black 
pepper, and various spices. They owe their action to the presence of a 
volatile oil. The volatile oils of fennel, thyme, parsley, anise, caraway, 
horseradish, mustard, and water-cress, stimulate the system, but do not 
incorporate themselves. Condiments and sauces (which are usually 
fluid mixtures of condiments), in time, generally weaken the organs, 
which they at first stimulate. The only exceptions are salt and vinegar. 666 
FOOD 
Foods, for the convenience of dyspeptics, may be divided into four 
classes : First, foods easily digested ; second, the moderately digestible; 
third, the difficult to digest; fourth, the indigestible. 
Class I.-The Easily Digested, or Safe. 
The varieties of food placed under this head may be safely used by 
all dyspeptics, and in most forms of dyspepsia, keeping out of view a 
few exceptional individuals who have peculiar idiosyncracies which 
reverse all ordinary rules of dietetics. A ladder of diet under this 
class would begin with milk. Milk has already been considered, and is 
easy of digestion; equal parts of milk and lime or soda-water will prevent 
it from causing weight or uneasiness. It is more easily digested if drunk 
before the cream is allowed to rise, as previous to that the particles of 
oil are more minutely divided. Of course no acid food or drink should 
be taken for some time after milk. Milk takes about two hours to digest. 
It is important not only that a thing should be easily digested, but 
that it should possess nourishing properties after it is digested ; the 
most easily digested thing is not always the most nourishing. In milk 
we have a food, not only easily digested, but nourishing. Beef-tea, 
mutton broth, and, indeed, most liquid foods, are easily digested, for 
little digestion is required before they are absorbed by the veins, etc., 
of the stomach or duodenum. Where the mucous membrane of the 
stomach is inflamed, food like thick soup may disagree, for the liquid 
part gets absorbed, leaving the solid on a stomach, which does not 
afford gastric juice enough to digest it. This is frequently the case in 
fevers, therefore only the most fluid forms of food should be allowed in 
such cases. Milk and rice, or sago, or tapioca, require no longer time 
to digest than milk alone. 
Under the first class may be placed all farinaceous diet, as bread and 
milk, milk puddings, and milk itself. Eggs, tripe, white fish, especially 
whiting and sole, plaice and salmon-trout, as they are devoid of oil or 
fat. The lean of a mutton-chop and underdone roast beef may usually 
be tolerated by weak stomachs. Also raw oysters ; jellies, baked cus- 
tard ; chicken broth with some of the chicken grated down (as the 
chicken is of a close fibre.) The breast of turkey roasted, and boiled 
partridge are admissible. Also extract of meat, grapes, ripe oranges 
the pips being rejected. 
Soda biscuits (sometimes called soda crackers), toasted bread, aerated 
bread, and stale bread-not new or home-made bread-are suitable. 
Drinks.-Barley soup; toast and water; cocoa without starch, and 
plenty of milk; beef-tea; mutton broth, with the fat all skimmed off; 
and veal broth, may be taken; also lemonade, ginger-beer or soda-water. FOOD. 
667 
All the above are easily digested, though much will depend on the 
cooking, or preparing, for if badly cooked, or cooked twice, they may 
be made indigestible, and therefore would be placed under the second 
and third class of foods. 
If time in digestion were alone taken into account in classifying 
articles of diet for dyspeptics, many vegetable substances would be 
added, as salad, potatoes, hash meat and vegetables, apple dumplings, 
etc., for these are chymified in as short a time as boiled mutton; but 
vegetables are so apt to set up fermentation, that they must be placed in 
the third class. 
Class II.-Foods Moderately Digestible. 
These take from two to three hours to digest. Boiled.eggs-boiled 
enough just to coagulate the white. Mutton, roast and boiled; and 
mutton-chops. Beef, roast and underdone; and tender beef-steak. Beef 
is more difficult to digest than mutton, its fibres being more infiltrated 
with fat. Chicken; wild rabbit; sweetbread; pigeon; quail; prairie 
chicken. Oysters cooked, and oyster soup; turtle fins; cod and turbot. 
Mealy potatoes; raw cabbage with vinegar; cream and butter; sugar. 
Venison, which to some stomachs will be found rather stimulating. Turtle 
if young and plainly cooked. Milk and yelk of eggs, though these may 
lie heavily because of the fat they contain. Farinaceous preparations, as 
farina, Indian corn-bread, etc., should be placed in this second class. The 
fat of bacon is easily digested ; so is cod-liver oil. Other fats should be 
placed under the third class. Game is easier to digest than poultry or meat. 
Coffee and weak tea, with plenty of milk, should be placed in this class. 
Class III.-Foods Difficult to Digest. 
These take from three and a half to four and a quarter hours. They 
are mostly unsuited for dyspeptics, and if taken should be taken with 
caution, at once leaving them off if pain or other inconvenience be 
caused. This is a "dangerous" class, to say the least, and under it are 
included: liver and kidney; fried beef, or cold roast beef stewed; 
boiled salt beef; fowl boiled or roasted; roasted duck or wild duck; 
lamb and suckling pig; soup from beef, with vegetables and bread; 
hash meat and vegetable. Salmon, herrings, and sprats-these abound 
in oil and are stimulating, causing thirst and an uneasy feeling in 
the stomach. Pheasant and partridge (being rich and stimulating); 
duck and also goose, their flesh being permeated with fat. Ham 
and eggs-the fat of salt pork and bacon is less injurious than fresh 
animal fat-omelets; jams. These latter irritate, therefore they may 
be useful in constipation. 
Fancy bread, rolls, home-made bread, cakes, hot buttered toast, hot 668 
FOOD. 
biscuits, pastry, suet and yeast pudding and pancake, muffins and 
crumpets. 
Preserved meats, as sardines ; tongues ; salmon ; and mackerel. 
In this class may be placed vegetables, as boiled carrots, turnips, 
parsnips, beans and peas, new potatoes (on account of being so waxy.) 
Cucumbers, anchovies, celery, onions, garlic and leeks, etc. Some of 
these relatively may not be difficult to digest, but on account of the ten- 
dency spoken of to disagree in dyspeptics, they should be regarded as 
dangerous, and some of them even poisonous, to certain stomachs. 
The same may be said of fermented liquors-beer, ale, stout, and porter; 
also most wines, the light wines, as claret and burgundy, excepted. 
Strong tea, and perhaps coffee, should also be placed here; also pickles 
and condiments, unless aromatics are required, then they should be used 
with caution. Almonds, nuts, and all substances intimately incor- 
porated with oily matter, or things hard and difficult of penetration by 
gastric juice, unless they are previously powdered in a mortar; therefore, 
only a limited quantity of cheese can be digested, especially if roasted. 
Cheese is very nitrogenous, and, therefore, very nourishing when 
digested. Shrimps; shell-fish, as crabs, lobsters, and mussels; entrees 
and other dishes seasoned with spices, are all difficult to digest. 
Class IV.-Indigestible. 
The following are very difficult to digest, and should always be 
avoided by those who have weak digestive organs; and by those who 
are strong they should be sparingly used, unless they have ostrich-like 
stomachs: 
Veal and ham pie. 
Pork. 
Veal. 
Beefsteak pie. 
Sausages. 
Salt beef. 
Cheese. 
"Puff" pastry. 
Hashes and stews. 
Melted butter. 
Red herrings. 
Eels. 
Fried dishes. 
Roe and milt. 
Hard-boiled eggs. 
Radishes. 
Nuts. 
Dumplings. 
Husks of fruit. 
Rinds of fruit. 
Raw spirits. 
Unripe fruit. 
New bread. 
New potatoes. 
Shell-fish. 
Currants. 
All tough substances, vegetable and animal. 
The most of the above take from four hours to five and a half hours 
to digest. 
Dr. Beaumont, a surgeon in the United States army, made some 
interesting experiments upon a Canadian who had been shot in the left 
side. In the process of healing, an aperture was left, by means of 
which Dr. Beaumont was able to observe everything that took place in 
the stomach. As the result of his experiments and observations, we 
have the following table, showing the digestibility of food in order of FOOD. 
669 
time, the first column giving the articles of diet, the second the mode of 
preparation, and the third the mean time required for digestion, indi- 
cated in hours and minutes : 
Dr. Beaumont's Table 
ARTICLES OF DIET. 
Mean Time of Digestion. 
Preparation. 
H. 
M. 
Rice 
Boiled 
1 
0 
Pigs' feet, soused 
Boiled.. 
1 
0 
Tripe, soused 
Boiled .. 
1 
0 
Eggs, whipped 
Raw 
1 
30 
Trout, salmon, fresh 
Boiled .. , 
1 
30 
30 
cc cc ' cc 
Fried .... 
1 
Soup barley 
Roiled 
1 
30 
Apples, sweet, mellow 
Raw . .. 
1 
30 
35- 
45 
Venison steak 
Broiled 
1 
Brains, animal 
Sa^o . . 
Boiled 
1 
Boiled 
1 
45 
0 
5 ; i ' । । । । । i . । 
Tapioca 
Boiled . 
2 
Barley 
Boiled 
2 
0 
Milk* 
Boiled .... 
2 
0 
Liver, beef's, fresh 
Broiled 
2 
0 
Eggs, fresh 
Raw 
2 
o 
Codfish, cured, dry 
Boiled 
2 
o 
Apples, sour, mellow 
Raw 
2 
o 
Cabbage, with vinegar 
Raw 
2 
o 
Milk 
Raw 
2 
15 
Eggs, fresh 
Roasted 
2 
15 
Turkey, wild 
Roasted 
2 
18 
" domestic 
Boiled 
2 
25 
Gelatine 
Boiled 
2 
30 
Turkey domestic 
Roasted 
2 
30 
Goose, wild 
Roasted 
2 
30 
Pig, suckling 
Roasted 
2 
30 
Lamb fresh 
Broiled 
2 
30 
Hash meat and vegetables 
Warmed 
2 
30 
Beans pod 
Boiled 
2 
30 
Cake, sponge 
Baked 
2 
30 
Parsnips 
Boiled 
2 
30 
Potatoes, Irish 
Roasted 
2 
30 
cc ' a 
Baked 
2 
30 
Cabbage head 
Raw 
2 
30 
Spinal marrow, animal 
Boiled 
2 
40 
Chicken, full-grown 
Fricaseed 
2 
45 
Custard 
Baked 
2 
45 
Beef, with salt only 
Boiled 
2 
45 
Apples, sour, hard 
Raw 
2 
50 
Oysters, fresh 
Raw 
2 
55 
Eggs, fresh 
Soft Boiled 
3 
0 
Bass, striped, fresh 
Broiled 
3 
0 
Beef, fresh, lean, rare 
Roasted 
3 
0 
Beef-steak 
Broiled 
3 
0 
Pork, recently salted 
Raw 
3 
0 
Cl cc * cc 
Stewed 
3 
0 
Mutton, fresh 
Broiled 
3 
0 
CC 14 
Boiled 
3 
0 
Soup, bean 
Boiled 
3 
0 
Chicken soup 
Boiled 
3 
0 
Aponeurosis 
Boiled 
3 
0 670 
FOOD. 
De. Beaumont's Table. 
Mean Time of Digestion. 
ARTICLES OF DIET. 
- 
Preparation. 
H. M. 
Dumpling, apple 
Boiled 
3 0 
Cake, corn 
Baked 
3 0 
Oysters, fresh 
Roasted 
3 15 
Pork, recently salted 
Broiled 
3 15 
Pork steak 
Broiled 
3 15 
Mutton, fresh 
Roasted 
3 15 
Bread, corn 
Baked 
3 15 
Carrot, orange 
Boiled 
3 15 
Sausage, fresh 
Broiled 
3 20 
Flounder, fresh 
Fried 
3 30 
Catfish, fresh 
Fried 
3 30 
Oysters, fresh 
Stewed 
3 30 
Beef, fresh, lean, dry 
Roasted 
3 30 
Beef, with mustard, etc 
Boiled 
3 30 
Butter 
Melted 
3 30 
Cheese, old, strong 
Raw 
3 30 
Soup, mutton 
Boiled 
3 30 
Oyster soup 
Boiled 
3 30 
Bread, wheat, fresh 
Baked 
3 30 
Turnips, flat 
Boiled 
3 30 
Potatoes, Irish 
Boiled 
3 30 
Eggs, fresh 
Hard boiled ... 
3 30 
Eggs, fresh 
Fried 
3 30 
Green corn and beans 
Boiled- 
3 45 
Beets 
Boiled 
3 45 
Salmon, salted 
Boiled 
4 0 
Beef 
Fried 
4 0 
Veal, fresh 
Broiled 
4 0 
Fowls, domestic. 
Boiled 
4 0 
a cc 
Roasted 
4 0 
Ducks, " 
Roasted 
4 0 
Soup, beef, vegetables, and bread 
Boiled 
4 0 
Heart, animal 
Fried 
4 0 
Beef, old, hard, salted 
Boiled 
4 15 
Pork, recently salted T 
Fried 
4 15 
Soup, marrow-bone 
Boiled 
4 15 
Cartilage 
Boiled 
4 15 
Pork, recently salted 
Boiled 
4 30 
Veal, fresh 
Fried 
4 30 
Ducks, wild 
Roasted 
4 30 
Suet, mutton 
Boiled 
4 30 
Cabbage 
Boiled 
4 30 
Pork, fat and lean 
Roasted 
5 15 
Tendon 
Boiled 
5 30 
Suet, beef, fresh 
Boiled 
5 30 
Experience has mostly verified the results given in this table, but a 
few of the things require altering by the dyspeptic. Thus venison, 
though put down at 1 h. 35 m., will be found too rich and stimulating 
for weak stomachs, and will require to be placed on the second, or even 
the third class of foods. So pork, which in St. Martin's stomach only 
took three hours to digest, will prove quite indigestible to all dyspeptics; FOOD-FORCEPS. 
671 
though those who live in the country, with plenty of fresh air and 
exercise, will digest pork much better than dwellers in town. 
For further information on this subject the reader is referred to the 
various individual articles of food-animal food, vegetable food, fruits, 
etc.,-under their respective headings in this work. The subjects of 
food in sickness, in infancy and in old age are treated under the head- 
ings Cookery for the Sick, Sick-Room; Child, Children; Age, Old; 
etc. (See Diet, Digestion, Alimentary Canal, Aliment, Milk, Car- 
bon, Albumen, Starch, Breakfast, Luncheon, Dinner, Supper, Meals, 
Salt, Cold, Animal Heat, Sleep, Exercise, Physiology, Boiling, 
Broiling, Roasting, Health, Abstinence, Starvation, Adulteration of 
Food, Cereals, Flour, Flesh, etc.) 
FOOD, ADULTERATION OF. (See Adulteration of Food.) 
FOOT, foot [Ger. fuss, Lat. pes^ is that part of the lower extremity 
below the leg, with which we stand and walk. It is composed of three 
series or groups of bones-the tarsal, or hindermost; the metatarsal, 
which occupy the middle portion; and the phalanges, which go to form 
the toes. The tarsal bones are seven in number. Above, they are con- 
nected with the tibia and fibula bones of the leg, and below form the 
heel and the hinder part of the instep. They are bound together in 
various directions, by a number of ligaments, one of the principal of 
which is the plantar ligament, which is of great strength, and passes 
from under the surface of the heel-bone, near its extremity, forward to 
the ends of the metatarsal bones. The foot, naturally a beautiful struc- 
ture, is usually so much interfered with in civilized life, as to be deprived 
of much of its beauty, and even of its utility. Its movements are 
impeded by its being confined in tight-fitting boots ; while in place of the 
boots being conformed to the shape of the feet, the feet are made to 
conform to the shape of the boots. The consequences of which are corns, 
bunions, cold feet, and a number of other evils, from which so many 
suffer in the present day. 
FOOT-BATH. (See Baths and Bathing.) 
FORAMEN, fo-ra'-men [Lat. a hole], is a term applied to certain 
holes or openings of the human body, more particularly of the skele- 
ton; as the various foramina of the skull. The foramen ovale is a pas- 
sage or communication between the two auricles of the heart in the 
fcetus. 
FORCEPS, for'-seps [Lat.], is the name given to certain instruments 
of various shapes, according to the purposes they are intended to serve; 
but the principle of all is that of a pair of pincers, with two blades, 
either with or without handles. They are much used in surgery, 
especially for taking hold of substances that cannot be conveniently laid 672 
FORCEPS-FOREIGN BODIES IN THE EAR. 
hold of with the lingers. Certain kinds are used for tooth-drawing; 
others for securing the mouths of arteries, in order to their being tied; 
others are used for cutting; others in lithotomy, or for extracting foreign 
bodies from wounds; and others in midwifery, for aiding delivery in 
difficult cases. 
FORE-ARM, fore-arm, the lower arm, between the elbow and the 
hand. It contains two bones-the radius and the ulna. These are 
jointed at their upper extremity to the single bone of the arm; at their 
lower extremities to the small bones of the wrist. The bones in the fore- 
arm are very often broken, and of children, are often bent by accident, 
without fracture. (See Fractures, Arm.) 
FOREIGN BODIES IN AIR PASSAGES, for'-in [Lat. foris, 
for as, without, abroad]. Various are the bodies which may be put into 
the mouth, and accidentally find their way through the larynx into the 
windpipe, as fruit stones, morsels of food, false teeth, coins, buttons, 
etc. When any such body is thus introduced, it gives rise to paroxysms 
of cough and difficulty of breathing, and in some cases causes death, 
either by obstructing the respiratory process, or by setting up inflamma- 
tion of the lungs. This state of things can hardly be mistaken for 
croup, for we have the history of the sudden onset of the disease in a 
person previously in good health, and frequently an adult, and expira- 
tion is usually more difficult than inspiration. In croup the patient is an 
infant, and often a male child of two or three years of age, and inspira- 
tion is more difficult than expiration, being of a characteristic crowing 
character. 
Treatment.-If the offending substance be loose and round we must 
order the patient to bed, and he must take some form of narcotic medi- 
cine-paregoric or laudanum generally being the most convenient-(see 
Paregoric, Opium), so as to allay the spasm existing in the little muscles 
guarding the entrance to the larynx and windpipe; for in this is the 
main obstacle to the foreign body being removed by the violent cough- 
ing set up by its presence. Several cases are put on record in which 
foreign bodies were extricated from the windpipe by the patient placing 
his head downwards, and at the same time the spasmodic affection of 
the laryngeal muscles may be relieved by the previous inhalation of 
chloroform. Should these means prove unsuccessful, an artificial open- 
ing may be made by the surgeon into the windpipe; in fact, the opera- 
tion of tracheotomy may be performed ; and the inspired and expired air 
now passing through this newly-formed doorway, the muscular spasm 
relaxes, and the foreign body is removed by coughing. (See Foreign 
Bodies in the Gullet, Accidents.) 
FOREIGN BODIES IN THE EAR. (See Ear, Diseases of the.) FOREIGN BODIES IN THE EYE-FORMULAE. 
673 
FOREIGN BODIES IN THE EYE. (See Eye, Diseases of the.) 
FOREIGN BODIES IN THE GULLET. Foreign bodies lodged 
in the back part of the throat give rise to difficulty of breathing, suffo- 
cative cough, and a sense of choking; this condition may prove fatal in 
two ways, either suddenly by refusing admission of air to the lungs, or 
by producing ulceration by the long continued contact of the foreign 
body, accompanied by profuse expectoration of purulent matter, diffi- 
culty of breathing, hectic fever, and night sweats. 
Treatment.-The patient must be placed in a chair, and having 
thrown his head back, must be made to open his mouth widely, one or 
two fingers of the right hand should then be thrust as far down the 
throat as possible, and passed round, with a view of feeling, and getting 
hold of the offending substance; thus fins and fishbones often become 
entangled under the finger nail, and, if not, after we have found out the 
situation of the foreign body, we must endeavor to pull it up by means 
of a pair of long, curved forceps. If the body be small and sharp, as 
a fishbone, and has passed down the gullet beyond the reach of the 
finger, it may be pushed downwards by swallowing a crust of bread, or, 
if large, rounded, and soft, it may be thrust down by the probang, which 
consists of a piece of bone or sponge attached to a whalebone stem, and 
having the necessary curve to correspond with the direction of the gullet. 
Impending suffocation has, in such circumstances, been relieved by a 
person, full of presence of mind, rapidly removing from an umbrella 
one of the pieces of whalebone, and introducing it into the gullet. 
When, in using such an instrument, the foreign body is reached, it is to 
be pushed by it gently downwards. When the impacted body is of an 
indigestible or irritating nature-as, for example, a piece of money- 
instead of being pushed downwards, it is better, if the necessary 
instrument is at hand-a pair of long curved forceps-to effect its 
removal. 
Sometimes, smooth bodies, having a rounded form, may be dislodged 
from the gullet by the exhibition of a brisk emetic; pieces of food may 
be got rid of in this simple way. As a last resource, when the body 
remains fast, and cannot be removed upwards or downwards, and the 
patient's life is in danger, an operation, called by surgeons cesopha- 
gotomy, has been performed, but with unsatisfactory results ; it consists, 
essentially, of cutting an opening into the gullet, introducing a pair of 
slender forceps, and extracting the foreign body through this artificial 
aperture. Striking on the back will often relieve simple cases of chok- 
ing. (See Foreign Bodies in Air Passages, Accidents.) 
FOREIGN BODIES IN THE NOSE. (See Nose.) 
FORMULAE. (See Chemistry.) 674 
FOUL AIR-FRACTURES. 
FOUL AIR. (See Air, Malaria, Disinfectants, Ventilation, 
Houses. ) 
FOWL. (See Poultry.) 
FOWLER'S SOLUTION, fowl'-erz so-lu'-shun, is a solution of the 
arsenite of potash, introduced into practice by Dr. Fowler, as a substi- 
tute for the quack medicine called tasteless ague drop. It is the most 
commonly used of arsenical preparations; is alterative and antiperiodic, 
and, after quinine, is the best cure for ague. It is also of great use in 
all periodic disorders, and in diseases of the skin. It is to be given 
cautiously, in doses of 3 to 5 drops, gradually increased to 20, two or 
three times a day, always after eating. (See Arsenic.) 
FOXGLOVE. (See Digitalis Purpurea.) 
FRACTURES, frakt'-yurz [Lat. fractura: frango, fr actus, to 
break], of the bones are accidents which, from their nature, can only be 
treated with certain efficiency and success by the educated surgeon; but 
on the other hand, from their frequent occurrence, particularly in situa- 
tions where no surgical assistance can be readily procured, it is highly 
desirable that unprofessional persons should be able to manage them in 
something like an intelligent manner. 
The existence of fracture is, in some situations, made out with diffi- 
culty, even by the skilful; this is particularly the case in the vicinity of 
joints such as the ankle, hip, shoulder, etc., but in others, as in the middle 
of the long bones, such as those of the leg, thigh, fore-arm or arm, the 
fact is often too obvious to be overlooked by the most careless. The 
general symptoms of fracture having occurred, are pain and loss of 
power over the injured limb, which is altered in shape or crooked, 
probably swollen and shortened. Its lower extremity hangs loosely, 
and is more movable than it ought to be, motion being generally accom- 
panied with a sensation of grating, perceptible both to the sufferer and 
to the person handling the limb. The broken ends-generally the 
upper one-probably project against the skin, or, it may be, protrude 
entirely through it, constituting a compound fracture. Much of the dis- 
placement of the fractured ends of the bone is due to the contraction of 
some of the muscles of the limb, which are, from the nature of the 
injury, freed from the controlling counter-action of other muscles. This 
fact it is important to remember in the treatment, during which, when 
it can be done without sacrificing too many other essential points, the 
injured limb should be placed in a position which allows the muscles 
generally to be in a relaxed condition. In addition to these local signs, 
a person who has suffered severe fracture is generally faint and depressed 
for some time after. In many cases of fractured bones, however, the 
symptoms are far from being so plainly marked as described above. FRACTURES. 
675 
The fracture of a bone is, of course, in itself, a severe injury, but it 
is rendered infinitely more so, by the wounding and tearing of the soft 
parts of the limb by the, generally, ragged ends of the bone; this, 
therefore, it is desirable to prevent, as much as possible, both in remov- 
ing the sufferer and afterwards. 
It being ascertained that a fracture has occurred, if surgical assist- 
ance is not immediately at hand, the removal of the sufferer will proba- 
bly be requisite. If the upper extremity be the part involved, it should 
be well supported by a sling in the meanwhile, and the sufferer will find 
walking a much easier and less painful mode of locomotion than any 
other. Much injury and suffering are often inflicted upon persons who 
have fractured a lower extremity, by hasty and injudicious management 
in the removal; the lower end of the limb is left entirely unsupported, 
or at best, is carried by some of those around, causing thereby great 
pain, increasing the wounding of the soft parts within, or, it may be, 
occasioning the protrusion of the bone through the skin; and thus, 
especially if the last should occur, diminishing greatly the chances of a 
good recovery. A person who has fractured the leg, if he be not 
already lying on the ground, should be placed there till a shutter, a 
door, or flat board of some kind can be procured ; this should be placed 
alongside, covered of course with coats or the like, and the sufferer, 
gently, rather slid than lifted upon it; on this he is to be hand-carried, 
even if the distance is considerable, as much preferable either to cart or 
carriage conveyance. Before lifting, however, the fractured limb should 
be secured from motion as much as possible, either by tying it to the 
sound one by means of handkerchiefs, or by straw or other material 
placed about it. In most cases of fracture of the leg, relief will be given 
at once by bending the knee, and placing the leg, lying on its outer side, 
upon a pillow, or other soft material. In the meanwhile, a firm bed 
should be prepared for the patient; a mattress is most suitable if 
procurable, if not, a board of sufficient length, passed under the ordin- 
ary bed, will do; the object of this is to prevent the sinking which 
inevitably occurs from a person lying long in one place in bed, a circum- 
stance which interferes much, both with comfort and treatment. The 
object in view in the treatment of a fractured bone, is to preserve the 
broken ends in contact, as steadily and as exactly in their proper relative 
positions as possible, so that the curative and consolidatory process may 
proceed without disturbance, and that when this is complete the symme- 
try of the limb may be unaltered. In giving directions as to the man- 
agement of fractured bones by unprofessional persons, the author feels 
how difficult the task, of conveying the information, is to himself, and 
how still more difficult it must be to those unaccustomed to deal with 676 
FRAC TUBES. 
such matters, to treat them at all satisfactorily from a written descrip- 
tion; at the same time cases do occur, in which the choice lies only 
between perfect ignorance and some amount of information of the 
methods to be adopted. For such cases this article is written; for cer- 
tainly no sufferer from fracture, in his senses, would submit to, nor any 
unprofessional person undertake the treatment, if skilled assistance was 
in any way procurable. In addition, the author would strongly advise 
any who are likely, in their course through life, to be thrown much in 
out of the way circumstances, and who would wish to be useful, to see 
for themselves in some hospital the mode of putting up fractured bones. 
A few hours, even, of observation, would teach them more than 
all written descriptions, though these might afterwards refresh the 
memory. 
Either after or before the patient is placed in bed, the clothes 
must be removed, cut off, the injured limb; of course by the seams if 
possible. The proper applications must meanwhile be got ready as 
quickly as may be. These are, splints, such as are recommended in 
each particular form of accident, with their cushions and bandages. 
(See Bandages.) Some surgeons delay the application of the splints for 
some days, till the swelling, which always occurs more or less after frac- 
ture, has subsided, and some cases may occur in which this is desirable; 
but the majority of practitioners put the splints on as soon as possible 
after the accident, and this.is certainly the preferable practice. There 
almost always exists a tendency to spasmodic starting of a limb which 
has been fractured, for some time after the accident, and this constantly 
tends to displace the bones, and to increase the laceration and swelling 
of the soft parts; this may in a great measure be prevented by the early 
steadying of the whole limb by the splint, which, however, need not be 
bound tightly, and may be so applied as to be loosened at once if requis- 
ite. The elastic splint cushions entirely obviate this objection. These 
are made of vulcanized india-rubber, and are inflated with air, which can 
be increased or diminished as required. 
A splint is simply an agent which can be bound to a fractured limb, 
and which will keep it in the straight position; it may, therefore, be 
made of wood, iron, leather, or even straw. The variety of splints is 
very great, but as this article is written for use in situations where only 
the simplest means are supposed to be at hand, the simplest modes of 
management only will be adverted to. Moreover, fractures may be 
treated without splints, properly so-called, as by starch bandage or the 
like, or by position simply. As the continued contact of hard splints 
would occasion pain, they are usually cushioned or padded; this may be 
effected by any soft material, care being taken that the padding projects FRACTURES. 
677 
everywhere beyond the edges of the splint, to which it may, if conve- 
nient, be attached by tapes. 
Lastly, all things being arranged, the setting of the fracture remains 
to be effected. This, which is always painful, consists in bringing the 
broken ends into contact, as much as possible in their proper relative 
position. In some few cases, as in the leg, it may happen that although 
there is fracture, there is no displacement; but in the majority of 
instances the broken ends overlap one another, being drawn by the 
action of the muscles; the main requisite, therefore, in the reduction of a 
fracture, is by gentle but steady drawing down of the lower extremity of 
the limb-whilst the upper is fixed-to bring the ends to a level, and, if 
possible, place them one against the other; in the drawing down, how- 
ever, the hand should not grasp the extremity of the fractured bone but 
should be applied below the joint. Thus, in setting a fractured thigh, 
the surgeon grasps the leg, not the lower part of the thigh, etc. After 
a fracture has been once set, it should never, if possible, be disturbed 
again. This does not mean that the appliances are not to be removed, 
and the progress of the case inspected ; for if this be not done, and if by 
any chance the proper position should have been disturbed, the bones 
may become solidly fixed in an improper manner, and deformity result, 
or the skin may become ulcerated; but the appliances should not be 
removed, if possible, before the end of the first week, and if all seems 
going on well, not moved again for ten days at least, unless for some 
special purpose. If a fracture is often disturbed or pulled about during 
the process of consolidation, it may chance that this will only be effected 
imperfectly, and what is called a false joint formed, that is, the broken 
part, instead of being firm, moves like a joint, and the limb is useless. 
It had better be crooked or shortened. 
Much care is always required that a limb which has been frac- 
tured is not used too soon after the accident, otherwise it may either 
be snapped again, or it may be bent. The first advance towards the 
cure of a broken bone is the throwing out of a jelly-like matter around 
the ends; this gradually becomes more solid, and, at last, is converted 
into a thick ring of bone; but for this latter change the lapse of some 
months is requisite; although, therefore, the uniting material, or 
"callus," as it is called, may be strong enough for ordinary purposes, 
a considerable time before ossification has been effected, it will not bear 
extraordinary efforts. 
With respect to the general treatment of a person who has suffered 
from fracture, it is always advisable that for some little time after the 
accident the diet should be lowered, but that when the inflammatory 
stage is passed, the individual should return as much as possible to his 678 
FRACTURES. 
ordinary food. Care must be taken, if the person has been accustomed 
to much alcoholic stimulant, that it is not unduly abstracted, otherwise 
the powers of the constitution will be so reduced that the reparative 
process cannot take place, and the fracture will remain ununited. In 
fractures of the lower limbs, the use of a bed-pan and urinal of some 
kind will be required, and attention must be given to the back, that it 
does not get sore. See article Fever, for precautions as to this. 
Fracture of the skull.-Violence applied either directly to the head, 
or communicated to the skull through the spine, may be sufficient to 
fracture the bone with or without breaking the skin. The accident is 
sometimes sufficiently obvious even to the inexperienced, at other times, 
as in the case of a simple crack, it is not detectible even by the most 
skilful; but whether plainly apparent or only suspected, the existence 
of fracture amounts to the same thing, as far as the unprofessional are 
concerned, as concussion (see Concussion) ; the case ought to be seen as 
soon as possible by a surgeon. The symptoms will in many respects 
resemble those of and following concussion, and may be similarly 
treated; if there is external wound as well as fracture, simple water 
dressing should be used. (See Dressing.) When a portion of bone is 
driven down upon the brain by external violence, it occasions apoplectic 
insensibility by the pressure it produces; in such cases the aid of the 
surgeon is imperatively called for, to relieve by elevating the depressed 
bone. 
Fracture of the lower jaw is generally tolerably evident. The 
simplest treatment is that recommended by Professor Ferguson. Two 
narrow wedges of cork about an inch and a half long, a quarter of an inch 
thick at the base, and sloping away to a point, are placed between the 
teeth, one on each side; a piece of pasteboard softened in water, or of 
gutta percha, is then to be moulded round the jaw and fixed, either by a 
bandage or handkerchief going over the crown of the head. By this 
method, space is left between the front teeth for the administration of 
liquid nourishment. The sufferer should rinse the mouth frequently 
with tincture of myrrh and water. 
Fracture of the bones of the spine is a rare accident. It may be 
suspected when, after injury to the spine, loss of sensation in, or 
power over the part, ensues below the site of the accident. In such a 
case nothing could be done by unprofessional persons beyond placing 
the sufferer in as easy a position as possible. (See Spine, Diseases and 
Injuries of the. ) 
Fracture of the ribs is known by the pain which is felt at the injured 
part at every motion of the body, even by breathing. The sufferer 
feels a grating sensation, which may be felt by another person laying FJMCT&FF& 
679 
the hand on the place. The chief risk involved m fractured ribs is 
from injury to the lungs by the sharp ends of the bone, and when this 
occurs it is apt to give rise to inflammation, which will require the usual 
treatment of the affection, from whatever cause arising. (See Inflamma- 
tion.) On this account an individual who has suffered from fractured ribs 
should be especially careful, and for some little time after the accident 
should reduce his usual diet considerably. The application of the hot bran- 
bag for some days after the accident will afford much relief, and it may be 
used over the usual bandage. When ribs on both sides of the chest are 
injured, this, with leeches if requisite, should be the sole application; 
the patient being confined to bed for at least a fortnight or three weeks 
in the posture found to be the easiest, which will probably be a half- 
sitting one, supported by pillows or some other means. (See Bed.) 
When the ribs on one side only are injured, less confinement is required, 
but the chest should be encircled as firmly as can be borne comfortably, 
with a band of stout calico from eight to ten inches wide, and double ; 
this should go once and a half round, and be sewed; a month will 
probably be required for the cure. 
Fracture of the collar bone is a frequent accident, usually from falls 
on the shoulder. It is generally easily detected. As the use of the 
collar-bone is to keep the shoulder back, when broken, the shoulder of 
the injured side falls forward, pushing the broken ends over one another. 
The object of treatment, therefore, must be to keep back the shoulder by 
artificial means, until the bone has recovered its solidity. This might 
be done by keeping a person confined to bed, and in such a position that 
the weight of the shoulder falling backwards would pull the bone into 
position without any other means being used; few persons, however, 
will submit to the confinement necessary, and other methods are resorted 
to; they are varied, but the following will most easily, and with the best 
prospect of success, be adopted by the unprofessional. A wedge-shaped 
pad, of any firm material-a pair of stockings folded will do-is to be 
enveloped in the middle of a soft shawl or handkerchief of suitable size. 
The pad is then to be placed in the arm-pit of the injured side, the ends 
of the shawl must next be crossed over the opposite shoulder and 
tied in the arm-pit; folded cloth of some kind being interposed to 
prevent fraying of the skin. Another handkerchief or band of some 
kind, is next to be applied, so as to bind the arm down to the side in 
such a manner that the pad in the arm-pit acts as a fulcrum, or gives 
such a purchase as allows the outer end of the broken collar-bone to be 
pulled outwards, as the arm is bound to the side; a sling enveloping the 
whole fore-arm, is next to be applied, and completes the apparatus, which 
should be worn for a month at least. If carefully attended to this 680 
FRACTURES. 
apparatus will prove very effectual, and the means for it can always be pro- 
cured. It should be understood that the principle of the treatment is, 
extending the broken bone by means of the pad in the arm-pit. It is 
sometimes requisite to apply a bandage from the fingers upwards to pre- 
vent swelling. (See Bandages.) 
Fractures and other injuries about the shoulder-joint are often so 
obscure that no uneducated person could distinguish them. The best 
management until surgical assistance can be procured, if it is far distant, 
will be perfect rest; probably much comfort maybe derived from the use 
of the pad in the arm-pit as recommended for broken collar-bone, and also 
of a sling supporting the fore-arm, wholly or only at the wrist, as may 
be most easy to the patient. The confining band, must not, however, be 
used. 
In fracture of the shaft of the arm-bone it is better to put the whole 
limb in a sling at once, and if the person has to go to the surgeon, if not too 
far, he will find it easier to walk than to ride in any conveyance. Confine- 
ment to bed will be requisite for some days at least, after the accident. The 
injured limb being laid in an easy position on a pillow, if there is much 
swelling, it must be lightly bandaged from the fingers to the shoulder, 
and a couple of splints of wood or other firm material, two and a half 
inches wide, applied one on each side the limb and secured with just 
sufficient firmness to prevent movement by means of two or three looped 
bandages. Pasteboard makes an excellent splint, and is to be found in 
most houses, in one shape or another, such as a box or the boards of a 
large book, etc. It should be softened in hot water for a few minutes 
before it is applied, and when it is removed, it will have moulded itself 
accurately to the shape of the parts, and will retain that shape when 
quite firm and hard. It should be, padded with wool, cotton, or soft 
flannel. The bandage is made by taking a doubled length, sufficient 
for the purpose required, of the common roller bandage; one end, 
or tail of the bandage, is passed through the flannel looped extrem- 
ity, and may then be tied to the other tail. This form of bandage 
has the great advantage of being easily loosened if requisite, on 
account of swelling. After the first two days, when the swelling 
has subsided, the fracture of the arm may be put up more firmly 
and permanently. After bandaging the limb tolerably firm, a splint of 
pasteboard or of gutta percha, or leather, or indeed of any firm material, 
is to be put on each side of the limb. These ought, however, to be 
shaped to come a little way along the fore-arm, and having been pre- 
viously shaped on the sound arm, instead of the looped bandage, should 
be well fixed by means of the common roller, which may be kept 
from slipping by the addition of starch or paste as it is put on. FB AC TUBES. 
681 
Instead of the splints, however, the starch bandage alone, if the indi- 
vidual is not very muscular, may be used; but in this case, both the 
inner and outer bandage must be well saturated with strong starch, flour 
paste, or gum, or white of egg, and it is well to make the addition of 
strips of stout paper, pasted down over the inner bandage, and covered 
by the outer one, to give additional firmness. In this case, it will be 
requisite to keep the arm very quiet till the paste has dried, or a wooden 
splint may be tied outside the bandages till this has taken place. A 
sling will be requisite to support the hand and wrist, but not the elbow, 
which should be allowed to hang, the weight tending to keep the bone 
straight. 
Fracture of the fore-arm is a very common accident. In children 
the bones are most frequently partly broken and partly bent; in adults 
both bones or one only, may be broken; in the latter case, the sound 
bone acts as a splint to hold the other in place; and should the accident 
be detected, a perfectly straight splint of light wood applied to the inside 
of the arm, and extending from the elbow to the tips of the fingers, fixed 
by a common roller, or by some looped bandages, is all that is required; 
and. indeed, when both bones are broken, the same treatment will 
be sufficient, though some apply a splint on each side. After the 
lapse of a fortnight, in adults, the splints may be taken off, and starch 
bandage used; but in children who are liable to falls it is better to give 
them the protection of the wood for some time longer. In fracture of 
the fore-arm, the sling ought to give support from the elbow to the ends 
of the fingers, and the limb must of course be kept bent at the elbow 
during the period of cure. 
Fracture of the fingers is treated by a narrow, straight, wood splint, 
or by starch bandage. 
Treatment of a fracture of the lower extremities by an unprofessional 
person must be a most unfortunate contingency; but the simpler the 
means used, the more likely will its management be conducted with some 
«fficiency. 
In a case of fracture of the thigh, the removal and preparation of 
the sufferer having been effected as already pointed out, the following 
apparatus is such as an unprofessional person might, with a little care, 
manage efficiently; and the materials for its construction can scarcely 
ever fail to be procurable. Three pieces of wood, about three-eighths 
of an inch in thickness, will be required, and the measurement as to 
length should be made on the sound extremity. One of the pieces must 
be sufficiently broad to extend completely under the limb, and suffi- 
ciently long to extend from just above the middle of the thigh to below 
the calf of the leg, being edged off at either end. The next piece to be 682 
FT AC TUBES. 
fixed on the outer side of the under one, should extend from just above 
the hip to a little beyond the foot, and must be pierced with two holes 
at the upper end; the remaining piece should extend from about two- 
thirds up the thigh, to a little beyond the foot; being fixed to the inner 
side of the under piece, and connected with the outer piece at the lower 
end, a slanting support for the sole of the foot and about the same width, 
being fitted in, so that it will admit of the limb being extended to quite 
its full length; this being ascertained by measurement of the sound leg. 
The middle of the apparatus forms a kind of box. A soft handkerchief 
padded must now be placed between the thighs. At this stage the 
limb must be set. One person should hold the body of the sufferer 
firmly at the hips, whilst another grasping the leg just above the ankle 
by a gentle and steady pull, straightens the injured limb to the same 
length as the sound one; the broken ends of the bone being by this 
means brought into contact. The apparatus having been previously 
well padded with any soft material-even chaff or dried leaves will do- 
the broken limb, still kept on the stretch, should be gently placed in it. 
The foot must then be secured to the padded foot-board by means of a 
bandage or handkerchief, the heel being also well supported by the same 
or some similar application. The heel may be still further supported by 
means of a double tape sewed to the toe of a sock, previously put upon 
the foot; the tape being carried over the top of the foot-board, and tied 
to a nail or peg, fixed to the back. The ends of the band or handkerchief 
passed between the thighs are to be passed through the holes in the upper 
end of the piece of wood which extends along the outside of the thigh,, 
and tied with sufficient firmness to keep the limb on the stretch. This 
is the essential part of the treatment-the foot bound to the foot-board, 
and the band tied through the holes in the upper part of piece just 
described, act against one another, and keep the limb extended. The 
upper end must next be secured by a band passed round the body, and 
the fixing of the apparatus is complete. It will be well, however, to fill 
up all the interstices between it and the limb by means of soft material 
stuffed in, and when this is done, as a further means of security, to fix 
one or two bandages or handkerchiefs round both apparatus and limb. 
The above contrivance is a modification of the one most used by sur- 
geons for the treatment of fractured thigh, but requires much less ban- 
daging, and is, for this reason, preferable. In the usual form of long 
thigh splint, the entire efficiency of the arrangement depends upon the 
application of the bandage, and no unprofessional person is likely to put 
it on properly. The apparatus may be used for fractures of the upper 
part of the leg, as well as for the thigh. Another simple mode of treat- 
ing fractures of the lower part of the thigh, or upper part of the leg, is FRACTURES. 
683 
by means of two pieces of wood and a large cloth, such as a table-cloth, 
in each side of which one of the pieces is to be folded up, until there is 
just space left to contain the limb, which being set, and placed in the 
space so left, the boards are to be tied up to it on each side by means of 
handkerchiefs, or stout tapes. Again, the sound limb may be made to 
act as a splint to the broken one. Pads of some soft material should be 
placed between the most prominent points of each, such as the knees, 
ankles, great toes, etc.; and padded bands, two or three yards long, are 
to be wound round the legs as they are placed together, just above the 
ankle, and just below the knees. Or the broken thigh may be laid on 
a pillow, on its outer side, in the easiest position for the patient. 
Under the former of the two last-mentioned modes of treatment, a 
short splint, extending to the length of the thigh, of wood, tree bark, or 
any other firm material, may be applied on the outer side, and will give 
additional support; under the last-mentioned, such a short splint may be 
used on each side. 
In fractures of the leg, particularly of the lower portion of it, a dif- 
ferent apparatus must be used, although in many respects the mode of 
management as regards padding, etc., is the same. 
Should a person break a leg-that is, fracture the bone between the 
knee and the ankle-in any ordinary situation, the probability is that 
there would be immediate requisition for the attendance of a regular sur- 
geon, and that the accident would be treated by him in his own mode. 
But limbs may be broken far away from skilled assistance; and it is in 
such cases that the swing mode of treatment becomes the most valuable 
to the sufferer, and the most easy to the unprofessional attendant. The 
principle of the swing splint is a semi-circular receptacle for the limb, 
proportioned of course to its size, which can be swung by means of 
bands of any sort to a cradle or framework made of a board, to which 
are fixed iron rods, across which runs the piece of iron or wood, this 
forming a support from which the splint, containing the leg, is hung. 
Of course, this framework may be made of any material that may be at 
hand, such as green wood, or any other of which an ordinarily sugges- 
tive mind may avail itself. Likewise the splint for the limb, may be 
formed of rough slats of wood tacked together, or of a piece of bark, or, 
indeed, of any sufficiently firm material that can be formed into the 
splint, and be strong enough to bear a support for the foot. This recep- 
tacle for the limb could be cushioned with dried leaves, moss, grass, or 
any soft material, and slung in its cradle with pieces of cord, if nothing 
better presented itself. The apparatus being ready, the fractured limb 
should first be arranged as straightly and comfortably as possible in its 
splint, and should then be slung in the cradle in the mode and position 684 
FRACTURES. 
most comfortable to the patient. It is scarcely requisite to point out, 
even to the unprofessional person, how great must be the comfort and 
ease to a sufferer from fractured leg to have the injured limb placed in 
apparatus which yields to every movement like a well-springed carriage, 
even should the limb not be set in quite the best surgical mode. It does, 
happen that sufferers from such accidents have to be taken long dis- 
tances before they can reach professional aid. In such cases the swing 
splint, constructed by some intelligent person, upon the principles above 
enunciated, will be found of much value. 
In short, the principles of the above apparatus are: A semi-circu- 
lar receptacle for the limb, padded with some soft material; a support 
for the foot, also padded; a cradle as above described, and swing sup- 
ports-cords or such like-by which the splint is swung from the cross- 
bar of the cradle; a cavity, formed or cut out of the splint where the heel 
rests. 
In setting the limb the thigh must be grasped by one person, and 
the foot by the other. The easiest position for the limb will be with the 
knee bent. 
Reference to the foregoing portions of this article, especially that on 
fractured thigh, will sufficiently explain the general management of 
these cases. 
To recapitulate.-1The first removal of a patient who has suffered a 
fracture should always be conducted with the care enjoined in the first 
part of this article. The bed for a patient suffering from fracture must 
always be a firm one. The adjustment and putting up of a fracture 
should be effected as quickly after the accident as may be, allowance 
being made for swelling, and if this becomes extreme, loosening of the 
apparatus resorted to. In setting, the bones above and below the injured 
one, not the injured one itself, are to be grasped; parts, such as the heel, 
etc., are to be relieved as much as possible from the effects of the con- 
tinued pressure which they must necessarily undergo during the treat- 
ment. It must always be borne in mind, that whatever appliances are 
used in the treatment of fractures, they are all but different means to 
the one end-that of keeping the broken extremities of the bone in con- 
tinued steady contact with as much ease to the patient as possible; that 
when this has been done for three or four weeks, lighter applications 
than those used at first maybe employed, such as the starch bandage, etc. 
In conclusion, the foregoing article will be of small benefit to those 
dwelling in the midst of civilization; but its hints-and our space admits 
of but little more-may prove invaluable to those dwelling, or who may 
be destined to dwell, in a thinly-peopled country, or in such situations 
as on board ship, in which fractures are far from being uncommon FRA CT URES-FRECKLES. 
685 
accidents. Even if proper assistance be ultimately procurable, the intelli- 
gent management of a case for the first few days may be of the highest 
importance; and if it should happen, that throughout, it has been left 
to unprofessional management alone, even should a limb somewhat 
deficient in symmetry be the result, its cure is not likely to be more tardy 
or less painful, because those around are not in total ignorance of how it 
ought to be conducted. 
Compound fractures are those in which there is a wound through the 
skin, permitting access of the external air to the seat of the fracture. 
The contingency is a truly serious one to be without the assistance of a 
surgeon. Sometimes the bone protrudes considerably through the skin, 
and its end requires to be sawn off before it can be returned to its 
proper position. The great object is to heal the external wound as 
quickly as possible, and probably as good a plaster as any will be a 
piece of linen soaked in the blood, and when this is separated by the dis- 
charge, the simple water dressing. (See Accidents, Dislocations, Ban- 
dages, Dressing, etc.) 
FRAMBCEZIA, OR YAWS, fram-be-zhe-a [Fr., from framboise, a 
raspberry], a disease of the skin, indigenous to Africa, the West Indies, and 
some parts of America. It consists of imperfectly suppurating tumors, 
which gradually increase in size until they become as large as, and some- 
what resemble, a raspberry. The period during which the disease is in 
progress varies from a few weeks to several months. When it has 
reached its height, it usually continues for some time without undergoing 
much change, and then passes away. It seldom proves dangerous, and 
only affects the same person once. 
FRAXINUS, fraks'-e-nus [from Lat. frango, I break, in allusion to 
its brittleness], the European flowering ash, a genus of the Nat. order 
Oleaceoe, consisting of about fifty species, mostly natives of Europe and 
North America. The sweet concrete exudation known as manna is pro- 
cured by making incisions in the stems of certain species of Frawinus, 
chiefly F. Ornus and rotundifolia, natives of Calabria, Apulia, and 
Sicily. Manna is a mild, agreeable laxative, very suitable for children, 
to w'hom it may be given in doses of 60 to 120 grains. It is, however, 
apt to produce flatulence. It owes its properties to a peculiar resin 
called mannite. 
FRECKLES, frek'-klz [Ger. fleck, a spot], are small yellow or 
brownish spots which appear on the face, and sometimes on the neck, 
hands, or other parts of the body, especially of fair persons, or persons 
much exposed to the weather. Various applications have been proposed 
for their removal, and a liniment composed of lime-water and oil, with 
the addition of a little ammonia, is one of the best. Water, weakly 686 
FRECKLES-FR FITS. 
acidified with lemon-juice, is sometimes useful as a wash. (See Epiielis, 
Almond Paste.) 
FREEZING, TO AVOID. (See Cold, Animal Heat.) 
FRICTION, frik'-shun [Lat. frico^ to rub], or rubbing a portion of 
the body, either with the hand or with some interposed material, is of 
much importance as a curative agent. Applied to the skin by means of 
rough towels, hair gloves, etc., it excites its nervous sensibility, and the 
circulation of blood through its capillary vessels. Friction with the 
hand in thickenings and congestion of parts beneath the skin is often of 
much service, and in none is its beneficial effect more obvious, than 
where the breasts are painfully distended with milk after childbirth. 
The various oils, etc., used along with friction, are generally secondary 
in their effects to the mechanical effect, and are chiefly serviceable in 
facilitating the movement of the hand; some however, are really bene- 
ficial ; the stimulant applications by exciting, and the anodyne by sooth- 
ing ; moreover, some, such as cod-liver oil, turpentine, etc., appear to 
exert a specific effect. (See Liniment, etc.) 
FRICTIONAL ELECTRICITY. (See Electeicity.) 
FRIEDRICHS HALL BITTER WATER. (See Mineeal Watees.) 
FRIGHT. (See Feae.) 
FRINGE-TREE. (See Ciiionanthus Vieginica.) 
FROST. (See Cold.) 
FROST-BITES, frost'-bites. These are quite common in the north- 
ern parts of this continent. The parts most likely to be attacked are the 
feet, hands, nose, ears and cheeks. The attack is often so singularly 
free from pain, that the victim is not aware of it until his attention is 
called to it. Owing to the stoppage of the circulation by the cold, the 
part, unless relieved by proper treatment, soon dies. The treatment 
consists in keeping the person away from the strong heat and applying 
cold in the shape of snow or cold water, rubbing the part vigorously 
until reaction takes place. After this has set in apply sweet-oil, coal-oil, 
lard, or lime-water and oil. If sores follow they must be dressed in the 
same way as burns. For slight frost-bites, putting the part in strong 
salt and water for half an hour will be found very beneficial. (See 
Buens oe Scalds, Cold, Deessing, Peteoleum, Vaseline, etc.) 
FROSTWORT. (See Helianthemum Canadense.) 
FROZEN FEET, HANDS, FACE, ETC. (See Feost-Bites, Cold, 
Peteoleum, Vaseline.) 
FRUITS, froots [Lat. fruor, fructus, to enjoy]. The custom of 
serving fruits as the first dish at the breakfast table is a healthy one. 
Fruits should also be eaten freely at luncheon. The reader is referred 
to the individual articles on the various fruits. Apples must be classed FRUITS-FUNCTIONAL DISEASES OF THE HEART. 
687 
among the most wholesome fruits; their prevailing acid is the malic. 
When perfectly ripe they are wholesome for most persons, but, like 
fruits generally, should be eaten in the forenoon, and not after a mixed 
meal of meat and other things. When cooked they are aperient. (See 
Pyrus Malus, or The Apple Tree; Cider, Food, Diet, Luncheon, 
Stone-Fruit, etc.) 
FRYING, fri'-ing, is a mode of cookery very unsuitable for persons 
of weak digestion. 
FUCUS VESICULOSUS, fu'-kus ve-sik-u-lo'-sus, sea-wrack, also 
called bladder fucus. This sea-weed is perennial, with leaf flat, smooth 
and glossy, from one to four feet long, from half an inch to an inch and 
a half broad, furnished with a midrib throughout its length. The plant 
grows upon the shores of Europe and of this continent, attaching itself 
to the rock by its expanded woody root. 
M. Duchesne having given a trial to this fucus in inveterate psoriasis, 
in which it had considerable reputation as a remedy, found it of little 
value; but he observed an unexpected effect, that of diminishing fat 
without in other respects injuring the health ; and was thus induced to 
try it as a remedy for morbid obesity. His anticipations of its efficacy 
in this affection were not disappointed. He employs the whole plant, 
either in substance or in the form of pill, in decoction, or in extract. It 
is not till two or three weeks after beginning with the remedy that its 
effects in diminishing the obesity begin to be perceived, and one of the 
flrst signs of its favorable action in this respect is the increase of the 
urine, and the appearance of a black pellicle on its surface. Dr. God- 
frey tried the experiment on himself with satisfactory results, confirming 
the statements of M. Duchesne. Dose: of fluid extract, j to 1 tea- 
spoonful ; of solid extract, 8 to 15 grains; of pills, 3 grains each, 3 to 
5 pills. 
The above doses may be taken three times a day in the beginning of 
the treatment, and increased gradually to half a fluid ounce of the fluid 
extract-a quantity which will be borne in most cases without any 
derangement of the stomach. To obtain any marked results from this 
remedy, it must be used patiently for a term of weeks. (See Corpu- 
lence. ) 
FULL THROAT. (See Goitre.) 
FULNESS. (See Plethora.) 
FUMIGATION. (See Contagion, Disinfectants.) 
FUMITORY. (See Corydalis Formosa.) 
FUNCTIONAL DISEASE. (See Disease.) 
FUNCTIONAL DISEASES OF THE HEART. (See Heart, 
Diseases of the.) 688 
FUNGUS-FUSEL OIL, OR FOUSEL OIL. 
FUNGUS, fun'-gus [Lat.], is a term applied to any luxuriant forma- 
tion of flesh on an ulcer, commonly known as proud flesh. It is also 
applied to a disease of the structure of a part which enlarges, is soft and 
excrescential. Fungus Hcematodes^ or soft cancer, is a peculiar morbid 
growth, having a remarkable resemblance to the medullary substance of 
the brain, and hence sometimes called medullary sarcoma. In some 
instances its color is quite white, in others light red, and occasionally it 
has been found of a dark red color; it is extremely vascular in structure* 
and the coats of its vessels are remarkably delicate, whence result fre- 
quent hemorrhages. Extirpation is the only mode of treatment known 
to have any effect in this disease, and, as in ordinary cancer, this fre- 
quently affords only temporary relief. (See Cancer, Proud Flesh.) 
FUNIS, fu'-nis [Lat]. The navel cord. 
FUR, fur [Low Lat. furra], as an article of dress, may be either 
extremely beneficial or the reverse, according to the manner in which it 
is used. When worn over other clothing in the open air, or as a regular 
fixed article of clothing in itself, the bad conducting power of fur ren- 
ders it one of the most efficient protectors against cold, or rather pre- 
servers of heat, we possess ; but when it is used as an occasional article 
of dress, it is a dangerous one, and has proved so in the various forms 
in which it has been worn by females. When kept close to the skin- 
as of the neck or throat-for any length of time, it produces excited 
action and perspiration, which is liable to be suddenly checked the 
moment it is thrown back, and cold and sore throat are the consequences ; 
very many cases of this kind occur, and the cause unsuspected, is repeated 
again and again with the same effect, laying the foundation perhaps of 
serious disease by the improper use of the very means employed to 
guard against it. Many females liable to cold and sore throat have been 
surprised how that liability has vanished with the laying aside of the use 
of fur round the throat. The change must, however, be made at first 
with caution. It is not, however, the fur which is at fault, but the 
uncertain mode of using it; moreover, its power of exciting the skin 
renders it a valuable agent when worn permanently next it, particularly 
upon the chest in winter, by persons with delicate lungs. It not only 
protects from cold, but keeps up mild counter-irritation. A prepared 
hare or rabbit skin, lined, makes as good a fur chest protector as any 
other. 
FURUNCLE, fu'-rung-kl [Lat. furunculus\ a boil. (See Boil.) 
FUSEL OIL, OR FOUSEL OIL. (See Amyl.) GALBANUM-GALLIC ACID. 
689 
G. 
GALBANUM, gal'-ba-num [Lat.], a fetid gum resin used in medi- 
cine, internally as an antispasmodic, and externally as a stimulant and 
discutient application to indolent tumors and chronic swellings. It is 
imported from India and the Levant, having probably been brought 
down the Persian Gulf, and is usually met with in irregular tears about 
the size of a pea, agglutinated into masses. Its properties are similar to 
those of assafoetida, but it is less powerful. Botanists have as yet been 
unable to determine the plant yielding this resin. The compound pill 
of galbanum, now commonly called the compound pill of assafoetida, is 
made by heating together and stirring till of proper consistence, 2 ounces 
each of assafoetida, galbanum, and myrrh, with 1 ounce of treacle. Dose, 
5 to 10 grains. Galbanum plaster is composed of 1 ounce each of gal- 
banum, ammoniacum, and yellow wax, and 8 ounces of lead plaster. 
GALIUM APARINE, ga'-le-um a'pa-rine, or cleavers, a perennial 
plant, belonging to the Nat. order Rubiacea. It grows in moist places, 
both in Europe and the United States, and is known by the common names 
of goose-grass, gravel-grass, catchweed, and poor robin. It is a valu- 
able refrigerant and diuretic and is beneficial in suppression of urine, 
inflammation of the kidneys and bladder, and in the scalding of urine in 
gonorrhoea. Dose : of the fluid extract, 1 to 2 teaspoonfuls; of the infu- 
sion, 1 to 4 fluid ounces, 3 or 4 times a day. (See Infusion.) 
GALL, gawl [Ang.-Sax. gealla\, the bile. (See Bile.) 
GALL BLADDER, gawl' blad'-dur [Sax. gealla, gall; Lat. vesi- 
cula fellis], in Anatomy, is an oblong membranous receptacle, situ- 
ated on the concave side of the liver, under the right lobe. It is about 
the size of a small hen's egg, and resembles a pear in shape. It serves 
as a reservoir for the bile, which, when digestion is not going on, regur- 
gitates through the cystic duct, and is retained for future use. The cys- 
tic duct connects the gall-bladder with the hepatic duct, which proceeds 
from the liver, and the two, when united, form the ductus communis 
choledochus, by which the bile is conveyed to the duodenum. 
GALLIC ACID, gal'-lik [from galls\. This important vegetable 
acid exists ready formed in the gall-nut, in sumach, and in a large num- 
ber of other astringent vegetables. It is employed medicinally as an 
astringent, being given internally in doses of 2 to 10 grains. It is 
used externally in the form of glycerine of gallic acid, composed of 1 690 
GALLIC ACID-GALL-STONES. 
ounce of gallic acid to 4 fluid ounces of glycerine. It has been found 
very useful in bleeding from the lungs, in excessive menstruation, in 
water-brash, and in bleeding from the nose. In the latter case a piece 
of cotton steeped in a strong solution of gallic acid, is inserted in the 
nostril. 
GALLOPING CONSUMPTION. (See Consumption.) 
GALL, OX. (See Fel Bovinum Pukificatum.) 
GALLS, OB GALL-NUTS, gawlz, are excrescences produced upon 
the twigs of a species of shrubby oak, by the prick of an insect, for the 
purpose of depositing its eggs. They are brought from the shores of 
the Levant, and from Asia. Galls are powerfully astringent, owing to 
the tannin, or astringent principle they contain, which, in its separated 
form is now largely used in medical practice. Gall ointment is a useful 
application in piles in persons of relaxed or enfeebled constitution, but 
is quite the reverse in those of full habit, in whom the piles are in a 
state of active inflammation. The best form of ointment is: galls, in 
very fine powder, 2 drams; opium, in powder, 1 dram; lard, 1 ounce; 
well rubbed up together. Infusion of galls is the best antidote to poison- 
ing by tartrate of antimony. 
GALL-STONES, ga/wl'-stonz, are concretions formed from the peculiar 
crystalline ingredient of the bile-the cholesterine. The concretions are 
of every variety in point of size, up to that of a walnut; when small, 
the number, either passed by the patient, or found in the gall-bladder 
after death, is often very great. These concretions may, and often do, 
exist in the gall-bladder, without giving rise to any unpleasant symptoms; 
their presence only being discovered on examination after death; but 
should one of them from any cause, pass into the duct, it gives rise to 
most violent spasmodic pain, which continues with little intermission 
until the stone has descended into the bowel through the ducts. 
The ordinary calibre of the gall-duct is about that of a goose-quill, 
and the stone is generally of much larger size; the operation therefore 
is often a protracted one. 
Symptoms.-Symptoms of gall-stone often supervene suddenly; the 
person is seized with the most agonizing pain in the region of the gall- 
bladder ; probably, there is severe shivering and vomiting, and these do not 
disappear till the stone has passed; there may or may not be jaundice, 
probably not, as long as the obstruction does not pass into the common 
duct and so stop the flow of bile from the liver. If j'aundice comes on, 
the evacuations from the bowels become white and chalky in appearance. 
The fact of there being no fever present and that the pain caused by a 
passing gall-stone is relieved instead of aggravated, by pressure, is suffi- 
ciently indicative of the absence of inflammation. After the occurrence GALL-STONES- GANE. 
691 
of the above symptoms, it is always proper to examine the evacuations 
from the bowels, to verify the disease by finding the cause. Gall-stones 
are easily detected in the evacuations, as they float upon water. 
Treatment.-When an individual is suddenly seized with symptoms of 
gall-stone, no time should be lost before applying hot applications over the 
seat of the pain, or getting the sufferer into a warm bath. Opium ought to 
be given at once; the first preparation at hand-probably laudanum or 
paregoric-in full and repeated doses. If laudanum is used, 30 drops may 
be given immediately, and the dose repeated by 20 drops at a time every 
half hour, or oftener, till the unbearable pain is subdued. As the retching 
is often severe, and liquids of every kind are vomited as soon as taken, 
pills of solid opium-1 grain each-are more likely to be retained, 
and are therefore preferable; they may not, however, be at hand in an 
unexpected attack. Persons who are liable to repeated attacks of gall- 
stone should keep these pills beside them. If the stomach will not 
retain the remedies, the opium must be administered by injection; a pint 
or more of gruel, with 40 drops of laudanum, repeated if requisite. 
Mustard plasters over the seat of the pain may be useful, but are much 
inferior as an application to the hot bran poultice, on the surface of which 
laudanum may be sprinkled. (See Bran.) 
The suddenness of the attack of gall-stone, and the agony of the 
pain, render it one of the diseases in which unprofessional persons may 
afford most valuable assistance by judicious management^ and by follow- 
ing the above directions they will certainly give relief, perhaps from 
many hours of suffering, if medical assistance is distant. A person who 
has once suffered from gall-stone ought, of course, to be examined med- 
ically. (See Bile, Opium, Paregoric.) 
GALVANISM, gal'-van-ism, the electricity of chemical action; voL 
taic electricity. (See Electricity.) 
GAMBOGIA, gam-bo'-je-q, camboge or gamboge, a gum-resin pre- 
pared from a Siam tree, whose proper botanical classification is still 
unsettled. It is a hydragogue cathartic and anthelmintic. Its tendency 
to cause vomiting and griping may be obviated by combining it with 
other purgatives, as in the compound cathartic pill of the pharmacopoeia, 
or by giving it in the liquid form largely diluted. It is used in dropsi- 
cal affections, obstinate constipation, affections of the brain, and occa- 
sionally as a remedy for tape-worm. It should not be given during 
pregnancy, nor while there is any inflammatory condition of any of the 
abdominal organs, nor is it a proper cathartic for infancy and childhood. 
Dose of the powder, 1 to 5 grains ; of the compound gamboge pill, 5 to 
15 grains. 
GAME, game [Ang.-Sax. gamen\, wild animals used as food, the 692 
GAME- GANGRENE. 
flesh of which is for the most part easily digestible and suited to many 
persons on account of the less proportion of fatty or oily substances 
which it contains. Of course, game, like other articles of food, may be 
rendered hurtful, by sauces and modes of dressing. (See Food.) 
GANGLION, gang' -gle-on [Gr.], is a small rounded or elongated 
nervous mass, of a reddish-gray color, situated in the course of the 
nerves. They are of two kinds, one forming part of the cranial system 
of nerves, and situated near the origins of many of the cranial and all of 
the vertebral nerves; the other forming part of the sympathetic system, 
extending in a series along each side of the vertebral column, and occur- 
ring numerously in other parts. They differ widely from each other in 
figure and size, some of them being large and conspicuous, while others 
may be almost termed microscopic. 
Ganglion, in Surgery, is a small indolent fluctuating tumor, developed 
in the course of the tendons, and containing a semi-fluid secretion enclosed 
in a cyst. They sometimes form without any apparent cause, but gener- 
ally they arise from some wrench or tension of the tendon. They are most 
frequently situated about the wrist, and the swelling is usually globular; 
but when much enlarged, it is rendered irregular by the pressure of the 
tendons. The treatment consists in rupturing the cyst and allowing the 
contained fluid to be extravasated into the cellular tissue, where it is 
speedily absorbed, whilst the cyst inflames and becomes obliterated. A 
common mode X)f rupturing them is either by firm compression with the 
thumb, or by striking the swelling sharply with some obtuse body, as 
the back of a book, the part being subsequently bandaged, and rest 
enjoined for a few days. 
GANGLIONIC SYSTEM. (See Nervous System, Ganglion.) 
GANGRENE, gang'-green [Gr., from grao, I feed upon], is a term 
applied to the first stage of mortification, so called from its eating away 
the flesh. It is divided into two kinds, the moist and the dry; the for- 
mer, called also inflammatory or acute gangrene, is that which is pre- 
ceded by inflammation; while the latter, called also chronic or idiopathic 
gangrene, is that which takes place without any visible inflammatory 
action having preceded it. 
Causes.-The most frequent causes of grangrene are violent inflam- 
mation, erysipelas, contusions, burns, cold, deficient circulation of the 
blood, or impaired nervous energy. 
Symptoms.-When it results from high and active inflammation, 
there is at first severe pain in the part attacked, and generally a consid- 
erable degree of swelling. After a time, however, the part from being 
painful, loses all sensibility and becomes cold, the redness disappearing, 
and being replaced by an irregular dark color of the skin, in some parts GANGRENE. 
693 
approaching to black, while in others it is of a dark brown or greenish 
hue. If there is a running sore, the discharge from it will cease; the 
cuticle is raised by vesications, from which, on breaking, there issues a 
bloody serum. The constitution sympathizes with these local changes; 
the inflammatory fever of the earlier period disappears, and is succeeded 
by great languor and debility; the pulse is weak, quick, irregular, and 
sometimes intermittent; the stomach is deranged, delirium frequently 
occurs, and hiccough is one of the most characteristic signs of the dis- 
ease in its more advanced stage; the countenance also indicates the 
existence of great local and constitutional derangement, the features are 
collapsed and the eyes sunk. When the gangrene is not the result of high 
and active inflammation, the inflammatory or febrile symptoms are slight 
or altogether wanting; but there is the same discoloration of the skin, 
vesication, discharge of bloody serum, and morbific appearance. 
Treatment.-In the treatment of this disease, during the active 
inflammatory stage, local bleeding with leeches, and also bleeding from 
the arm, if the strength of the patient warrant it; but care has to be 
taken to reduce the general tone of the system as little as possible. 
Soothing fomentations and warm poultices should be applied to the part, 
and as internal remedies, quinine, wine, and opium (which see) will be 
found most beneficial. 
When the gangrene cannot be stopped in its first stages, then the 
separation of the mortified parts is to be expedited, which is best done by 
yeast or port-wine poultices, supporting the constitution at the same time. 
(See Poultice.) When this cannot be done, the removal of the limb, if 
practicable and not contra-indicated by a too weakened state of the body, 
is the only chance of saving the patient's life. Gangrene resulting from 
severe cold, is remarkable for the little pain generally preceding, the 
part having frequently perished without the patient being aware of the 
circumstance. A part suffering from a severe degree of cold should first 
be rubbed with snow or a coarse towel, in order to restore the suspended 
circulation, avoiding at first any artificial heat, which might be the 
means of inducing inflammation. Gangrene may also arise from a dis- 
eased state of the blood-vessels, attended with debility of the constitu- 
tion, a form of the disease commonly known as gangrena senilis. It 
rarely occurs except in advanced life, and usually attacks the lower 
extremities, proceeding from the toes upwards. Its progress is some- 
times slow and sometimes rapid; in some cases it is attended with little 
or no pain, in others it is very painful. As the parts mortify, they 
become dry and hard. The constitution should be strengthened by the 
free use of quinine, opium, and port wine, and the part should be covered 
with lint moistened with camphorated spirits of wine, and the limb 694 
GANGRENE- GAR GLES. 
wrapped in cotton. Hospital gangrene, or phagedena gangrenosa, is a 
form of this disease which attacks open wounds or ulcers, and is so called 
from its appearing most frequently in crowded hospitals, and causing a 
fearful mortality among the patients. Its symptoms and treatment are 
similar to those already mentioned. (See Mortification.) 
GAOL FEVER, gale, a form of typhus. (See Typhus Fever.) 
GAPING, OR YAWNING, gape-ing, is a nervous affection, indi- 
cative of nervous exhaustion and depression of the circulation. Persons 
in health are, as is well known, liable to gape when tired; like other ner- 
vous affections, it is apt to give rise to imitation in others. Gaping is, 
however, a not unfrequent symptom of disease-functional or organic- 
particularly of the chest. Attacks of hysteria accompanied with fainting, 
or of spasmodic asthma with depression of the action of the heart, are 
often ushered in by gaping. Persons who suffer from disease of the 
heart are also liable to fits of gaping. 
GARDEN ANGELICA. (See Archangelica.) 
GARDEN CELANDINE. (See Chelidonium. ) 
GARGET, OR POKE. (See Phytolacca Decandra.) 
GARGLES, gar'-glz [Lat. gargar^sma, from Gr. gargarizo, I wash 
the throat], are liquid applications to the throat and upper part of the 
gullet, etc., used in affections of these parts. Gargles are too often 
used as astringents, particularly in the first stage of inflammation of the 
tonsils, etc., or sore throat. In these cases, the warm water, or gruel 
gargle, is a much better remedy, with the addition of a small quantity 
of vinegar. The common domestic gargle of sage tea and vinegar 
answers very well. As a general rule, in the first stages of sore throat it 
is better to use the simple soothing gargles, nearly as warm as can be 
borne; in the latter stages, when there is often much stringy phlegm about 
the throat, the more stimulating and astringent gargles will be useful. For 
the latter, from 4 to 5 drops of muriatic acid in the ounce of water is as 
good a form as any; or the infusion of roses with 10 to 15 drops of 
dilute sulphuric acid to the ounce. Another very useful gargle in cases 
of relaxed sore throat is made with 1 dram of alum, £ ounce of tincture 
of myrrh, and water sufficient to make up the pint. Cayenne pepper 
infusion is also used as a gargle. (See Infusion, Capsicum.) In cases of 
chronic weakness of the throat, with tendency to frequent swelling and 
inflammation, a gargle of oak bark decoction, or of salt water, is of 
much service used every morning for some time. (See Decoction.) 
Gargling is effected by throwing the head back, and, consequently, the 
fluid back in the throat, and expelling the air through it from the lungs; 
it is thus worked, as it were, into every part of the throat. 
In cases of relaxed throat with white patches, a gargle of borax GARGLES- GASTRITIS, ETC. 
695 
dissolved in water is often useful; the addition of a little cream of tartar 
will allow of more borax being dissolved in the water. The foul smell 
proceeding from certain ulcers of the throat will be removed by gargling 
with the following solution: permanganate of potash, 1 dram; water, 
12 ounces. 
Chlorate of potash is very useful and very popular as a gargle, 
especially for common sore throat, sore mouth, etc. It may be used in 
the proportion of 1 dram to 4 ounces of water. For further informa- 
tion concerning its uses as a gargle, see Chlorate of Potash, Sore 
Throat. 
GARLIC. (See Allium, Onion.) 
GAS, gas [Ang.-Sax. gast, breath, spirit], is an elastic fluid, which 
is permanently aeriform at all ordinary temperatures, being distinguished 
from vapors, which are only temporarily elastic and aeriform. (See 
Ammonia, Carbonic Acid, Chlorine, Hydrogen, Laughing Gas, Nitro- 
gen, Oxygen, Coal-Gas.) 
GAS, ACCIDENTS FROM. (See Coal-Gas.) 
GASTRIC FEVER. (See Typhoid Fever.) 
GASTRIC JUICE, gas'-trilc [Gr. gaste-r, the stomach], is the name 
given to the digestive fluid contained in the stomach, and which is 
secreted by the gastric glands on the introduction of food or other for- 
eign substance. It is a clear, colorless, transparent fluid, inodorous, a 
little saltish, and very perceptibly acid. Its most singular component is 
a peculiar organic substance called pepsin, to which its special properties 
are chiefly owing. The use of the gastric juice is to dissolve the various 
kinds of food in the stomach, reducing the albuminous and gelatinous 
portions of it to a state fit for absorption into the system. It has also 
an antiseptic property, as it suspends putrefaction, and restores the 
freshness of tainted meat. (See Digestion, Stomach, Pepsin.) 
GASTRITIS, OR INFLAMMATION OF THE STOMACH, gas- 
tri'-tis [Lat.], occurs in two forms, one the acute, the other the chronic. 
The acute form, arising spontaneously, is an exceedingly rare disease, 
so much so that the celebrated Prof. Watson, author of "Watson's 
Practice of Medicine," declares he never saw it. 
Causes. - It is almost invariably caused by mechanical injury, 
especially by swallowing the vegetable or mineral acids, or other irri- 
tant and corrosive drugs. 
Symptoms.-Burning pain, increased by swallowing, and constant 
nausea or vomiting, hiccup, tenderness and distention of the whole abdo- 
men. The mind becomes oppressed, the spirits cast down, and the pulse 
small and thready. The patient soon becomes faint, the body cold, and 
his skin pale and bathed in cold perspiration, while the weakness becomes 696 
GASTRITIS, ETC. 
extreme. Thirst is urgent and the bowels are costive, except in the 
case of corrosive poisoning, when there is frequently diarrhoea. The 
pain is increased by pressure on the stomach, and by every movement 
of the patient. Its progress is rapid, and it may destroy life in twenty- 
four, and sometimes in twelve hours. 
Treatment.-If the pain be very severe, half a dozen leeches may be 
applied over the stomach, and when removed, the bites may be covered 
with a light, soft, warm, linseed meal poultice, and the patient be kept 
in a horizontal position. Cold water in small quantities, if retained, 
will do no harm, and will prove grateful; if the water be rejected, small 
pieces of ice may be allowed to dissolve in the mouth. Purgatives 
must not be given by the mouth, but the bowels be cleared out by injec- 
tions of w'arm water, or soap and water. After the bowels have been 
moved, injections of laudanum and starch (30 or 40 drops of the former 
to 3 or 4 ounces of the latter) do very much good. They relieve the 
pain and check the vomiting. If the stomach be capable of retaining 
anything, food in the shape of barley water, arrowroot or uel may be 
given, and grain of powdered opium every four hours. 
Chronic Inflammation of the Stomach is a very common disease, 
and gives rise to all the symptoms of indigestion. 
Causes.-It may follow an acute attack or be the result of excessive 
eating or drinking, as well as of long-continued abstinence. Arsenic, 
or corrosive sublimate in small quantities may be the exciting cause, also 
anything that interferes with the passage of the food into the bowels, as 
stricture, or cancer of the smaller end of the stomach. 
Symptoms.-These are pain, flatulence, sour eructations, a sense of 
weight and oppression after meals, nausea and vomiting. The pulse is 
quick and full, the tongue red and glazed. There is often a troublesome 
water-brash, and great prostration of strength. 
Treatment.-Strict attention must be paid to the diet of the patient. 
All kinds of farinaceous food, such as arrowroot, gruel, tapioca, rice, 
sago, with milk, jellies and beef-tea, may be allowed. Whatever food 
is given should be given in very small quantities, not more than 1 
or 2 tablespoonfuls at a time, and often. If the pain be severe, 
it may be alleviated by a mustard blister to the epigastrum, or by 
counter-irritation with tartar emetic ointment. White bismuth, in doses 
of 8 or 10 grains, either alone or combined with 5 grains of the com- 
pound kino powder, may be given with advantage two or three times a 
day. If the bowels are sluggish, from 3 to 5 grains of the compound 
soap pill may be given once a day. Tepid milk alone has frequently 
effected a cure. 
Preventive treatment.-Chronic inflammation of the stomach, inas- GASTRITIS, ETC-GELSEMIUM SEMPERVIRENS. 
697 
much as it is a disease very frequently caused by errors in eating and 
drinking, may almost invariably be prevented by a due regard for the 
laws which should guide us in these respects. Irregularity in eating, 
either in regard to time or quantity, imbibing large draughts of either 
hot or cold liquids during meals, taking very active exercise immediately 
after eating, eating or drinking while very warm, should be scrupulously 
avoided, especially by those in whom there is a tendency to this trouble, 
and the most rigid observance of regularity and moderation be faithfully 
enforced. (See Dyspepsia, Digestion, Diet, Meals, Food, etc.) 
GASTRODYNIA, gas-tro-diri-e-q, the stomach colic, or pain in the 
stomach. (See Cramp, Colic.) 
GAULTHERIA PROCUMBENS, gawt-the'-re-q pro-kum'-benz, or 
wintergreen, a perennial shrub belonging to the Nat. order Ericaceae. 
It grows in all parts of the United States and Canada, and is known in 
different parts by the common names, partridge berry, deer berry, grouse 
berry, and mountain tea. All parts of the plant are used medicinally. 
It is stimulant, aromatic, and astringent, and has been found useful in 
chronic mucous discharges, as a stimulant in debility, and as a carmina- 
tive in the colic of young infants. Dose: of the fluid extract, 1 to 2 
teaspoonfuls; of the infusion, 1 to 2 fluid ounces; of the volatile oil, 1 
to 5 drops, as frequently as may be found necessary. (See Infusion.) 
GAYFEATIIER. (See Liatris Spicata.) 
GELATINE, OR GLUE, jeV-drtin [Spanish, gelatina, from the 
Lat. gelo, I freeze], is an azotized component of animal bodies, of sim- 
pler constitution than the azotized albuminous compounds. It may be 
extracted from tendons, skin, etc., by long boiling, and from bones by 
dissolving out their earthy matter by acids; it occurs pure in many 
fishes, the air-bladders of which are formed of gelatine; isinglass, so 
well known as a jelly-making compound, being the prepared swimming 
or air-bladders of the sturgeon, cod, ling, etc. The gelatine sold as such 
is generally prepared from bones. Many persons have a prejudice 
against this gelatine, and imagine it is not so good as that which they 
extract from calves' feet, etc. As regards the amount of nutriment, it 
must be precisely the same, as there is no reason to believe that the 
manufacture is otherwise than properly conducted, it is a pity that many 
should deprive themselves and others of so convenient an addition to sick 
cookery. It is much used now for the purpose of covering pills, and for 
making capsules to enclose nauseous medicines. 
GELSEMIUM SEMPERVIRENS, jel-se'-mi-um semper-vi'-renz, 
or yellow jessamine, a perennial plant belonging to the Nat. order 
Apocynacece. It abounds throughout the Southern States, being exten- 
sively cultivated as an ornamental vine, and is known by the common 698 
GELSEmUM SEMPERVIRENS-GENTIANA, ETC. 
names, wild jessamine, bignonia, and woodbine. The root is the part 
used in medicine. It is an excellent febrifuge, and has proved very 
efficacious in nervous and bilious headache, colds, inflammation of the 
lungs, hemorrhage, and cholera, and is said to subdue in from two to 
twenty hours, the most formidable and complicated, as well as the most 
simple fever, incident to our country and climate. When an overdose 
has been taken, the proper antidotes are brandy, quinine, or aromatic 
spirits of ammonia. Dose: of the fluid extract, 3 to 10 drops; of the 
tincture, 5 to 20 drops, repeated every two, three or four hours. 
GENERAL HEALTH, jen'-er-al helth [Lat. generalis; genus, a 
kind]. By the term is meant, the state of the body and its functions 
collectively, in contradistinction to the condition of any special portion 
of the frame. The state of the general health is always an important 
consideration, with respect to local maladies, both as regards their treat- 
ment and ultimate prospects. The latter must always be more serious 
when the general health begins to suffer. (See Disease, Health.) 
GENERATION. (See Sterility.) 
GENTIAN. (See Gentiana.) . 
GENTIANA, jen-she-a -na, the typical genus of the Nat. order Gen- 
tianacece. The officinal gentian, so well known for its bitter tonic prop- 
erties, is the root of G. lutea, a native of the mountains of Central and 
Southern Europe. Gentian possesses, in a high degree, the tonic powers 
which characterize the simple bitters. It excites the appetite, invigor- 
ates digestion, and moderately increases the temperature of the body 
and the force of the circulation. It acts without causing any astringency; 
indeed, is occasionally laxative. It may be used in all cases of pure 
debility of the digestive organs, or where a general tonic impression is 
required. 
Dyspepsia, gout, amenorrhoea, hysteria, scrofula, intermittent fevers, 
diarrhoea, worms, are among the many affections in which it proves 
useful; but it is the condition of the stomach and the system 
generally, not the name of the disease, which must be taken into 
consideration in prescribing it. Dose: of the fluid extract, to 1 tea- 
spoonful ; of the compound fluid extract, | to 1 teaspoonful; of the solid 
extract, 3 to 15 grains; of the tincture, 1 to 2 teaspoonfuls; and of the 
infusion, 1 to 2 fluid ounces, three or four times a day. (See 
Infusion. ) 
GENTIANA QUINQUEFLORA, or five-flowered gentian, a valu- 
able tonic and antiperiodic. Used largely as a substitute for quinine in 
malarial diseases, and as a tonic in atonic conditions of the digestive 
apparatus and derangement of the biliary organs. Dose of the fluid 
extract, 10 to 30 drops. GEOGRAPHICAL DISTRIBUTION OF DISEASE. 
699 
GEOGRAPHICAL DISTRIBUTION OF DISEASE, je-o-graf'-M 
[Lat. geograpkicus\. As plants and animals vary according to different 
degrees of latitude, so also do the characters of diseases differ, and people 
are influenced in regard to their health in proportion as they migrate 
from land to land. It is a fact, also, that certain miasmatic and other dis- 
eases are so completely under the influence of temperature that they are 
capable of being arranged systematically in zones. The diseases sus- 
ceptible of being thus classified, are chiefly yellow fever, the plague, 
typhus and typhoid fevers, and cholera. These zones may be broadly 
indicated as the tropical, temperate and polar zones. 
I. The Tropical Zone.-The limiting line of this zone ascends some- 
what in summer when the sun is north of the equator, and descends 
again in winter, when the sun is to the south of it. The class of dis- 
eases which characterize this zone are the worst forms of malarious fevers, 
dysentery, diarrhoea, cholera, yellow fever, and hepatic affections in 
their most aggravated forms. The fevers of this tropical disease-realm 
prevail in their greatest intensity in the vicinity of marshes, the borders 
of lakes and the shores of rivers and the sea. The great centres of these 
malarious diseases in the different continents are : (1) In America; the 
shores of the Gulf of Mexico, the West India Islands, and the northern 
portion of South America. (2) In Asia; India, China, Borneo, and Cey- 
lon. (3) In Africa; the countries round the Gulf of Guinea, Madagascar 
on the west, and Mozambique on the east, and Algeria and islands of the 
Mediterranean on the north. 
II. The Temperate Zone.-The regions where diseases of this type 
prevail correspond to the north and south temperate zones. Itembraces 
the most healthy regions of the world, in which the prevailing causes of 
ill-health are mostly due to the condensation of people in towns and 
cities. Nearly every type of disease has a representative in this realm. 
Typhus and typhoid fever prevail between the parallels of 44° and 60° 
in Western Europe, and between 30° and 50° in America. Yellow fever 
prevails on the southern shores of Spain, the northwest coast of France, 
Northern Italy, and along the shores of the Mississippi river, and por- 
tions of the Atlantic coast in America. Intermittent and remittent fevers 
prevail in the Netherlands, Sweden, Central Italy, the northern, middle 
and western parts of the United States, and in the Dominion of Canada, 
and generally where marshy, undrained lands exist. Small-pox prevails 
where vaccination has not checked its ravages ; and consumption and 
rheumatism prevail almost everywhere. Where the people are crowded 
together in large cities, dysentery, diarrhoea, cholera, and other of the 
tropical diseases prevail sometimes, especially when proper sanitary pre- 
cautions are not taken for their prevention. 700 
GEOGRAPHICAL, ETC.-GESTURES IN SICKNESS. 
III. The Polar Zone.-In this zone catarrhal affections, influenza, 
scurvy, erysipelas, diseases of the skin and digestive organs, prevail. 
Its southern limits are the northern boundaries of the previously 
described zone. Commencing on the western shores of North America, 
above Sitka, it' extends southward across the district of the Canadian 
Lakes, sinking south and east as far as Boston and New York. Thence 
it crosses to Europe, ascending to the borders of Iceland, whence it 
sinks toward Norway and Sweden, and, running above St. Petersburg 
and Moscow, crosses into Siberia. 
GERANIUM MACULATUM, je-ra -ne-um mak-u-la'-turn, or cranes- 
bill, a perennial plant belonging to the Nat. order Geraniacea. It is com- 
monly known by the names crowfoot and alum root. It is a native of the 
United States, growing in low grounds and open woods all over the 
country. The root is the part used in medicine, and yields with alcohol 
an extract called geraniin. It is astringent and tonic. As an astringent 
it contains considerably more tannin than kino, and may be employed in 
all cases where astringents are indicated. It is a superior agent in the first 
stages of dysentery, diarrhoea, and cholera morbus. It is efficacious in the 
treatment of hemorrhages, the whites, gleet, diabetes, etc. The tincture 
is an excellent local application in sore throat and ulceration of the 
mouth. It may be applied to ulcers externally, and in combination with 
alum and gum arabic, it is a good application to bleeding -wounds and in 
bleeding from the nose. Good as a wash and gargle in relaxation of 
the uvula, and affections of the mouth and throat, as well as an injection 
in the whites and gleet. The absence of unpleasant taste, and of all 
other offensive qualities, renders it peculiarly serviceable in the cases of 
infants, and of persons of delicate stomachs. Dose: of the fluid extract, 
| to 1 teaspoonful; of the solid extract, 3 to 15 grains; of the powdered 
root, 20 to 30 grains; of the decoction, 1 to 2 fluid ounces. (See De- 
coction.) 
GERARDIA, je-rar'-de-a, or feverweed, an American perennial plant 
of the Nat. order Scrophulariaceai, commonly known as American fox- 
glove. It grows from two to three feet high, and is found in dry ridges 
from Canada to Georgia. All parts of the plant are used medicinally. 
It is diaphoretic, antiseptic, and sedative. The warm infusion, in doses 
of from 1 to 3 fluid ounces, produces very free perspiration in a short 
time. It is used for this purpose in febrile and inflammatory diseases. 
(See Infusion.) 
GERMAN LEOPARD-BANE. (See Arnica.) 
GERMAN TINDER. (See Amadou.) 
GESTATION, OR PREGNANCY. (See Pregnancy.) 
GESTURES IN SICKNESS. (See Symptoms.) Geranium Maculatum. (Cranesbill.) GEUM. RIVALE-GILLENIA TRIFOLIATA. 
701 
GEUM RIVALE, je-um ri'-va-le, or avens root, a perennial plant 
belonging to the Nat. order Rosaceoe. It grows in moist meadows all 
over the United States, and is commonly known as water avens, purple 
avens, and throat root. The root is tonic and astringent, and has been 
found of use in diarrhoea and dysentery, the whites, dyspepsia, con- 
sumption and intermittent fever. Dose: of the fluid extract, to 1 
teaspoonful; infusion, 1 to 2 fluid ounces, three or four times a day. 
(See Infusion.) 
GIANT SOLOMON'S SEAL. (See Convallaria Multiflora.) 
GIDDINESS, DIZZINESS, OR VERTIGO, gid'-de-nes [Sax. 
gidig\ Lat. vertigo, from verto, I turn], is a dizziness or swimming oif 
the head, with more or less of mental confusion, and a loss of power to 
balance the body. The objects around in many cases appear to be 
moving about in different directions, often conjoined with a sense of 
dimness or darkness, or with sounds of bells or drums in the ear. It 
generally comes on suddenly, and is symptomatic of various diseases, 
arising, as it does, from some disturbance or debility of the nervous 
power. It generally precedes a fainting fit, or an attack of apoplexy; 
attends fevers, inflammations and many other diseases, and not unfre- 
quently arises from some organic disease of the brain or heart. It fre- 
quently arises from indigestion, or may be caused by some poison in the 
blood, as alcohol or opium, or, indeed, by anything that greatly alters 
the circulation of the blood through the brain. 
Treatment.-In most cases it may be traced to weakness or nervous 
debility, and hence the treatment should be to strengthen the system by 
means of tonics, particularly iron, by nourishing diet, change of air, 
exercise, bathing, and the like. A fullness of the blood-vessels of the 
brain may frequently be owing to lack of tone in the vessels, arising 
from weakness rather than from any preternatural determination of 
blood to the head. In persons, however, of full habit of body, whose 
heads are hot, and whose arteries are pulsating with undue force, a spare 
diet, purgatives, blisters behind the ears, or setons in the nape of the 
neck, will form the proper treatment. Frequently giddiness, when 
arising from indigestion, will be got rid of by administering a brisk 
purgative. (See Tonics, Cathartics, Seton, Dyspepsia.) 
GILLENIA TRIFOLIATA, jilde -ne-a tri-fode-a-tq, or Indian 
physic, a perennial plant about two or three feet in height, belonging to 
the Nat. order Rosacea. It grows in woods, gravelly soils, and in moist 
and shady situations from Canada to Florida. The bark of the root is 
the part used in medicine, and should be gathered in autumn. It con- 
tains an active principle called gellenin, which, in doses of £ grain, is 
sometimes used in medicine as an emetic. 702 
GILLEN I A TRIFOLIATE-GLANDERS. 
Indian physic is emetic, cathartic, sudorific and expectorant. In 
srtiall doses it is tonic, and resembles ipecac in its mode of action. This 
agent has been used with considerable success in suppressed menstrua- 
tion, rheumatism, dropsy, habitual costiveness, dyspepsia, worms, and 
in intermittents. In all cases where the object is to produce vomiting, 
it is recommended as a safe and efficacious medicine. 
The dose of the powder as an emetic is 20 to 25 grains, repeated at 
intervals of half an hour. Dose, of fluid extract, as an expectorant, etc., 
4 to 12 drops y as an emetic, etc., 15 to 30 drops. 
GIN, jin [From Fr. genievre, juniper], the well-known liquor, also 
known as Geneva, or Holland, contains oil of juniper, and when first 
introduced was used simply as a diuretic medicine. It ultimately, how- 
ever, became an object of trade and of general-too general-use. It 
certainly often increases the flow of urine in a marked degree. 
GINGER. (See Zingiber Officinale.) 
GINGER, WILD. (See Asarum.) 
GINSENG. (See Panax Quinquefolium.) 
GLAND, gland [Lat. glans}, in Anatomy, is an organ of the body, 
composed of blood-vessels, nerves, and absorbents, in which secretion is 
carried on; as the lachrymal, mammary, and salivary glands. Glandu- 
lar swellings are not unfrequent, especially in weak and scrofulous per- 
sons. They occur about the neck, or other parts of the body, are com- 
paratively painless, and of very slow growth, with little or no tendency 
to suppuration. In such cases, the system should be strengthened with 
tonics, as iron and quinine, nourishing diet, and pure air. Cod-liver oil 
is also usually of great service, and where practicable, sea-bathing should 
be adopted. 
When there is no inflammation, and the glands merely remain 
indurated, iodine is a very useful application in producing absorp- 
tion, as by painting the part with tincture of iodine, or applying the red 
iodide of mercury ointment, diluted with lard. Glandular swellings also 
occur in certain diseases, as scarlet fever, etc. 
GLANDERS, glan'-durz (from gland), sometimes called farcy, the 
malignant disease to which the horse, the ass, and the mule are subject, 
is also capable of being communicated to man, certainly by inoculation, 
perhaps by simple contact with the skin. Should any of this discharge 
come in contact with an abrasion of the skin, or even get lodged on the 
sound skin, as of the hands, or be snorted upon the nostrils or eyes of 
man, it is capable of originating this horrible disease. In from two days 
to a week after inoculation, the attack is ushered in with fever symp- 
toms, or by vomiting and diarrhoea, small tumors which ulcerate and 
discharge form under the skin in various situations, and there is yellow GLANDERS- GL YCERINE. 
703 
viscid discharge from the nostrils, etc. Almost every case of this fear- 
ful disease has proved fatal. 
GLANDULAR SWELLINGS. (See Gland.) 
GLASSES. (See Vision.) 
GLAUBER'S SALT, glow'-burz [after Glauber], in Chemistry, the 
old name for sulphate of soda. (See Soda.) 
GLAUCOMA, glaw-kd-ma [Gr. glaukos, azure], an opacity of the 
vitreous humor, producing imperfect sight, and sometimes total blindness. 
It is liable to be mistaken for a cataract. If the eye is examined by a 
favorable light, there appears a greenish spot behind the pupil. It is 
often hard to distinguish, and, as a rule incurable, though not always. 
GLEET, gleet [Ang.-Sax. glldan, to glide], a mucous discharge from 
the urethra, commonly a sequel of gonorrhoea, or clap. For treatment 
etc., see Gonorrhcea. 
GLOBULES OF THE BLOOD. (See Blood.) 
GLOBULIN, glob'-u-lin [Lat. globulus], the substance which forms 
the nucleus of the red blood globules. 
GLOBUS HYSTERICUS, glo'-bus [hysterical ball], is a symptom in 
hysteria, marked by the feeling of a ball rising upwards to the throat, 
frequently attended by a feeling of suffocation. It is very common with 
persons of a nervous temperament, and is occasioned by the air ascend- 
ing in the oesophagus being prevented by spasm from reaching the 
mouth. (See Hysteria, Nervous Disease.) 
GLOSSITIS, OR INFLAMMATION OF THE TONGUE. (See 
Tongue.) 
GLOTTIS, glot'-tis [Gr.], in Anatomy, is the name given to the 
superior opening of the larynx, situated immediately behind the root of 
the tongue and covered by the epiglottis. (See Larynx.) 
GLUCOSE, glu'-kose, grape sugar, that form of sugar which is found 
in acid fruits and plants. It is the form in which sugar is generally 
found in diabetes and hence it is sometimes called diabetic sugar. 
GLUE. (See Gelatine.) 
GLUTEN, glu'-ten [Lat.], in Chemistry, a characteristic ingredient 
in cereal seeds. If the flour of wheat or rye be made into a paste with 
water, and washed in a bag of fine linen, the starch is carried down by 
the water along with the sugar and dextrine; the remaining gray, sticky 
and mucous mass is gluten. Gluten may be assumed to be the principal 
flesh-forming substance contained in wheat. 
GLYCERINE, glis'-e-rin [Gr. glukus, sweet], in Chemistry, C6II8O6 
the sweet principle of oils and fats, which is separated from them during 
the process of saponification. It is a viscid, colorless liquid of a sweet 
taste, soluble in water and alcohol in all proportions, but sparingly so in 704 
GLYCERINE-GOAT S KILK. 
ether. In medicine, it is used in preference to oil or other fatty matters, 
to keep sores in a soft condition, on account of the ease with which it 
may be washed off. It is a useful application to chapped hands, and it 
is also employed as a solvent for various medicines, as starch, borax, 
carbolic, gallic, and tannic acids. Glycerine of starch is formed by 
rubbing together 1 ounce of starch and 8 fluid ounces of glycerine till 
they are intimately mixed, then transferring to a porcelain dish and 
applying a heat gradually raised to 240°, stirring constantly till a trans- 
lucent jelly is formed. In the other cases the proportions are 4 fluid 
ounces of glycerine to 1 ounce of borax, etc. 
A glycerine ointment useful for chapped hands and lips, and all 
excoriations of the skin, is made as follows: Melt together spermaceti, % 
ounce, white wax, 1 dram, with oil of almond, 2 ounces; put these 
into a Wedgewood mortar and add 1 ounce of glycerine, rubbing together 
until well mixed and cold.' 
In the baldness following debilitating diseases, the following has 
been applied to the scalp with much benefit: Aromatic spirit of ammo- 
nia, 1 dram; glycerine, | ounce; tincture of cantharides, 1 dram; rose- 
mary water, 8 ounces. In partial deafness, accompanied with a dry, 
shining appearance of the internal ear, glycerine dropped into the 
passage or introduced on a piece of cotton, has been productive of much 
good. 
GLYCYRRIIIZA GLABRA, glis-e-rl'-za gla'-lrra, or liquorice root, 
is a perennial plant belonging to the Nat. order Leguminosw. It is an 
inhabitant of Southern Europe, where it is known by the names of sweet- 
wood and Spanish root. It is emollient, demulcent and nutritive, and 
by its action on the mucous surfaces, lessens irritation. This property 
has rendered it very beneficial in coughs, catarrh, and irritation of the 
urinary organs. The powdered root has been found capable of almost 
entirely disguising the taste of quinine. Dose: of the fluid extract, 1 
to 4 teaspoonfuls; infusion, 1 to 4 fluid ounces. (See Infusion.) 
GNAPHALIUM MARGARITACEUM, narfa'-le-um mar'-ga-rit-a- 
se-um, or life-everlasting, a plant belonging to the Nat. order Compositor. 
It grows on dry hills and in woods throughout the United States. It is- 
anodyne and astringent, and has been found beneficial, internally, in 
diarrhoea, dysentery and pulmonary affections, and externally in sprains, 
bruises, boils and painful swellings. Dose: of the fluid extract, | to 2 
teaspoonfuls; infusion, 1 to 3 fluid ounces. (See Infusion.) 
GOAT'S MILK, gotes [Ang.-Sax. gat], is an excellent nutritious 
article of food in certain cases of great debility, and especially in con- 
sumption, where there is disease of the bowels. It may be artificially 
made as follows: Take 1 ounce of fine chopped suet, and put it in a GOAT'S MLLK-GOITRE, OR BRONCHOCELE. 
705 
muslin bag; boil it slowly in a quart of new milk; sweeten with white 
sugar. 
GODFREY'S CORDIAL, god'-freez, is a well-known quack medi- 
cine, frequently given to children in order to soothe them and keep them 
quiet. When used indiscriminately, as it commonly is, it often causes 
much mischief, and even sometimes occasions death. This is owing to 
opium which it contains. 
GOITRE, OR BRONCHOCELE, goi'-tur [Fr. goitre, probably a 
corruption of Lat. guttur, the throat]. This disease consists of enlarge- 
ment or hypertrophy of the thyroid gland, which is placed in front of the 
windpipe. It is much more common in chalky districts, and is very fre- 
quently seen in Switzerland. From it being a common affection in Der- 
byshire, England, it has been called the Derbyshire neck. 
Causes.-This affection was for a long time supposed to be due to 
some abnormal condition of the atmosphere; but has since been proved 
to arise from drinking water contaminated with chalk. 
Symptoms.-The lobes of the gland are more distinctly marked, and 
rise with the larynx and pharynx in the act of swallowing. This'enlarge- 
ment may depend upon various morbid conditions-thus, it may be due 
to inflammation, and to cancerous or cartilaginous deposits; sometimes 
it is the result of simple hypertrophy, having no malignant tendency; 
and in rare cases, it is due to bony deposits. Bronchocele, besides 
being unsightly, generally affects the processes of respiration and swal- 
lowing, and in some cases impedes the circulation of the blood. It is 
much more common in women than men, and frequently some disorder 
of the uterine functions is present at the same time; in some cases the 
disease is hereditary, and in very rare instances children have been born 
goitrous. 
Treatment.-The patient should be removed from the chalky district, 
and iodide of potassium freely given. 
Take of Iodide of potassium Half a dram. 
Bicarbonate of potash Twenty grains. 
Fluid extract of cinchona. ...Half an ounce. 
Pure water Five and a half ounces.-Mix. 
Give 2 tablespoonfuls three times a day. 
While the patient is taking this medicine internally, she should paint 
the enlargement over with compound tincture of iodine, or rub into it a 
small piece of the compound iodine ointment every night and morning. 
When the health is much impaired, cod-liver oil and iodide of iron may 
be given together, thus : 
Take of Cod-liver oil One ounce. 
Syrup of the iodide of iron Two drams.-Mix. 
Give two teaspoonfuls three times a day. 706 
GOITRE, OR BRONGIIOGELE-GONORRHEA. 
Several surgical operations have been proposed to relieve this trouble- 
some affection; but none of them have met with sufficient success to 
warrant its repetition. Thus, a seton has been passed through the en- 
larged gland, the arteries nourishing its substance have been tied, and 
the whole gland has been extirpated. 
GOLD, gold [Ang.-Sax. gold], symbol Au. (giurum); equiv. 197; spec, 
grav. 19.3. Pure gold for chemical purposes maybe obtained by dissolv- 
ing standard gold in 1 part of nitric and 4 parts of hydrochloric acid. The 
solution is diluted and filtered, and evaporated almost to dryness, to 
expel the excess of acid. The remaining salt is then boiled with a solu- 
tion of sulphate of iron, which precipitates the gold as a dark bluish- 
purple powder which is subsequently washed with water and hydrochloric 
acid. Gold, in its ordinary metallic form, has a reddish-yellow color, 
but when very much extenuated it transmits a green light. When pure 
it is nearly as soft as lead, and is the most malleable and ductile of all 
metals, but is inferior to many in its tenacity. It does not combine 
directly with any of the non-metallic elements, except chlorine, bromine, 
fluorine,' and phosphorus. The oxygen acids do not combine with either 
of its oxides, and the only way in which the chloride can be formed is 
by dissolving it in hydrochloric acid, to which some oxydizing substance 
has been added, such as nitric acid, chromic acid, or binoxide of man- 
ganese. Selenic acid acts upon it by oxidation, its acid being converted 
into selenious. The hydrated alkalies do not act upon gold, except in a 
strong current of air, when auric acid is formed, which combines with 
the alkali. The higher alkaline sulphides dissolve it in the form of ter- 
sulphide. The terchloride of gold, AuC14, is made by dissolving metallic 
gold in aqua regia. It is very soluble in water and alcohol, and still 
more so in ether. The ethereal solution is the aurum potabile of the 
ancients. Terchloride of gold has occasionally been used as a medicine 
in syphilis, scrofula, and rheumatic affections; but it is mainly employed 
as a test for atropia and other alkaloids. 
GOLDEN OINTMENT, gole'-dn oint'-ment, is a compound of sul- 
phuret of arsenic and spermaceti ointment, and is a good application for 
the lids of inflamed and sore eyes. 
GOLDEN RAGWORT. (See Senecio Aureus.) 
GOLDEN ROD. (See Solid ago Odora.) 
GOLDEN SEAL. (See Hydrastis Canadensis.) 
GOLDEN SENECIO. (See Senecio Aureus.) 
GOLD THREAD. (See Coptis Trifoliata.) 
GONORRHOEA, gon-or-re -a [Gr. gone, semen, and reo, to flow], is 
an inflammation of the mucous membrane of the urethra, produced by a 
specific poison, and accompanied by a peculiar discharge. The essential GONOIUUKEA. 
707 
nature of the poison is still unknown, but it appears to have a predilec- 
tion for mucous surfaces, and especially for that of the genito-urinary 
organs. From a few hours, to four or five days, elapse between the 
exposure to the contagious matter and the full development of the 
results. 
Causes.-This disgusting disease can only be caused by direct contact 
with the poison before mentioned, either during cohabitation or by direct 
inoculation, in which case it may attack the extremity of the rectum, the 
nose or the conjunctiva of the eye, sometimes destroying sight in twenty- 
four hours. It is communicated from one sex to the other. 
Symptoms.-These are divided into three stages. In the first stage 
there is merely an intense itching of the orifice of the urethra, and the 
discharge of a thin, whitish fluid. In the second, or inflammatory stage 
of the disease, the discharge becomes thick and purulent, the genital 
organs and the parts in the vicinity become swollen and exquisitely tender, 
and the urine is passed by several small streams, accompanied by great 
pain ; the nights are marked by almost entire loss of sleep, and the pres- 
ence of a very bad condition, known as chordee, which is a painful 
contraction of the fraenum or cord of the penis. In the third stage 
these active symptoms have all abated, and there is merely a thin dis- 
charge, partly mucus and partly pus, and known as gleet. If proper 
care and attention are paid to the disease, it will get well in the course 
of two or three weeks; but when it is neglected it will continue for many 
months, and end in fistulous sores, and often in death; hence the 
advisability of early consulting a physician. Mismanagement of this 
disease, which so often occurs in treatment by the unprofessional, is 
always attended by the most baleful effects; therefore, trusting to 
domestic treatment or resorting to advertising quacks {all who advertise 
must be designated as such), is dangerous in the extreme. When 
gonorrhoea attacks the female, the mucous membrane of the vagina and 
uterus are the parts usually affected, but the other symptoms are the 
same as in the male. The same general treatment is required in both 
sexes. In the female, however, there are other discharges which may 
easily be mistaken for this, and great care should be exercised lest the 
reputation of an innocent woman should be tarnished. This disease 
is sometimes complicated with the more horrible symptoms of syphilis 
or venereal poisoning. 
Treatment.-Before the inflammatory stage has set in, the disease 
may frequently be cut short by the painful agency of injecting into the 
urethra, every four hours, a syringeful of a solution made by dissolving 
2 grains of nitrate of silver (lunar caustic) in 8 ounces of water. If the 
discharge becomes bloody the nitrate must be discontinued, and sulphate 708 
G ONORRIKEA- G O UT. 
of zinc (white vitriol) 5 grains to 1 ounce of water, be substituted instead, 
until the discharge ceases. At the same time the bowels must be kept 
open with a mild aperient, when necessary, and all exercise and stimu- 
lants be avoided. In the inflammatory stage the patient must be kept 
absolutely at rest, all stimulants avoided, low diet enforced, and injec- 
tions discontinued. The patient's drinks should be linseed tea, barley 
water, slippery elm tea, etc. It is important to keep the bowels open 
with 3 or 4 grains of calomel, every alternate night, followed by a dose 
of castor-oil in the morning. A hip-bath of the temperature of 80° is 
advisable, at least once a day. As soon as the fever has subsided, resort 
may be had to the injection of sulphate of zinc mentioned above, while 
10 drops of balsam of copaiba, or a teaspoonful of tincture of cubebs, 
should be taken three or four times a day. Copaiba is usually adminis- 
tered in capsules, to avoid the unpleasant taste. Chordee may be over- 
come by 10 grains of Dover's powder each night; 10 to 15 grains of lupulin 
at bed-time, will answer the same purpose. The gleet that follows is 
often a very tedious affair, and can only be cured by a long course of 
treatment and very temperate habits of living. The mineral waters of 
Sparta, Wisconsin, are remarkable for their efficacy in gleet. 
Preventive treatment consists in a rigorous observance of the seventh 
commandment. (See Balsam of Copaiba, Barosma, Buchu Compound.) 
GOOSE. (See Poultry.) 
GOOSEBERRY, gooz -ber-re, one of our most wholesome fruits. It 
is aperient, and the seeds of ripe gooseberries add to this property, by 
their mechanical action upon the bowels. 
GOOSE-GRASS. (See Galium Aparine.) 
GOSSYPIUM HERBACEUM, gossip -e-um her-ba'se-um, or cotton 
root, a native of tropical America, belonging to the Nat. order Malvaceas. 
The bark of the root is the active medicinal part. It is an emmena- 
gogue, and acts with more safety than ergot. It is an excellent remedy 
in the treatment of chlorotic and anaemic females. Dose: of the fluid 
extract, 2 to 4 teaspoonfuls; infusion, 2 to 5 fluid ounces. (See Infu- 
sion. ) 
GOULARD'S EXTRACT, goo'-lardz, a saturated solution of sugar 
of lead, called also extract of lead. (See Lead.) 
GOUT, gowt. [Lat. gutta, a drop]. This disease, under the Greek 
name of Arthritis, has long been familiar to physicians; the word gout, 
from the Lattin gutta, being applied to it in obedience to an old doctrine 
which ascribed its origin to a drop of acrid matter deposited on the sur- 
face of the affected joints. 
Causes.-Gout is very often a hereditary disease, but it may also be 
acquired ; when so, its more direct causes are luxurious living, and the GOUT. 
709 
sedentary habits which so frequently accompany that indulgence. Gout 
rarely occurs in early life, and most frequently presents itself between 
the ages of twenty-five and fifty. Men suffer from it in much greater 
number than women. 
Symptoms.-Acute gout, or what is called a fit of the gout, generally 
commences at night with a severe pain in the ball of the great toe, 
though other joints in the body may be its seat; the part affected soon 
becomes red and swollen, possessing a glistening appearance, and the 
pain acquires the lancinating or shooting character. Symptoms of con- 
stitutional disturbance either accompany or speedily succeed the local dis- 
order. Such are a quick pulse, increased heat of skin, confined state of 
the bowels, and urine which, besides possessing a high color, deposits, 
after a little time, a sediment more or less dense. While the disease, 
when assuming the form now briefly described, is liable to be developed 
without the occurrence of any premonitory symptoms, the more usual 
course is for the patient to have suffered for some days from derange- 
ment of the stomach, with loss of appetite, and other indications of its 
approach. More particular reference need not be made here to the 
various forms of gout, or the peculiar sufferings of gouty patients. 
Treatment.-The treatment of the gout is divisible into two prominent 
particulars: what is required during the fit, and the suitable management 
of the patient after its declension or in the intervals of the attacks; for 
when the disease has once occurred, it manifests a great tendency to 
return: 
Under the former may be ranked, first of all, rest, especially of the 
affected part, and the application over it of a piece of flannel dipped in 
warm water. The patient's food should be of the simplest description 
during the continuance of the paroxysm. The remedy which has been 
chiefly employed in the treatment of gout, as well as of all forms of 
gouty ailments, is the meadow-saffron, or colchicum. Of it there are 
several different preparations. Perhaps the wine of colchicum is the 
most frequently employed, and in an attack of the disease it may be 
administered alone, or with a little magnesia, as a draught at bed-time, 
and repeated in the morning along with a dose of some laxative. The 
dose of the wine of colchicum in such circumstances, for an adult, should 
not exceed 30 or 40 drops; it may thus be continued for several succes- 
sive days. Usually the attack of the disease does not last more than a 
few days. 
It is by careful attention to diet and regimen that, during the inter- 
vals of the paroxysmal attacks of gout, the patient is to be treated. No 
precise rules applicable to all sufferers can be laid down; but while tem- 
perance in the use of, if not abstinence from, fermented liquors, should 710 
G 0 UT- GRA GILL AR I A. 
be practised by the great majority, it is specially incumbent upon those 
whose general health has not as yet been damaged by repeated attacks 
of the disease. Some sufferers from gout there are who, having long 
indulged, positively require their accustomed stimulation, and if alto- 
gether deprived thereof, would the more certainly be attacked. Exercise 
is good for all except the thoroughly debilitated; but even in the case 
of the young and strong, it should not be so great as to be followed by 
much fatigue. The bowels, if they tend to be confined, should be care- 
fully regulated; and for this purpose no means are better than small 
doses of rhubarb (10 grains) and bicarbonate of potash (15 grains). 
Let attention be further paid to the condition of the skin; to maintain its 
ready transpiration is of great importance. Lastly, as regards diet, all 
articles of food should be selected from their being as readily as possible 
digestible. (See Food.) White fish and white flesh-as of fowl, rabbit, 
and such like-if they do not form the entire, should, certainly constitute 
the staple commodities. Sherry wine, and the lighter German wines when 
quite sound, as Hock and Moselle, which increase the elimination by the 
kidneys, are preferable to port and burgundy, and, generally speaking, 
also to claret. 
Gout, as is well known, is apt to attack internal organs, and specially 
the stomach; when so, the patient experiences violent pain, with sick- 
ness, and a sensation of great faintness. This is often a formidable, 
not unfrequently it is a fatal, form of the gout. If it turn out upon 
inquiry, that some indigestible article of food has been recently taken, 
it is always well in such circumstances to exhibit an emetic ; and after its 
operation, or without its administration, if the stomach be supposed to 
be at the time free from any deleterious substance, a glass of warm 
brandy and' water, either alone or with the addition of 30 or 40 
drops of laudanum, should be given. Attempts, which are sometimes 
successful, may also be made to determine the gout to a less dangerous 
locality, as the feet, by covering them with mustard poultices, or placing 
them in a hot bath. If great pain in the stomach come on without the 
sense of faintness and the cold surface with feeble pulse, then possibly a 
dose of magnesia, alone or with rhubarb powder, or of bicarbonate of 
potash, may relieve the pain, and render further interference unneces- 
sary. (See Diet, Food, Ale, Wine, Exercise, Uric Acid.) 
GRACILLARIA, gra-sil-la'-re-g, in Botany, a species of plants be- 
longing to the Nat. order Algce, or Sea-weeds. The Gracillaria lichen- 
oides, is our Ceylon moss. It is nutritive, emollient, and demulcent, 
and may be employed in the form of a decoction or jelly as a food for 
children and invalids; and medicinally in pulmonary complaints, diar- 
rhoea, etc. Gracillaria plocaria, is Corsican moss. It has been used GRA CILLARIA- GRA VEL-PLANT. 
711 
principally as a vermifuge, but its properties have been much overrated. 
(For Iceland Moss, see Cetraria.) 
GRADUATED MEASURE FOR ADMINISTERING MEDI- 
CINES. (See Household Medicines.) 
GRAIN. (See Weights and Measures.) 
GRAINS. (See Cereals, Avena, Flour, Oatmeal, Corn Meat., 
Bread, Food.) 
GRAINS OF PARADISE. (See Amomum. ) 
GRANULATED, gran'-udate-ed, prepared in the form of grains, as 
granulated citrate of magnesia. 
GRANULATIONS, gran-uda'-shuns [Lat. granum, a grain], are the 
small red rounded points which cover the surface of a healing sore. 
They are very vascular and bleed easily. When the granulations are 
deficient, the sore is depressed, smooth and glazed-looking, and is not 
healing well. When the granulations are excessive they constitute what 
is called proud flesh. In this state they are paler than they should be, 
and require depressing or astringing by some caustic or astringent agent, 
such as lunar caustic, blue vitriol, etc. (See Caustic, Ulcers.) 
GRAPE, grape [Fr. grappe\, the fruit of the vine, one of, if not the 
most wholesome of fruits; when ripe it contains sugar abundantly, vege- 
table jelly and mucilage, and the characteristic tartaric acid in com- 
bination with potash, also gluten, on which depends its property of 
ready fermentation, in which respect the juice of grape excels all other 
vegetable juices; undergoing spontaneously the necessary change, and 
becoming converted into true wine by its own inherent power of fermen- 
tation. The juice, if kept a few hours, will spontaneously ferment. As 
a cooling article of diet, ripe grapes are most wholesome and invaluable in 
many cases of illness; but must be forbid when their aperient properties 
may prove injurious. Of late years, what is called the grape-cure has 
been introduced into Germany: the persons undergoing it living chiefly 
on grapes, of which they have to consume many pounds weight per day, 
and bread. It is probable that in some states of constitution this cool- 
ing system of diet may be useful; it has, however, at least one serious 
drawback: the continued application of the acid of the fruit to the teeth 
completely dissolves off* the enamel. (See Fermentation, Raisin, 
Wine.) 
GRAPE CURE. (See Grape.) 
GRAPE SUGAR. (See Glucose.) 
GRAVEL. (See Calculus, Urine, Lithotomy, Lithotrity, Hydran- 
gea Arborescens.) 
GRAVEL-GRASS. (See Galium Aparine.) 
GRAVEL-PLANT. (See Epigtea Repens.) 712 
GRAVEL-ROOT-GRINDELIA ROBUSTA. 
GRAVEL-ROOT. (See Eupatorium Purpureum.) 
GRAVEYARDS. (See Sanitary Science.) 
GRAY POWDER. (See Grey Powder.) 
GREEN SALVE, green saw or sdlv [Ang.-Sax. grene], a preparation 
made by melting together equal quantities of white gum, turpentine and 
bayberry wax. It should be strained and stirred until cold. It is a use- 
ful application to scrofulous and other ulcers. 
GREEN-SICKNESS. (See Chlorosis.) 
GREEN TEA. (See Tea.) 
GREEN VITRIOL, OR SULPHATE OF IRON. (See Iron.) 
GREEN WALL PAPER, POISONOUS. (See Arsenic in Wall 
Paper. ) 
GREGORY'S POWDER OR MIXTURE, greg'-o-reez, a compound 
of 2 parts of rhubarb, 4 parts of calcined magnesia, and 1 part of ginger. 
It is taken either simply, in water, or with water along with some stim- 
ulant, such as a teaspoonful of sal-volatile; it is a good stomachic and 
gentle aperient; but persons sometimes get too much in the habit of 
taking it regularly, and injure the tone of the stomach by the undue amount 
of magnesia. In severe cases of colic, attended with constipation and 
griping pain in the bowels, 1 teaspoonful of Gregory's powder with 30 
drops of sal-volatile, may be taken in a wine-glassful of peppermint water 
every three hours till the bowels are moved. It seldom fails to give 
relief. 
GREY, OR GRAY POWDER, gra, a mild mercurial preparation. 
Very useful as an alterative medicine in childhood, when the evacua- 
tions are pale and unhealthy. For this purpose, 2 or 3 grains of gray 
powder, with a like quantity of rhubarb or magnesia, may be given for 
two or three times, on alternate evenings. 
GRIEF. (See Passions.) 
GRINDELIA ROBUSTA, grin-de-le-a ro-bus'-tg^ a native of the 
Pacific Slope. A few years ago, when it was introduced from California 
to the medical profession as a specific for asthma-as near as any single 
drug could be a specific-it was looked upon with some suspicion. But 
now it has won its way to the foremost rank, everywhere, as an anti- 
asthmatic of sterling value. 
In our common cases of bronchitis, or winter catarrhs, it is also of 
great value in doses of a | to 1 teaspoonful of the fluid extract repeated 
every three or four hours as required. 
In hay fever, grindelia has also proven advantageous. In this case 
the remedy is best dispensed in simple syrup, or, if a cathartic is needed 
(for often the bowels are irregular in these cases), combined with the 
fluid extracts of senna and rhubarb. In these cases a somewhat larger GRINDELIA ROBUSTA-GROWTH. 
713 
dose of the remedy is needed than in the bronchial cases. A useful for- 
mula would be: fluid extract of grindelia robusta, 4 fluid ounces; fluid 
extracts of senna and rhubarb, of each, 1 fluid ounce. Then of this mix- 
ture take 1 dessertspoonful every half hour or so till relief is felt, when 
diminish the dose to three or four times a day. 
The usual dose of the pure fluid extract is a to 1 teaspoonful in cases 
of asthma; and it may be thus taken in sweetened water every half hour, 
or hour, if necessary; then the dose should be diminished to three or 
four times a day. The formula above given for hay fever would not be 
a bad one for asthmatics to use, as they are frequently troubled with con- 
stipation. 
GRIPING-, gripe-ing, is pain produced in some portion of the bowels, 
in consequence of irregular contraction of the muscular coat; it is in fact 
a minor form of colic, or spasm, and is to be relieved by the manage- 
ment recommended under those heads. Some medicines are more liable 
to gripe than others, and some individuals are more than others sus- 
ceptible of these griping properties. The inconvenience is generally 
and successfully remedied by the addition of some carminative or 
aromatic, such as one of the essential oils-clove, cinnamon, etc.,-or 
by ginger, etc. Pills which are apt to gripe are more effectually cor- 
rected by the addition of 1 or 2 grains of extract of henbane, when that 
medicine is admissible. Some medicines are rendered griping by faulty 
preparation. This is especially the case with senna. (See Colic, 
Spasm. ) 
GROCER'S ITCH. (See Skin, Diseases of the ; Impetigo.) 
GROUND HOLLY. (See Chimaphila Umbellata.) 
GROUND LAUREL. (See Epigjsa Repens.) 
GROUND LEAF. (See Chimaphila Umbellata.) 
GROUND MOSS. (See Polytrichum Juniperum.) 
GROUND RASPBERRY. (See Hydrastis Canadensis.) 
GROUSE BERRY. (See Gaultheria Procumbens.) 
GROWTH, groth, or increase of size of the body, as a whole, or of 
any part of it, is dependent, as a healthy process, first on a proper 
amount of nervous excitation, and second, on a due supply of healthy 
blood. When any part, such as the arm of a workman, is regularly and 
vigorously exercised, the nervous power and the flow of blood are 
directed to it in increased proportion, it acquires additional substance, or 
grows; but should the same arm become paralyzed, how quickly will it 
diminish in bulk. Up to a certain period of life the body grows; in 
animals this varies with the species; in man, the process continues, gen- 
erally, up to the twentieth year, or even beyond. When growth ceases, 
it is not that new material ceases to be added to the body, for this is 714 
GR O WTH~ G PARANA. 
unceasingly being effected to supply the place of those constituents of 
the frame which are continually being used up; but the balance between 
the food taken and assimilated, and the waste of the body, is equalized, 
and after growth has ceased, this balance-with the exception of fatty 
deposits-is, during health, maintained with but little variation during 
the years of life's prime. When old age comes on, that is after the 
sixtieth year, the balance inclines the other way; the waste now exceeds 
the reparative nutriment which it is in the power of the system to 
receive and elaborate, and the tissues all diminish in bulk, the stature, 
even, becoming less. 
Young persons require nutriment, not only to sustain the wasting 
process of respiration, and of motor change or movement, but they 
require, also, sufficient to supply the growing tissues of their entire body 
with the various elements which go to perfect their composition; if 
these elements are not supplied, development is either arrested, or, the 
tendency to growth continuing, the bones and tissues generally lengthen, 
without acquiring their healthy substance. As a rule, the appetite of a 
healthy growing child for plain and wholesome food ought never to be 
stinted. (See Food, Digestion, Exercise, Excitants, Health, etc.) 
GRUEL, OATMEAL. (See Cookery for the Sick.) 
GRYPHOSIS, gri-fo'-sis [Gr. from grupoein, to incurvate], in 
Surgery, is a disease of the nails, which turn inwards, and irritate the 
soft parts below. (See Nails, Ingrowing of the.) 
GUAIACUM, gwa -ya-kum [from guayac, its native name], a genus 
of the Nat. order ZygophyUacew. The species G. officinale is a fine 
evergreen tree from forty to sixty feet in height, and of a dark, gloomy 
aspect. It is a native of the West India Islands. The wood is remark- 
able for its hardness, toughness and durability, qualities which render it 
particularly valuable for many purposes. It is known in commerce as 
lignum-vitae. This wood and a resin obtained from it are officinal, and 
are known respectively as guaiacum-wood and guaiacum-resin. Both 
the wood and resin are used as stimulants, diaphoretics, and alteratives, 
chiefly in gout and rheumatism, and also in syphilitic and various cutane- 
ou-s affections. The dose of the resin is from 10 to 30 grains. The mixture 
is formed by triturating ounce of the resin in powder, with ounce of 
refined sugar and ounce of gum acacia powdered, and adding gradually 
1 pint of distilled cinnamon water. Dose, 4 to 2 fluid ounces. The 
ammoniated tincture is formed by macerating 4 ounces of the resin 
powdered in 15 fluid ounces of the aromatic spirit of ammonia for seven 
days, in a well-closed vessel; then filter, and add of the spirit of ammo- 
nia enough to make 1 pint. Dose, £ to 1 teaspoonful. 
GU ARANA, gar-a'-ng^ a preparation from the seeds of the Paulinia. G UABANA- G UMS. 
715 
Sorbilis^ a Brazilian tree belonging to the Nat. order Sapindaceas. 
It is held in high repute as a remedy for sick headache, bowel com- 
plaints, neuralgia and rheumatism. Dose: of the powder, 30 to 40 
grains ; fluid extract, 10 drops to 1 teaspoonful, three or four times 
a day. 
GUINEA PEPPER. (See Amomum.) 
GUINEA WORM. (See Filaria.) 
GULLET. (See (Esophagus.) 
GULLET, FOREIGN BODIES IN THE. (See Foreign Bodies in 
the Gullet.) 
GUM, gum [Fr. gomme\ a vegetable product, which forms a slimy solu- 
tion with water, but is insoluble in alcohol, ether, and oils. There are 
six varieties of gum-gum-arabic, gum-Senegal, gum of the cherry and 
other stone-fruit trees, gum-tragacanth, gum of Bassora, and the 
gum of seeds and roots. All these gums, except the last, flow sponta- 
neously from the branches and trunks of their trees, and sometimes from 
the fruits, in the form of a mucilage, which dries and hardens in the air; 
the gum of seeds and roots, however, requires to be extracted by boil- 
ing water. A number of very different substances are confounded in 
commerce under the name of gum. Thus, gum elemi and gum copal, 
which are true resins; gum ammoniacum, which is a gum-resin; and 
gum elastic (caoutchouc), which differs from both, are all called gums. 
GUM-AMMONIAC, OR AMMONIACUM. (See Ammoniacum.) 
GUM-ARABIC. (See Arabic, Gum; Acacia; Gum.) 
GUMBOIL, gum'-boil, is a small abscess which forms in the cellular 
substance of the gum. At first it is sufficient simply to protect it against 
cold; but if it continues to advance, the process of ripening may be 
hastened by hot application to the cheek, next to the swelling. If the 
pain be excessive, a leech applied to the part will usually afford relief. 
As soon as the presence of matter can be ascertained, it should be let 
out by a free incision. 
GUM-DRAGON. (See Astragalus.) 
GUM-ELASTIC. (See Caoutchouc.) 
GUM OF BASSORA. (See Bassora Gum.) 
GUMS, gumz [Ang.-Sax. gomd\. The gums which closely invest, but 
do not adhere to the teeth, are composed of mucous membrane of a dense 
insensible character. In the investigation of disease, the gums frequently 
afford valuable information respecting general constitutional disorder. In 
sea-scurvy, the gums become spongy and swollen, extend over the teeth, 
and bleed easily. In persons who have been long subjected to the action 
of lead, slowly introduced into the system, either in the course of their 
occupation, or, as sometimes occurs, from the ordinary drinking water 716 
G UMS- G UTT A-PER CHA. 
having become impregnated with the metal from lead pipes, a blue line 
is often observable along the edge of the gum. A pink line in the same 
situation has also been pointed out as showing itself in persons affected 
with pulmonary consumption. In constitutional affection by mercury, 
it is well known that the gums become inflamed, sore and spongy, in 
some cases of disease affecting the mouth, the gums become dark or 
black in color, and the breath is extremely foetid. 
Of course, in cases where the state of the gum is indicative of con- 
stitutional affection, that must be attended to, but the condition of the 
gums in any case, may generally be much relieved by the use of astrin- 
gent substances in the form of washes; none, perhaps, is better than 
the tincture of myrrh, but camphor dissolved in alcohol may also be used, 
or, indeed, almost any one of the astringents. A dram of alum dis- 
solved in a pint of water makes a very good and cheap wash. 
In the case of black-looking gums, with foetid exhalation, a wash 
made of 2 drams of muriatic acid to 1 pint of water will be found 
most especially useful, or 2 drams of the solution of chloride of soda 
may be used with equally good effect. Such a case, however, must 
require medical attendance. The gums in the teething of children require 
much attention. (See Children.) 
GUM-SENEGAL. (See Gum; Arabic, Gum.) 
GUM-TRAGACANTH. (See Astragalus. ) 
GUN-COTTON. (See Pyroxyline, Collodion.) 
GUNSHOT WOUNDS. (See Wounds.) 
GUTTA-PERCHA, gut-tg -per'-tshg^ the concrete juice of the Isonan- 
dra Gutta, a tree belonging to the family of the Sapotacea. It grows 
abundantly in Singapore, Borneo, and other islands of the Eastern Archi- 
pelago. The tree, which is called percha, grows to the diameter of five 
or six feet, and on being notched, yields a milky juice, which solidifies 
after exposure to the air, forming the gutta-percha of commerce. It is 
a tough, inelastic substance, becoming soft and plastic at 212°, at which 
temperature it may be moulded into shape, which it retains without 
change until it is cool. It also possesses the valuable property of weld- 
ing together at the temperature of boiling water. Its plastic properties 
render it extremely useful. Being impervious to moisture, and resisting 
the actions of acids and alkalies to a great extent, it is of much use to the 
chemist as a material for making bottles, carboys, baths, etc. It may 
be rolled into thin transparent sheets, which are much used for surgical 
purposes, being perfectly impervious to moisture. 
Gutta-percha solution is beneficial as a protective covering for com- 
pound fractures, open cancers, suppurating gangrenous surfaces, burns, 
abrasions, wounds, etc. It may be applied by a brush or by pouring. G UTT A-PER CHA-HABIT. 
717 
A delicate film is left by evaporation of the liquid, which completely 
excludes the air and acts as an artificial cuticle. It has been topically 
employed w'ith advantage in various cutaneous affections, scrofulous and 
indolent ulcers, and to prevent pitting in small-pox. 
GYMNASTICS, jim-nas-tiks [Gr. gumnastike from gumnos, naked], 
a term applied to those exercises of the body and limbs which tend to 
invigorate and develop their powers. These exercise a very important 
influence upon health, strengthening the system and warding off or cur- 
ing many forms of disease. Indeed, there is probably no more likely 
way of inducing disease than by giving oneself up to indolence and inac- 
tivity. Gymnastic exercises, practised under proper control, must act 
beneficially, both mentally and physically. They strengthen the various 
organs of the body, and render them more able and efficient servants of 
the mind; they accelerate the circulation of the blood, increase the action 
of the various secretive organs, promote the carrying off of effete mate- 
rials, render the body less susceptible to the influence of heat or cold, and 
enable it to ward off many forms of disease. They also strengthen the 
will by giving it increased power over the bodily organs, restrain the 
imagination and fancy within proper limits, and in a remarkable degree 
abate the desire for sensual pleasures. Indeed the mental benefits 
which they confer are probably equally great with the physical, for they 
give clearness and precision to thought, cheerfulness, courage, presence 
of mind, and independence of spirit. "If you wish to develop the mind 
of a pupil," says Rousseau, "develop the power which that mind has to 
govern; exercise his body; make him healthy and strong, that you may 
make him prudent and reasonable." 
But it must be remembered, gymnastics are too often practised in an 
injurious manner, causing violent straining of the limbs, joints,etc. It is 
said by many eminent authorities, that professional gymnasts often die 
prematurely from heart disease, etc., incurred by violent exercise. 
Gymnastics, to be beneficial, must be indulged in with discretion and 
moderation. (See Exercise, Movement Cure.) 
GYPSUM. (See Calcium.) 
HABIT, hab'-it [Lat. habitus ; hdbeo, habitus, to have]. The con- 
nexion existing between the influence of the will and certain sensations 
and motions in the living body, is a fact of which every one must be 
conscious from personal experience; when, however, the actions resulting 718 
HABIT-IIHI AI A TO CELE. 
from these sensations and motions are, after frequent repetition, per- 
formed without a distinct and conscious exercise of the will, they are 
said to be the result of habit. These habits, however, are of the body, 
and are distinct from habits of the mind, influences which act upon the 
will itself, with lesser or greater power, and impel the individual to cer- 
tain acts. 
It is, perhaps, needless to advert to the proverbial power which habit 
exercises, not only over man but animals, becoming to them a "second 
nature," and to their offspring a natural tendency. So powerful an 
agent, both mental and physical, as habit, cannot fail to be largely 
implicated in the consideration of the nature and treatment of disease. 
It is sometimes of the greatest consequence, not only to break the influ- 
ence of habits of which the mind is conscious, but even of habits of 
disease over which the mind has generally no control. This is particu- 
larly the case with respect to periodic diseases of the nervous system, 
such as ague, etc., which, after a time, appear to be continued rather 
from the habit of the constitution than from any other cause. 
Still more widely connected with the treatment of disease, is the 
acquisition of good habits, in the room of bad ones, which are often the 
causes of impaired health. Some individuals constantly eat and drink 
too much, from mere habit, others take little or no exercise "from 
habit," and although conscious of these and other negligences, often 
require considerable exertion of the will, aided by the almost despotic 
commands of a medical attendant, before they can break through them. 
The good effects of habit in persons liable to constipation have already 
been pointed out in the article Costiveness ; in this case the habit 
originating in the will, becomes, after a time, partly or wholly involun- 
tary. 
There is, however, another state of disorder, and a more intractable 
one, in which the influence of habit may be most beneficially exercised. 
It is that state of hypochondriac unrest called the "troubled mind." In 
such a condition, nothing is more valuable, than the habit of daily, at 
certain fixed times, forcing the mind to bend itself to some definite con- 
tinuous employment, one which it will require some degree of mental 
exertion to carry on, and which will maintain its interest, perhaps an 
increasing one, from day to day. (See Hypochondriasis, Melancholia.) 
HJEMATEMESIS, hem-a-tem'-e-sis [Gr. blood; and emeo, to 
vomit], vomiting of blood from the stomach. (See Hemorrhage.) 
HJEMATOCELE, lie-mat'-o-sele [Gr. alma, and Icele^ a tumor], a 
soft, fluctuating tumor of the testicles caused by a blow or other injury 
to the part. It is simply blood effused into the cavity of the scrotum, 
which flows out as soon as an opening is made for its escape. IIXIAI A TOXYL ON-IIAIII 
719 
HaEMATOXYLON, he-ma-toks'-e-lon [Gr. aima, blood; xulon, 
wood], a genus of the Nat. order Leguminosce, the species II. campe- 
chianum is a tree of sub-tropical America, yielding the wood commonly 
known as logwood. The sliced heartwood of this tree is the part used 
in medicine. The chips are of a reddish color, having a feeble, agree- 
able odor, and a sweetish taste; a small portion chewed imparting to the 
saliva a dark pink color. It is tonic and astringent, without any irrita- 
ting properties. It does not constipate nor so readily disorder the diges- 
tive organs as many other astringents, hence its use may be continued 
for a longer period. It may be employed as an astringent to control diar- 
rhoea, hemorrhages and excessive night sweats. The mildness of this 
drug gives it a preference over many others in the treatment of the diar- 
rhoeas of children. Dr. Churchill speaks favorably of logwood both as 
an internal and local application in treatment of the whites, mentioning 
many cases of improvement and recovery. In cancer and gangrene an 
ointment of the extract proves serviceable. 
The decoction is formed by boiling 1 ounce of the chips in 1 pint of 
distilled water for ten minutes, adding 60 grains of powdered cinnamon 
bark, straining, and adding distilled water to make up 1 pint. Dose: of 
the decoction, 1 to 2 fluid ounces: fluid extract, £ to 1 teaspoonful; solid 
extract, 5 to 30 grains. 
HaEMATURIA, he-ma-tu -re-a [Gr. aima, blood, and ouron, urine], 
is bloody urine, a discharge of blood with the urine, owing usually to a 
diseased state of the kidneys or bladder. It is a symptom of a diseased 
state of one or other of these organs, to which the treatment is to be 
directed. (See Urine.) 
HaEMOPTYSIS, he-mop '-te-sis [Gr. aima, blood, and ptusis, spit- 
ting], bleeding from the lungs. (See Hemorrhage.) 
HaEMORRHAGE. (See Hemorrhage.) 
Haemorrhoids. (See Piles. ) 
HAIR, hare [Ang.-Sax. hcer], is a development from, it might be 
called a prolongation from, the outer or scarf skin. Each separate hair 
is contained in a pit which passes into the true skin or through it, into 
the tissues beneath. Into this pit the outer or scarf skin is folded, and 
from this folding the hair is developed, consisting of an external or den- 
ser portion composed of flat over-lapping scales, and an internal porous 
pith, which contains the coloring matter. 
The condition of the hair is often highly symptomatic of the bodily 
condition, at the same time it is, of course, liable to alteration from local 
influences. 
The hair is apt to become split or forked in consequence of weak 
growth; this generally occurs in persons in a debilitated condition. 720 
HAIR-IIAIR-CAP MOSS. 
Keeping it cut tolerably short is a good preventive, but of course removal 
of the bodily weakness of which the state of the hair is symptomatic, is 
essential. The color of the hair is indicative of constitution and temper- 
ament. (See Temperament.) Its changes in color indicate generally 
the advance of years, but sometimes the premature gray speaks of con- 
tinued mental toil and trouble, and it has followed at once upon violent 
mental emotion, a few hours sufficing for the change. 
The unfortunate queens, Mary of Scotland and Marie Antoinette, are 
both said, among many others, to have been instances of this effect of 
mental emotion upon the hair; and the fact of this direct connection 
between the condition of the body and the coloring matter of the hair, 
renders it probable that permitting the hair of children to be kept long, 
is really subjecting them to a source of constitutional weakness. 
Falling out of the hair occurs from weakness, either of the body gen- 
erally, or of the hair bulbs or follicles themselves. Various stimulant 
local applications are used in such cases. (See Baldness.) Balsam of 
Peru, 1 dram, stirred well into 1 ounce of simple cerate when melted, is 
said to be a good application. Of late years, several very interesting 
diseases of the hair have been discovered by the aid of the microscope. 
They are dependent upon the presence of vegetable parasitic fungi, and 
can only be properly recognized and treated by a skilful medical man. 
Removal of the hair is a proceeding frequently called for in the 
treatment of disease, especially of febrile and inflammatory affections 
affecting the head. In these cases, it maybe entirely removed, at once, 
without risk, and should be shaved off when the full effect of the pro- 
cedure is required. Some persons, especially females, are often much 
vexed at the shaving of the head in fever, etc. Its necessity is, of 
course, or ought to be, answer sufficient; but it often happens, that if 
the hair has not been taken off during the course of disorder, it must, 
from tendency to shed afterwards, be shaved off during convalescence. 
When the hair is removed in persons not suffering from acute disease, 
it must be done cautiously, especially if this natural clothing has been 
somewhat long and thick. Where it must be taken off, entirely, and 
at once, the head should be protected by a cap of flannel, otherwise 
neuralgic or rheumatic attacks may be the consequence. 
Frequent cutting undoubtedly strengthens the growth of the hair, 
and frequent brushing and washing are quite the best methods for pre- 
serving its health and cleanliness, and ought, along with the assistance 
of the one-sided comb, to be solely trusted to-the irritating "small 
tooth comb" ought to be banished from use entirely. (See Baldness, 
Dandriff, Scalp, Skin.) 
HAIR-CAP MOSS. (See Polytrichum Juniperum.) Hamamelis Vibginica. (Witch Hazel.) HAIR GLOVE-HAMAMELIS VIRGINICA. 
721 
HAIR GLOVE. This is a glove woven of horse hair, with the 
ends left on. It is used to remove the superfluous cuticle, and in all cases 
where counter-irritation is required, may be employed with advantage. 
HALLUCINATION, hal-lu-se-na'-shun [Lat. hallucination from hal- 
lucinor, I err], denotes an error or mistake of the senses. It was a 
favorite maxim of Kant's "that the senses do not deceive us at all-it 
is only the judgment that deceives us." This is indeed true of illusions, 
where what is represented to consciousness are objects really existing, 
but different from what they really are; but it is not true as regards 
hallucinations strictly so called, where the senses convey to conscious- 
ness what do not really exist. Hallucinations do not depend upon 
the judgment, but are somatico-physical abnormities. In illusions we 
have chiefly to consider the external occasion and the mental con- 
dition of the individual; in hallucinations, the organic and physical 
condition. They sometimes only affect one, sometimes several, and 
even all the senses. Hallucinations of the sight are perhaps the 
most frequent, and are commonly visions of sparks, flames, luminous 
spectres, terrific phantoms, etc. Hallucinations of hearing are also very 
common-humming or ringing in the ear, the sound of voices, etc. 
Hallucinations of smell are much more rare; but hysterical persons often 
smell objects which are not present; such as sulphur, musk, violets, etc. 
Hallucinations of taste resemble those of smell; and hallucinations of 
touch are also rare. The hallucination has always a subjective ground; 
either the receptive organ suffers, or the leading nerve, or the reacting 
cerebral centre, chiefly from pressure of blood, cramp, etc. The course 
and termination of these states of mind, which are only symptomatic, 
issue, after longer or shorter duration, either in health, from undeceiving 
the patient, or, if this does not happen, in a fixed idea, in insanity. The 
hallucinations of sight and hearing, on account of the psychical dignity 
of their organs, are especially of a fatal import. (See Insanity.) 
HAM. (See Bacon, Pork.) 
HAMAMELIS VIRGINICA, ha-marrt-edis vir-jin'-e-ka^ or witch 
hazel, a perennial shrub belonging to the Nat. order Berberidacea. It 
grows in almost all sections of the United States, and in different parts 
is known by the common names striped alder, winter bloom, snapping, 
and spotted alder. The bark and the leaves are the parts used in medi- 
cine. Witch hazel is tonic, astringent, and sedative, and is used in 
hemorrhages, and diarrhoea and dysentery, and excessive mucous dis- 
charges. Locally it is used as a wash for sore mouth, and for scald head. 
Dose: of the fluid extract, 1 to 2 teaspoonfuls; infusion, 1 to 2 fluid 
ounces; syrup, 2 to 4 teaspoonfuls, three or four times a day. (See 
Infusion. ) 722 
HAND-HANGING. 
HAND, hand [Ger. hand, Lat. manus}, is the lower portion of the 
superior extremity, the great organ of touch and prehension. The hand 
is that which distinguishes man in the class of mammals, he being the 
only animal possessed of two hands. That which constitutes the hand, 
properly so called, is the power of opposing the thumb to the other 
lingers, so as to seize upon the most minute objects. The hand is com- 
posed of a number of small bones, twenty-seven in all, so arranged as 
to combine the greatest possible degree both of strength and flexibility. 
These are arranged in three divisions-those of the carpus, metacarpus, 
and phalanges. They are connected together by numerous ligaments 
running in various directions, by means of which the bones are kept in 
their proper positions. Besides these there are the various muscles of 
the hand, which give to it the several motions of flexion, extension, 
abduction, adduction, and circumduction. The hand is also richly sup- 
plied with blood-vessels and nerves. This wonderful agent of the human 
mind is much exposed to injury. When this occurs, as it often does, at 
a distance from medical aid, one principle must ever be remembered, 
that the preservation of as much of the member as possible, even of a 
single finger, or of part of one, is of the highest moment with reference 
to future usefulness. In a crush of the hand, when bleeding is not great, 
the best treatment will be to place it in a large warm poultice, and keep 
at rest until medical aid is procured. The management of various acci- 
dents, etc., will be found under such heads as Artery, Dislocations, 
Fractures, Wounds, etc. (See Anatomy, Fingers.) 
HANDS, BLISTERED. (See Blistered Hands or Feet.) 
* HAND SHOWER-BATH FOR CHILDREN. (See Baths and 
Bathing. ) 
HANGING, hang'-ing, suspension of the body by the neck-may 
cause death, in three distinct modes; by compressing the windpipe, and 
producing suffocation; by compressing the veins of the neck, and caus- 
ing apoplexy; or more rarely by dislocating the neck. The two former 
modes may be mixed up together; the latter, when it does occur, is in 
consequence of a "fall," such as is given at a public execution; it of 
course causes instantaneous death. Recovery from hanging must in 
some degree depend upon the completeness or not of the interruption to 
the passage of air through the windpipe for any time; it is not likely 
that resuscitation will be effected if this has continued four minutes. 
The first thing to be done when a person is found hanging is, of course, 
to cut him down at once, to loosen the material around the neck, to dash 
cold water over him, and to bleed. In such an emergency, a person 
would be quite justified in cutting across the temple, where the artery 
beats, with a penknife, and allowing blood to flow to the extent of 10 or HANGING-HA Y ASTHMA. 
723 
12 ounces. The bleeding could be controlled until the arrival of a sur- 
geon, by means of pressure against the bone. In most respects, the 
treatment of a person hanged must be similar to that of one drowned, 
except that the application of heat would scarcely be requisite in the 
same degree. (See Deowning.) 
HARDHACK. (See Spiraea Tomentosa.) 
HARELIP, hare-lip [Lat. labium leporinum^ is applied to a con- 
genital malformation of the lip, from its fancied resemblance to the lip 
of a hare. It is a cleft or division of one or both lips, but usually the 
upper. Sometimes there is a considerable space between the parts, and 
occasionally the cleft is double, there being a little lobe, or small portion 
of the lip, between the two fissures. Sometimes, also, the fissures extend 
through the bones of the mouth. The operation for the hare-lip consists 
in paring off the edge of the separated parts on each side, and bringing 
the two new surfaces together, so as to close up the fissure, retaining 
them in their places by means of what is known as the twisted 
suture. This operation should be performed as soon as possible after 
birth. 
HARTSHORN, POISONING BY. (See Alkalies, Poisoning by.) 
HARTSHORN, SPIRITS OF, OR SAL-VOLATILE. (See Ammo- 
nia.) 
HATRED. (See Passions.) 
HAWKWEED. (See Hieracium Venosum.) 
HAY ASTHMA, ha, sometimes known as rose-cold or hay fever, 
seems to be a mixture of ordinary asthma and catarrh. 
Causes.-It appears to be due to the inhalation of particles of finely 
divided hay and spring grass, and occurs in spring when the meadows 
are being mown. Powdered ipecacuanha will, in some instances, pro- 
duce the same effect, and also the aroma of certain kinds of strawberries. 
It is an uncommon disorder, only a few of those exposed to the cause 
being ever affected with any of its symptoms. 
Symptoms.-Watering of the eyes and nose, tightness across the 
chest, cough and mucous expectoration, difficulty of breathing and 
sneezing, giving rise to the feeling of impending suffocation. It attacks 
some persons very suddenly, and at a distance sometimes of several miles 
from the exciting cause. It appears to run in families. 
Treatment.-The chief point in the treatment is to remove from the 
source of the infection. Tincture of the lobelia injlata has been highly 
recommended and may be given as follows : 
Take of Tincture of lobelia One dram. 
Pure water Three ounces- Mix. 
Give a tablespoonful three or four times a day. 724 
HAY ASTHMA-HEADACHE, ETC. 
The tonic plan of treatment, consisting of the administration of iron 
and quinine, has many advocates. 
Take of Sulphate of quinine Forty grains. 
Sulphate of iron Twenty grains. 
Dilute sulphuric acid Two drams. 
Pure water One pint.-Mix. 
Give a tablespoonful before each meal and at bed-time. 
Arsenic, in the shape of two drops of Fowler's solution in water after 
each meal, is an effectual remedy, but is not safe in the hands of unpro- 
fessional persons. 
Preventive treatment.-Dr. Watson recommends the use of a respi- 
rator, during the hay season, and also that rags dipped in a solution of 
chloride of lime, should be hung in various places, and a small bottle 
of Labarraque's disinfectant be carried about the person. (See Labar- 
raque's Disinfecting- Fluid.) 
A visit to the White Mountains of New Hampshire is usually attended 
with great benefit, and Colorado and the Lake Superior region offer the 
best places of refuge from this disease in the West. (See Health 
Resorts. ) 
HAY-SAFFRON. (See Crocus Sativus.) 
HAZELWORT. (See Asarum.) 
HEAD. (See Anatomy, Brain, Caput.) 
HEADACHE, CEPHALALGIA, OR CEPHALALGY, hed'-ake 
[Ang.-Sax. heafod, head; ace, ache] is one of the most frequent ailments, 
and the result of a great variety of causes; consequently many varieties of 
headache are enumerated by medical writers; the consideration of all 
these in a work like the present would tend rather to confuse than to 
enlighten. The subject will probably be rendered most clear and useful 
to the unprofessional reader by considering it generally under the divis- 
ions of: 
Headache from overfulness of blood; headache from deficiency of 
blood, or debility; headache from excited or inflammatory action; head- 
ache from sympathy, and headache from anomalous causes. 
If a person who suffers from headache is of full habit generally, if he 
is sleepy, dull, the vessels of the face full; if the uncomfortable sensation 
in the head is aggravated by stooping, by an abundant meal, by stimu- 
lants, or by sleep, overfulness is the probable cause, and reduction of the 
diet, purging the bowels with calomel and colocynth, and with occasional 
doses of saline medicine, exercise, bathing the head with cold water, 
and, if the symptom is very severe, the application of a few leeches to 
the temples will be beneficial. If the urine is deficient, cream of tartar 
in some form may be taken with advantage. The above species of HEADACHE, ETC. 
725 
headache, the result of general overfulness of blood, may also be occa- 
sioned by whatever impedes the circulation, such as affection of the 
heart or liver; when the latter is the cause, the pain is frequently most 
severe at the back of the head. 
When, on the other hand, headache occurs in a person of weak consti- 
tution, when it is produced by or aggravated by exertion of mind, much 
talking, etc., when there is listlessness, both of mind and body, rather 
than oppression-the face pale, the pulse weak-debility is the probable 
cause, although at the same time there may be overfulness of blood in 
the interior of the head itself; very frequently, however, in this kind of 
headache, the head is hot, without there being any particular flushing of 
the countenance. This form of headache also is frequently accompanied 
with indigestion, and is very common in students and anxious men of 
business. Anything like abstraction of blood will certainly prove injur- 
ious ; but cold to the head may be of service, not only as a temporary 
remedy, but habitually used by means of washing with cold water. 
Exercise, attention to the state of the bowels, without purging, some care 
in diet, and relaxation of mind, particularly by means of change of scene 
and air, will be most useful. In such cases, the whole system is weak- 
ened-the brain and nervous system, the circulating system, the diges- 
tive organs-and they act and react on one another. 
Headache from excitement or inflammatory causes is such as occurs 
in the first stages of inflammation of the brain, and in some forms of 
fever, or it follows violence to the head. It of course falls to be treated 
under the articles on these contingencies generally. 
Sympathetic headache is very common, and is evidently connected 
with disorder in some organ of the body, such as the kidneys, womb, 
etc. Headache, sympathetic with disorder in the stomach, or some 
part of the alimentary canal is, however, the most frequent form. The 
presence of bile, or of indigestible food in the stomach, almost certainly 
occasions dull pain in the forehead; an alkaline, or too acid condition of the 
contents of the organ exerts the same effect. The various symptoms of 
indigestion will generally point to the cause. In the first two, an emetic 
or some aperient, such as the compound rhubarb pill, or a stimulant, will 
probably remove the disorder. A vegetable acid, such as vinegar, many 
persons know from experience, will at once cure the headache, especially if 
it occurs from the use of oily or greasy food; and again when acid eruc- 
tations, heart-burn, etc., indicate the presence of superabundant acid, a 
dose of soda, potash, or magnesia will correct the cause, and remove the 
effect. 
It is in the form of headache, commonly known as sick headache, 
that the new remedy guarana exercises such a marked influence. In 726 
HEADACHE, ETC.-HEALTH. 
doses of 30 to 40 grains of the powder, or to 1 teaspoonful of the fluid 
extract, it often acts like a charm. (See Guarana.) 
Under the head of anomalous headaches, may here be classed all such 
as are not referable to any distinct cause. They constitute a considera- 
ble proportion of the cases of headache generally, and frequently baffle 
both the investigation and treatment of the medical adviser. (See 
Bilious Headache.) 
HEALTH, helth [Ang.-Sax. haltK], is that condition of the living 
body in which all the vital, natural, and animate functions are performed 
easily and perfectly, and unattended with pain. It consists in a natural 
and proper condition and proportion in the functions and structures of 
the several parts of which the body is composed. Physiology teaches 
us that there are certain relations of these functions and structures to 
each other, and to external agents, which are most conducive to their 
well-being, and which constitute the condition of health. Deviations 
from the due balance between the several properties or parts of the 
human frame constitute disease. The most perfect state of health is 
generally connected wTith a certain conformation and structure of the 
bodily organs, and well marked by certain external signs and figures, a 
well proportioned body, calm and regular circulation of the blood, free 
and full respiration, easy digestion, etc. There are, unfortunately, few 
persons who can be said to enjoy perfect health; and hence, in ordinary 
language, when we speak of health, we imply merely a freedom from 
actual disease. In this sense, the standard of health is not the same in 
every individual; that being health in some which would be disease in 
others. The healthy pulse in adults averages from seventy to eighty 
per minute, yet there are some in whom ninety or one hundred is a 
healthy pulse ; and others again, in whom the normal rate is from forty 
to sixty. Muscular strength and activity, nervous power and the power 
of sensation, vary exceedingly in different individuals, yet all within the 
limits of health. There is scarcely any earthly blessing men hold so 
lightly as health, and yet there is none the loss of which they so deeply 
deplore. Every man is accountable, in a much greater degree than is 
generally supposed, for his health. We often hear it said, that the 
deaths of the young and gifted are mysterious dispensations of Provi- 
dence ; when, if physiology were questioned, she might prove that they 
had fallen victims to their own neglect, or violation of laws to which 
inevitable penalties have been attached, and which have been imposed 
upon our nature for our benefit. A human being, supposing him to be 
soundly constituted at first, will continue in health until he reaches 
old age, provided that certain conditions are observed, and no 
injurious accident shall befall. This is a proposition so well supported HEALTH. 
727 
by an extensive observation of facts, that it may be regarded as 
established. 
It becomes, then, important to learn what are the conditions essential 
to health, in order that, by their observance, we may preserve for our- 
selves, what is justly esteemed as the greatest of earthly blessings, and 
dwell for our naturally appointed time upon the earth. A general 
acquaintance with these conditions may be easily attained by all, and to 
pay them obedience is much more within the power of individuals than 
is generally supposed. 
The leading conditions essential to health may be thus enumerated: 
1. A constant supply of pure air; 2. A sufficiency of nourishing food- 
rightly taken-and suitable clothing; 3. Cleanliness; 4. A sufficiency of 
exercise to the various organs of the system; 5. A right temperature; 
6. A sufficiency of cheerful and innocent amusements; and, 7. Exemption 
from harassing cares. 
Of course, a thousand accidents may befall us; and the statement 
of holy writ, that "there is but a step between us and death," is con- 
stantly true, yet, notwithstanding the many circumstances which are 
beyond our control, such as the race we belong to, our sex, the climate 
we live in, our social and financial position in life, hereditary tendency 
to disease, and in some instances, our occupations, it is beyond dispute, 
that it is within the power of a large proportion of the human race to 
prevent decrepitude and reach a hale old age. "The wicked shall not 
live out half their days," says an inspired writer, and it is just as true, 
that he who deliberately violates the laws of life and health, will go down 
to a premature, and in many instances, a dishonored grave. For further 
information on this all-important subject, the reader is referred to the 
whole work, for it all bears upon it. (See Sanitary Science, Food, 
Diet, Digestion, Dyspepsia, Meals, Breakfast, Luncheon, Dinner, 
Supper, Cookery for the Sick, Growth, Regimen; Rule, Living by; 
Drinks; Stimulants, Alcoholic; Habit, Exercise, Gymnastics, Move- 
ment Cure, Training, Pleasure, Recreation, Excitants, Travelling, 
Air, Ventilation, Disinfectants, Water, Climate, Health Resorts, 
Mineral Waters, Ablution, Baths and Bathing, Toilet; Skin, Care 
of the; Cold, Damp, Heat, Contagion, Light, Cold Feet, Clothing, 
Education, Chest, Flannel, Disease, Sleep, Early Rising, Life, Pas- 
sions, Occupation, Poverty; Age, Old; Climacteric Disease, Houses, 
Bed-Room, Chimney, Drainage, Walls and Wall Papers, Electricity, 
Hereditary Tendency, Menstruation, Marriage, Children, Sterility, 
Circulation of the Blood, Respiration, etc. See also the numerous 
individual subjects on the various articles of food, such as Beef, Mutton, 
Potato, Cabbage, Bread, Oatmeal, Raspberry, Strawberry, etc.) 728 
HEALTH, PUBLIC-HEALTH RESORTS. 
HEALTH, PUBLIC. (See Sanitary Science.) 
HEALTH RESORTS. An article on this subject is rendered 
necessary by the fact that within the past few years a great many places 
have sprung into notoriety, claiming to possess certain advantages in 
regard to water, temperature, location or scenery, for the cure of special 
diseases of the human system. In regard to many of these places, an 
examination of their respective merits has shown that they have been 
puffed into fame by parties who have lots to sell, or by interested share- 
holders in hotel or mineral water companies. On the other hand there 
are a great number of localities, both on this continent and in the old 
world, possessing special advantages as places of resort for parties suf- 
fering from individual cases of disease. Persons in the early stage of 
consumption, and those who are predisposed to attacks of bronchitis, 
catarrh, asthma, hay-fever, rheumatism, certain forms of heart disease, 
and emphysema of the lungs, as well as persons of a weak and feeble 
constitution generally, will often derive great benefit, and in many 
instances, prolong life, by passing a season or two at one of our warm 
and sheltered health resorts, provided, always, that it be well selected 
according to the advice of some medical man to whom the suitability of 
the place to the particular case is well known. It is very certain that 
many, for want of proper information on the subject, make an inju- 
dicious choice of a resort, and many more do not make the best -choice, 
and consequently fail to reap all the advantage they might from a resi- 
dence in a place suited to their requirements. 
In regard to the health resorts of the eastern hemisphere, it is not 
necessary to more than mention the names of a few of them, for the 
reason that those who possess sufficient means to take such an extended 
trip can easily acquire the necessary information from other sources. 
Among the favorite resorts in Britain, are Hastings, Margate, Tor- 
quay, Isle of Wight, Clifton, Brighton, St. Leonard's Ramsgate, Dover, 
Folkstone, and Jersey and Guernsey in the English Channel. 
On the Continent, beautiful retreats, too numerous to mention, may 
be found among the Swiss lakes; along the sunny shores of the South 
of France, and under the blue skies of Italy. 
The Azores and the Canary and Madeira Islands in the Eastern 
Atlantic Ocean, on account of their mild and equable temperature, are 
peculiarly adapted for a resort for the consumptive. 
In Canada, St. Catharines and Caledonia Springs, both in the Prov- 
ince of Ontario, are resorted to for the benefit to be derived from the 
mineral springs to be found there, while the beautiful scenery and clear, 
bracing air of the Muskoka district render it a delightful resort for the 
dyspeptic and careworn denizen of the heated and dusty town and city. HEALTH RESORTS. 
729 
Thousands seek vigor and relaxation there every summer; although the 
winters are long and severe, consumption is almost unknown there. 
Murray Bay, Cacouna and Tadousac in Quebec, are popular resorts both 
for health and pleasure, and are made doubly attractive by the magnifi- 
cent scenery to be met with in the voyage down the St. Lawrence. 
The principal resort of New England, is the White Mountains of New 
Hampshire, known as the Switzerland of America, a famous refuge for 
patients suffering from that peculiar form of asthma, known as hay-fever. 
The diversified scenery and fine sea-air have made Newport, R. I., 
a famous watering place. 
Long Branch and Schooley's Mountain in New Jersey, are favorite 
places of resort, the latter being visited for its chalybeate waters. They 
are very strongly charged with iron, and are very beneficial in all cases 
requiring the use of a ferruginous tonic. 
New York State has a great many popular resorts, chief among which 
are the Saratoga and Ballston salt springs; Sharon, Avon and Oak 
Orchard chalybeate springs; Clifton sulphur springs; and the carbo- 
nated springs at Lebanon. (See Mineral Waters.) 
Bedford and Gettysburg in Pennsylvania, are also resorted to for 
their mineral waters. Anderson's Spring, at the former place, contains 
iron in combination with other valuable ingredients, and the spring at 
Gettysburg contains a proportion of lithia, rendering its water valuable 
in the case of gouty, rheumatic, and dyspeptic subjects. 
The White and Red Sulphur Springs in Virginia, are popular places 
of resort, as are also the Alum Springs at Rockbridge and Church Hill, 
in the same State. In old ulcers and certain cutaneous affections of a 
chronic character, these alum waters are particularly serviceable. 
The pleasant little town of Aiken in South Carolina, six hundred 
feet above the level of the sea, is singularly free from all malarial influ- 
ences during the whole year, and is an excellent place of refuge for those 
who have been a long time suffering from disease of an intermittent or 
remittent character, as well as for the weak-lunged, who cannot endure 
either the dry cold of the North-Western States, or the moist heat of 
Florida and Texas. 
Florida has annually more health-seekers than any other portion of 
the continent. Its comparative freedom from miasmatic vapors, and its 
singularly equable temperature, render it a very desirable residence for 
the consumptive and bronchitic, especially that portion of it near the 
Miami river in the southeast. Jacksonville, with its superior accommo- 
dations, is the principal resort for invalids, whence, as strength permits, 
they branch off to the various springs and other watering-places through- 
out the healthy portion of the State. 730 
HEALTH RESORTS. 
Corpus Christi in Texas, possesses about the same temperature as 
Jacksonville, Florida, and is annually visited by hundreds of visitors 
with weak lungs. Austin, San Antonio and Galveston, in the same 
State, are also popular places of resort among health-seekers. 
The Hot Springs of Garland County, Arkansas, are in the vicinity 
of the Ozark Mountains, and are from six hundred to seven hundred feet 
above the level of the Gulf of Mexico. A quantitative analysis of the 
water of these springs shows them to contain very valuable ingredients, 
rendering them extremely serviceable in the treatment of rheumatism, 
scrofula, asthma, disease of the kidneys and bladder, and all disorders of 
menstruation. Arkansas possesses the smallest percentage of deaths 
from consumption of any State in the Union, a fact well worthy of con- 
sideration by the weak-lunged. 
Nashville in Tennessee, and Louisville in Kentucky, are favorite 
places of resort for those seeking refuge from the debilitating effects of 
the extreme heat farther south. 
In Michigan, Eaton Rapids, Grand Haven, and St. Louis, with their 
famous magnetic mineral springs, so useful in the treatment of rheuma- 
tism; Grand Ledge, St. Joseph, and Lake Zurich, are a few of the most 
prominent places of resort. 
Wisconsin and Minnesota are dotted all over with places noted for 
the special advantages they offer as residences for invalids. Thousands 
visit these States every year for the benefit of their health, many of 
whom go away thoroughly recuperated, and still many more*wonderfully 
improved. In the former State, Waukesha is famous for the Bethesda 
and Glenn springs, which are said to be wonderfully efficacious in the 
treatment of diabetes, Bright's disease, rheumatism, female weakness, 
diseases of the kidneys and bladder, and many other chronic affections. 
Sparta, in the Upper LaCrosse Valley, since the mineral springs were 
discovered in 1867, has been both a sanitarium and a fashionable place 
of resort. Besides these, may be mentioned, Geneva Lake, Devil's 
Lake, Sheboygan, Green Bay, Madison, Prairie du Chien, Lakeside, 
Nashotah, and many others, all desirable locations for the residences of 
health-seekers. Winona, the Queen City of Minnesota, is noted f<?r the 
salubrity of its climate, and is visited by many invalids. St. Paul, in 
the proximity of many beautiful lakes, is a famous health-resort ; one of 
the most popular in the United States. Frontenac and Lake City, on 
the shores of Lake Pepin, Minneapolis, Minnehaha Falls, Owatonna, 
Albert Lea, Red Wing, Faribault, Mankato, Rochester, and Lake Minne- 
tonka, are all desirable locations, and have many patrons. 
Colorado.-For patients suffering from hayfever, asthma, catarrh, and 
the early stages of consumption, there is no place on this continent equal HEALTH RESORTS-HEART 
731 
to Colorado. Persons far advanced in pulmonary consumption are some- 
times sent there, but it is a mistake; they go there only to die. For such, 
the climate of Minnesota or Western Kansas is far preferable. Denver, 
Lakin, Pueblo, Canon City, Colorado Springs, Manitou, and Hartsei 
Hot Springs, are the chief places of resort in the Centennial State. 
The water of the latter place is said to be very serviceable in the treat- 
ment of rheumatism, asthma and neuralgia. 
The climate of the National Park and Yellowstone Lake Regions, 
in Wyoming Territory, either as pleasure resorts or as resorts for 
invalids, is rarely equalled; and the scenery is probably unequalled any- 
where in the world; and as these regions become more accessible, they 
will be converted into a great national sanitarium. 
California is visited by many consumptives and rheumatics with 
marked benefit. The reader is referred to the article Consumption, for 
further information concerning the Golden State as a health-resort for 
the consumptive. (See Mineral Waters, Climate, Acclimatization, 
Consumption, Travelling, Health.) 
HEALTH, TENDENCY TO. (See Disease.) 
HEARING. (See Ear, Deafness ; Ear, Diseases of the; Cerumen.) 
HEART, hart [Ang.-Sax. hetyrte, Lat. cor], the great central organ 
of the circulation of the blood, is a 
hollow muscular organ in the form 
of an irregular cone, placed ob- 
liquely in the 'lower or front part of 
the thorax, and inclining most to 
the left side. The base is directed 
towards the spine, and corresponds 
with the fourth and fifth dorsal ver- 
tebrae, while the apex points be- 
tween the cartilages of the fifth and 
sixth ribs on the left side. The size 
of the heart is generally computed 
to be a little more than that of the 
closed fist of the individual. It is 
enclosed in a membranous bag, 
called the pericardium, but loosely, 
so as to allow free motion. It con- 
tains four cavities-two at the base, 
termed auricles, and two at the 
apex, named ventricles. The right 
auricle has four apertures-one 
from the superior vena cava, by which the blood is returned from the 
The Heart and Large Vessels. 
A, Right Ventricle. D, Left Auricle. 
B, Left " E, Aorta. 
C, Right Auricle. F, Pulmonary Artery. 732 
HEART-HEART- B URE. 
upper portion of the system; one from the inferior vena cava, return- 
ing the blood from the lower parts of the system; one from the coronary 
vein, by which the blood is returned from the heart itself; and one 
into the right ventricle. The blood passes from the right auricle into 
the right ventricle, the entrance to which is guarded by a fold of the 
lining membrane, forming a valve, called the tricuspid, from its present- 
ing three points. The blood is sent from the right ventricle into the 
pulmonary artery, by means of which it is conveyed to the lungs. The 
entrance to the pulmonary artery is guarded by three semilunar valves, 
which prevent the blood from again flowing back into the ventricle. The 
blood is returned from the lungs to the heart by the pulmonary veins, 
which convey it into the left auricle. From this it is sent into the left 
ventricle, the entrance into which is guarded by the mitral, or bicuspid 
valve, consisting of two pieces, of which the right one is much larger 
than the other. The left ventricle has its walls much thicker than the 
right, and forces the blood into the aorta, for distribution over the entire 
system. At the commencement of the aorta, there are three sigmoid or 
semilunar valves, as in the pulmonary artery, for preventing the blood 
from returning. The heart of a foetus differs from that of an adult, in 
having a foramen ovale, through which the blood passes from the right 
auricle to the left. The exterior fibres of the heart are longitudinal, the 
middle transverse, and the interior oblique. The contraction of the heart 
is termed systole; its dilatation, diastole. (See Artery, Veins, An- 
atomy, Circulation of the Blood; Heart, Diseases of the.) 
HEART-BURN, kart'-burn, is a burning or irritating sensation, felt 
either at the pit of the stomach or top of the throat, and occasioned by 
undue acidity, or by acrid matters in the stomach. It is generally 
relieved by an alkali-potash, soda, magnesia, or chalk-which neutral- 
izes the acid. It is not, however, advisable to have too frequent recur- 
rence to these palliative remedies, for they are only palliatives, they can 
not be taken habitually without weakening, not only the stomach, but the 
system generally. Heart-burn cannot continue to recur without there being 
an error somewhere ; either the diet is badly regulated, or the digestive 
organs require something more than simple neutralization of the super- 
abundant acid. This acid is a badly formed gastric juice, and if it is 
neutralized, whatever digestive power it might possess is destroyed, con- 
sequently the stomach is called upon to secrete another supply before the 
food can be digested-a call upon its powers which cannot fail to be inju- 
rious. Moreover persons finding how quickly a dose of alkaline medicine 
removes the uncomfortable sensation of heart-burn, are very apt to trust 
to the palliative, and continue their indulgences, rather than to practise 
the self-denial requisite to effect a cure of the cause. HEART-BURN-HEART, DISEASES OF THE. 
733 
Some persons find Spanish liquorice a good palliative in heart-burn. 
Twelve grains of bismuth, with 5 grains of aromatic powder, taken three 
times a day, in a little milk, will seldom fail to relieve. If there is much 
flatulency, Gregory's powder, in % dram doses, is good, and where the 
pain is great, 5 drops of laudanum may be taken with each dose. (See 
Diet, Dyspepsia, Digestion, Acidity of the Stomach, Water-Brash, 
ETC.) 
HEART, DISEASES OF THE. The heart, from the important part 
which it plays in the animal economy, is subject to various serious, and 
often fatal diseases. Like the other viscera, it is removed from the eye, 
so that little knowledge of its condition can be obtained by inspection; 
and hence we must have recourse to other means. The ear is the prin- 
cipal means of obtaining a knowledge of the state of the heart, and by 
auscultation and percussion (which see) we are enabled to detect the 
existence of various diseases. The heart gives out two sounds, 
known as the first and second, w'hich are distinguished from each other. 
The first sound is longer than the second, and the interval between the 
first and second sounds is shorter than that between the second and first. 
They have been compared to the two syllables lupp, dupp. Any mani- 
fest alteration in these sounds is indicative of the existence of disease. 
They maybe high or low, clear or dull, muffled, rough, intermittent, etc. 
Murmurs or regurgitant sounds may arise from diseases of the valves. 
The power of distinguishing between the normal and abnormal sounds 
of the heart, and of the causes producing the latter, can only be obtained 
by lengthened experience. Diseases of the heart are usually divided 
into two classes-(1) functional or nervous; and (2) structural or organic. 
Chief among the former are palpitation, syncope, or fainting, and 
angina pectoris (which see). They are chiefly to be met with in persons 
of a naturally nervous temperament, more especially women suffering 
from hysteria, or other like complaints, and may be induced by great 
mental excitement. In such cases great attention should be paid to the 
general health, and, by means of tonics, sea-bathing, and gentle open- 
air exercise, the system is to be strengthened. Violent exertion, and 
strong mental excitement, are particularly to be avoided. Among the 
principal organic diseases to which the heart is subject are pericarditis, 
carditis, endocarditis, atrophy, hypertrophy, dilatation, and valvular 
disease. 
Pericarditis, or inflammation of the pericardium, may be induced by 
exposure to damp or cold, or by other causes, which give rise to inflam- 
mation in other parts. It frequently arises from acute rheumatism, or 
from Bright's disease. It is characterized by great tenderness over the 
region of the heart, amounting when pressed, to sharp cutting pains which 734 
HEART, DISEASES OF THE. 
prevent the patient from lying upon the left side. If, as is usually the case, 
the pleura is involved, there will be acute pain on coughing or drawing 
a deep breath. Sometimes the attack is not so severe, and only a slight 
pain is felt, or only a sense of heaviness and oppression. Generally the 
action of the heart is increased, sometimes so much so as to constitute 
palpitation. Frequently there is a considerable quantity of fluid effused 
into the cavity of the pericardium, which is sometimes externally visible 
by the bulging out over that part. Its mode of treatment depends very 
much upon the particular circumstances of each case. Where the dis- 
ease is rapid and violent, bleeding may be of great service; but this 
course is not so much relied on or practised now as formerly. The 
bicarbonate of potash, in % dram doses every two or three hours, is 
recommended, together with opium, to relieve the pain and restless- 
ness. Poppy fomentations, o.r linseed-meal poultices, applied to the 
part, serve to relieve the pain, and the vapor-bath will usually be 
found beneficial. The diet should at first be light and nourishing; 
but if the patient is very weak, stimulants will be necessary, and after- 
wards the system should be strengthened by tonics. 
Carditis, or inflammation of the heart itself, sometimes occurs, but 
it is usually accompanied with inflammation of the pericardium; the 
symptoms in both cases are the same, and the treatment will, conse- 
sequently, be similar in both. 
Endocarditis.-The like remarks also apply, in a great measure, to 
endocarditis, or inflammation of the interior lining membrane of the 
heart, which is usually accompanied by one or both of the above. In 
this case there is more or less of fever and anxiety, and a peculiar sound 
of the heart is heard upon auscultation. 
Atrophy, or a wasting of the heart's substance, arises from a defi- 
ciency in the supply of nutritive matter. It is usually accompanied by 
general emaciation, and will be pretty sure to terminate in death. When 
the heart is examined after death, its tissues are found to have under- 
gone a change, and instead of a striped, to present a homogeneous 
appearance. This is called fatty degeneration. The treatment is to 
strengthen the system by tonics, wholesome and nutritious diet, open- 
air exercise, sea-bathing and the like. 
Hypertrophy, or enlargement of the heart, on the other hand, is the 
result of an excess of nutrition, the nutritive process appearing to go 
on more rapidly than the absorbent. In this way the heart is often 
greatly enlarged in bulk, and its operations seriously interfered with. It 
is usually distinguished into three kinds: (1) simple, when the walls 
of the heart, or its divisions, are thickened, without any diminution in 
the capacity of the cavities; (2) eccentric, or aneurismal, when the walls HEART, DISEASES OF THE. 
735 
are thickened, and the cavities likewise enlarged; and (3) concentric, 
when the cavities are diminished in proportion to the thickening of the 
walls. The first of these is least common, and the second the most 
frequent; and any of them may effect a single cavity or the whole heart. 
From the force with which the blood is propelled in such cases being 
greatly increased, the tendency is to produce hemorrhages, aneurism of 
the aorta, apoplexy, etc. The pulsations are frequently regular, but 
strong, sometimes even visibly raising the bed-clothes, and the chest is 
bulged out over the part. Rest, abstinence and more or less depletion, 
according to circumstances, are the proper means to be employed in such 
a case; and usually, with care and perseverance, the symptoms will be 
much alleviated. 
Dilatation of the heart is where one or more of the cavities are 
enlarged in size without the substance of the heart itself being increased. 
It is sometimes caused by increased action of the heart, and may be pro- 
duced by excessive exertion or strong excitement of any kind; it fre- 
quently also arises from want of sufficient muscular strength in the heart 
itself, or from some obstruction to the free passage of the blood. It is 
characterized by want of vigor in the circulation, and by feebleness and 
inability for exertion in the patient: he will often be exhausted by the 
loss of even a small quantity of blood and may even be carried off during a 
trifling hemorrhage. Attention to the general health, so as to strengthen 
the patient and restore the circulation to its normal state, while all exci- 
ting causes are to be avoided, are the means to employ in such circum- 
stances. 
Valvular disease of the heart.-The valves of the heart are subject to 
a variety of diseases which interfere with their proper action: these are 
among the most easily detected of the organic diseases, on account of 
the sounds produced by them. The valves frequently become thickened, 
so that they do not act freely, or close imperfectly, leading to obstruction 
or regurgitation of blood. Being connected with the endocardium, or 
internal lining membrane, diseases of the valves often result from 
repeated attacks of endocarditis. These obstructions tend to produce 
oppressions of the breath, apoplectic fits, sanguineous and serous con- 
gestions-as haemoptysis, albuminuria, dropsy, etc. The mode of treat- 
ment in such cases will depend upon the particular symptoms present. 
It would be quite profitless in this work to enter into anything like 
detail respecting diseases of the heart or their treatment;, disorders so 
varied in their nature and symptoms can only be properly investigated 
and managed by a medical man, conversant with the mechanism and the 
functions of the human frame at large, and in their relations of mutual 
dependence. 736 
HEART, DISEASES OF THE. 
As might be expected, affections of the heart generally, are evi- 
denced by pain in the chest, difficult breathing, cough, palpitation, etc.; 
and at other times byfaintings, giddiness, irregular pulse, etc.; but there 
is not one of these symptoms, or any combination of them, which may 
not be developed under certain bodily conditions, although the heart is 
perfectly sound ; none, therefore, need alarm themselves merely because 
such symptoms occur; they happen at times more or less to all, still they 
ought not to be neglected; if they continue to recur, a medical man 
should be consulted. If there is no disease the mind is set at rest, and 
any general disorder which may have caused the symptoms will probably 
be rectified. The above cautions are given because there is no class of dis- 
eases of which people are so apt to fancy themselves the subjects as 
those of the heart; and the more they think of the symptoms, the more 
likely are they to continue or increase, from an organ so intimately con- 
nected with the emotions of the mind as the heart. Again, even if the 
heart be unaffected, it is by no means advisable to permit it to continue 
to be functionally disordered, either by mental emotion or by sympathy 
with other organs, for the functional disorder may end in the organic 
disease; that it does so sometimes is evident from the fact, that there is 
no more fertile source of heart disease, than those convulsions, either 
commercial or political, which occasionally agitate society. 
If disease of the heart, either incipient or confirmed, does exist, it 
cannot too soon be discovered by examination, nor the necessary precau- 
tions and regulated mode of life too soon adopted: for with these pre- 
cautions, a large majority of persons who are the subjects of heart 
affection, may not only continue to live for years, sometimes many years, 
but to enjoy life. True, the knowledge to any one that he is himself 
the subject of heart disease may be uncomfortable, but it cannot be 
unprofitable; he may be aware that heart diseases are sometimes apt to 
have a sudden termination, and that his life may be somewhat more in 
jeopardy than that of an unaffected person; but surely to every right- 
thinking man, this fact would rather be an argument why he should 
know his real condition; the possibility of his being called away from 
the affairs of this life without warning, should be a reason for his keep- 
ing them well arranged; and still more important, should it be a reason 
that in conducting his earthly stewardship, he should do it, not only with 
reference to this world, but to give account of it in another; and when 
the many chances and contingencies of life are considered, the conscious- 
ness of being the subject of heart disease amounts to little more than 
such contingencies assuming a more prominent position in the mind, and 
to the individual it may be a merciful dispensation. It may seem to 
some that in writing thus the author is assuming the character of the HEART, DISEASES OF THE-HEAT. 
737 
clerical rather than of the medical adviser; it is not so, it is but taking 
advantage of the privilege which falls to the lot of the physician, when 
he has in his power times and opportunities in his relations wTith society, 
when the word in season cannot be out of place, as far as the welfare of 
those entrusted to his care is concerned. 
The causes of affection of the heart are very numerous; as already 
noticed, mental disturbance and agitation is a most frequent one, also 
mental depression and grief, which if long-continued, appear to exert 
much influence over the organ, and to make the phrase "a broken 
heart," not altogether a poetical fiction. Violent passion strongly affects 
the heart-its indulgence may lay the foundation of disease, which its 
repetition strengthens, and may bring to a fatal termination. Rheuma- 
tism, or rather rheumatic fever, is probably another of the most fertile 
sources of heart affection. In this disease, inflammation of some por- 
tion of the membranes covering or lining the heart is apt to occur, and 
to be followed by such effects as induce permanent change. Violent 
physical exertions, dissipation of all kinds, particularly the abuse of 
spirituous liquors, are all originators of the above affections. It has 
been said that persons with heart affections may continue to live and 
enjoy life, but it must be under a more regulated and restricted system 
of living than is imperative on persons in health. Everything which 
may be a cause of heart affection, must also be a source of aggravation; 
all mental or physical excitement especially so. When these are guarded 
against, the rest may be summed up in-strict attention to the general 
health. Whenever an old symptom becomes aggravated, or a new one, 
such as swelling of the legs, etc., appears, medical advice should always 
be taken. The great secret in these affections consists in maintaining 
the balance of the various functions, and this can only be done by the 
judicious management of a medical attendant. (See Heart, Ausculta- 
tion, Percussion, Stethoscope, Angina Pectoris, Hysteria, Palpita- 
tion of the Heart, Fainting, Circulation of the Blood, Health, 
Tonics, etc.) 
HEART SPASM, OR ANGINA PECTORIS. (See Angina Pec- 
toris.) 
HEAT, heet [Ang.-Sax. hatu or heat]. The imponderable agent 
which gives to our senses the feeling of heat, is in scientific language 
called caloric, to distinguish it from the term heat, used to designate the 
sensation. In this article, however, the one term heat is employed. It 
is not requisite here to enter into a consideration of the nature of heat; 
its sources, as best known, are the great fountain of it, the sun; there 
is also the heat developed in the interior of the earth; that produced, 
or at least manifested, by friction, and also by combustion, chemical 738 
HEAT. 
change, and in the bodies of animals (see Animal Heat), and in some 
plants. 
Heat is interesting in a medical point of view; first, from its effect 
upon the healthy body-its physiological effect; and second, from its 
effects as a remedy in disease-its therapeutical effect. 
Of the first, the physiological effects of heat, much has been said 
under Acclimatization, Animal Heat, etc., which it is unnecessary to 
repeat here, these articles sufficiently point out the effect of continued 
high temperature-from 80° to 110°-such as occurs in tropical climates, 
upon the human body. 
When the heat becomes very intense, particularly if there is direct 
exposure to the rays of the sun, more immediate and marked effects 
result; the brain may be affected, and sun-stroke, or "coup de soleil," 
as it is called, be the consequence. This affection, which is not uncom- 
mon in our cities, is sometimes also witnessed in the case of harvest- 
laborers in this country, in very hot summer weather. The affected 
person falls insensible, the face flushed and swollen, and the vessels beat- 
ing violently. The most efficient remedies are said to be pouring cold 
water on the head, and the administration of a small quantity of stimu- 
lant-ammonia or brandy. (See Sunstrokes.) The skin of persons ex- 
posed to extreme heat is liable to be affected with what is called "prickly 
heat;" an eruption of small pimples, or of minute blisters. In either 
case, the use of a tepid bath, with a little lead lotion, will allay the 
symptoms; and it may be well to take some cooling saline aperient. 
(See Prickly Heat.) 
Although continued exposure to heat produces these effects, it is now 
well known, that the living human body is capable of supporting, with 
impunity, exposure to an atmosphere of very elevated temperature, con- 
siderably above that of boiling water, provided the air be dry. The 
development of unusual heat at any part of, or over the whole body, 
is usually an attendant on feverish and inflammatory attacks. In scarlet 
fever, and in inflammation of the lungs this is particularly the case. 
It has lately been proved by a most extended and careful series of 
experiments, that 98° Fahrenheit is the average temperature of the 
human body in health, and that in fever and inflammation, the tempera- 
ture (as ascertained by a glass hand-thermometer, placed in the arm-pit) 
exceeds this by 4°, 6Q, or 8°. This is no less the case when the patient 
complains of cold and shivers, for while the skin feels cold, the blood is 
heated. 
The use of heat in the treatment of disease is very frequently alluded 
to in this work, more especially because it is not only one of the most 
extensively useful, but also one of the safest and most generally applicable HEAT-HEDEOMA PULEGIOIDES. 
739 
remedial agents which can be placed in unprofessional hands. Heat 
may be used as a remedial agent, simply as a soother, or-if we may be 
allowed the expression-an anodyne. In cases of severe pain such as 
colic, gall-stones, gravel, etc., heat properly applied, seems to act as heat 
simply, upon the nervous system, exerting an anodyne effect and reliev- 
ing the spasm. For this purpose it may be used, by means of bottles or 
tins filled with hot water, hot bricks, etc; but these solid bodies are not 
so useful or pleasant as other more yielding agents; and bags filled with 
heated grain, oats, salt, bran, or some such material are to be preferred. 
Elastic cushions, which can be filled with hot water, are also admirable 
for the purpose. When a derivative action (see Derivative) is required, 
as it is in inflammation and inflammatory pain, then heat with moisture 
must be used, and nothing answers better than the agency of moist heated 
bran. The great effect of the heat and hot vapor when used, in these cases, 
is to produce perspiration from the part, and thus to combine this means 
of relief with the anodyne action of the elevated temperature. The use of 
heat, especially of moist heat, in the treatment of disease, is especially 
pressed upon the attention of the unprofessional reader, for it is a remedy 
almost always procurable, and almost always safely useable. There are, 
however, a few exceptional cases, in which the use of heat is not desir- 
able. These are such as call for astringing rather than relaxing. Bleed- 
ing from, and swelling of various parts may be increased by heat, which 
must therefore be avoided. (See Animal Heat, Bran, Fomentation, 
Poultice, etc.) 
HEATING HOUSES. (See Houses.) 
HECTIC FEVER, kek'-tik [Gr. kektikosy habitual], is an intermit- 
tent form of fever which occurs in the latter stages of consumption, and 
also of other diseases of a slow wasting character. The paroxysm of 
hectic, usually comes on towards six o'clock in the evening, the person 
becomes heated, perhaps thirsty, the eyes are brighter than usual, the 
cheeks reddened-sometimes beautifully colored-and display the cir- 
cumscribed "hectic flush," at the same time an almost morbid eleva- 
tion of spirits is not uncommon. Towards midnight, the stage of fever 
is succeeded by that of perspiration, which increases as morning 
approaches, till towards four or five o'clock the patient is completely 
soaked in moisture and is left in a state of painful exhaustion. (See 
Consumption. ) 
HEDEOMA PULEGIOIDES, he-de-o'-mapu-le-je-oi'-deez, or Ameri- 
can pennyroyal, a plant belonging to the Nat. order Lamiacew. It is com- 
mon to all parts of the United States and Canada, and is known by the 
common names squaw-mint, tick weed and stinking balm. It is an aromatic 
stimulant, diaphoretic and emmenagogue, and is used in flatulent colic 740 
IIEDEO MA PELEG IO IDES-HELONIAS DIO IC A. 
and sick stomach. The infusion given warm will promote perspiration 
and also the menstrual discharge. Dose of the fluid extract, 2 to 4 tea- 
spoonfuls; the infusion may be taken freely. (See Infusion.) 
IIEDERA HELIX, hed'-e-ra hediks, or ivy, an evergreen creeper, 
belonging to the Nat. order Araliaceos. It is common all over the 
United States and Canada, as well as Europe. The leaves and berries 
are the parts used; the former, in decoction (see Decoction), has been 
found a useful application in salt rheum and itch; the latter are emetic 
and cathartic. They are not much used. (See Poison Ivy.) 
HELIANTHEMUM CANADENSE, kede-andke-raumkan-a-dense', 
or frostwort, a perennial plant, belonging to the Nat. order Cistacea. It 
grows on dry, sandy soil throughout the United States and Canada, and is 
known in some localities as frostweed, rock rose and scrofula plant. It 
is tonic, astringent, and alterative, and has been used in scrofula and 
some cutaneous diseases, and as a gargle in scarlet fever. Dose: of the 
fluid extract, 1 to 2 teaspoonfuls; of the syrup, a tablespoonful three or 
four times a day. The infusion is used locally as a wash. (See Infusion.) 
TIELIANTHUS ANNUUS, kede-an'-thus an'-nib-us^ or sunflower, an 
annual plant belonging to the Nat. order Asteracea. It grows throughout 
both Europe and America. The seeds have a great reputation as a 
diuretic. The infusion may be taken freely. (See Infusion.) Planted 
round a dwelling in marshy districts, sunflowers are said by good 
authorities to prevent miasmatic diseases, such as ague, and are often 
planted in large numbers for that purpose. 
HELLEBORE, AMERICAN. (See Veratrum Viride.) 
HELLEBORES NIGER, kelde-ko'-rus nl'-jur^ or black hellebore, a 
plant belonging to the Nat. order Ranuncsilacece. It is a native of 
Southern Europe, and from flowering at Christmas time, is called the 
Christmas rose. The fibres of the roots are the parts used medicinally. 
In proper doses it is a drastic cathartic, diuretic, anthelmintic and 
emmenagogue. Some physicians consider it superior to all other medi- 
cines for promoting the menstrual discharge. Dose: of the fluid extract, 
10 to 20 drops; solid extract, 1 to 5 grains; tincture, £ to 1 teaspoonful, 
three times a day. Its properties are very powerful, and it should be 
used with great caution. 
HELONIAS DIOIC A, kedo'-ne-as di-oi'-ka, or unicorn root, belong- 
ing to the Nat. order dAelanthacecs^ a perennial plant, growing one or two 
feet high, sometimes known as drooping starwort and colic root. It grows 
in most places all over the United States and Canada. The root is the part 
used in medicine. It is tonic, diuretic and vermifuge, and is beneficial in 
dyspepsia, loss of appetite and colic. It exercises a marked curative 
influence on the uterus and its appendages, whites, suppressed and painful HELONIAS DIOIC A-HEMORRHAGE, ETC. 
741 
menstruation, and predisposition to miscarriage. Prof. Ives recom- 
mends it as efficient in checking nausea and vomiting. Dose: of the 
fluid extract, 1 to 2 teaspoonfuls; syrup, to 1 fluid ounce. 
HEMATURIA, OR BLEEDING FROM THE BLADDER. (See 
Urine.) 
HEMICRANIA, OR BROW AGUE, hem-e-kra -ne-g, called by the 
French IMigraine^ and commonly known in this country as megrim, is a 
headache affecting the brow, and sometimes extending over one side of 
the head alone, leaving the other unaffected. In a great many instances 
it is periodical in its character, attacking the person at a certain hour on 
successive days, continuing during a defined period, and again as regu- 
larly subsiding; not uncommonly, however, it continues in an unmiti- 
gated degree for many hours, or even days. It is frequently connected 
with disorder of the system generally; failure of appetite, sickness and 
mental depression being usual accompaniments. 
When distinctly periodic in its nature, it yields readily to the admin- 
istration of quinine. After the bowels have been freely acted upon by 
some laxative medicine, from 5 to 10 grains of the compound colocynth 
pill, the quinine may be given in doses of from 2 to 5 grains every two 
or three hours until the pain ceases. When not distinctly periodical in 
its occurrence, and when evidently associated with general weakness, 
the preparations of iron are strongly indicated. The tincture of iron 
may be given in doses of from 10 to 20 drops in water thrice daily, or 
citrate of iron and quinine in 2 or 3 grain doses three times a day, or 
the syrup of the iodide of iron in doses of from 10 to 20 drops for a child, 
20 to 30 for an adult, thrice daily. The sulphate of iron, 1 or 2 grains in 
combination with 1 to 3 grains of extract of aloes, in the shape of a pill, 
three times a day, is an excellent preparation for this purpose. 
HEMIPLEGY, hem -e-plej-e, paralysis of one side of the body. (See 
Paralysis.) 
HEMLOCK. (See Pinus Canadensis.) 
HEMLOCK, POISON. (See Conium.) 
HEMORRHAGE, OR BLEEDING, hem'-or-raj [Gr. haima, blood ; 
and rhegnumt, I break or burst], is the escape of blood from its own 
proper vessels, but the term is usually applied to cases in which the 
effusion takes place in considerable quantity, and is rapidly poured out. 
Hemorrhage may be either external or internal; in the former instance, 
it is almost invariably the result of wound of some blood-vessel, either 
artqry or vein; in the latter, the blood may also be poured out by a large 
vessel, but generally, it is exuded through the lining membrane, or into 
the tissues of the part in which it occurs, from the minute vessels-so 
minute indeed, that after fatal cases of internal hemorrhage, the closest 742 
HEMORRHAGE, ETC. 
examination may fail to detect any visible opening, or openings from 
which the blood can have escaped. 
For information respecting external hemorrhage, or such as occurs 
from arteries or veins, the reader is referred to the articles under these 
heads. (See Artery, Arterial Hemorrhage, Veins, etc.) 
Internal hemorrhage, when it does occur from a large vessel, is the 
result of that vessel having been opened by disease, such as aneurism 
(see Aneurism), or by ulceration; but these instances are comparatively 
few. The head is an exception, however, to this remark, for hemorrhage 
within its cavity is almost always occasioned by the rupture of a vessel. 
(See Apoplexy, Concussion of the Brain.) Hemorrhage from piles is 
also exceptional. (See Piles.) 
Internal hemorrhage may be either of an active or a passive charac- 
ter; that is, in the former case the effusion of blood is preceded and 
accompanied by feverish symptoms, quickened pulse, thirst, with a sen- 
sation of fullness, and heat in the part whence the blood flows; in the 
latter these symptoms are absent. The effect of active hemorrhage is, 
generally, to give relief, either to the constitution at large, or to the par- 
ticular part; indeed, by some, active hemorrhage is regarded as a natural 
cure of what might otherwise prove an attack of inflammation. Passive 
hemorrhage, on the other hand, almost invariably weakens; it is the result 
of weakness and relaxation, which its occurrence tends to increase. 
As regards the management of or interference with continued cases 
of hemorrhage, unprofessional persons ought not, and cannot with any 
propriety have anything to do; but when the occurrence itself actually 
takes place, a knowledge of the best mode of proceeding may be of 
much service, for though in the case of active hemorrhage, benefit may, 
up to a certain point, be derived from the circumstance, the process 
might, possibly, especially if improperly managed, run on to an undue 
extent, and even affect life. 
Hemorrhage is more liable to occur from some parts of the body 
than others, and particularly from the mucous membranes which line the 
nasal and air-passages generally, from the alimentary canal, and genito- 
urinary organs. "Another important fact in respect to hemorrhages by 
exhalation is, that they proceed more frequently from certain parts of 
these mucous membranes than others, according to differences in 
age. Thus, in children they are most common from the membrane that 
lines the nasal cavities; in youth, from the mucous membrane of the 
lungs and bronchi." In middle life, from the bowels or bladder, or in 
the head. 
When an individual is suddenly seized with bleeding or hemorrhage 
from any part, as a general rule, perfect quietude of body and mind HEMORRHAGE, ETC. 
743 
should be observed, and cold is the simplest and readiest astringent, 
applied in the various forms of cool air, cold water, etc. Medicinal as- 
tringents (see Astringents) may be resorted to, and should the resulting 
depression be extreme, stimulants may be required, but their administra- 
tion calls for the greatest caution, and it must be remembered, that the 
state of depression may be the chief security to the patient against an 
immediate return of the bleeding. 
The causes of hemorrhage are various. As might be expected, gen- 
eral plethora, or superabundance of blood is a common one, hence, per- 
sons who take but little exercise, and live freely, are liable to it more 
than others. Perhaps the most general cause of hemorrhage is conges- 
tion, or accumulation of blood in any one part or organ of the body, in 
consequence of some impediment to the circulation; thus, disease of the 
heart, by damming up the blood in the lungs, or disease of the lungs 
themselves which impedes the flow, may, either of them, cause spitting 
of blood; or disease of the liver may cause hemorrhage from the 
bowels. 
Bleeding from the nose ^Epistaxis') is sometimes very profuse, and, 
either on this account, or from frequent repetition, may be the source of 
great weakness, in constitutions that can ill afford the drain, for its 
occurrence is not uncommonly associated with tendency to chest affec- 
tion. Many various methods for its suppression are had recourse to, 
but cold applied to the forehead, spine, or other parts of the body, 
is the most general. Raising both arms above the head has been 
said to stop the flow quickly, or a small quantity of solution of alum (see 
Alum), as strong as it can be made, may be thrown up with a syringe; 
or a piece of linen, soaked in the solution, may be stuffed up the nostril. 
From 10 to 15 drops of dilute sulphuric acid may be given in water at 
intervals, according to the nature and persistence of the attack. 
Bleeding from the nose, in persons advanced in life, must be much 
more cautiously interfered with than in the young. In the former, it is 
generally preceded by symptoms indicative of congestion about the head 
and, consequently, is a natural relief. It may, of course, go to an 
extreme extent, and require checking. 
Bleeding from the lungs, or spitting of blood, is generally preceded 
by symptoms indicative of undue determination or congestion of blood 
to, or in these organs. Oppressed breathing, cough, pain in the chest 
and feverish symptoms usually precede the attack, and just previous to 
it a saltish taste is generally perceived. Bleeding from the lungs may 
occur in every degree, from a mere tinge of the expectoration, to the 
copious coughing up of fluid blood. The blood is coughed up, whereas, 
when it comes from the stomach, it is vomited, a distinction which 744 
HEMORRHAGE, ETC. 
appears evident enough, but which is not always readily made in prac- 
tice. The management of hemorrhage from the lungs must be that 
recommended for hemorrhage generally. Until medical assistance can be 
procured, perfect quiet is to be observed, cool air, especially on the chest, 
freely admitted, and cold, or iced and acidulated drinks given plentifully. 
Alum will also be found useful. (See Alum.) Should the attack continue, 
and medical assistance still be absent, cupping on the chest (see Cup- 
ping), or between the shoulders, might be had recourse to. Sulphuric 
acid may be given as recommended for bleeding from the nose, or in an 
extreme case, when medical aid is far distant, 3 grains of sugar of lead 
maybe given, made into a pill with crumb of bread, every two, or three, 
or four hours, being washed down by a draught of vinegar and water. 
The expressed juice of the common nettle is sometimes popularly used, 
and, it is said, efficaciously, to check bleeding from the lungs; the dose 
1 teaspoonful three times a day. The inhalation of the smoke from the 
burning leaves of the belladonna, is said to check the immediate flow of 
blood from the lungs. For this purpose 1 dram of the cut and dried 
leaves is to be thrown upon glowing coals. In tendency to passive 
hemorrhage from the lungs, Dr. Theophilus Thompson recommends the 
following lozenge to be used as occasion may require. Take of pow- 
dered gum arabic, and of white sugar, each 3 drams; powdered traga- 
canth drams; alum, 2 drams ; catechu, 3 drams; rose-water sufficient 
to form a mass which is to be divided into sixty lozenges. When the 
cough is troublesome, it will be best allayed by a few drops of laudanum. 
'The causes of hemorrhage from the lungs are such as have been named 
above; persons of scrofulous constitution, or who have any malforma- 
tion of the chest are most liable to suffer from it. It rarely occurs in 
children. The exciting causes of this form of hemorrhage are such as 
call the lungs into active, strong, or continued exertion, such as violent 
bodily movements, much loud exercise of the voice, playing on wind 
instruments, etc.; these things must therefore be sedulously avoided by 
those who have any tendency to the disorder. Temperance and modera- 
tion, strict attention to the condition of the bowels, and to any accidental 
disorders of the chest, will be the best safeguards. Whilst treating of 
this subject, it should be mentioned that persons are often needlessly 
much alarmed, from thinking they are expectorating blood, whilst the 
fluid simply comes from the throat or gums, or, it may be, is the conse- 
quence of blood from the nose trickling down the back of the throat. 
It perhaps is scarcely necessary to add, that the above details of manage- 
ment are. not meant to stand in the place of competent medical advice. 
This should never be dispensed with in so serious a disorder as spitting 
of blood. HEMORRHAGE, ETC.-HEPATITIS, ETC. 
745 
In hemorrhage from the stomach (fl emat emesis), the blood is vom- 
ited, not coughed up; its causes and treatment, modified, of course, by 
the difference in the organ, and its site, are similar to those detailed in 
hemorrhage from the lungs. Vomiting of blood in young females, is 
not a very uncommon accompaniment of disorder of the menstrual func- 
tions, and can scarcely be considered a dangerous affection. The restora- 
tion of the proper excretion is, of course, the most effectual remedy. 
Vomiting of blood may happen in consequence of blood which has 
been effused from the nose having been swallowed ; in this case it is gen- 
erally darkened by the digestive action of the stomach. Blood from the 
lungs is generally much more frothy than that ejected from the stomach. 
In either case, the more florid the hue, the more active or inflammatory 
the hemorrhagic tendency. Profuse discharge of blood from the bowels 
often occurs in the course of fever, or from diseases of the abdominal 
organs, such as the liver, etc. Flow of blood from the bladder (Hema- 
turia), will be adverted to under the article Urine. (See Abortion, Acci- 
dents, Artery, Arterial Hemorrhage, Axilla, Childbed, Piles, Veins, 
Wounds, Styptics.) 
HEMORRHOIDS. (See Piles.) 
HEMP, INDIAN. (See Indian Hemp.) 
HENBANE. (See IIyoscyamus Niger.) 
HEPATIC, hepat'-ik, belonging to the liver. (See Liver.) 
HEPATICA AMERICANA, he-pati-e-kg a-mer-e-ka'-ng, or liverwort, 
an American plant belonging to the Nat. order Ranunculaceoe. It grows 
in the woods and on the sides of hills and mountains, and is known also as 
liver leaf and kidney liver leaf. The whole plant is used in medicine. 
It is a mild demulcent tonic and astringent, and has been employed with 
success in affections of the liver and lungs, and also in the early stages 
of diarrhoea and dysentery. Dose: of the fluid extract, 2 to 3 teaspoon- 
fuls; of the syrup, 1 to 2 fluid ounces. The infusion may be taken 
freely. (See Infusion.) 
HEPATITIS, OR INFLAMMATION OF THE LIVER, hep-a-ti'- 
tis [Gr. hepar, the liver], occurs in two forms, the acute and the chronic. 
It is a common disease in tropical countries, but is comparatively rare 
in northern climes. 
Causes.-Acute inflammation of the liver as already stated, is most 
generally due to the influence of a tropical climate; when not occurring 
in this way, it is almost always the result of mechanical injury, inflam- 
mation of the veins, dysentery, or the sequence of intemperance and the 
abuse of alcoholic stimulants. 
Symptoms.-Acute pain, of a darting character about the right breast, 
increased by inspiration and by lying on the right side, and ofttimes 746 
IIEPAT IT IS, ETC. 
extending to the right side of the neck and the right shoulder and collar- 
bone. The breathing is short and hurried, and there is a slight cough, 
nausea and vomiting are present, and the patient is troubled with hiccup. 
The skin is hot and dry, the mouth parched and the urine scanty, and 
there is great thirst. The spirits are depressed, the whites of the eyes 
are tinged with yellow, the countenance is sallow, and the bowels are 
constipated. When they do move, the evacuations appear to be desti- 
tute of bile and look like clay. 
Treatment.-Some few years ago, the usual plan of treating this dis- 
ease, as many others, was to bleed the patient freely from the arm, to 
apply leeches over the inflamed organ, and to give mercury internally, 
but most physicians of the present day have discarded all these reme- 
dies as useless, in the cure of this disease, and nourishing food and 
strengthening mixtures have been found more successful; such as iron 
and quinine, or the mineral acids with bark. 
Take of Sulphate of iron Twelve grains. 
Sulphate of quinine Ten grains. 
Dilute sulphuric acid .One dram. 
Pure water Six ounces.-Mix. 
Take 2 tablespoonfuls three times a day. 
Or, if the mineral acids be preferred: 
Take of Dilute nitro-muriatic acid Half a dram. 
Infusion of gentian Six ounces.-Mix. 
Give 2 tablespoonfuls three times a day. 
The congested liver may be greatly relieved by freely acting upon 
the bowels by some active purgative, and for this purpose sulphate of 
magnesia is very useful. 
Take of Sulphate of magnesia One and a half ounce. 
Tincture of henbane One dram. 
Peppermint water Six ounces.-Mix. 
Give two large tablespoonfuls morning and night. 
Inflammation of the liver may terminate in recovery, or may run 
into the chronic form; in some cases end in suppuration, an abscess 
being formed in the substance of the liver; or gangrene and death may 
be the result of acute inflammation attacking this organ. When the 
hepatic abscess is at length formed, lowering measures do harm-the 
system should be well supported by animal broths, and wine, and other 
stimulants; if the abscess be adherent to the walls of the abdomen, it 
may be carefully punctured, but most physicians think it best to let it 
break of itself; for if the liver be not adherent, some of the puriform 
matter will escape into the cavity of the abdomen and give rise to fatal 
inflammation. 
Chronic inflawimation of the liver may be brought on by the same HEPATITIS, ETC.-HEREDITARY TENDENCY, ETC. 
747 
causes as the acute form, or may be the sequel of it, or it may be due to 
the presence of cancer, hydatids, or scrofulous tubercles, and it is fre- 
quently caused by the too free indulgence in spirituous liquors. It is 
attended with the same symptoms as the acute form, but they are much 
less severe. 
Treatment.-The bowels should be acted on freely, and kept regu- 
larly open by saline purgatives. 
Take of Sulphate of magnesia Twelve drams. 
Carbonate of magnesia Three drams. 
Peppermint water Six ounces.-Mix. 
Give two tablespoonfuls once or twice a day. 
The compound iodine ointment may be rubbed in over the inflamed 
organ. Muriate of ammonia and the extract of dandelion have been 
much recommended, and may be thus given: 
Take of Muriate of ammonia One-half dram. 
Extract of dandelion One dram. 
Camphor water Six ounces.-Mix. 
Give two tablespoonfuls three times a day. 
Blisters applied over the inflamed organ often do good by relieving 
the hepatic congestion. The patient should take moderate exercise in 
the open air, and, if he can spare time, should get change of air and 
scene to counteract the languor, lassitude and depression of spirits so 
constantly accompanying all kinds of hepatic disorders. The diet should 
be nutritious, but not stimulating, and the intemperate man must give 
up his alluring drinks. 
Preventive treatment.-Inflammation of the liver is one of those 
diseases which may be generally prevented by the due observance of 
the ordinary laws of health. The man who eats regularly, takes mod- 
erate exercise, pays proper regard to cleanliness, and as a rule avoids 
high living and indulgence in alcoholic stimulants and narcotics, will not 
have much trouble with his liver. 
HEPATIZATION, kep-a-te-za-shun^ a term applied to a diseased 
state of a lung in which the spongy character of its texture is lost, 
becoming hard and solid, and of the nature of liver, whence the name. 
(See Pneumonia.) 
HERBS, erbz [Lat. herba\, plants which have stems that die down 
annually to the surface of the ground. As a general rule herbs used in 
pharmacy should be collected when they are beginning to flower in a 
dry day about midday, when they contain least moisture; they should 
then be subjected to a gentle heat, and afterwards spread out and fre- 
quently turned, so as to dry quickly. 
HEREDITARY TENDENCY, HEREDITARY DISEASE, ke-red'- 
e-ta-re [Lat. kereditarius\. The transmission of a tendency towards 748 
HEREDITARY TENDENCY, ETC. 
certain forms of disease from parents to children, and from ancestry 
generally to their descendants, has been an acknowledged fact from 
remote ages; a proof of the unmistakable character and frequency of 
the incident. Some portions of the body are more liable to be affected 
by transmission than others, "but no organ or texture is exempt from 
the chance of being the subject of hereditary disease;" and although 
some diseases are well known to be much more generally inherited than 
others, we have no means of determining how far the limitation extends, or 
whether indeed it does not include diseases generally within its bounds. 
Although there are maladies, such as small-pox, which are so directly 
inherited that the offspring is actually found to be affected with them 
when born, this is not the common rule, the hereditary taint acting 
rather by giving the bias to the development of the disease; and it is 
observed that those children which more nearly resemble the parent in 
physical conformation, are more likely also to resemble in liability to 
certain forms of hereditary affections. It is not necessary, however, for 
the transmission of hereditary disease that it should be developed in the 
parent, who, although the connecting link between a grandparent and 
grandchild as regards the disease bias, may yet have been entirely free 
from the transmitted disorder. In other words, a hereditary tendency 
to disease seems often to skip over one generation. 
Hereditary predisposition may be derived from a parent direct, and 
from a parent only in whom a certain state of disorder has been devel- 
oped, independent of previous hereditary influence; whatever debilitates 
the system, whether it be advanced life, dissipated habits, or the like, is 
almost certain to affect the children, and may originate a tendency to 
scrofula in a family previously free from it. Even a transient bodily 
condition seems frequently to influence the offspring, more particularly 
as regards the nervous system; drunkenness in the parent produces 
idiotic children; mental excitement communicates its own tendency. 
Again, disease apparently hereditary may be developed in a family 
without its being traceable in the descent; that is, the children, many, or 
all of them, may be liable to certain forms of disease, towards which 
neither the parents nor ancestors generally had displayed any marked 
tendency. The fact is one not uncommonly met with. 
Scrofula and consumption, gout and rheumatism, insanity and par- 
alysis, asthma, epilepsy, blindness, and a good many other diseases, are 
well ascertained to be transmitted by hereditary tendency. It is not, 
however, necessary that the tendency should develop itself under the 
exact form of the disease of the parent; thus, scrofula, instead of show- 
ing itself as consumption, may take the form of insanity, or gout may 
be substituted for gravel. HEREDITARY TENDENCY, ETC.-HEUCHERA, ETC. 
749 
The practical importance of a knowledge of these hereditary tenden- 
cies is self-evident. There are perhaps few, if any, who do not inherit 
some predisposition to certain forms of bodily disorders; it must, there- 
fore, be not only to the advantage, but it must be the duty of every 
responsible person to consider what these predispositions are in himself, 
and to endeavor, as far as circumstances will permit, to avoid their being 
excited; still more important is it, in the contraction of marriage, to 
consider whether union with one having similar hereditary tendencies 
'will not certainly entail upon offspring an irremedial predisposition to 
disease thus devolved upon them from both parents. This argument 
derives tenfold force if the parents happen to be nearly related by blood, 
for even in healthy families the marriage and intermarriage of near rela- 
tives almost certainly leads to the production of weakened and weakly 
descendants. (See Consumption, Insanity, Marriage, Scrofula, etc.) 
HERNIA. (See Rupture.) 
HERPES, her'-peez [Gr. herpo, I creep], is a disease characterized by 
inflamed patches, of irregular form and size, comprising clusters of vesi- 
cles of minute size; these yield a fluid which dries into a thin incrusta- 
tion that drops off, seldom leaving any perceptible scar. It is not 
contagious, and usually runs its course in two or three weeks, requiring 
no further treatment than perhaps an acetate of lead lotion to allay the 
smarting, and an aperient to move the bowels if necessary. One form 
of this disease, herpes zoster, zona, or shingles, makes its appearance in 
the form of a band encircling half the circumference of the body. This 
is popularly regarded with great fear, and some people believe that 
death will ensue if the band completely encircles the body. This, how- 
ever, is not the case unless the patient be very old and feeble. It is 
usually preceded or attended by feverish symptoms, languor, loss of 
appetite, headache, sickness, chills, with frequently severe pains of a 
neuralgic nature. The febrile symptoms usually subside when the erup- 
tion is completed. Very little is necessary in the way of treatment 
beyond attention to the bowels and regulation of the diet. The local 
irritation maybe relieved by an acetate of lead lotion, and if the pain be 
severe, opiate fomentations may be applied. 
HERRING, her'-ring, like the other oily fishes, is apt to disagree 
with weak stomachs. 
HEUCHERA AMERICANA, hu'-she-ra a-mer-e-ha'-na, or alum root. 
This is a perennial plant of the Nat. order Saxifragaceae. It is a native of 
the United States, and grows in shady places all over the country. The 
root is the part used, and, as its name indicates, it is a powerful astrin- 
gent. It has been found useful in dysentery and diarrhoea, and also in 
most of the hemorrhages. It has the same properties as the cranesbill, 750 
IIEUCIIERA, ETC.-IIIP-JOINT DISEASE, ETC. 
and is used in similar cases. When used internally, the decoction or 
infusion may be taken in doses of a wine-glassful, three or four times 
a day. (See Infusion.) 
HICCUP, OR HICCOUGH, hik'-kup or hik'-kof [Lat. singultus^ is 
a spasmodic affection of the diaphragm (see Diaphragm). Generally a 
trivial and transient inconvenience; its occurrence in the last stages of 
acute disease is a grave, often a fatal, symptom, indicative of giving way 
of the nervous system generally. 
Continued and obstinate hiccup sometimes occurs in the persons 
more especially of young females of a hysterical tendency, and may con- 
tinue for weeks without cessation, except during the hours of sleep, in 
spite of all kinds of treatment. The causes of ordinary hiccup are gen- 
erally fasting, or some sudden stimulant taken into the stomach, such as 
highly-seasoned soup; and the affection generally subsides of its own 
accord. When inconvenient, nothing is so likely to remove it as some 
active emotion of the mind suddenly excited. The continued sipping 
and swallowing of cold water is a frequent domestic remedy; or antispas- 
modics, such as sal-volatile, may be useful; or a little sugar will often 
afford relief. In the attacks of continued hiccup above mentioned, a 
medical man should be consulted; but the disorder will frequently run 
its course in spite of his treatment. Acupuncture has been said to be a 
successful mode of treatment. 
HICKORY. (See Carya.) 
HIERACIUM VENOSUM, hi-e-rd-se-um ve-nd-sum^ or hawkweed, 
a plant belonging to the Nat. order Aster acece. It is found on dry hills 
and in pine woods in the northern and eastern parts of this country. It 
is tonic, astringent and expectorant, and has been found useful in scro- 
fula and in profuse menstruation. The juice of the fresh leaves is 
reputed to cure warts. Dose of infusion or of syrup, 2 to 4 fluid ounces. 
(See Infusion.) 
HIGH CRANBERRY. (See Viburnum Opulus.) 
HIP-BATH. (See Baths and Bathing.) 
HIP-JOINT, hip'-joint. The hip-joint is formed on the one hand by 
the head of the thigh-bone, and on the other by the deep cup, or cavity, 
which is excavated for its reception in the bones of the pelvis, or hips, 
thus constituting a ball and socket-joint, which, although it may suffer 
dislocation, can only do so from extreme violence in peculiar directions, 
and in peculiar positions of the limbs. (See Dislocations, Hip-Joint 
Disease, etc.) 
HIP-JOINT DISEASE, OR MORBUS COXARIUS, hip'-joint 
diz-eez is a disease of the joint just described, to which children of a 
scrofulous constitution are more peculiarly liable. HIP-JOINT DISEASE, ETC. 
751 
Hip disease prevails in cold moist climates, and attacks chiefly chil- 
dren between the ages of seven and fourteen, though it is not unfre- 
quently met with both before and after this time of life. 
Symptoms.-The first symptom complained of, is generally pain of 
the knee, which often exists for months before any indication can be per- 
ceived of the true seat of the disease. Sooner or later the patient is 
observed to walk awkwardly and less vigorously than usual; and when 
the circumstances on which this difference depends are investigated, it 
appears that the affected limb is elongated and emaciated-that the 
convexity of the hip is flattened so that the furrow between it and the 
thigh is less distinct and more oblique in its direction-and that, in 
standing, the foot is advanced a little before the other one, with the toe 
slightly averted, and that the patient does not rest his weight upon it. 
Pain is now felt in the hip-joint itself, and though aggravated by motion, 
often becomes more severe from time to time, without any such cause of 
irritation. It is most apt to do so during the night, particularly when 
the weather is wet and changeable. In this second stage, the disease 
remains several months, and sometimes a year or two. At length the 
symptoms which have been mentioned, either disappear, and the limb 
recovers its former condition, or they are succeeded by others still more 
disagreeable. In the latter case, the limb becomes considerably shorter 
than the sound one; its mobility at the same time being much impaired 
or altogether destroyed, and permanent rotation either inwards or out- 
wards also taking place. Collections of matter now generally make their 
appearance, most frequently on the outer side of the thigh, but occa- 
sionally in the groin and hip. In some few intances, but very rarely, 
the fluid of these abscesses is absorbed, but the ordinary course which it 
follows, is to issue externally through openings formed, either by ulcer- 
ation, or artificially by the surgeon. The patient then, after a tedious 
illness, becomes hectic and dies; or recovers with a stiff* joint, and a 
wasted useless limb. 
Treatment.-It is of the highest importance as regards ultimate 
results, that this affection should be placed under proper surgical treat- 
ment in the earliest stage in which it can be detected; but its approaches 
are often so insidious that in most cases it has made considerable advance 
before it is even suspected by parents that there is anything wrong. 
It may be well to know that in some cases, and in certain stages of 
the disease, great relief, and possibly even permanent benefit, is to be 
derived from keeping the limb permanently extended, that is, pulled 
downwards. This can readily be done by means of a weight attached 
to a bandage wound round the limb, and hung over a piece of wood at 
the bottom of the bed. (See Hip-Joint.) 752 
Hili VDO-IIO IKEO PATIIY. 
HIRUDO. (See Leech.) 
HISTOLOGY, kis-tol'-o-je. Histology treats of the minute struc- 
tures of parts of the human body, discernible only by the microscope. 
(See Anatomy, Physiology, etc.) 
HIVES, klvz, an eruption of the skin, usually occurring in summer, 
and recurring many times in the same person. The eruption is charac- 
terized by small, red pimples, lasting sometimes a week or two. They 
appear usually on arms, thighs, neck, back, and occasionally on the face. 
They give rise to almost intolerable itching. It is frequently caused by 
the continuous use of oatmeal. The treatment consists in refraining 
from obnoxious articles of diet, relaxing the bowels with some saline 
aperient, a seidlitz powder, a teaspoonful of epsom salt, or a dessert- 
spoonful of effervescent citrate of magnesia. Locally, weak soda water, 
a teaspoonful of baking soda to a pint of warm soft water, will almost 
invariably allay the itching. In obstinate cases, arsenic is a useful 
remedy, but should never be given except by a physician. 
HIVES, the croup, a disease characterized by sonorous and suffoca- 
tive breathing. (See Croup.) 
HIVE-SYRUP, hive'-sir-up, compound syrup of squill. (See Scilla 
Maritima. ) 
HOARSENESS. (See Aphonia, Bronchitis, Sore Throat, Clergy- 
man's Sore Throat, Cough, Croup, Colds.) 
HOFFMAN'S ANODYNE, kof'-manz an-o-dine (compound spirits 
of ether.) It possesses the stimulating powers of ether with anodyne 
properties. It is a very useful remedy in cases of general unrest, inabil- 
ity to sleep, etc., depending on nervous irritation from pain, weakness, 
or other causes. Hoffman's anodyne is also very useful as a carmina- 
tive, probably exceeding in this respect any of the aromatics. In cases 
of flatulence, depending upon nervous disturbance (hysteria, etc.) it is 
especially useful. 
In earache, exposing the ear to the fumes of spirits of ether is often 
attended with great relief. It may be effected by mixing equal parts of 
the spirits and hot water in a vial and applying its aperture to the exter- 
nal ear. Hiccough is often immediately arrested by 20 to 30 drops of 
Hoffman's anodyne in 10 teaspoonfuls of some aromatic water. .Dose, 
% to 1 teaspoonful in sweetened water. 
HOME SICKNESS. (See Nostalgia.) 
HOMOEOPATHY, ko-me-op'-a-tke [Gr. komoios, like, and pathos, 
state or feeling], is the name given to a system of medical treatment 
introduced by Samuel Hahnemann, a German physician, in 1796, and 
now extensively practised, and having many adherents. Hahnemann had 
observed that Peruvian bark, which acts as a specific in ague, sometimes HOMEOPATHY-HORDEUM 
753 
produced upon the healthy subject exactly the same symptoms as 
those of the disease which it served to cure. Continuing his observa- 
tions in the same direction, he fancied that he had obtained a number of 
other instances to the same effect; and at length he came to the conclu- 
sion that diseases are cured by such substances as produce symptoms 
similar to them on the healthy body; hence the great doctrine of this sect 
is, "Similia similibus curantur" (similars are cured by similars). Their 
opponents they term allopathists [Gr. alios, other, and pathos, state], 
and assert their doctrine to be, " Contraria contrariis curantur" (con- 
traries are cured by contraries.) 
HONEY, hun-e [Lat. mel}, the well-known substance collected by 
bees from flowers, consists almost entirely of sugar, partly crystallizable, 
and partly not so; the first being similar to grape sugar, and capable of 
undergoing at once the vinous fermentation. Honey varies in degree as 
regards fragrance and taste, according to the flowers from which it is 
collected, and in some instances, it is even of a poisonous nature, in con- 
sequence of being collected from poisonous plants. As an article of 
diet, honey is wholesome for most persons, although with some it causes 
acidity, and others it gripes. It is slightly aperient. For medicinal 
purposes, especially domestically, honey is frequently used, and answers 
wTell as a pleasant addition to cough mixtures, etc. Mixed with a little 
vinegar or lemon-juice, it is useful in cases of sore throat and cough, 
with adhesive expectoration. 
Honey is frequently used mixed with borax in cases of thrush 
in children, and in sore mouths generally. The form is a bad one in 
all such cases, and especially in the former disease. (See Borax, 
Oxymel. ) 
HONEY AND VINEGAR SYRUP. (See Oxymel, Honey.) 
HONEYSUCKLE BUSH. (See Diervilla Canadensis.) 
HOOD-WORT. (See Scutellaria Lateriflora.) 
HOOPING COUGH. (See Whooping Cough.) 
HOP. (See Humulus Lupulus.) 
HOPE. (See Passions.) 
HORDEUM, hor'-de-um [Lat.], barley, a genus of the Nat. order 
Graminaceoe. The principal species or varieties of cereal barley in cul- 
tivation are practically distinguished by the arrangement of the seeds, 
as two-rowed, four-rowed, and six-rowed. Barley is used dietetically in 
the manufacture of bread; and, in the form of malt, most extensively 
in the production of ale, beer, and ardent spirits. It is the common 
grain in use for the latter purpose in this country. Barley deprived of 
its husk constitutes pot barley. When both husk and integuments are 
removed, and the seeds rounded and polished, they form pearl barley, 754 
IIORDEUM-HOT BATH 
and this, when ground, is called patent barley. (See Barley, Barley- 
Water, Food, etc.) 
HOREHOUND. (See Marrubium Vulgare.) 
HORNETS' STINGS. (See Bites and Stings.) 
HORSEBACK EXERCISE. (See Exercise.) 
HORSE-CHESTNUT. (See ^Esculus.) 
HORSE-FLY WEED, OR WILD INDIGO. (See Baptista Tinc- 
TORIA.) 
HORSERADISH. (See Armoracia.) 
HORSETAIL. (See Equisetum Hyemale.) 
HORSE-WEED. (See Collinsonia Canadensis.) 
HOSPITAL FEVER, Iios'-pe-tql, a form of typhus. (See Typhus 
Fever.) 
HOSPITAL GANGRENE. (See Gangrene.) 
HOSPITALS, hos-pe-tqlz [Lat. hospitalia, apartments for guests; 
hospes, a guest]. In large towns these benevolent institutions are an 
inestimable boon to the poor, more particularly in the present defective 
condition of sanitary arrangements. In them, with the exception of 
privacy, they have all that the wealthiest in the land can command; 
skill, cleanliness, food, medicines, and comforts of every kind. It is 
much to be regretted, that the inhabitants of rural districts are, in a great 
measure, deprived of the resources of an hospital of some kind, especi- 
ally in the case of contagious disease invading their crowded cottages. 
The construction of hospitals is a subject which has of late years 
much engaged the thoughts of architects, physicians, and sanitary 
reformers; and many systems have been proposed as emendations on 
the old methods. The pavilion, cottage, and corridor styles have been 
brought up in contrast ; but it would be impossible in the present article 
to enter upon their different advantages. Suffice it to say, that hospitals 
for the sick should be advantageously situated, well-aired, thoroughly 
drained, soundly built, and not hemmed in by other buildings ; and the 
rooms and galleries for the reception of the patients should be lofty, well 
lighted, and effectively ventilated.. 
It is incalculable how much advantage might accrue to thickly popu- 
lated districts, and how much good might be done by establishing such 
institutions as cottage or village hospitals, where the poor might 
receive all the benefits attending upon first-rate nursing and lodging, and 
in short all the benefits of hospital treatment without its disadvantages. 
In most places a cottage or house with sufficient accommodation for six 
to twelve beds, might be rented at a moderate rate, and many would 
cheerfully volunteer to do the nursing. (See Bed, Bed-Room.) 
HOT BATH. (See Baths and Bathing.) HOT BISCUITS-HOUSEHOLD MEDICINES. 
755 
HOT BISCUITS. (See Biscuits, Hot.) 
HOUND'S TONGUE, OR DYSENTERY WEED. (See Echino- 
SPERMUM VIRGINICUM.) 
HOUSEHOLD MEDICINES, hous'-hold. In sections of the coun- 
try remote from medical aid, or in which even the most ordinary drugs 
cannot be procured without some difficulty, it is very desirable that every 
family should be provided with a small stock of whatever medical or 
surgical material any intelligent person might, with reasonable care and 
ordinary common sense, employ. There is not the same necessity exist- 
ing in the case of parties possessing facilities for procuring professional 
aid, although there is no objection, even in such cases, unless they 
should place their dependence upon it, instead of seeking proper advice. 
It is well, however, to be prepared always for all emergencies. Many 
of the most powerfully curative medicines within reach, are such as can 
only be used with safety by a physician, and cannot, therefore, be 
recommended to form part of a domestic medicine chest. And here it 
is important to say, that whatever drugs are procured, should be pur- 
chased from a respectable druggist, and be invariably kept in some 
secure place, easy of access, under lock and key. This is rendered 
necessary for two reasons; firstly, that no accident may occur; and, 
secondly, that the medicines may not deteriorate in value from careless 
exposure. At a trifling expense, a nicely arranged medicine chest, with 
little compartments for the separate bottles, and additional room for lint, 
sponge, adhesive plaster, oiled silk, and other simple appliances that 
may be deemed necessary, may be procured from any respectable 
druggist. Where these are not within reach, a few directions to a 
tinsmith will enable him to construct one very cheaply, of japanned tin, 
that will answer every purpose. The following list includes all, or 
nearly all, that would be found requisite in any section of our country. 
The doses of each may be found by referring to the separate articles 
under their respective headings. Medicines administered as tonics or 
alteratives, may usually be taken three or four times a day. 
Aloes-In powder and in fluid extract. 
Alum-In powder. 
Ammonia, Carbonate-In glass-stoppered 
bottle. 
Ammonia, Aromatic Spirit, or Sal-Volatile. 
Ammonia, Solution-In glass-stoppered 
bottle, for liniments. 
Ammonia, Acetate-(Spirit of Mindererus.) 
Antimonial Wine. 
Anise-Oil or essence. 
Arnica-Tincture for liniments; flowers 
for fomentations. 
Aromatic Powder. 
Assafoetida-Tincture and gum. 
Balsam of Tolu-In tincture or syrup. 
Bismuth-Subnitrate or white bismuth. 
Blister-In the shape of plaster or fluid. 
Borax-In powder. 
Bromide of Potassium. 
Buchu-In leaves and fluid extract. 
Calumba-In root coarsely powdered or 
fluid e xtract. 
Camphor-In gum and spirit. 
Capsicum-In powder and fluid extract. 756 
HOUSEHOLD MEDICINES. 
Catechu-In powder or fluid extract. 
Carbolic Acid. 
Castor Oil. 
Caustic, Lunar-In sticks. 
Chalk-Prepared. 
Chamomile Flowers. 
Chloride of Lime. 
Chlorodyne. 
Cinchona- In bark and fluid extract. 
Cinnamon-Oil or essence. 
Cotton Wadding. 
Court Plaster. 
Cream of Tartar. 
Creasote. 
Copper, Sulphate of-(Blue Vitriol.) 
Cubebs-In powder. 
Dandelion-In pills and fluid extract. 
Dover's Powder. 
Epsom Salts-(Sulphate of Magnesia.) 
Flaxseed, or Linseed-Whole and ground. 
Galls-In powder. 
Gallic Acid. 
Gentian-Root and fluid extract. 
Ginger-In tincture. 
Glycerine. 
Gum Arabic-In powder. 
Ipecacuanha-Powder and syrup. 
Iodine-Tincture. 
Iron, Sulphate of-(Green Vitriol.) 
Iron, Tincture of-In glass-stoppered 
bottle. 
Jalap-In powder. 
Juniper Berries, or Oil. 
Lead, Acetate of, or Sugar of Lead. 
Lemon Juice. 
Magnesia-Calcined or Fluid,and Citrate of 
Mercury-Calomel, and Gray Powder, and 
Red Precipitate. 
Muriatic Acid-(Spirit of Salt)-In glass- 
stoppered bottle. 
Mustard-In close tins. 
Myrrh-Tincture. 
Nitre, Sweet Spirit of. 
Nitric Acid-In glass-stoppered bottle. 
Oil-Camphorated. 
Opium-In powder. 
Opium, Tincture-(Laudanum.) 
Opium-Compound tincture-(Paregoric.) 
Peppermint, Oil. 
Pills-Compound cathartic, assafcetida, 
compound rhubarb, aloes and iron, 
podophyllin. 
Potash-In solution (Liquor Potass.) 
Potash, Bicarbonate-In powder. 
Potash, Chlorate of. 
Potash, Nitrate of-(Saltpetre.) 
Potassium, Iodide of. 
Podophyllin-In powder. 
Quassia-In chips. 
Quinine. 
Rhubarb-In powder, tincture and syrup. 
Salicine-In powder. 
Salicylic Acid-In glass-stoppered bottle. 
Santonine-In powder. 
Sarsaparilla-In fluid extract. 
Seneka-In fluid extract. 
Senna-In leaves or fluid extract. 
Soda, Bicarbonate of-In powder. 
Spermaceti. 
Sulphur-In powder. 
Sulphuric Acid-(ElixirVitriol)-In glass- 
stoppered bottle. 
Tartaric Acid. 
Tannin. 
Turpentine. 
Uva Ursa-In leaves and fluid extract. 
Valerian-Root and fluid extract. 
Wax. 
Zinc, Sulphate of-(White Vitriol.) 
Great precaution should be taken in having all bottles and parcels 
carefully labelled. 
In this list are not included those medicines which, though very use- 
ful, are indigenous in almost every part of the country, the medicinal 
parts of which may easily be procured, and decoctions and infusions 
prepared according to the directions given in this work-or the prepara- 
tions of all the indigenous plants mentioned in this work, are pro- 
curable at the better class of drug stores-such as boneset, queen's 
root, life-root, poplar, gold thread, wild cherry, pleurisy root, turkey HOUSEHOLD MEDICINES-HOUSES. 
757 
corn, and a host of others. In addition to the above list of medi- 
cines, every fully-equipped medicine chest should be provided with 
a set of scales with weights, a small graduated glass measure, a funnel, 
a spatula, and a moderate-sized mortar and pestle. The graduated glass 
measure indicating teaspoon, dessert-spoon and tablespoon is the most 
convenient. (See Dose, Weightsand Measures, Mortars and Pestles, 
Powders; also the various individual articles on medicines throughout 
this work.) 
HOUSEMAID'S KNEE. (See Knee.) 
HOUSES, kouz'-ez [Ger. kaus}. The first thing to be taken into con- 
sideration in the erection of a new dwelling is the choice of a site. In 
choosing a dwelling place a man should ask himself these questions: 
Is it dry? Is it airy? Has it a good aspect? Is there plenty of water? 
Is it good ? Is the drainage good ? What is the character of the soil ? 
Dryness.-A damp house is always unhealthy. The damp may 
come from the ground, and may rise in the walls to a considerable height, 
or it may come from a leaking roof or choked rain-pipe, or from rain 
leaking through thin, porous walls. If the floor be of brick, or if the 
boards be laid only a few inches from the soil, the house will invariably 
be damp. There should always be a current of air beneath the floor. 
Stone and brick walls should always be hollow, and should be lathed 
before plastering, for if these precautions be not taken, damp, unhealthy 
walls will be the result. There is one common practice in the country 
which often makes the houses damp: all the dirty water of the house is 
thrown on the ground, or in a "slush-hole" close to the dwelling, under- 
neath which it passes. Many an attack of typhoid fever has been caused 
in this way. 
Good air.-The people will never be perfectly healthy until they 
have learned the importance of breathing pure air. If possible, a man 
should choose a house in a somewhat elevated position; low-lying situa- 
tions, especially if damp, being proverbially unhealthy. There should 
also be plenty of space around it, so that the dwellers may exist without 
having to breathe their neighbors' air. The windows should open both 
at the top and the bottom, and every opportunity should be embraced of 
letting in the fresh air. The following simple plan will always insure a 
supply of fresh air, and may be carried out during the coldest weather 
of winter; Lift up the window at the bottom two or three inches, and 
insert a piece of wood prepared for the purpose, the whole length, so as 
to support the window, and .close the opening. The air then enters at 
the middle of the window between the sashes (as the sash of the lower 
window is raised above that of the upper), and passes upwards toward 
the ceiling; it mixes so gradually with the air of the room that no draught 758 
HOUSES. 
is felt. Impurity of the air often arises from impurity of the walls, 
floors and furniture. The walls should be well cleaned regularly, and if 
there be paper on them, the owner should see that arsenical paper is not 
used, and that new paper is not put on until the old is removed. All 
green wall paper contains arsenic. Gas should never burn in a room 
unless there is a tube to carry off the products. The bed-rooms 
should not be on the ground floor unless there be ample cellarage 
beneath, and the ceiling should be at least eight to ten feet high. Every 
house should be provided with plenty of cellar room, extending under the 
whole surface of the floor, and the cellar should be as thoroughly ven- 
tilated as the remainder of the dwelling. The chimney should extend 
from the cellar floor to at least four feet above the surface of the roof, 
and be properly covered so as to admit air, but exclude rain. In the 
summer the fire-place should not be closed up, as the chimney is an 
excellent ventilator. 
Good aspect.-Every house, and as many rooms in the house as pos- 
sible, should have a warm, sunny aspect; both light and warmth have 
a considerable influence on health, and it is easy to shut out the sun if 
required. The old Italian proverb, ' ' Where the sun does not enter, the 
doctor does, ' ' contains a great deal of truth. 
Good water.-As the cause of many diseases is known to be carried 
by the water, too much caution cannot be exercised in regard to the 
water supply. Water should be entirely without smell; all bad-smelling 
waters are unwholesome. Every man who has control over the sources 
of water supplying his house, should watch over them most carefully and 
see that no drain-pipe runs near his spring or well. Too often the cess- 
pool and well are in close proximity. Every house in which the water 
is supplied by a company should be furnished with a charcoal filter. 
No house should be without a cistern, and care should be taken that 
the escape does not open into the sewer. 
Drainage.-The condition of the house-drainage in many parts of the 
country is very unsatisfactory. In every house the exit-drain should be 
well-ventilated just after it leaves the building, so that at any rate the 
dwellers may be safe from the risk of the sewer-air penetrating into their 
sleeping apartments. In many houses in the towns and cities, the water 
is carried into the rooms, and a sink provided to carry it off again after 
having been used; the sink-pipe runs into the sewer, and the warm room 
is sure to draw sewer-air from the sink. This is the fertile source of dis- 
ease and death in many dwelling-places,, and should be religiously 
guarded against. 
Character of the soil.-Dry impermeable soils are the best to build 
on, and next to these, dry, gravelly soils that permit the water to drain HO USES-HUMEE US. 
759 
through them. Low-lying places, near marshes or the banks of sluggish 
streams, should be avoided as sites for dwelling-houses. 
Heating.-The most healthful methods of warming houses are either 
by means of steam, combined with ventilating apparatus, or by means 
of fire-places, which are of themselves the very best ventilators that can 
be introduced into our residences. Neither of these modes are available 
to the masses, the apparatus for the former being too costly, and so com- 
paratively few houses being provided with the latter, their places having 
been usurped by stoves, which cannot be so wholesome, if but for one 
reason, namely, the very defective ventilation which they afford, if any 
at all; besides causing a dryness of the air, which is not only uncom- 
fortable, but unhealthy. Where stoves are used, extra provision should 
be made both for ventilation and moisture. If the system of heating in 
towns and cities, by means of steam pipes-emanating from reservoirs, 
and distributed to every part of the city in a similar way to water 
pipes-should prove practicable, as we have every reason to believe it 
will, a great boon will be conferred upon the masses of the people in our 
populous towns and cities, by giving them the luxury of heating by 
steam at rates not exceeding the cost of warming by stoves. (See 
Chimney, Stoves, Bed-Room, Air, Ventilation.) 
Lighting.-Each room should, if possible, be provided with two 
windows. Every one is aware how vegetables are blanched if excluded 
from the light; the same process takes place in the human frame. A 
good roseate color can be secured only by the presence of plenty of light. 
The healthy individual pales and dies, and the sick one cannot possibly 
recover where darkness takes the place of light. 
If, therefore, a house be dry, with a good exposure, and capability of 
external ventilation; if the floors, walls, ceilings, cellars and furniture 
are kept clean; if the rooms are spacious, well-lighted, well-ventilated, 
and kept at a temperature of 65° to 70° Fahrenheit, and are per- 
fectly free from sewer-air, or from emanations from the ground, 
and if the water supply be good and plentiful, the house cannot be 
accused of any illness which may occur in it. The illness must arise 
from conditions external to the house. (See Air, Ventilation, Bed- 
Room, Chimney, Drainage, Sanitary Science, Water, Walls and 
Wall Papers, Damp, Whitewashing.) 
HUMAN BODY, TEMPERATURE OF. (See Heat.) 
HUMERUS, hu'-me-rus [Lat.] The anatomical name of the arm- 
bone. This bone is, at its upper end, articulated or jointed at the 
shoulder, to the shoulder-blade or "scapula;" and at the elbow, by the 
lower end, to the two bones of the fore-arm. (See Shoulder, Scapula, 
Elbow, Fore-Arm, etc.) 760 
HUMID, OR MOIST TETTER-HUNGER. 
HUMID, OR MOIST TETTER. (See Impetigo.) 
HUMOR, yu-mor, or ku'-mor [Lat. humus, the ground; because 
moisture was supposed to spring from the ground], a general name for 
any fluid, but more especially applied to the fluids of the human body, 
and often to these in their morbid state. The term is used without any 
reference to disease in speaking of the fluids of the eye. (See Eye.) 
HUM ULUS LU P ULUS, hu'-mu-lus lu'-pu-lus, or common hop, a 
perennial plant belonging to the Nat. order Urticacece. It is a native of 
both Europe and America. The hop is tonic, hypnotic, febrifuge and 
anthelmintic. It has a tendency to produce sleep and relieve pain when 
opiates are inadmissible. A pillow stuffed with them is often used to 
procure sleep, and hops heated in a flannel bag are a common and useful 
remedy for neuralgia and toothache. The infusion is a good tonic in 
weak or irritable conditions of the stomach. The hop contains a peculiar 
principle called lupulin, which has been much in use for several years. 
Dose: of the fluid extract, to 1 teaspoonful; of the solid extract, 5 to 
20 grains; of lupulin, 5 to 10 grains; of the infusion, a teacupful, three 
or four times a day. (See Infusion.) 
HUNGER, Kung'-gur [Ang.-Sax.], a peculiar sensation experiencedin 
the region of the stomach, in consequence of the want of solid food. The 
sensation of hunger is at first rather agreeable, but it quickly becomes 
unpleasant, when prolonged. The sense of keen appetite is always 
delightful when there is a prospect of satisfying it; but that sinking in 
the stomach which ensues, soon changes from uneasiness to absolute 
pain, which rapidly becomes acute; and if aliment still be held back, 
the sensation produced is as if the stomach were being torn by pincers. 
A state of general exhaustion, feverishness, headache, light-headedness, 
often passing into madness, follows. The whole being seems absorbed 
in one desire, before which even maternal instinct has been known to 
give way, and mothers have disputed with their companions for the flesh 
of their dead infants. The physiological causes of hunger are not well 
understood, and great difference of opinion exists among scientific men 
on the subject. According to popular belief, the sensation of hunger is 
caused by the emptiness of the stomach, which, in the opinion of some 
physiologists, allows the sides of that organ to rub against each other, 
and the friction causes the sensation. This, however, is wrong, for the 
stomach is usually empty for some time before the feeling of hunger is 
experienced; and, as is well known, the stomach may be empty for 
days together, as in illness, without any sensation of hunger. Another 
theory is that the gastric juice accumulates, and attacks the walls of the 
stomach. This, however, has been proved not to be the case. 
A French philosopher made several experiments on the subject of HUNGER-HYDRARGYRUM CUM GREECE, ETC. 
761 
inanition, according to which it appears that death from hunger occurs 
when the waste reaches 0.4; that is to say, supposing an animal to 
weigh 100 lbs., it will die when its weight is reduced by fasting to 60 lbs. 
Death may possibly occur before that stage, but life cannot exist after it. 
In the case of human beings, death usually occurs in from eight to ten 
days of total abstinence from food and drink; but much depends upon 
the peculiar constitution of the individual, his age, health, habits, etc. 
Some die on the fifth or sixth day, while others can survive ten, twelve, 
or even sixteen days. (See Animal Heat, Abstinence, Appetite, 
Digestion, Food, Thirst, Starvation.) 
HUNTSMAN CAP. (See Sarracenia Purpurea.) 
HUNYADI JANOS WATER. (See Mineral Waters.) 
HYBRID, hi'-brid [Gr. hubris, an injury, because its nature is 
tainted], is a term applied to the offspring of two animals or plants of dif- 
ferent species. Neither hybrid animals nor plants propagate their species. 
HYDATID, hi'-da-tid [Gr. hudatis, a vesicle, from kudor, water], a 
term applied rather vaguely to various cyst-like productions, which are 
sometimes found in the bodies of men and animals. 
HYDRAGOGUE, ki'-dra-gog [Gr. hudor, water; ago, I expel], a 
term applied to violent cathartics, which bring away a large quantity of 
watery secretion from the intestines. (See Cathartics.) 
HYDRANGEA ARBORESCENS, ki-dran'-je-q ar-bo-res'-sens, or 
hydrangea, is a perennial plant belonging to the Nat. order Saxifra- 
gacece, and is sometimes known by the name of seven barks. It grows 
on mountains and hills, and near streams throughout the Southern, 
Middle and Western States. The root is the part used. 
The leaves of hydrangea are tonic, sialagogue, cathartic and diuretic. 
This plant was introduced to the notice of the profession by Dr. 
Butler, of Burlington, N. J., as a remedy for the removal of calculus, or 
gravelly deposits in the bladder. It has seemed also to have the power 
of relieving the excruciating pain attendant on the passage of a calculus 
through the ureter. The power of curing stone in the bladder does not 
appear to be claimed for it; it is only when the deposits are small, when 
in that form of disease known as gravel, that it is an efficient remedy; 
then by removing the nucleus, which if allowed to remain in the organ, 
would increase in size and form stone, the disease is averted. In an 
overdose it produces unpleasant symptoms, such as dizziness of the 
head, oppression of the chest, etc. Dose: of the fluid extract, 1 to 2 
teaspoonfuls; the infusion, 2 to 4 fluid ounces. (See Infusion.) 
HYDRARGYRUM. (See Mercury.) 
HYDRARGYRUM CUM CRET^E, OR GREY POWDER. (See 
Grey Powder.) 762 
HYDRASTIS CANADENSIS-HYDROCEPHALUS. 
HYDRASTIS CANADENSIS, hz-dras'-tis Ican-a-den'-sis^ or golden 
seal, is a perennial plant belonging to the Nat. order Ranunculacew. It 
is known by the various names of yellow puccoon, ground raspberry, and 
turmeric root, and is found growing in woods and shady places through- 
out Canada and the United States. The root is the part used. It con- 
tains a resinoid called ITydrastin. Its principal medicinal quality is a 
powerful bitter tonic, highly useful in all cases of debility and loss of 
appetite. It appears to have a specific stimulating effect upon the 
mucous membrane beyond what would follow the use of a simple tonic. 
As a tonic it has been successfully used in dyspepsia, chronic affections 
of the mucous coats of the stomach, erysipelas, remittent and intermit- 
tent fevers, typhoid fever, torpor of the liver% and general cases requir- 
ing a tonic. 
In chronic diarrhoea and dysentery, combined with geranium, it has 
given satisfaction; also, in combination with geranium as a valuable 
injection in gleet, chronic gonorrhoea, and leucorrhoea; likewise in 
inflammation and ulceration of the internal coating of the bladder. Dose: 
of fluid extract, to 2 teaspoonfuls; solid extract, 2 to 5 grains; hydras- 
tin, $ to 5 grains. 
HYDRATE OF CHLORAL. (See Chloral.) 
HYDRATE OF LIME. (See Calcium.) 
HYDROCELE, hi'-dro-seel, a dropsical swelling within the scrotum. 
It requires proper surgical treatment for its cure, but a patient may 
derive much comfort by wearing a bag truss, or some similar support, 
until he is relieved by operation. 
HYDROCEPHALUS, hz-dro-sef-adus [Gr. hudor^ water; kephale. 
the head], is a term applied to dropsy, orwrater in the head. Physicians 
distinguish it into two kinds, the acute and the chronic, both of which 
are almost exclusively confined to infancy and childhood. Acute hydro- 
cephalus is an inflammatory disease rapid in its course, and requiring 
decided treatment; chronic hydrocephalus, on the other hand, may go 
on for many years. 
Symptoms.-In acute hydrocephalus, the child is usually restless 
and fretful, the skin is hot and dry, the pulse quickened, the appetite 
impaired, and the bowels costive. The eyes are dull and heavy, the 
face flushed, and the child complains of pain and heaviness of the head. 
After a time, the symptoms become more manifest. The pain in the 
head becomes more intense, the restlessness is much increased, the 
expression of the countenance is altered, especially that of the eyes, 
which are often directed irregularly, with the pupils unequally dilated. 
The appetite is lost, and sometimes there is vomiting. The sleep is very 
much disturbed, and frequently the child awakens with a loud scream; HYDR O CEPHAL US-II YD R O CIIL OR IC A CID. 
763 
the pulse is low and irregular, and often convulsions take place. The 
disease frequently proves fatal in two or three days, or even less; but 
sometimes it is protracted over two or three weeks, depending chiefly 
upon the age and strength of the child and the violence of the disease. 
Treatment.-The treatment of this disease must necessarily depend 
upon the strength and condition of the patient, the great object being to 
subdue the inflammatory action of the brain. Blood is to be freely 
abstracted by leeches. Active purgatives are also to be administered, 
and cold water cloths applied to the head. When the active symptoms 
of the disease have been overcome, the system is to be gradually restored 
by tonics, cautiously administered. 
Chronic hydrocephalus differs from the other, not only in its progress 
being much slower, but from being rarely, or only slightly, attended 
with inflammation, and from there being always more or less of a collec- 
tion of watery fluid in the brain, which is not invariably the case with 
the former. The chronic form is frequently hereditary, occurring in the 
children of weak or scrofulous parents, and it usually makes its appear- 
ance before, or speedily after, birth. The fluid sometimes amounts to 
many pints, giving the head a very large and unsightly appearance. It is 
sometimes lodged in the membranes enveloping the brain, but more fre- 
quently it is contained in the ventricles and other cavities of that organ 
itself. This disease is always attended with more or less of intellectual 
derangement. The vision is usually considerably impaired, with squint- 
ing; speech is imperfect, and the power over the voluntary muscles is 
partially lost. These symptoms gradually increase, convulsions and 
paralysis at length make their appearance, and death at last supervenes. 
The duration of the disease is extremely various; sometimes it may ter- 
minate fatally in a few months, at other times it may go on for many 
years. From the early period at which this disease usually makes its 
appearance, little can be done to arrest its progress. Purgatives, diur- 
etics and alteratives are the means usually adopted. In some cases, 
good is done by bandaging; and, as a last resource, puncturing is not 
unfrequently successful. Hydrocephalus is no disease for domestic treat- 
ment, and the best medical aid should be procured as soon as possible. 
(See Brain.) 
HYDROCHLORIC ACID, hi-droddo'-rik as'-id [from hydrogen 
and chlorine], spirit of salt, marine acid, muriatic acid, or chlorhydric 
acid, a colorless gas of a peculiar pungent odor and an intensely acid 
taste, irritating the eyes and lungs considerably. It is heavier than air, 
having a specific gravity of 1.269. Water absorbs 480 times its volume 
of this gas at 40°, increasing in volume by one-third, forming a colorless 
fuming liquid known as hydrochloric acid in the laboratory. The 764 
HYDR O CHL ORIC A CID-HYDR O GEN. 
hydrochloric acid of the Pharmacopoeia is a nearly colorless and strongly 
acid liquid, emitting white vapors, having a pungent odor, and a specific 
gravity of 1.16. It forms an ingredient in a number of pharmaceutical 
preparations. The diluted acid is formed of 8 fluid ounces of the acid 
and a sufficiency of distilled water to make 26| fluid ounces at 60° Fahr. 
It is frequently given in dyspepsia, particularly when arising from a 
morbid condition of the gastric juice, and sometimes in cases of putrid 
fever. Dose, from 10 to 20 drops. 
HYDROCYANIC ACID, kl-dro-se-an-ik [from hydrogen and cyano- 
gen], prussic acid, or cyanhydric acid. This important compound 
is composed of equal volumes of hydrogen and the compound gas 
cyanogen. It is prepared by submitting a cyanide to distillation 
with a strong acid. Diluted hydrocyanic acid, containing two per cent, 
by weight of the acid, is given in doses of 2 to 8 drops, as a sedative 
and anodyne. It is particularly useful in spasmodic coughs of every 
description, particularly in asthma, chronic bronchitis, and whooping 
cough. It has also been employed with success in palpitation, and other 
diseases of the heart, in affections of the stomach and neuralgia. In 
cases of poisoning with hydrocyanic acid, it acts so quickly and power- 
fully as to afford little time for the operation of antidotes. The means 
usually recommended are the pouring of cold water on the head and 
spine, keeping up respiration artificially, cautiously inhaling largely 
diluted chlorine, taking hot brandy and water, and the ammoniated 
tincture of iron. 
HYDROGEN, hi'-dro-jen [Gr. hudor, water; gennao, I produce], 
in Chemistry, symbol H; equivalent 1; specific gravity 0.0692. Hydro- 
gen is an elementary substance, first isolated as a constituent of water 
by Cavendish, in 1766. It is a colorless, transparent, tasteless, inodor- 
ous gas, permanent at all temperatures, and resisting all efforts to liquefy 
it. It is the lightest substance in nature, being 14.47 times lighter than air, 
and 100 cubic inches of it weighing only 2.14 grains. In combination 
with water, it is most extensively distributed throughout nature. It also 
exists in combination with carbon in most inflammable minerals. It is 
an important element in all organic substances, and enters into the com- 
position of most substances in daily use, whether drawn from the 
mineral, vegetable, or animal kingdom. Having a very great attraction 
for oxygen and chlorine, when in the nascent condition, it is much 
employed in the laboratory for deoxidizing or dechlorinating purposes. 
It is prepared in a variety of ways, the most usual being by pouring 
dilute sulphuric acid on granulated zinc or iron clippings, when the fol- 
lowing reaction takes place: Zn 4- SO3IIO = Zno + SO3 + H. It may 
also be prepared by passing steam over red-hot iron filings, by plunging II YD It O GEN-HYDR OP IIO BIA. 
765 
sodium or potassium into water, or by electrolysis of water; all of which 
methods are more scientifically interesting than practical. Mixed with 
air, it may be breathed without any other effect than raising the pitch of 
the voice many notes higher. Mixed with oxygen, olefiant gas, or 
atmospheric air, it forms an explosive compound of great power. Hydro- 
gen is used principally in the oxyhydrogen blowpipe. 
The principal compounds of hydrogen are water, ammonia, hydro- 
chloric acid, sulphuretted hydrogen, and carburetted hydrogen, which is 
commonly known as marsh gas. It is very inflammable, and forms the 
explosive gas of mines, when mixed with air. Olefiant gas and phos- 
phuretted hydrogen are two inflammable compounds of hydrogen of less 
importance. 
The union of hydrogen gas with sulphur constitutes the very offensive 
smelling gas, sulphuretted hydrogen, which is one of the products of 
the decomposition of organized bodies, and also forms the characteristic 
feature of many of the mineral waters. 
HYDROPATHY, hi-drop'-a-the [Gr. hudor, water, and pathos, dis- 
ease], is a mode of curing disease by means of the application of water. 
The system owes its origin to one Vincenz Priessnitz, who, in 1826 
established an institution at his native place, Grafenburg, in Austrian 
Silesia, for the cure of diseases on this mode. The system soon spread, 
and now there are in this country a number of large hydropathic estab- 
lishments. Without claiming for the system all that its votaries demand, 
there can be no doubt that it is of the greatest benefit in a great number 
of cases. Particularly is it of service in cases of indigestion, nervous- 
ness, an impaired constitution, a too full habit, or in such as have been 
living freely, without taking much exercise. The system of dietary and 
exercise that is kept up at these places is, perhaps, not less conducive to 
a cure than the baths. (See Baths and Bathing, Ablution.) 
HYDROPHOBIA, hi-dro-fo'-be-a [Gr. hudor, water, and phobeo, I 
fear], is a disease occasioned by the bite of a rabid animal, and so called 
from the great dread that those who suffer from it manifest at the sight 
of water. The dog, cat, fox, and wolf are the animals among whom 
this disease is most common-among whom it is natural; but there is, 
perhaps, no animal to whom it is not capable of being communicated, 
as it is to man. A dog who is suffering from this disease becomes soli- 
tary, morose, and sullen ; runs about wildly, and bites at whatever comes 
in his way; but his respect for his master is at first unaltered. As the 
disease advances he becomes more furious, gnawing and biting at what- 
ever comes in his way; he forgets his master, breathes quickly and 
heavily, his tongue hangs out, his mouth is continually open, and dis- 
charges a large quantity of froth. In this state he seldom lives more 766 
II YD HO PHOBIA. 
than four-and-twenty hours. The poison exists in the saliva of the rabid 
animal, and may be communicated either by a bite or by licking a 
wounded part. 
Symptoms.-After the poison has been received, the wound usually 
heals up in the ordinary way. At a period, however, varying from a 
month or six weeks to perhaps eighteen months, symptoms of the dis- 
ease begin to manifest themselves. The part becomes painful, red, and 
swollen, and shooting pains are felt, extending from it to the central 
parts of the body. Very soon after this (within a few hours perhaps, 
but certainly within a few days) the specific constitutional symptoms 
make their appearance; he is hurried and irritable ; speaks of pain and 
stiffness, perhaps, about his neck and throat; unexpectedly he finds him- 
self unable to swallow fluids, and every attempt to do so brings on a 
paroxysm of choking and sobbing, of a very distressing kind to behold. 
The symptoms rapidly increase in severity. The nervous irritability 
becomes extreme, the paroxysms are greatly more violent, and are 
excited not only by any attempts to swallow liquids, but by the very 
sight or sound of them; even the waving of a polished surface, as of a 
mirror before the eyes, or the passage of a gust of wind across the face, 
being sufficient to excite it. Death occasionally takes place within 
twenty-four hours, but sometimes it may be protracted to the fifth or sixth 
day; usually, however, it terminates fatally on the second or third day. 
Treatment.-Nothing can be said to be known of the nature or char- 
acter of this disease, and as little is known regarding its treatment. 
Various means have been tried, but few, or any of them, have met with 
any success, and none of them have received general adoption. It is 
not, however, every one that is bitten by a rabid animal that has hydro- 
phobia. John Hunter records that in one case twenty-one persons were 
bitten by a mad dog, and only one of them had hydrophobia; and others 
have come to the conclusion that, on an average, only one person in 
twenty-five bitten will have hydrophobia. In the treatment of this dis- 
ease, the great thing is to remove the poison before it has extended itself 
into the system. This is best done, where possible, by excision of the 
wounded part, care being taken that every portion of it is removed. 
Where it is impossible to use the knife effectually, a powerful caustic 
should be applied freely over the whole surface of the wound, so as to 
destroy the effect of the poison. As the poison is not very active, these 
means are usually effective, though employed some time after the receipt 
of the wound; but, of course, in such circumstances, all due haste is to 
be adopted, and it is well, before the arrival of medical assistance, to 
keep carefully washing the part with tepid water. For full treatment of 
bites of rabid dogs, see Bites and Stings. HYDR OTHO RAX-HYPER. 
767 
HYDROTHORAX, hi-dro-tho'-rdks, dropsy of the chest. (See 
Dropsy.) 
HYGIENE, hi'-jeen [Gr. hugiaino, I am in health], is applied to 
that branch of medicine which relates to the preservation of health. 
(See Health, Sanitary Science, etc.) 
HYOID BONE, hi'-old [Lat. os hyoides], is a bone between the 
root of the tongue and the larynx, so called from its supposed resem- 
blance to the Greek letter u. It consists of a body, two horns, and 
appendages, and serves to support the tongue and afford attachment to 
a variety of muscles. 
HYOSCYAMUS NIGER, hi-os-si'-a-mus ni'-jur, or henbane, a bien- 
nial plant belonging to the Nat. order Solanacem. It is a native of 
Britain and of Europe generally, which has been naturalized in this 
country. All parts of the plant are medicinal, but the leaves are most 
generally used. They should be gathered when the plant is in flower. 
The active principle of henbane is a very powerful poison called hyos- 
cyamin. 
Henbane is a powerful narcotic. In medicinal doses it is anodyne, 
hypnotic, calmative and antispasmodic; allaying pain, soothing excit- 
ability, inducing sleep and arresting spasm. It does not produce con- 
stipation like opium, but has a tendency to act as a laxative. It is used 
in chronic cough, irritation of the urinary organs, and inflammatory 
cases attended with excitability; is employed with advantage in painful 
spasmodic affections, hysteria, rheumatism and gout; and also, combined 
with colocynth, in painters' colic and mania; it is also used externally to 
allay the irritation of very sensitive parts, and the infusion dropped into 
the eye dilates the pupil like belladonna. It is employed as an anodyne, 
soporific, antispasmodic, and sedative, in cases where opium would dis- 
agree ; it is also used in fomentations, as a topical sedative and anodyne. 
Neuralgic and spasmodic affections, rheumatism, gout, hysteria, and 
various pectoral diseases, as catarrh, whooping cough, asthma, consump- 
tion, etc., are among those in which it is most frequently prescribed. It 
is much used in connection w'ith griping cathartics, the disagreeable 
effects of which it is thought to counteract. Dose: of the fluid extract, 
10 to 20 drops; solid extract, to 1 grain; pills, | grain each, 2 to 4 
pills; tincture. 10 to 30 drops. 
HYPER, hi'-pur [Gr. huper, over, beyond], a Greek preposition, 
which is conjoined with other words in order to denote excess, or any- 
thing beyond, or over and above, the original quality of the word to 
which it is added, as hyperoernia, an excess of blood in any part, or con- 
gestion; hypertrophy, a morbid increase of any organ, without change 
in the nature of its substance, arising from an excessive nutrition. 768 
HYPERICUM PERFORATUM-HYPOCHONDRIASIS, 
HYPERICUM PERFORATUM, hiper'-e-kum per-for-a'-turn, or 
Johnswort, a plant belonging to the Nat. order Ilypericaceoe. It is a 
native of both Europe and America. It is astringent, sedative and 
diuretic, and is used in suppression of urine, diarrhoea, dysentery, worms, 
hysteria, jaundice and hemorrhage. Externally, it is employed to dispel 
hard tumors, caked breasts, and the blackness that follows bruises. 
Dose: of the fluid extract, j to 1 teaspoonful; infusion, 1 to 2 fluid 
ounces, three or four times a day. (See Infusion.) 
HYPERTROPHY. (See Hyper.) 
HYPERTROPHY OF THE HEART. (See Heart, Diseases of 
THE.) 
HYPNOTICS, hip-not'-iks, a term applied to those medicines that 
procure sleep. 
HYPOCHONDRIAC REGION. (See Abdomen.) 
HYPOCHONDRIASIS, hip-o-kon-dri'-a-sis^ in Medicine, is a disease 
characterized by extreme sensibility of the nervous system, leading the 
patient to believe himself to be suffering from some terrible and imagin- 
ary disease, or to be much worse than he really is. 
Causes.-The causes of this disease are various, arising, as it does 
usually, from an impaired condition of the nervous system. Young men 
of studious habits are very apt to suffer from this disease. Those too, 
who, from want of occupation and a due amount of exercise, acquire a 
luxurious habit, often fall a prey to it. 
Symptoms.-The ideas of such persons often partake of the most 
extravagant character. He may fancy that he is immensely tall, or 
inordinately small; that he is heavy as lead, or light as a feather; that 
he is composed of glass, or is a lump of butter. They are all extremely 
timid, and their fears are exercised upon trifles, or are altogether ground- 
less. They dwell constantly upon their own sufferings, and are usually 
morose, peevish, suspicious, and misanthropic, and frequently suspect 
their nearest and dearest friends of designs upon their life. There is 
frequently also functional derangement of certain organs, especially of 
those connected with the nutritive processes. 
Treatment.-The cure must of necessity vary somewhat, according 
the nature of the disease. In general, the great thing is to withdraw 
the patient's mind as much as possible from himself. For this purpose, 
cheerful society and change of scene should be adopted. The system 
ought to be strengthened by tonics, and exercise in the open air. If it 
arises from idleness and luxury, the great cure is plenty of active exer- 
cise and a spare diet. In all cases the state of the digestive organs 
should be attended to, and the bowels kept in a strictly normal condition. 
One of the most valuable aids in the cure of this disease, is the daily HYPOCHONDRIASIS-HYSSOPUS OFFICINALIS. 
769 
habit of compelling the mind at certain fixed times, to bend itself to 
some definite continuous employment, that will necessitate some degree 
of mental exercise, and that will maintain its interest from day to-day. 
(See Melancholy, Monomania, Insanity, Habit, Dyspepsia.) 
HYPOGASTRIC. (See Abdomen.) 
HYPOPHOSPHITES, kipo-fos'-fites, a series of salts formed by the 
union of hypophosphorous acid with a base. The principal members of 
the series are, lime, soda, potash, iron, manganese, and ammonia. 
Phosphorus constitutes an important element in the human economy; it 
is found in the brain, nerves, blood, tissues, etc., and when there exists 
a deficiency, morbid symptoms are induced, which can be got rid of only 
by re-supplying the system. The hypophosphites accomplish this in the 
most direct manner. They are supposed to act in two ways; on the one 
hand they reinforce the principle constituting the nervous power; on the 
other, they are essentially blood-generating in their nature. They pos- 
sess in a high degree all the medicinal effects attributed to phosphorus, 
without any of its dangers. The hypophosphites are indicated in all 
those maladies marked by a want of nervous tone, such as consumption, 
scrofula, epilepsy, rickets, and chronic convulsive disorders. They may 
be given in doses of from 10 to 20 grains, three times a day, but they are 
generally administered in combination in the form of syrup. 
The following are the principal combinations to be found for sale, 
with the doses of each: Syrup of the hypophosphites of lime, soda, 
potassa, and iron. This preparation is peculiarly applicable to weakly, 
ill-fed children, and cases of debility generally. Dose: 1 teaspoonful 
three times a day. Syrup of the hypophosphite of iron, an excellent prep- 
aration whenever a blood restorer is indicated. Dose: 1 to 4 teaspoon- 
fuls three times a day. Syrup of the hypophosphites of iron and man- 
ganese, a form peculiarly suited for administration in cases of pulmon- 
ary consumption. Dose: 1 teaspoonful three times a day. Syrup of 
the hypophosphites of iron and quinine, particularly serviceable in the 
debility consequent upon typhoid fever and other diseases. In some 
stages of intermittent and remittent fevers it can also be used with 
advantage. Dose: 1 to 2 teaspoonfuls three times a day. Syrup of the 
hypophosphites of lime and soda. Dose: 1 to 3 teaspooufuls three 
times a day. Recently the hypophosphites have been combined with 
cod-liver oil. 
HYSSOP. (See Hyssopus Officinalis.) 
HYSSOPUS OFFICINALIS, hiz'-20-pus of-fis-in-d-lis, or common 
hyssop, a perennial herb belonging to the Nat. order Labiacea. It is 
raised in gardens, both in this country and in Europe. It is stimulant, 
aromatic, carminative and tonic. It is used with sage and alum as a 770 
HYSSOPUS OFFICINALIS-HYSTERIA. 
gargle for sore throats. The leaves applied to bruises relieve the pain 
and disperse the dark color. Dose: of the fluid extract, to 2 teaspoon- 
fuls; the infusion, 1 to 4 fluid ounces. (See Infusion.) 
HYSTERIA, kis-te'-re-a [Gr. hustera, the womb], is a nervous affec- 
tion to which females are particularly subject. This complaint appears 
in such a variety of forms, and simulates such a variety of diseases, that 
it is scarcely possible to give a just character or definition of it. There 
are few maladies that are not imitated by it, and whatever part it attacks, 
it assumes the appearance of the disease to which that part is liable. 
Causes.-It is generally connected with uterine irregularities, and 
occurs most frequently with persons between the ages of fifteen and forty- 
five and fifty, and is most common with single women of weakly consti- 
tution, and who lead sedentary lives. 
Symptoms.-In general hysteria, the attack is usually preceded by 
dejection of spirits, anxiety of mind, difficulty of breathing; a ball is felt 
advancing upwards from the stomach into the throat, and threatening 
to stop the passage of the air; then the trunk and limbs of the body 
become violently convulsed, the patient sobs and cries and occasionally 
bursts out into fits of laughter. After a time, these symptoms gradually 
cease, a quantity of wind is evacuated upwards, with frequent sighing 
and sobbing, and the woman recovers the exercise of sense and motion, 
frequently without any recollection of what has taken place during the 
fit, feeling however, a severe pain in the head, and a soreness all over 
the body. A fit of hysteria may last from a few minutes to several 
hours, or even days. It is to be distinguished from an epileptic fit by 
the absence of foaming at the mouth, by the sobbing and crying, by the 
milder expression of countenance, and by its being gradual and preceded 
by the sensation of a ball. Hysteria assumes various other forms; as 
palpitations of the heart and difficult respiration; pains in different 
parts, as the head, left breast, etc.; different forms of paralytic affec- 
tions, etc. The hysteric fit, however alarming and dreadful it may 
appear, is rarely accompanied with danger, and never terminates fatally 
unless it passes into epilepsy, or the patient be in a very reduced state. 
Treatment.-During the paroxysm the patient must be protected 
from injury; she should be removed to a cool room, her dress loosened, 
and she may be roused by pouring cold water over her face and chest. 
Ammonia may be held to her nostrils, and the following antispasmodic 
draught prescribed: 
Take of Ammoniated tincture of valerian... .Twenty drops. 
Camphor water One and a half ounce.-Mix. 
Or a foetid injection may be given thus: 
Take of Tincture of assafcetida Six drams. 
Mucilage of starch Six ounces.-Mix HYSTERIA-ICE. 
771 
During the intervals between the fits the general health must be 
improved, the functions of the uterine system attended to, and moral 
and mental discipline brought to exert its influence upon the excitable 
temperament of the patient; if she be weak, pale, and deficient in blood, 
iron should be given, and the bowels kept regular in their action by 
aperient pills. 
Take of Ammonio-citrate of iron One dram. 
Compound spirits of ammonia One dram. 
Salicine .. .Half a dram. 
Pure water Six ounces.-Mix. 
Take two tablespoonfuls three times a day. 
Take of Compound extract of colocynth... .Two scruples. 
Calomel Twenty-four grains.-Mix. 
Divide into twelve pills, two of which must be taken occasionally at bed- 
time. 
Hysterical patients should be ordered to use the cold shower or 
plunge bath every morning. Of all nervous affections this spreads the 
most rapidly by moral contagion ; if one patient in a ward be hysterical, 
oftentimes several of her companions become affected with the same 
disease. Sympathy, too, has a great influence over this disease: when 
the patients excite the pity of their friends and those who may chance to 
be around them, they can command a fit of hysteria at their desire. 
Hysteria, though dependent on physical derangements, is a disease 
to a considerable extent under the control of the will; and this fact 
should be urged upon the patient, when sufficiently sensible. Hot rooms, 
late hours, and novel reading must be avoided by all girls predisposed 
to this affection. Married life often proves a cure. To compare the 
symptoms of the hysterical paroxysm with those of the epileptic fit, read 
the article on the causes, symptoms and treatment of epilepsy. (See 
Epilepsy, Imitation.) 
HYSTEIHTIS, his-te-ri'-tis, inflammation of the womb. (See Womb.) 
I. 
ICE, ise [Lat. glades], the familiar and also the technical term for 
water in the solid state. Water, on being cooled, contracts until the 
temperature has fallen to about 39° Fahr., when it begins to expand. 
At the freezing point, 32°, under ordinary circumstances, ice is formed 
which, in consequence of the continued expansion, has only 0.93 of the 
specific gravity of water at 39°. The ice, therefore, floats upon the surface. 772 
ICE-ICHTHYOSIS. 
The uses of ice are various in all parts of the world, either for cooling 
wines and other beverages, or for confectionery purposes. Ice is often 
an agent of the greatest value in the treatment of disease, one, indeed, 
for which there is at times no substitute. As an external application, 
when cold is desirable for the purpose of reducing the heat of any par- 
ticular part, such as the head, ice manifestly offers the most efficient 
means; it may either be permitted to dissolve in the water in which the 
cloths are dipped, or, better, it may be pounded and placed on the part 
in bladders, or in elastic water-cushions. 
Ice has been applied to the spine, of late, with varying success, in 
the treatment of epilepsy and other nervous diseases, by means of ice- 
bags. They are made of elastic material, and extend from the neck 
to the bottom of the spine, being so nicely constructed that there is no 
fear of wetting the patient's clothes, and so causing discomfort. 
As an internal remedy, in inflammatory affections of the stomach, in 
obstinate vomitings, and in hysteria, small fragments of ice swallowed 
frequently or allowed to dissolve in the mouth, are often not only of the 
most essential service, but the remedy is one most agreeable to the feel- 
ings of the patient. In inflammatory affections of the throat and upper 
part of the windpipe, either the result of cold, or of accident, such as 
that which so often occurs to children in consequence of their swallowing 
boiling water from the spout of a kettle, ice given in small, frequently- 
repeated morsels, will be found at once one of the safest, best and most 
agreeable remedies. It has been found useful in loss of voice. Ice is 
of service in checking vomiting or hemorrhage. It is also given in 
typhus and other fevers. (See Cold, Iced Drinks.) 
ICED DRINKS, OR ICES, iste, as articles of luxury, if taken mod- 
erately, cautiously and slowly, and when the stomach is not full of food, 
are not injurious to healthy persons. It was found, however, in Dr. 
Beaumont's experiments, that cold fluids and the like produced a reduc- 
tion in the temperature of the stomach to the amount of 20° or 30° 
Fahr., and that the organ did not recover its proper heat for some time. 
As, however, the natural temperature of the stomach-about 100° Fahr. 
-is necessary for healthy digestion, it is evident that the custom of eat- 
ing ice after dinner, or after any full meal, must materially interfere with 
the disposal of that meal. (See Ice.) 
ICELAND MOSS. (See Cetraria, Cookery for the Sick.) 
ICE-PLANT. (See Monotropa Uniflora.) 
ICHOR, i'-kor [Gr.], a term used to denote a thin, aqueous and acrid 
discharge from wounds, ulcers, etc. 
ICHTHYOSIS, ik-the-o'-sis [Gr. ichthus, a fish], a disease of the skin 
which takes its name from the surface of the cuticle suggesting the idea ICHTHYOSIS-IDIOCY AND IMBECILITY. 
773 
of the scaly skin of a serpent or fish. It appears principally on the 
external parts of the limbs and round the joints, as of the knee or elbow. 
The scales rest on an uninflanied surface, and there is no heat, pain or 
itching. It is not common, and the remedies known are only palliative, 
as warm bathing and the use of mucilaginous and glycerine lotions to 
mollify the roughness. 
ICTERUS. (See Jaundice.) 
ICTERUS INFANTUM, ik'-te-rus in-fan-turn, the jaundice of 
infants. (See Yellow Gum.) 
IDIOCY AND IMBECILITY, id'-e-o-se [Gr. idiotes, originally an 
ignorant person; one who practiced no art or profession; a person deprived 
of sense; an imbecile], may be regarded as degrees of deficient mental 
manifestation, consequent upon a similar disordered or defective state of 
the brain. Some have defined the difference that idiocy is congenital, 
and imbecility acquired; but, generally, imbecility is regarded as a minor 
degree of idiocy. 
An idiot has been defined as one "who knows nothing, wishes noth- 
ing, and can do nothing," whose instincts scarcely prompt him to seek 
food under the pressure of hunger; from this lowest condition of all, up 
to the weak mind or judgment, every shade of idiocy, weak intellect, 
imbecility or silliness, is met with, and all perhaps are, more or less, 
capable of improvement, by means of attention to the physical health, 
and by education of the faculties. 
Till within the last few years, the general idea has been, that idiocy 
was incurable; the unfortunate beings, whether in the families of the 
rich or of the poor, were allowed to grow up, their physical wants at- 
tended to in accordance with the circumstances in which they happened 
to be placed, but their mental condition left without attempt at cultiva- 
tion. Fortunately the error has been exposed, and institutions are now 
in successful operation, for the end of elevating these unfortunate beings 
from their debased position. The fact, that idiocy has been regarded 
too much as a thing of the mind alone, independent of physical influ- 
ences, has tended in some degree to interfere with the efforts for its 
amelioration; attention to the physical health is a matter of paramount 
necessity. In the case of the cretins of Switzerland, the fact is peculiarly 
manifest. Enough has been said to give hope to those who number 
amid their families an idiot, that something may be done to ameliorate 
the calamity, and to induce them, as soon as the condition of an idiot 
child becomes manifest, to place it, or, if possible, to get it placed under 
judicious management at an early age. In a paper lately read by Dr. 
Forbes Winslow, before the Medical Society of London, England, he 
remarks with regard to the causes of idiocy. The great mass of idiots 774 
IDIOCY AND IMBECILITY-IMITATION 
were said to spring from an unhealthy stock, and have either been the 
children of idiotic parents, or of those of vitiated organizations, of 
scrofulous diathesis, or of intemperate habits. Dr. Winslow referred to 
the effects of intermarriages of near relatives, and to the influence of the 
mind of the mother, as well as that of the father, upon the condition of 
their offspring. (See Brain, Insanity.) 
IDIOPATHIC, id-e-o-path'-ik [Gr. idios, one's own; pathos, an 
affection], a term applied to a disease which is not dependent on any 
other complaint, and therefore opposed to those diseases called symp- 
tomatic. 
IDIOSYNCRASY, id-e-o-sin'-kra-se [Gr. idios, proper; sun, with; 
krasis, temperament], means a peculiar temperament of mind or body; 
a state of constitution peculiarly susceptible to be affected by certain 
agents, which in general produce no effect upon others. In this way, 
some persons are violently affected by honey, coffee, butter, etc. What 
are commonly called antipathies belong to this class. 
IDIOT. (See Idiocy.) 
IGNATII. (See Stryciinos Ignatii.) 
ILEUM, il'-e-um [Gr. eileo, I turn about, from its numerous convo- 
lutions], in Anatomy, is the name given to the last portion of the small 
intestines, which terminates at the valve of the caecum. (See Intestines. ) 
ILEUS OR ILIAC PASSION, il'-e-us, a violent colic. (See Colic.) 
ILIUM, il'-e-um, the side bone of the pelvis. It is called also os 
innominatum, or nameless bone. 
ILLUSIONS. (See Hallucination.) 
IMBECILITY. (See Idiocy, Insanity.) 
IMITATION, im-e-ta'-shun [Lat. imitatid}. The tendency to imi- 
tate, by which all, perhaps, but especially children, are more or less 
influenced, is, of course, an important consideration in the education of 
the latter, particularly With respect to the imitation of involuntary move- 
ments or peculiarities, such as stammering, squinting, etc., which young 
persons are very apt to acquire, if much associated with those who are 
subjects of them. The power of the tendency to imitate in causing the 
diffusion of disease of the nervous system, such as hysteria, epilepsy, etc., 
is well known. That in many cases the power of the will may prevent 
the manifestation or development of disease from imitation, has often 
been proved. The anecdote related of Boerhaave is known to most. 
This celebrated physician was consulted respecting the girls of a school, 
who, daily, one after the other, became the subjects of hysteria, simply 
from imitation: Boerhaave had it made known that his mode of treat- 
ment must be to apply actual cautery, that is a red-hot iron, to the spine; 
not another case of hysteria occurred. (See Hysteria.) IMPATIENS PALLID A-IMPOTEN CE. 
775 
IMPATIENS PALLIDA, im-pa -she-enz pal-li-da, jewel weed, or 
balsam weed, impatiens fulva or speckled jewel, and impatiens balsam- 
ina, are all plants belonging to the Nat. order Balsaminacew. They 
grow in moist, shady places throughout the United States, and some 
parts of Canada. The whole plant is used in medicine. It imparts its 
virtues to water. The decoction is used in jaundice and dropsy. The 
juice is said to remove warts, and to cure ringworm and salt-rheum. 
Dose of decoction, 1 to 2 fluid ounces, three or four times a day. (See 
Decoction. ) 
IMPERFORATE ANUS, im-per'-fo-rat [Lat. in, priv., and per- 
foro, perforatus, to bore through]. Infants are sometimes born with 
the lower extremity of the bowels completely closed. An operation has 
been successful, and the child has lived. Of course it must be shown to 
a surgeon. 
IMPERFORATE VAGINA, im-per'-fo-rat va-ji'-na. A complete 
closure of the vagina is a defect with which female infants are sometimes 
born. It can only be remedied by a skilful surgical operation. 
IMPETIGO, im-pe-ti'-go [Lat., from impetire, to infest], in Medi- 
cine is an eruption of yellow itching pustules, appearing in clusters, and 
terminating in a yellow, thin, scaly crust. It is the pustular form of 
eczema, and is known also as humid or moist tetter, and discharges a 
thin acrid ichor. It occurs on all parts of the body, but most commonly 
on the extremities. Frequently it occurs on the face or head, and some- 
times in children so thickly as to appear like a mask; it is then known 
as crusta lactea, or milk crust. It is almost confined to the lower orders, 
and chiefly to children that are ill-fed and scrofulous. A variety of it is 
produced by the action of certain irritants upon the skin, as on the 
hands of those who work among sugar, known as the grocer's itch; also 
on the hands of bricklayers, known as the bricklayer's itch. The erup- 
tion is not contagious. The treatment consists in attention to the gen- 
eral health, a mild and generous diet, without stimulants, cod-liver oil, 
and tonics, especially quinine, mild aperients, or, when there is much 
inflammatory action, purgatives, and a frequent use of the warm bath. 
The best local applications are lotions of extract of poppies, and zinc 
ointment. (See Eczema.) 
IMPOTENCE, im'-po-tense [Lat. impotent unable], incapability of 
sexual intercourse. This may be the result of some congenital defect, 
or of disease of the organs; but it most commonly arises from some 
functional or moral cause. The class of criminal indulgences involved 
in a consideration of this subject are such as we can but hint at here; to 
unveil their secrets would be to open one of the saddest and most degrad- 
ing pages of the book of humanity. In all cases of impotence we would 776 
IMPOTENCE-INFANCY, INFANT. 
recommend an immediate recourse to a medical man, but by no means 
to place any confidence in advertising quacks, who fatten on the credulity 
of their fellow-men. (See Onanism, Nocturnal Discharges, Semen, 
Sterility, Damiana, Barosma, Electricity, Stryciinos Nux Vomica.) 
IMPURE AIR. (See Air.) 
INCISION, in-sizh'-un [Lat. incido, to cut into], a clean cut made 
into the soft parts with a sharp instrument. 
INCISORS, in-si'-zorz [Lat. incisor es, from incido, I cut], the name 
given to the four front teeth in each jaw, from their use in cutting the 
food. (See Teeth.) 
INCOMPATIBLES, in-kom-pat'-e-blz, salts and other substances 
that cannot exist together in solution without mutual decomposition, or 
other chemical action, taking place, on each other. 
INCONTINENCE OF URINE. (SeeBed-Wetting; Bladder, Dis- 
eases OF THE.) 
INCUBUS OR NIGHTMARE. (See Sleep, Dreaming.) 
INDIAN BERRY. (See Cocculus Indicus.) 
INDIAN CORN, OR MAIZE. (See Cereals, Corn Meal.) 
INDIAN HEMP, ind'-ygn or in'-de-qn. Two entirely different 
drugs are known by this name. In England cannabis indica is known 
by that designation, while in America it is applied to the Apocynum 
cannabinum, the Cannabis being here known as foreign Indian hemp. 
(See Cannabis, Apocynaceje. ) 
INDIAN PHYSIC. (See Gillenia Trifoliata.) 
INDIAN PINK ROOT. (See Spigelia Marilandica.) 
INDIAN SHOE. (See Cypripedium Pubescens.) 
INDIAN TURNIP. (See Arisjema.) 
INDIA-RUBBER. (See Caoutchouc.) 
INDIA-RUBBER BEDS. (See Beds.) 
INDIGENOUS, in-dij'-e-nus [Lat. indigene, a native], a term applied 
to diseases, animals or plants peculiar to a country. 
INDIGESTION. (See Dyspepsia.) 
INDIGO. (See Indigofera.) 
INDIGOFERA, in-di-gof -e-rg [indigo and Lat. fero, I bear,] a 
genus of the Nat. order Leguminosoe. The species I. tinctoria, ccerulea, 
and probably some others, yield commercial indigo, one of the most 
important of dyeing materials. Indigo is very poisonous ; but in proper 
doses it has been employed in epilepsy and erysipelas, though its value 
in such diseases is by no means well established. 
INDIGO-WEED, OR WILD INDIGO. (See Baptisia Tinctoria.) 
, INEBRIATE ASYLUMS. (See Dipsomania.) 
INFANCY, INFANT. (See Child, Children; Age.) INFANTICIDE, ETC.-INFLAMMATION. 
777 
INFANTICIDE, OR CHILD MURDER, in-fan' -te-side [Lat. infan- 
ticidium; infans, inf antis, an infant, and caado, to kill], lias been prac- 
tised from very early times. One of the most difficult questions of 
medical jurisprudence is to ascertain the murder of a child newly born. 
It has first to be determined whether the child was born dead or alive, 
and next, whether its death was occasioned by violence, or was the result 
of natural causes. If it be proved that the child was born alive, and 
subsequently destroyed, either by violence or wilful neglect, the offence 
is murder, and punishable accordingly. 
INFANTILE CONVULSIONS, OR FITS. (See Convulsions.) 
INFANTS, CATARRHAL AFFECTIONS OF. (See Snuffles.) 
INFANTS' FOOD. (See Cookery for the Sick; Child, Children; 
Food, Milk.) 
INFECTION, in-fek'-shun [Lat.], is the propagation of disease by 
means of deleterious or offensive effluvia contained in the atmosphere. 
The offensive matter may either proceed from decomposition of animal 
or vegetable substances, or may emanate from the bodies of persons 
affected by particular diseases. The presence of some of these agents 
may be recognized by the smell, of others only by their mischievous 
effects. The most important means of disinfection is ventilation. 
Various chemical agents are also employed for this purpose; as chlor- 
ine, chloride of zinc, perchloride of iron, sulphurous acid, carbolic acid, 
etc. (See Contagion, Disinfectants.) 
INFIRMARY, in-fir'-ma-re [Lat. infirmus, infirm], is an hospital 
for the reception and medical treatment of the sick poor. Fortunately, 
in almost all of the considerable towns of this country there are now 
establishments of this description, supported either by public subscrip- 
tions or by private endowments. (See Hospitals.) 
INFIRM, CARE OF. (See Age, Old ; Climacteric Disease, Bed- 
Room, Sick-Room, Cookery for the Sick, etc.) 
INFLAMMATION, in-fiam-ma'-shun [Lat. inflammo, to burn], is 
an action set up in the living body, which is characterized by redness 
and swelling of the portion affected by heat and pain. When these 
phenomena occur on a visible part, they are recognizable by all, but 
when they-that is inflammation-occur internally, their presence must 
be judged of by concomitant symptoms. Few diseases are unaccom- 
panied by inflammation in a greater or less degree in some part of their 
course, and many seem to owe their characters and influence chiefly to 
its presence. Nevertheless, inflammation is not solely a process of dis- 
ease tending to disease, it must accompany the reparative action of the 
wound or fracture; in other words, the means of reparation are the con- 
sequences of inflammation. 778 
INF LAMM A TION. 
When inflammation of a part occurs, the chief effect is, determina- 
tion of the blood to it, the stream being quickened in some parts, and 
in others impeded, whence arise the characteristic redness and swelling, 
heat and pain, the latter, especially, being the result of pressure on the 
nerves by the distended tissues. After the process has continued 
for some time, it may subside, the parts resuming the same appearance 
and action they possessed before it arose. This termination of inflam- 
mation is named "resolution: " it is of course the most desirable of all, 
and to bring it about, the efforts of the medical man are directed. In 
the event of inflammation not terminating by ''resolution," it may give 
rise to effusion of serum, that is, of the watery portion of the blood; 
this effect is familiar in the case of scald or blister; internally, it hap- 
pens in pleurisy, in water on the brain, etc. (See Pleurisy.) 
This effect of inflammation is •undoubtedly, in many instances, produc- 
tive of bad consequences. A third and most important termination of 
inflammation is the effusion of what is called "lymph," that is of an adhe- 
sive-at first liquid, afterwards solid-matter, which becomes a permanent 
medium of connection between two parts. (See Adhesion.) As, how- 
ever, this exudation of adhesive matter takes place as a necessary conse- 
quence of inflammation, in many cases irrespective of circumstances, it 
must happen that it is sometimes as much a source of injury as it is at 
others of benefit; thus, in the case of inflammation within the abdomen, 
it may glue the bowels together; in the chest, it may fix the lungs to the- 
side, or the heart to its containing bag. Nevertheless, even internally, 
it is often beneficial; it may seal parts together in such a way as to pre- 
vent the escape of matters, as, for instance, from the bowels into the 
abdomen, which must otherwise have proved fatal. 
But inflammation may terminate in none of the ways above-men- 
tioned ; it may go on to the formation of pus or matter, as in the case 
of abscess. (See Abscess.) Or ulceration may take place-(see Ulcers) 
-or, lastly, the vitality of the inflamed part being completely destroyed, 
mortification occurs, and the tissues dissolve or break down into one 
putrefying mass. These various effects of inflammation are in some 
degree dependent upon the violence of the action in the first instance, 
but they are modified by the nature of the affected tissue. What has 
now been said, however, will demonstrate how closely this important 
process is connected with the whole science and practice of medicine,, 
and how greatly all treatment must have reference to it; and, especially, 
to induce its termination in "resolution," which leaves the affected 
part uninjured in structure and function. 
The means used to procure resolution of inflammation are bleeding, 
either general or from the arm, or local by means of leeches, cupping. INFLAMMATION 
779 
etc., which relieve the overloaded and obstructed vessels; further, 
fomentations and poultices, that is, heat and moisture, which relax and 
also relieve from the accumulation of blood by producing perspiration; 
also medicines, such as diuretics, diaphoretics, purgatives, etc. In some 
cases, when inflammation is seated on the surface, it is treated success- 
fully by the direct application of astringents to the parts. Thus, inflam- 
mation of the covering membrane of the eye is cured by an astringent 
wash, along with the more directly medical treatment; the diet in most 
cases of active inflammation requires great reduction. 
In addition to the local symptoms of inflammation, there are those of 
the constitution, which always accompany the process, except in its most 
trivial forms. These are fever, inflammatory, hectic, or typhoid, accord- 
ing to the nature and extent of the local affection, the part involved, or 
the constitution of the patient. The first occurs generally in the active 
stage of inflammation; the second, should matter be formed; the third, 
if mortification or sloughing takes place. When inflammation in some 
of its forms is going on within the body, the blood acquires the peculiar 
property of becoming buffed, after it has been drawn from a vein, that 
is, instead of the clot being formed by coagulation, presenting a red sur- 
face, it is covered on the top by a tough yellow coat of greater or less 
thickness. 
Although redness, swelling, heat and pain, when combined, certainly 
indicate inflammation, they do not do this separately; the redness of 
blushing is no inflammation, and pain may result from spasm, swelling 
may be caused by simple effusion; heat by exercise. The above char- 
acteristic symptoms, moreover, are greatly modified by the site and 
nature of the inflamed part; the severity of the pain, especially, being 
by no means commensurate with the importance of the affected organ. 
Some parts, such as bone, which in their healthy state possess but slight 
sensation, become when inflamed most acutely sensitive. Further, in 
some respects, pain in inflammation is a deceitful guide; sometimes it is 
altogether absent when its presence might have been fully anticipated ; 
and again, if felt, it is not perhaps at the affected part, but at some dis- 
tance from it. As a general rule, inflammatory pain is increased by 
pressure, and is in this way distinguished from the pain of spasm. In 
some forms of inflammation, such as those of gout, rheumatism, etc., 
what is called metastasis occurs, that is, the action seems to be trans- 
ferred from one portion of the body to another. This tendency of inflam- 
mation may, of course, be exerted either for good or evil. Its good the 
physician tries to imitate, when by blisters and other means, he endeav- 
ors to produce inflammation artificially upon the skin, with the view of 
drawing it off from some more directly vital and less accessible organ. 780 
INFLAMMATION-INFLAMMATION OF THE LIVER. 
The causes of inflammation are very numerous; whatever irritates locally, 
as familiarly exampled by dust in the eye, will cause it; but it may also 
originate from causes affecting the constitution, such as cold, or it may 
arise in the course of constitutional diseases, such as fever. 
Such are the principal general points connected with the subject of 
inflammation, with which it is expedient unprofessional readers should 
be acquainted; a clear understanding of them will tend greatly to assist 
the formation of rational and common sense ideas respecting the nature 
and progress of disease, and will throw light upon some, at least, of the 
whys and wherefores of its rational treatment. 
The inflammations which affect the body may be classed as external 
and internal. 
The external inflammatory affections, properly so called, are the 
various skin diseases, particularly erysipelas, which is, essentially, 
inflammation of the skin; inflammation of the eye, ear, throat, etc. 
The internal inflammatory affections are those of the brain, of the 
chest and lungs, including laryngitis and croup, which affect the wind- 
pipe ; and bronchitis, which is situated in the air-tubes; also pneumonia 
and pleurisy, and carditis, or inflammation of the heart. 
Of the abdomen, the inflammations are those of the stomach and 
bowels generally, and of the other viscera, such as the liver and kidneys 
and womb. In addition to the above, there are inflammations of the 
blood-vessels, especially of the veins, inflammation affecting the bones, 
joints, etc. All these are entered into sufficiently under their separate 
articles. (See each individual article referred to in the first nineteen cross 
references succeeding this article. See also, Cold.) 
INFLAMMATION OF THE AIR-PASSAGES. (See Bronchitis.) 
INFLAMMATION OF THE BLADDER. (See Bladder, Dis- 
eases OF THE.) 
INFLAMMATION OF THE BOWELS. (See Enteritis, Peri- 
tonitis.) 
INFLAMMATION OF THE BRAIN. (See Brain, Diseases of 
THE.) 
INFLAMMATION OF THE BREASTS. (See Breast.) 
INFLAMMATION OF THE EAR. (See Ear, Diseases of the.) 
INFLAMMATION OF THE EYES. (See Ophthalmia; Eye, Dis- 
eases OF THE.) 
INFLAMMATION OF THE HEART, OR CARDITIS. (See 
Heart, Diseases of the. ) 
INFLAMMATION OF THE KIDNEYS. (See Nephritis.) 
INFLAMMATION OF THE LARYNX. (See Laryngitis.) 
INFLAMMATION OF THE LIVER. (See Hepatitis.) INFLAMMATION OF THE LUNGS-INFLUENZA. 
781 
INFLAMMATION OF THE LUNGS. (See Pneumonia, Bron- 
chitis, Pleurisy.) 
INFLAMMATION OF THE SPINE. (See Spine, Diseases and 
Injuries of the.) 
INFLAMMATION OF THE STOMACH. (See Gastritis.) 
INFLAMMATION OF THE TONGUE. (See Tongue.) 
INFLAMMATION OF THE WINDPIPE. (See Croup.) 
INFLAMMATION OF THE WOMB. (See Womb.) 
INFLAMMATORY FEVER, inflam'-ma-to-re, the high state of 
febrile excitement accompanying an attack of acute inflammation of any 
organ. (See Inflammation, Fever.) 
INFLAMMATORY RHEUMATISM, OR ACUTE RHEUMA- 
TISM. (See Rheumatism.) 
INFLUENZA, influ-en'-za [Italian, signifying influence]. This 
disease is the best specimen of an epidemic disease, and is often called 
epidemic catarrh. It is a peculiar feverish attack, accompanied with 
catarrhal affection of the air-tubes of the lungs, and great prostration 
of strength. It is not uncommon to call various forms of cold and 
catarrh, influenza; but the true influenza is a very distinct disease, 
and seldom occurs but as an epidemic, attacking large numbers at 
once. 
Symptoms.-The symptoms of influenza are those of general fever; 
coming on suddenly, there is shivering, loss of appetite, perhaps vomit- 
ing, heat and thirst, with cough, frontal headache, and generally great 
depression and languor. The feverish symptoms may last from one day 
to ten, but their general duration is from three to five, or seven days, 
the cough usually remaining a variable time, after the acute symptoms 
are gone, according to exposure and circumstances, such as a predispo- 
sition to cough, etc. 
Treatment.-To the strong and healthy, influenza is but a trifling 
disease ; it certainly prostrates even them for a few days and leaves them 
weak, but it is in almost all cases perfectly devoid of danger-with 
ordinary care-and requires little or no medicine. A few days in bed, 
according to the severity of the case, with low diet, a gentle aperient, 
and diluents, the feet in hot water, being all that is required. If the 
catarrhal symptoms are severe, treatment similar to what is recom- 
mended in the articles Catarrh or Common Cold, and Catarrh,Chronic, 
may be had recourse to. 
To the weakly and the aged, influenza is, on the other hand, a com- 
paratively fatal disease, and from the almost universal nature of its 
attack, carries off more perhaps, of these classes, than many more 
apparently severe and more dreaded disorders. The attack of influenza 782 
INFL UENZA-INFUSION 
in the description of persons above mentioned, should be the signal for 
medical attendance. It is apt, especially when neglected, to run on to 
bronchitis, or to inflammation of the lungs. Lowering means especially, 
must not be resorted to; confinement to bed, and the use of diaphoretic 
remedies, as recommended in the article Catarrh or Common Cold, will 
be required; broth, strong or weak, must be allowed, according to circum- 
stances ; if the strength is deficient, wine may be requisite, and stimulant 
expectorant medicines, especially in the aged, if the expectoration is 
abundant, viscid, and difficult to be got up. In such cases, the follow- 
ing will be found useful: Take of carbonate of ammonia, 30 to 40 grains; 
tincture of squill, 1 dram; wine or syrup of ipecacuanha, 40 drops; 
water or camphor julep, sufficient to make an eight-ounce mixture, of 
which 2 tablespoonfuls may be given every three or four hours. If the 
cough is very irritating and troublesome, 2 teaspoonfuls of paregoric may 
be added to the above, but the opium rather tends to check the free expec- 
toration, which is so desirable. Demulcent drinks, such as barley-water, 
should not be neglected, and a mustard plaster, or blister, to the chest 
will do good. In severe forms of the disease, with difficult breathing, 
if the strength is much reduced and the appetite bad, 2 or 3 fluid ounces of 
decoction of cinchona bark may be given during the day. Persons who 
generally suffer from delicacy of chest should beware of allowing the 
effects of influenza to hang about them; the debility and cough are very 
apt, if predisposition exists, to lay the foundation of consumption. The 
strong and healthy may trust to the domestic management of influenza, 
the weak and aged ought to have proper medical advice, if it is within 
reach. (See Demulcents, Cold, Cinchona, Diaphoretics.) 
INFUSION, in-fu'-zkun [Lat. infusio], is the submission of sub- 
stances to the action of water, hot or cold, for the purpose of extracting 
from them certain portions soluble in the fluid. The most familiar 
instance of an infusion is common tea. The object of an infusion is to 
extract volatile and other substances, which would either be dissipated 
or injured by exposure to higher heat, such as decoction or boiling; 
indeed, some infusions are better made without heat at all. 
The commonest method of forming a hot infusion is, to pour the 
water boiling upon the substance, cover, and allow the whole to stand 
near the fire for some time before it is permitted to become cold. If the 
substance to be infused is thick or tenacious, it ought, of course, either 
to be cut up, or well bruised before being submitted to the action of 
water. As a general rule, and unless stated differently, the infusions 
mentioned in this work, contain the active properties of 1 ounce of the 
drug, extracted by a pint of boiling water. (See Drug, Decoction.) 
The chief inconvenience connected with infusions, is the great tendency INFUSION-INJECTION. 
783 
to spoil; some, such as calumba and dandelion, becoming unfit for use 
in twenty-four hours in summer. It is said that if the infusion be poured 
boiling hot into a bottle, filled up to the top, and the bottle immediately 
well corked, it will keep good a long time. 
INFUSION OF MALT. (See Cookery for the Sick.) 
INGROWING NAILS. (See Nails, Ingrowing of the.) 
INGUINAL, ing'-gwe-ngl [Lat. inguinis, the groin], relating to the 
part between the abdomen and the thigh. The groin is frequently called 
the inguinal region. 
INGUINAL HERNIA. (See Rupture, Inguinal.) 
INHALATION AND INHALERS, ln-ha-la'-shun [Lat. inhalatio}, 
is the "inspiration," or drawing in, of vapor-sometimes of powder- 
into the lungs, as a form of medical treatment for the cure of disease. 
The steam from water may often be used as a Safe domestic inhala- 
tion, in cases which require the local application of heat and moisture ; 
indeed, in sore throat steaming is very commonly had recourse to. It 
may also be employed with advantage in cases where the breathing is 
difficult, with tenacious expectoration, especially in old people. In chest 
affections, such as consumption, with spasmodic cough, the vapor of 
boiling water, into which has been put a few drops of sulphuric or chloric 
ether, or 10 or 12 drops of laudanum, will frequently afford much 
temporary relief. Medicated inhalations, such as those from chlorine, if 
used at all, must be so under direct medical superintendence. It is 
probable that the slow, imperceptible, but continual breathing of an 
atmosphere impregnated with such medicinal agents as chlorine, iodine, 
etc., is more likely to be of service than their temporary use in more 
powerful doses. 
Various methods of inhaling steam are employed: simply holding 
the mouth over a pitcher of hot water will answer, but if the throat be 
the part affected, the vapor is most directly conducted to it by means of 
a tube of some kind. A funnel inverted over the vessel from which the 
steam issues, will do very well. Where vapor is wished to be inhaled 
by persons confined to bed, or very weak, a good method is to place a 
quantity of hot bran in a suitable vessel, pour some boiling water upon 
it, and place it under a light cloth, which also covers the face of the 
patient. If desired, various forms of inhalers can be procured of the 
druggists. (See Atomizer.) 
INJECTION, in-jelc -shun [Lat. injicio^ I cast in], is a medicated 
liquor thrown into some cavity of the body by means of a syringe or 
other apparatus. Those injections which are thrown into the rectum are 
called enemata, or clysters. For full information on this subject, see 
Clyster. 784 
INJUPIES, ETC-INSANE ASYLUMS. 
INJURIES AND DISEASES OF THE SPINE. (See Spine, 
Diseasesand Injuries of the.) 
INLAND AIR. (See Air.) 
INOCULATION, in-ok-u-la'-shun [Lat. inoculatio\ is the introduc- 
tion of a poison into the system by means of a wound. Any poison 
which will thus affect the part in which it is placed, of the system gen- 
erally, may he said to be introduced by inoculation. The term is most 
generally used with reference to the poison of small-pox. (See Small- 
Pox, Poisons.) 
INSANE ASYLUMS, in-sane' a-si'-lums. Insanity is a disease, 
which, when once developed, ought never to be kept under domestic 
management, or rather mismanagement; the only reasonable hope rests 
with speedy removal to proper care, and to a state of external circum- 
stances specially adapted to promote recovery. Asylums for the insane 
are not what they were, and the most attached and affectionate relative 
need not fear to place the afflicted under the protection of a well- 
managed establishment. 
Prompt treatment is of most importance, and obstacles which make 
it difficult of access, afford a pretext and palliation for that repugnance 
to resort to isolation, which still exists in the minds of friends and 
guardians, but which is fading and falling, and must ultimately fall 
before the influence of a system of discipline, founded upon humanity, 
and which is open to investigation. The procrastination which occurs 
when an individual is attacked with insanity, in adopting the only course 
which can ensure the enforcement of judicious means of care and cure, 
is the result of various causes; frequently it may be traced to ignor- 
ance that the extravagance and incoherence which inflicts so much 
pain, and creates so much confusion, are symptoms of diseased organi- 
zation; and to scepticism that these originate, increase, disappear, or 
are removed, according to the same principles, and nearly in the same 
manner that gout and jaundice are mitigated or removed. If the opin- 
ion were generally prevalent, that insanity in all cases, whether its 
development is determined by disappointment or by a blow on the head, 
whether signalized by great constitutional disturbance or apparent 
robustness of frame, depends upon bodily disorder, and can only be 
reached, whether curable or not, through the body, and by agents which 
act in accordance with the known laws of the economy; advice would 
be sought at once, or as speedily as in other maladies : the powers or 
efficacy of medicine would be put to a fair test, and it is admissible to 
anticipate that the mortality and evils of an intractable class of diseases 
would be materially diminished. Even now, when months are allowed 
to elapse before assistance is obtained, a very large proportion of the INSANE ASYL UMS-INSANITY. 
785 
more transient and trivial cases of mania are found to recover under 
judicious management, while one-third, at least, of the more desperate 
and chronic and hopeless cases, which are sent to public institutions 
because they have set all conciliatory and temporizing expedients at 
defiance and resisted the treatment pursued, are ultimately restored to 
such a degree of intelligence as to capacitate for the resumption of 
former pursuits and responsibilities, and for the performance of the 
duties of active life. 
The character of the moral management is activity without excite- 
ment, progress, the combination of self-government, with appeals to the 
intellect and sentiments. There is always something to expect to pre- 
pare for; some anticipation or some retrospect. Patients are participa- 
tors in every arrangement. They are identified with the recreation as 
well as the labors of the community. They are led to understand that 
each progressive step is not merely for them, but by them. They are 
their own gardeners, laborers, players, precentors, librarians, and, under 
certain restrictions, their own police. Each day has its appropriate 
relaxation, as well as its duties ; but monotony, which engenders torpidity 
rather than tranquillity, even the monotony of continued recreation, is 
obviated by useful pursuits and physical exertion. (See Insanity.) 
INSANITY, in-sari-e-te [Lat. in, not; sanus, sane, sound], is one of 
the most terrible diseases to which the human race is subject. 
Causes.-The causes which may lead to insanity, particularly in those 
whose mental constitution is weak, are very numerous. In many cases 
the tendency to insanity is hereditary, and transmitted from parents to 
children. Excessive study, strong mental excitement, grief, jealousy, 
disappointment, frequently also lead to it. Religious, political, and 
commercial excitement are also fertile causes. 
No fact is more clearly ascertained than the vast amount of insanity 
caused by drunkenness. The temporary insanity of intoxication cannot 
be indulged in with impunity; it may be frequently repeated, but at 
length the mind permanently gives way, and the individual may become 
a confirmed lunatic. 
Characteristics.-Sometimes insanity comes on quite suddenly, with- 
out any warning whatever; at other times there is a previous derange- 
ment of the animal functions, loss of appetite, restlessness, and want of 
sleep. It is usual to distinguish insanity into different kinds. 
1. Moral insanity, in which there is a morbid perversion of the feel- 
ings, affections and active powers, without any illusion or erroneous con- 
viction impressed upon the understanding. 
2. Intellectual insanity, affecting the reasoning powers, and which 
may be either general or partial, the latter as in monomania. 786 
INSANITY. 
3. Mania, or raving madness, in which the mental faculties are 
notoriously impaired, the patient gives way to all sorts of extravagances, 
and if not prevented, will do mischief to himself or others. 
4. Dementia, imbecility, fatuity, when the mental powers become 
gradually impaired, the sensibilities diminished, and the person at length 
becomes careless, or dead to all that is going on around him. 
Usually, however, two or more of these kinds occur together. Moral 
insanity frequently manifests itself in a desire to steal, or appropriate 
the property of others. In monomania, the patient reasons correctly 
upon all matters except one, which forms the subject of his insanity. 
Imbecility usually commences with loss of memory and the power of 
concentrating the attention for any time upon one subject; then all con- 
trol is lost over the thoughts, and the mind wanders meaninglessly from 
one subject to another; at length there is a carelessness to all that is 
going on around, and life may become a mere existence, the mental 
faculties being entirely lost. 
Idiocy differs from imbecility in being congenital, while the latter is 
acquired, or produced by disease. Idiocy may be produced by various 
causes connected with the parents ; as intermarriages of near relatives, 
intemperance, scrofulous habits, some powerful influence acting on the 
mother during pregnancy. Idiots present every degree of mental imbe- 
cility, down to the lowest shade, without sense sufficient to satisfy the 
mere wants of nature. The head of the idiot is usually very small, par- 
ticularly in the regions of the forehead; in some cases, however, it may 
be quite natural, and in others large and misshapen. The beneficial 
effects of attention to the physical health, and of education, are mani- 
fested even in the case of idiots. (See Idiocy.) 
Treatment.-1The chances of recovery depend greatly on the compli- 
cation, or otherwise, of insanity with other diseases, particularly epilepsy 
or paralysis, with either of which it is nearly hopeless. It is also influ- 
enced by the form of the disease, the period of its duration, the age, 
sex, and constitution of the patient. The mean duration of cases ter- 
minating favorably is from five to ten months; after the latter period, 
recovery is very doubtful. In advanced life, insanity is generally per- 
manent, and imbecility is very rarely curable. While insanity may arise 
from some affection of the brain which speedily terminates in death, yet, 
in general, it is not necessarily a fatal disorder, for lunatics have been 
known to live thirty, forty, or fifty years after being seized with their 
disease. It is one of the signs of the advance of the present age that the 
treatment of the insane is no longer what it was; they are no longer 
loaded with chains and confined to some dungeon, but are treated with 
kindness and consideration, and allowed all the liberty that the nature of INSANITY-INSTR UNENTS, S UR GIO AL. 
787 
their malady admits of. In the cure of insanity, in which great progress 
has recently been made, the means adopted naturally resolve themselves 
into medical and moral. When the malady proceeds from, or is accom- 
panied by, physical derangement, as it usually is, it is necessary to 
ascertain the nature of this, and to take means for its removal. If there 
be excitement and inflammatory action, mild antiphlogistic measures 
will be necessary, together with aperients and a low diet. If, on the con- 
trary, there is debility and prostration of strength, a nourishing diet will 
be required. When, as is often the case, want of sleep is an attendant 
symptom, opiates are to be given. In all cases, exercise, fresh air, and 
cleanliness are required. The moral treatment of the insane consists in 
diverting their thoughts by occupations and amusements, and in gaining 
their confidence by kind and conciliatory measures. 
A very erroneous idea exists, particularly among the ignorant, that if 
a person be insane, he cannot act or look like a rational being at all, but 
must be constantly doing things in an insane manner; consequently, if 
the individual be simply lunatic or monomaniac, without being actually 
under the influence of maniacal excitement, or even should he have a 
"lucid interval," that is, a temporary cessation of mania, and tempor- 
aryreturn, either wholly or partly, of his rational condition, those around 
are apt to be lulled into a false security, the vigilance or attendance is 
relaxed, and a momentary return of the delusion is attended, perhaps, 
with the most serious consequences, rendering nugatory hours and days 
of anxious care. (See Delirium, Delirium Tremens, Dipsomania, 
Monomania, Melancholy, Hypochondriasis, Insane Asylums, Suicide, 
Idiocy, etc.) 
INSENSIBILITY, OR UNCONSCIOUSNESS. (See Coma, Faint- 
ing, Apoplexy, Intoxication, Concussion, Concussion of the Brain, 
Shock, etc.) 
INSPIRATION, in-spe-ra-shun [Lat. inspiration, the act of draw- 
ing air into the lungs, and the opposite of expiration, which consists 
of its expulsion; the two together constituting respiration. (See Res- 
piration. ) 
INSTRUMENTS, SURGICAL, in-stru-ments [Lat. instrumentwn\. 
But few of the mechanical agents used by the surgeon in the treatment 
of diseases or injuries can ever be of legitimate use to unprofessional 
persons living within reach of a medical man, but there are sparsely set- 
tled portions of the country where physicians are few and far between, 
and where such articles of utility could not be procured when wanted. 
It is advisable, therefore, that parties about to remove to such a location, 
should provide themselves with a few of those simple instruments, which 
in case of emergency, any one might use for the relief of pain and 788 
INSTRUMENTS, SURGICAL-INTESTINES, etc. 
sickness. The list might be extended by the party taking the trouble to 
get a little practical instruction from the family physician before removing. 
The following list will include all, or nearly all, that could be of much 
service in the hands of an unprofessional: 
Two pairs of Forceps, one straight and 
one curved, for tooth-drawing. 
One Gum Scarificator, for lancing the 
gums of children during dentition. 
Two Lancets for bleeding, and one Vac- 
cinating Lancet. 
One pair of Forceps for dressing wounds. 
One pair of Spring Forceps for seizing a 
divided artery. 
Two pair of Scissors, one with sharp, and 
one with blunt points. 
One Caustic Holder. 
One small Syringe for the ear and nostrils, 
and for cleansing wounds. 
Two Enema or Injection Syringes, one 
of them with a long pipe, which in case 
of necessity could be used as a stomach 
pump. 
One Silver Probe, for examining wounds. 
One Tenaculum, a slender hook to which 
a handle is attached, used for laying 
hold of and drawing forward a bleed- 
ing vessel to permit of its being secured 
by a string. 
One Tourniquet, an instrument used for 
compressing a divided artery, and thus 
arresting hemorrhage until it can be tied. 
One silver, and two or three gum-elastic 
Catheters, of different sizes, for drawing 
off the water. 
One case of Straight and Curved Needles 
and some silk thread for sutures. 
All of the above can be safely used by a man of ordinary intelligence 
who has had a little practical instruction in their management. 
INTEMPERANCE. (See Stimulants, Alcoholic ; Dipsomania, 
Intoxication, Delirium Tremens, Insanity, Health, Longevity.) 
INTERCOSTAL, in-ter-kos'-tai [Lat. inter, between, and costa, a 
rib], is a term applied to certain muscles, vessels, etc., situated between 
the ribs. There are two sets of intercostal muscles, the external and 
internal, which decussate each other like the strokes of the letter X. 
INTERMARRIAGE. (See Marriage.) 
INTERMITTENT, in-ter-mit'-tent [Lat. inter, between, and mitto, 
I send], a term applied to diseases, which, like ague and neuralgia, 
come on in paroxysms, between which there is an interval of compara- 
tive freedom from the symptoms of the disease. The term is also 
applied to the pulse, when some of its beats are as it were omitted. 
INTERMITTENT FEVER, OR FEVER AND AGUE. (See 
Ague. ) 
INTERMITTING PULSE. (See Pulse, Exercise.) 
INTESTINAL WORMS. (See Worms.) 
INTESTINES, OR BOWELS, in-tes'-tinz [from Lat. intus, within], 
in Anatomy, is that part of the alimentary canal which extends from the 
stomach to the anus, and is situated in the cavity of the abdomen. It is 
composed of three coats, or membranes-the peritoneal, the muscular and 
the villous. It is divided into the small and large intestines. The small 
intestines have three divisions-the duodenum, so called from its length, INTESTINES, ETC.-INTOXICATION. 
789 
being about twelve finger-breadths, and which commences at the pyloric 
end of the the stomach; the jejunum, so named from being generally 
found empty; and the ileum, terminating by a transverse opening into the 
large intestines, called the ileo-caecal valve. The large intestines have 
likewise three divisions-the caecum, colon, and rectum. The caecum, 
or blind-gut, so called because it forms a cul-de-sac, or short rounded 
pouch, is about two and a half inches in length, and has attached to it 
a narrow round and tapering part called appendix coed. It is situa- 
ted in the right iliac region. The colon first ascends towards the 
liver, then passes across the abdomen under the stomach to the left side, 
where it is contorted like the letter S, and descends to the pelvis. 
Hence it is divided into three parts, called the ascending portion, the 
transverse arch, and the sigmoid flexures. The rectum is a continuation 
of the colon in the pelvis, proceeding in a straight line to the anus. 
The entire length of the intestinal canal is about six times that of the 
body. The small intestines have internal membranous folds, called 
valvuloe conniventes; while the large intestines have three strong mus- 
cular bands, which run parallel upon the surface. (See Anatomy, Ali- 
mentary Canal, Colon, Digestion, Enteritis, Peritonitis, Rectum.) 
INTOXICATION, in-toks-e-ka'-shun [Lat. in, and toxicum, a poison], 
the state produced by the excessive use of alcoholic liquids or inebriat- 
ing substances. In general, intoxication comes on gradually, and several 
stages may be noted in its progress. Thus,.it shows itself at first by a 
general liveliness and excitability; during this stage, the circulation of 
the blood becomes more rapid, and all the functions of the body are per- 
formed with more freedom. While in this condition, the mental powers 
seem to act more freely; the imagination is stimulated, the fancy more 
lively, and the feeling of strength and courage increased. The effect 
on the brain is much more decided in the second stage of intoxication. 
Then, all the peculiarities of character, the weaknesses and failings of 
temperament which the individual can keep under and conceal in his 
sober moments, manifest themselves. Consciousness begins to be 
attacked, secret thoughts are revealed, and the sense of propriety lost. 
The peculiarities of this stage are summed up in the old proverb, in vino 
veritas, "in wine there is truth." In the next stage, consciousness is 
still more weakened, the balance of the body cannot be kept, the sight 
becomes confused, and the brain dizzy. After this point, the mind 
seems to be entirely overwhelmed by the tumult of animal excitement, 
consciousness is utterly extinguished, the tongue can only mutter inco- 
herent gibberish, the face becomes suffused with blood, the eyes protrude, 
and perspiration streams from the pores of the skin. Lastly, when com- 
pletely prostrated, the victim of intoxication sinks into a heavy slumber, 790 
INTOXICATION-IODIDE OF POTASSIUM. 
closely resembling the stupor of an apoplectic fit. It is difficult to dis- 
tinguish intoxication in its most profound state from apoplexy, asphyxia, 
or the extreme effects of cold. In general the odor of the breath is one 
of the best means of diagnosis. (See Apoplexy.) 
Treatment.-In profound intoxication, recourse should at once be 
had to the stomach pump in order to remove any of the alcoholic fluid 
not already absorbed. Strong tea or coffee should then be administered, 
and the heat of the body promoted if it has fallen. Sometimes cold 
effusion over the head and chest will be of service. (See Dipsomania; 
Stimulants, Alcoholic; Insanity, Delirium Tremens.) 
INULA HELENIUM, in'-u-la he-le'-ne-um, or elecampane. This 
is a very large herbaceous plant belonging to the Nat. order Com- 
posite. It yields a starch called inulin. Elecampane has been used 
in medicine since a very early age. It is aromatic, stimulant and tonic, 
and has also diuretic, diaphoretic, emmenagogue and expectorant prop- 
erties. Formerly it was employed in complaints peculiar to females, 
and is now used considerably in suppressed menstruation. 
The chief use of elecampane is in lung affections, derangements of 
the liver, and general debility. Dose: of fluid extract, % to 1 teaspoon- 
ful; of the infusion, 1 to 2 fluid ounces, every three or four hours. (See 
Infusion. ) 
INUNCTION, in-unlt-shun [Lat. inunctio\ the rubbing of an oint- 
ment upon the skin, for the purpose of promoting the absorption into 
the system of any medical substance contained in the ointment. Oint- 
ments which contain mercury or iodine are principally used with this 
intent. 
Inunction of cod-liver oil in cases of great emaciation, especially in 
children and in patients of a consumptive or scrofulous tendency, has 
been found of decided benefit. In cases, too, of obstinate vomiting, for 
instance, in young infants, when everything is rejected by the stomach 
as soon as taken, the rubbing in of cod-liver oil twice a day, may be 
resorted to. 
INVERSION, in-vur'-shun [Lat. inversion the turning inside out of 
an organ, such as the womb. It is a serious accident, which sometimes 
occurs under peculiar circumstances, as after labor. The assistance of a 
medical man is always imperatively called for. 
IODIDE OF POTASSIUM, i'-o-dide po-tas'-se-um, is the most 
important of the several preparations of iodine, and is applicable to an 
extended number of diseases. It produces very marked effects on the 
secretions, which it uniformly increases, and into which it readily passes. 
It generally increases the appetite and flesh. The general character of 
its action is to remove superfluous tissue, carrying off the material by Inula Helenium. (Elecampane.) IODIDE OF POTASSIUM-IODINE, ETC. 
791 
the kidneys. It is very beneficial in scrofula in all its forms; occasionally 
in chorea after the preparations of iron have failed; in gout, albuminuria, 
ague; in the various forms of syphilis, syphilitic sore throat, gonorrhoea, 
leucorrhoea, neuralgia, bleeding from the lungs, and lead palsy. In that 
form of rheumatism characterized by wandering pains in the bones, its 
efficacy is attested by the highest authority. It is pronounced the best 
remedy in mercurio-syphilitic sore throat. It has been successfully em- 
ployed in scrofulous inflammation of the eye, given in the compound 
syrup of sarsaparilla. This valuable medicine, when given in small 
doses, will occasionally give rise to troublesome symptoms, and severely 
affect the system. Five grains have produced catarrh, conjunctivitis, 
difficulty of breathing, and other serious disturbances. Dose, from 2 to 
10 grains. (See Potassium.) 
IODIDE OF SULPHUR. (See Sulphur, Iodide of.) 
IODIDES OF ARSENIC AND MERCURY, SOLUTION OF. 
(See Solution Iodides of Arsenic and Mercury.) 
IODINE, I0DINUM, OR I0DUM, i'-o-din [Gr. lodes, violet- 
colored], in Chemistry, symbol I, equivalent 127, specific gravity of 
vapor, 7.186. Iodine was discovered by Courtois, in 1812, in the waste 
liquors produced in the manufacture of soda from sea-weed. It is con- 
tained in nature, principally in sea-plants and sea-water, in the forms of 
iodide of sodium, potassium, and magnesium. It also occurs combined 
with silver in iodide, a mineral found sparingly in Peru. The great 
source of iodine is burnt sea-weed, commonly known as kelp. Iodine 
generally occurs in commerce in the form of bluish-black scales having 
a metallic lustre somewhat resembling plumbago. At ordinary tem- 
peratures, it is volatile, emitting an odor closely resembling chlorine, 
but somewhat weaker. Its specific gravity is 4.947. It fuses at 225° 
and boils at 347°, giving forth a magnificent violet vapor, from which it 
derives its name. Iodine taken internally in large doses is a violent 
poison, but in small quantities it is much employed in the treatment of 
scrofula and syphilis, to remove glandular swellings, swellings of the 
joints, etc. A strong solution of it may be frequently painted over 
these swellings with advantage. It is also of great use in the treatment 
of goitre. (See Goitre.) The solution is made by dissolving 20 grains 
iodine and 30 grains of iodide of potassium in 1 fluid ounce of distilled 
water. It is used externally or internally. Dose: internally, 5 to 10 
drops. The tincture is made by dissolving £ ounce of iodine and % 
ounce of iodide of potassium in 1 pint of rectified spirits. Dose: 5 to 20 
drops. The ointment is made by mixing together 32 grains each of 
iodine and iodide of potassium, with 1 fluid dram of proof spirit and 2 
ounces of prepared lard. For liniment dissolve 1£ ounce of iodine. £ 792 
IODINE, ETC.-IRIS FIORENTINA. 
ounce of iodide of potassium, and J ounce of camphor in 10 fluid ounces 
of rectified spirit. The principal of the other preparations containing 
iodine are-iodide of iron: dose, 1 to 5 grains; iodide of potassium, 
dose: 2 to 10 grains; red iodide of mercury, dose: 1 to J grain ; green 
iodide of mercury, dose: 1 to 3 grains ; iodide of sulphur, used in making 
iodide of sulphur ointment. Iodine and its preparations are much used 
by medical men, but with the exception of the tincture, can scarcely be 
said to fall within the sphere of domestic medicine. 
IODO-BROMIDE OF CALCIUM COMPOUND ELIXIR. (See 
Calcium, Compound Elixir Iodo-Bromide of.) 
IODOFORM, i-od'-o-form, is volatile, insoluble in water, soluble in 
alcohol and ether, and has a very large proportion of iodine. Its ther- 
apeutic uses are analogous to those of iodine and the iodides, over which 
it has the advantage of being less irritant, more readily absorbed and 
assimilated. In small medicinal doses, iodoform appears to possess a 
union of tonic, stimulant and alterative properties, exercising at the same 
time a remarkable influence on the nervous system. Various forms of 
scrofula, syphilis, goitre, amenorrhoea, obstinate skin diseases, such as 
lepra, salt rheum, and chronic eczema, etc., have been benefited by its 
use. Much testimony could be adduced relative to its utility in scrofu- 
lous enlargements of the glands, goitre, and neuralgic affections. Dose: 
one to three grains. 
IPECACUANHA, OR IPECAC. (See Ceph^lis.) 
IPECACUANHA SPURGE. (See Euphorbia Ipecacuanha.) 
IPOM2EA JALAPA, ipo-me'-q jqdapj-q, or jalap, a Mexican plant 
belonging to the Nat. order Convolvulacea. The tuber is the part used 
in medicine. It is a safe and efficacious purgative, operating with 
rapidity and certainty, causing little irritation, producing copious watery 
stools, and leaving but little subsequent constipation. Its efficacy is 
greatly increased by the addition of cream of tartar. It has been suc- 
cessfully used in dropsy, constipation, disease of the brain, and scrofu- 
lous disease of the joints. It should not be given in inflammatory con- 
ditions of the alimentary canal during pregnancy, nor during the men- 
strual discharge. Dose of the powder for an adult, 5 to 25 grains; for 
an infant, 2 to 5 grains; of the fluid extract, J to 1 teaspoonful; of the 
solid extract, 3 to 8 grains; of the tincture, | to 2 teaspoonfuls; of the 
compound jalap powder, composed of 5 ounces of powdered jalap, 9 
ounces of cream of tartar, and 1 ounce of ginger, 30 to 60 grains, repeated 
in four to six hours if necessary; jalapin, the active principle of jalap, 1 
to 2 grains. , 
IRIS. (See Eye.) 
IRIS FLORENTIN A, i'-ris flor-en-ti'-nq, or orris root, a European IRIS FIORENTINA-IRON. 
793 
plant belonging to the Nat. order Irtdacece. It possesses cathartic and 
diuretic properties, and in large doses acts as an emetic. 
The earlier writers favor orris in the treatment of constipation and 
want of tone of the digestive organs; in dropsical affections, and in 
purulent discharges from the mucous membrane of the urethra. It is 
pleasant to the taste, and forms an unobjectionable medicine. The root 
has been used to conceal obnoxious breath, and enters into the composi- 
tion of many tooth powders. It is chiefly employed now in compounds, 
on account of the pleasant odor it imparts. Fluid extract is the most 
convenient preparation. To be used at discretion. 
IRISH MOSS. (See Chondrus.) 
IRIS VERSICOLOR, i'-ris ver'-sedcul-ur, or blue flag, is a perennial 
plant belonging to the Nat. order Iridacew. It is common throughout 
the United States and Canada, and is known by the names flag lily, 
fleur-de-lis, and liver lily. It contains an oleo-resin called Iridin. The 
root is the part used medicinally. It is cathartic, alterative, anthelmintic 
and diuretic, and has been used with great success in dropsy, scrofula, 
and affections of the liver, kidney and spleen. Dose: of the powdered 
root, 5 to 20 grains; fluid extract, 20 to 50 drops; solid extract, 1 to 4 
grains; iridin, £ to 5 grains; tincture, 1 to 2 teaspoonfuls. 
IRON, I'-urn [Ang.-Sax. iren\^ in Chemistry, symbol Fe (ferrum), 
equivalent 28, specific gravity 7.844. This important metal is most exten- 
sively diffused over nature, occurring not only in the inorganic kingdom, 
but entering into the composition of vegetable and animal structures. It 
is found in nearly every part of the earth, in the form of ores. In its pure 
state, iron presents a dusky-gray color and a rather feeble lustre, which 
is greatly improved by polishing. It is not affected by dry air or oxy- 
gen; but if moisture be present, it gradually passes into the state of 
hydrated sesquioxide, or rust, as it is termed in common parlance. Iron 
combines with most of the metals to form alloys. It decomposes the 
diluted hydrogen acids with great facility, eliminating hydrogen. Nitric 
acid attacks it with the evolution of binoxide of nitrogen. Dilute sul- 
phuric acid also dissolves iron with evolution of hydrogen. Iron, in the 
metallic state, is of great use to the chemist for precipitating certain 
metals, such as copper, from their solutions in the metallic form. The 
tonic and strengthening properties of iron are well known, even popu- 
larly, and, probably, we have no remedy of the kind so generally useful 
and applicable in cases of debility; at the same time, it is not so much 
adapted for domestic use as many medicines of less value. The cases 
in which preparations of iron are most employed are not emergencies, 
they are usually constitutional affections of some standing, in which 
medical advice is not only requisite for the general treatment, but also 794 
in on-in on wo od. 
as a guide for the administration of the iron, which, improperly given, 
may do much mischief; persons who are habitually costive, who suffer 
from piles, or from determination of blood to the head, require to be 
especially careful with respect to the use of medicines containing iron; 
and should never take them without medical advice. The weak, the 
pallid, the delicate, may, for the most part use them with greater safety, 
and very generally with benefit. 
The following are the principal preparations of iron used in medi- 
cine : 
Reduced iron, or powder of iron-dose : 
two to six grains. 
Tincture of the acetate of iron-dose: ten 
to forty drops. 
Ammonio-chloride of iron-dose : four to 
twelve grains. 
Ammonio-citrate of iron-dose: five to ten 
grains. 
Ammonio-tartrate of iron-dose: three 
to eight grains. 
Arseniate of iron-dose: one-twentieth to 
one-tenth of a grain. 
Bromide of iron-dose: one to three grains. 
Carbonate of iron with sugar-dose: three 
to twenty grains. 
Citrate of iron-dose two to eight grains. 
Iodide of iron-dose: one to five grains. 
Syrup of iodide of iron-dose: fifteen to 
sixty drops. 
Lactate of iron-dose: ten to twenty grains. 
Solution of perchloride of iron-dose: three 
to ten drops. 
Muriated tincture of iron-dose: ten to 
forty drops. 
Solution of pernitrate of iron-dose: ten to 
sixty drops. 
Peroxide of iron, commonly called the 
sesquioxide, carbonate, subcarbonate and 
red oxide of iron-dose: ten to forty 
grains. 
Hydrated sesquioxide of iron, the most 
efficient antidote to poisoning by arsenic 
-dose: a tablespoonful every five or ten 
minutes. 
Phosphate of iron-dose: three to ten 
grains. 
Pyrophosphate of iron-dose three to ten 
grains. 
Citrate of iron and quinine-dose: five ta 
ten grains. 
Citrate of iron and strychnia-dose: two to 
three grains. 
Sulphate of iron, or green vitriol-dose: 
one-half to three grains. 
Potassio-tartrate of iron-dose: five to 
twenty grains. 
Tannate of iron-dose: ten to thirty grains- 
Valerianate of iron-dose: one-half to one 
grain. 
Wine of iron-dose: one to four teaspoon- 
fuls. 
Citrate of iron, quinine and strychnia- 
dose three to five grains 
Dialysed iron-dose: ten to twenty drops- 
A great many very elegant preparations of the different salts of iron, 
in combination with other tonic and blood-restoring remedies, are to be 
found on the druggists' shelves in every city and village throughout the 
country. They are principally in the form of syrups or elixirs. The 
strength varies according to the manufacturer, but as the dose is always 
to be found on the label, no mistake need ever occur. (See Citrate of 
Iron, Citrate of Quinine and Iron, Citrate of Iron and Strychnia.) 
IRON SPRING'S. (See Mineral Waters.) 
IRON-WEED. (See Vernonia Fasiculata.) 
IRON-WOOD. (See Ostrya Virginica.) IRRITABILITY-ISINGLASS. 
795 
IRRITABILITY, ir-re-ta-lnl'-e-te [Lat. irritabilitas\ cannot perhaps 
have a better definition than that of Abernethy, "excited debility." It is 
a symptom of many diseases, trying both to patients and to their attend- 
ants, but one for which every allowance and consideration ought to be 
made. Those who have never suffered from the weakness of disease, 
especially such as affects or has affected the nervous system, cannot 
imagine in how many ways, which appear not only trifling, but absurd, 
to a person in health, the irritability of the invalid may be jarred upon. 
The term irritability is also used to express that property of muscular 
fibre, to which it owes its powers of contraction. 
IRRITATION, ir-re-ta'-shun [Lat. irritatio}, may be defined as dis- 
eased excitement, not amounting to inflammation. Many of the diseases 
of children partake more of irritation than inflammation. What is called 
irritation of an organ may take place at a distance from the source of 
the irritation; thus, worms and other matters in the intestines may cause 
convulsive and other affections consequent upon irritation of the brain, 
or the irritation of the gums in teething may also cause convulsion, or 
spasmodic croup. The irritant action being in these cases in the first 
place felt by the brain, and thence reflected so as to affect the muscles 
which are thrown into spasm. 
IRRITATION OF THE SPINE. (See Spine, Diseases and Inju- 
ries of THE.) 
ISCHURIA, is-hu-re-g [Gr. ischo^ I retain; ouron, the urine], 
denotes a retention of the urine, and is distinguished from dysuria in 
that, in the latter case, the discharge is attended with much difficulty, 
whereas in the former there is a total retention. This last may arise 
either from mechanical obstruction or paralysis of the bladder, or it may 
arise from the kidneys having lost the power of secreting the urine. The 
latter (ischuria renalis) is more properly termed suppression of urine, 
and is known by the bladder being found to be empty on introduction of 
the catheter. It is is usually occasioned by long over-indulgence in 
strong drinks. The urea and other elements of the urine, instead of 
being discharged, are accumulated in the blood. The patient complains 
of uneasiness in the head and loins, becomes heavy and drowsy, sinks 
into a comatose state, and expires in the course of four or five days. 
Medicine can hold out little hope of relief in this disease. (See Urine; 
Bladder, Diseases of the.) 
ISINGLASS, i'-zing-glas, a very pure form of gelatine or animal 
jelly, prepared from certain parts of the entrails of several fish. The 
best isinglass is prepared in Russia, from the membranes of the sturgeon, 
especially from its air-bladder and sounds, which are very large. Isin- 
glass of the purest kind is used in confectionery, and also largely in 796 
ISINGLASS-ITCH 
refining wine and beer. It is almost without color, taste, or smell; is 
usually in thin pieces; and is soluble in water. It is dissolved readily 
by most acids, but is not soluble in alcohol. 
ISSUE, ish'-shu [Fr. issuer, to go out; Lat. fonticulus, a little foun- 
tain'], in Surgery, is an ulcer artificially formed, and kept open, so as to 
discharge matter, for the purpose of removing an unhealthy condition 
from some neighboring part of the system. It is usually formed by 
making an incision through the integuments with a lancet, or other sharp 
instrument, sufficiently large for the insertion of one or more peas, which 
are retained there by a strip of adhesive plaster, so as to prevent the 
wound from healing, and keep up a state of constant irritation. The 
actual cautery and caustic potash are also employed in forming issues, 
being applied to the part till it sloughs, and the ulcer thus formed being 
kept open, either with peas or some irritating substance. Setons are 
another form of issue, made by passing a broad fiat needle, threaded 
with silk or other suitable substance, under a portion of the skin, and 
leaving the silk in the passage, with an end hanging out on each side. 
Issues are principally employed for the removal of chronic disorders 
of internal organs, particularly such as are of an inflammatory nature, 
the object being to withdraw the action from the internal organ, w'here 
it might be attended with danger, to without, where it is important. 
In the management of all issues great cleanliness should be observed, 
and the part dressed several times a day. A fresh portion of silk should 
be pulled through the wound every day, so as to keep up a constant 
irritation and discharge. 
ITCH, itsh [Ang.-Sax.; Lat. scabies, ivcna scabo, I scratch], a disease 
of the skin characterized by an eruption of pustules or of small vesicles, 
the two being frequently intermixed, and accompanied by an intolerable 
itching ; whence it derives its name. It has been divided into different 
classes; but the distinction is of no practical importance. It occurs 
chiefly about the fingers and wrists, and the flextures of the joints; but 
it may also attack other parts of the body, the face being the only part 
on which it never appears. It is caused by a minute insect-the Acarus 
or Sarcoptes scabiei-lodging under the skin, and is readily communi- 
cated by contact. The only proof of the existence of itch is the pres- 
ence of the insect, and this is readily detected by means of the micro- 
scope. 
Treatment.-Sulphur is usually regarded as the great specific for 
this disease. It is commonly used in the form of an ointment, smeared 
over the parts once or twice a day, washing them carefully with soft soap 
and hot water for some time before each application. This is so neces- 
sary to cure, that some hold that it is principally owing to the action of ITCH-JAUNDICE, OR ICTERUS. 
797 
the soft soap. The following ointment is also recommended: 2 parts of 
sublimed sulphur; 1 part of subcarbonate of potash; and 8 parts of lard. 
This usually takes from six to eight days to effect a cure. The follow- 
ing ointment, however, is said to effect a cure in four days, viz., recent 
grains of staphisagria, in powder, 3 parts by weight; and boiling lard, 
8 parts, digested for twenty-four hours at a temperature of 100° in a 
sand-bath, and strained. A mixture of spirits of turpentine and coal-oil 
as strong as can be borne, will generally suffice to destroy the insect. 
One dram of carbolic acid to | an ounce of glycerine, in 8 ounces of 
soft water is an effectual remedy. A solution made of 1 part chloride 
of lime to 20 or 30 parts of soft water, will also speedily effect a cure. 
After a cure is effected, care must be taken to destroy the insects and 
eggs that may be among the clothes of the patient. If these are not 
destroyed, they should be exposed to a temperature of not less than 
180°, by being put into an oven, or into hot water, or by ironing them 
with a hot iron; or they should be well fumigated with sulphurous acid 
gas, which may be formed by igniting a rag dipped in melted sulphur. 
(See Mercurial Ointment.) 
ITCH, BARBERS', itsh bar'-burs. This is a very troublesome dis- 
ease occurring on the bearded part of the face. It is very difficult to 
cure. The beard must be kept clipped with the scissors, and the razor 
laid by, frequent bathing with castile soap and water is an essential part 
of the treatment. Tar ointment and carbolic acid, the same strength as 
for true itch, used twice or three times a day, is the most likely to effect 
a cure. In obstinate cases resort must be had to a physician. (See 
Itch. ) 
ITCH, GROCERS'. (See Impetigo ; Skin, Diseases of the.) 
IVY. (See Hedera Helix.) 
IVY, AMERICAN. (See Ampelopsis.) 
IVY, POISON. (See Rhus Toxicodendron.) 
JABORANDI. (See Pilocarpus Pennatifolius. ) 
JAIL FEVER, jale, a form of typhus. (See Typhus Fever.) 
JALAP. (See Ipomcea Jalapa.) 
JAMES' POWDER. (See Antimony.) 
JAMESTOWN-WEED, OR JIMSON. (See Datura Stramo- 
nium.) 
JAUNDICE, OR ICTERUS, jan'-dis ik'-te-rus [Fr. jaunisse^ from 798 
JAUNDICE, OU ICTERUS. 
jaune, yellow], cannot be looked upon as a disease in itself, but is rather 
a symptom of some morbid action going on in the liver, and one of 
peculiar interest and importance. 
Causes.-There are two distinct classes of jaundice. In the one, this 
symptom is due to some obstruction in the passage of the bile from the 
liver after it has been duly secreted; and in the other, the bile has not 
been secreted at all, but is retained in the blood. Jaundice may be con- 
genital, the little infant being born without any bile-ducts to convey 
away the secretion. The bile-ducts may be obstructed by pressure from 
without, as by the gravid uterus or distended bowels, or there may be 
a gall-stone blocking them up from within in its endeavor to pass from 
the gall-bladder to the bowels. Cancer of the liver, and adhesive 
inflammation of the ducts may give rise to it; and there is one form due 
to mental influence. Thus, Dr. Watson mentions a case in which an 
unmarried female became intensely yellow upon its being disclosed that 
she had borne children; and another of a medical man who became 
jaundiced from the intense anxiety caused by an approaching examina- 
tion. When jaundice affects newly-born infants from some defect in the 
development of the biliary ducts, it is called icterus neonatorum. 
Jaundice is not generally a dangerous affection unless due to organic 
disease of the liver, or mental shock. Old people, whose constitutions 
are already worn out, frequently become emaciated, and never rally from 
its attack ; and in some cases it seems to take a deadly turn from the 
first, the skin of the patient assuming a greenish-black color. 
Symptoms.-1The skin assumes a greenish-yellow color, and is subject 
to most intense itching. The complexion is sallow, and the whites of 
the eyes tinged with biliary matter, being of a dull yellow color. The 
urine becomes very highly colored, resembling in appearance blood or 
old ale. The stools are of very light color, containing little or no 
biliary coloring matter, and are of a clayey nature. The bowels 
are much constipated, wanting the purgative effect of the bile. The 
intellect seems to become impaired in prostrated cases, and the patient 
grows stupid. There is much emaciation, and a strong tendency to 
hemorrhage is manifested by various organs of the body. One form of 
jaundice, as has been stated, is due to the breaking up of the biliary 
ducts, and this is often due to th 5 presence of a gall-stone which is trying 
to pass, and which gives rise to intense suffering and acute pain in the 
region of the liver. The patient suffers severely from shivering and 
distinct rigors; there is often nausea and vomiting, and in some cases 
in which the foreign body does not pass, the patient becomes exhausted 
and sinks under protracted sufferings. Gall-stones are more common 
in females than in males, as they lead a more indolent and sedentary JAUNDICE, OR ICTERUS. 
799 
life, which are strong predisposing causes to the formation of biliary 
calculi. Gall-stones frequently occur in those who are fat, and are rare 
before the age of forty. They are found frequently in great numbers in 
the gall-bladder of the same patient. Thus, we have ourselves seen 
twenty or thirty in the same body; and instances are placed on record 
in which several hundreds of these bodies have existed together. 
When so many occur in the same patient, they are smooth and angular 
in form, and of a small size; but should there be one solitary gall-stone 
formed, it assumes an oval form, and grows to a large size. 
Treatment.-Before having recourse to medicine in the treatment of 
jaundice, we must first endeavor to find out the morbid condition on 
which it depends, and, if possible, to relieve it. Thus, should inflam- 
mation of the liver be present, this must be treated as described in the 
article Hepatitis; wflien it is due to some obstruction of the bile- 
ducts, hot fomentations, warm poultices, and the warm bath, will give 
relief, the patient being at the same time placed on low diet. Opium 
must be given internally to allay pain and relieve spasm, and if possible, 
to allow the gall-stone to pass, shonld there be one already in the canal 
of the common bile-duct. 
Take of Bicarbonate of potash Half a dram. 
Nitrate of potash One scruple. 
Laudanum One dram. 
Camphor water Six ounces.-Mix. 
Give 2 tablespoonfuls three times a day. 
Mustard poultices and turpentine fomentations may be applied over 
the seat of the pain, and anodyne injections thrown up the bowels. 
When the pain is relieved, and the biliary calculus has in all probability 
passed into the bowels, the following active purgative should be given to 
carry it off: 
Take of Sulphate of magnesia Six drams. 
Carbonate of magnesia Three drams. 
Peppermint water Six ounces.-Mix. 
Give 2 tablespoonfuls three times a day. 
When the disease is due to suppression of bile, purgatives are also 
useful. Taraxacum or dandelion has been recommended by some medi- 
cal men, and may be given thus: 
Take of Extract of Dandelion One dram. 
Powdered gum acacia Two drams. 
Pure water Six ounces.-Mix. 
Give 2 tablespoonfuls three times a day. 
In all instances the patient should be kept in bed and placed on a 
restricted diet. Manganese has been well spoken of as a remedy in this 
disease: in large doses it acts as a purgative, and is supposed to increase 800 
JAUNDICE, OR ICTERUS-JESUIT S BARK 
the excretion of bile. It may be given in the form of the sulphate, thus: 
Take of Sulphate of manganese One and a half dram. 
Water Two ounces.-Mix. 
Make a draught, and let it be taken early in the morning. 
Indolent and sedentary habits must be given up, and more active 
exercise taken by those who have a tendency to grow stout, and to the 
formation of biliary calculi. 
In cases of jaundice from mental emotion, saline purgatives should 
be freely given, especially the sulphate of magnesia, as directed above. 
During the last few years podophyllin, which acts in large doses as a 
drastic cathartic, and is much used in liver complaints, has been recom- 
mended. It may be given in the following pill: 
Take of Podophyllin Three grains. 
Compound extract of colocynth Twenty-four grains. 
Extract of henbane. Six grains.-Mix. 
Beat into a mass, divide into six pills, and give 1 every morning. 
The itching of the skin may be relieved by a lotion containing gly- 
cerine. The following is the proper strength: 
Take of Glycerine Two ounces. 
Water Two ounces.-Mix. 
Make a lotion, and apply it frequently to the part affected. (See Bile, 
Biliary Disorders, Biliousness, Gall-Bladder, Gall-Stones, Liver, 
ETC.) 
JAW, LOWER, DISLOCATION OF. (See Dislocations.) 
JAW, LOWER, FRACTURE OF. (See Fractures.) 
JAWS. (See Anatomy, Face.) 
JEALOUSY. (See Passions.) 
JEFFERSONIA DIPHYLLA, jef-fer-so'-ne-q di-fil'dq^ or twinleaf, 
a small perennial plant belonging to the Nat. order Berberidaceoe. It 
grows throughout the Middle and Western States. The root, which is 
the*part used, is diuretic, alterative, antispasmodic and diaphoretic, and 
has been found beneficial in chronic rheumatism, dropsy, spasms, cramps 
and nervous affections. Dose: of the decoction, 2 to 4 fluid ounces; of 
the tincture, 1 to 3 teaspoonfuls, three times a day. (See Decoction.) 
JEJUNUM, jeju'-num [Lat. jejunus, hungry], the second portion 
of the small intestines, so called from its being generally found empty 
in the dead body. (See Intestines.) 
JELLY. (See Cookery for the Sick.) 
JERSEY TEA. (See Ceanothus.) 
JERUSALEM OAK. (See Chenopodium Anthelminticum.) 
JESSAMINE, YELLOW. (See Gelsemium Sempervirens.) 
JESUIT'S BARK. (See Cinchona.) JEWEL WEED-JENIFER BERRIES. 
801 
JEWEL WEED. (See Impatiens Pallida.) 
JIMSON. (See Datura Stramonium.) 
JOHNS WORT. (See Hypericum Perforatum.) 
JOINTS, joints [Lat. junctura], also called articulations. The joints 
generally, from their mobility and exposed situation, are very liable both 
to accident and disease; in either case much care on the part of the 
attendants, and much patience on that of the patient, is called for, as it 
need scarcely be remarked that the most perfect rest is, in most cases of 
disease affecting the joints, the essential, for which no other remedial 
measures will compensate. Incurable disease of the bones of a joint 
does not now, under the improvements of modern surgery, necessitate 
the loss of the limb-the joint, such as the elbow, and even the knee, 
may be cut out, and in the course of time, a tolerably useful member 
remain, a kind of new joint being formed. (See Anatomy, Ankle, 
Elbow, Hip-Joint, Knee, Bones, Dislocations, etc.) 
JOINTS, DISLOCATIONS OF. (See Dislocations.) 
JOY, joi [Lat. gaudium, joy; gaudeo, to rejoice]. This powerful 
and instantaneous mental emotion, may act beneficially upon the body, 
but it may do so in the reverse. There are so many recorded instances, 
either of overturned reason, or of death resulting from excessive and 
sudden joy, that too great caution cannot be exerted in arousing it in 
persons of a nervous temperament, or in those who are debilitated by 
disease. Epilepsy has resulted from sudden joy. (See Passions.) 
JUGLANS CINEREA, ju-glanz sin-e-re-q, or butternut tree, a 
large tree belonging to the Nat. order Juglandew. It grows throughout 
Canada and the Northern, Eastern, and Western States, and is called 
also the white walnut tree. The bark of the root and the leaves are the 
parts used in medicine. They contain a resin called juglandin. But- 
ternut is a mild cathartic, very efficacious in habitual constipation, dysen- 
tery, and other affections of the bowels. Its action produces no debility. 
It is much used as a domestic remedy in intermittent and remittent 
fevers. Juglandin answers an admirable purpose as a laxative and 
cathartic. Dose: of fluid extract, 1 to 2 teaspoonfuls; solid extract, 5 to 
20 grains; juglandin, 1 to 5 grains; decoction, 1 to 2 fluid ounces, three 
or four times a day. (See Decoction.) 
JUGULAR VEINS, ju'-gudqr [Lat. jugulum, the neck], are the 
veins which run down the sides of the neck, and carry the blood down- 
wards from the head. They are divided into external and internal, the 
two afterwards uniting and going with the subclavian vein to form the 
superior vena cava, which terminates in the superior part of the right 
auricle of the heart. 
JUNIPER BERRIES. (See Juniperus.) 802 
JUNIPERUS-KELP, OR BARILLA. 
JUNIPERUS, ju-nip'-e-rus, a genus of plants belonging to the Nat. 
order Plnaceoe. The Juniperus Communis, or common juniper, is a 
bushy shrub, common to both the north of Europe and America. 
Juniper berries are stomachic, carminative, and diuretic, and act as a 
healthful stimulant in chronic affections of the bladder. They are prin- 
cipally used as an addition to more powerful diuretics in dropsical 
affections. Dose: of the fluid extract, 1 to 2 teaspoonfuls; of the 
infusion, 1 to 2 fluid ounces; of the oil, 1 to 5 drops, every three or 
four hours. (See Infusion.) 
The Juniperus Sabina, or common savin, is a native of the south 
of Europe, and of the northwest of America. The tops of the plants 
are the parts used. It is a stimulant, especially to the skin and uterus, 
and has been found useful in complaints of the kidney, suppression of 
the urine, and suppressed menstruation. Dose: of the fluid extract, 10 
to 30 drops; solid extract, 1 to 5 grains; oil, 1 to 6 drops; decoction, 2 
to 4 fluid ounces, three or four times a day. (See Decoction.) 
The leaves of the Juniperus Virginiana, or red cedar, which grows 
throughout the United States and Canada, possesses similar properties to 
the savin, and may be used in similar cases. 
KALMIA LATIFOLIA, kal '-me-a lat-e-fo'-le-q, sheep laurel, or 
mountain laurel, a perennial plant, belonging to the Nat. order Ericaceae. 
It grows in rocky soils and in damp places all over the United States. 
In large doses it is poisonous and requires to be used with great caution. 
Medicinally it is sedative and astringent, and has acquired a reputation 
in syphilis, jaundice, ophthalmia, neuralgia and inflammatory fevers. The 
fresh leaves stewed in lard, are useful in scald head and other affections 
of the skin. Dose: of the powdered leaves 10 to 30 grains; tincture, 
10 to 20 drops. 
KAMELA. (See Rottlera Tinctoria. ) 
KAVA-KAVA, ka ^a-ka -wl a new drug lately introduced as a 
remedy for the cure of gonorrhoea. It is prepared from the root of the 
Piper 2Jethysticum, a tree found growing in Tahiti and other Pacific 
islands. The natives use it in consumption and bronchitis, and in this 
country it has been found useful in gonorrhoea, gleet, rheumatism and 
gout. Dose of the fluid extract, 30 to 60 drops, three times a day, in a 
goblet of water. 
KELP, OR BARILLA. (See Barilla.) KERAIES HINER AL-KIDNEY, DISEASES OF THE. 
803 
KERMES MINERAL. (See Antimony.) 
KEROSENE. (See Petroleum.) 
KIDNEY, kid'-ne [Aug.-Sax.; Lat. ren],is the name of a double gland 
having for its office the secretion of the urine. The form of the kidney 
resembles that of a French bean, its average length being from four to 
four and a half inches, its breadth two inches, and its thickness one inch. 
The two kidneys are situated in the lumbar region, one on each side of 
the spine, on a level with the last two dorsal and the first two lumbar 
vertebrse; they are of a brownish-red color, flattened from before back- 
wards, and grooved on the interior border for the great vessels. They 
are covered by a thin, firm, transparent, cellular envelope, and inter- 
nally are composed of two substances-an exterior or cortical, and an 
interior or medullary. The kidneys are well supplied with blood-ves- 
sels and nerves, in accordance with the importance of their function. 
The renal arteries come directly from the aorta, and the large veins ter- 
minate in the vena cava. The nerves come from the renal plexus. (See 
Kidney, Diseases of the; Bright's Disease, Urine.) 
KIDNEY, DISEASES OF THE. The kidneys are subject to a 
variety of dangerous and painful diseases arising from various causes. 
They may be arranged in two distinct classes-those which are the result 
of some cause acting locally, as calculi, retention of urine, or a blow on 
the loins; and those which are the result of a constitutional cause, act- 
ing upon the kidney by inducing an abnormal condition of the blood. 
(For disease of the kidney, arising from renal calculi, see Calculus, 
Urine.) 
In retention of urine, the ureter, pelvis, and infundibula become 
much dilated, and the cortical substance expanded and lobular on the 
surface. The mucous membrane frequently becomes ulcerated, inflam- 
matory deposits occur in the substance of the kidney, and the gland is 
destroyed by a slow atrophy, or more rapidly by suppurative inflamma- 
tion. Both kidneys are usually affected, but in different degrees. (See 
Ischuria.) Disease of the kidney from external violence is not of fre- 
quent occurrence. 
Among the diseases resulting from a constitutional cause is scrofu- 
lous disease of the kidney, which occurs in the form of small scattered 
deposits of tubercular matter, or it presents itself in the form of a thick 
curdy deposit, which leads to the formation of a large abscess. 
Cancer of the kidney is a disease less uncommon than it was formerly 
supposed to be. In the great majority of cases some of the neighboring 
parts are complicated, in one or other of which the disease obviously 
originated. 
Hydatids are occasionally found in the kidney. They are generally 804 
KIDNEY, DISEASES OF THE-KNEE. 
numerous or multiplied, and contained in a mother-cyst, which frequently 
acquires a large size, forming a tumor, which may be often felt externally. 
(See Hydatid.) 
Inflammation of the kidneys is fully treated in the article Nephritis, 
which see. (See also Kidney, Bright's Disease, Urine.) 
KIDNEY LIVERLEAF. (See Hepatica Americana.) 
KING'S CURE. (See Chimaphila Umbellata.) 
KING'S EVIL, kingz e-vil, a name for scrofula, which originated in 
the superstition that the disease was cured by the touch of a king. The 
practice is said to have originated with Edward the Confessor; it is, 
perhaps, needless to add that it has become obsolete. (See Scrofula.) 
KINO, ki'-no, the juice of the Pteroearpus Marsupium, a lofty tree 
of Hindostan. It is a pure astringent and used in the same cases as 
catechu. Dose: of the powder, 10 to 30 grains; the tincture, j to 2 
teaspoonfuls. The compound powder, containing 1 grain of opium in 
20 of the powder, is a valuable preparation in diarrhoea. The dose of 
the compound is from 5 to 20 grains. 
KNEE, ne [Lat. genu\. The knee is, perhaps, the most important 
joint in the body, and is certainly the most serious to be affected either 
by disease or injury: it is formed of three bones, the lower extremity of 
the thigh bone, the upper extremity of the larger leg bone, and the knee- 
cap, or patella, which lies on the fore part of the joint. The small bone 
of the leg does not enter into the construction of the joint. The rounded 
ends of the thigh-bone rest in shallow excavations in the expanded broad 
head of the bone of the leg, the knee-cap protects the joint in front, and 
enables the* muscles of the thigh to act with more advantage and greater 
leverage in the movements of the leg; the entire joint being fitted and 
bound together by means of cartilages and ligaments. (See Ligament.) 
The knee-joint is liable to become the seat of inflammation, either 
acute or chronic, caused either by violence or wounds, or as the result 
of constitutional causes. In any case, the disease is of so serious a nature, 
that it should as soon as possible be put under proper medical care. 
If the knee joint has been opened into by a wound, the only course 
for an unprofessional person to pursue in the absence of a surgeon, is to 
close it as quickly and effectually as possible (see Wounds), to put the 
joint in a state of the most perfect rest, to keep it cool with cold water 
applications, the sufferer being put on low diet, and the bowels attended to. 
When inflammation of the knee-joint arises, either as a consequence 
of wound, or from any other cause, very free leeching is requisite, along 
with fomentations and poultices, and the constitutional treatment of 
inflammation generally. Blisters near the joint should never be used in 
an early stage. KNEE-KOUMISS, OR KUMISII. 
805 
White swelling of the knee, so dreaded popularly, consists of increased 
effusion of fluid into the joint consequent upon disease of some portion 
of its structure; this, however, and other chronic diseases of the knee, 
require so much educated skill and care, that they must be treated by 
the medical man; till his aid is procured, the most perfect rest of the 
limb, the suppression of extra heat by cooling applications, the soothing 
of pain by warm fomentation or poultice, attention to the state of the 
bow'els and to the diet, is all that should be attempted. White swelling 
is often connected w'ith a weakened and scrofulous state of the constitu- 
tion, consequently all debilitating measures are, generally, to be avoided. 
The knee is sometimes the seat of a very unpleasant affection, termed 
loose cartilage, which consists of a rounded gristle-like body lying loose 
within the joint, and which being apt in the motions to be squeezed 
between the surface of the bones, causes severe sickening pain, and may 
occasion the person to fall. The surgeon must be applied to. (See 
White Swelling.) 
The kneepan, from its exposed situation in front of the joint, is liable 
to various accidents, to fracture, also to dislocation, being pushed to one 
side; it may be replaced, either by the knee being bent by a second indi- 
vidual, or by straightening the knee, and bending the thigh upon the 
body, so as to relax the muscles on the fore part of the thigh, within the 
tendons of which the knee-cap is situated. 
Housemaid's knee.-On the fore part of the knee-cap, between 
it and the skin, is placed a small "bursa" which is liable to become 
inflamed in persons who have to kneel much on hard substances. 
The affection is called "housemaid's knee," from its frequent occur- 
rence in that class of servants, who kneel a good deal. Matter is 
liable to form in consequence of the inflammation, and in this case the 
treatment of abscess generally is requisite. If the disease be taken 
early, the knee should be rested, and the inflammation subdued by a few 
leeches and fomentations, etc.; a blister will frequently remove the 
swelling, or it may be painted over with tincture of iodine, once daily, 
for some time. Occasionally it remains in spite of treatment, and ulti- 
mately disappears of itself. When acute, red, and painful, especially if 
accompanied by a tendency to erysipelas, medical advice should at once 
be sought, as it will then probably require active treatment to subdue 
the inflammation. (See Leg, Dislocations, Joints, Patella ok Knee- 
Pan.) 
KNEE-JOINT, DISLOCATION OF. (See Dislocations.) 
KNEE-PAN, FRACTURE OF. (See Patella.) 
KNOT-GRASS. (See Collinsonia Canadensis.) 
KOUMISS, OR KUMISH. (See Kumiss.) 806 
KOUSSO, OR CUSSO-LABARRAQUE'S, ETC. 
KOUSSO, OR CUSSO, kous'-so, is the product of a plant brought 
from Abyssinia, and certainly appears to be a most efficient cure for tape- 
worm. In two cases-which had resisted all previous treatment-the 
author found the kousso perfectly successful. At the same time, it is 
not improbable, if the root of the male fern, found so abundantly in 
this country, was employed with the same precautions as the African 
remedy, that it would prove equally efficacious. The kousso should 
be taken in the morning fasting. The only preparation necessary 
is that all solid food should be abstained from for twenty-four hours 
before taking it; and a dose of castor-oil, or a saline purgative, admin- 
istered the previous evening. About half an ounce of the flowers 
should be infused in a glass of warm water, and taken thus, flowers and 
water together, on an empty stomach. In three or four hours, if the 
remedy has not operated, a dose of castor-oil, or a saline purgative, 
should be administered. (See Brayera, Aspidium, Worms, etc.) 
KRAMERIA TRIANDRA, kra-me'-re-g tri-an'-dra^ a tree belong- 
ing to the Nat. order Polygcdacea. It is a native of Southern and Cen- 
tral America, and the root is the part used in Medicine, and is commonly 
known as Rhatany. In medicine it is used as an astringent and tonic, 
and has been found well adapted for use in profuse menstruation, chronic 
diarrhoea, the whites, and incontinence of urine. Locally it may be 
used with benefit in bleeding from the nose, from the cavity of an 
extracted tooth, or the surface of a wound, and to spongy or bleeding 
gums. Dose,: of the fluid extract, to 1 teaspoonful; of the tincture, 
£ to 1 teaspoonful; of the solid extract, 5 to 20 grains; of the infusion, 
1 to 4 fluid ounces. (See Infusion.) 
KREASOTE, OR CREASOTE. (See Creasote.) 
KUMISS, ku-mis. Kumiss, koumiss, or kumish, is a vinous liquor 
made in Tartary, by fermenting either mares' or camels' milk. The 
drink sold in our towns and cities, under the above names, is an artificial 
preparation, purporting to possess the same properties as the real kumiss. 
LABARRAQUE'S DISINFECTING FLUID, lab'-g-raks, a solu- 
tion of chlorinated soda, the disinfecting properties of which were dis- 
covered by Labarraque early in the present century. It is a clear alka- 
line fluid, with a slight odor of chlorine. In large doses it is an irritant 
poison; in doses of 20 or 30 drops diluted in water, it is used in malig- 
nant fevers, putrid sore throat, dysentery, carbuncle and gangrene. LABABRAQUEB, ETC.-LAC SULPHURIS. 
807 
Externally it is used to remove felon, check ulceration, and in the treat- 
ment of some cutaneous diseases, as scald-head and prurigo. When 
used this way it must be diluted with about ten times the quantity of 
water. In contagious diseases it may be sprinkled around the room of 
the sick as a disinfectant. (See Disinfectants.) 
LABOR, la'-bur [Lat. labor\ in the usual sense of the word, as 
applied to hard work, may well form a subject for a few observations in 
a work like this, treating of the physiology of health and disease. We 
have this term from the Latin root labo, to fail, and we may define it as 
exertion of muscular strength, or bodily exertion up to the point of 
weariness, when the strength fails. Labor is undoubtedly healthful; it 
exercises the muscles, tends to the development of the physical powers, 
and promotes a healthy action in all parts of the frame. When God 
issued the fiat that man should earn his bread by the sweat of his brow, 
He beneficently, as well as wisely, ordained that, in thus laboring for a 
subsistence, he would be also conducing to such a vigorous state of 
bodily health as would best enable him to enjoy life; work, therefore, is 
good for all, and none should repine that they are called on to labor, 
but rather rejoice in the exercise of that physical strength with which 
they are gifted, in order that they may be useful to themselves and 
others. A life of idleness is a life of misery; the bodily and mental 
powers waste and decay if they be not exercised. Let us then labor 
cheerfully, remembering that by so doing we not only promote our own 
health, but also glorify God; for truly if it be done in the right spirit, 
Laborare est orare-work is worship-as the adage runs. (See Exer- 
cise, Mental Exercise, Health, etc.) 
LABOR, OR CHILDBIRTH. (See Childbed, Parturition.) 
LABORATORY, lab'-or-Orto-re [Lat. laboratorium^ from laboro, to 
labor], a place properly fitted up for the performance of chemical opera- 
tions. The fitting up of a laboratory is a matter demanding great 
knowledge and judgment, and must of course depend very much upon 
the nature and extent of the operations to be carried on. 
LABRADOR TEA. (See Ledum Latifolium.) 
LACERATION. (See Wounds.) 
LACHRYMAL, lak'-re-mal [Lat. lacryma, a tear], is a term applied 
to various organs in the neighborhood of the eye, and connected with 
the tears, as the lachrymal glands by which they are secreted, and the 
lachrymal duct by which they are conveyed away. (See Eye. ) 
LACING, TIGHT. (See Chest, Education.) 
LAC SULPHURIS, lak sul'-fu-ris [Lat., milk of sulphur]. Sulphur 
precipitated from solutions of alkaline persulphides by the addition of an 
acid, was formerly used in medicine under this name. (See Sulphur.) 808 
LACTATION-LAPPA ALIN OP. 
LACTATION, lak-ta'-shun [Lat. lacto, lactatus, to suckle; lac, lac- 
tus, milk], the secretion of milk. (See Milk, Pregnancy, Childbed, etc.) 
LACTEALS. (See Absorbents, Digestion.) 
LACTIC ACID, lak'-tik as'-id [from Lat. lac, milk]. (2IIO, 
C12H10O10.) Lactic acid is produced by natural or artificial fermentation 
from milk and other animal matter containing lactose, or sugar of milk. 
In its pure state it forms a transparent, inodorous, uncrystallizable, syrupy 
liquid, with a sharp acid taste. It is soluble in water, alcohol and ether, 
and may be distilled unchanged if air be excluded. Lactic acid enters 
into the composition of the gastric juice, the perspiration, and, in cases 
of diabetes, of the saliva and the urine. It is of considerable use in 
various kinds of dyspepsia, in doses of to 1 teaspoonful with syrup, 
before meals. 
LACTINE, LACTOSE, lak'-tin, lak'-tose, sugar of milk. (See Sac- 
CHARUM LACTIS.) 
LACTUCARIUM. (See Lactuca Sativa.) 
LACTUCA SATIVA, lak-tu'-ka sa-ti'-va, or garden lettuce, a 
vegetable belonging to the Nat. order Composites. The milky juice 
which flows from the stem when cut, is the part used in medicine. 
When dried it is called lactucarium. It is given as a substitute for 
opium, in checking diarrhoea, and allaying pain. Unlike opium, it 
produces no constipation nor excitement of the brain. Dose: of the 
fluid extract, | to 2 teaspoonfuls; lactucarium, 5 to 20 grains; syrup, 
% to 2 fluid ounces. 
LADIES' SLIPPER. (See Cypripedium Pubescens.) 
LAKE FEVER. (See Remittent Fever.) 
LAKE WATER. (See Water.) 
LAMB, lam [Aug.Sax.], like other young meats, is not so desirable 
for invalids as mutton. (See Food.) 
LAME BACK. (See Lumbago; Spine, Diseases and Injuries of 
the. ) 
LAMENESS. (See Ankle, Deformity, Hip-Joint Disease, Knee, 
etc.) 
LANCET, lan'-set [Fr. lancette'}, a sharp-pointed two-edged surgical 
instrument, used in venesection, and in opening tumors, abscesses, etc. 
LANGUOR. (See Debility.) 
LAPPA MINOR, lap'-pa mi'-nur, or burdock, a common plant 
found growing abundantly all over the United States and Canada. The 
root, which is the part used in medicine, is aperient, diaphoretic, and 
sudorific. It has been found useful in scurvy, scrofula, gout, and affec- 
tions of the kidneys. An ointment made of burdock has been used suc- 
cessfully in cutaneous diseases and old ulcers. Dose: of the fluid LAPPA MINOR-LARYNGITIS, ETC. 
809 
extract, 1 teaspoonful; solid extract, 5 to 20 grains; infusion, 1 to 2 
fluid ounces, three or four times daily. (See Infusion.) 
LARCH, AMERICAN. (See Larix Americana.) 
LARD, lard [Fr. lard; Lat. lardum\ the fat of swine after being 
melted and separated from the flesh. The prepared lard of the Phar- 
macopoeia {adeps praeparatus) is made from the internal fat of the abdo- 
men of the ^ig, perfectly fresh and removing as much of the membranes 
.as possible. 
Lard is used as principal component of various ointments, but is often 
injurious, in consequence of being slightly rancid, in which case, instead 
-of soothing, it has an extremely irritating effect upon abraded or blis- 
tered surfaces especially. Even when applied fresh, if allowed to remain 
too long unchanged, it will become a source of irritation. (See Oint- 
ments, Axunge.) 
LARIX AMERICANA, la'-riks a-mer-e-ka'-ng^ or American larch, 
commonly known as black larch, hackmetack and tamarac. It belongs 
to the Nat. order Pinaceoe. The bark is the part used. It is tonic, laxa- 
tive, diuretic and alterative, and is recommended in obstructions of the 
liver, jaundice and cutaneous diseases. The dose of the decoction is 2 
fluid ounces, three or four times a day. (See Decoction.) A tincture 
is prepared from the leaves, which is useful in bleeding from the lungs, 
diarrhoea, dysentery and profuse menstrual discharge. The dose is from 
20 to 60 drops, three times a day. ' 
LARKSPUR. (See Delphinium.) 
LARYNGISMUS STRIDULUS. (See Croup, False.) 
LARYNGITIS, OR INFLAMMATION OF THE LARYNX, 
lar-in-ji-tis [Fr. laryngite], may be either acute or chronic in its nature. 
Acute inflammation of the larynx is a comparatively rare, but 
-exceedingly fatal, form of disease, and medical aid must always be 
secured at the earliest possible moment. 
Causes.-1This disease may be the result of mechanical injury, or of 
some morbid condition of the blood: thus, it may be due to swallowing 
hot water, mineral acids, and the fumes of ammonia, or to injury done 
by the careless introduction of the tube of the stomach pump. It some- 
times arises from exposure to cold, and at others the inflammatory action 
extends from the tonsils. General Washington died of this disease, 
caused by snow lodging about the neck during a snow-storm. It fre- 
quently comes on in the course of the exanthemata, or contagious dis- 
eases, as erysipelas, measles, small-pox and scarlet fever. 
Symptoms.-It is characterized by a high degree of fever; the pulse 
is frequent and hard, and the patient manifests a considerable degree of 
restlessness and anxiety; he likewise complains of sore throat; and 810 
LARYNGITIS, ETC. 
among the earliest symptoms that bespeak danger, is difficulty of swal- 
lowing, for which no adequate cause is visible in the fauces; and to this 
is presently added difficulty of breathing. The act of inspiration is pro- 
tracted with wheezing, and the patient points to the pomum Adami 
(Adam's apple) as the seat of the disease. He speaks either hoarsely, 
or, what is more common, all power of audible voice in the larynx is 
lost, and he speaks only by means of his lips and tongue in a whisper. 
As the disorder advances, the patient's general distress increases. His 
countenance, from being flushed, becomes pale or livid; his looks 
anxious and ghastly; he struggles for breath, and if he does not obtain 
timely relief, dies of strangulation. Its course is generally rapid, ter- 
minating fatally within the fifth day, and even in some cases, within 
twelve hours. 
Treatment.-If the disease be due to cold, place the patient in a hot 
bath, and let him rest in bed in a room, steadily maintained at a 
temperature of 65°. He may inhale steam, and the air of the sick 
chamber should be moistened by diffusing steam through it. His feel- 
ings will be much relieved by the application of a hot sponge to his 
throat, and the following medicine must be regularly persevered in: 
Take of Ipecacuanha wine or syrup Thirty drops. 
Mix with a little water, and give a draught thus prepared every half 
hour till the patient vomits. 
Blood may be locally abstracted by cupping or the application of a 
few leeches to the neck. A blister is sometimes of great service, but, if 
applied, it must be to the upper part of the sternum, or chest, rather 
than on the front of the throat. The bowels should be promptly moved 
by an efficient cathartic. The diet must consist of strong beef-tea and 
mutton broth, and as soon as the powers of the patient begin to flag, 
stimulants must be promptly administered, such as the following: 
Take of Carbonate of ammonia Half a dram. 
Pure water Eight ounces- Mix,. 
Take an eighth part every two or three hours. In the absence of the 
above, other stimulants must be resorted to. 
When the patient seems to have but little chance of relief from the 
above line of treatment, the aid of the surgeon should be sought, who 
will, if he deem it expedient, perform an operation, technically called 
tracheotomy, which, if done early, will afford good hopes of success; for 
the obstruction being high up above the windpipe, an artificial opening 
is made below it, and air rushes in through this newly-made entrance to 
the lungs, and affords instant relief to the sufferer. 
Chronic inflammation of the larynx is most frequently seen in con- 
sumptive patients. During the long, weary course of pulmonary con- LARYNGITIS, ETC.-LAVANDULA. 
811 
sumption, the larynx often becomes thickened, inflamed, and ulcerated, 
causing the voice to be thick and hoarse, and, in some instances, to dis- 
appear altogether. This form of disease is not very amenable to treat- 
ment, but relief may frequently be given by applying to the affected 
organ, with a camel's hair brush, the following solution: 
Take of Nitrate of silver Twenty grains. 
Pure water One ounce.-Mix. 
It may be more conveniently applied with the atomizer. (See Croup, 
Consumption, Larynx, Atomizer, etc.) 
LARYNGOSCOPE, la-rin-go-skope [Gr. larynx and skopeo, I exam- 
ine], is an instrument lately brought into use by means of which the 
condition of the larynx may be ascertained. It consists of a small flat 
mirror, with a long stem, which, being previously warmed to prevent the 
breath from condensing upon it, is introduced into the mouth; while at 
the same time a stream of light is thrown upon the throat by means of 
a reflector. 
LARYNX, lar'-rlngks [Lat.], the organ of voice situated at the top 
of the windpipe. (See Lungs, Throat, Aphonia, etc.) 
LATERAL CURVATURE OF THE SPINE. (See Spine, Diseases 
and Injuries of the.) 
LAUDANUM, law'-da-num or lod'-g-num, tincture of opium. Dose: 
25 to 30 drops. (See Opium.) 
LAUGHING GAS, OR NITROUS OXIDE, laf'-ing gas, a name 
sometimes applied to protoxide of nitrogen, from its effects upon the 
human subject. A few deep inspirations are usually succeeded by a 
pleasing state of excitement, and a strong propensity to laughter, which 
soon subsides, without being followed by languor or oppression. Its 
effects, however, vary with different constitutions. In a word, its use is 
most dangerous for persons who have anything the matter with the brain, 
lungs, or heart. (See Nitrogen, Anaesthetics, etc.) 
LAUGHTER, laf'-ter, which arises from an excited condition of the 
nervous system, though proverbial as a promoter of health, may never- 
theless, if excessive and prolonged, give rise to serious consequences; 
the fit of laughter might pass into one of the convulsions in a predis- 
posed constitution; or in a child. The practice of tickling children, and 
thus keeping them in a state of laughter for some time, is strongly to be 
condemned, and may be attended with some mischief. (See Convulsions. ) 
LAUREL. (See Kalmia Latifolia.) 
LAVANDULA, lav-an-du-lg [Lat.], or lavender, a genus of the 
Nat. order Labi atm. The flowering heads of L. vera, the well known 
lavender, yield by distillation with water English oil of lavender, which 
is largely employed in perfumery; and also in medicine, as a stimulant, 812 
LA VAND ULA-LEAD. 
stomachic, and carminative. It is colorless or pale yellow, with the odor 
of lavender; and a hot, bitter, aromatic taste. The spirit of lavender 
is made by mixing 1 fluid ounce of the oil with 49 fluid ounces of the 
rectified spirit. Dose: £ to 1 teaspoonful. The compound spirits of 
lavender is a delightful aromatic compound, stimulant, cordial and stom- 
achic. It is extensively employed as an adjuvant of many medicines, 
and as a medicine to relieve gastric uneasiness, nausea, flatulence, and 
languor or faintness. It is a favorite remedy with hysterical and hypo- 
chondriacal persons. Dose, 30 to 60 drops. 
LAVENDER. (See Lavandula.) 
LAXATIVE, laics'-Ortiv [Lat. from laxo, I loosen], a term applied to 
such medicines as are gently purgative. (See Cathartics, Mineral 
Waters, Aperient.) 
LEAD, led [Ang.-Sax.], symbol Pb. [Lat. plumbum}, equivalent 
103.57, specific gravity 11.44, is one of the most important of the metals, 
both itself and its compounds being applied to many useful purposes. 
It occurs in nature in combination with a large number of substances; 
but its most valuable ore is galena, or sulphide of lead, found in large 
quantities in various parts of the world. Lead is a bluish-white metal, 
so soft that it may be marked with the nail. It may be beaten into 
pretty thin sheets, as well as drawn into wire; but its malleability and 
tenacity are both low. 
The uses of lead are very numerous; its compounds are well known, 
and its alloys are numerous and important. The salts of lead are 
mostly colorless. This metal is of importance in a medical point 
of view, both on account of its medicinal and of its poisonous 
properties. 
Of its various medicinal preparations, it will be sufficient here to 
notice three: The acetate, or sugar of lead; the solution of an acetate 
of lead, or Goulard's extract; and the lead plaster. 
The acetate or sugar of lead is used both externally and internally. 
In the former case, in the proportion of from 1 to 5 or 6 grains to the ounce 
of distilled or rain water, it forms one of the best cooling lotions; it may 
also be used slightly warm, either simply, or with the addition of 1 or 2 
drams of laudanum to the half pint. The weaker solutions of sugar of 
lead, 1 or 2 grains to the ounce, are often used as an eye-wash, but are 
not so generally useful as zinc. Internally, sugar of lead acts power- 
fully as an astringent, and may be given in doses of from 2 to 4 grains 
once in eight hours, in cases of emergency, by the unprofessional. It 
is generally made into pill with crumb of bread; often grain of opium 
is combined with it, and it is advisable to wash the dose down with a 
draught of weak vinegar and water. The few cases, in which, in the LEAD. 
813 
absence of all medical assistance, sugar of lead may be given domes- 
tically, are particularly noted when treated of in this work. 
The solution of lead {liquor plumbi) is used in the proportion of 
about 1 dram to the £ pint lotion. It ought to be known that symp- 
toms of lead-poisoning have been developed in consequence of the con- 
tinued use of lead lotions to ulcerated surfaces. 
Lead plaster is the most unirritating form of plaster we possess, and 
is preferable to diachylon on irritable skins; it is also the best in abra- 
sions and bed-sores. Lead, when conveyed into the system in minute 
doses for any length of time, occasions serious constitutional effects, the 
most remarkable being palsy, and obstinate constipation, with colic. 
Persons such as painters, type-founders, etc., who work with lead or 
its preparations, are peculiarly liable to be thus affected by it. Another 
very fertile source, however, of the introduction of lead into the system 
in individual minute doses, but ultimately, by the accumulation of these, 
in poisonous quantity, is from the pipes in which water is conveyed for 
household purposes. 
Lead poisoning.-The common use of lead or its preparations, in the 
arts, either legitimately or fraudulently, is not an unfrequent cause of 
disagreeable, sometimes of fatal attacks, in consequence of the metal 
finding its way into the body. The use of lead as a glaze to earthen- 
ware vessels may prove a source of great injury, being liable to be 
dissolved off, especially when the vessels are new, either by fatty or 
acid matters. Confectionery is sometimes colored with the yellow chro- 
mate of lead, or with Turner's yellow or chloride of lead; or whitened 
by the most poisonous preparation of all, the carbonate of lead. Wine, 
when sour, has been sweetened by the use of litharge, or oxide of lead, 
and in consequence of this fraud, a fatal epidemic colic at one time pre- 
vailed in Paris. Wine is also sometimes accidentally impregnated with 
lead, in consequence of shot, which had been used to clean bottles, 
having been left in them. Poisoning has occurred from this cause. 
Symptoms of colic have been brought on in persons living much in a 
room newly painted with lead colors. The white glazed cards are made 
so by means of lead, and might injure children, who are apt to suck 
them at times if they come in their way. Many of the hair dyes con- 
tain lead, and have caused injury. 
When the causes of lead poisoning act slowly, from the smallness of 
the quantity taken in at once, the symptoms are generally those described 
under Colic; but when the dose is large, it quickly brings on painful 
colic, vomiting, and extreme depression. In such cases, the best meas- 
ures to be pursued until medical assistance can be procured, would be 
the administration of vinegar in the first place, and, in six or eight 814 
LEAD-LEEK. 
minutes after, an emetic of a dram of sulphate of zinc, or some other 
sulphate, such as Epsom salts or Glauber salts, in quantity proportionate 
to the lead swallowed. The vinegar in the first place converts the lead 
into one of its least poisonous salts, and the one most easily decomposed 
by the sulphates. 
The accumulation of lead poison in the system is in many cases 
denoted by the existence of a bluish line along the margin of the gums, 
at their junction with the teeth, and is a sign which should always be 
looked for when any suspicion exists. (See Artizans and their Dis- 
eases, Colic, Costiveness, Paralysis, etc.) 
LEAD COLIC. (See Colic, Lead.) 
LEAD PLASTER. (See Plasters, Lead.) 
LEAD POISONING. (See Colic, Lead.) 
LEAD PUMPS. (See Pumps, Lead.) 
LEATHERWOOD. (See Dirca Palustris.) 
LEDUM LATIFOLIUM, le-dum lat-e-fo'de-um, or Labrador tea, 
an evergreen shrub belongingto the Nat. order Ericaceae. It is a native 
of the northern parts of the United States and of Canada. The leaves, 
which are the parts used in medicine, are expectorant and tonic, and in 
the form of infusion, have been found beneficial in irritation of the pul- 
monary membranes and in dyspepsia. The dose of the infusion is from 
1 to 2 fluid ounces, three or four times a day. (See Infusion.) 
LEECH, leetsh [Lat. hirudo^ from kaurio, I draw], a genus of 
red-blooded worms, which have an oblong body, with a sucker at 
one end and a mouth at the other. In the mouth there are small jaws, 
tongues, or plaits of skin, by which they are enabled to extract the 
blood of other animals, which forms their principal nourishment. Leeches 
derive their chief interest from their use as a remedial agent. Leeches 
vary in the quantity of blood which they can abstract, from one dram to 
half an ounce; from one to two drams is the average. When forcibly 
pulled away whilst sucking, the leech is very apt to leave the teeth, or 
plaits of the skin in the wound, giving rise to pain and inflammation of 
the part; the leech is also rendered incapable of biting again. One of 
the most certain methods of making leeches bite is to cleanse the skin 
thoroughly; and the leeches should be exposed to the air for a short time 
previous to their application, as by this means they will bite more 
eagerly. They may be applied to the part by holding them lightly in 
the fingers, if they are voracious; or they may be placed in a cup or 
glass which should be inverted over the part from which the blood is to 
be drawn. A leech should not be disturbed whilst sucking, but should 
be permitted to fall off. (See Bleeding.) 
LEEK. (See Allium.) LEG-LEMON. 
815 
LEG, leg [Du. lag], is commonly applied to the whole of the lower 
limb from the hip to the ankle, but properly it is confined to that portion 
which extends from the knee to the ankle, the upper portion being the 
thigh. The leg proper is formed of two bones, the tibia and fibula. 
The former of these is the larger, and articulates above with the thigh- 
bone, presenting for that purpose two articulating surfaces, an external 
and internal, known as the condyles of the tibia, and separated from 
each other by a large bony prominence termed the spine, and two rough 
surfaces, one in front the other behind the spine. On the outer side of 
the tibia is a projection marked inferiorly by a smooth surface for articu- 
lation with the upper extremity of the fibula. The body or shaft of the 
tibia is large and triangular above, but becomes smaller and more circular 
towards the inferior or tarsal extremity, where it expands and assumes a 
quadrilateral form. Internally it descends farther than in any other direc- 
tion, forming a projection termed the internal malleolus ; externally is a 
rough triangular surface which gives lodgement to the fibula and attach- 
ment to the ligaments which connect these bones together. It articulates 
below with the astragalus. The superioi- extremity, or head of the fibula, 
is round and irregular, and presents on its inner side, a smooth cartilagi- 
nous surface for articulation with the tibia. The tarsal extremity is 
large, and more prominent than the superior, and forms a large irregular 
projection of a triangular shape, termed the external malleolus. It 
articulates with the astragalus. (See Dislocations, Fractures, Thigh, 
Knee, Ankle, Foot, etc.) 
LEG, MILK. (See Milk-Leg.) 
LEMON, lem'-un [Fr. limon, Low Lat. limonium\, the fruit of the 
lemon tree ( Citrus limonum) is extensively cultivated in the South of 
Europe, and especially in Sicily, where the fruit forms an important 
article of commerce. The lemon is a variety of the citron, and belongs 
to the family Aurantiacece. Lemdn-juice (Inmonis succus) is obtained by 
subjecting the ripe fruit freed of its rind and seeds to pressure. It is a 
slightly turbid yellowish liquor, possessing a sharp acid taste and grateful 
odor. The lemon is a sick-room luxury; lemonade being a refreshing 
drink in febrile and inflammatory complaints. 
Until lately, the chief direct medical use of lemon-juice was in the 
treatment of scurvy (see Scurvy) but recently, it has been introduced as 
a remedy in rheumatic fever, and there are many testimonies to its value 
in this painful, and often tedious affection. Lemon-juice is not only a 
curative medicine in scurvy, but it is also a preventive; and it should, 
therefore, form part of the "sea-store" of all who are going a long sea- 
voyage. The juice may be procured at a moderate price from confec- 
tioners. The best method of preparing it for keeping, is to add about 816 
LEKON-LEPRA, OR LEPROSY. 
one-tenth of spirits of wine, to separate, by straining, the jelly-like matter 
which coagulates in consequence, and then bottle for use. "Salt of 
lemon," which is sold for removing the stains of ink or iron, is no 
preparation of lemon at all, but is a salt of oxalic acid: the name might 
lead to serious mistakes. 
The best lemons are smooth on the skin, and have a thin rind; if 
packed in newly-slaked lime in closed vessels, lemons may be preserved 
good for a considerable time. Oil of lemons is the oil expressed or dis- 
tilled from the fresh lemon-peel, and is imported chiefly from Sicily. It 
has a pale yellow color, agreeable odor, and warm and bitter taste. 
Syrup of lemons is made by heating to the boiling point 1 pint of lemon- 
juice strained, and then putting it into a covered vessel with 2 ounces of 
fresh lemon-peel till cold; then filter and add 2| lbs. of refined sugar, 
and dissolve with a gentle heat. Dose, 1 teaspoonful. To form the 
tincture, macerate for seven days in a closed vessel 2| oz. fresh lemon- 
peel, sliced thin, with 1 pint of proof spirit. Dose: | to 2 teaspoonfuls. 
(See Citrus, Citric Acid, Lemonade.) 
LEMONADE, leiruun-ade' [Er. limonade\, is a drink prepared of 
water, sugar, and the juice of lemons. It may be made by macerating 
2 lemons sliced, and 2 ounces of sugar in 1 pint of boiling water till cool, 
and then straining. There are different modes of making this delicious 
and healthful beverage. (See Lemon.) 
LENITIVES, len'-e-tivz [Lat. lenis, gentle], are purgatives which act 
in a gentle manner, and have a soothing effect (See Aperient, Cathar- 
tics, Mineral Waters.) 
LENS, CRYSTALLINE. (See Eye.) 
LEONURUS CARDIACA, le-o-nu -rus kar-de-a'-lea, or motherwort, 
a perennial plant belonging to the Nat order Lamiaceoa. It grows 
throughout the northern parts of this country. It is emmenagogue, ner- 
vine, antispasmodic and laxative, and is very useful in nervous com- 
plaints, suppressed menstruation, and in chronic diseases attended with 
restless disturbed sleep, spinal irritation and neuralgic pains. Dose: of 
fluid extract, 2 teaspoonfuls made into a warm infusion with hot water, 
three or four times daily. (See Infusion.) 
LEOPARDBANE. (See Arnica.) 
LEPRA, OR LEPROSY, le'-prg, lep'-ro-se [Gr. lepra, scaliness], is 
a disease characterized by the formation of scaly patches on the 
skin, of different sizes, but having always nearly a circular form. 
Physicians distinguish three varieties of this disease-lepra vulgaris, or 
common leprosy; lepra alphos, or white leprosy; and lepra nigricans, 
or black leprosy. 
Causes.-This disease sometimes makes its appearance without any .LEPRA, OR LEPROSY-LEPTANDRA VIRGINICA. 
817 
apparent cause, sometimes it may be induced by exposure to cold or 
damp, and sometimes it is evidently hereditary. 
Symptoms.-Leprosy first manifests itself in small distinct reddish 
elevations of the cuticle, which enlarge till they sometimes attain the size 
of a crown piece. They are covered with scales, which accumulate and 
form a thick prominent crust, and are quickly reproduced as they fall off. 
This disease usually makes its appearance first above the knee or elbow, 
and extends by degrees along the extremities, till sometimes the whole 
body becomes affected by it. Its progress is, in general, very slow, and 
it may continue in the same state for years. The general health of the 
patient is but little disturbed by this disease. In lepra alphos the scaly 
patches are smaller than in lepra vulgaris, and have also their central 
parts depressed or indented. The lepra nigricans differs from the others 
chiefly in the color of the patches, which are dark and livid. 
Treatment.-It is generally tedious of cure. The diet should be light 
and moderate, and all heating and stimulating liquors avoided. Exter- 
nally, warm baths, sulphur baths, and preparations of tar or creaso.te, 
are useful. The constitutional treatment will depend upon the condition 
of the body; if weakly, tonics, as quinine and iron, are to be admin- 
istered. Several obstinate cases are said to have been cured by admin- 
istering 10 drops of sulphuric acid three times a day in £ a pint of water, 
and bathing the part with a solution of % a dram of the acid in a pint of 
water. A solution of arsenic is often of advantage; but it can only be 
safely used under medical superintendence. (See Arsenic.) This dis- 
ease appears to have been much more prevalent, and of a severer type, 
in ancient than in modern times, if indeed this is the same disease, many 
being of opinion that the leprosy of ancient times resembled rather what 
is now known as elephantiasis. (See Skin, Diseases of the ; Elephan- 
tiasis.) 
LEPTANDRA VIRGINICA, lep-tan'-dra vlr-gin'-elcq, or leptan- 
dra, a perennial plant belonging to the Nat. order Scrophxdariaceoe. It 
grows from two to five feet high and is commonly known as Culver's 
physic, Culver's root, blackroot, and tall speedwell. The root, which is 
the part used in medicine, is tonic, cholagogue and laxative, and is 
employed in affections of the liver, in bilious and typhoid fevers, and in 
dyspepsia, diarrhoea and dysentery. It contains a peculiar resin called 
Leptandrin. The following powder has been found very useful in the 
treatment of diarrhoea and dysentery. 
Take of Leptandra root in powder One dram. 
Opium in powder Half a dram. 
Capsicum in powder .Half a dram.-Mix. 
Give from 1 to 3 grairs every four hours until the disease yields. 
52 818 
LEFT AND RA VIRGIN1CA-LEVIGATION 
Dose1: of fluid extract, % to 1 dram; leptandrin, J to 2 grains; pow- 
dered root, 20 to 60 grains. 
LESION, le' shun [Lat. laado, I hurt], is a term used to denote any 
kind of wound or bodily injury. 
LETHARGY, leth'-ar-je [Gr. lethe, forgetfulness; argia, inactivity], 
an unnatural tendency to sleep, is closely connected, as to cause, with 
langour and debility, and approaches apoplexy in character. It may arise 
from the opposite causes of over-fulness of blood, or from deficiency of 
circulation in the brain, from nervous exhaustion of that organ, or from 
actual disease in it, such as tumor, or abscess. The lethargic state may 
also arise from an impure or poisoned state of the circulating fluid, such 
as precedes- an attack of bilious cholera, or diarrhoea, or is a consequence 
of suppression of urine. It may also, of course, be the consequence of 
narcotic drugs, or of alcoholic intoxication. These latter contingencies 
should be kept in mind in the event of lethargy coming on suddenly; in 
such a case, the treatment, with precautions recommended under the 
article Apoplexy, should be adopted, modified, of course, in some degree 
on account of the milder character of the disorder. In the aged especially, 
lethargy is always to be regarded with suspicion; but in any case, the 
cause should be investigated by a medical man as soon as may be. (See 
Apoplexy, Biliary Disorders, Debility, etc.) 
LETTUCE, let'-tis [Lat. lactuca, from lac, lactis, milk, on account 
of the milky sap which flows when the plants are cut. ] 
As an article of diet, lettuce is in very general use, and with most 
persons, agrees well, though some find that it, in common with uncooked 
vegetables generally, disorders digestion ; others find its narcotic proper- 
ties, even in its mildest condition, inconvenient. Lettuce eaten at night 
has been had recourse to successfully, among others, by the celebrated 
anatomist Galen, as an antidote to sleeplessness. For medicinal prepa- 
rations of lettuce, see Lactuca Sativa. 
LEUCOMA, lu-kd-mq [Gr. leukos, white], is applied to a white 
opacity of the cornea of the eye. It is occasioned by acute inflammation, 
causing a deposition of lymph either upon the surface or into the sub- 
stance of the cornea. When merely superficial, it often passes away with 
the cessation of the inflammation, but when deep-seated it is frequently 
incurable. Astringent lotions are generally recommended. 
LEUCORRHCEA. (See Whites.) 
LEVATOR, le-va'-tur [Lat. levo, I raise], a name given to certain 
muscles which are employed in lifting the part to which they are 
attached, as the levator anguli oris which raises the angle of the mouth. 
LEVIGATION, lev-e-ga'-shun [Lat. loevigo, I rub or grind fine], the 
process of rubbing down or pounding minerals into a paste with water. LIATRIS SPICATA-LIFE. 
819 
LIATRIS SPICATA, li-a'-tris spi-ka-tq, or button snake root, 
known also by the common name of gayfeather, is a perennial plant 
belonging to the Nat. order Composites. It is found in dry woods and 
sandy Helds from New England to Wisconsin. The roots are stimulant, 
tonic, diaphoretic, diuretic and emmenagogue. It has been found effica- 
cious in gonorrhoea, gleet, and diseases of the kidneys, also in gravel 
and dropsy. It forms an excellent gargle in sore throat, and is useful 
also in suppression of the menses and in scrofula. In the Southern 
States it has been held to be an antidote to the poison of venomous 
snakes. Dose: of the fluid extract, 1 to 4 teaspoonfuls; infusion, 1 to 2 
fluid ounces. (See Infusion.) 
LICE. (See Acakus.) 
LICHEN, li'-ken or litsh'-en [Gr. leichen}^ a peculiar skin disease, 
characterized by the presence of small papules or pimples on an inflamed 
surface. It is one of the numerous phases of eczema, being the papular, 
as impetigo is the pustular, form of that disease. (See Eczema; Skin, 
Diseases of the. 
LICHENS, li'-kem or litsh'-enz [Gr. leichen\. Lichens are dis- 
tributed over all parts of the world, and form a considerable proportion 
of the vegetation of the polar regions and of mountain tops. Many 
species possess nutritive properties, from containing starchy matter, such 
being also emollient and demulcent. Others contain bitter principles, 
which render them tonic and astringent. None are known to be poison- 
ous. The most important one of the family is the cetraria islandica, or 
Iceland moss. (See Cetraria.) 
LICORICE, OR LIQUORICE. (See Glycyrrhiza Glabra.) 
LIFE, life [Ang.-Sax. lif\ The word, here, is simply taken in its 
one sense of man's actual material existence in the world; all persons 
of healthy mind have an instinctive desire to preserve life-instinctive, 
truly, it may be called at the present day; for the feeling with a large 
-a very large-class, seems to rise no higher. The only care seems to 
be, to protect from immediate, urgent, threatened danger. And life is 
yearly, daily, hourly extinguished in this country, by causes which are 
perfectly under man's own control to prevent-by causes which it is 
utterly unworthy of intelligent and responsible beings should continue, 
or be allowed to continue, in operation against them. It is enough 
confirmation to reiterate the fact that one-third of the children die before 
they reach the age of five years. They languish and die in the unwhole- 
some dwellings of city, town, village, and country. And this need not 
be; for, fearful as the loss of life now is, it is less, considerably, than it 
was fifty, even twenty years ago, and might be much lessened still. 
The whole science of medicine, surgery, the efforts of hygiene or sanitary 820 
LIFE. 
precaution, even the object of such a work as the present, is the pre- 
servation and prolongation of human life; and that it is not preserved 
nor prolonged to a much greater extent than it now is, cannot be for 
want of knowledge, at least among the better classes. 
The preservation and prolongation of life can never be simply a 
selfish consideration; man does not live for himself alone. But if none 
can doubt that the duration and value of life might be extended far 
beyond what it now is, it is equally certain that it is much greater than 
it was formerly. 
Ignorance of the laws of health, in the first instance, and obstacles 
to the carrying out of those laws in the next, have hitherto kept the 
average of life far below the average it ought to hold. Probably, too, 
indifference as to the means of prolonging human life has partly arisen 
from the very common error, which supposes that the evil of premature 
deaths has some compensating advantage in removing a portion of sur- 
plus population; whereas, in the general case, it is not the surplus, but 
the valuable portion of life that is thus lost. If a boy dies at some 
period between ten and sixteen, his existence has been an absolute cost 
to the community, and he was but just approaching the period when he 
might have become a productive member of it. If a husband dies in 
the early years of his married life, he leaves as burdens on the world a 
widow or children, for whom, in the general case, if he had lived, he 
would have worked ; "bearing out the fact that a country where life is 
precarious has to support more unproductive members than its neighbors. " 
It is a 'melancholy truth, resting on evidence only too strongly over- 
whelming, that the lives of the poorer classes, who inhabit the crowded 
districts of large cities, are liable to be shortened by a variety of causes. 
And yet these things need not be; there is no possible reason why the 
duration of life in a district in which it is low should not be greatly 
raised-the amount in some degree of course depending upon the nature 
of the district. Neither is there a reason why the standard should not 
be elevated in every district. That such will be the case at some future 
day there can be little doubt, nor is it unreasonable to suppose that there 
is yet a "good time coming," in which the value and duration of life 
will be extended greatly beyond what it is at present-greatly beyond 
perhaps what we at present can imagine-when science and benevolent 
exertion have corrected the errors and retained what is good of an 
advanced civilization; when sources of disease from without are removed, 
and when man has learned that health is better than great riches, and 
ceased to offer the former, either his own, or that of worn-down work- 
people, at the shrine of Mammon. (See Longevity, Health, Mortal- 
ity, Sanitary Science, Occupation, Poverty.) LIFE-EVERLASTING-LIGHT. 
821 
LIFE-EVERLASTING. (See Gnaphalium Margaritaceum.) 
LIFE, EXPECTATION OF. (See Mortality.) 
LIFE-INSURANCE, life-irv-shu-ranse^ the security of a sum of 
money to the family or to the survivors of an individual whose death 
involves loss or diminution of income to those survivors, may become an 
important consideration, when the chances of death or recovery in severe 
illness are nearly balanced-when the tranquillity or disturbance of the 
mind may make that balance incline to the one or to the other side. 
The racking thought of a wife and family left without provision, may 
drive away the sleep that would precede amendment-may give the last 
jar to the sinking nervous system. In this remedial point of view only 
can this important subject be alluded to here. (See Mortality.) 
LIFE-ROOT. (See Senecio Aureus.) 
LIFTING CHILDREN, lift'-ing, is a subject on which a few words 
are highly requisite. It is really surprising to see in what a cruel and 
dangerous manner children are often lifted about, not only by their 
nurses, but by their mothers; and the evil results are very commonly 
brought before medical men in the shape of sprains, dislocations, and 
even fractures. When a heavy child is perhaps seized by the hand or 
arm, and swung over a gutter, or the like, the wonder is, not when the 
injury results, but that it does not always result from the practice. 
Among boys, and even by those who are old enough to know better, 
there is a trick of lifting children or boys, by the hands placed under the 
chin and at the back of the head; this is most dangerous-dislocation 
of the neck, and instant death has been the result. (See Children.) 
LIFTING CURE. (See Movement Cure.) 
LIGAMENT, lig'-a-ment [Lat. ligamentum], is a strong elastic mem- 
brane connecting the extremities of movable bones. Ligaments are 
divided into capsular and connective, the former being so called from 
surrounding the joints like a cap. 
In their ordinary condition, the ligaments are not very sensitive; but 
when, in consequence of a strain of the joint, or sprain, they are over- 
stretched, they become acutely so. 
LIGATURE, lig-a-ture [Lat. ligature^ is applied to anything used 
in binding any part of the body. More particularly it is applied to the 
thread or silk used in the tying of arteries or veins that have been cut. 
The effects of a ligature is to divide the middle and internal coats, 
leaving the external and cellular coat whole, and thus the closing up of 
the canal is promoted by the adhesion of the cut edges of the internal 
coats. Hence the ligature should be small and round, not broad or flat, 
and should be tied with some degree of tightness. 
LIGHT, lite [Lat. lux}, the great agent by which our organs of vision 822 
LLGLTT-LLGIITNLNG. 
are enabled to see, and take cognizance of the beauties and wonders of 
creation. 
A ray of light is an exceedingly small portion of light as it comes 
from a luminous body. A medium is a body which affords a passage 
for the rays of light. A beam of light is a body of parallel rays. 
A pencil of rays is a body of diverging or converging rays. Con- 
verging rays are rays which tend to a common point. Diverging rays 
are rays which come from a point and continue to separate as they pro- 
ceed. The radiant point is the point from which diverging rays proceed. 
The focus is the point to which converging rays are directed. 
Light is of two kinds natural light, proceeding from the sun an 
stars; and artificial light, proceeding from bodies which are strongly 
heated. The glowing or shining appearance is called incandescence. 
Light is a powerful nervous stimulant, and our physical organization 
is largely indebted to it, for the proper development of those powers and 
proportions which go to constitute a vigorous and healthful existence. 
It is now a recognized fact, that a free supply of light is almost as neces- 
sary to health as fresh air or pure water; a fact which should never be 
lost sight of in the construction of dwelling-houses. Nothing is more 
favorable to the development of scrofula than a dark dwelling. The 
powerful stimulant action of light upon the eye is evinced by the fact, 
that strangers in the arctic regions are liable to suffer from inflammation 
of that organ, produced by the glare of reflected light from the snow, 
and that from the same cause the natives of those regions suffer from 
snow blindness. Light, however, exerts different effects according to its 
color; bright white, yellow, or red lights, are much more likely to injure 
the eye than those of a blue or green tinge. 
There are some affections of the brain and nervous system, and of the 
eyes, in which the patient requires a very subdued light, and sometimes 
its almost entire exclusion from the apartment, but it is a well-known 
fact, corroborated by abundant testimony, that convalescence takes place 
much more rapidly in a room large, airy, cheerful, and with plenty of 
sunlight. The question of the artificial lighting of our streets and dwell- 
ings is a very important one, both to municipal corporations and to 
householders, and in the matter of providing a safe, steady, and at the 
same time inexpensive artificial light, there is yet great room for improve- 
ment. (See Houses, Amaueosis, Eye; Eye, Diseases of the; Blind- 
ness, Sleep, etc.) » 
LIGHTNING, lite'-ning [Ang.-Sax. lihting, lihtincg, lihtung.'} 
Injury or death from lightning, appears principally inflicted through 
affection of the nervous system, although at the same time, severe and 
extensive wounds are not unfrequently produced. Burning, on the other LIGHTNING. 
823 
hand, is not occasioned by the electric fluid itself, so much as by the 
clothing, which is generally set on fire. Persons who are stunned, but 
not killed, by lightning, generally remain in a state of insensibility for 
some time, the breathing being slow and deep, the muscular system 
relaxed. In such cases, it will be proper to use means for preserving 
the animal warmth, which has a tendency to become depressed, to keep 
up artificial respiration, as recommended under article Drowning, to use 
mustard plasters to the spine and pit of the stomach, to administer from 
time to time, a little sal-volatile in water, if the patient can swallow- 
if not, to give a warm injection containing an ounce of turpentine-or 
to use such other means as are recommended under the articles Drown- 
ing, Carbonic Acid, and Choke-Damp, which may seem adapted to the 
case. It is a common idea, that persons who have been killed by light- 
ning do not stiffen, and that the blood remains fluid: it is erroneous. 
Lightning rods.-A house supplied with the proper kind of lightning 
rods-namely, those possessing all the requisites shown to be necessary 
by a scientific knowledge of the laws of electrical action-may be con- 
sidered as completely protected from the calamitous effects of the dis- 
charges of lightning. The rod should consist of round iron not less than 
three-fourths of an inch in thickness. Iron is named because cheap, 
easily procured, and a sufficiently good conductor. A rod of this size 
is in no danger of being melted by a discharge from a cloud. The rod 
should be round, from the fact that electricity repels itself, and possesses 
a tendency to escape into neighboring bodies from points or sharp edges; 
therefore flat or twisted rods must be imperfect conductors, as they have 
a tendency to give off lateral sparks from the sharp edges, during the 
passage through the rod, of the discharge, and which may in many cases 
ignite combustible materials. 
The rod should terminate above in a single point, and to preserve 
this and prevent it from being melted, it should be encased in a hollow 
cone of platinum. The lower end of the rod should be connected with 
the earth in the most perfect manner, and if possible, should be extended 
out from the house, under the ground, to a distance of fifty feet or more, 
and then sunk perpendicularly till it reaches moist earth. A still better 
way is to let the end of the rod terminate below the surface of the water 
in a well, but never in a cistern, for in the latter the water is insulated 
from the earth. 
It is always better that a lightning rod should be made of one piece of 
iron rather than of several sections joined together at the ends. The rod 
may be attached to the house by means of iron eyes driven into the wall; 
the extreme end or point of these being buried in non-conducting masonry 
or wood, will not tend to give off electricity at the time of a discharge. 824 
LIGHTNING-LIL Y 
Glass cylinders may be inserted in these eyes for the purpose of insulation, 
but this can be of but little importance, since the insulation is immedi- 
ately destroyed by the rain. 
The above observations relating to lightning rods, are deductions 
made from the writings of the late Prof. Joseph Henry, the Secretary 
of the Smithsonian Institute, Washington, D. C., and late President of 
the National Academy of Sciences. 
It would, considering how often the fact is reiterated, seem almost 
superfluous to point out the ordinary precautions which those who 
chance to be exposed to a storm of thunder and lightning, ought to 
adopt; but not a summer passes without lives being lost from sheer 
ignorance. Harvest laborers and others will persist in sheltering under 
trees, people will continue to put up, even iron, umbrellas in the midst 
of a thunder-storm, and mowers walk unconcernedly home with their 
scythes over their shoulders. If an individual is overtaken by a thunder- 
storm in a place where trees abound, he should avoid them as much as 
possible; a thorough soaking will be rather a protection than otherwise. 
If, on the contrary, the position is on a wide plain, where the body is 
the highest object, lying down is the safest procedure. In any case, 
metallic objects, such as sickles, scythes, etc., being laid aside at a con- 
siderable distance. Under shelter, the most hazardous position appears 
to be in a draught or current of air, such as between a door and window, 
this seeming to exert considerable influence upon the course of the 
electric fluid. A position in the middle of the room-if not in a draught 
nor near a stove-and a horizontal rather than a perpendicular one, 
are advisable. 
LIGHTNING RODS. (See Lightning.) 
LIGNUM VITtE. (See Guaiacum.) 
LIGUSTICUM LEVISTICUM, le-gus'-te-kum lewis'-te hum or lov- 
age. A plant belonging to the Nat. order Umbellifera^ and growing 
in the south of Europe. It is a stimulant aromatic, and has been em- 
ployed as a carminative and diaphoretic. The root, stem, leaves, and 
seeds have all been employed in medicine. The root and seeds are the 
most esteemed. The extract of the root acts upon the urinary organs, 
increasing the flow of urine, and is sometimes efficacious in bringing 
away gravel. The medicinal qualities of lovage have made the drug avail- 
able in removing visceral obstructions, dispelling flatulency, increasing 
perspiration, and in the treatment of jaundice. It is often added to 
purgative preparations, on account of its aromatic carminative properties. 
Dose: of the fluid extract, to 1 teaspoonful; of the infusion, 1 to 2 
fluid ounces, three or four times a day. (See Infusion.) 
LILY. (See Nymph^ea Odorata.) LIME-LINIMENT. 
825 
LIME. (See Calcium.) 
LIME, BURNS FROM, lime [Ang.-Sax. lime\. Burns from lime 
are not uncommon; in such cases, the best application is vinegar and 
water, or some other acid, if vinegar is not at hand-freely applied; the 
acid in this case converting the caustic lime into a harmless substance. 
The same treatment is to be pursued in the event of lime getting into 
the eye, the vinegar or acid being of course more largely diluted than 
when used to other parts. In any of these cases, the after consequences 
such as ulceration of the skin, or inflammation of the eye, must be 
treated as recommended in burns generally. 
LIME IN THE EYE. (See Lime, Burns from.) 
LIME-WATER. Take a handful of quicklime, slake it, and put 
it into a quart bottle full of soft water. Shake the bottle well, and 
then allow the undissolved portion of the lime to settle. Pour off the 
clear liquid when needed, replacing it with more water, and afterwards 
shaking the bottle briskly. For medicinal uses of lime-water, see Cal- 
cium. 
LINIMENT, Un'-e-ment [Lat. lino, I anoint], is an oily substance 
of a consistence intermediate between an ointment and oil, but so thin 
as to drop, and used to rub upon diseased parts. The term is also 
applied to a spirituous, or other stimulating application used in the same 
way. 
The following are examples of a few useful liniments: 
CAMPHORATED LINIMENT. 
Take of Gum camphor One ounce. 
Olive-oil Four ounces.-Mix. 
Useful in strains and bruises where there is no abrasion of the skin. 
LIME AND OIL LINIMENT. 
Take of Lime-water Two ounces. 
Olive-oil Two ounces.-Mix. 
Shake well together. Useful in burns, chapped hands and bruises. 
ACONITE AND CHLOROFORM LINIMENT. 
Take of Castor-oil Two drams. 
Chloroform Twto drams. 
Water of ammonia Two drams. 
Tincture of aconite root Two drams. 
Camphorated tincture of soap One ounce.-Mix. 
Useful in rheumatic and neuralgic pains. 
AMMONIA LINIMENT. 
Take of Solution of Ammonia One ounce. 
Olive-oil Two ounces.-Mix. 
Used in sore throats, sprains and bruises. 826 
LIN1MENT-LIP. 
ANODYNE LINIMENT. 
Take of Castile soap Six ounces. 
Opium One and a half ounce. 
Camphor Three ounces. 
Oil of rosemary Half an ounce. 
Alcohol Two pints. 
Steep the soap and opium in the alcohol for three days; filter and add 
the oil and camphor. This is a very useful liniment in sprains and 
rheumatic and neuralgic pains. 
LINSEED, lin'-seed, the seed of the linum usitatissimum, or common 
flax, contains a fixed oil, well known by its name of linseed-oil, which is 
procured from the seeds by pressure; the seeds also yield, when boiled, 
or infused in boiling water, a thick, almost tasteless, mucilage. Linseed- 
oil was formerly more employed in medicine than it is at present, its 
chief use now, being in the formation of the carron-oil, used by some in 
the treatment of burns. This is made by agitating together equal parts 
of lime-water and linseed-oil. (See Burns.) The infusion of linseed, 
or linseed tea, may be made in the proportion of half an ounce of the 
seed to a pint of boiling water. It is a cheap and very good demulcent 
remedy in coughs, and in irritation of the urinary organs. The meal of 
linseed is made by grinding the seeds, after the oil has been expressed 
from them; it is chiefly used for poultices. 
Linseed poultice is made by mixing 4 ounces of the meal gradually 
with 10 fluid ounces of boiling water, and adding £ fluid ounce of olive- 
oil with constant stirring. This forms one of the best and most conve- 
nient of all emollient poultices. (See Poultice.) 
LINSEED TEA. (See Cookery for the Sick.) 
LINT, lint [Lat. linum, flax], a term applied to old white linen 
cloth, scraped by hand or machinery, so as to render it soft and woolly. 
It is.used for dressing wounds, ulcers, etc., either alone, or smeared 
with suitable ointment or cerate. 
LION'S FOOT. (See Nabalus Albus.) 
LIP, lip [Ang.-Sax. lippa, Lat. labium or labrum], in Anatomy, 
is the outer edge or border of the mouth. The lips are composed of 
muscular fibres, glands, and cellular tissue, covered by mucous mem- 
brane. They owe their extremely red color to the thinness of the cov- 
ering membrane, and their sensitiveness to an abundant supply of minute 
nervous fibres. 
The color of the lips is closely connected with that of the blood, and 
also depends upon the vigor of its circulation. When the blood is poor 
and deficient in red globules (see Chlorosis) the lips become pale; 
when, again, from failure of the heart's action, as in fainting, the blood 
is not circulated properly, the lips also become pale; when, from disease, LIP-LIQUOR POT ASSN, POISONING BY. 
827 
the blood does not undergo its proper changes, the color of the lips, 
instead of being red, inclines more or less to purple. The lips, particu- 
larly the lower, are apt to become the seat of cancer in old people; 
especially, it is said, in those who have smoked much from a short pipe. 
A continued sore upon the lip that will not heal, in an old person, should 
be examined by a medical man; if it is such as to require removal, this 
cannot be done too soon.' 
Good health alone can impart to the lips their peculiar beauty; and 
the appearance of the lips, especially of the under lip, is generally con- 
sidered as a strong index of the state of the health. Cold cutting winds 
will often make the lips rough and uncomfortable. A little warm milk 
and water is the best and safest remedy for this, if the lips are not badly 
chapped. In this latter case, however, it may be necessary to apply to 
some of the emollient lip-salves, of which we have here given recipes. 
Delicate ladies, who value the appearance of their lips, will never use 
water either very cold or very hot. Tepid soft water is far more likely 
to keep the lips comfortable than any other; but, as we said before, 
everything depends upon the state of the health. (See Lip-Salve, Hare- 
lip, Skin, Cancer.) 
LIP-SALVE, lip'-sav. Ingredients: 1 ounce of oil of sweet almonds, 
ounce of white wax, ounce of spermaceti, 4 or 5 drops of oil of roses, 
and 4 grains of cochineal. Mode: Warm these before the fire till well 
mixed ; then leave them to cool. 
Another- White and Red.-1. "White-Spermaceti ointment or 
cerate, 1| ounce; finely powdered white sugar, | ounce; scent, a sufficient 
quantity. Mix.-2. Red-Spermaceti ointment, 1 ounce; alkanet root, 
f dram. Melt together till sufficiently colored; strain, and when consid- 
erably cooled, add 2 or three drops of oil of lavender. (See Lip.) 
LIQUID AMBAR, lik'-wid-am'-bgr' a genus of balsamiferous trees, 
constituting the Nat. order Atting iacea, or Batsimijluce. L. orientate 
yields the liquid storax of the drug-stores, obtained from the inner bark, 
and is the cortex thymiamatis^ or storax bark, of pharmacologists. Pre- 
pared storax is purified by means of rectified spirit, and straining. It is 
stimulant and expectorant, and is recommended in chronic bronchitis, 
catarrh, gonorrhoea, etc. Dose, 10 to 20 grains twice a day. 
LIQUOR AMMONIA. (See Ammonia.) 
LIQUOR AMMONIA ACETATIS, OR SPIRIT OF MINDERE- 
RUS. (See Ammonia.) 
LIQUORICE. (See Glycyrrhiza Glabra.) 
LIQUOR POTASStE. (See Potash.) 
LIQUOR POTASS2E, POISONING BY.. (See Alkalies, Poison- 
ing BY.) 828 
LIQ UOIIS-LITHONTRIPTIC. 
LIQUORS. (See Alcohol, Ale, Porter, Brandy, Gin, Rum, 
Whiskey, Wine; Stimulants, Alcoholic; etc.) 
LIRIODENDRON TULIPIFERA, lir-e-o-den'-dron tu-lepif'-e-rg, 
or white wood, a large American tree, commonly known as American 
poplar and cypress tree. The bark is aromatic, stimulant and tonic, and 
has been used successfully in intermittent fever, chronic rheumatism, 
hectic fever, night sweats and the diarrhoea attending consumption. 
Dose: of the fluid extract, | to 1 teaspoonful; of the infusion, 1 to 2 
fluid ounces. (See Infusion.) 
LISPING, lisp'-ing [Ang.-Sax. wlips, wlisp}. A species of psellis- 
mus, or defective enunciation; sometimes caused by an unusual length 
of tongue; sometimes by the loss of the front teeth, but often by 
affectation. (See Speech.) 
LITHARGE, lith'-arj [Gr. litkros, a stone, and ar gyros, silver], is an 
oxide of lead, which occurs in the form of reddish white scales. It is 
sometimes used to adulterate wine. Litharge ointment has been used in 
small-pox to prevent pitting. It is not superior to common lard. (See 
Lead. ) 
LITHIA. (See Lithium.) 
LITIIIASIS, le-thi'-a-sis [Gr. lithos, a stone], is the disease of the 
stone in the bladder or kidney. (See Calculus.) Also a disease 
of the eyelids, in which their margins are beset with small hard 
tumors. 
LITHIUM, lith'-e-um, in Chemistry, symbol Li, equivalent, 6.5; 
specific gravity, 0.59-one of the alkaline group of metals, of which 
potassium, sodium, caesium, and rubidium are the other members. 
It closely resembles these metals in most of its properties, forming 
an alkali by its union with oxygen, decomposing water at ordinary 
temperatures, and having so loW a specific gravity that it will float in 
the lightest known fluid. Lithium is the metallic base of lithia, one of 
the best remedies for gout; either as lithia water, which may be had in 
the form of aerated carbonate or effervescing citrate, in doses of from 5 
to 10 fluid ounces; as the carbonate of lithia, dose 3 to 6 grains; or the 
citrate of lithia, dose 5 to 10 grains. Lithia is also recommended for 
stone. Its action on the uric concretions is much more rapid than that 
of the salts of potassium and sodium. 
LITHONtRIPTIC, lith-on-trip'-tik [Gr. lithos, a stone, and tribo, I 
wear away], a term used to denote certain medicines which are believed 
to have the power of dissolving calculi in the bladder. The Vichy 
water, a solution of bicarbonate of soda saturated with carbonic acid, is 
said to have considerable effect, not only on lithic calculi, which it dis- 
solves by virtue of its alkali, but on the phosphatic, which it affects Liriodendron Tulipifera. (Whitfe Wood.) LITH0NTR1PTIC-LITMUS. 
829 
through its carbonic acid, and disintegrates the animal matter which 
cement them together. (See Calculus, Urine.) 
LITHOTOMY, le-thot'-o-me [Gr. I ethos, a stone, and temno, I cut], 
is the operation of cutting into the bladder, in order to extract one or 
more stones or calculi from it. Several methods have been recom- 
mended of extracting the stone; but there are only two of them that can 
be adopted with any propriety: one of these is called the high operation, 
from being performed immediately above the pubes. There are, how- 
ever, several objections to this mode of operation; and it is now rarely 
adopted, except for some special reason, as where there is disease of the 
urethra. The other is called the lateral operation, on account of the 
prostrate gland and the neck of the bladder being cut laterally In this 
case the incisions are made in the perinaeum, and the neck and lateral 
part of the bladder laid open, so as to allow of the extraction of the stone. 
Where large, it is sometimes necessary to crush the stone, and take it 
away piecemeal; in every instance the cavity of the bladder ought to be 
examined with the finger, to ascertain that there is no other stone pres- 
ent. Where numerous, they may be removed with a scoop; and if 
broken down, tepid water should be injected, so as to remove every por- 
tion of the calcareous matter, and prevent a nucleus remaining for the 
formation of a future stone. The after treatment is simple: the wound 
is left open, or only covered w'ith some simple ointment, and in a depen- 
dent position, that the urine may flow freely through it. The patient is 
to be kept quiet, and on a low regimen, and diluent drinks administered, 
and any symptoms of inflammation are to be met by prompt antiphlo- 
gistic treatment. In the course of two or three days the urine begins to 
flow by the urethra, and is soon wholly discharged in that way. (See 
Lithotrity, Calculus, Urine.) 
LITHOTRITY, le-thot'-re-te [Gr. Uthos, a stone, and terio, I break 
into pieces], is the operation of breaking into pieces a calculus in the blad- 
der by means of instruments passed into that organ through the urethra, 
so that the. fragments maybe discharged through the latter, and thus, 
the performance of the operation of lithotomy rendered unnecessary. 
This is one of the greatest triumphs of modern surgery, and its intro- 
duction has taken place since the commencement of the present century. 
The operation is so simple, attended with so little danger, and produc- 
tive of so little pain, as to render it, where it can be used, immeasur- 
ably preferable to lithotomy. When the calculi are very large or very 
hard, it cannot be adopted. (See Lithotomy, Calculus, Urine.) 
LITMUS, lit'-mus [Ger. lackmus}, a blue coloring matter obtained 
from the Rocella tinctoria, and moistened with a solution of carbonate 
of potash. It is much used by chemists as a rough test for the presence 830 
LITMUS-LIVER. 
of free acid or alkali in a solution or gaseous mixture. It is generally 
used in the form of litmus-paper, which is prepared in the following 
manner: Common commercial litmus is digested in water until a deep 
blue solution is formed; it is then filtered, and pieces of bibulous paper 
are dipped into it, and dried. Blue litmus-paper is burnt red by acids. 
Reddened by being suspended for a few seconds over the fumes of 
acetic acid, it serves as a test for alkalies, which restore it to its original 
color. 
LIVER, liv'-ur [Ang.-Sax. lifer, Gr. hepar\, is the secreting organ 
or gland by which the bile is formed. It is situated in the right hypo- 
chondriac and epigastric regions below the diaphragm, and is of a red- 
dish-brown color. Its form is irregular, being convex on the upper sur- 
face, irregularly concave below, very thick behind, and very thin in 
front; and in the adult it generally weighs from three to four pounds. 
It is divided into two principal lobes-the right and the left, the former 
of which is by much the larger. They are divided on the upper side by 
a broad ligament, and below by a considerable depression, or fossa. 
Between and below these two lobes is a smaller lobe, called lobulus 
Spigelii, which is bounded on the left by the fissure for the lodgement 
of the ductus venosus; on the right by the fissure for the vena cava. 
The lobulus caudatus is a tail-like process of the liver, stretching down- 
wards from the middle of the right lobe to the lobulus Spigelii. The 
liver, like the other viscera of the abdomen, receives an investment 
from the lining membrane of that cavity-the peritoneum, which, 
being reflected from it at different points, forms broad bands, connect- 
ing it with the surrounding parts. An investment of areolar tissue is 
also spread over the organ, extending into the interior, and forming 
thin but dense sheets to the vessels and canals, called the capsule of 
Glisson. The proper tissue of the liver is composed of a great number 
of granular bodies, of the size of millet, and called lobules, of a foliated 
appearance. The blood-vessels of the liver are the hepatic artery and 
veins and the vena portae; the lymphatics are numerous, and the nerves 
are supplied from the pneumogastric and phrenic, and the hepatic flexus. 
The liver thus receives two kinds of blood-arterial, by means of the 
hepatic artery, in small quantity, destined principally for the nourish- 
ment of the gland; and venous, by the vena portae, in much larger 
quantity, from which the bile is principally formed. The tributary 
branches, by the junction of which the main trunk of the portal vein is 
formed, comprise the veins which receive the blood from the stomach 
and intestinal canal, the spleen, pancreas, and gall-bladder. The 
secretion of bile (see Bile), though the chief and most obvious of the 
functions of the liver, is not the only one which it has to perform; for Lobelia Inflata. (Lobelia.) LIVER-LOBELIA INFLATA. 
831 
recent discoveries have shown that important changes are effected in 
certain constituents of the blood, in its transit through this gland, 
whereby they are rendered more lit for their subsequent purposes in the 
animal economy. From the labors of Bernard and others, it appears 
that the low form of albuminous matter conveyed from the alimentary 
canal by the portal vein requires to be submitted to the influence of the 
liver before it can be assimilated by the blood. The liver also possesses 
the remarkable property of forming sugar out of principles in the blood 
which contain no trace of saccharine or amylaceous matter. The 
excretory apparatus of the liver consists of the hepatic, common, and 
cystic ducts, and the gall-bladder. The biliary ducts commence by 
small twigs in each lobule, and join, forming, where they emerge from 
the gland, the hepatic duct. This duct, after passing down for a short 
distance, is joined at an angle by the cystic duct from the gall-bladder. 
The common duct thus formed is called the ductus communis choledochus, 
and empties itself into the duodenum. The retention of the materials of 
the bile in the blood acts like a poison upon the nervous system, and if 
the suspension of secretion is complete, death soon takes place. Much 
of the cerebral disturbances accompanying dyspepsia, some forms of 
which are popularly known as liver complaint, is doubtless due to 
deficiency of the biliary secretion, and the non-elimination of certain 
deleterious constituents. (See Bile, Biliary Disorders, Biliousness, 
Gall-Stones, Jaundice, Digestion, Dyspepsia; Hepatitis, or Inflamma- 
tion of the Liver.) 
LIVER COMPLAINT. (See Biliary Disorders, Biliousness, 
Bilious Cholera, Costiveness, Hepatitis, Jaundice, Podophyllum 
Peltatum, Mercury, Cathartics, etc.) 
LIVER LILY. (See Iris Versicolor.) 
LIVERWORT, OR LIVER LEAF. (See Hepatica Americana.) 
LIVING BY RULE. (See Rule, Living by.) 
LIXIVIATION, liks-iv-e-a'-shun [Fr. lixiviation}^ process of sepa- 
rating the soluble from the insoluble portions of compounds by steeping 
and washing in water. The extraction of the soluble salts contained in 
kelp is an example of lixiviation. 
LOBE, lobe [low Lat. lobus\ is a term applied to the more or less 
separate parts of which the glands of the body are composed. Thus we 
have the lobes of the brain, lungs, liver, etc. Lobe is also applied to 
the pendant portion of the ear. (See Ear.) 
LOBELIA INFLATA, lo-be-le-a, or lobelia, a common weed belong- 
ing to the Nat. order Lobeliacece^ growing in waste fields, and by the 
roadsides throughout the United States and Canada. It is known by the 
common names of Indian tobacco, and asthma root. All parts of the 832 
L OB ELIA INFLA TA-L 0 CK-JA IE 
plant are used in medicine. Lobelia is an active emetic, and in small 
doses a diaphoretic and expectorant. It is of especial use in spasmodic 
asthma, and is used also in catarrh, croup, whooping cough and other 
affections of the air-passages and lungs. By its nauseating properties 
it is very efficacious in subduing spasm. 
In regard to the caution which should be observed in administering 
lobelia, Dr. Waring remarks as follows: "It is always advisable to 
commence with small doses, and increase them as the patient is able 
to bear the medicine, discontinuing its use if it cause nausea, intermit- 
ting pulse, or great depression." Dose: of the fluid extract as an emetic,. 
| to 1 teaspoonful, as an expectorant, 10 to 60 drops; of the tincture, 
1 to 2 teaspoonfuls; of the infusion, 1 fluid ounce every £ hour, until 
vomiting ensues. 
LOBSTER, lob'-stur [Ang.-Sax. loppestre, lopystre^ hleapan, to leap], 
like most shell-fish, is unfit for persons of weak digestion. (See 
Fish.) 
LOCHIA, lo-ki'-a [Gr. locheyo, to bring forth], the "cleanings" after 
delivery. (See Childbed, Parturition.) 
LOCK-JAW, lok'-yaw, is the popular name for the first and partial 
symptom of a fearful spasmodic disease, known to medical men as 
tetanus. 
Causes.-The most usual exciting causes of lock-jaw or tetanus, are 
wounds, especially of a punctured character, but in some persons, the 
very slightest injury is sufficient to develop the disease; in this climate, 
however, it is fortunately comparatively rare; in warm climates it is 
common; it is also liable to prevail among the wounded after battles, if 
exposed to much vicissitude of weather; indeed, cold will occasionally 
give rise to lock-jaw independent of injury. When lock-jaw arises from 
a wound, it shows itself in from four days to three weeks after the injury. 
It is a very fatal disease, the greater proportion of those affected by it 
dying; some, however, recover. 
Symptoms.-Not only the muscles of the jaws, but the muscles of the 
body throughout, are, more or less, extensively thrown into violent spasm, 
so strong, indeed, that the teeth or bones may be broken by it. The set 
of muscles most generally affected, after those of the jaws, are those of 
the back; the patient, by the spasm, is bent like an arch, so that the 
back of the head and the heels alone touch the bed; occasionally the body 
is bent forward. The disease most frequently commences with a sensa- 
tion of stiffness and soreness of the muscles of the neck and jaws; the 
latter become fixed, and the spasm extends more or less over the body. 
It is needless to add, that this extensive cramp is attended with the most 
severe pain, which is also in most cases experienced severely about the L O CEJA W-L ONGEVITY. 
833 
pit of the stomach, being dependent, doubtless, on spasm of the dia- 
phragm. 
Treatment.-Of course, as soon as practicable, a medical man should 
be called to a case exhibiting even the slightest tendency to lock-jaw after 
an injury; in the meantime, large, very large doses of opium in the liquid 
forms of laudanum, or of sedative solution, may be administered, even 
by unprofessional persons; they may mitigate the sufferings of this 
dreadful disease; commencing with from 30 to 60 drops of laudanum; 
the same doses, if they can possibly be swallowed, may be repeated at 
intervals of from half an hour to an hour, as long as the system remains 
unaffected by the drug; if the medicine cannot be given by the mouth, it 
must be by injection. 
In addition to the above, the affusion with cold water may relieve. 
The patient having been taken out of bed, and a quantity of cold 
water dashed over the body, and down the spine, is immediately to 
be rubbed dry and replaced in bed-quiet sleep may possibly follow. 
Whilst the jaws are firmly closed, nourishment cannot, of course, be 
given in the usual way; a medical man will probably administer it by 
means of a tube passed into the stomach, either by the nose, or by mouth, 
passing it behind the teeth; until his arrival, should that be delayed, the 
administration of small injections of meat broth will assist in main- 
taining strength. (See Tetanus, Convulsions, Cramp, Spasm, Wounds, 
ETC.) 
LOCUST TREE. (See Robinia Pseudo-Acacia.) 
LOGWOOD. (See ELematoxylon. ) 
LOINS, loinz [Ang.-Sax. lendenu], is applied to the lower and pos- 
terior part of the trunk of the body, or the space between the upper edge 
of the pelvis and the last of the ribs. The lower end of the vertebral 
column is in this region, and the vertebrae composing it are termed the 
lumbar vertebrae. 
LONGEVITY, lon-jev'-e-te [Lat. longcevitas\ the prolongation of 
life to a period much above seventy years. Prolonged life is, in some 
respects, hereditary; generally the ages at which the different members of 
a family die, bear a very near average to one another, even despite the 
influence of occupation, habits, and condition of life, although these, 
undoubtedly, exert considerable influence in determining the period at 
which the component tissues of one or more of the organs begin to give 
way. 
There are quite a number of cases of extreme longevity on record 
in America as well as Europe. Henry Jenkins, of Yorkshire, England, 
is said to have lived to the extreme age of 169, while Joseph Crele, of 
French extraction, died in Wisconsin, 1866, at the age of 141. These 834 
LONGEVITY. 
are extraordinary cases, but there seems no good reason why any one 
not tainted with the seeds of inherited disease, nor compelled by the 
force of circumstances to violate the necessary conditions, should not 
attain an age of from fourscore to one hundred years. 
The inhabitants of the northern temperate zone, as a rule, attain a 
greater age than those of any other portion of the earth's surface. The 
white race is longer lived than any of the colored races, and the 
pure breeds than those which are the product of unseemly miscegena- 
tion. 
Married people live longer than single, and, notwithstanding all the 
risks and cares incident to child-bearing, there are many more instances 
of longevity among females than among males. For obvious reasons, 
the wealthy live longer than the poor, and the professional and 
commercial classes longer than those who live by the sweat of their 
brow. 
There are certain occupations which preclude the possibility of long 
life. Those who spend their working hours exposed to the fumes of 
arsenic and other poisonous metals, and those who are constantly breath- 
ing an atmosphere laden with irritating dust, as knife-grinders, of neces- 
sity, fill premature graves, though much may be done, even here, to 
alleviate the circumstances and to prolong life. 
Diet, clothing, exercise, sleep, occupation, and place of residence are 
all matters more or less under individual control, and in the proper 
observance of the common sense rules laid down under the different 
articles on these subjects is to be found the true method of prolonging 
life, and of preventing the decrepitude which too often accompanies old 
age. 
Signs of a long life.-Freedom from hereditary taint, a constitution 
uninjured by dissipation or disease, elasticity of both mind and body, 
which will enable the individual rapidly to recover the effects of injury 
or disappointment, a financial and social position which will exempt from 
undue exposure and bodily and mental worry, with regular and active 
habits, are a possession of priceless worth and valuable signs in the fore- 
cast of long life. 
Many tables and calculations have been made at different times, with 
a view of determining the extent to which the duration of life is affected 
by the circumtances in which individuals may be placed. The following 
table, from Caspar, of Berlin, shows how greatly the average duration 
of life varies in different classes in Germany. Though this table may 
apply in the main to this country, still the American or English profes- 
sional man reaches a much higher average age than indicated in the last 
four items of this table. LONGEVITY- LOSS OF VOICE. 
835 
Of 100 persons in each of the following classes, there have reached 
the age of 70 years and upwards: 
Theologians 42 
Agriculturists 40 
Superintendents 35 
Manufacturers, merchants and commercial men generally.... 35 
Mechanics 35 
Laborers 35 
Military men 32 
Subalterns 32 
Advocates or lawyers 29 
Artists 28 
Teachers and professors 27 
Physicians 24 
Another table, by a different observer, exhibits the difference of 
locality as follows; the observations were taken from a French depart- 
ment. 
Inhabitants to one 
death annually. 
Mountain parishes 38.3 
Sea-side 26.6 
Corn or grain districts 24.6 
Stagnant and marsh districts 20.8 
(See Health, Disease, Sanitary Science; Age, Old; Climacteric 
Disease, Diet, Food, Meals, Digestion, Exercise, Regimen, Excitants, 
Mental Exercise, Recreation, Health Resorts, Mineral Waters, 
Climate, Passions; Stimulants, Alcoholic; Clothing, Flannel, Air, 
Ventilation, Houses, Light, Bed-Room, Sleep, Early Rising, Ablu- 
tion, Baths and Bathing, Toilet, Education, Occupation, Poverty, 
Life, Hereditary Tendency, Marriage, Mortality, etc.) 
LONGING, long'-ing, is the term applied to the almost morbid 
craving for certain articles of diet, with which some females indulge 
themselves during pregnancy; it is probably a phase of hysteria. Under 
the circumstances, it is only right and humane to yield to those fancies 
in some measure; but when there is any real or adequate reason for 
their being debarred, it may be insisted upon, without the risk of the 
consequences popularly supposed to follow. (See Pregnancy.) 
LONG LIFE. (See Longevity.) 
LONG PURPLES OF SHAKESPEARE. (See Arum.) 
LOOSENESS OF THE BOWELS. (See Diarrhcea, etc.) 
LORDS-AND-LADIES. (See Arum.) 
LOSS OF BLOOD. (See Hemorrhage.) 
LOSS OF FLESH. (See Atrophy, Emaciation.) 
LOSS OF HAIR. (See Baldness, Vaseline.) 
LOSS OF SIGHT. (See Amaurosis, Blindness.) 
LOSS OF VOICE. (See Aphonia.) 836 
L OTIONS-L UMBAGO. 
LOTIONS, lo'-shunz [Lat. lotto ; lavo, lotum, to wash], are liquid 
applications, principally composed of water, used either to the skin or to 
the mucous surfaces, such as the inside of the mouth or of the nostrils. 
The variety of lotions from plain water-which is often a most excellent 
one-upwards, is very great. Lotions may be classed as-1. Cooling; 
2. stimulating; 3. astringent; 4. soothing; and 5. sedative. Of the 
first, water is an example, either alone, combined with spirit, from 
an ounce to 1 ounce to the % pint, or combined with vinegar. The 
lead lotion (see Lead) is another example of the cooling lotion, but in 
this case it is astringent at the same time. Water, with one-third or 
one-half spirit of wine, applied to the skin by means of lint, which is 
covered to prevent evaporation, is a good example of a stimulating lotion. 
Very cold water, the lotion of sulphate of zinc or of white vitriol, in the 
proportion of from 1 to 10 grains to the ounce of water, and other 
astringents in solution, form the astringent lotions; the various prepa- 
tions of opium; decoction of poppies; decoction of hemlock, etc., are 
soothing lotions : the prussic acid lotion, a sedative one. 
The reader is referred to the various articles, such as Lead, Zinc, etc. 
LOUSE. (See Acaeus.) 
LOVAGE. (See Ligusticum Levisticum.) 
LOVE. (See Passions.) 
LOW DIET, lo di'-et, must necessarily be a comparative term, 
influenced by the previous habits of the patient, but generally it means 
the absence of all stimulants and animal food from the allowances-gen- 
erally of eggs also-and a diminished amount of bread nourishment. 
Weak tea, bread, diluted milk, cocoa, gruel, arrowroot, sago, and such 
like preparations, generally, constitute the staple of low diet in this 
country; to these, however, the cooling fruits may frequently be added. 
Half diet includes the above with the addition of puddings, of milk and 
eggs, of broth, and it may be of a small allowance of meat. (See Absti- 
nence, Hungee, Staevation, Food, Diet, Regimen, etc.) 
LOWER JAW, DISLOCATIONS OF. (See Dislocations.) 
LOWER JAW, FRACTURE OF. (See Feactuees.) 
LOW SPIRITS. (See Hypochondeiasis, Neevous Diseases, Melan- 
choly, Dyspepsia.) 
LOZENGE. (See Teoche oe Lozenge.) 
LUMBAGO, lum-ba'-go [Low Lat. ; Lat. lunibt^ the loins], is rheu- 
matism of the large muscles of the back, and like rheumatic affections 
generally, is often extremely painful, the pain being increased by stoop- 
ing, and again when the person attempts to rise. This peculiar aggra- 
vation of the pain by these movements is generally stated to be the dis- 
tinction between this disease and painful affections of the kidney. In L mi BA G O-L UNO HEO N. 
837 
lumbago, nothing affords more, if so much relief, as hot moist applica- 
tions to the back, continued from twelve to twenty-four hours at a time, 
and followed by the soap liniment combined with one-sixth part of tur- 
pentine, rubbed well into the back and loins. 
Nothing is better than the old woman's plan of putting several folds 
of flannel over the back and applying a smoothing iron as hot as it can 
be borne-"Ironing the back." 
Ten grains of Dover's powder, with a couple of grains of calomel, 
given at bed-time, and followed in the morning by a dose of castor-oil or 
infusion of senna, will expedite the cure. Whilst the person is confined 
to bed under the influence of the hot applications to the back, it will be 
advisable to give warm diluent drinks tolerably freely. In severe cases 
the safest plan is to have medical attendance, if possible. Should the 
urine be scanty or high-colored, 10 grains of carbonate of potassa, with 
a teaspoonful of sweet nitre, may be taken in a wine-glassful of water twice 
a day, with advantage. Persons liable to attacks of lumbago should 
wear a flannel belt round the loins. (See Rheumatism, Clothing, 
Flannel.) 
LUMBAR, lum'-bar [Low Lat. lumbaris; Lat. lumbi, the loins], 
belonging to the loins. The term is frequently used in connection with 
abscess. In children of weak and scrofulous constitution, abscess in the 
loins, or "lumbar abscess," is apt to occur, and is often connected with 
disease of the vertebrae, or bones of the spine. Continued complaint of 
pain in the back, with any awkwardness in walking, particularly if accom- 
panied with failure of the general health, should awaken suspicion, and 
give occasion for the child being examined by a surgeon. Lumbar 
abscess may occur in adults. (See Abscess.) 
LUMBRICUS, Lum-bre-kus [Lat. for slippery], a worm. Applied 
to the large round worms which occur in the intestines. (See Worms.) 
LUNACY. (See Insanity. ) 
LUNAR CAUSTIC, lu'-nar kaws'-tik [Lat. luna, the moon], a term 
applied to nitrate of silver, cast in sticks, and used by surgeons for 
cauterizing purposes. (See Nitrate of Silver.) 
LUNATIC ASYLUMS. (See Insane Asylums.) 
LUNCHEON, lunsh'-un, a kind of intermediate meal, and therefore 
sometimes an unnecessary one. Many laborers have lunch between 
breakfast, and dinner, and again between the latter meal and supper. 
Many of the commercial and professional classes, and people of leisure 
are apt to make luncheons a kind of dinner-a meal of animal food and 
stimulants, which, if superadded to dinner, is certainly unnecessary, and 
therefore productive of disorder. Either the luncheon should be made 
a bona fide dinner at an early hour, or it should be a meal without animal 838 
L UNCHEON-L UNGS. 
food-provided, of course, that an additional amount of animal nutriment 
is not considered necessary by a medical man, as a remedial measure. 
Fruit is generally wholesome at luncheon. 
LUNG FEVER. (See Pneumonia.) 
LUNGS, lungz [Ang.-Sax. lunge\ the organs of respiration. The 
lungs are two, each occupying its own side of the chest, the left being 
rather the smallest, on account of the greater space being taken up by 
the heart on the left side. The latter organ is situated in the space 
between the two lungs, which are separated from one another by a middle 
partition. Air passes into the lungs by means of the windpipe, or 
trachea, to the top of which is fixed the larynx, or organ of voice; 
at its lower extremity, the trachea divides into two branches, or bronchi, 
of unequal length, one for each lung; these bronchi on entering the lung 
subdivide into branches, and these again into still smaller tubes, until 
after continued division and subdivision, they end in the air-cells. These 
air-cells are minute membraneous cavities, on the membraneous walls of 
which the blood circulates in a network of veins, in such a manner as to 
be brought into intimate contact with the air which is drawn into the 
lungs at each inspiration; nothing, indeed, intervening between the blood 
in the veins, and the air in the air-cells, but a membrane so thin that it 
allows the transpiration of the gases and vapor, which takes place as 
the blood becomes purified by means of this air contact. In consequence 
of their structure being adapted for the admission of air into numberless 
minute cells, the lungs feel spongy when pressed between the fingers. 
Those who are curious on the point, will learn more from five minutes' 
examination of the lungs and windpipe of a sheep or calf, in a butcher's 
shop, than from any description. In these, however, the mode of death, 
by bleeding, gives the lungs a much paler color than their natural one. 
The tubes, the air-cells, the blood-vessels, etc., of the lungs are held 
together by "cellular" tissue, and the entire organ is enveloped by a 
membrane-the "pleura"-which covers its surface, and is thence 
" reflected " to cover the inner surface of the ribs of the chest; in this 
way forming a shut pouch, or sac, the inner surfaces of which are in 
contact, and these being in the healthy state perfectly smooth, and 
moistened with a lubricating fluid, they glide over each other in every 
motion of the chest. The trachea, and the bronchi at first, are com- 
posed of incomplete "rings" of cartilage, connected together by an 
elastic tissue; the former tube-the windpipe-as generally known, 
occupying the fore part of the neck, and lying in front of the gullet. 
The larynx or organ of voice, which is placed on the top of the wind- 
pipe, extends to the base of the tongue; its situation is often strongly 
marked in thin men, especially if somewhat advanced in life, when it LUNGS. 
839 
forms the prominence popularly called "Adam's apple." This prom- 
inence is caused by a cartilage which forms a main portion of the body, 
or box, of the larynx. Into the composition of this wonderful instru- 
ment of articulate and vocal sound, various other cartilages, ligaments, 
muscles, etc., enter, and the whole is lined by a continuation of the 
mucous membrane of the mouth, which after passing through the larynx, 
lines the trachea, or windpipe, and follows the branchings of the bronchi. 
The cavity of the larynx is divided by a constriction of a triangular form 
-the glottis-and is protected from injury by a heart-shaped cartilage- 
the epiglottis-which, especially in the act of swallowing, -when the 
larynx is drawn upwards, completely closes the opening. 
From the above slight sketch, the general reader may derive some 
idea of the important organs of respiration. To recapitulate : situated at 
the base of the tongue, and protected from injury by the cartilage of the 
epiglottis, is the larynx, constricted in the centre, and ending in the tra- 
chea, or windpipe, which, descending in front of the neck into the chest, 
divides into the right and left bronchi; these, entering their respective 
lungs, divide and subdivide, till the minute branches enter the air-cells, 
on the thin walls of which the blood circulates in a network of veins, and 
undergoes purification by absorption of the oxygen of the atmosphere, 
whilst it frees itself from carbonic acid and watery vapor. 
The act of respiration is partly involuntary-that is, goes on, as 
duiing sleep, independent of any exercise of the will; it is, however, as 
all know, capable of being, to a certain extent, controlled by the will; 
this being, doubtless, a necessary adjunct to the power of the utterance 
of sound. The process of respiration is essentially effected by means 
which enlarge the capacity of the chest: these means are the various 
muscles attached to the ribs, and which by elevating them, increase the 
diameter of the chest from before backwards (see Chest), and also the 
diaphragm and muscles of the abdomen, which, by their downward and 
outward motions, increase the capacity of the chest from below ; the 
enlargement of the chest by these agencies, either in combined or sepa- 
rate action, has the effect of causing the air to rush in, or to be sucked 
into the chest, as it is into a pair of bellows. If the cavity was empty, 
it would rush into it; as it is, it rushes into the spongy distensible lungs 
and distends them, it may be assisted in some degree by the action of 
the lungs themselves. The air having been thus drawn into the chest 
by an active movement, is immediately thereafter expelled by a com- 
paratively passive one; the active- muscular movement ceasing, the ribs 
descend, and regain their position, by their own weight and elasticity. 
The movements, however, both of inspiration and expiration, may be 
increased-forced-by the will; and in this case, other muscles are 840 
L UNGS-L UNG WORT 
called into action, and those usually employed in the process are more 
strongly exerted. It is the necessity for these forced efforts in the asth- 
matic, which, after the frequent repetition, gives the peculiar curve of 
the shoulders so often observable. The average number of respirations 
in a minute varies from fifteen to twenty-two in different individuals, and 
even in the same at different times. The end of the process of respira- 
tion-that is, the change undergone by the blood, in consequence of its 
exposure to atmospheric air in the lungs-has been sufficiently entered 
into in articles Aeration, Blood, Circulation of the Blood, Respira- 
tion, etc. ; it is therefore unnecessary to repeat it here. 
The passage of the air into and through the lungs, gives rise to cer- 
tain definite sounds perceptible to the attentive ear applied closely to the 
outside of the chest. These sounds vary but slightly in healthy indi- 
viduals; consequently, any deviation from them is indicative of disease, 
experience furnishing the link which enables the physician to pronounce 
upon the nature of the disorder, from the nature of the sound, or from 
its entire absence, which latter condition occurs, either when the lung is 
rendered so solid by diseased action, that air cannot penetrate its tissue, 
or when it is condensed-pressed together-by the presence of fluid 
within the chest. Moreover, it is evident, that organs like the lungs, 
which in their natural healthy state, are distended with air, must, when 
the side of the cavity within which they are contained is struck, give out 
a somewhat hollow sound; but that, should the lungs become solid, or 
the cavity more or less filled with water, the sound, instead of being 
hollow, will be dull or flat. It is further evident, that the power of con- 
ducting sound must be altered by the various alterations in the structure 
of the lungs, and that the voice must sound differently to the ear applied 
to the chest, according to these alterations. These brief observations 
will, perhaps, convey to the general reader, some idea of the means of 
judgment, and of the principles on which they depend, which the physi- 
cian avails himself of when he goes through the-to the unprofessional- 
somewhat mysterious-looking process of physical examination of, or 
sounding the chest. 
The narrowness of the triangular chink in the larnyx, through which 
the air passes, always renders disease of this organ a matter of anxiety 
and of danger, for that small opening cannot be obstructed for three or 
four minutes, without death ensuing. For particular diseases of the 
lungs, see Asthma, Consumption, Hemorrhage; Bronchitis, Acute; 
Bronchitis, Chronic ; Pleurisy, Pneumonia. See also Carbon, Carbonic 
Acid, Respiration. 
LUNGS, BLEEDING FROM. (See Hemorrhage.) 
LUNGWORT. (See Pulmonaria Officinalis.)