MEDICAL DICTIONARY

and may be employed for a similar purpose. Bi-bora to of soda, or borax, is an excellent antiseptic agent and is m specially useful combined with honey and glycerine the treatment of thrush in children, and also in the aphthous sore throats of adults. Chloride of sodium or common salt, is one or the most useful agents which we po e , as from it the stomach derives the hydrochloric acid which is e ential to the gastric juices Bromide of sodium, again, is frequently employed in the treatment of hooping-cough, as it po e es valuable antispasmodic properties. Salicylate of soda lias recently become a most valuable medicine in the treatment of rheumatic affections, some preferring it to salicine itself. Somnambulism, or Sleepwalking, is due to an unhealthy condition of the nervous system brought by the presence of some irritating matter, usually within the alimentary canal. This excites the nervous centres to a state of unnatural activity during the epoch of sleep, or rather it should be said that sleep is disturbed by a species of wakefulne . As a rule, somnambulism is a ociated with dyspepsia of one form or another, or a constipated state of the lower bowel these causes being removed, therefore, will; usually result in the ce ation of this disagreeable and sometimes dangerous manifestation. Sore Throat may be of several varieties, such as relaxed throat, catarrh of the throat, tonsilitis or quinsy, diphtheria, scarlatina, etc., but in this paragraph quinsy or tonsilitis accompanied by a rheumatic condition of the blood will be specially considered. As is well known, certain individuals are peculiarly liable to this affection, but invariably these are of a rheumatic diathesis, and} the inflammation which exists very frequently develops into an absce within the tonsils, causing most excruciating pain on any attempt at swallowing, accompanied by high fever, and liable to be succeeded by acute rheumatism after it has disappeared. It is invariably ushered in by a feeling of shivering, great prostration, and considerable fever, together with a very furred tongue, and constipated state of the bowels. Whenever quinsy is suspected to be threatening, following:—Salicine the best remedy to administer internally is the and chlorate of potash, ounces— of each 2£ drachms guaiacum mixture, 6 de ert-spoonful to; be given every two hours to an adult, and a teaspoonful to a child eight or ten years of age every two hours. At the same time the system should be well kept up by a stimulating and nutritious diet, port wine being especially beneficial, and egg flip, strong chicken soup, beef juice, and plenty of milk being amongst the most valuable forms in which nutrition can be administered. If these measures are energetically and promptly adopted, the disease will frequently be cut short and an immense amount of suffering (prevented, while at the same time the aftereffects will be annihilated. It is a great mistake to think that quinsy can be averted by the old-fashioned and obsolete methods of treatment which have been, and at the present day are yet frequently prescribed, such as mustard and linseed meal poultice, blistering, gargles, etc. Aconite, however, has been and frequently is still employed in the treatment of these affections, and no doubt proves very beneficial when there is no specific disease present This remedy has many advocates, and no doubt has been specially useful in ordinary congestive attacks of the throat. It, however, simply acts by its effect upon the circulation, thereby reducing the tendency to congestion and favouring resolution without the inflammation having proceeded to suppuration. Its benefits, however, are not nearly so great as those conferred by the administration of the guaiacum, chlorate of potash, and salicine mixture, before mentioned. With regard to the local applications which are made by means of gargles, these, it must be confe ed, have a certain beneficial effect by the astringent properties which they usually po e , while, if combined with some antiseptic, such as sulphurous acid, carbolic acid, or vinegar, they may act directly ns destructive agents to the poison which is exerting its influence in the developing of the inflammation, and therefore on this account they are not to be deprecated, but at the same time I \yould insist that they must not be depended upon. Quinsy, tonsilitis, or sore throat, ill any form whatever, is usually secondary to a lowered condition of the vital powers and this is, as a rule, if not directly due to, dependent; for its start upon a constipated condition ol the lower boweL Sound, or Sounding, is a term applied... to. the investigation by the ear of the condition ot the various organs contained in the cavities of the body, especially those of the chest. (See Ear.) Spasm is a painful contraction of the voluntary m or involuntary muscles of the body, such as cramp the legs, colic of the bowels or womb, angina pectoris when the heart is alFectod, of the biliary duct when gall stones are present, or of the ureter when a calculus is pa ing from the kidneys towards the bladder. It is characterized by sudden agonizing pain in the region of the part affected, which in a short time subsides, but only to be renewed when further muscular action is brought into play. The very severe pain that is induced in any form of spasm makes it important to rocure speedy relief, and this can only be obtained y the action of some narcotic anti spas in odic agent. Among the most useful and universally beneficial ot which in these circumstances is the subcutaneous injection of morphia next to this, the frequent application of very hot fomentations; freely sprinkled over with laudanum, and afterwards the administration of opium by the mouth, or the administration of chloroform by inhalation. If the spasm is in the alimentary canal, any local or constitutional remedies that may be applied should invariably be followed by the free administration of a purgative. If, on the other hand, the gall duct is the seat of the disorder, together with the subcutaneous injection of morphia and the local application of opium, olive oil should be administered in large and frequently repeated doses. If the ureter is the seat of disease, ana the calculus is pa ing from the kidney to the bladder, great benefit may often be derived by setting the patient in a hot si tzbath for a considerable period, at frequently repeated intervals. If the heart is affected, as it is in angina pectoris, the greatest benefit will be derived from the inhalation of nitrate of amyl, or the administration of this substance combined with nitro-glycerine in minute doses, while and the condition of the stomach should be carefully attended mouth—the to, and antispasmodics administered by the niost most valuable of which are chloric ether combined with a ram on i a ted tincture of valerian. There spinal is another form of spasm which frequently attacks to children, especially if the digestive organs or bowels lower are out of order. This is called spasmodic or spurious This croup, and will generally be relieved by the admin is diminishing tration of a good dose of castor oil, while the upper spinal part of the chest and throat should be well rubbed with which an antispasmodic liniment, such as the following:— outwards, Liniment of soap and opium, liniment of belladonna, and and compound camphor, of each equal parts—a little and of which should be well rubbed into the throat and body, upper part of the chest every two or three hours. and Spasmodic Diseases are characterized by curve involuntary contractions of the various muscles, e.g. becomes lockjaw, which causes contraction of the muscles of As the face; St. Vitus’s dance, where the patient is unable two to direct the voluntary movements in consequence of hare-lip), spasmodic contraction of the muscles which he wishes halves to bring into play. Colic is a spasm of the muscular neighbourhood fibre of the intestine. Gall stones produce spasmodic lining contraction of the muscular structure contained in the the gall duct. Gravel also causes this affection in the distends muscular ti ue contained in the ureter. Cramp is looking another form of spasmodic disease, but the greatest termed development of this affection is found when epilepsy sidered is present in an individual. An epileptic convulsion is operative neither more nor le than very strong spasmodic concan yujsions of the various muscles of the body, due to integrity irritation at the base of the brain. Spine Spectacles should always be selected under the falls supervision of a competent optician, who will be able occur to adapt the lenses to the various peculiarities which sequence the Speculum individual may be subject to. effects LS.an instrument largely used in the are—depre ion diagnosis and treatment of diseases oi the internal or organs, especially those of the ear. nose, bowel, and which womb. As these have no special interest to the public below at large, it is quite unnece ary to go into details with regard to any of them. Spermaceti Is a hydro-carbon very much resembling in its composition paraffin wax. It is found in the head of the sperm whale, and is employed largely in the preparation of ointment, pomades, etc., as it is po e ed of no odour. Spinach is a wholesome as well as a nutritious vegetable, and, as a rule, is easy of digestion. The taste for it, however, is always an acquired one, and in consequence of its peculiar llavour it is not a general favourite. Spine, or Spinal Column, is a chain of twenty-iour bones which enter into the composition of its structure. They are arranged and fitted to each other in such a way as to permit the most extensive motion of the trunk of the body in all directions, and at the same time enable it to retain its equilibrium. Besides being the means of keeping the body erect, it acts the important part of a shield for the spinal marrow, protecting it against the most violent shocks and concu ions. From between the various bones which constitute the vertebral column the different nerves are given off for the supply of the upper limbs, trunk, and lower limbs. Each vertebra has its peculiar characteristic marks i and can be recognized from its appearance by any one who understands anatomy. The vertebral column is divided into several sections, such as the cervical vertebrae, the two upper of which are most especially concerned in supporting the head the uppermost of these is named the ' atlas,' on which; the head moves in the performance of its movements forwards and downwards, and backwards and downwards. The second vertebra, called the ‘ axis,’ rests upon the bony ring of the atlas, and is kept in its position by strong ligamentous bands which run acro from one side of the ring of the first vertebra to the opposite side, and cro the tooth-like proce of the second vertebra binding them firmly together. By this arrangement the head is [enabled to move from side to side as well as from before backwards. When the neck is broken in the proce of hanging it is the tooth-like proce of this vertebra which pre es forward upon the spinal cord thus extinguishes life. In all, there are seven vertebrae in the neck, the seventh or last being the prominent of all, and is therefore called the * vertebra prominens. The next subdivision of the column is the dorsal portion, which gives support the ribs. After this come the lumbar vertebrae, the of them resting upon the sacrum, which see. is composed m of a series of vertebrae gradually breadth, but moulded together. The column is not straight, but has various curves are natural to it. The principal of these is one which increases the capacity of the chest, one which tends inwards at the small of the back, these a ist in maintaining the equilibrium of the and also in supporting the viscera of the chest abdomen. As a rule, there is generally a slight towards the right side, which when aggravated transformed into lateral curvature of the spine. the spine, like the rest of the body, is made up of lateral halves, it may (just as in the formation of from an incomplete union of the two primordial of the body, at times remain deficient in the of the loins, by which the membranes the spinal canal are left unprotected except by skin, and the fluid accumulating at this region the membranes and skin, and forms a lividbag full of semi-transparent fluid, which is ‘spina bifid a.’ At one time this was con a fatal malformation, but at present, by measures being skilfully adopted, the tumour frequently be completely annihilated, and the of the canal re-established. Concu ion o/tho is not an unfrequent result of a severe injury from on the feet or on the back directly. It may also from severe blows upon the back, and in con of this latter fact it frequently arises from the of railway accidents. The usual symptoms of the whole system, with a complete incomplete lo of power in the portions of the Gody are supplied by nerve6 i uing from the spine the seat of the injury, and occasionally acute PEARS' CYCLOPAEDIA. pain comes on in the lower limbs. The organs supplied uy these nerves are also liable to be interfered with, such as the bowel and bladder, which frequently lose all power of retaining their contents, and thus add very much to the distre of the patient. Until medical aid can be procured, the best thing to do in the circumstances is to place the patient carefully in the recumbent posture, and keep him perfectly quiet. Any inflammatory action which may supervene upon such an accident will require the usual treatment, such as leeching, cupping, fomentations, poultices, the application of soothing liniments, etc. The bowels should be kept active by means of purgatives or enemata, as the case may seem to warrant. Patients who are suffering from injuries of the spine, by constantly lying in one osition, are very liable to be affected with bed-sores. F t is therefore desirable that a water-bed be procured, which will not only add to the comfort of the patient, but at the same time reduce the tendency to bed-sores to a minimum. Surgical measures can frequently be employed now that antiseptic surgery is so well understood, and by these means pre ure removed from any portion of the cord where it may be found to exist. If there is actual displacement of any of the vertebral bones paralysis must nece arily supervene, in consequence of the pre ure which is brought to bear upon the spinal marrow. Irritability of the Spine is a condition which frequently exists in hysterical and nervous women. It is diagnosed by tapping the spine, and when percu ion is applied to the point where the irritability exists the patient will complain of intense pain. This condition is usually a ociated with some diseased condition of the womb or ovaries, but local treatment by the application of an anodyne liniment or soothing plaster will afford considerable relief. Irritation of the spine is due to various causes, such as inflammation, rupture of the ve els within the cord, hardening or softening of the structure. Softening at the medulla oblong at a, which is that portion of the cord] nearest to the brain, is not an unfrequent concomitant, if not an actual cause, of epilepsy. The usual symptoms when the spine is irritated are—a disordered condition of the functions of sensation and motion, accompanied by twitchings of the parts supplied from the diseased portion of the cord. It is quite impo ible that any lay individual can treat such a disease; therefore, it is imperative that medical aid be called in with the least po ible delay. It would appear that lockjaw is invariably due to the poison of tetanus acting upon the spine. Cerebro-spinal meningitis in many instances would appear t® be an infectious disorder. This is accompanied by high fever, and is usually ratal. Curvature of the Spine is due to a diseased condition of the bones, and is closely allied to rickets. It is a ociated very intimately with tuberculosis. The treatment most to be. recommended when this unfortunate deformity exists is, to have the patient enveloped in a plaster of Paris jacket, and administer muriate of calcium in combination with the compound syrup of the hypophosphites three times a day after meals, and at the same time maintain the strength by administering freely a nutritious diet. The length of time that the jacket should remain on is about three months. Lateral curvature, on the other hand, is not usually a ociated with disease, but is the effect of the body being continually or repeatedly bent in the direction which the curvature a umes. Of course it is very liable to occur in those of a delicate constitution, more so than in the strong and robust. This deformity was much more common before attention was directed to its prevalence by those having charge of the educational establishments of the country, before which time children were permitted to sit at desks which were quite unsuitable to their requirements. Plaster of Paris jackets are here again most useful to remedy the mischief which has been in ignorance developed. Gymnastics should also be recommended, and carried out very thoroughly. Spirits, Low, are generally attributable to some functional or organic disease affecting the stomach, liver, womb, or ovaries. Spitting Of Blood may be from two sources, viz. the lungs, when it is termed ‘ haemoptysis or from the stomach, when it is named ‘ haematemesis.’ In either case i! is a symptom which requires very prompt attention. Until medical aid can be suminoneu, the patient should be kept perfectly quiet, and ice administered by the mouth, while eight grains of gallic acid mixed in half a wine-gla ful of water to which twenty drops of ehxir of vitnol have been added may be administered every two hours. If this does not succeed in arresting the haemorrhage, three grains ox ergotine combined with lifteen drops of liquid extract of hamamelis may be administered with elixir of vitriol every four hours It the haemorrhage proceeds from the stomach, great care should be taken with regard to the food that is administered, and this should be composed of the most digestible substances that can be given, such as peptonized milk, Valentine's or Wyeth's beef juice, raw meat, etc. Splint is an apparatus for keeping fractured bones —a in position. They can be made out of almost anything piece of wood, cardboard, or plaster of Paris, or starch laid upon a bandage and allowed to dry. Spongio Piline is a mixture of sponge with some other substance, such as cotton or linen, and afterwards covered with a waterproof substance such as india-rubber. It is frequently employed as an application when compre es or fomentations are indicated. Spra,in is the result of an accident, which either over-stretches or ruptures the ligaments surrounding a joint. The ankle and wrist are most liable to this accident. When such occurs it develops pain of a most excruciating character, which is immediately followed by considerable swelling of the part, and po ibly discolouration—the swelling and discolouration being due to the rupture of small ve els which supply the part which has been injured. If the discolouration does not show itself after the accident it will undoubtedly do so at a later period, and if the limb has been placed in a horizontal position this discolouration may spread to a considerable extent up the limb. Sprains may frequently be confounded with fractures, especially when the ankle is involved, as a small projection of the tibia and fibula, called in each case the * malleolus,’ maybe factured, and when this occurs it of course adds very much to the gravity of the accident. In a sprain, however, pure and simple, no such complication arises. The treatment that is suggested in sprains is that which will give the most immediate relief to the pain which has been incurred, and probably the most efficient method of treating this is by the application of four or six leeches over the seat of injury. The effect of leeches in such circumstances is very apparent and always beneficial—the pain will speedily subside, and the convalescence of the part be very much accelerated. If, however, the sprain has existed for a considerable time, leeches will not then be of the same service, and hot fomentations and soothing liniments may be applied at regular intervals, with a view of relieving the intense suffering that always accompanies the rupture of ligaments, which practically constitutes a sprain. After the liniment has been applied, a firm bandage should be brought to bear upon the parts which have been injured, both to promote absorption of the fluid that is being effused by the accident, and also to support the weakened joint. It is a mistake to keep a patient who has been suffering from a sprained joint too long in one position, as thereby stiffening of the joint is liable to result, so that after a day or two’s rest slight movement should be encouraged (at the same time retaining the bandage in position), with a view of strengthening the weakened parts. In about ten days or a fortnight aftenvards the joint should be placed under a douche bath, and afterwards rubbed vigorously with a rough towel, so as to stimulate the proce of absorption which must nece arily go on until the sprain is completely recovered from. Squill is grown on the banks of the Mediterranean, and is a bulb resembling in many of its external appearances an ordinary onion. It is a useful medicine in bronchitis and catarrhal affections of the chest, and is usually administered either in the form of tincture, syrup, or oxymel. It also po e es useful diuretic properties, which render it a useful adjunct to other me a i cines, such as digitalis, ipecac, etc., in diseases which are dependent upon a catarrhal condition of the lungs or chest. The following mixture, into which squill enters very largely, is most efficacious in bronchitis, viz. Ipecac, 3 drachms; chloric ether, 3 drachms chlorodyne. 3 drachms and syrup of squills to make; 3 ounces—a teaspoonful j of which is to be taken at frequent intervals when the cough is troublesome. Squint is due to a spasmodic contraction of the rectus muscle of the eye at one side or other. It is a most disfiguring deformity, but fortunately it is one that can at any time be removed by a simple operation. In technical language it is termed ‘strabismus.’ The method of operating for the cure of squinting is exceedingly simple, and with the a istance of cocaine can be performed without any suffering on the part of the patient. In recent years, before the discovery of cocaine, it was usually nece ary to place the patient under chloroform to enable the operation to be succe fully performed, and doubtle even at the present time this is preferable to cocaine. Starvation, or Abstinence from Food, may proceed to a very considerable degree without actual danger to life accruing. It is a well-known fact that we eat much more than our body requires for actual nourishment. It is also well known that we can live a longer period without food than we could without water. When starvation has proceeded to an undue extent and food again comes within reach, this should at first be partaken of very, very sparingly indeed, as otherwise tne individual may die from the effects of over-eating whereas, if food is given in very small and gradually-increasing; quantities, the stomach will become accustomed to it, and gradually We know acquire power to digest an ordinary meal. all the dreadful effects of famine and of the enormous death-rate that accompanies this dreadful calamity. If, however, the authorities in the districts affected were to take the precaution of husbanding all the food that they could annex, a great deal of life might easily be saved by giving this out in small but sufficient quantities to the afflicted people. Several experiments have recently been made on the human body to test its powers with regard to abstinence from food. Such experiments, however, should not be encouraged, as they are only carried out by men who court notoriety and make money out of their exhibition. The body is always provided with a sufficient amount of fat to enable it to retain its temperature under even extraordinary conditions, and if starvation is accompanied by a warm temperature, so that the animal heat can thus bo retained, an individual will be enabled to endure starvation with much le risk to life than otherwise he would be able to do. The fat of course goes first in every instance of starvation, this being consumed in nature’s attempts to retain the animal heat of the body. It may seem quite paradoxical to state that starvation very frequently occurs in the midst of plenty, but such is actually the case, for although a person partakes of quite a sufficiency of food to sustain him in ordinary circumstances, and keep him at the same time in good health, all things beine equal, yet, although digestion may go on pretty fairly under such circumstances, the organs of a imilation may be so deficient as to be unable to absorb the food, and thus render it useful in the maintenance of health. This condition is peculiarly apparent in tubercular disease, which attacks the glands of the abdomen hence wasting and debility supervene, notwithstanding; the fact that an abundance of nourishment may be taken by the individual. In the gradual starvation which occurs where food is deficient the symptoms usually commence by great depre ion of the nervous system, this being apparent in the ordinary sensations and mental powers of the individual. This, however, will invariably be accompanied by an irritable condition of the system, and po ibly some aberration of the mental powers. The physiognomy of the person becomes sallow and dusky, the eyes inanimate. and a general appearance of imbecility appears to exist. The stomach loses its activity, and thus the digestion, as well as the appetite, is impaired. Languor and despondency, with a disposition to sleep, from which he is apt to wake in a dreadful nightmare, usually are the symptoms which manifest themselves in star which vation. As is to be expected, there is a sensation of chilline , also breathle ne , palpitation, giddine , judicious middle layer is composed of muscular ti ues, whose movements are voluntary and continuous during the proce of digestion. It is by means of the muscular coat that the churning proce is kept up when food is undergoing digestion. The innermost coat is made up of mucous membrane, this being continuous with that of the gullet and mouth, and that of the intestines. The mucous lining Is drawn into folds or wrinkles called ' rugae,' which extend longitudinally. When the organ is at rest this lining membrane is of a pale pinkish colour, but whenever its functions are called into exercise it becomes much reddened by the increased supply of blood which it receives to enable it to secrete the gastric iuice in sufficient abundance for its requirements. The chiet disorders which the stomach is liable to are—indigestion, gastralgia or neuralgia of the stomach, gastritis or inflammation of the stomach It is also A liable to organic disorders, such as cancer and ulcer. blow over the region of the stomach produces intense prostration, pain, and a sensation of impending danger. This is evidently due to the fact that the concu ion affects the large nerve centres which lie immediately behind this organ. Stone is a term applied to concretions which form in the gall bladder and kidney. Stra.ini.ng at stools is invariably an indication of some irritable condition of the lower portion of the colon. This may arise either from constipation or a dysenteric condition of the bowel. (See Constipation, Dysentery.) Stramonium is a drug which is largely employed in the treatment of asthma. The most beneficial effects are derived from smoking the stems and leaves of the plant. It seems in asthma to exert a powerful antispasmodic effect. In the proce of smoking it should be inhaled as deeply as po ible into the lungs. It enters largely ipto the various preparations which are advocated for the treatment of asthma. Strangulation, when applied to the throat, invariably results in suffocation, in consequence of the circulation of air being interfered with therefore, the patient dies if the strangulation is continued; for even a very short period. The term is also applied to hernia or rupture, when the gut is said to become strangulated, and the part that is protruding becomes constricted and cut off from the neighbouring portion of the gut, when, as a consequence, gangrene of the ruptured portion is liable to occur if it is not speedily attended to. Stricture is a term which is applied to a contracted condition of various canals, such as of the urethra, the neck of the womb, vagina, etc. In the two Strychnine latter cases it is generally called atresia. is one of the most powerful tonic remedies which - we po e in muscular and nervous atony. Its poisonous effects are first of all apparent upon the muscles controlling the movements of the jaws, afterwards upon those of the chest, and lastly the muscles of the limbs become affected. As it is well known, strychnine is a deadly poison when given in lethal doses; at the same time, it is one of the most valuable medicines contained in the pharmacopoeia. It is especially useful as a subcutaneous injection in certain forms of paralysis which are not due to organic disease. It is also employed in this method in chronic alcoholism or dipsomania. Doubtle , in this respect it po e es properties which few other drugs can po ibly lay claim to. It is also a valuable nerve tonic, and may be given with great advantage in certain forms of dyspepsia and muscular atony. Its effects are not only manifest upon the voluntary, but also upon the involuntary muscles hence it becomes a useful agent in promoting a -healthy; action of the involuntary muscles, such as those of the heart, bowel, womb, bladder, etc. The dose of strychnine for an adult is one-twentieth of a grain, which may be repeated three times a day, while for a child from eight to twelve years of age one-fiftieth to one-thirtieth of n grain will be found quite sufficient. Stye is a pimple which forms upon one or other of the eyelids and proceeds to suppuration, sometimes giving rise to considerable inconvenience and constitutional disturbance. Invariably it is the result of a low state of the general health. With a view to arrest the progre of this disagreeable affection, the best