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the forms of British gymnastics, should be adopted as regular habits.

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Purgatives, I have generally found, not needed in the plethoric form; the bowels usually act once or twice in the day. But in the asthenic obesity of old people, where the abdominal walls are weakened by long pressure of an unnatural weight, it is necessary to employ them.

"But there is one class of medicines so universally applicable to all cases of obesity that I think a trial should never be omitted. The chemical affinity of alkalies for fat, point them out as appropriate alteratives in this complaint, and experience proves that they are suitable to the state of the digestive organs. The most eligible one is liquor potassæ, and it may be administered in much larger quantities than any other. If given in milk and water we may safely commence with half-a-drachm, and raise the dose to a drachm and a drachm and a-half, three times a-day. The milk covers the taste of the potash better than any other vehicle. It has, truly, the advantage of saponifying a portion of the remedy, but there is no evidence to prove that its efficacy is thereby endangered; indeed, soap itself has been strongly recommended."

Vinegar, which is sometimes foolishly taken largely, with a view to reduce fat, can only do so by disordering the digestive organs.

Food of a fatty nature is generally difficult of digestion. As a remedy in the cure of disease, the fats of various animals, deer, vipers, &c., were formerly used in medicine. In some cases of irritability or low inflammation of the lining membrane of the stomach, fatty food seems to be serviceable.

Refer to-Axunge- Bacon-Digestion Food, &c.

FATUITY.-Mental imbecility. FAVUS.-A peculiar skin disease, generally developed on the head, but occasionally elsewhere, and remarkable from the yellow cupped scabs being the site of development of a minute fungus.

FAUCES. THE GORGE.-The space and its sides between the back part of the tongue and upper part of the gullet.

FEAR, the exact opposite from faith, is one of those depressing agents which always acts unfavourably 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, heartdisease, &c., date from fright. In children, particularly of a nervous temperament, the influence of fear, either in jest or earnest, is most seduously 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 practised, 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. Further, if a child has been systematically frightened about the dark, &c., it may, if accidentally placed in it, suffer serious injury from fright.

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FEBRICULA-A slight fever.

FEBRIFUGE.-Any medicinal agent which has the power of subduing fever. The term was much more used in former times than it is now.

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FECULA, or STARCH, is a principle universally diffused throughout the vegetable kingdom, nearly approaching gum in composition; it is found in various parts of plants, where it is evidently destined to be a store of nutriment for their young or newlydeveloped parts; thus, in seeds it nourishes the young plant; in tubers, such as the potato, the bud shoots; in the sago palm, the young leaves. Before, however, it can afford suitable nourishment, it must be converted into sugar, and this is done by the influence of diastase, a substance already treated of. It need scarcely be said that whilst starch fulfils its peculiar office as regards the vegetable, it is a no less important provision for animal wants; it is in short one of the chief elements of nourishment derived from the vegetable kingdom for the support of animal life. Amid other examples, arrow-root is nearly pure starch. Starch occurs in the form of granules, which vary considerably in size and shape, according to the tribe of plants from which they are obtained; of this figs. A, B, C, D, are instances; these represent

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B

C

D

respectively the starch granules of West India arrow-root, East India arrow-root, Tahiti arrow-root, and potato arrow-root,* commonly called British arrow-root. These granules are composed, as represented, of concentric layers, the outer of which, when exposed to a temperature of 160° in water, burst, and allow the inner layers to be dissolved, consequently starch of any kind, after exposure to the above heat, can never be restored to its original condition. It is scarcely requisite to remark, that starch is insoluble in cold water, differing in this respect from gum.

The composition of starch is simple, that is to say, it is made up of carbon and water, or carbon and the components of water, oxygen and hydrogen, but it contains no

• Lancet Sanitary Commission.

From this it

nitrogen, no earthy matters. is evident that the nourishing power of starch, and of starchy articles of food generally, is limited, that is to say, they cannot yield what they do not possess, nitrogen and earthy salts; but as these are requisite for the full nourishment of every portion of the frame, starchy food, either alone or in too great preponderance, cannot sufficiently nourish the body, particularly during the period of growth. This will bear out remarks made under articles "Arrow

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root, "Bread, &c., which show that animals may be starved to death if fed on starch alone, or articles principally composed of starch, and that through ignorance of these facts, infants and children have been seriously injured by the improper regulation of their food. But though starch, and such-like compounds, such as sugar, gum, &c., cannot build up bone and muscle, they can protect them, they can furnish respiratory aliment, or fuel, and also, when not thus required, assist largely in the formation of fat.

Refer to Animal Food-Blood-Digestion, &c.

FEMORAL ARTERY.-The great artery of the thigh.-See Artery.

FEMUR.-The thigh-bone.-See Thigh

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bone.

FERMENTATION is a process of decomposition, or of change, in the relations of the various elements of fermentable bodies. For the action of this process of decomposition or of fermentation, it is indispensable that certain "azotized" substances, named ferments, should be present. These substances all belong to the albuminous principles; bodies which in a moist condition putrefy and decompose spontaneously. Thus, a solution of pure sugar will not ferment however long it may be kept; but if a decomposing-putrefyingazotized ferment, either animal matter or vegetable albumen, or gluten, or yeast be added to the solution, the change quickly commences, and goes on until fermentation is complete. Vegetable juices, such as that of the grape and others, and even a solution of brown sugar, take on the process of fermentation spontaneously, because they contain sufficient azotized principles-approaching the putrescible albuminous animal matter in composition-to act as ferments. Milk also takes on a spontaneous process of fermentation for the same reason, but it is not the alcoholic; no gas is evoked, and instead of spirit, a peculiar acid, the

"lactic

is generated. Temperature, moreover, exerts much influence upon the process of fermentation, and some juices yield

either alcohol or lactic acid according to whether the process is carried on under a low or high temperature. The acetous fermentation or that which results in the production of acetic acid, or vinegar, is carried on in a temperature of from 70° to 85° Fahr., and of course likewise requires the presence of a ferment. A certain amount of moisture and elevation of temperature are essential to the process of fermentation; dryness and cold alike stop the action.

"The identity in composition of the chief constituents of blood, and of the nitrogenized constituents of vegetable food, has certainly furnished, in an unexpected manner, an explanation of the fact, that putrefying blood, white of egg, flesh, and cheese, produce the same effect in a solution of sugar as yeast or ferment."

The explanation is simply this, that ferment or yeast is nothing but a vegetable principle, resembling these animal ones, in a state of decomposition. As it is that modification of sugar only, named grape sugar, which is capable of being converted into alcohol; all fermentable substances, whether containing cane sugar, or starch, must be, and are, as the first step of the process, converted into grape sugar. Antiseptics stop the process of fermentation.

"The maturation, as it is called, or sweetening of winter fruits, when stored up for their preservation in straw, is the result of a true fermentation. Unripe apples and pears contain a considerable amount of starch, which becomes converted into sugar by the nitrogenous constituent of the juice passing into a state of decomposition, and transmitting its own mutations to the particles of starch in contact with it."*

Refer to- – Alcohol-Antiseptic-Vinegar, Yeast, &c.

FERMENTED LIQUORS, that is, beverages 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. Ancient records, including those of scripture, all tend to shew that fermented liquors have been known and used from the earliest periods. In the present day, the principal fermented liquors in use are-1. Grape wines;

*Liebig's Letters on Chemistry.

2. Domestic or home-made wines, which are for the most part rendered fermentable by the addition of sugar; 3. Liquors made from the fermented juice of the apple or pear; 4. Malt liquors from various grains, principally barley. For further information the reader is referred to the individual articles on the above subjects, also to Drinks, Food, &c.

FERN, or MALE FERN,-or as it is called in botanical language, the "Aspidium Filix Mas," is a common native plant, noted principally as a remedy in tape worm, but until lately too much neglected. It is probable, that if given with the same care and precaution, it might not be found inferior to the now celebrated Kousso. The male fern -fig. A-grows chiefly on strong ground, in slightly-shaded situations; no description could guide an unprofessional and unbotanical person to gather it with certainty if it cannot be recognised from the figure—

A

A-but, perhaps the safest plan for any one wishing to use it, would be to have the plant either collected for him, or both it and its distinctive characters pointed out by some competent person. Dr. Christison gives the following directions :-The root, which is the part of the plant used, should be collected between the end of May and the middle of September. It should be cleared of foreign matters, root fibres, and old or decayed tufts, but without being washed. It should then be dried quickly and thoroughly in the open air without heat, and in the shade; these tufts, as well

as the parts of the root-stock, which are greenish internally, should alone be detached, and immediately reduced to powder; and the powder must be kept in wellclosed bottles." It should not be trusted to when above one year old. The usual dose of the powdered root, is from one to three drachms; but the oil extracted by means of ether is the best preparation, the dose eighteen grains given at night, either in pill, emulsion, or mixed with castor-oil, and repeated again in the morning. It is better to avoid much food just before taking the dose of either powder or oil, or during their operation, and it is always requisite to follow the last dose taken with some aperient-castor-oil is perhaps the best-two or three hours afterwards. The worms are discharged dead.*

Refer to-Kousso-Worms, &c. FERRUGINOUS-connected with iron. FETOR-is a bad odour of any kind. In many cases it is the result of the process of putrefactive decomposition or fermentation, and may be developed either on the external or in the internal parts of the body. The use of chlorine, or of chloric ether, in various ways is the best corrective. The mercurial fetor is a peculiar odour, always acquired by the breath when the constitution is sensibly affected with mercury.

Refer to-Chlorine-Mercury, &c. FEVER is that condition 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.

Further, 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 two last only we have to do at present, the others fall to be considered under their own heads. Remittent fever may be regarded as an aggravated form of intermittent fever or ague; it has the regular succession of hot, cold and sweating stage, but the interval between the paroxysms is not characterised 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. Under these

* A case of tape worm successfully treated by male fern, is recorded in the Lancet, for March 6th, 1852.

circumstances, it would answer no good end here to devote more space to the subject, further than to advise all who are about to reside in hot climates, to inform themselves thoroughly on this as well as other matters connected with the preservation of health, and also on the nature and management of the diseases in and connected with their future home.

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 assistance 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 domestically. 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 powers either in the duties or pleasures of life, is easily tired, sleep is disturbed, 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 100, the tongue is furred, probably brownish and dry, sleep is disturbed 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 terminates 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 consequence, and lies in a state of dreamy muttering, there is convulsive starting of the fingers or other parts of the body, picking at the bedclothes, 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 forms of 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 recognisable, so that its general management 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, and our endeavour must be to place these powers in the most favourable condition possible for the struggle, and, where they appear to be insufficient, assist. Sometimes the constitutional power will throw off fever at the very onset. Probably, few medical men have not experienced in their own persons, when attending fever patients, that they had contracted the disease, and that after all its symptoms had been in course of development for four-and-twenty, or even eight-and-forty hours, it has been cast off, probably, by perspiration or diarrhoea, and health restored. From this almost ephemeral attack, to the week after week of continued fever, the disease may be thrown off at any period of its course. A person attacked with fever, ought to be placed in as roomy and well-aired a situation as possible, 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; if nourishment is taken, it should be given in moderate quantities, and consist principally 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 favourable issue, with much more certainty than under a more meddlesome treatment, care being taken when signs of amendment shew 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; violent delirium may require the treatment pointed out under the article devoted to the subject; difficulty of breathing and cough may render a blister on the chest desirable, or tenderness of the bowels on pressure, particularly in the right iliac region-see Abdomen-may call for the application of half a dozen leeches. Diarrhoea may require to be checked-see Diarrhea-or constipation removed by gentle aperients; castor-oil or rhubarb or senna will generally be found safest and best, or by clysters. Sleeplessness at night, with convulsive starting of the fingers, may require opium-see Delirium

or the general sinking of the powers, the pulse becoming feeble and easily extinguished, 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 frequentlyrepeated 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 waterproof 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 charcoal have been recommended for the same purpose, and where this article 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

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