and by daily constant gentle attempts at movement. ANEURISM-SEE ARTERY. terminate human life; it occurs more generally after middle age, and is more frequent in men than women. The attack is characterised by the sudden onset of agonizing pain, referred to the centre of the chest, or a little to the left side of it, passing through to the spine, up to the left shoulder, and down the arm of the same side even to the extremities of the fingers. Sometimes both arms are affected. Along with the pain, which is always said to be agony be of one of the usual pint bottles, should be taken, in divided portions, daily, or a couple of glasses of port-wine, if the former disagrees. An anæmic patient ought to retire ANGINA PECTORIS, OR SPASM OF to rest by ten o'clock, and to rise, as a THE HEART, is one of the most formidgeneral rule, by half-past seven, but oughtable and painful of the affections which never to delay breakfast beyond the mere time required for dressing; going out before the meal is quite out of the question, and, indeed, in some cases, where there is a tendency to fainting, it is better to have a cup of coffee, or warm milk, before rising, and, even to this, as a temporary remedy, it may be requisite to add a teaspoonful of brandy. The skin must be attended to, but by tepid sponging only. The bed should be a hair mattress. Exercise in the open air on foot or horseback, must be regular, but not car-yond description, there is a sensation as of ried beyond comfortable fatigue. Change of air to the sea-side, or to a chalybeate spring, is of great service. Mothers are often anxious about the non-appearance of the monthly discharge; its absence is but a symptom of the disease, and it is better that the constitution should not be drained even by it, until it is able to support it. Such are the general rules respecting anæmia, but a confirmed case should always be submitted to the medical man--causes may be aggravating, or effects such as consumption, springing from the disease, which he only can detect. Moreover, in extreme cases of this disease, sudden death has occurred. Refer to Chalybeates-Iron, &c. ANESTHESIA.-Loss of sensation. ANALYSIS.-The art of separating and distinguishing the various constituents of a compound body, either as regards quality or quantity. In judicial inquiry, it is most important, and were its power and perfection more generally known, the dread of almost certain discovery, would tend to check the too common crime of poisoning. -It is possible for the chemist to make the 1000th of a grain of arsenic demonstrable. ANASARCA.-See DROPSY. ANATOMY.-The science which treats of the structure of organized beings. It is divided under the heads of-General Anatomy, which regards the general features and relative position of the various portions of a body; and Structural Anatomy, which regards the intimate and microscopic structure of the various textures. ANCHYLOSIS.-Stiffening of a joint may be complete or partial. In the former case, it is best let alone; in the latter, much may be done to restore, by friction with oleaginous substances cod liver-oil, &c.by bathing the joint with warm sea-water A instant impending death. The paroxysm ceases as suddenly as it comes on. Angina pectoris may be preceded by warning symptoms, palpitation, shortness of breathing, indigestion, or it may come on unheralded by any of these, generally during some slight exertion, as walking up hill, or during strong mental emotion, but not unfrequently in the night, after the first sleep. An attack of angina pectoris is an emergency affecting life, to which there are few equal; full, instant, stimulation is demanded, and the first agent of the kind at hand must be used, till other remedies and proper assistance can be procured. glass of spirits and water as hot and strong as it can be swallowed, and with it, if procurable instantly, sixty drops of laudanum must at once be given. A strong mustard-poultice is at once to be applied to the front of the chest, and the same between the shoulders-hot applications to the feet. If the paroxysm be not subdued in a quarter of an hour, the stimulant is to be repeated with half the quantity of laudanum, and this again, after the same interval, if requisite. Spirits have been mentioned as being the most readily procurable, but when ether and sal volatile, either one or other, or both, are at hand, they are preferable, and must be given in just so much water as will permit of their being swallowed; a tea-spoonful of each with sixty drops of laudanum. A person who has once suffered an attack of angina should never be without these three requisites, laudanum, or better, Battley's sedative solution-ether-sal volatile. It is needless perhaps to say, that all these measures of an emergency in which not a moment is to be lost, are whilst waiting the arrival of the medical attendant, and that to him must be entrusted the direction of that regulated mode of life, which must ever be adopted after an attack of this disease. The treatment of the emergency it may be highly important for an unprofessional person to be acquainted with, that of the interval, which may extend to months or even years, with care, must be left in the hands of educated skill alone. The great resource, in whatever form is most advisable; it passes readily into and mingles with the blood, and affords an immediately available supply of carbon and hydrogen to keep the animal temperature going. regular, steady supply of wine when required in fever, must be kept up, and this cannot be too strongly impressed upon the mind of the attendant. Half an hour's nap on the part of the nurse may lose a life. But internal heat cannot do all in our cold clime, and with artificial modes of living, and it is of the utmost importance, especially in the young and delicate, to maintain the full temperature of the surface by proper clothing. The subject is one, respecting which much carelessness and ignorance prevails in all classes of society in this country, and children, half clothed for the sake of appearance, with bare chests and limbs, and exercise not sufficiently active to counteract the effects of the chill, are exposed to all the evils resulting from internal congestions of the blood repelled from the surface. Warm clothing is, in some respects a substitute for food, and either man or animal requires less nourishment when protected from cold. It is well known to agriculturists, that sheep or cattle will fatten more quickly under cover in winter, than if exposed to the weather. The reason is obvious, they are able to store up in their bodies, that which otherwise must have gone to keep them warm. When it is considered, that abstraction of animal heat, by cold and wet, is one of the most fertile sources of fatal disease, the importance of maintaining the full temperature of the body is manifest. It is well known that exercise is the best antagonist to cold, it is so, by quickening the respiration, and thus increasing the supply of oxygen taken in by the blood, which is also circulated more rapidly. In fact, to use the simile which compares the body to a stove, exercise gives a free draught for the process of combustion. Continued exposure to an extreme degree of cold, which carries off the animal heat more quickly than it can be generated, it is well known, gives rise to over-powering drowsiness, which, once yielded to, is death. It must be resisted, and when one of a party thus exposed is inclined to yield, the others must resort to every means calculated to rouse, even—as has been done,-by thrashing him along; the temper which is excited is a most excellent resistant of cold. Refer to ANIMAL HEAT is the temperature which every animal body is enabled to sustain, independent of surrounding media. In healthy men, the average temperature of the body is 98° or 99°, in some diseases it rises considerably. Whether our animal temperature is sustained in part from other sources or not, it is generally, now considered, to be chiefly due to the continual union of the carbon and hydrogen derived from the food, and from the bodily tissues, with the oxygen conveyed to every portion of the living frame, from the lungs, by the blood. One great fulfilment therefore of the food we digest, is to keep us warm, by the continual combustion of elements going on within us, consequently, persons who can consume and digest large quantites of food, have much greater power of resisting cold than those who cannot, and chilliness is one very constant symptom of impaired digestion; the stomach is unable to keep the system supplied with fuel. The point is one of considerable importance in the selection of crews for arctic expeditions, and ought to have some influence with intending emigrants in their choice of a future home. An individual who suffers from habitual weakness of digestion, ought to choose a warm or genial climate in preference to a cold one. Fats and oils especially, which contain much carbon and hydrogen, afford great protection against severe cold, accordingly all northern people, like the Esquimaux, consume them in large quantity, and Europeans travelling in northern latitudes have always copied the natives in this respect. Alcoholic fluids, like fat and oil, contain much carbon and hydrogen, but their stimulant properties, and more evanscent influence, render them unfit for ordinary consumption to sustain animal heat, although on extraordinary occasions they are invaluable. When from illness or any other cause, sufficient food cannot be taken to keep up a due temperature, fuel is supplied at the expense of the bodily tissues, more especially of the fat as the case is in hybernating animalsand if illness, such as fever continues, even the supply within the body threatens to fail, and the person is actually in danger of dying of cold. It then becomes imperative to get into the circulation as much "respi-culation-Food. ratory food," as much nourishment as possible, simply, as fuel. Much may be done by strong animal broths, but alcohol is the Aeration-Blood-Lung-Cir ANIMATION SUSPENDED is the term applied to that condition in which the life of the body is threatened, in conse quence of respiration having been stopped | or impeded, but in which there still exists a possibility of life being preserved. The chief causes of suspended animation, are drowning, hanging, immersion in choke damp or irrespirable gas, and intense cold. These may be referred to under their proper heads. ANISE-aromatic and carminative, is used chiefly in the form of the distilled water to correct flatulence in children, but is not so generally liked by them as dill water, which is equally efficacious. The dose is a tea-spoonful. The essential oil of aniseed is used to flavour mixtures, and is given in doses of five or six drops, for an adult, upon lump sugar. Refer to-Carminative. ANKLE, is the joint connecting the foot with the leg-fig. A-it belongs to the class, Fig, A. A of hinge joints, and is formed by the extremities of the large and small bones of the leg-fig A, 1 and 2-on the one side, and the smooth, "articulating" surface of a bone of the foot, named the "astragalus" on the other, the whole being kept in place by means of strong ligaments-4 and 5. The position of the ankle joint renders it peculiarly liable to injury-strain, dislocation, or fracture of the leg bones close to their extremities. Whenever the least suspicion exists that violence to the ankle has caused more than a sprain, no time should be lost in submitting it to the examination of the surgeon, such injuries are often extremely obscure, and there is much difficulty in making out their exact nature after swelling has come on. A simple sprain of the ankle, is to be treated in the mode directed to be followed in these injuries generally. In cases of dislocation, occurring at a great distance from medical aid, and when from the extreme distortion of the foot, the acci dent is distinctly apparent, some attempt ought to be made by those near to replace the parts; for this purpose, the sufferer being laid down, one individual should grasp the leg firmly just below the calf, whilst another, grasping the heel with his left hand, and the lower part of the instep with his right, endeavours, by extension in the first place, and slight turning of the foot towards its proper position, to reduce the dislocation. The ankles in children are very apt to become gradually distorted from weakness generally, and of the ligaments in particular, and the deformity is often not discovered until it has considerably advanced, the bones become altered in shape, and even the spine affected, from the habitual malposition of the body. The best general remedies are, attention to the general health and strength of the child, as directed in the article " Children," the prohibition of long standing, and enforcement of regular but moderate exercise. The ankles ought to be bathed every morning with cold salt water, and well rubbed afterwards with a rough towel. Many contrivances, boots of various kinds, &c., are, and have been used in cases of weak ankles; unless, in extreme cases, they are better avoided, and the case left to the gradual strengthening measures above recommended. If artificial supports supply the place of the natural ones, the latter will not regain the proper tone and strength essential for permanent cure. One of the many forms of elastic sock or stocking, may, however, be worn with advantage. In addition to the above means, considerable mechanical power may be exerted by making the inner, or outer margin of the sole of the boot-for cloth boots should always be worn in such cases-thicker or thinner, according to the nature of the deformity; thus, if the ankle be inclined to project inwards, the sole should be raised on the inner side, and vice versa Regular perseverance in the above mode of treatment will, in most cases, effect a cure without the more complicated contrivances often used. Attention, too, ought always to be paid to the habits of standing practised by the child. Children are sometimes born with ankles distorted. See Club feet. Refer to Dislocation-Joint-Sprain, &c. ANODYNES must be regarded as constituting one of the most benevolent provisions of the Creator for the relief of his creatures. The removal of pain by an anodyne, is like a breath of heaven. The more generally used anodynes are opiumbelladonna- aconite - conium-hyoscyamus-lettuce-hop-camphor. ANOREXIA.-Loss of appetite. ANTACID, in medical language, means whatever directly neutralizes acid secretions, more especially of the stomach and bowels. The principal antacids are potash, soda, ammonia, lime, chalk, and magnesia. The use of antacids can only be palliative, and their continued regular use is productive of serious mischief; they inevitably destroy the tone of the stomach, and aggravate permanently the evil they may temporarily relieve. Whenever antacids are frequently called for, it is a sign that there is other disorder, though perhaps less prominent, which must be looked for and cor rected. ANTIMONY is the metallic base of our antimonial preparations; of these, the most useful, are tartarized antimony or tartar emetic, antimonial wine, antimonial, or James's powder, and the compound, Plummer's pill. Of these, tartar emetic, the most powerful, is a remedy which stands without a rival as the controller of some forms of inflammation. A compound salt of antimony, potash, and tartaric acid, it is formed in crystals, but usually sold as a white powder. It is sufficiently soluble in water to be conveniently administered in that fluid, which should always be used soft or distilled: a simple solution of the medicine is preferable in most cases. In large doses, tartar emetic acts as a powerful irritant poison, causing intense nausea, vomiting, severe pain in the bowels, purging, bloody stools, and extreme general depression; and even in comparatively small doses, these effects are sometimes liable to be developed in degree, especially in children. Great caution, therefore, is required. In case of a poisonous, or overdose of tartar emetic having been swallowed, the best remedy is some astringent infusion, Peruvian bark, nut galls, or strong tea. There is considerable variation in the strength of the dose of tartar emetic, given by medical men; when, under necessity, it is dispensed by others, the sixth to the eighth of a grain only, should be given to an adult. A convenient form, is to dissolve two grains of the salt in half a pint of soft water slightly warmed, and of this, to give a table spoonful every three or four hours, so as to keep up continued nausea. Vomiting may follow the first dose or two, but after that, in most cases, the stomach becomes tolerant of the remedy. By giving tartarized antimony dissolved in a moderately small quantity of water, its irritant effects are less liable to be exerted upon the bowels, and should they come on, a few drops of laudanum, if otherwise admissible, must be given in some demulcent, barley or rice-water, and the demulcent alone continued as common drink. To children, tartarized antimony must be administered with great caution, and is better avoided by the unprofessional, except in the extreme cases, of croup, or severe inflammation of the lungs, plainly existing, and occurring at a distance from proper medical assistance. In the former alarming disease, tolerably full doses are required to make a quick impression upon the system, and to induce speedy vomiting. For a child of six or seven years, a single grain must be dissolved in an ounce of water, and a tea-spoonful of the solution, given either alone, or in a little water as drink, every quarter of an hour, till free vomiting is produced. In inflammation of the lungs, half the dose must be given; but this advice, let it be remembered, applies only to the severe diseases above mentioned, when occurring at a distance from medical aid. The practice of administering antimony to children, generally, is not well, unless under medical sanction, and in those of weak constitution may be productive of serious or fatal results. For a simple emetic, antimony is seldom well adapted, and should not be used when others are obtainable. ANTIMONIAL WINE is a solution of tartar emetic in wine, two grains to the fluid ounce; in many cases, it is a convenient preparation, but of course liable to the same dangers as the watery solution; it is muchtoo much, used popularly, especially as an emetic. In inflammatory diseases, the amount of wine which must be given with each dose is objectionable. It is most useful as a simple diaphoretic, given at bedtime, in doses of from ten to thirty drops, and combined, with half an ounce of spirit of Mindererus. James's powder, although a secret preparation, is comparatively so mild and certain in its operation as a diaphonetic, that it is very generally prescribed by medical men; dose, three to eight grains. The pharmaceutical imitation-antimonial powder-is not to be depended on. Plummer's pill contains antimony in small proportion. See PLUMMER'S PILL. ANTISEPTIC. A substance which counteracts the tendency to fermentation, or putrefaction in organized bodies. Chlorine, mineral acids, salt, alcohol, volatile oils, cold, &c., all act as antiseptics. Refer to-Fermentation. ANTISPASMODIC.-That which allays pain arising from muscular spasm, or indeed any severe pain unconnected with inflammation. Anodynes, therefore, are antispasmodics, but there are others of the class which are stimulants, and which do not appear to possess any anodyne effect. The principal stimulant antispasmodics, are ether-which may also be regarded as anodyne-ammonia, valerian, assofœtida, musk, and the various forms of spirit, brandy, &c. The anodyne antispasmodics, are quite the safest for unprofessional administration; they cannot do mischief, which the stimulants certainly will, in the event of inflammation being present. Heat is, however, one of the best, and certainly the safest antispasmodic for general use; in spasm of the stomach, in colic, in gravel, in gall-stone, indeed, in pain generally, the continued application of heat,- -as high a temperature as can be well borne-acts certainly, safely, gratefully. The antispasmodics above enumerated, are more directly applicable to the treatment of painful spasm; those which are employed in the treatment of spasmodic diseases, such as St. Vitus'-dance, hooping-cough, &c., are many of them more properly tonic remedies; chloroform, as a general antispasmodic, is eminently serviceable. Refer to--Anodynes-Spasm-Heat, &c. ANUS.-The fundament or terminating outlet of the alimentary canal. Itching in this situation is at times extremely troublesome, it will generally be allayed by slight relaxation of the bowels, effected by a few doses of sulphur and magnesia, half a drachm of each taken every night, and by the use of a lotion composed of two or three grains of acetate of lead in the ounce of water. Fissure of the anus is a most painful affection, which requires the care of the surgeon. Prolapsus of the bowel, piles, and fistula, all occur in this situation. The anus is kept closed by a sphincter muscle which surrounds it. When this muscle loses its power, as it does in some diseases, involuntary discharges occur. Refer to-Fistula-Piles-Prolapsus. AORTA.-The main artery of the body, which arises directly from the heart, and from which all the secondary arteries have their origin except one, the pulmonary.See fig. The aorta is divided into an ascending portion A, an arch B, and a descending portion C, the latter being subdivided into a thoracic portion C, and abdominal C 2. The origin of the aorta from the heart, is just opposite the junction of the fourth rib with the breast-bone. The passage from the heart into the aorta, is closed by three "semilunar" valves, which, -B C.2 when perfect, effectually prevent any regurgitation of blood. Refer to Artery-Heart. APERIENT. Whatever opens the bowels gently-a laxative, in contradistinction to purgatives, and cathartics, which act strongly. See Laxative. APHONIA.-Loss of voice may be owing to inflammatory swelling, either acute or chronic, or to ulceration of the lining membrane of the larynx, to paralysis, or to hysterical affection. Coming on suddenly, accompanied with fever, pain in the larynx and upper part of the throat increased on swallowing, and difficulty of breathing, the above symptom must be regarded with some apprehension, as one of the concomitants of rapidly fatal disease, acute laryngitis. Loss of voice, however, frequently occurs, quite unconnected with the other symptoms mentioned, and is then not to be so seriously regarded. Many persons are liable to it after exposure to night or foggy air, or after much, or loud talking. Persons living in damp houses suffer from this form of aphonia, which is probably owing to the thickening or great susceptibility of the laryngeal membrane. When it continues, nothing affords greater relief than antimonial ointment, or croton oil, rubbed over the forepart of the neck so as to produce a free eruption. Blisters may be used, but are |