nutritive power, the latter holding the first place, in consequence of its containing a larger amount of gluten; in some respects, however, the oat is the superior grain. See Grains. The oat is most largely used in Scotland; the seed is there "kiln-dried, stripped of its husk and delicate outer skin, and then coarsely ground," in which state it constitutes "Scotch oatmeal." It may be thought that the cheapness of the oat might prevent its meal being adulterated, but in the recent examination of the subject, by the Lancet Sanitary Commission, it was found, that much of the oatmeal sold in London is adulterated with barley-flour, a much less nutritious article of diet. In England, oatmeal is chiefly used for making gruel,- See Cookery;-but the meal, or rather oat-flour, prepared in England, is of very inferior quality to the Scotch, and even when meal is made professedly in imitation of the Scotch_preparation, it is a very poor substitute. In Scotland, oatmeal is most largely employed for the well-known "porridge," which constitutes the breakfast of a great proportion of the population, and almost universally of the children of all classes, and except, perhaps, for a few persons, a more wholesome one could not be found. In a few individuals, the use of oatmeal causes heart-burn, and occasionally sickness, and, of course, must then be abandoned. One of the most beneficial properties of the oat, especially in the form of the Scotch meal, is its aperient power; in many children, the use of oatmeal porridge for breakfast will entirely correct a tendency to constipation. The proper method of making oatmeal porridge is, to have the requisite quantity of water boiling upon the fire, and to sprinkle the meal into it from the hand, stirring constantly, not only at the time, but during the twenty minutes that the mixture should be boiled. Sufficient salt for seasoning is to be added during the process. In Scotland, the stirrer is generally made of wood. When the mixture is boiled sufficiently, it must be poured into a saucer or soup-plate, till it is sufficiently cool. It is generally eaten with milk, but buttermilk, treacle, or beer are also used. A pint of water, and a tea-saucerful of oatmeal, will make a good soup-plateful of porridge. When oatmeal, coarsely prepared, is too largely used, especially in a dry state, it may cause concretions in the bowels,-see Concretions, but this effect never follows its proper moderate employment. Refer to-Grains-Groats-Poultice, &c. OBESITY.-See Fat. OBSTETRICS.-The art of midwifery. -See Child-bed. OCCIPUT.-The back part of the head. CEDEMA is the term applied to the swelling caused by the effusion of serum into the cellular tissue beneath the skin.— See Dropsy. CESOPHAGUS.-See Gullet. OIL-from Oleum, derived from the name of the olive which yields the well-known oil, Oils are the products of either the vegetable or animal kingdom; they are divided into fixed oils-which also include the fats, -and volatile oils. Oils are also divided into drying and non-drying, according to their power of solidification by absorption of oxygen from the air. Fixed oils vary from the most limpid fluid, to the hardest suet, according to the amount of solid or fluid fatty matter in their composition, all fixed oils, and animal fats, being separable into two, and often three different principles; one named oleine remains fluid at the lowest temperature, the next, margarine, has a higher melting point, and the third, stearine, the highest of all. The separation-under the influence of cold into oleine and margarine may often be witnessed in olive-oil in winter. Fixed oils are further distinguished by their leaving a greasy stain on paper, which is not dispelled by heat, and by their power of forming soaps with the caustic alkalies. Volatile oils are of great variety; the odoriferous properties of the vegetable kingdom depending on their presence. These oils are generally limpid, should be colourless, but are for the most part slightly_yellow; their taste is usually pungent. Like the fixed oils, the volatile oils cause a greasy stain upon paper, which, however, entirely evaporates under the influence of heat, thus affording an easy test of adulteration with a fixed oil, which is sometimes practised. Some volatile oils, such as turpentine, oil of lemons, juniper, &c., are composed simply of carbon and hydrogen. Others, such as lavender, peppermint, &c., &c., also contain oxygen in addition,-camphor belongs to this division,-and a third section, those of garlic, mustard, &c., have sulphur added. The principal fixed oils used in medicine are carminative properties. They form a long list-amber, aniseed, bergamot, cajuput, camphor, cassia and cinnamon, camomile, cloves, copaiva, cubebs, dill, fennel, juniper, lavender, lemon, marjoram, mint, orange, peppermint, penny-royal, pimento, rosemary, rue, savine, sassafras, turpentine, &c. OINTMENTS-are greasy or unctuous preparations, about the consistence of firm butter; they are much less used as dressings in modern practice than they formerly were, and their number might be reduced with much advantage; they have been supplanted by the more elegant, cleanly, and in every way superior, water-dressing. Occasionally, a greasy application is requisite, and then nothing answers better than perfectly fresh lard, or sweet olive-oil, or, when fresh, the simple ointment, containing spermaceti or wax to give additional firmness. The form of ointment for purposes of counter-irritation, inunction, &c., is sometimes convenient, but even this, as in the case of tartar emetic, might be often avoided. The ointments most likely to be useful for domestic practice are, antimonial-ointment, gall-ointment, hydriodate of potashointment, mercurial and red precipitateointments, simple or spermaceti-ointment, sulphur-ointment, and zinc-ointment. The composition of these is given under the head of the active ingredient they contain. Simple spermaceti-ointment is made by melting together spermaceti five ounces, white wax fourteen drachms, oliveoil twenty ounces, stirring continually till the mass is perfectly cold. One of the great objections against ointments is, that so many of them, if kept, become rancid, and thus form a most. irritating application. Refer to-Dressing. OLIVES,-the product of the Olea Europaa, or olive-tree, though used in the form of preserved olives, are better known as the source of the well-known OLIVE, OF SALAD OIL, which is procured by crushing from the perfectly ripe fruit. Good olive-oil, is of a pale yellow colour, and should be almost free from either smell or taste. It is often adulterated with the inferior fixed oils. As an article of diet, olive-oil agrees well with many, and some persons find it useful as an aperient, but it is very weak in action. In pregnancy, however, with irritable and yet confined bowels, it occasionally answers better than the usual castor-oil. Olive-oil is most used in medicine as an external application, both as an addition to ointments and as a liniment.-See Ammonia, Camphor, &c. OMENTUM, OR CAUL.-A membrane, more or less covered with fat, which is spread over the intestines. It probably acts as a protection against cold. The great loading of the omentum with fat, is one of the chief causes of the protuberance of the abdomen in very corpulent people. ONANISM.-The crime of Onan-selfpollution-requires no further notice here, than to put parents upon their guard respecting their children, in connection with this ruinous vice acquired at school, and indulged in, in ignorance either of its sin or evil consequences. Some of the most lamentable instances of youthful decrepitude, nervous affections, amaurotic blindness, and mental debility and fatuity in early life, which come before medical men, are traceable to this wretched practice. Whenever young people, about the age of puberty, exhibit unaccountable symptoms of debility, particularly about the lower limbs, with listlessness and love of solitude, look dark under the eyes, &c., the possibility of vicious practices being at the root of the symptoms should not be entirely lost sight of. ONION AND GARLIC.-The former of these well-known vegetables, may be considered either as a condiment, or as an article of real nourishment. In its raw state especially, the onion, by virtue of the volatile oil it contains, is a powerful stimulant, but one only to be used with advantage and impunity by the owners of strong stomachs, who intend for the time being to eschew civilized society; under this proviso, the onion may really, at times, prove, and has done, of much value as a stimulant. By boiling, the onion is deprived of much of its pungent volatile oil, and becomes an agreeable, mild, and nutritious vegetable; it is less wholesome either fried or roasted, a portion of the volatile oil being retained, and empyreumatized, and thus rendered very irritating to the stomach. The onion possesses diuretic properties. A roasted onion, cut in half, and the centre scooped out, is a frequent domestic remedy applied to boils, with a view of hastening their breaking. Garlic is a more powerful stimulant than onion; when applied to the skin, either fresh or in a pulp, it acts like a mustard cataplasm. Garlic is diuretic, and possesses other properties, but its abominable smell is quite sufficient to exclude it from use, when so many more efficient and agreeable substitutes are obtainable. ONYCHIA-is a species of ulcer very difficult to heal, situated at the side of, and underneath the nail. It is usually dependent on general constitutional debility which requires to be attended to see Debility Tonics, &c. The local irritation about the nail may be treated by poultices, and afterwards by the mercurial black wash, but the disease will probably require the attention of a medical man. OPHTHALMIA.-See Eye. OPINION, MEDICAL. A medical opinion on a case of disease includes, first, the " "Diagnosis" or conclusion arrived at respecting the nature of the disease; second, the conclusion as to the appropriate treatment; third, the "Prognosis or opinion respecting the ultimate termination of the case. Under articles "Diagnosis,' ," "Medicine, Science of," and " Prognosis," these points are sufficiently entered into. OPIUM-is the milky juice, dried, of the seed vessels of the common garden poppy; it is, perhaps, the most useful remedy in the entire list of medical agents used by man, and has probably given more relief to human suffering, than any physical means we are acquainted with. Õpium may be procured from other species of poppy, but that above named is its regular source. The drug is chiefly collected in Asia Minor, in Egypt, and in Hindostan, but has been made in Britain. It is procured by making oblique incisions about half through the external wall of the unripe poppy capsule or seed vessel, and allowing the milky juice to become partially dry, when it assumes a brown colour, and tenacious consistence; at this stage, the opium is generally gathered by scraping it off the capsule by means of a stick or some other instrument, by which it is transferred to the receiving vessela cocoa-nut shell or the like; it is then further dried, after which it is, in some places, packed in leaves, in masses of various size, or, as in Egypt, made into rolls, or small flat cakes. Opium, when bought as imported, is apt to contain much impurity; by far the best condition, therefore, in which to purchase it for direct use, is the properly prepared powder, which must be kept in a well-closed bottle. The preparations of opium used by medical men are very numerous; the most useful of these only will be referred to in this article. Opium is most familiarly known in its action upon the human body, first, by its power of compelling sleep-its sedative, soporific, or narcotic property; and second, by its power of relieving pain, its anodyne property; these actions, however, are much varied, and others are developed in accordance with the influence of circumstances, either permanent or accidental, such as the dose, and mode of administration; the state of the person taking it at the time, whether physical or mental, his temperament, previous habits, &c. It is well known, that among the Orientals, opium is employed rather as a stimulant, as we use wine, than as a sedative, and its use for this purpose has very widely extended of late years in this country. When taken with the above view, the dose requires to be small-that is comparatively so according to the habits of the individual-and if sleep approaches, it requires to be resisted; after this state if it occurs, in those who are stimulated by opium, a state of unusual physical, and especially of mental, activity is excited, accompanied with exalted brilliancy of ideas; after some hours this subsides, leaving drowsiness, inactivity, and low spirits. If, however, the dose of opium has been a large one, or if the individual gives way to the inclination to sleep which follows even a moderate dose, heavy slumber is the result, varying in duration according to the dose of the drug, and other contingent circumstances. Such is the more ordinary medicinal effect of opium, but whether the effect produced be one of excited, or of sedative action, pain is either modified or wholly subdued for the time being. When the effects of an ordinary dose of opium are passing off, most persons experience some amount of uncomfortable sensation; dryness of the mouth, headache, low spirits, and sickness; this latter symptom especially, is sometimes so distressing, as almost to debar the use of opium in certain ințlividuals. Sometimes, opium produces neither sleep nor the pleasing excitement so valued by its votaries; but gives rise to feverish restlessness, headache, thirst, &c. This may arise from constitutional peculiarity, from a state of previous feverish excitement, from the drug having been swallowed too soon after a meal, or from other causes. In whatever way it is conveyed into the system, whether by the stomach, by the skin, as by external application, &c., opium seems to exert its peculiar effects upon the brain and nervous system; it further modifies the secretions, particularly those of the mucous membranes; it checks the flow of bile, and powerfully constipates the bowels; but it determines to the skin, and causes sweating. The constipating action of opium is sometimes one of its chief inconveniences, but in those who consume it regularly, this effect generally soon passes off. The action of opium upon the system is in the first place greatly modified by custom; persons who habitually take it for purposes of intoxication, find it necessary, gradually opium has been employed, instead of, as more usually happens, its fluid preparation, laudanum. The symptoms are, giddiness and drowsiness, from which the person may be roused by noises, shaking, &c.; but this quickly passes into apoplectic stupor, with slow, "stertorous breathing; and, ultimately, if the case proves fatal, into death, with or without convulsions: these being most common in children. In addition to the above symptoms, the face is pale and ghastly looking, the surface cold, but may be covered with perspiration; the urine is unpassed; the pupils of the eye are generally contracted; the odour of opium may possibly be detected in the breath. to increase their dose if they wish to experience the to them-agreeable influence; such persons, when consulting a medical man, ought always to inform him of their habit, otherwise, when ordering what would be only a suitable dose for the generality of persons, he may be prescribing little more than a tithe of the ordinary amount consumed by his patient. It is, perhaps, needless to point out that serious consequences might result. Again, the existence of certain diseases, particularly of a spasmodic or painful character, very greatly modifies the power of opium over the system; this is peculiarly exemplified in such diseases as lockjaw, &c. Persons, even, who are ordinarily very susceptible to the action of opium, The treatment of a case of poisoning by when suffering severe pain, can often take opium must, in the first place, be to proit in considerable quantity, without expe- cure the evacuation of the poison from the riencing its usual effects, or, indeed, any stomach. For this purpose a medical man effect beyond relief to pain. Age is another may use the stomach-pump; but others circumstance, which affecting the power of must attempt it by emetics.-See Emetics. action of all medicinal agents, seems pecu- If sulphate of zinc (white vitriol) be proliarly to do so in the case of opium, its in- curable, half a drachm should at once be fluence augmenting in a rapidly increasing given, dissolved in water; or five grains of proportion as the earliest epoch of life is sulphate of copper (blue vitriol), in the approached; indeed, during the first two same way; or mustard or salt may be tried or three years of life, it is impossible to ex- if neither of the above are at hand; or ercise too great caution in the administra. ipecacuanha combined with a stimulanttion of opium; many accidents are known a couple of tea-spoonfuls of sal volatile or to ensue from its careless, or ignorant, or of brandy; or the throat may be irritated criminal use, and doubtless many more with a feather. In some cases, vomiting there are which never come to light. A and even diarrhoea, occur spontaneously, single drop of laudanum has been known and certainly diminish the danger. When to prove fatal to a young infant. Even in the stomach has been cleared, but not beinfancy, habit, nevertheless, enables compa- fore, vegetable acids-lemon-juice, vinegar, ratively large doses of opium to be given, cream of tartar-may be given freely; or but the most lamentable results accrue to strong coffee, without either milk or sugar. the constitution, and, ultimately, death itself -See Coffee. At the same time, every may be the consequence. No one should means must be used to keep the patient be tempted to give opium in any form to a from lapsing into lethargy; cold, or alterchild, unless under medical sanction, ornate cold and hot, water, may be dashed under the pressure of some of such circumstances as are pointed out in various parts of this work—see Children—and when it must be given, it should be in the form of laudanum, in the most cautiously graduated dose. To an infant under two months old, one-quarter to one-third of a drop only should be given at once, and repeated at intervals of an hour, if required; and even in this way, no unprofessional person should venture to exceed the amount of one single drop of laudanum to an infant under six weeks old. Poisoning by opium, either by accident or design, is a very common occurrence. The symptoms generally set in from half an hour to an hour after the drug has been swallowed, but this circumstance depends partly upon the form in which the poison is taken, being delayed longer when solid over the body; mustard-plasters used between the shoulders, and continual movement kept up. This is usually, and very properly, done by keeping the patient in continual motion for many hours between two assistants. Lastly, galvanism or electricity may be used, and artificial respiration kept up. A most remarkable case of recovery, the result of the persevering employment of these two agents-galvanism and artificial respiration-is recorded in the Lancet, March 27th, 1852, by Dr. Herapath, under whose care the case occurred. In this case, a "small tea-spoonful" of laudanum was given by mistake to an infant but thirty-nine days old, and the whole retained. The case is cited as an instance of how much may be done by persevering and well-directed efforts to save life. Tannin, the active principle of oak bark, has been recommended in opium poisoning. It is perhaps not much to be depended on, but in the absence of other remedies a strong decoction of the bark might be used. It must be remembered, that in poisoning by opium, partial consciousness may be restored, and yet the patient, if unattended to, may relapse and die. It has been suggested that many of the symptoms of poisoning by opium are the result of the dryness of the lining membrane of the airtubes-which is one of the invariable consequences-preventing the due oxygenation or purification of the blood, the fact should not be lost sight of, especially as it may be remedied by making the patient inhale steam freely. The quantity of opium required to destroy life, may probably be stated at from four to five grains of solid opium as a dangerous dose to an adult, and from a drachm and a half to two drachms of laudanum, and upwards. The average time in which death ensues, in consequence of poisoning by opium, is twelve hours; but it may occur considerably earlier. Opium as a medicine is useful in a great variety of diseases, but as its employment is mentioned under the separate articles, it is unnecessary to repeat the information here. The most useful preparations of opium are Opium powder.-To be kept in a wellstopped bottle. Average dose for an adult, one grain. Tincture of opium, or laudanum-which contains one grain of solid opium in nineteen minims. Average dose for an adult, fifteen to twenty minims, or about twenty five to thirty drops. Of all the preparations of opium, this is the most generally useful and valuable, and the safest. Its dose may be regulated to the minutest proportion, and when properly made, it keeps well. Tincture of opium with camphor, or Paregoric,-which contains one grain of solid opium to the half-ounce. Average dose for an adult, one drachm to three drachms. Compound opium powder with ipecacuanha, or Dover's powder-which contains one grain of solid opium in ten.— See Dover's Powder. Compound opium powder with chalk which contains one grain of opium in forty. Average dose, twenty to forty grains. As external applications, the soap and opium liniment, and the opium plaster, are both useful. There are many other preparations of opium used, but the above would be ample for the best stored emigrant chest ; and therefore for any home use. Persons generally, will find it more advantageous to purchase the preparations ready made, but in some cases, it may be requisite to make laudanum themselves. To make Laudanum :-Take of opium, sliced, three ounces; water, thirteen fluid ounces by measure. Macerate the opium in the water, in a wide-mouthed bottle for a couple of days, shaking up occasionally; and then add twenty-seven ounces of rectified spirit of wine; macerate for ten days or a fortnight, and filter. Of course a much smaller quantity may be made at once, observing the same proportions. Laudanum and paregoric are best administered in water; Dover's powder, or the compound chalk powder, in some thick substance, such as gruel. When solid opium is given, it is best in the form of pill, without admixture. Laudanum is sometimes used as an external application, being put into poultices, &c.; it is also used to rub on the gums in toothache. It must not be forgot, that in any of these ways, if employed incautiously, or in excessive quantity, it may affect the system, and even prove dangerous. For the use of laudanum in clysters, the reader is referred to the article on the subject. In addition to the preparations of opium above mentioned, two others require notice; one of these, the valuable, though secret, Battley's Sedative Solution, will be found noticed under its special article; the other, morphia, is the special sedative or narcotic principle of opium. Opium is a very compound body, and includes other principles, on some of which its stimulant and other powers more particularly depend; morphia, therefore, being separated from these, is more purely sedative, and is not found so frequently to occasion the disagreeable aftereffects which often follow the use of opium; in other respects, its action and applications are the same. Morphia, on account of its insolubility, is generally prescribed in the form of the more soluble acetate or muriate of morphia. The latter is the best and more certain preparation dose, from quarter to half a grain. The graduated morphia lozenge is a most effectual and comparatively agreeable remedy in irritable cough; ten or fifteen of the lozenges may be taken in the course of the same number of hours. In Edinburgh, the same lozenge, combined with ipecacuanha is made, and is very useful in may cases. Refer to-Poppy-Dalby's Carminative— Godfrey's Cordial, &c. |