the confinement to bed. The selection of a truss, is always better left to the judgment of a medical attendant. Where price is an object, the old form of truss-fig. B-may be used, it answers extremely well; in some cases; however, a Salmon and Ody's truss, somewhat similar to-fig. A,-but modified to fit the groin, is found more useful. The peculiar feature of this truss is, that the circular or oval pad is attached to the spring by a ball and socket joint. In some persons, owing to flatness of the back, it is difficult, almost impossible, to make a spring truss fit at all; for such and other difficult cases, the spiral supporters of M. Bourjeaurd, fig. C. may probably be

found of use. There are many advantages connected with this elastic form of truss, particularly the extended support which it gives to the walls of the abdomen, at those parts where they are weakest, and most apt to give way. This, it need scarce be observed, the simple steel springs cannot do. The use of air pads, is an additional comfort. In the case of labouring men, and others, who perspire much, the springs of the steel trusses are constantly breaking, in consequence of the corrosion caused by the sweat. The author has suggested covering the springs with sheet gutta percha as a preventive. In a few cases, it is necessary to wear a truss even during the night, for some time at least, but generally it may be dis

pensed with during the horizontal posture, being put on before getting out of bed. It is important that a truss fit well, otherwise it is of little actual service, and is apt to cause excoriations, &c.; it is also requisite that the strength of the spring be proportioned to the nature of the case. Further, it is important, that the truss is not put on whilst any of the hernia is " down." When as sometimes happens, a rupture is "irreducible," that is, cannot be entirely returned within the abdomen, a bag truss suited to the nature of the case is requisite. The causes of rupture are various; in one sense it may be said to be hereditary, that is, some individuals inherit a tendency to weakness about those parts, which are the usual seat of rupture. The direct causes are such as induce undue pressure by the walls of the abdomen upon its contained viscera, hence the disease is most frequent among those who have to make strong exertions. Soldiers whose belts compress the upper part of the abdomen, and cavalry soldiers, who at certain times ride without stirrups, are not unfrequently the subjects of the disease. It is also brought on by hard riding, or by leaping in the hunting field. Hence, those who are in the least liable, should avoid all such causes ; and those who wear a truss, should bear in mind, that if the natural support has given way, the artificial may also. It may become a question with a ruptured individual, how far the hazard of sea-sickness, and the consequent mechanical action of vomiting is to be incurred. Strict attention to the state of the bowels is imperative, by all who are the subjects of rupture, more especially, as nothing is more likely either to cause, or to aggravate the affection, than the straining of constipation; at the same time strong purgatives are not advisable. The danger of a rupture is not in proportion to its size; when small and recent, it is more liable to become strangulated. Ruptures may of course occur in both groins of the same person; in this case a double truss is requisite.

When rupture in the groin occurs in infants, it is usually of considerable size, descending into the scrotum, and becoming very tense whenever the child cries. In the early periods of life spring trusses cannot very well be worn, those made of elastic material will answer best, frequently no truss is used. Strict attention to the bowels, and bathing the loins of the child every morning in cold salt water, will do much to prevent the disorder getting worse, and will sometimes effect a cure.

RYE. This hardy grain possesses a nutritive power about equal to that of barley.

It has slight aperient properties. The chief point of interest connected with this grain is the peculiar diseased or fungus growth -the Ergot of Rye-which is apt to be developed upon the seed.-See Ergot.

SACCHARINE-of the nature of sugar. -See Sugar.

SACRUM-or OS SACRUM-is the bone of the pelvis, which fits in like a wedge between the two irregular lateral bones; upon it the spine rests.-See Pelvis. The bone derives its name from having been formerly offered in sacrifices, whence it was considered sacred.

SAVINE.-See Juniper.

A

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SAFFRON is procured from the blue autumn flowering crocus, which is cultivated extensively for the sake of the drug, both in this country and in France, Spain, &c. In the centre of each crocus-flower rises the 'style," which terminates in three wedgeshaped,notched divisions -fig. A. which are called "stigmata"-these stigmata, with a portion of the upper part of the style, constitute saffron, being clipped off when fully developed,and dried carefully. Saffron is sold either in the form of "hay saffron," or of "cake saffron," the former being composed of the loose dried stigmata, the latter of these parts beaten into a cake, before they are quite dry. In Eastern countries, saffron is still largely used medicinally; in this, except as a colouring matter, it is little employed. It is stimulant and anti-spasmodic. Saffron is liable to much adulteration.

SAGE-like other plants, which contain essential oil, is stimulant and carminative. It is a good deal used domestically in the form of "tea" or infusion, especially as a gargle, combined with vinegar.

SAGO. This well-known dietetic article is the produce of various species of palmtree, being obtained from the cellular substance contained within the stems of that tribe of plants. The stem is split, the cellular substance scooped out, and stirred up with water to separate the fecula or starchy matter, which, while suspended in the water, is passed through a sieve, then allowed to subside, and, being dried, forms the "sago meal" of commerce. This sago-meal, after having been made into a paste with water, "granulated," and again dried, constitutes the sago of the shops; common or "brown

SAINT ANTHONY'S FIRE.-A popular name for erysipelas.-See Erysipelas SAINT VITUS'S DANCE-known to medical men by the name of "Chorea," is a disease strongly indicative of nervous disorder, its precise nature, however, is at present obscure. Probably it may be occasioned by direct causes, that is, by causes seated in the great centres of the nervous system, or by indirect causes, which act by "reflex action,"-see Nervous System-in the same way that teething in infants produces convulsion; that is to say, irritation in some portion of the body, as in the bowels, may, in the first place, give rise to functional irritation of the brain and spinal chord, which irritation, acting as if its original seat was in these great centres, is "reflected" on the body generally, or, at least, upon some portion of it, causing the irregular muscular movements of the disorder in question. St. Vitus's dance is, for the most part, a disease of youth, occurring before puberty, and usually disappearing at that period of life, if it has continued so long. It is more common in girls than in boys in the proportion of three to one. It may, however, continue into adult life. It rarely proves fatal; indeed, in those subjects of the disease who have died during its existence, it has been a question whether death has not been the result of other co-existing maladies.

The most manifest symptom of St. Vitus's dance is continued involuntary actions of the voluntary muscles, to a greater or less degree. The extent of the muscles affected, and the intensity of their affection, varying with the severity of the disease. The movements, however, generally cease entirely during sleep, and in all cases certainly are diminished. The ordinary voluntary movements are still capable of being performed after a fashion; that is, in an unsteady, uncertain, and somewhat grotesque manner. It seems as if, after the voluntary impulse had been communicated to them, an additional involuntary one interfered to throw the limb or other part out of the usual steady movement.

The disease generally commences with twitching about the face or neck, or in a particular limb, gradually extending to one side of the body, or to the whole body, as the case may be. Pain is seldom complained of, but it does sometimes occur in the head. The appetite may remain quite good, but the bowels are possibly confined, and their secretions unhealthy. To this depraved state of the bowels, or to constipation, or to the presence of worms, the disease is often traceable; in females, it is not unfrequently connected with the menstrual function, especially if it be delayed, or imperfect. The irritation of the coming of the second teeth has been assigned as a cause; and there is no doubt that imitation, especially among females, may spread the disease, which is most general, as might be expected, in persons of a nervous tendency; and it is said, those with dark hair and eyes are more liable to it than those of a blonde complexion. The duration of the attacks varies from ten days or a fortnight to months; but having once existed, it is, up to the age of puberty at least, apt to recur, or to be reexcited.

As regards the treatment of chorea, the best plan is, as soon as possible to submit the case to a proper medical examination, for, as already explained, it may be dependent merely on some casual irritation, which skill will at once detect and remedy. The disease, moreover, is one devoid of danger, and as there can be no question that many cases of it will get well without any treatment at all, it evidently is better without active unprofessional interference.

Dr. Watson says, that when pain in the head exists, he finds benefit from the moderate abstraction of blood by leeches, and if persistent pain does exist, the application of four or five leeches might be had recourse to, if the individual is of full florid habit. In any case, no harm, but almost certain benefit, will result from acting on the bowels freely, more moderately, of course, in a weak subject than in a strong one. For this purpose, the compound colocynth pill simply, or combined, for two or three doses in succession, with calomel or blue pill, will be of service, or the blue pill and black draught, or compound decoction of aloes draught may be given. After the bowels have been well cleared, if the subject of the disease be weak and pallid, iron will be required. In the disease in question, the red carbonate of iron, as given by Dr. Elliotson, has been found extremely useful in large doses, from a drachm upwards, given twice or three times a day; other preparations of iron, however, may be given, or quinine.

The author has found the oxide of zinc of much service, but these are remedies which ought to be given under medical sanction. The shower-bath is often serviceable in St. Vitus's dance, but for some individuals the shock is too powerful, and seems rather to increase the disease; for such, the douche down the spine may be substituted. In all cases, attention to the general health is required. Good diet, exercise, change of air, and attention to the hours of sleep, and to free ventilation of sleeping rooms, are all circumstances to be kept in mind in such cases.

&c.

Refer to-Convulsion - Nervous System,

SALADS--generally, being composed of raw vegetables, are unsuited for persons of weak digestion; when, however, the stomach is capable of digesting them, the general effect on the system appears to be beneficial, particularly in salads derived from the tribe of the cruciferous plants, to which the water cress, radish, mustard, cress, scurvy grass, &c. &c. belong.

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Many persons with whom raw vegetables, such as salads, cucumbers, &c., invariably disagree, if eaten "undressed," find the addition of the ordinary salad, or " Florence" oil, correct the tendency. In this country, some individuals have a prejudice against the use of oil. It is difficult to see why it should extend to the beautiful preparation in question.

SALEP is prepared from the bulbs of the orchis mascula. It is imported chiefly from the Levant, but some is brought from India. It consists of a peculiar kind of gums, termed bassorin and fecula. It is more nutritive than either arrow-root or sago, and consequently is better adapted for the convalescent than for the sick. It is prepared by dissolving the powdered salep in hot water, with assiduous stirring, and adding to the solution sugar and milk.*

SALICINE-is a "peculiar bitter crystallizable principle," obtained from the bark of the willow, or of the poplar. In some respects it resembles quinine, and has been brought forward as a cheap substitute for that expensive medicine, especially in the treatment of ague, neuralgia, &c. That salicine is a most excellent tonic remedy there is no doubt, one moreover, which is applicable to cases in which quinine is inadmissible, the former remedy being less likely to heat, or to cause headache; in such cases, however, as ague, or neuralgia, it does not seem to exert the same powerful curative effect, although it might well be

* Thomson's Sick Room.

used, either in its prepared form, or in the form of an infusion of the willow bark itself, in the absence of quinine or of cinchona bark. The dose of salicine as a tonic, is from one to two grains given as a powder, or dissolved in water, or if a stimulant be required, dissolved in a little sherry. For neuralgia it should be given in the same doses as quinine.

-

SALINES or salts are distinguished from other bodies by their general properties of incombustibility, aptness for combination, and a peculiar taste generally known as a saline taste. Salines are better illustrated by their many well known examples, such as common salt, potash, soda, Epsom salts, &c., than by any description.

SALIVA- --or spittle, the fluid which moistens the mouth, is secreted by glands, disposed around that cavity. These glands are three on each side. The principal, or parotid gland - see Parotid is situated beneath the angle of the lower jaw, the salivary fluid secreted by it, being conveyed into the mouth by a duct, which opens between the gum of the upper jaw and the cheek, opposite the second double tooth. A second salivary gland lies deep below the tongue, its duct opening by the side of the bridle, or tie, of the tongue, just behind the corresponding front "incisor" tooth of the lower jaw. Where the duct opens there is a perceptible eminence, from which, when some individuals gape, a small jet of saliva is apt to be projected at least a foot beyond the mouth; this is caused by the muscles exerted in gaping, compressing the gland and its duct. The third salivary gland, the "sublingual," lies partly just below the duct of the last mentioned, its small ducts conveying the saliva into the mouth, close to the other. As, therefore, these glands are situated on each side of the mouth, there are six salivary glands in all. The saliva, or spittle, for the supply of which such ample provision is made, contains about one per cent. only of solid matter, which consists partly of animal constituents, and partly of saline. The saline constituents are similar to those contained in the blood, with the addition of a peculiar salt, a sulphocyanide. The animal principle, known by the name of "ptyaline," resembles in action the vegetable principle" diastase" in possessing the power of converting the starchy constituents of the food into saccharine aliment -See Digestion.-When food is not being taken, the secretion of saliva is very greatly diminished, and in sleep seems to be almost suspended altogether; no sooner, however, is the appeasement of hunger by food com

menced-and indeed, previous to the food being taken-than the flow of saliva begins, the secretion continuing to be poured out as long as the meal continues. The amount of saliva, secreted in the period of four and twenty hours, has been estimated at from fifteen to twenty ounces, but it is very difficult to ascertain the precise quantity, and probably it varies.

The importance and the functions of the saliva in the process of digestion, have been variously estimated by different observers. Its action upon starchy matter, has been already noticed. The experiments of Dr. Wright of Birmingham,` detailed in his valuable papers on the saliva, tend to shew that its alkaline properties are necessary to the perfect fulfilment of the digestive process generally. Dr. Wright observed, that after a full meal, the saliva became more strongly alkaline, and that if, instead of swallowing this alkaline saliva, he spat it out, there was manifestation "of abundance of acidity, with much pain at the stomach," but that if he neutralized the acid on the stomach, by a dose of carbonate of soda, the alkaline condition of the saliva quickly diminished, as if, being no longer required, the alkalinity was withdrawn. The saliva, however, is not constantly alkaline, it is frequently acid, especially during fasting, the acidity has been attributed to the mucus of the mouth, with which the secretion is necessarily intermingled. Dr. Wright performed a variety of experiments with the view of determining the influence of the saliva in the digestive process. From these experiments he formed the following conclusions.

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That saliva has the power of modifying, and to a certain extent of digesting vegetable and animal substances.

"That it has a more powerful action upon vegetable than upon animal matters. "That acids or alkalies, added to saliva, diminish or destroy its digestive properties. "That the presence of saliva in the stomach is essential to healthy digestion."

Of course the saliva performs other functions beyond the simple assistance of digestion, it facilitates especially, all the movements connected with mastication, and speech. The "tartar" which accumulates about the teeth, is a mixture of the earthy salts and animal matter contained in the saliva.

The influence of the mind upon the secretion of saliva is very considerable, the popular saying of the "mouth watering," at the sight of tempting food, is an illustration of its increase from this cause, its diminution under the influence of painful

emotion, such as fear, is well ascertained, and indeed, in some Eastern countries, is practically acted upon as a means of detecting crime. If a crime, such as a theft, is committed, and a number of persons such as a staff of servants, are generally suspected, the whole of the suspected are placed together, and caused to chew and then spit out a handful of rice, in the presence of the examiner; it is said that such is the feeling in these countries with regard to the test, that the fear of the real criminal diminishes the secretion of his saliva to so great an extent, that the portion of rice chewed by him remains comparatively unmoistened. There is a peculiar affection of the salivary secretion, to which some dyspeptic persons are liable, which the author has never seen described in any medical work, and which he believes is generally confounded with pyrosis or water-brash; it consists of the rapid flow of a quantity of limpid saliva into the mouth, or from it, in a stream, if permitted, accompanied with a sense of constriction about the jaws; the flow continues for a minute or two at a time. It is generally preceded by symptoms of indigestion, of heartburn, or of irritation in the stomach. It is in fact a symptom of indigestion, and an instance of "reflex" action-see Nervous System-Indigestion or of irritation in the stomach acting upon the salivary glands, which seem to be peculiarly susceptible to irritation from such causes. The above remarks upon the uses of the saliva, may explain in some measure, the disordered digestion, from which many smokers, who waste this fluid, suffer. Indigestion is a very common malady in America, and may in part be occasioned by the well known habit of spitting," peculiar to the country. SALIVATION—is the excessive secretion of saliva from any cause. The term is best known in connexion with mercurial salivation see Mercury · salivation may however arise from other causes, a course of iodine medicines may occasion it, and nitric acid has the same effect, it also arises from constitutional causes. Salivation, that is, simple increase of the flow of saliva, is not an unfrequent concomitant of the first stages of pregnancy.

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Refer to Indigestion.

SAL PRUNELLE-is saltpetre, which has been fused by heat, and cast in a mould, generally of a globular form. The preparation is used by some persons in incipient sore throat, with advantage; the ball of the salt being allowed to dissolve gradually in the mouth.

SALT.-The term salt is applicable to saline matters generally-See Salines-in this article, however, it is regarded in its conventional acceptation of "common salt," as used in daily life. Common salt is a compound of soda and muriatic acid, or in another view, of chlorine and sodium and water. It is therefore either a muriate of soda, or a chloride of sodium with water. Indeed, common salt, is one great source whence the soda of commerce, now so cheap, and so extensively used, is obtained. See Chlorine-Soda, &c.

Common salt is most generally procured either from the salt mines, such as those of Cheshire, from saline springs, such as exist in America, or in Germany, or from seawater; in the two latter cases by evaporation. However, obtained in the first instance, salt, generally, requires to be purified from other saline ingredients, with which it is usually mingled, and which particularly, interfere with its keeping properties, causing it to become moist. Of late years, the finer descriptions of salt have become so cheap that the coarser kinds are scarcely seen.

As regards the use of salt as a condiment, or as an addition to food, by man, there can be no doubt as to its beneficial effects; indeed, the desire for salt, seems almost to be instinctive, as a necessary for health. In countries at a distance from the sea, and where from the absence of saline springs, salt is difficult to procure-as in the interior of Africa-it is most highly prized as a necessary of life. Many travellers, have described a temporary deprivation of salt, as one of their greatest hardships; and, to descend to the lower creation, the way in which the salt springs or "licks" in America, are frequented by the wild animals, is evidence of instinctive desire; and, indeed the eager devouring of salt by, and consequent improvement of condition among domestic animals, sufficiently testify, if not the absolute necessity for, at least the great benefit arising from the admixture of salt with food. Salt, unquestionably assists, and renders more perfect the process of digestion, moreover, it forms one of the constituents of the blood, and of the body generally. If salt be denied, the digestion is weakened; the general tone and nourishment of the body are impaired,

SALMON -Like the other oily fishes, is less digestible than white fish_generally, for persons of weak stomach. Like other articles of food too, which contain oil, it is apt to prove highly injurious, if eaten in a state of decomposition. Indeed, death has been the result of a meal of pickled salmon which had become somewhat decomposed.