SPECIFIC is a term applied to a medicine which is known from experience to cure a particular disease or set of symptoms, the action by which it does so being unexplained. Thus, quinine is specific in ague and other periodic diseases-specific, at least, within certain limits. That is, it is generally successful, though not always so. This applies to other specifics so called. SPECTACLES.-See Vision. SPECULUM.-A surgical mirror, adapted to assist the examination of internal parts of the body. SPEECH.-Distinctness of speech, or articulation, is so intimately connected with the full command and free movement of the tongue, that indistinctness is often a valuable leading symptom in the investigation of disease, especially of a nervous character. The "thick" articulation of the drunkard is an instance of the affection of the tongue from nervous disorder; the same thing occurs in paralysis and other diseases of the brain; in some cases, the articulation of particular letters being interfered with, such as "d" being substituted for "1." Stammering in the speech cannot be said to be a disease, being rather a functional disorder; this is evident from the fact, that, under certain circumstances, a habitual stammerer does not stammer, and that cases have occurred in which most inveterate stammering has been completely cured-as history tells us in the case of Demosthenes-by the exertion of the will. Moreover, stammering is often caused either by imitation in children, or by nervousness in both children and adults. This nervous ness is often the result of debility, and of weak constitution—a fact which should not be lost sight of, for if such be the case, every means of strengthening should be used.See Children, &c. At the same time, whilst the general health is sustained, much may be done by checking children, and making them speak at all times slowly. Much pains with children, and much perseverance and selfcommand in adults, is required in the efforts to overcome the defect in question, but there is the encouragement that it has been effected. When it can be done, a child should be placed under the care of a person experienced in the moral and intellectual training of children thus afflicted. Surgical operations on the tonsils and uvula have been proposed, even by high authorities, and practised largely for the cure of stammering, but they have never met with the cordial support of the profession, Articulation is sometimes indistinct from the tongue being "tied," that is, too much confined in its motions by its natural bridle or "frænum."-See Tongue. When this is discovered in early life it is very easily rectified.-See Children. SPERMACETI-is a species of concrete oil found in the head of the sperm whale. Its appearance is sufficiently well known. It was formerly used internally, on account of its supposed healing properties, and according to this idea the "spermaceti draught' was a favourite lying-in-room remedy. Spermaceti is now used only as an addition to ointments.-See Ointment. SPHINCTER MUSCLES-are muscles the office of which is to close the apertures round which their fibres run, usually in a circle. SPINACH.-This well-known vegetable is one of the most wholesome we possess, and less liable than most others to disagree. The leaves of either the common beet-root or of the mangel wurzel, when cooked like spinach, form a substitute in some respects even superior to the former vegetable. SPICES.-See individual articles, Cin-Pepper, &c. namon SPINE-or SPINAL or VERTEBRAL COLUMN-is a chain of twenty-four bones, called the "vertebræ❞ -see Skeleton-so beautifully contrived and fitted to each other, that while they permit the most extensive motion of the trunk of the body, they at the same time preserve it-in man at least-firm and erect, and guard the spinal cord or marrow-see Nerves-against all but the most violent injury. The spinal cord, thus guarded, is inclosed in the spinal canal, which is continued through the vertebral chain, from the head downwards, to and into the "sacrum" bone of the pelvis. on the bodies rests the main weight of the parts above them, they are also extensively subservient to the motions of the spine. The bodies form the inner portion of the spinal column.-See Chest-Skeleton. Attached to the body, one on each side, are "laminæ," or projections-fig. A, B, 2-which serve to inclose the canal of the spinal cord; from the junction of these laminæ proceeds what is called the "spine" of the vertebre.-Fig. A, B, 3. These "spinous processes" projecting backward, give the peculiar character of the spinal column, when examined in a living, and especially a thin person. In addition to the parts above named, there are what are called the "transverse processes." -Fig. B, C, 4. These processes are chiefly concerned in affording attachments to the muscles, and in the dorsal vertebre, in giving firmness and support to the ribs.See Ribs. There are various other distinctions common to the vertebre which it is unnecessary to enter into here. The bodies of the vertebre are separated from each other by what are called "inter-vertebral cartilages."-Fig. C, 5. These cartilages are endowed with remarkable elasticity, yielding with every motion of the body, and breaking the effect of the shocks, which must have been communicated to the brain with every step, had the spinal column been all bone. Moreover, the variations in thickness of this component of the spinal column, contribute greatly to mould its different curves. In addition to being fitted to one another in a most beautiful manner, the vertebræ are firmly braced together by a series of ligaments of various kinds, which permit, but yet restrain motion. One of these ligaments is shewn-fig. C, 6-which runs down the bodies of the vertebre externally; a similar ligament runs down the interior of the spinal canal, and there are others.-See Ribs-fig. B, 2. The two upper cervical or neck vertebre which are more especially concerned in supporting the head, are peculiar. The uppermost one, named the "atlas," from its office, is little more than a ring of bone, with two lateral joint surfaces on which the head moves in the performance of bowing motions. The second vertebre, called the axis-fig. B-has, in addition to the ordinary body of a vertebre-1-a tooth-like process or projection-fig. B, 7-which, projecting upwards, rests within the bony ring of the first vertebre, and is kept in position by a strong "transverse" ligament, which, running across from one side of the ring of the first vertebre to the opposite, crosses the tooth-like process of the second vertebre, as at the dotted line-8. By this arrangement, as a moment's reflection will show, the side to side motion of the head is secured, which, in combination with the bowing motion exercised on the first or atlas vertebre, permits of that perfect capability of movement with which an all-wise Creator has endowed the noblest part of man. Should the above transverse ligament be broken by any chance, or by violence, as sometimes occurs in hanging, the tooth-like process, thus set at liberty, presses forward upon the spinal cord, and instantaneously extinguishes life. It is the danger of this occurrence which the author adverts to in the article on "Lifting Children." The seventh or lowest cervical vertebre is remarkable for being more prominent than the others, and is by this easily recognizable in the living body. The dorsal vertebræ support the ribs; their spinous processesfig. A, 3-overlap one another like the tiles of a house-see Ribs-fig. B—while the spines of the neck and loin vertebræ project outwards. The "lumbar" or loin vertebre-fig. C-are the strongest in the body; the lowest of them rests upon the sacrum bone-see Pelvis-and, indeed, this bone is evidently a series of vertebræ consolidated to fulfil the functions of their position. rally ends fatally, but not so invariably as to justify the child being left to its fate without an attempt to save it. This attempt can only be made by the surgeon, and will probably consist of cautious evacuations, at intervals, of the fluid contained in the bag, pressure being at the same time employed. Natural cure is said to have occurred in consequence of the fluid being allowed to escape through an ulcerated opening. Concussion of the spinal cord is not unfrequent, as a consequence of heavy falls on the feet, especially on the heels, or of direct blows on the back. The usual symptoms are depression of the system, with loss of sensation and power of motion of the lower portions of the body, which either passes off in the course of a few days, or remains permanently, perhaps passing into disease. Occasionally, very acute pain in the lower limbs comes on. In cases of concussion of the spinal cord, the power of evacuating the urine is sometimes lost, in which case the use of the catheter will have to be resorted to by the surgeon, whose speedy presence is requisite in every case of the accident in question. The best thing that can be done until aid is procured, is to place the patient as carefully as possible in the most easy position, and to keep him perfectly quiet. Any symptoms of inflammation following such an injury will require the usual treatment of leeches, fomentations, poultices, &c., the bowels being acted on by purgatives given by the mouth or in clysters, &c. In patients confined to bed after injuries of the spine, bed-sores are particularly to be guarded against; moreover, if sensation be much impaired, and the case be neglected, a sore may make considerable progress before it is discovered. Even if a case of injury of the spine does well, it is apt to be tedious, and the lost powers are very slowly regained. Friction repeated frequently, warm saline bathing, the douche, and gentle exercise of the limbs, are the most beneficial remedies. Displacement of vertebræ can rarely take place without extreme violence, and, even then, fracture generally accompanies the accident, except in the case of the upper vertebræ of the neck, alluded to DISEASES AND INJURIES OF THE SPINE. in the last article. Displacement is accomThe spine is liable to be the seat of a pecu-panied to a greater or less extent by injury liar malformation at birth. This consists to the spinal cord, and consequently by in the deficiency of the posterior portions of paralysis of the parts below: if the injury a certain number of the vertebræ, generally is high up, instant, or at least speedy those of the loins, by which the membranes death being the result. In the event of an lining the interior of the spinal canal are individual surviving, for a longer or shorter left uncovered, except by the skin, both time, such an accident, all that others can membranes and skin being distended into a do, till proper assistance is procured, will livid-looking semi-transparent bag contain- be to place the person in an easy posture, to ing fluid. This peculiar malformation gene- administer stimuli with due caution, and to The spinal column constructed as above described is not straight, but has various natural curves; the principal of these is one outwards, which increases the capacity of the chest, and one inwards at the small of the back, which assists in maintaining the equilibrium of the body, and also in supporting the contents of the abdomen.-See Chest, fig. A. The canal which runs through the entire spine is continuous with the cavity of the skull by the opening in the base of the head-see Skull-and the membranes and nerve substance of the spinal cord, are, through the above opening, continuous with the brain and its membranes.-See Nervous System. The equilibrium of the spine, and therefore of the body generally, and the motions of the trunk, are effected by means of the various muscles attached in a longitudinal direction, chiefly to the posterior portions of the vertebræ. endeavour to preserve the proper heat of the paralysed parts, by friction and warm applications, bearing in mind the cautions given under article "Paralysis." The spine is liable to various diseases, such as inflammation, apoplexy of the cord, softening, &c., the latter being not an unfrequent concomitant of epilepsy. Pain in the part, and disorders of the functions of sensation and motion, and convulsive twitching, are the most usual symptoms. It is not possible, that beyond temporary soothing measures, such as bran poultices, &c., unprofessional interference in such cases can be usefully employed. In cases of severe pain, however, opiates may be cautiously given till a medical man sees the case. In some forms of fever, and of lock-jaw, the spine is affected. Functional disorder, and what is called "irritation of the spine," are extremely common, especially in females, and are often at the root of the obstinate palpitations, and many of the nervous and hysterical derangements of the sex. In such cases, if the back be carefully examined, a tender spot may generally be discovered somewhere in the upper part of the spine, and often, when there is more than one tender spot, lower down. In these situations, the spine may be simply tender on pressure, or pressure may cause pain to radiate as it were from the point, round the body, or, in severe cases, may bring on hysterical symptoms at once, and fainting. Such cases are frequently overlooked. They are generally connected with debility of constitution, and require the well directed treatment of a medical attendant. The use of the tepid or cold douche down the spine, followed by friction with a rough towel or flesh-brush, does much to relieve in such cases, often more than counter-irritation. The general health requires attention, and, generally, tonics, quinine and iron, are called for. Exercise must be regular, but not carried to fatigue, which is injurious. In severe cases repeated small blisters are sometimes useful. Curvature of the spine is far from being uncommon; it is of three varieties, the angular curvature, lateral curvature, and curvature backwards. The first of these, angular curvature, is caused by diseasecaries of the bodies of some of the vertebræ themselves, which, permitting the bone to yield under the weight of the body, causes angular distortion at the seat of the affection. This disease, being sometimes at first accompanied with little pain, may be overlooked. It usually occurs in children, and in young people of delicate, and especially of scrofulous, constitution. Matter forms in connexion with the diseased bone, and gra vitating downwards, shews itself as abscess lower down, perhaps in the loins or groin. The first symptoms of this disease may be the child wincing or crying out from sudden pain in some movement of the spine. If allowed to go on unchecked, very great deformity ensues, and the constitution is at length worn out. The great essential of treatment in this form of curvature, is rest, in such a position as will take the pressure off the diseased bones, this being best effected by the use of the inclined plane, the patient lying either on the back or face; but this, and the local and constitutional treatment, can only be properly conducted under medical superintendence. Lateral curvature is not, like the above, the result of disease, but is the mechanical effect of repeated and continual malposition of the body. It is the form of spinal curvature from which nurse-girls who are put at too early an age to carry heavy children frequently suffer, it is also the affection met with among the pupils of injudiciously conducted female schools. It of course is most liable to occur in weakly subjects, but may take place in any young person, who is compelled, habitually, to maintain the body, even without additional weight, in one position for any length of time-see Education-and, especially, if compelled to support a weight on, or to make undue exertion with, any one side of the body. The first thing, generally, which attracts attention in this form of curvature, is the appearance of the shoulder, which assumes the prominence popularly known as "growing out;" that is, it evidences the displacement from its symetrical position, which it, in common with the ribs, experiences from the curvature of the spine. If the incipient curvature be neglected, as a matter of necessity, for the support of the head in an upright posture, a second curvature takes place in a direction opposite to the first, giving the spine the curves laterally in the form indicated fig. A.-and distorting the body as represented. The causes of the above common deformity which have been pointed out, naturally indicate, that the first step towards cure must be the removal of the producing cause. If a weight has been carried, if exertion made, if injudicious school management, such as too long continued sitting or standing upright, has occasioned the deformity, it must be put a stop to at once. Such a course, with general tonic measures, rest of the body for a considerable portion of the day, equal exercise of the muscles connected with the upper extremities, and cold or tepid salt douche, with regular general exercise, will probably remove the tendency A to curvature in incipient cases. If, however, SPONGE.-This well known production of the animal kingdom is chiefly brought from Turkey. The great uses of sponge in medical, and especially surgical matters, need not be dwelt on here; suffice it to remark, that sponges selected for such purposes should be free from the gritty particles which are often present in considerable quantity in inferior sponges. Burnt sponge was formerly the best remedy in cases of "bronchocele;" it is now known that its power of removing that disease depended on the presence of iodine.-See Todine—— Bronchocele, &c. SPONGIO PILINE.-See Poultice. SPORADIC DISEASES. Diseases which show themselves in individual cases, in contradistinction to epidemic and contagious diseases. SPRAIN OR STRAIN.- This painful injury is the result of forcible overstretching of the ligaments-see Ligaments—of a joint. In their natural state, the ligaments are but slightly sensitive, but when overstretched they are acutely so; there are few, perhaps, who have not, in a greater or less degree, experienced the sickening pain of a sprained wrist or ancle, the two joints which are most frequently the seat of the injury; their liability arising from their immobility, compared with such a joint as the shoulder, which is more liable to dislocation. A sprain is attended with pain, which, perhaps, causes faintness or vomiting; when this passes off, it is found that the joint cannot be employed as usual, every attempt renewing the suffering; shortly, swelling comes on, followed by the heat and pain of inflammation. An injury of this kind, it need hardly be said, should not be slighted; for should it be so, in some constitutions, it may lay the foundation of irremediable disease. Few, perhaps, have either the power or the will to neglect a strain at first, but very many are inclined to rebel against the rest and confinement SPIRITS.-See Stimulants - Brandy - necessary for its perfect cure, which ought Gin, &c. to be effected before the joint is brought into SPITTING OF BLOOD.-See Hemorr- active use. When a sprain has occurred, hage-Lungs, &c. Refer to-Education, &c. SPLEEN OR MILT-is a body of variable size, which is situated in the left hypochondriac region- see Abdomen. It is somewhat of a spongy texture, and is capable of containing blood so largely, that its office in the economy-which even now is not yet clearly made out-has been supposed to be that of a blood reservoir. Recent investigations point to its close connexion with the condition of the blood corpuscles. The spleen is liable to become greatly enlarged in cases of continued ague-see Ague. SPLINT.-See Fractures. complete rest is the first necessity, accompanied by the soothing influences of fomentation and poultice, well and thoroughly made use of, from the very first; the early employment of the remedies doing much to alleviate the suffering. When, in the course of a few hours, inflammatory signs appear, six, eight, or ten leeches may be applied around the joint with advantage, and if the patient is of at all full habit, a few doses of purgative medicine should be given. To allay the pain, six or eight grains of Dover's powder, with a couple of grains of calomel, may be given at night, and followed in the |