See also:

• THERAPEUTICS (Gr. BepaaeuTLKIi, Sc. TEXVrt, from Beparebsty, to serve)

THERAPEUTICS (Gr. BepaaeuTLKIi, Sc. TEXVrt, from Beparebsty, to serve)  , the name given to that See also:

• BRANCH (from the Fr. branche, late Lat. branca, an animal's paw)

branch of See also:

• MEDICINE

medicine which deals specifically with the means employed to cure disease if possible, or to See also:

• CONTROL (Fr. contrdle, older form contre rolle, from Med. Lat. contra-rotulus, a counter roll or copy of a document used to check the original; there is no instance in English of the use of " control " in this, its literal, meaning)

control and lessen its evil results when a cure is impossible . The cure which is sought for may either be symptomatic or See also:

• RADICAL (Lat. radix, a root)

radical . Various morbid conditions of the See also:

• BODY

body generally may give rise to different symptoms . Thus a gouty See also:

• CONDITION (Lat. condicio, from condicere, to agree upon, arrange; not connected with conditio, from condere, conditum, to put together)

condition may See also:

• MANIFEST (Lat. manifestus, clear, open to view)

manifest itself in one See also:

• MAN
• MAN, ISLE OF (anc. Mona)

man as See also:

• ECZEMA (Gr. EKE a, a cutaneous eruption)

eczema of the skin, giving rise to redness and intense itching; in another as See also:

• NEURALGIA (Gr. veiipov, nerve, and iXyos, pain)

neuralgia, causing most sevete See also:

• PAIN (from Lat. poena, Gr. robin, penalty, that which must be paid: O. Fr. peine)
• PAIN, BARRY (1867– )

pain; in a third as See also:

• BRONCHITIS

bronchitis, producing a distressing cough; in a See also:

• FOURTH

fourth as See also:

• DYSPEPSIA (from the Gr. prefix Sur-, hard, ill, and 'irirreiv, to digest)

dyspepsia, giving rise to flatulence and intestinal disturbance; and in a fifth as inflammation of the See also:

• GREAT

great toe, accompanied by redness, swelling and pain . The therapeutic See also:

• MEASURES

measures employed in these different cases may be directed towards alleviating the symptoms, such as itching, pain, cough and swelling, in which See also:

• CASE
• CASE, JOHN (d. 1600)

case the treatment will be merely symptomatic; or they may be directed towards removing the See also:

• ROOT (late O.E. rot, adopted from Scand., cf. Norw. and Swed. rot, Dan. rod; the true O.E. word was wyrt, plant, represented in Ger. Wurz or Wurzel; the ultimate root is the same in both words, and is seen in Lat. radix)
• ROOT, ELIHU (1845– )

root of the disease, viz, the gouty condition underlying them all, and thus effecting a radical cure . It very frequently happens that we do not know what the underlying condition is, and we are forced simply to relieve as best we can the most prominent and most distressing symptoms . In symptomatic treatment we are frequently obliged to use remedies simply *because we know they have done See also:

• GOOD, JOHN MASON (1764-1827)

good before in similar cases, and we expect them to do so again without having the least See also:

• IDEA (Gr. Ibia, connected with i&eiv, to see; cf. Lat. species from specere, to look at)

idea of how they See also:

• ACT (Lat. actus, actum)

act . Thus in acute See also:

• GOUT

gout the most See also:

• COMMON

common and most trusted remedy for removing the pain is See also:

• COLCHICUM

colchicum, but at See also:

• PRESENT

present we do not know what See also:

• ACTION

action it has upon the See also:

• SYSTEM

system, or why it gives so much ease in the pain of gout while it has comparatively little effect upon pain due to other causes . This See also:

• PLAN
• PLAN (from Lat. planes, flat)

plan of treatment is termed empirical . It is a useful method, and is often very satisfactory, but i t has the disadvantage that it admits of but little progress, and when a trusted empirical remedy fails we do not know precisely in what direction to look for a substitute . In contradistinction to empirical we have rational See also:

• THERAPEUTICS (Gr. BepaaeuTLKIi, Sc. TEXVrt, from Beparebsty, to serve)

therapeutics, by which we mean the application of a remedy, whose mode of action we know more or less perfectly, in diseased conditions, the nature of which we also understand more or less fully . As an example may be taken the use of nitrite of amyl in angina pectoris .

It has been found that in many cases of this disease the pressure of See also:

• BLOOD

blood within the See also:

• ARTERIES (Gr. ap-rnpia, probably from a"spew, to raise, but popularly connected by the ancients with ai7P, air)

arteries becomes increased, probably from spasmodic contraction of the arteries themselves . Nitrite of amyl has the See also:

• POWER [WILLIAM GRATTAN] TYRONE (1797-1841)

power of dilating the arteries; it has consequently been employed with much success in lowering the blood pressure and removing the pain in angina pectoris . But such rational knowledge as this not only enables us to remove pain at the See also:

• TIME (0. Eng. Lima, cf. Icel. timi, Swed. timme, hour, Dan. time; from the root also seen in " tide," properly the time of between the flow and ebb of the sea, cf. O. Eng. getidan, to happen, " even-tide," &c.; it is not directly related to Lat. tempus)
• TIME, MEASUREMENT OF
• TIME, STANDARD

time, but See also:

• HELPS, SIR ARTHUR (1813-1875)

helps us to prevent its recurrence . For on the one See also:

• HAND
• HAND (a word common to Teutonic languages; cf. Ger. Hand, Goth. handus)
• HAND, FERDINAND GOTTHELF (1786-185r)

hand knowledge of the fact that nitrite of amyl lessens blood pressure has led to the successful employment of other nitrites and bodies having a similar action, and on the other the knowledge that increased blood pressure. tends to cause anginal pain leads to the See also:

• PROHIBITION (Lat. prohibere, to prevent)

prohibition of any See also:

• STRAIN (through O. Fr. straindre, estraindre, mod. i treindre, from Lat. stringere, to draw tight, related to stress, stretch, string, &c.)

strain, any See also:

• FOOD
• FOOD (like the verb " to feed," from a Teutonic root, whence O. Eng. foda; cf. " fodder "; connected with Gr. lrareicOae, to feed)

food, any exposure to See also:

• COLD (in O. Eng. cald and ceald, a word coming ultimately from a root cognate with the Lat. gelu, gelidus, and common in the Teutonic languages, which usually have two distinct forms for the substantive and the adjective, cf. Ger. Kolte, kalt, Dutch koude

cold, and also of any medicines which would unduly raise the blood pressure . Here we See also:

• NOTICE

notice one of the greatest advantages of rational over empirical therapeutics . In cases of angina, while the resistance opposed to the action of the See also:

• HEART
• HEART, LUNG

heart by spasm in the vessels may be great, the heart itself may be feeble, and it may therefore be necessary to give some remedy which will increase the power of the heart . But if such a remedy were given alone it might, and probably would, act on the arteries as well as the heart, and by causing the contraction of the vessels do more harm than good . But if we know what remedies will increase the power of the heart and what will lessen resistance in the vessels, we may combine them and thus obtain the See also:

• OBJECTS

objects we desired, viz. removal of the pain, better action of the heart, and more perfect circulation . The testing of ideas by observation and experiment which was begun in See also:

• ANATOMY
• ANATOMY (Gr. avaroyil, from ava-silo c', to cut up)

anatomy by Vesalius. and by See also:

• HARVEY
• HARVEY, GABRIEL (c. 1545-1630)
• HARVEY, SIR GEORGE (1806-1876)
• HARVEY, WILLIAM (1578—1657)

Harvey in See also:

• PHYSIOLOGY (from Gr. 4 i s, nature, and koyos, discourse)

physiology, was applied by See also:

• MORGAGNI, GIOVANNI BATTISTA (1682-1771)

Morgagni to alterations in the See also:

• ORGANS

organs produced by disease, by See also:

• BICHAT, MARIE FRANCOIS XAVIER (1771–1802)

Bichat to the tissues, and by See also:

• VIRCHOW, RUDOLF (1821-1902)

Virchow to the See also:

• CELL (from Lat. cella, probably from an Indo-European kal —seen in Lat. celare, to hide; another suggestion connects the word with Lat. cera, wax, taking the original meaning to refer to the honeycomb)

cell . The study of disease in the living body may be said to have been begun by See also:

• JOHN
• JOHN (1167–1216)
• JOHN (1290-c. 1320)
• JOHN (1296-1346)
• JOHN (1371–1419)
• JOHN (1468-1532)
• JOHN (1801-1873)
• JOHN (Heb. llni')
• JOHN (ZAPOLYA) (1487-1540)
• JOHN, 4TH MARQUESS OF TWEEDDALE (c. 1695-1762)
• JOHN, DON (1545-1578)
• JOHN, DON (1629–1679)
• JOHN, GOSPEL OF ST
• JOHN, or HAYS (1513–1571)
• JOHN, THE APOSTLE
• JOHN, THE EPISTLES OF

John See also:

• HUNTER, JOHN (1728-1793)
• HUNTER, ROBERT MERCER TALIAFERRO (r8o9-1887)
• HUNTER, SIR WILLIAM WILSON (1840-19oo)
• HUNTER, WILLIAM (1718–1783)
• HUNTER, WILLIAM ALEXANDER (1844-1898)

Hunter, See also:

• DEVELOPED

developed by Magendie, See also:

• CLAUDE, JEAN (1619-1687)

Claude See also:

• BERNARD, CHARLES DE
• BERNARD, CLAUDE (1813-1878)
• BERNARD, JACQUES (1658--1718)
• BERNARD, MOUNTAGUE (1S2o—1882)
• BERNARD, SAINT
• BERNARD, SAINT (Iogo-1153)
• BERNARD, SIMON (1779—1839)
• BERNARD, SIR THOMAS, BART

Bernard, See also:

• BROWN
• BROWN, CHARLES BROCKDEN (1771-181o)
• BROWN, FORD MADOX (1821-1893)
• BROWN, FRANCIS (1849- )
• BROWN, GEORGE (1818-188o)
• BROWN, HENRY KIRKE (1814-1886)
• BROWN, JACOB (1775–1828)
• BROWN, JOHN (1715–1766)
• BROWN, JOHN (1722-1787)
• BROWN, JOHN (1735–1788)
• BROWN, JOHN (1784–1858)
• BROWN, JOHN (1800-1859)
• BROWN, JOHN (1810—1882)
• BROWN, JOHN GEORGE (1831— )
• BROWN, ROBERT (1773-1858)
• BROWN, SAMUEL MORISON (1817—1856)
• BROWN, SIR GEORGE (1790-1865)
• BROWN, SIR JOHN (1816-1896)
• BROWN, SIR WILLIAM, BART
• BROWN, THOMAS (1663-1704)
• BROWN, THOMAS (1778-1820)
• BROWN, THOMAS EDWARD (1830-1897)
• BROWN, WILLIAM LAURENCE (1755–1830)

Brown-Sequard and others . Of See also:

• LATE

late years enormous impulse has been given to our knowledge of the See also:

• CAUSATION

causation of disease by microbes, through the See also:

• WORKS

works of Gaspard, who injected putrid See also:

• MATTER

matter into the See also:

• VEINS

veins of a living See also:

• ANIMAL
• ANIMAL (Lat. animalis, from anima, breath, soul)

animal; by Villemin, who discovered that See also:

• TUBERCULOSIS

tuberculosis is infective; by Davaine; and especially by See also:

• PASTEUR, LOUIS (1822-1895)

Pasteur, See also:

• KOCH
• KOCH, ROBERT (1843–1910)

Koch and others toonumerous to mention, who have worked, and are still working, at the microbic causation of disease with marvellous success . The natural end of See also:

• LIFE

life is that all the organs should become old and gradually decay at the same time, so that at the last the individual should become less and less active, weaker and weaker, and finally See also:

• DIE
• DIE (Fr. de, from Lat. datum, given)

die without any definite disease, without pain and without struggle .

But this is exceptional, and generally one See also:

• PART

part gives way before another, either on See also:

• ACCOUNT
• ACCOUNT (through O. Fr. acont, Late Lat. comptum, cornputare, to calculate)

account of one part being naturally weaker or of one part having been overtaxed or more severely attacked by some injurious See also:

• EXTERNAL

external See also:

• INFLUENCE (Late Lat. influentia, from influere, to flow in)

influence, or by some undue preponderance of another part of the body itself . For See also:

• HEALTH

health consists in a due proportion between the action of all the different parts of the body, and if one part be unnaturally strong it may See also:

• LEAD
• LEAD (pronounced iced)

lead to injury or See also:

• DEATH

death . Thus a very strong heart, although it may be useful to its possessor for many years, See also:

• DRIVING (from " to drive," i.e. generally to propel, force along or in, a word common in various forms to the Teutonic languages)

driving the blood rapidly through the vessels, and supplying all his tissues with such abundant nutriment as to enable him to endure great exertion, See also:

• MENTAL

mental or bodily, may in the end cause death by bursting a See also:

• VESSEL (O. Fr. vaissel, from a rare Lat. vascellum, dim. of vas, vase, urn)

vessel in the See also:

• BRAIN (A.S. braegen)

brain, which might have resisted the pressure of a feebler circulation for years longer . On the other hand, a heart that is too feeble may cause its owner's death by its in- Disease ability to carry on the circulation against increased by feeble-resistance . This may occur suddenly, as when the See also:

• HESS
• HESS, HEINRICH HERMANN JOSEF, FREIHERR VON (1788-1870)

Hess or resistance is increased in the arterial system by a excessivf e action o sudden exertion or strain, and more slowly when the one pars resistance is increased in the pulmonary circulation of the by inflammation of the See also:

• RESPIRATORY

respiratory passages . The body. See also:

• THYROID (Gr. Ovpoea3i'is, shield-shaped, from Ovpeos, a large oblong shield, shaped like a door, Obpa, and eiSos, form)

thyroid gland, which is situated in front of the See also:

• NECK (O. Eng. hnecca; the word appears in many Teutonic languages; cf. Dutch ride, Ger. Nacken; in O. E. the common word was heals; cf. Ger. Hals)

neck, yields a secretion which passes into the blood and there tends to maintain a See also:

• STATE
• STATE, GREAT OFFICERS OF

state of moderate See also:

• DILATATION (from Lat. dis-, distributive, and lotus, wide)

dilatation in the blood-vessels and of oxidization in the tissues, so that the circulation remains good and the body-See also:

• HEAT (0. E. haktu, which like " hot," Old Eng. hat, is from the Teutonic type haita, hit, to be hot; cf. Ger. hitze, heiss; Dutch, hitte, heet, &c.)

heat and See also:

• MUSCULAR

muscular activity remain well maintained . When this gland becomes enlarged, and its secretion consequently increases, the vessels dilate, the heart beats more rapidly, the skin becomes too hot, the See also:

• NERVOUS

nervous system becomes irritable, and tremors occur in the limbs . On the other hand, when it becomes atrophied the circulation becomes feeble, the See also:

• FACE (from Lat. fades, derived either from facere, to make, or from a root fa-, meaning " appear "; cf. Gr. cbatvstv)

face heavy and dull, the patient suffers from cold, the features grow lumpish, mental processes become sluggish, and bodily vigour diminishes . Disease of the whole body may thus be produced by over-action or under-action of some part of it, but such causes of disease are slight as compared with the effect of external noxious influences, and more especially the effect of microbes . These enter the body through various channels, and once they have effected a lodgment they grow, multiply and give rise to various poisons which attack and injure or destroy different tissues or organs in the body . Various safeguards are provided by nature to prevent their entrance . On the skin we have a thick epidermis through which microbes cannot pass, although if an microbes. entrance is obtained for them by a prick or cut they may readily grow in the tissues below and spread from them throughout the whole body .

They pass more readily through mucous membranes, but almost every one of these is provided not only with a coating of mucus, which obstructs their passage, but with some reflex mechanism which tends to remove them . Thus irritation of the See also:

• EYE
• EYE (O. Eng. edge, Ger. Auge; derived from an Indo-European root also seen in Lat. oc-ulus, the organ of vision (q.v.)

eye causes winking and secretion of tears, by which the irritant is removed; irritation of the See also:

• NOSE (O.Eng. nosu, cf. Dutch neus, Swed. nos, snout; the Aix in Provence. Both at Aix and at Lyons he acquired great connexion with O.Eng. nasu is obscure, cf. Ger. Nase, Lat. pares, distinction by his labours during outbreaks of the plague. In nostrils,

nose causes See also:

• SNEEZING (0. Eng. fneosung, from fneosan, to sneeze, cf. Dutch fniezen, allied to the obsolete neeze, and ultimately to be referred to root seen in Gr. irveiv, to breathe; the initial s is due to association with numerous words, such as snort, snuff, snor

sneezing; of the See also:

• AIR (from an Indo-European root meaning " breathe," " blow ")
• AIR, or ASBEN

air-passages, coughing; of the See also:

• STOMACH (Gr. vrbsaxos from arbga, a mouth)

stomach, vomiting; and of the intestines, See also:

• DIARRHOEA (from Gr. &Q, through, pfw, flow)

diarrhoea . Even when they have passed through an See also:

• ABRASION (from Lat. ab, off, and radere, to scrape)

abrasion in the skin or through the mucous membranes and enter the blood they are met, in some instances, by a toxic action of the blood itself upon them; and in others they are attacked by the See also:

• WHITE
• WHITE, ANDREW DICKSON (1832– )
• WHITE, GILBERT (1720–1793)
• WHITE, HENRY KIRKE (1785-1806)
• WHITE, HUGH LAWSON (1773-1840)
• WHITE, JOSEPH BLANCO (1775-1841)
• WHITE, RICHARD GRANT (1822-1885)
• WHITE, ROBERT (1645-1704)
• WHITE, SIR GEORGE STUART (1835– )
• WHITE, SIR THOMAS (1492-1567)
• WHITE, SIR WILLIAM ARTHUR (1824--1891)
• WHITE, SIR WILLIAM HENRY (1845– )
• WHITE, THOMAS (1628-1698)
• WHITE, THOMAS (c. 1550-1624)

white corpuscles, which destroy them, eat them up, and See also:

• DIGEST

digest them, the See also:

• PROCESS

process being known as See also:

• PHAGOCYTOSIS (Gr. 0ayeiv, to eat, devour, and KtTOS, cell)

phagocytosis . The greater the number of leucocytes that can reach the spot where the invading microbes enter the more quickly can the microbes be destroyed and See also:

• GENERAL
• GENERAL (Lat. generalis, of or relating to a genus, kind or class)

general infection prevented . The microbes appear in many cases to attract the leucocytes (See also:

• POSITIVE (or PORTABLE) ORGAN

positive chemiotaxis), but when very virulent they usually repel the leucocytes (negative chemiotaxis) and excrete toxins which kill the leucocytes . The irritation caused by the microbes generally is followed by dilatation of the vessels of that part and thus more leucocytes are brought up to the fight . This dilatation may be increased by See also:

• LOCAL

local warmth, and poultices or fomentations are commonly applied to inflamed parts; recently suction apparatus has been used for the same purpose or ligature so as to cause venous stasis (Bier's treatment). hlisters also cause local dilatation of vessels, but are usually applied to the skin for inflammation in deep-seated parts, such as the lungs, though they also relieve pain in the See also:

• JOINTS

joints in acute See also:

• RHEUMATISM (from Gr. /56µa, flux)

rheumatism . Bier increases the blood in a part by compressing the veins and thus producing passive instead of active congestion . The toxins produced by microbes, if too weak to destroy the leucocytes, induce them to secrete See also:

• ANTI, or CAMPA

anti-toxins, which not only act as antidotes to the toxins and are injurious to the microbes, but also increase the phagocytic power of the leucocytes (opsonius of See also:

• WRIGHT, CARROLL DAVIDSON (1840-1909)
• WRIGHT, CHAUNCEY (1830-1875)
• WRIGHT, JOSEPH (1734-1797)
• WRIGHT, SILAS (1795-1847)
• WRIGHT, THOMAS (1809–1884)
• WRIGHT, THOMAS (1810—1877)
• WRIGHT, WILLIAM ALDIS (1836– )

Wright) . By inoculation with increasing doses of these the resistance of the organism is greatly increased and the invading microbes destroyed . The vaccine is usually made by sterilizing a virulent culture and the proper dose is ascertained by noting the extent to which the power of the leucocytes to envelop- and digest the microbes is increased . Moreover, the products of microbic secretion tend to produce See also:

• FEVER (Lat. febris, connected with fervere, to burn)

fever .

The high temperature characteristic of this condition is no doubt injurious to the body itself, but it is frequently more so to the microbe which has invaded the organism; and thus fever, instead of now being regarded as a morbid condition to be suppressed by every means in our power, is considered to be a reaction of the organism tending to protect it by destroying the infection . But it must be kept within limits, lest it should of itself cause death, and here again we see the difference between empirical and rational medicine . Fever is not to be looked upon as an unmitigated evil, to be removed if possible, but rather as a defensive mechanism by which the organism may prevent invasion from noxicus microbes . Nevertheless, as in a See also:

• CAMPAIGN

campaign the general's plan may be spoiled by too hasty or too eager action on the part of some of his troops, so the defensive arrangement carried to excess may prove injurious or fatal to the organism . Thus too great a rise of temperature in fever may kill the patient; and the aim of therapeutics is to restrain the temperature within proper limits, neither allowing it to rise too high nor to fall too See also:

• LOW, SETH (1850- )
• LOW, WILL HICOK (1853- )

low . The old plan of lowering it by means of cold See also:

• BATHS

baths was known to Musa, the physician of See also:

• AUGUSTUS (a name 1 derived from Lat. augeo, increase, i.e. venerable, majestic, Gr. Ee0avr6s)

Augustus, and by it he saved the See also:

• EMPEROR (Fr. empereur, from the Lat. imperator)

emperor's life; but the same treatment killed the emperor's See also:

• NEPHEW

nephew . The introduction of the clinical thermometer, which allows us to ascertain exactly the amount to which the temperature rises in fever or to which it is reduced by antipyretic measures, is to the physician like the See also:

• COMPASS (Fr. corn pas, ultimately from Lat. cum, with, and passus, step)

compass to the sailor, and allows him to See also:

• STEER, PAUL WILSON (186o– )

steer safely between two extremes . After the struggle between the organism and the microbes is over, even when it has ended victoriously for the former, injuries are See also:

• LEFT

left behind which require repair . Every one has noticed after prolonged fever how thin and weak the patient is, and both the muscular and nervous power throughout the whole body are sadly in want of repair . Where there has been local See also:

• MISCHIEF

mischief due to inflammation the dead leucocytes must be re-moved, and this is done either by their being converted into pus in one See also:

• MASS (O.E. maesse; Fr. messe; Ger. Messe; Ital. messa; from eccl. Lat. missa)
• MASS, IN

mass, and making their way through the tissues to the nearest See also:

• SURFACE

surface, whether of skin or mucous membrane, from which it can be discharged, or they may undergo a process of fatty degeneration and absorption, leaving behind in some cases cheesy matter, in others hard connective See also:

• TISSUE (Fr. tissu, tissue, participle of tisser, Lat. texere, to weave)

tissue . Poisons formed by microbes are partly eliminated by the kidneys, partly by the mucous membrane of the stomach and intestines, and possibly also by the skin . In old days See also:

• FREE

free elimination by these channels was looked upon as a sign of returning health, and was termed a " See also:

• CRITICAL (in alphabetical order of authors)

critical " diuresis, diarrhoea or sweating, according to the channel through which the eliminative act had occurred .

By therapeutic measures we strive to limit as far as possiblethe entry of injurious microbes into the organism, to expel or destroy them and their harmful products, and to maintain the strength of the organism itself . One of the influences which is most injurious to the body, and favours most the invasion of microbes, is chill . So much is this the case that some diseases which are now known to be due to infection were formerly attributed entirely to the effect of cold . Thus See also:

• PNEUMONIA (Gr. ?rveu AMP, lung)

pneumonia is now known to be due to the diplococcus pneumoniae, and yet its invasion occurs so frequently after a chill that it is almost impossible not to look upon chill and pneumonia as cause and effect . The See also:

• REASON (Lat. ratio, through French raison)

reason of this appears to be that the diplococcus is frequently present in the mouth or air-passages without giving rise to any symptoms; but when the patient is exposed to chill, and the tissues of the respiratory passages are thereby weakened, the diplococcus grows, multiplies and gives rise to inflammation of the lungs . Even what are known as common colds are probably due chiefly to microbic infection aided by a chill, just as in the case of pneumonia . Therapeutic measures which are commonly adopted in the treatment of a cold have for their See also:

• OBJECT

object to destroy the microbes before they penetrate fairly into the organism, and to restore the See also:

• BALANCE (derived through the Fr. from the Late Lat. bilantia, an apparatus for weighing, from bi, two, and lanx, a dish or scale)

balance of the circulation and increase the strength of the invaded parts . Thus carbolic See also:

• ACID (from the Lat. root ac-, sharp; acere, to be sour)

acid or carbolized See also:

• AMMONIA (NH3)

ammonia are sniffed into the nose to destroy the microbes there, or the nose is washed out by an antiseptic See also:

• SOLUTION (from Lat. solvere, to loosen, dissolve)

solution as a nasal douche; See also:

• BISMUTH

bismuth or See also:

• MORPHINE

morphine are insufflated, or See also:

• ZINC

zinc ointment is applied, to See also:

• COVER (from the Fr. convert, from couvrir, to cover, Lat. cooperire)

cover the mucous membrane, and protect it from further irritation; and various antiseptic gargles, paints and powders applied to the pharynx in See also:

• ORDER
• ORDER (through Fr. ordre, for earlier ordene, from Lat. ordo, ordinis, rank, service, arrangement; the ultimate source is generally taken to be the root seen in Lat. oriri, rise, arise, begin; cf. " origin ")
• ORDER, HOLY

order to prevent the microbic inflammation from extending to the pharynx and down the trachea and bronchi, for many a severe bronchitis begins first by sneezing and nasal irritation . Sometimes the patient is put to See also:

• BED
• BED (a common Teutonic word, cf. German Bett, probably connected with the Indo-European root bhodh, seen in the Lat. fodere, to dig; so " a dug-out place " for safe resting, or in the same sense as a garden " bed ")

bed and the circulation is encouraged, especially on the surface of the body, by the use of hot See also:

• SPIRITS

spirits and See also:

• WATER

water, or See also:

• OPIUM (Gr. amov, dim. from Orbs, juice)

opium and See also:

• IPECACUANHA

ipecacuanha, while the outside of the nose is protected to a certain extent from loss of heat, and consequent irritation, by smearing it with a See also:

• TALLOW (M.E. talugh, talg, cf. Du. talk, L. Ger. talg ; the connexion with O.E. taelg, dye, or Goth, tulgus, firm, is doubtful)

tallow See also:

• CANDLE (Lat. candela, from candere, to glow)

candle or rubbing some ointment over the skin . At the same time, if the See also:

• THROAT (O. Eng. protu, prote or }Prota, possibly from preotan, to press, whence threat, or, with loss of initial s, connected with strut, to swell)

throat has begun to show signs of being involved, a hot See also:

• POULTICE

poultice or wet See also:

• PACK (apparently from the root pak-, paq-, seen in Lat. pangere, to fasten; cf. " compact ")
• PACK, OTTO VON (c. 1480-1537)

pack is applied to the neck . Both inflammation and fever are protective processes calculated to defend the organism against the attacks of microbes . But protective processes misdirected or carried to excess may become injurious or even dangerous to the organism .

As an instance of misdirection, we may take the irritation which remains in the eye after a particle of dust has been removed, or the itching of the skin which occurs in eczema . The irritation of the conjunctiva caused by dust leads to winking of the eye-lids, lachrymation and rubbing, which tend to remove it; but after the dust has been removed violent rubbing tends rather to keep up the irritation; and sometimes, if the particle of dust remains under the eyelid and is See also:

• SHARP, GRANVILLE (1735-1813)
• SHARP, JAMES (1618-1679)
• SHARP, JOHN (1645-1714)
• SHARP, RICHARD (1759-1835)
• SHARP, WILLIAM (1749-1824)
• SHARP, WILLIAM (1856-1905)

sharp and angular, the process of rubbing may cause it to injure the conjunctiva much more than if it were left alone . In the same way itching is often caused by the presence of See also:

• INSECTS

insects or other irritants upon the skin, and it tends reflexly to cause rubbing, which is useful by removing the irritant . But when the irritation is situated in the skin itself, as in eczema, the scratching tends to increase inflammation, and makes the irritation worse . In the same way, the reflex act of coughing is useful in removing either See also:

• FOREIGN

foreign bodies or excessive secretion from the air passages; but when the mucous membrane of the respiratory See also:

• TRACT (from Lat. tractare, to treat of a matter, through Provencal tractat and Ital. trattato)

tract is irritated and inflamed, it produces a feeling of tickling and a See also:

• DESIRE

desire to cough sometimes very violently; yet the coughing simply tends to exhaust the patient, because there is really little or nothing to bring up . The same is the case in inflammation of the See also:

• LUNG

lung substance itself . As an example of excessive action we may take sneezing, which is calculated to remove irritants from the nose, but when too powerful may cause the patient to burst a blood-vessel . In See also:

• PHTHISIS (Gr. 49Lnns " wasting ")

phthisis also, although there may be some expectoration to bring up, yet a good See also:

• DEAL

deal of the irritation is in the lung substance, and the efforts of coughing are far greater and more continuous than are required for the removal of expectoration, and they simply exhaust the patient . In inflammation of the stomach also such continuous vomiting occasionally occurs that the patient's life is in danger by his inability to retain food; and similar danger also occurs from inflammation of the intestines and consequent diarrhoea . We will next take the various parts of the body, and consider more in detail the therapeutic measures most commonly em-Defensive ployed in the treatment of their diseases . The de-measures. fensive See also:

• POWERS, HIRAM (1805-1873)

powers of the body against microbes, when actually on or in it, may be classed as means (r) of passive de-fence, (2) of active See also:

• DEFENCE
• DEFENCE (Lat. defendere, to defend)

defence, and (3) of repair . Besides these, however, we must consider the See also:

• PROTECTION

protection of the whole body from injury caused by (a) inaction, or (b) overaction, or (c) weakness of any one of its parts .

The means of passive and active defence are sometimes so closely associated that it is difficult to distinguish between them . Thus if a little diphtheritic sputum were coughed into a See also:

• PERSON, OFFENCES AGAINST THE

person's eye, or some blood containing See also:

• ANTHRAX (the Greek for " coal,” or " carbuncle," so called by the ancients because they regarded it as burning like coal; cf. the French equivalent charbon; also known as fievre charbonneuse, Milzbrand, splenic fever, and malignant pustule)

anthrax bacilli were to See also:

• TOUCH (derived through Fr. toucher from a common Teutonic and Indo-Germanic root, cf. " tug," " tuck," O. H. Ger. zucchen, to twitch or draw)

touch a raw spot upon the hand, the removal of microbes in either case by washing with See also:

• SIMPLE

simple water might be regarded as a means of passive defence, whilst washing them away with an antiseptic lotion might be regarded as active defence, because the antiseptic would tend not only to remove but to destroy the microbes . In the same way, washing the skin with spirit would tend to harden the epidermis and thus prevent the entrance of microbes; and the application of an ointment to an abrasion would have a similar action . But by the addition of some antiseptic to the ointment its defensive action would be converted from passive to active, and its power to prevent infection would become greater; and if inflammation had already set up in the skin, the addition of opium, See also:

• BELLADONNA (from the Ital. belle donna, " beautiful lady," the berries having been used as a cosmetic)

belladonna, or See also:

• COCAINE, C17H21NO4

cocaine would lessen local pain; and an astringent, either metallic or organic, would restrain inflammation and accelerate repair . The thickening of the epidermis in the hands and feet, which occurs from See also:

• CONSTANT, BENJAMIN (1845-1902)

constant use, is nature's See also:

• PROVISION (Lat. provisio)

provision for See also:

• MEETING (from " to meet," to come together, assemble, 0. Eng. metals ; cf. Du. moeten, Swed. mota, Goth. gamotjan, &c., derivatives of the Teut. word for a meeting, seen in O. Eng. Wit, moot, an assembly of the people; cf. witanagemot)

meeting the extra See also:

• WEAR

wear to which these parts are subjected by much use; but pressure is See also:

• APT

apt to cause the defensive process to be- carried too far, and to lead to corns, which give rise to much pain and annoyance . To remove these salicylic acid dissolved in flexible See also:

• COLLODION (from the Gr. &M a' , glue)

collodion is now generally employed . When this is painted upon the part the See also:

• CORN (a common Teutonic word; cf. Lat. granum, seed, grain)
• CORN (fromm Lat. corms, horn)

corn usually peels off in a See also:

• DAY (O. Eng. dreg, Ger. Tag; according to the New English Dictionary, " in no way related to the Lat. dies")
• DAY, JOHN (1574-1640?)
• DAY, THOMAS (1748-1789)

day or two, and the patient is cured . But the object of therapeutics is not merely to cure . It is, in the words of the old See also:

• FORMULA
• FORMULA (Lat. diminutive of forma, shape, pattern, &c., especially used of rules of judicial procedure)

formula, Curare, cito, tulo, et jucunde, Principles to cure quickly, safely, and pleasantly . There are of cure. therefore in most prescriptions (i) a basis or See also:

• CHIEF (from Fr. chef, head, Lat. caput)

chief ingredient intended to cure (curare), (2) an adjuvant to assist its action and make it cure quickly (cito), (3) a corrective to prevent or lessen any undesirable effect (tulo), and (4) a vehicle or excipient to make it suitable for See also:

• ADMINISTRATION (Lat. administrare, to serve)

administration and pleasant to the patient (jucunde) . In the remedy just mentioned the salicylic acid forms the basis; but sometimes chloride of zinc or lactic acid is added to it to make it act more quickly, and these are the adjuvants . See also:

• EXTRACT (from Lat. extrahere, to draw out)

Extract of belladonna is added to lessen the pain which might occur during the removal of the corn, and this acts as a corrective, while the flexible collodion forms a means of applying it conveniently, and constitutes the vehicle .

The surface of the skin may be invaded by parasitic organisms and may exhibit spots, which are removed by something which will destroy the See also:

• PARASITE (From Gr. irapa, beside, Tiros food)

parasite, such as ointments containing See also:

• MERCURIAL

mercurial salts . In See also:

• PSORIASIS

psoriasis the epidermis separates in flakes at various & See also:

• ITEM (a Latin adverb meaning " also," " likewise ")

item- spots which have not been subjected to pressure, matron. and to cure it ointment containing See also:

• TAR

tar or other See also:

• PRO

pro-ducts of the dry See also:

• DISTILLATION (from the Lat. distillare, more correctly destillare, to drop or trickle down)

distillation of See also:

• WOOD, ANTHONY A2 (1632-1695)
• WOOD, JOHN GEORGE (1827—1889)
• WOOD, MRS HENRY [ELLEN] (1814—1887)
• WOOD, SEARLES VALENTINE (1798—188o)

wood is employed . When the true skin is inflamed various appearances may arise, according to the intensity and extent of the inflammation, and the eruption may be papular, vesicular, pustular, tubercular, bulbous or ulcerative . To lessen irritation the skin is protected by dusting powders, such as See also:

• OXIDE

oxide of zinc, See also:

• STARCH

starch, See also:

• FULLER, ANDREW (1954-1815)
• FULLER, GEORGE (1822—1884)
• FULLER, M
• FULLER, MARGARET, MARCHIONESS
• FULLER, MELVILLE WESTON (1833-1910)
• FULLER, THOMAS (16o8-1661)
• FULLER, WILLIAM (1670--c. 1717)

fuller's See also:

• EARTH
• EARTH (a word common to Teutonic languages, cf. Ger. Erde, Dutch aarde, Swed. and Dan. jord; outside Teutonic it appears only in the Gr. 'pq'e, on the ground; it has been connected by some etymologists with the Aryan root ar-, to plough, which is seen in
• EARTH, FIGURE OF
• EARTH, FIGURE OF THE

earth, &c., or by ointments . Irritation is lessened by lotions containing substances that will diminish irritability of the See also:

• NERVE (Lat. nervus, Gr. vevpov, a bowstring)

nerve-endings and skin, such as carbolic acid, hydrocyanic acid, morphine or opium, cocaine, belladonna or atropine . Where the surface is ulcerated it may be protected from external violence and placed under favourable conditions for healing by covering it with See also:

• LINT (in M. Eng. linnet, probably through Fr. linette, from lin, the flax-plant; cf. " line ")

lint moistened with water and with oil-See also:

• SILK

silk over it to pre-vent evaporation . If the granulations tend to become too abundant, some astringent, such as sulphate of See also:

• COPPER (symbol Cu, atomic weight 63.1, H=1, or 63.6, O = 16)

copper or sulphate of zinc, is added to the water . On the other hand, when the ulceration is old and the circulation through it poor, the aim of the therapeutist is to reawaken the normal reparative process, to bring about increased circulation and increased tissue See also:

• CHANGE (derived through the Fr. from the Late Lat. cambium, cambiare, to barter; the ultimate derivation is probably from the root which appears in the Gr. «a urmu', to bend)

change, and thereby insure healing . For this reason a See also:

• BLISTER (a word found in many forms in Teutonic languages, cf. Ger. Blase; it is ultimately connected with the same root as in " blow," cf. " bladder ")

blister is placed upon the callous See also:

• ULCER

ulcer, which heals with the fresh inflammation thus excited . The treatment of inflammation of mucous membrane is based upon the same principles as inflammation of the skin, and there too we usually See also:

• ASSOCIATE (Lat. associates, from ad, to, and sociare to join)

associate means (r) for removing microbes, (2) for destroying them, (3) for lessening the irritation they produce, and (4) for repairing any mischief they have done . Thus in the eye and See also:

• EAR (common Teut.; O.E. are, Ger. Ohr, Du. oor, akin to Lat. auris, Gr. ovs)

ear, lotions containing an antiseptic, a sedative and an astringent are very generally used . For inflammation of the mouth a similar See also:

• COMBINATION (Lat. combinare, to combine)

combination is used as a mouth See also:

• WASH, THE

wash, in the throat as a gargle, and in the nose as a wash and sometimes as an ointment or spray, the ointment possessing the See also:

• ADVANTAGE

advantage of protecting the delicate nasal mucous membrane from irritation by stopping the entrance of irritant dust into the nasal cavities .

In the stomach we aid the vomiting by which microbes or the products of decomposition of food are usually eliminated by giving to the patient repeated See also:

• DRAUGHTS (from AS. dragan, to draw)

draughts of hot water so as to wash the stomach clean . Frequently this is sufficient; but if the stomach refuses to eject its objectionable contents, we may either give an emetic or wash it out by means of a stomach-See also:

• PUMP

pump or See also:

• SIPHON, or SYPHON (Lat. sipho; Gr. vi4xov, a tube)

siphon . Similar procedures are used for the See also:

• INTESTINE (Lat. intestinus, internal, usually in neuter plural intestina. from intus, within)

intestine, and one of the best methods of treating the diarrhoea consequent upon the presence of irritating substances in the intestinal See also:

• CANAL
• CANAL (from Lat. canalis, " channel " and " kennel " being doublets of the word)

canal is to give a dose of See also:

• CASTOR

castor-oil together with a few drops of See also:

• LAUDANUM

laudanum . By means of the castor-oil the irritating substances are removed, and the laudanum which is mixed with the purgative soothes the intestine . Even in cases of very acute intestinal diseases similar treatment is now pursued, and instead of treating See also:

• DYSENTERY (from the Gr. prefix Ova-, in the sense of " bad," and Evmpov, the intestine)

dysentery simply by sedatives or astringents, an eliminative treatment by means of sulphate of See also:

• MAGNESIA

magnesia is largely employed . After the irritant has been removed either from the stomach or intestine, a feeling of irritation of the mucous membrane may remain, and sickness, diarrhoea or pain may continue in the stomach and intestine although the irritant is no longer present within them, just as the flow of tears and desire to rub may remain in the eye after the piece of grit which has occasioned it may have been re-moved . The condition which remains after the irritant has been removed is one of inflammation more or less intense . The process of inflammation is a defensive one, but if carried too far may prove injurious . For the purpose of checking the inflammatory processes and lessening See also:

• DISCHARGE (adapted from the O. Fr. discharge, modern decharge, from a med. Lat. discargare, to unload, dis- and earn care, to load, cf. " charge ")

discharge from mucous membranes astringents are employed . Some of these are of See also:

• MINERAL

mineral and some of See also:

• VEGETABLE

vegetable origin, but they almost all possess one chemical See also:

• PROPERTY

property in common, namely, they precipitate See also:

• ALBUMIN, or ALBUMEN (Lat. albus, white)

albumin . This power is possessed alike by a See also:

• GLASS
• GLASS (O.E. glees, cf. Ger. Glas, perhaps derived from an old Teutonic root gla-, a variant of glo-, having the general sense of shining, cf. " glare," " glow ")
• GLASS, STAINED

glass of See also:

• BRANDY

brandy, by solution of See also:

• LIME
• LIME (O. Eng. lim, Lat. limes, mud, from linere, to smear)

lime, soluble salts of zinc, copper, or See also:

• SILVER

silver, by tannic and gallic acids, as well as vegetable juices and extracts which contain them . The strength of the astringent application and the mode of its ad-ministration are varied according to the delicacy and position of the mucous membrane affected .

Thus to the eye we may use a solution of sulphate of zinc of See also:

• HALF

half a See also:

• GRAIN (derived through the French from Lat. granum, seed, from an Aryan root meaning " to wear down," which also appears in the common Teutonic word " corn ")

grain to the See also:

• OUNCE

ounce, while to the ear, urethra or vagina a solution of four to eight grains or even more may be applied . For the stomach and intestines we employ the same See also:

• DRUG
• DRUG (from Fr. drogue, a word common in Romance languages, cf. Span. and Ital. droga; the origin of the word is obscure, but may possibly be connected with Dutch droog, dry)

drug in the See also:

• FORM (Lat. forma)

form of a pill; and when it is desired to act especially upon the intestines, the pills are made of a harder consistence or less soluble preparation, or are covered with keratin, so that they may not act much, if at all, upon the stomach while passing through it before reaching the intestines . The heat which occurs in inflamed parts is chiefly due to the larger amount of blood circulating in the part on account of the dilatation of the vessels . The pain is due to stretching of the nerve fibrils or See also:

• COMPRESSION

compression of them by the turgid vessels in the swollen tissues . This latter cause is chiefly observed when the tissues are of a very unyielding See also:

• CHARACTER (Gr. xapareri7p, from xap&crew, to scratch)

character; for example, when the inflammation occurs in a See also:

• BONE (a word common in various forms to Teutonic languages, in many of which it is confined to the shank of the leg, as in the German Bein)
• BONE, HENRY (1755-1834)

bone or under a thick fibrous and unyielding membrane . The swelling, heat and pain may sometimes be relieved by See also:

• MERE
• MERE, ADALBERT (1838-1909)

mere change of position altering the flow of blood to. the inflamed part . Thus when inflammation occurs in the See also:

• FINGER

finger, as in a See also:

• WHITLOW

whitlow, the pain is not only constantly severe, but it is increased by every pulsation of the heart, and thus has a throbbing character . By raising the hand nearly to a level with the See also:

• HEAD (in 0. Eng. heafad; the word is common to Teutonic languages; cf. Dutch hoofd, Ger. Haupt, generally taken to be in origin connected with Lat. caput, Gr. KerbOvi7)
• HEAD, SIR EDMUND WALKER, BART
• HEAD, SIR FRANCIS BOND, BART

head both the constant pain and the severity of the throbs may be relieved, as the blood is not sent with such great force into the arteries and returns more readily through the veins . In other parts of the body the same See also:

• RELIEF

relief may be obtained by raising the inflamed part as high as possible . Relief is.frequently given also by both heat and cold, and at first sight it seems See also:

• STRANGE, SIR ROBERT (1721-1792)

strange that agents having such an opposite action should each produce a similar effect . The reason probably is that the application of cold causes contraction of the arteries leading to the inflamed part, while heat by dilating the vessels around forms a See also:

• SIDE
• SIDE (mod. Eski Adalia)

side channel through which the blood passes, the tension in the seat of inflammation being thus lessened in both cases . When the inflammation occurs in soft parts where the surrounding vessels can be readily dilated, heat often affords more relief to the pain than cold, but when the inflammation is in a bone or in unyielding fibrous tissues, cold generally gives more relief .

For example, the pain of a See also:

• GUM (Fr. gomme, Lat. gommi, Gr. Kµµ1, possibly a Coptic word; distinguish " gum," the fleshy covering of the base of a tooth, in O. Eng. gbma, palate, cf. Ger. Gaumen, roof of the mouth; the ultimate origin is probably the root gha, to open wide, seen in

gum-See also:

• BOIL

boil is generally relieved more by warmth, because the yielding tissues of the gum, mouth and cheek can be readily relaxed by heat and their vessels dilated; but when the pain is dependent upon inflammation in the hard unyielding socket of a tooth, cold generally gives greater relief . The removal of blood, either by incision or by the application of leeches, some-times gives considerable relief to the pain and tension of inflamed parts . Blisters applied at some distance from inflamed parts are also sometimes useful; and probably they produce this good effect by causing a reflex contraction of the arteries in the inflamed part, and thus acting like a cold application . Certain drugs have the power of relieving inflammation by slowing the heart and rendering its impulse more feeble . Amongst those are to be classed small doses of See also:

• ACONITE (Aconitum)

aconite and colchicum; the former especially tends to lessen the process of inflammation generally, when it is not too severe . There can be little doubt that the intensity of inflammation frequently depends very much on the condition of the blood, and that by altering the blood inflammation may be lessened . Thus free purgation, and especially purgation by cholagogues and salines, has See also:

• LONG, GEORGE (1800-1879)
• LONG, JOHN DAVIS (1838– )

long been recognized as a useful means of reducing the inflammatory process . For example, a mercurial pill at See also:

• NIGHT

night, followed by salts and See also:

• SENNA (Arab. sand)

senna in the See also:

• MORNING

morning, will often relieve the pain in toothache or gum-boil, and lessen inflammation not only in the mouth, but other parts of the body as well . Such remedies are termed antiphlogistic . Venesection (blood-letting) at one time was highly esteemed as an antiphlogistic measure, and while it is possible that it has now fallen too much into disuse, there can be no doubt that at one time it was very greatly abused, and was carried to such an excess as to kill many patients who would have recovered perfectly had they been let alone . Although the high temperature in an inflamed part is chiefly due to the increased circulation of blood in it, yet the presence of inflammation appears to cause increased formation of heat either in the inflamed part itself or in the body generally, because we rarely find inflammation exist to any extent without the temperature of the body being raised and a febrile condition produced . Two very old remedies for fever are acetate of ammonia and nitrous See also:

• ETHER, (C2H5)2O

ether .

These were formerly given empirically, simply because they had been found to do good . Now we can see the reason for their administration, because the nitrous ether, consisting chiefly of See also:

• ETHYL

ethyl nitrite, dilates the superficial vesselsand thus allows greater See also:

• ESCAPE (in mid. Eng. eschape or escape, from the O. Fr. eschapper, modern echapper, and escaper, low Lat. escapium, from ex, out of, and cappa, cape, cloak; cf. for the sense development the Gr. iichueoOat, literally to put off one's clothes, hence to sli

escape of heat from the surface; while acetate of ammonia, by acting as a diaphoretic and stimulating the secretion of sweat, increases the loss of heat Fever. by evaporation . When a patient is covered with several blankets, loss of heat from the surface both by See also:

• RADIATION, THEORY OF

radiation and evaporation is to a great extent prevented, but if a See also:

• CRADLE (of uncertain etymology, possibly connected with " crate " and " creel," i.e. basket; the derivation from a Celtic word, with a sense of rocking, is scouted by the New English Dictionary)

cradle be placed over him, so as to raise the bedclothes and allow of free circulation of air around his body, both radiation and evaporation will be increased and the temperature consequently lowered . If his body be left uncovered except by the See also:

• SHEET

sheet or blanket thrown over the cradle, the loss of heat is still greater, and it may be much increased by sponging the surface with either hot or cold water so as to leave it slightly moist and in-crease evaporation . The temperature may be still further reduced by placing vessels filled with See also:

• ICE (a word common to Teutonic languages; cf. Ger. Eis)

ice inside the cradle . When the patient is very restless, so that cradling is impossible, a wet pack may be employed, a sheet wrung out of cold water being wrapped See also:

• ROUND (O. Fr. rond, Lat. rotundus, the Fr. is the source also of Du. rond; Ger., Swed., Dan. and Nor. rond)

round him, and over this a blanket . The pack has the See also:

• DOUBLE
• DOUBLE (from the Mid. Eng. duble, the form which gives the present pronunciation, through the Old Er. duble, from Lat. duplus, twice as much)

double effect of restraining his movements and thus lessening the See also:

• PRODUCTION (Lat. productionem, from producere, to pro-duce)

production of heat, while at the same time it dilates the vessels of the skin and produces loss of heat . The See also:

• RESTRAINT (from " to restrain," Lat. restringere, to hold back, prevent)

restraint which it imposes and the equal See also:

• DISTRIBUTION (Lat. distribuere, to deal out)

distribution of heat over the surface frequently cause See also:

• SLEEP (0. Eng. slcepan; Ger. schlafen; cf. Lat. labi, to glide, and " slip ")

sleep quickly in patients who have previously been wildly delirious and entirely sleepless . When the temperature continues to rise in spite of wet sponging and cradling, recourse must be had to the cold See also:

• BATH
• BATH, THOMAS THYNNE
• BATH, WILLIAM

bath . The bath should be brought to the bedside and the patient, wrapped in a sheet, should be lifted into it by two attendants . The water should be at the temperature of 90° and gradually reduced by the removal of hot water and displacement by cold, until the temperature of the patient as taken in the mouth is reduced to about 991° or 99°° . After this the patient should be taken out and again put into bed .

It is inadvisable to See also:

• LOWER

lower the temperature quite to the normal while the patient is in the bath, as frequently it falls after his removal, and may fall so far as to induce collapse . In cases where no bath is available a large See also:

• MACKINTOSH, SIR JAMES (176 1832)

mackintosh sheet may be spread upon the bed under the patient, the tides and See also:

• TOP (cf. Dan. top, Ger. Topf, also meaning pot)

top may be raised by pillows, and cold water may be applied to the surface of the body with large See also:

• SPONGES

sponges . The mackintosh sheet forms a shallow bath, and the water may afterwards be run off from it at the lower end of the bed . Another way of applying cold is to See also:

• DIP (Old Eng. dyppan, connected with the common Teutonic root seen in " deep ")

dip an See also:

• ORDINARY (med. Lat. ordinarius, Fr. ordinaire)

ordinary sheet into cold water, apply it for three or four minutes to the surface of the body, then remove it and replace it by another sheet while the first one is being dipped in water . By the alternate use of the two sheets, or by the use of one quickly wrung out of cold water as soon as it becomes warm, the patient's temperature may be rapidly reduced . There are a number of drugs which have a very powerful action in lowering temperature . Most of these belong to the aromatic See also:

• GROUP

group of bodies, although one of them, antipyrin, belongs rather to the furfurol group . Carbolic acid has an antipyretic action, but on account of its poisonous properties it cannot be employed as an antipyretic . Salicylic acid has a strong antipyretic action, and is most commonly used in the form of its See also:

• SODIUM [symbol Na, from Lat. natrium; atomic weight 23.00 (0=16)]

sodium See also:

• SALT (a common Teutonic word, cf. Dutch zout, Ger. Salz, Scand. salt; cognate with Gr. &Xs, Lat. sal)
• SALT, SIR TITUS, BART

salt, which is much more soluble than the acid itself . Amongst other antipyretics, the most important are See also:

• QUININE

quinine, See also:

• PHENACETIN

phenacetin and antifebrin . These probably lessen fever by their action upon the nerve centreswhich regulate the temperature of the body, and partly by their peripheral action in causing the secretion of sweat . Very high fever in itself will cause death, the fatal temperature in rabbits being 114.6° .

Before death occurs the See also:

• PULSE

pulse and respiration become exceedingly rapid and weak, and See also:

• COMPLETE

complete unconsciousness sets in . That these symptoms are simply due to heat is shown by the fact that if the temperature be quickly reduced by the application of cold the symptoms at once subside . But the See also:

• DELIRIUM (a Latin medical term for madness, from delirare, to be mad, literally to wander from the lira, or furrow)

delirium which is common in fever, although it may be partly due to rise of temperature, is very often due to poisons in the blood, for in some cases it occurs with quite a low temperature, toe or See also:

• ROE (or Row), SIR THOMAS (c. 1581—1644)
• ROE, EDWARD PAYSON (1838-1888)

roe, whereas in others the temperature rises to ro4 and toe with no delirium whatever . The presence of toxins in the blood not only affects the brain, causing delirium, but also other organs, the heart and lung, and may cause fatal See also:

• SYNCOPE (Gr. vvyKO7n , a cutting up or short, from Kbirrew, to cut)

syncope or respiratory failure . Many years ago Dr S . L . Mitchill (1764—1831) pointed out in See also:

• AMERICA

America the resemblance which exists between symptoms of poisoning by snake venom and infective fevers) . S . See also:

• WEIR (from O. Eng. wer, a dam; cognate with werian, to defend, guard; cf. Ger. Wehr, defence)
• WEIR, ROBERT WALTER (1803-1889)

Weir See also:

• MITCHELL
• MITCHELL, DONALD GRANT (1822—1908)
• MITCHELL, MARIA (1818—1889)
• MITCHELL, SILAS WEIR (1830-)
• MITCHELL, SIR THOMAS LIVINGSTONE (1792-1855)

Mitchell and others have shown that See also:

• SERPENT (Lat. serpens, creeping, from serpere; cf. "reptile " from repere, Gr.4 ml-eta)

serpent venom consists chiefly of albumoses, and the toxins formed by infective bacilli have a somewhat similar chemical nature . Calmette and See also:

• FRASER
• FRASER, ALEXANDER CAMPBELL (1819– )
• FRASER, JAMES (1818-1885)
• FRASER, JAMES BAILLIE (1783--1856)
• FRASER, SIR WILLIAM AUGUSTUS

Fraser found that when small doses of snake venom, insufficient to cause death, are injected into an animal, temporary disturbance is produced; but after a few days the animal recovers, and a larger dose is then required to produce any symptoms . By gradually increasing the dose the animal becomes more and more resistant, until at last a dose fifty times as great as that which would at first have produced immediate death can be injected without doing the animal any harm . If a See also:

• HORSE (a word common to Teutonic languages in such forms as hors, hros, ros; cf. the Ger. ross)

horse be chosen for the experiment, a considerable quantity of blood may be withdrawn without injuring the animal .

When this is clotted the serum is found to act as an anti-venin, so that when mixed with the venom of a snake it renders it harmless . Although this result is best obtained when the venom and serum are mixed in a glass before injection, yet if they he injected at the same time in different parts of the body the animal will still be protected and the See also:

• POISON

poison will not produce its usual deadly results . What occurs with snake venom takes See also:

• PLACE (through Fr. from Lat. platea, street; Gr. IrAar6s, wide)

place also when the toxins are formed by microbes, and a new method of treatment by anti-toxic serums has been introduced of late years with great success . This is most commonly and successfully used in the treatment of See also:

• DIPHTHERIA (from 8c4BEpa, a skin or membrane)

diphtheria . This disease depends upon th