Part 133

=DISLOCA'TION.= _Syn._ LUXATION; DISLOCATIO, L. The forcible displacement of a bone from its socket, either by violence or disease. The latter happens when the textures forming the joint have been destroyed by some independent organic affection. "A considerable share of anatomical knowledge is required to detect the nature of these accidents; and it is much to be lamented that students neglect to inform themselves sufficiently on the subject." (Sir A. Cooper.) In common cases the bones may be frequently replaced by forcibly extending the limb. This should be done as early as possible, and before inflammation sets in. The latter should be combated by aperients, local bleeding, refrigerant lotions, &c. Dislocations frequently exist without the fact being suspected, the swelling and inflammation being referred to other causes.

=DISPLACE'MENT.= See PERCOLATION.

=DISTEM'PER.= A disease among dogs, usually characterised by a running from the nose and eyes, and a short dry cough; followed by wasting of the flesh, and loss of strength and spirits. At length the brain suffers, and fits, paralysis of the extremities, or convulsions come on. Laxatives and emetics are the best remedies. If there is much diarrh[oe]a, astringents may be afterwards given. The violence of the fits may be mitigated by the administration of antispasmodics, and by the warm bath. The distemper is a contagious disease, and is generally fatal to weakly and very young dogs. Fits in the advanced stages of the disease are seldom followed by recovery. Impatience of light, red eyes, obstinate diarrh[oe]a, spasmodic twitchings, a yellow colour of the skin, and a pustular eruption, are also bad symptoms.

=Distemper Powders (Blane's).= The basis of these is said to be '_aurum musivum_,' or bisulphide of tin. That of another advertised nostrum is a mixture of mercury and chalk, with a little rhubarb and ipecacuanha.

=DISTILLA'TION.= The evaporation and subsequent condensation of the vapour of fluids, by means of a still and refrigerator, or other similar apparatus. DRY DISTILLATION is a term applied to the distillation of substances _per se_, or without the addition of water or other volatile fluid. DESTRUCTIVE DISTILLATION is the distillation of substances at temperatures sufficiently high to decompose them, by which their elements are separated, or evolved in new combinations. FRACTIONAL DISTILLATION is the separation of substances having different boiling-points, by distilling the mixture with a gradually increasing heat, and collecting the products which come over at different temperatures in separate receivers. See HYDROCARBON, STILL, &c.

=Distillation.= The art of the distiller; the manufacture of spirituous liquors as practised on the large scale.

The process of distillation, as carried on in the distilleries of Great Britain, may be divided into four general operations, viz.--1. The mashing, or formation of a saccharine infusion from certain vegetable matters, as malt, barley, oats, rye, &c. 2. The cooling of this wort or liquor. 3. The fermentation, or process by which the sugar of the cooled wort is converted into alcohol. 4. The separation of the spirit so formed by means of a still and refrigerator. By the first operation the materials for the formation of the alcohol are obtained; by the second, they are brought to a temperature most favorable to the transformation that takes place in the third, after which it only remains to free the product of the last operation from the foreign matter with which it is associated; this is done in the fourth, which, correctly speaking, constitutes the only part of the process which can be called distillation.

The general principles of the first three of the preceding operations are noticed in the articles BREWING, FERMENTATION, &c. It will there be seen that the amylaceous or starchy matter of the grain is first 'saccharified,' and afterwards converted into alcohol, and that certain precautions are necessary to render the process successful and economical. In many of the distilleries of Great Britain molasses and analogous saccharine substances are employed, in which case the vegetable principle (sugar) essential to the formation of alcohol is already present, and merely requires simple solution in water of a proper temperature, to be ready to be subjected to immediate fermentation. In general, however, the sources of spirit in England are the various kinds of grain; barley, rye, maize, and rice are those commonly employed. These are ground and mixed with bruised malt, in various proportions, and are mashed in a similar manner to malted grain. The fermentation is carried on until the density of the liquor ceases to lessen or 'attenuate,' which is determined by an instrument called a saccharometer. When this point is arrived at, the 'wash' is submitted to distillation, to prevent the access of the acetous fermentation, which would lessen its alcoholic value.

During the process of distilling off the spirit of the fermented 'wash' or 'wort' a hydrometer is employed to ascertain the 'strength' of the liquor that passes over. As soon as this has fallen to a certain point, the operation is stopped, and the 'spent wash' removed. The spirits obtained by the first distillation are generally called 'low wines,' and have a specific gravity of about ·975. By rectification or 'doubling,' a crude milky spirit, abounding in oil, at first comes over, followed by clear spirit, which is received in a separate vessel. The process is continued until the alcoholic content of the distilled liquor has considerably diminished, when the remaining weak spirit that distils over, called 'faints,' is caught separately, and mixed with the low wines preparatory to another distillation. The strongest spirit passes over first, and the condensed liquor gradually becomes weaker, until it ceases to contain alcohol. By receiving in separate vessels any given portion of the product, spirit of any required strength, within certain limits, may be obtained. The same object is more conveniently effected by surrounding the top of the capital of the still with a water bath, of a temperature corresponding to that of alcoholic vapour of the strength it is desired to obtain. Thus, if we keep the temperature of the water at about 198° Fahr., we shall obtain proof spirit; if at 192°, a spirit 20 o. p.; and so on for other strengths.

It is found from experience, and is readily accounted for by theory, that the lower the temperature at which the distillation is conducted, the stronger will be the product, and the less quantity of oil or other volatile matter will come over along with it. To promote this, it has been proposed to carry on the process _in vacuo_, but on the large scale this has never been adopted. The distillation of the wash is usually performed in a separate set of stills to those employed for the rectification of the low wines. For very strong and tasteless spirit, a third and even a fourth rectification is employed, conjointly with other methods, to abstract the water and to remove any foreign matter that vitiates its odour or flavour. A portion of soap is generally put into the still with the wash, to prevent excessive frothing.

We have said that the processes of mashing, &c., in the distillery are similar to those adopted in brewing beer. We may add that, as richness in alcohol, and not flavour, is the object aimed at in the distiller's wash, not only is a large quantity of unmalted grain employed, but the process of boiling the wort with hops is omitted altogether. The wort is commonly 'set' at 70° Fahr., and the fermentation and attenuation of the liquor pushed as far as possible by large and repeated doses of the best 'top-yeast' of the porter brewers.

It often happens that raw spirit prepared from damaged grain is contaminated with a highly acrid and volatile fatty substance, which is powerfully intoxicating and irritating to the eyes and nostrils, and possesses an odour very similar to that of an alcoholic solution of cyanogen. This may be got rid of by dilution with water and skilful rectification, when most of it passes over with the first and last 'runnings,' the intermediate portion being less loaded with it. Another plan is to filter the spirit successively through 6 or 7 separate vessels containing pine or willow charcoal before rectifying it. In some distilleries the contaminated spirit is well agitated with a considerable quantity of olive oil, and after repose decanted, diluted with water, and rectified as before. The ordinary corn oil or fusel oil of raw spirit is generally, for the most part, intercepted by a self-regulating bath arranged between the still-head and the refrigeratory.

The quantity of spirit obtained from various substances, and even from pure sugar, depends upon the skill with which the several operations are conducted. By theory, pure sugar should yield 51% of alcohol; but in practice 11·925 galls. of proof spirit is the largest quantity which has yet been obtained from 112 lbs. of sugar. By the revenue authorities this weight of sugar is estimated to afford 11-1/2 galls. of proof spirit. The average product is, perhaps, about 1 gall. of spirit of this strength for every 10 lbs. of sugar. According to Harmstädt, 100 lbs. of starch yield 35 lbs. of alcohol, or 7·8 galls. of proof spirit; and 100 lbs. of the following grains produce the accompanying quantities by weight of spirit of sp. gr. ·9427, or containing 45% of pure alcohol:--wheat, 40 to 45%; rye, 36 to 42%; barley, 40%; oats, 36%; buckwheat, 40%; maize, 40%; the mean being 3·47 galls. of proof spirit. It is found that a bushel of good malt yields 2 galls. of proof spirit, and that the largest quantity of proof spirit obtained from raw grain, mashed with 1/5 or 1/6 of malt, does not exceed 22 galls. per quarter.

The distiller is allowed to produce worts from any substance, and at any specific gravity, provided such gravity can be correctly ascertained by the saccharometer approved of by the Board of Inland Revenue. He is not, however, allowed to mash and distil at the same time. See ALCOHOL, BRANDY, FERMENTATION, FUSEL OIL, GIN, STILL, &c.

=DISTOMATA.= A genus of fluke-like parasites infesting men and the higher vertebrate animals. The egg is about the 1/280th of an inch long and 1/270th inch wide.

The embryo is frequently met with in sewage water, from which, if it be removed and placed in pure or distilled water, it soon dies. The embryo which does not become a distoma gives rise to a progeny (gradually formed from germ-cells within it) consisting sometimes of one, but much more often of a number of bodies of various forms and structures, each of which possesses powers of movement and locomotion. But the creatures of this second development are not distomata; neither are the offspring to which they in their turn give rise. Like their immediate progenitors, this offspring produce in their interior germ-cells which develop into minute worms having tails, and displaying great vivacity when placed in water. These latter alone exhibit the characters of true distomata. "These cercaria now either become enclosed, like a chrysalis in a pupa state, or they penetrate into the bodies of soft animals, become encysted and parasitic. It appears probable that the distomata enter the human intestinal canal as cercaria, and then pass into the biliary passages."[260]

[Footnote 260: Blyth.]

A case is on record of two distomata having been extracted from the foot of a woman, into which it has been surmised they gained an entrance as cercaria whilst the woman was bathing.

It is thought that shell-fish, as well as uncooked fish when eaten, may be the means of introducing these parasites into the human system. The embryos of the _Distomata hepaticum_ swim about and live in water, which may probably, when drunk, be the means of conveying them into the bodies of men and sheep. The ailments and symptoms to which these pests give rise depend upon the particular organ or portion of the body in which they establish themselves.

In man they are a frequent cause of hæmaturia and dysentery. In sheep they occasion fearful mortality, giving rise to the disease known as 'the rot,' and killing thousands of flocks annually.

"The number of species affecting men are usually enumerated as nine--viz. _Fasciola hepatica_, _Distoma crassum_, _D. lanceolatum_, _D. ophthalmobium_, _D. heterophyes_, _Bilharzia hæmatopia_, _Tetrastoma renale, Hexathrydium renarum_, and _H. pinguicola_."[261]

[Footnote 261: Blyth.]

=DISTORTIONS.= In treating of this subject we shall confine ourselves to those distortions which are preventable--or rather, we may say, of two out of the three which will be discussed, which are voluntary.

One very common form of bodily distortion is crooked or curved spine. It is mostly met with in young girls of from ten to sixteen years of age; and first shows itself either in the elevation of one shoulder above the other, or in a growing out of one of the shoulder blades, or of one side of the bosom beyond the other. The elevated shoulder is generally the right one. At the same time the right side of the chest is unnaturally high, and rounded; whilst the opposite or left shoulder and chest are on the contrary depressed and concave. Very frequently these conditions are accompanied by a projection of the left hip, and a curving inwards of the loins on the right side. With persons so afflicted the spine presents an appearance that has not inaptly been compared to a long italic _f_.

Spinal curvature arises from a weakened state of the muscles, ligaments, and bones of the backbone. It is most frequently met with in those whose occupation compels them to stand the greater part of the day; as well as in persons who pass many hours at the desk or at needlework. Spinal curvature is also common in young fragile girls acting as nursemaids, and as such unduly subjected to carrying heavy infants on one side. Amongst the children of the poor, those of tender years are much too frequently put to this objectionable form of drudgery. Any one's recollections of a walk through a poor neighbourhood will enable them to call to mind many instances they must have seen of smaller babes being nursed by larger ones. Those subjected to too long standing, no doubt because the posture affords them relief, unconsciously contract the habit of frequently standing on the right leg--of _standing at ease_ on it, as it is called--and at the same time of bending the left knee a little; and since this position causes the right shoulder to be raised, and the left side of the pelvis to be thrown out of its place, it will be evident from what has been already said that, if persisted in, it will end in distorting the spine in the manner above indicated.

The same results will also follow in those other cases, such for instance as in too long an application at the desk or at the needle, as well as the carrying for an undue length of time a heavy child in the arms; these all being occupations in which one side of the body is subjected to an undue and unequal strain over the other.

"Why one-sided postures should cause distortion must be evident, when it is considered that the intervertebral substance is compressible to such an extent that an adult man of middle stature loses about an inch of his height after having been in the erect posture during the day, and does not regain it till after some hours of rest. Since the united thickness of the intervertebral substance in an adult man is about 3·875 inches, we see that they lose nearly one fourth by compression, which they do not recover till after some hours of rest. But if the weight of the body falls unequally on the spine day after day, it must be evident that they will become compressed on one side more than the other; and that if their elasticity be impaired, and the muscles and ligaments be weak, and the bones soft, as they are in young persons who have not a sufficiency of fresh air, wholesome food and active exercise, this lateral distortion will become permanent.[262]

[Footnote 262: Dr Druitt.]

Another cause tending to distortion of the spine is the foolish habit of using corsets, a practice which contributes to weaken the dorsal muscles. When the shoulders are continually supported by a corset, the dorsal muscles upon which the support ought to fall have their functions usurped by the corset, and hence fail to receive their proper development, and consequently lose their power; the result being an inability on the part of the body to support itself without the corset, and a sinking and bending of the spine when it is removed. In boys, who never wear corsets, spinal curvature is rarely met with. In girls, who do, it is constantly to be found. To guard against spinal distortions, bad and awkward positions of the body should, wherever possible, be prohibited. Amongst the prejudicial postures indulged in by the young, we have already mentioned the habit of standing on one leg and of carrying heavy loads on one side of the body.

To these may be added the habit of lying crooked in bed, and that of young girls spending a long time in a constrained position in dressing their own hair. Every one-sided motion may lead to distortion if it be frequently repeated, and the tendency once existing, the evil grows day by day. The use of corsets should be strenuously discountenanced. The early detection of spinal distortion is a matter of considerable importance. Hence the advisability of mothers, nurses, governesses, and other guardians of children or young girls, frequently examining the bodies of their charges to note if they present any of the peculiarities we have indicated at the commencement of this article. Should any of these develop themselves, aid should immediately be sought of a skilful medical practitioner.

Dr Lewis Sayre, in his work 'Spinal Disease and Spinal Curvature' says:--"The great object in the treatment of Pott's disease is to maintain _rest of the affected part_ by such means as will not debar the patient from the benefits of fresh air, sunlight, and change of scene. The patient should not be permitted to assume the upright position before he has been fitted with some artificial support capable of removing all pressure from the bodies of the diseased vertebræ. This object may be obtained by straightening the spinal column in such a manner that the weight of the body is borne by _the transverse_ processes and not by the bodies of the vertebræ." Acting on these principles, Dr Sayre partially envelopes the patient in a jacket of plaster of Paris, surrounding the body from the pelvis to the axillæ.

Although Dr Sayre's work is almost entirely devoted to a much more serious affection of spinal curvature than that treated of here--viz. posterior angular curvature, in which actual disease of the bones of the vertebræ is concerned--his treatment is no less applicable to the milder form of distortion to which our remarks have been directed. Dr Sayre himself states that 300 cases have been treated by his method with very signal success, and very many eminent surgeons bear testimony to the soundness of the principles concerned in it. For the details of its application consult the author's work before alluded to.

Serious as are the effects very frequently arising from spinal curvature, amongst which may be included lameness, lung disease, and inability to perform the functions of maternity; still worse results in addition to the two last of these ensue in the case of a persistence in another form of distortion, which is none the less dangerous because it is voluntary. The distortion to which we refer is that caused by the practice of tightlacing.

Foremost among the conditions absolutely essential for the preservation of health and bodily well-being, is the due performance of the function of the lungs, heart, liver, kidneys, stomach and other important organs. The object of the ribs within which most of these organs are more or less wholly contained is to protect these latter from external pressure, and therefore injury; as well as to allow them unimpeded and unrestricted action. To ensure this freedom of movement for the parts and organs within the ribs, it will be evident that every possible obstacle tending in any degree to compress them, or circumscribe their limits should be especially avoided.

Instead of the avoidance of such dangers, however, what course do the silly votaries and dupes of that most senseless and remorseless of all tyrants--Fashion--pursue? One the very reverse; and which is opposed, not only to personal comfort and common sense, but, since it mars nature's outlines, to symmetry and our proper canons of the grace of the female figure. By means of corsets, tight stays, and other implements of torture the ribs are pressed _inwards_ to such an extent that all the conditions we have insisted on as essential to health are imperilled, and eventually become overthrown. Now, this mischievous and unnatural pressure exerted on the stomach pushes that organ out of its proper position, and in doing so forces the diaphragm also out of its place; a disturbance which so curtails the space in which the movements of the lungs and the heart are performed, that if the pernicious custom be persevered in these latter organs become seriously and incurably diseased. The liver also shares in the damage inflicted, and frequently becomes incapable of discharging its office. The very much larger number of young women than of young men who die of consumption is undoubtedly referable to the fact that a large proportion of the majority are the victims of tightlacing. Nor is it difficult to understand why this should be, since we know that if the lungs are prevented exercising their full powers of expansion, unnaturally diminished function will set up disease in them, which, if there be a predisposition, will probably be consumption. This cause also, by preventing the blood becoming properly oxygenated, gives rise to a large class of disorders due to impurity of the vital fluid. Organic disease of the heart is by no means an uncommon contingency if tightlacing be persevered in; for that organ is not allowed room to beat, nor the blood to circulate. One effect of this is seen in frequent fainting fits.

Again, tightlacing not infrequently stops the growth and arrests the development of a young girl's _mammæ_, thus seriously incapacitating her from suckling her babe when she becomes a mother. It also indirectly has a very prejudicial effect upon health by preventing its votaries from taking sufficient walking exercise; free bodily movement with accompanying expansion of the lungs becomes impossible with those encased in a vice of unyielding armour, such as constitutes pestilent stays and corsets. Amongst the minor evils wrought by the baleful custom, we may mention indigestion (for the pressure of the stays weakens the stomach, and sets up this troublesome complaint), with its accompaniments of flatulence, heartburn, pain in the chest, &c. Constipation is also another of its attendant ills; so also are bad breath and a red nose.