Part 41

=APOMORPHINE.= _Syn._ APOMORPHIA. C_{17}H_{17}NO_{2}. A remarkable base, obtained from morphia by Matthiessen and Wright. It is possessed of powerful emetic properties. Introduce into a strong glass tube, closed at one end, 1 part of pure morphia, and 20 parts of pure hydrochloric acid; these should not occupy more than one fifteenth of the tube. Seal the open end, and place the glass tube in another of cast iron, closed with a screw, and heat the whole in an oil-bath at a temperature between 140° and 150° C., during three hours. After cooling, the morphine has been converted into apomorphine, which can be purified as follows:

The tube is opened, and the liquid it contains diluted with water and neutralised by bicarbonate of soda; then an excess of this salt being added, the apomorphine is precipitated with any morphia that may remain. The liquid is decanted, and the precipitate is exhausted with ether or chloroform, which dissolves the apomorphine only. To the ethereal or chloroformic liquor are afterwards added a few drops of hydrochloric acid to saturate the base. Crystallised apomorphine then separates spontaneously, and is deposited on the sides of the vessel. These crystals are washed rapidly with cold water, and purified by crystallisation from boiling water. The apomorphine can be obtained by precipitating a concentrated solution of this hydrochlorate by bicarbonate of soda; the precipitate is white, but turns green rapidly in the air. It should be washed with a little cold water, and promptly dried to avoid this alteration.

=AP'OPLEXY= (-pl[)e]ks-e). _Syn._ APOPLEX'IA, APOPLEX'IS, L. (from [Greek: apo-plêssô], I astound, or strike down, Gr.); APOPLEXIE, Fr.; SCHLAGFLUSS, Ger. A disease so named on account of the suddenness and violence of its attacks.

_Symp._ Sudden suspension or loss of the powers of sense and motion; the heart continuing to beat and the lungs to act, but generally with difficulty. During the fit the patient usually lies in a state resembling sleep, or the stupor induced by drunkenness. In some cases there is paralysis of one side of the body, and convulsions of the other. In the sanguineous or sthenic variety, or the one which is most common, the pulse is hard and full, the countenance flushed and bloated, and the breathing stertorous; in the serous or asthenic variety, the pulse is feeble, the skin cold, and the countenance pale. "The presence of convulsions is indicative of great danger." (Dr Cheyne.) In both cases the patient is generally found lying on his back, in a state of complete insensibility, which defies every effort to arouse him; the eyelids almost cover the eyes, which are fixed and devoid of intelligence, whilst the pupils scarcely change their dimensions under the varying influence of light and darkness; the lips are usually purple or very dark; and both the lips and nostrils have generally a slight trembling movement communicated to them by the deep and laborious breathing of the patient.

_Treat._ In this disease, more than perhaps any other, medical aid should be immediately sought. In the mean time the patient should be placed in an easy posture, in a well-ventilated apartment, and in the sanguineous or sthenic variety, in as erect a position as possible; but in the asthenic variety, when the face is pale, with the head and shoulders only moderately elevated. The neckcloth should be removed, and the clothes loosened, and the head and neck laid bare. Crowding round the patient should be particularly avoided, and a free exposure to fresh air secured in every possible way. When medical aid cannot be immediately procured, blood should be freely taken (say 15 to 20 fl. oz., or more) from the arm, by any person competent to do so; unless the face be pale, and the pulse feeble, when cupping at the back of the neck, or leeches behind the ears, should be substituted for ordinary bleeding. Cold water should be dashed on the head, the legs placed in pretty warm water, and blisters or mustard poultices applied between the shoulders. In the mean time 8 or 10 gr. of calomel may be administered, and its action subsequently promoted by the use of saline purgatives and stimulating clysters. When there is a difficulty of swallowing, a couple of drops of croton oil may be applied to the tongue; or it may be poured on sugar, before placing it in the mouth. Indeed, this mode of relieving the bowels should be adopted in all extreme cases, as soon as possible. Emetics should be carefully avoided. The only exception to this rule is, when the stomach is distended by a heavy undigested meal; when an emetic is hazarded as the less of two evils. Nasal stimulants, as smelling salts or aromatic vinegar, should also be avoided. If the bleeding has not afforded some relief, it may be repeated in from 3 to 5 hours. When these means prove successful, the remainder of the treatment may consist in the administration of mild purgatives and diaphoretics, and the avoidance of stimulating food or drinks, and of other like exciting agents.

_Prev., &c._ The premonitory symptoms of apoplexy are giddiness, pain and swimming in the head, loss of memory, faltering in speech or using one word for another, diminished sensibility either of body or mind, or both, drowsiness, noises in the ears, specks floating before the eyes, nightmare, frightful dreams, laborious respiration, heavy yet unrefreshing sleep, an inclination to sigh without any moral cause, cramp in the legs at night when there is no irritation of the bowels to account for them, &c. &c. When any of these symptoms occur (especially in "free livers") aperient medicines and a light diet should be at once had recourse to, and wine, beer, and spirits avoided as the most dangerous poisons. If the symptoms increase or continue, active purgation, a still lower diet, and even bleeding may be had recourse to. Pure air, early rising, regular habits, gentle muscular exercise, and loose, easy clothing, are powerful preventives of apoplexy. By attending to the admonitions of nature, and adopting the simple means which are within the reach of all, it is indisputable that many fatal cases of apoplexy might have been avoided, and a still larger number lessened in severity.

Robust, plethoric persons, with short thick necks, are universally accounted the most liable to apoplexy. In them the fit generally comes on without warning; and when once attacked with this malady they are especially liable to its recurrence. But it must be recollected that the possessor of no particular constitution or temperaments, to whatever class it may belong, enjoys immunity from the attacks of apoplexy--a disease more fatal among Englishmen than the natives of other countries.

_Obs._ A loss of consciousness exists alike in apoplexy, epilepsy, narcotism from opium and opiates, complete intoxication, and common fainting. These may be distinguished by observing that--in EPILEPSY there are almost always convulsions, and more or less rigidity of the limbs, with (generally) foaming at the mouth and gnashing or grinding of the teeth, and frequently, the utterance of noises often not unlike the barking of a dog; whilst stertor and laborious breathing, as a rule, are absent:--in the stupor produced by OPIUM, MORPHIA, &c., the face is pale, calm, and perspiring, and the respiration is tranquil and without stertor; whilst the patient can, in almost all cases, be temporarily aroused to consciousness and kept awake by being made to walk between two attendants; the odour of opium or laudanum is also frequently perceptible in the breath or ejected matter:--in the insensibility of INTOXICATION the pulse is usually feeble, and the patient may be temporarily roused by violent shouting in the ear, or by the application of nasal stimulants, particularly the common smelling-bottle (if strong); and the breath, and ejected matter (if any), smells of liquor:--in ordinary FAINTING the face and lips are pale, the breathing quiet, the pulse scarcely perceptible, the limbs mobile, and the fit lasts only a few minutes.

_Treatment for Horses._ Give in the first place a strong stimulant internally, and apply mustard embrocations to the belly and spine. Bleed, should the pulse be small and indistinct.--_In the parturient apoplexy of cows._ Bleed in the very earliest stage; give salts and croton; diluents; no solid food; let the body and legs be rubbed and clothed; use catheter; apply ice and refrigerants to head and neck; give frequent clysters of linseed gruel; remove milk every hour, and apply rubefacients to the spine.

=APOSEP'EDIN= (-d[)i]n). A substance found in putrid cheese, and supposed to be a product of the fermentation of caseine. Mulder and others have shown that it is merely impure leucine.

=AP'OSTEME=[dagger] (-t[=e]me or -t[)e]m). _Syn._ AP'OSTEM[dagger]; APOSTE'MA[dagger], L. An abscess or collection of purulent matter in any part of the body.

=APPARA'TUS.= [L., Eng.; class. pl., appara'tus; Eng. pl., appara'tuses--Webster.] _Syn._ APPAREIL, Fr.; APPARAT, GERÄTHSCHAFT, Ger. In technical language, the instruments, utensils, and mechanical arrangements, employed in any operation, experiment, or observation, or in any art or trade.

=Apparatus.= In _anatomy_ and _physiology_, a catenation of organs all ministering to one general purpose or function; as the digestive apparatus, respiratory a., &c.

=APP'ETITE.= _Syn._ APPETI'TUS, L.; APÉTIT, Fr.; APETIT, BEGIERDE, ESSLUST, Ger. The natural desire of gratification, whether corporeal or mental. In _physiology_, the instinctive inclination to perform certain natural functions, as those of digestion and generation; but appr., the natural desire for food. In _psychology_ and _philosophy_, the APPETITES (pl.) are affections of the mind directed to general objects, as fame, glory, or riches; these when subsequently turned to particular objects, constitute the PASSIONS, as envy, gratitude, revenge, or love. In its common and unqualified sense, the word appetite is confined to the desire for food; and in that sense chiefly concerns us here.

The sensations of hunger and thirst are seated in the stomach, and their recurrence at proper intervals is a necessary consequence of vital action, and is essential to the existence of the body in a state of vigour and health. Any alteration from their normal condition indicates diseased action of the stomach, or of the nervous system or circulation; or it may result from vicious habits. A healthy appetite for food is usually a most certain indication that nature requires a supply; but in the indulgence of this appetite certain regulations should be observed, and a boundary should be put to mere animal gratification. By slowly eating and thoroughly masticating the food, the stomach becomes gradually and equally distended, and the individual feels himself satisfied only after he has taken a quantity sufficient for the nourishment of his body; but, on the contrary, if the food be swallowed rapidly, and without proper mastication, it presses heavily and roughly against the sides of the stomach, and induces a sensation of fulness before a sufficient meal has been made. The consequences are, that hunger soon returns, and the party must either have recourse to food between the usual time of meals, or suffer the consequences of imperfect nutrition. Exercise and labour, within certain limits, promote the healthy functions of the stomach and bowels, through the action of the muscles of the abdomen increasing the peristaltic motion of these viscera. An inordinate appetite in persons leading a sedentary life is generally indicative of the food passing off imperfectly digested, or of the coats of the stomach being relaxed, or even diseased. More food is required in winter than in summer, in consequence of the greater radiation of the heat of the body; and hence the increased appetite which is usually an accompaniment of that season. In persons who lead a more sedentary life in winter than in summer, either no change of this kind occurs, or the reverse is the case; the want of exercise producing a diminution of appetite corresponding to the increase of it that would otherwise result from the seasonal change of atmospheric temperature, or even greater. Deviations of the appetite from the healthy standard, or the normal condition, constitutes DEFECTIVE or DISEASED APPETITE.

Deficiency or loss of appetite (AN'OREXY; ANOREX'IA, L.) generally arises from disordered stomach; but is also frequently symptomatic of other affections, particularly dyspepsia, biliousness, feverishness, and organic diseases of the lungs, stomach, and primæ viæ. It is a common consequence of sedentary life, and of extreme mental anxiety, excitement, or exhaustion. The _treatment_ will necessarily vary with the cause. In simple spontaneous cases the appetite may generally be improved by outdoor exercise, and the occasional use of mild aperients, especially salines and aloetics. When the affection arises from the stomach being loaded with bile and crudities, an emetic in the evening, followed by a stomachic purgative the next morning, with an occasional aperient afterwards, will seldom fail to effect a cure. With heavy drinkers a gradual reduction of the quantity of the strong liquors usually consumed is generally followed by a restoration of the appetite and digestive powers. The change thus gradually effected in the course of 8 or 10 days is often almost magical. The excessive use of liquors--especially of spirits, wine, or beer, or even of warm weak ones, as tea, coffee, soup, &c.--is always prejudicial. Hence drunkards are particularly subject to defective appetite; and teetotallers and water-drinkers to a heartiness often almost approaching voracity. See BILE, DYSPEPSIA, &c.

Depraved appetite (PI'CA, L.), or a desire for unnatural food, as chalk, cinders, dirt, soap, tallow, &c., when an idiopathic affection or when depending on vicious tastes or habits (as is often the case in childhood), it may be treated by admixing very small doses of tartar emetic or ipecacuanha with the objectionable food or articles. When symptomatic of pregnancy, a plentiful and nutritious diet, including the red meats, with a little good malt liquor or wine, may be adopted with advantage. When symptomatic of chlorosis, to this diet may be added the use of chalybeate tonics, and sea or tepid bathing; when of dyspepsia, a light diet, bitter tonics, free exercise, fresh air, and cold bathing, will generally effect a cure.

Insatiable appetite (CANINE APPETITE, VORACITY; BULIM'IA, L.) is generally symptomatic of pregnancy, or worms, or diseases of the stomach or the viscera immediately connected with it; but sometimes exists as a separate disease, and is even said to be occasionally hereditary. When it occurs in childhood, worms may be suspected, and vermifuges administered. In adults, a common cause is imperfect digestion, arising from stomach complaints or gluttony, when the languor and gnawing pains of disease are mistaken for hunger. In this case the diet should be regulated and the bowels kept gently relaxed with mild aperients, and tonics (as bark and steel), or bitters (as orange-peel and gentian), may be administered. When pregnancy or vicious habits are the cause, the treatment indicated under DEPRAVED APPETITE may be adopted. When the affection is occasioned by acidity in the stomach, an emetic, followed by the moderate use of absorbents or antacids, will generally effect a cure. In those cases depending on a highly increased power of the stomach in effecting rapid and complete digestion, its contractile force and morbid activity may be often allayed by the copious use of salad oil, fat meat, &c., by the cautious use of opiates, or by the use, or freer use, of tobacco (either smoked or chewed, or both). A cathartic daily, with a dose of blue-pill, or mercurial powder, every second or third day, is also often advantageous. 25 or 30 drops of solution of potassa, in broth, twice or thrice daily, has also been recommended. See BILE, DYSPEPSIA, WORMS, &c.

=APP'LE= ([)a]p'l). _Syn._ MA'LUM, PO'MUM, L.; POMME, Fr.; APFEL, Ger.; APPEL, Dut.; APLE, Swed. This well-known fruit is the product of the cultivated varieties of _pyrus malus_ (Linn.), or the crab-apple of our hedges; a tree of the nat. ord. Rosaceæ. The date of its amelioration from the wild state is probably very remote, as several kinds are noticed by Pliny in a manner that would lead to the inference of a high antiquity. Pippins, or 'seedling improved apples,' are said to have been introduced into this country from the South of Europe towards the end of the 16th century. Don enumerated 1400 varieties of the cultivated apple; there are now probably above 1650. Rennet apples (POMA RENETTIA) are those ordered in the P. Cod. to be used in pharmacy. In _botany_ and _composition_, the term apple (POMUM) is used to designate any large, round, fleshy fruit, consisting of a 'pericarp,' enclosing a tough 'capsule' containing several seeds; as love-apple, pine-apple, &c.

The wood of the apple-tree is much used in turnery; that of the crab-tree is generally preferred by mill-wrights for the teeth of mortise-wheels.

The expressed juice of 1 _cwt._ of ripe apples, after the free acid has been saturated with chalk, yields from 11 to 13 _lbs._ of a very sweet, but uncrystallisable sugar.

Apples have been analysed by Fresenius, and were found to have the following composition:--

SOLUBLE MATTER-- Sugar 7·58 Free acid (reduced to equivalent in malic acid) 1·04 Albuminous substance 0·22 Pectous substances, &c. 2·72 Ash 0·44 INSOLUBLE MATTER-- Seeds 0·38 Skins 1·44 Pectose 1·14 [Ash from insoluble matter included in weights given] [0·13] Water 85·04 ---------- 100·00

=Love'-apple=[double-dagger]. The tomato.

=Mad'-apple=[double-dagger]. The larger Mecca or Bussorah gall. They are also called DEAD-SEA APPLES, A. OF SODOM, &c. See GALLS.

=Acid of Apples.= Malic acid.

=A'PRICOT.= _Syn._ A'PRICOCK[dagger]; ARMENI'ACUM MA'LUM, PRÆCO'TIUM, L.; ABRICOT, Fr.; APRIKOSE, Ger. The fruit of _armeniaca vulgaris_ (Lamb.; _prunus armeniaca_, Linn.), a rosaceous tree indigenous in Armenia, Cachmere, &c., and now cultivated in every temperate region of the world. Under the name of _præcox_ it was known in Italy in the time of Dioscorides; but it was not introduced into England until the reign of Henry VIII (A.D. 1540). Its cultivation has since been zealously attended to by our gardeners, and it is now one of the choicest and most esteemed of our wall-fruits, and is particularly valued for desserts. It is reputed to be nutritious, easy of digestion, laxative, and stomachic. The seeds are bitter and saponaceous.

Apricots are principally eaten as gathered; but are also dried, candied, and made into jam. In _confectionery_, the Brussels and Breda varieties are preferred to the larger and sweeter kinds. See FRUIT, PRESERVES, &c.

=Apricots, Briançon'.= The fruit of _armeniaca brigantiaca_ (Pers.). Acidulous; seeds or kernels, by expression, yield HUILE DE MARMOTE.

=A'QUA= (-kw[)a]). [L.] Water.--AQUA DESTILLA'TA or A. DISTILLA'TA, is distilled water; A. FLUVIA'LIS or A. EX FLU'MINE (-[)i]n-e), river-water; A. FONTA'NA, spring-water; A. MARI'NA or A. MA''RIS, sea-water; A. MINERA'LIS, mineral water; A. NIVA'LIS or A. EX NI'VE, snow-water; A. PLUVIA'LIS, A. PLU''VIA, or A. IM'BRIUM, rain-water, soft water; A. PUTEA'NA or A. EX PU'TEO, well, pump, or hard water.

=Aqua.= In _chemistry_ and _pharmacy_, this word was formerly applied to numerous preparations and articles now included under other heads. See EAU, ESPRITS, HAIR-DYES, LIQUORS, SOLUTIONS, WATERS, &c.

=Aquafor'tis.= [L.] Literally, 'strong water,' the name given by the alchemists to the acid obtained by distilling a mixture of nitre and sulphate of iron. The word is still commonly employed by mechanics and artists to designate the impure fuming nitric acid of commerce, and is thus also retained in trade. By these parties concentrated nitric acid is called 'spirit of nitre.' 'Double aquafortis' merely differs from the other in strength. See NITRIC ACID.

=Aqua Amarella.= A compound for hair-dyeing; is prepared with sugar of lead, common salt, and water.

=Aqua Græ'ca, A. Orienta'lis.= See HAIR-DYES.

=Aqua Mari'na.= [L.] The beryl[dagger].

=Aqua Mirab'ilis=[dagger]. [L.] Literally, 'wonderful water,' a cordial and carminative spirit distilled from aromatics, and formerly reputed to possess many virtues.

=Aqua Re'gia.= [L.] Nitrohydrochloric acid, originally so called, by the alchemists, from its power of dissolving gold.

=Aqua Toffa'nia.= [L.] See ACQUETTA.

=Aqua Vi'tæ=[dagger]. [L.] Literally, 'water of life,' a name familiarly applied to the leading native distilled spirit. Thus, it is whiskey in Scotland, usquebaugh in Ireland, geneva in Holland, and eau de vie or brandy in France. When the term is employed in England, French brandy is understood to be referred to. See ALCOHOL, &c.

=Aqua Vitæ Aromatico-Amara.= (F. Bolle, formerly J. B. Claude, Berlin). Galangal ginger, [=a][=a], 2 parts; orange berries, European centaury, gentian, cinnamon, angelica, [=a][=a], 1 part; alcohol, 30 parts; water, 26 parts. Digest and filter. (Hager.)