ni SPLINT. 



that the lower end of the spleen can be felt under the margin of the 

 ribs upou the left side, there can be no doubt with respect to the 

 distant When the hypertrophy doe* not reach this extent, its most 

 characteristic symptoms, are a sense of weight in the left side, with 

 or without evident swelling ; inability to lie with ease on the right 

 side: debility, without corresponding emaciation; disordered stomach, 

 irritable bowels, dry cough, and absence of fever. The spleen, when 

 enlarged, U always felt to be harder than in a natural state, but pressure 

 upon it with the hand seldom produces pain. An hypertrophy of the 

 spleen is sometimes followed by ascite* ; but there will frequently be 

 no dropsy of the abdomen, even where this organ has been for a long 

 time much enlarged. When this form of disease has been connected 

 with ague, it more frequently subsides than in any other case; and the 

 quina, which has been prescribed to cure the hitter affection, will pro- 

 bably be serviceable also to the former. " When the enlargement has 

 taken place independently of this cause," .iy Hr. liaallie, "it hardly 

 ever subsides of itself, or La materially diminished by medicine. 

 According to my experience, mercury, administered both externally 

 and internally, produces very seldom any good effect ; I have seen, I 

 think, more advantage from a setou inserted under the skin which 

 the spleen. In some coses it has appeared to be diminished in 

 size by this remedy, and to be rendered softer ; but I do not recollect 

 a single instance, except after ague, iu which it has been reduced to 

 nearly its natural size. Temperate living, abstaining from violent 

 exercise, and keeping the bowels open, must be to a certain degree 

 useful iu retarding the progress of the disease." The remedy largely 

 employed in India for the cure of chronic tumour of the spleen is a 

 compound of garlic, aloes, and sulphate of iron. When emaciation 

 and diarrhoea are present, the garlic and aloes are macerated in brandy ; 

 under other circumstances, in vinegar. The proportion of aloes is so 

 regulated as to produce three evacuations daily ; and the medicine also 

 product's copious secretions from the kidneys. The Decoctum Alves 

 Compatitum with the Ttnclin-a or Acctum Sriltir would probably prove 

 equally effectual. The moxa, and even the actual cautery, have been 

 recommended for this disease ; and emetic cataplasms of tobacco- 

 leaves, renewed constantly so as to keep up frequent vomiting, have in 

 some instances produced the happiest effects. 



Atrophy of the spleen is by no means so common as hypertrophy ; 

 and though some instances ore related by modern writers, yet their 

 statements are so meagre and unsatisfactory, that no use can be made 

 of them. It is sometimes found exceedingly small and even shrivelled 

 when some other organ is much enlarged, where there have been 

 great discharges of blood, hi ascites, and in extensive chronic disease. 

 This form of disease of the spleen obviously admits of no remedy. 



Hydatida iu the spleen are found now and then, but not very often ; 

 Dr. Baillie had never met with a single case of them. It is hardly 

 possible to discover their existence during the life of the patient, nor, 

 even if it were more easy, could the complaint receive any cure, or 

 even amendment, from medicine. The disease arises quite uncon- 

 sciously to the patient; the first intimation of its existence being 

 debility, dyspepsia, and the uneasiness created by a slowly increasing 

 tumour, which in its progress causes further derangement by com- 

 pression and displacement of other organs, and becomes itself per- 

 ceptible externally. It is only when the containing membrane, or 

 some organ, becomes inflamed, that fever, pain, and their fatal con- 

 sequences ensue. Hydatids may prove fatal by passing into the 

 peritoneal cavity from ulceration of the containing sac, or by disturbing 

 the circulation, or by irritating other viscera; or the patient may live 

 very long with this complaint, and die eventually of another disease 

 during the indolent continuance of this. 



Melonosis and calculi of the spleen ore noticed shortly by Dr. 

 Bigsby, but the instances are too rare to require any particular remarks 

 here. 



Rupture of the spleen from some external violence occurs not 

 unfrequently ; but in the majority of coses the injury is so over- 

 whelming that little ia left for the medical practitioner to do. Free 

 venesection and perfect rest have occasionally saved life ; but in many 

 instances the patient dies iu a few hours. In these latter cases the 

 symptoms are great shiverings, coldness of body, vomiting, and other 

 signs of extreme collapse : when there is time and strength for reaction, 

 there is considerable fever, with a remarkable heat of skin, and great 

 pain iu the left side or all over the abdomen ; the stools and urine are 

 not materially affected. 



(Good's Study of Med. ; Gregory's Theory and Fract. of Med. ; 

 Bigsby, in ' yd p. uf Prafl. Med., from which works, with Dr. Haillie's 

 (posthumous) Lectures and Obterv. on Med., great part of the patho- 

 logical part of this article is token.) 



SPLINT is a piece of wood or other rigid substance which is used 

 in surgery to maintain any part of the body iu a fixed position, and 

 especially for the purpose of holding steadily together the portions of 

 a fractured bone. Splints vary almost infinitely in form and size, 

 according to the part to which they have to be adapted, and the 

 position in which it is to be held ; the number and the arrangement of 

 them in each case are equally subject to variation ; nor can a surgeon 

 have a better rule than that of following no general plan, but of deter- 

 mining in each case the apparatus best fitted for its peculiar exigencies. 

 [KiiACTum:.] The material of which they are commonly made ia light 

 wood ; each splint consisting cither of one piece cut nearly to the form 



SPRAIN. 7S 



and size of the limb, or of several pasted together with a strap of linen 

 so as to be flexible in one direction. In some cases tin is a prei 

 material ; in some stiff pasteboard. In many cases also it i 

 advantageous to adapt the splints exactly lo all the irregularities of 

 the limb; and as this cannot be done with wood or any unyielding 

 material, it is usual to employ one which, being applied moist ai< 

 gradually hardens. Stiff pasteboard will sometimes be sufficient, 

 especially for children ; but a better material for general use is sole- 

 leather or gutta percha, applied while quite pliant after having been 

 well soaked in hot water, and then bandaged closely to the limb and 

 allowed to dry. Another plan of this kind now much i-mpioyi-rl is to 

 form a splint of linen and some glutinous material, such as starch, or a 

 mixture of white of egg and flour, or of mucilage of gum-oral 

 whiting, made as thick as bird-lime. In using these, the In 

 other part should be thinly padded with soft lint ; then strips of coarse 

 linen soaked in the tenacious material should be laid on, one over the 

 other, till on each side of the limb they form a layer about as thick as 

 a common wooden opliut. The whole should theu be surrounded 

 with a neatly-applied bondage soaked in starch. When dry, splints of 

 this kind will so exactly fit the part to which they are applied; and be 

 so rigid, that a patient may with safety execute the slighter natural 

 movements of a limb within a fortnight after it has been fractured. 

 All the further care of a simple cose of fracture will generally consist 

 in the occasional replacement of the starched bandage, and the 

 adaptation of the splints, by cutting their edges, to the change of 

 form which the limb may undergo as the swelling diminishes. 

 Splints of this kind however must not be applied till all the inflam- 

 mation immediately consequent on the fracture has ceased. See 

 Druitt's ' Surgeon's Vade-mecum.' 



SPONDEE (tpondcus, norSiios) is a foot which consists of two long 

 syllables ( - ). The name is derived from mtoySii, a libation, as the 

 metrical prayers on such an occasion were generally of a slow and 

 solemn movement. To produce this solemnity the spondee ia often 

 used instead of a dactyl in the hexameter or pentameter : and in 

 iambic, trochaic, or anapujstic metres, instead of an iambus, trochee, 

 or anapaest. There is no metre which consists of spondees alone, and 

 indeed such a metre would bo very disagreeable, even if i< 

 possible ; but spondees produce a good ellect when mixed with other 

 feet. An hexameter verse which has a spondee iu the fifth place, is 

 called a spondaic verse. 



SPONGIA, MEDICAL USES OF. The use of sponge by surgeons, 

 in its natural state, to absorb fluids, needs no notice, but it is also 

 employed by them under the name of sponge tent, when prepared in 

 a particular manner. This consists iu dipping the sponge in i 

 wax, and compressing it between iron plates till it hardens on cooling ; 

 it is then cut into cylindrical or other forms. The pieces are intro- 

 duced into sinuses and other narrow canals, with the intention of 

 dilating them by the expansion of the sponge, when the wax melts by 

 the heat of the part. Sponge tents are however little used by modern 

 surgeons. 



According to the analysis of Horncmanu, sponge consists of a 

 substance similar .to osmazoinc, animal mucus, fat oil, a substance 

 soluble in water, a substance only soluble in potash, and traces of 

 chloride of sodium, iodine, sulphur, phosphate of lime (?), silica, 

 alumina, and magnesia. 



When sponge has been cut into pieces, beaten in order to free it 

 from little stones and shells, and burnt in a closed iron vessel, till it 

 is black and friable, it is then called burnt sponge (spvnyia vita). As 

 the virtues of this greatly depend on the proportion of iodine con- 

 tained iu the sponge, much of which is volatilised by the high 

 temperature required in calcination, it has been proposed only to 

 expose it to such a heat as will thoroughly dry, colour it brown, and 

 render it friable, when it may be powdered, and preserved in well- 

 closed bottles. For use it is generally formed into an electuary or into 

 lozongea. A test of itd goodness consists in heating it in a glass flask 

 with sulphuric acid, and if copious violet-coloured fumes be evolved, 

 this proves that it contains much iodine. Burnt sponge has been 

 almost completely superseded iu the treatment of bronchocele and 

 scrofula by iodine and its preparations ; but as it obviously consists 

 of a natural combination of many of the principles which have been 

 deemed useful in scrofula, it ought not to be hastily discarded. It is 

 with great propriety retained in the Dublin PhannMO] 



SPONTANEOUS COMBUSTION. [CoMBusTiOM.] 



SPORADIC (the Greek word axopattitfa, with the term: 

 dropped) is a term applied to any disease which, being usually epidemic 

 or contagious, occurs at any time in a few persons, without spreading 

 extensively through a district For example, in the year 1841 

 cases of sporadic cholera occurred ; that is, several persons, at clii 

 times and in different parts of the country, were affected with a disease 

 in no respect different from the cholera which raged as an ep; 

 in 1832 ; but it did not spread beyond them by contagion, nor did it 

 attack a number sufficient to give it the character of an cpidemie. 

 The circumstances on which the occasional occurrence of diseases that 

 are usually epidemic, iu a sporadic form, depend, are altogether 

 unknown. 



SPOUT, WATER. [WATEB SI-OUT.] 



SPRAIN, or STRAIN, is an injury of muscular or tendinous tis- 

 sues, resulting from their being forcibly stretched beyond their natural 



