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=EPIDEM'IC.= Common to many people. In _pathology_, an epidemic disease (EPIDEMIC; EPIDEMY) is one which seizes a number of people at the same time and in the same place, but which is not dependent on any local cause, but on some extraordinary condition of the air. When a disease is peculiar to a people or nation, and appears to depend on local causes, it is said to be 'ENDEMIC' or 'ENCHORIAL,' Thus, Asiatic cholera may be taken as an example of the first, and the agues of low countries, and the goitre of the Alps, as examples of the other.
Epidemics may be divided into indigenous and exotic. Amongst the former may be included scarlet fever, measles, hooping-cough, influenza, typhoid; whilst the latter embrace such as are imported, viz. Asiatic cholera, plague, &c.
No year pa.s.ses without the prevalence of an epidemic of one kind or the other in this country.
The following enactments for the prevention of epidemic diseases are now in force:--
"Whenever any part of England appears to be threatened with, or is affected by, any formidable epidemic, endemic, or infectious disease, the Local Government Board may make, and from time to time alter and revoke, regulations for all or any of the following purposes, viz.:--
"(1) For the speedy interment of the dead; and--
"(2) For house-to-house visitation; and--
"(3) For the provision of medical aid and accommodation, for the promotion of cleansing, ventilation, and disinfection, and for guarding against the spread of the disease;--
"and may by order declare all or any of the regulations so made to be in force within the whole or any part or parts of the district of any local authority, and to apply to any vessels as well as arms or parts of the sea within the jurisdiction of the Lord High Admiral of the United Kingdom, or the Commissioners for executing the office of the Lord High Admiral for the time being, for the period in such order mentioned, and may by any subsequent order abridge or extend such period." (P. H., s. 134.)
"All such regulations, &c., made by the Local Government Board are to be published in the 'London Gazette,' and such publication is to be held as conclusive evidence." (P. H., s. 135.)
"The local authority of any district within which, or part of which, regulations so issued by the Local Government Board are declared to be in force, shall superintend and see to the execution thereof, and shall appoint and pay such medical or other officers or persons, and do and provide all such acts, matters, and things as may be necessary for mitigating any such disease, or for superintending or aiding in the execution of such regulations, or for executing the same, as the case may require. Moreover, the local authority may from time to time direct any prosecution or legal proceedings for or in respect of the wilful violation or neglect of any such regulation." (P. H., s. 136.)
"The local authority and their officers shall have power of entry on any premises or vessel for the purpose of executing or superintending the execution of any regulations so issued by the Local Government Board as aforesaid." (P. H., s. 137.)
"Whenever, in compliance with any regulation so issued by the Local Government Board as aforesaid, any poor-law medical officer performs any medical service on board any vessel, he shall be ent.i.tled to charge extra for such service, at the general rate of his allowance for services for the union or place for which he is appointed, and such charges shall be payable by the captain of such vessel on behalf of the owners thereof, together with any reasonable expenses for the treatment of the sick.
"Where such services are rendered by any medical pract.i.tioner who is not a poor-law medical officer, he shall be ent.i.tled to charges for any service rendered on board, with extra remuneration on account of distance, at the same rate as those which he is in the habit of receiving from private patients of the cla.s.s of those attended and treated on shipboard, to be paid as aforesaid. In case of dispute in respect of such charges, such dispute may, where the charges do not exceed _twenty pounds_, be determined by a court of summary jurisdiction; and such court shall determine summarily the amount which is reasonable, according to the accustomed rate of charge within the place where the dispute arises for attendance on patients of the like cla.s.s as those in respect of whom the charge is made." (P. H., s. 138.)
"The Local Government Board may, if they think fit, by order authorise or require any two or more local authorities to act together for the purposes of the provisions of this Act relating to prevention of epidemic diseases, and may prescribe the mode of such joint action, and of defraying the costs thereof." (P. H., s. 139.)
"Any person who--
"(1.) Wilfully violates any regulation so issued by the Local Government Board, as aforesaid; or,
"(2.) Wilfully obstructs any person acting under the authority or in the execution of any such regulation shall be liable to a penalty not exceeding five pounds." (P. H., s. 140.)
=EPIGAS'TRIC.= In _anatomy_, pertaining to the EPIGAS'TRIUM, or the part of the abdomen over the stomach.
=EPILEP'SY.= _Syn._ FALLING SICKNESS; EPILEPSIA, MORBUS CADUCUS, L. The popular name of this disease arises from the patient, when attacked by it, suddenly falling to the ground. The other leading symptoms consist of convulsions, stupor, and, generally, frothing at the mouth. It comes on by fits, which after a time go off, leaving a certain amount of la.s.situde and drowsiness behind. Sometimes certain peculiar symptoms precede the attack.
Among these, a sensation of coldness or of a current of cold air from the extremities of the body towards the head (AURA EPILEPTICA), palpitation, flatulency, stupor, and an indescribable cloud or depression, are the most common. The occurrence of these symptoms are not, however, uniform, even in the same patient; but it generally happens that the party falls down suddenly, and without the slightest warning.
Epilepsy is often symptomatic of other affections, as excessive irritation of the primae viae from worms, indigestible or noxious food, or poison; or it depends on local injuries, particularly those of the head, accompanied with lodgments of water on the brain, tumours, pressure, &c. Violent affections of the nervous system, sudden frights or fits of pa.s.sion, violent mental emotions, the sudden suppression of old evacuations, and, in childhood, difficult teething, are also common causes of sympathetic epilepsy. Occasionally it arises from mobility of the sensorium, induced by plethora, or by excessive debility. In such cases the treatment must be energetically directed to the removal of the exciting cause.
When epilepsy occurs as an idiopathic or primary affection, or when it cannot be referred to any apparent cause, more especially when the attack commences about the age of p.u.b.erty, and the fits are frequent, it is generally hereditary, and there is great danger of its terminating either in apoplexy, or lunacy, or imbecility.
The treatment of idiopathic epilepsy is princ.i.p.ally directed to the improvement of the general health, and the diminution of nervous irritability by sedatives and tonics. Among the first, camphor, ether, henbane, hemlock, musk, oil of cajeput, opium, and morphia, and, more recently, hydrocyanic acid, have been princ.i.p.ally relied on. Among the second, bark, cascarilla, quinine, strychnia, valerian, the sulphate of iron, zinc, and copper, a.r.s.enious acid, and nitrate of silver, have each their zealous advocates. The objection against the last preparation is the danger of its disfiguring the patient, by tinging the skin of a permanent dull, leaden hue. In cases accompanied with plethora, a low diet, daily out-of-door exercise, and the frequent use of aperients, with occasional blistering, cupping, and other depletive measures, are indicated; whilst in those marked by inanition and debility, an entirely opposite course must be adopted. When the disease is complicated with syphilis, a mild course of mercury may be given; and when with scrofula, iodine, iodide of pota.s.sium, or cod-liver oil, a.s.sisted by sea-bathing, will be proper.
Among other methods of treatment may be mentioned the administration of an active emetic or purgative, twice weekly, in the morning, when the stomach is empty. The first has now few supporters; but the second is said to be often productive of great benefit.
During a fit of epilepsy the only thing that can be done for the patient is to prevent the sufferer injuring himself, and to loosen every part of his dress that presses on his head, neck, or chest. When premonitory symptoms occur, a brisk emetic, a large dose of laudanum and ether, a cold plunge or shower bath (when not contra-indicated), or anything else which gives a sudden shock to the system or raises its tone, frequently prevents the accession of the fit.
Epilepsy more commonly attacks children than adults, and boys than girls.
"Its returns are frequently periodical, and its paroxysms commence more frequently in the night than in the day, being somewhat connected with sleep. It is sometimes counterfeited by street impostors in order to excite the charity of the pa.s.sers-by.
_For Animals._ All animals are subject to attacks of epilepsy, more particularly dogs and pigs. The animal seized with the fit loses the senses of sight and hearing, and falling down exhibits the same symptoms as those which accompany the disease in human beings. Cattle, although they bellow greatly during an attack, rarely die from it; but it not infrequently suffocates dogs, and is in them a not unusual cause of sudden death. The fit, which lasts from ten to fifty minutes, when it pa.s.ses off, leaves the animal dull, and is apt to return. Epileptic fits are a frequent accompaniment of distemper in dogs. They are often induced in cattle by tough and indigestible food, and in these as well as in dogs, by intestinal worms. Hot weather and excitement, especially in dogs, are a frequent cause of an epileptic fit. By energetic treatment after the first attack the further course of the malady may often be arrested. The best treatment is to give, when the fit is over, a brisk purge, with an ounce of oil of turpentine in horses or cattle, and twenty to forty drops in dogs. If the disease is caused by worms give the medicines ordered in such cases.
=EPISPAS'TICS.= See BLISTER and VESICANT.
=EP'ITHEM.= _Syn._ EPITHEMA, L. Any external liquid medicine for local application; as an embrocation or lotion. Some writers confine the term to those preparations which are intended to be applied by means of a cloth dipped into them. See LINIMENT, LOTION, &c.
=Epithem, Astrin"gent.= _Syn._ EPITHEMA ASTRINGENS, L. _Prep._ 1.
Powdered ice, 7 dr.; powdered catechu, 1 dr.; mix.
2. (Brera.) Powdered bole and rhatany, of each 1 oz.; vinegar of roses, q.
s. to form a paste. Both are applied to the nostrils and forehead to stop bleeding at the nose.
=Epithem, Gly"cerin.= _Syn._ EPITHEMA GLYCERINae, L. _Prep._ (Mr Startin.) Glycerin, 1 oz.; rose water and lime water, of each 3 or 4 fl. oz.; powdered gum tragacanth, q. s. to form a thin mucilage. In scalds, burns, and excoriations.
=Epithem, Vermifuge.= _Syn._ EPITHEMA VERMIFUGUM, L. (Hoffmann). Wormwood and centaury, beaten up with aloes and colocynth, and applied over the belly.
=Epithem, Vesica'ting.= _Syn._ EPITHEMA VESICATORIUM, L. _Prep._ 1.
(Alibert.) Rye or barley meal, made into a paste with vinegar, and 30 to 40 gr. or more of powdered Spanish flies sprinkled over the surface.
2. (Ph. L. 1746.) Spanish flies (in fine powder) and wheat flour, equal parts, made into paste with vinegar, q. s. As a blister.
=Epithem, Vol'atile.= _Syn._ EPITHEMA VOLATILE, E. AMMONIae, L. _Prep._ (Ph. L. 1764.) Common turpentine and water of ammonia, equal parts. An excellent counter-irritant; either with or without the addition of a little olive oil.
=EPIZOOTIC DISEASES.= These are diseases which attack different species of domestic animals in the same manner that epidemics do man. These maladies ravage large tracts of country, frequently causing great mortality amongst the various animals inhabiting the localities visited by them; different animals being a.s.sailed by different forms of epizootic disease.
For instance, there is the rinderpest, or plague peculiar to cattle, the typhoid or gastric fever which prevailed so largely amongst horses in this country in 1854, and 1861 and 1862; the smallpox of sheep; the diphtheria affecting oxen, sheep, goats, and pigs; the influenza of horses, and the charbon of pigs. Dogs, cats, tame and wild birds, fish,[277] silkworms and bees, each suffers from a special variety of epizootic disease.
[Footnote 277: Great mortality has prevailed amongst the salmon during the present year, owing to the attacks of a peculiar white fungus, called the _Saprolegnia ferox_, a parasite that multiplies so rapidly as speedily to envelope any fish it attacks.]
Epizootic diseases are met with in most European countries. They are very common in Russia, where they commit great devastation amongst the horned cattle, 400,000 of which are said to die annually from their ravages. Of epizootics, Mr Finlay Dun says:--"They extend at the same time over large tracts of country, attack in a similar manner great numbers of animals, tend to a.s.sume a typhoid form, and withstand badly all depletive treatment. They depend upon some general causes as yet unknown, but which it has usually been thought sufficient to term "atmospheric;" but are always most common and fatal amongst animals breathing impure air, densely crowded, badly fed, or exposed to cold winds; and are generally prevented or robbed of their virulence by guarding against such debilitating causes, and maintaining a high standard of health."
=EQUISE'TIC ACID.= In _chemistry_, a substance identical with ACONITIC ACID (which _see_).
=EQUIV'ALENT.= (EQUIVALENCY.) In modern _chemistry_, the equivalent of a body is that weight of it which will exactly replace in a compound 1 atom of hydrogen or 1 atom of either of the other monivalent elements (_see_ Table, _below_).
Monivalent elements are those which replace one atom of hydrogen in chemical combinations in the ratios of their atomic weights.
One atom of a divalent, trivalent, tetrivalent, pentivalent, and hexivalent element replaces respectively, or is equivalent to, two, three, four, five, or six atoms of hydrogen or of any other monivalent element.
(For further information on this subject consult the works on chemistry by Fownes, Miller, Kay-Shuttleworth, &c.)
_Table of the Elements, arranged according to their Equivalency_.
-----------+-----------+----------+-------------+------------+------------ Monivalent. Divalent. Trivalent. Tetrivalent. Pentivalent. Hexivalent.
-----------+-----------+----------+-------------+------------+------------ Hydrogen Oxygen Boron Carbon Nitrogen Sulphur Fluorine Barium Gold Silicon Phosphorus Selenium Chlorine Strontium Tin Vanadium Tellurium Bromine Calcium t.i.tanium a.r.s.enic Tungsten Iodine Magnesium Thorium Antimony Molybdenum Caesium Zinc Niobium Bis.m.u.th Osmium Rubidium Didymium Tantalum Iridium Pota.s.sium Lanthanium Zinconium Ruthenium Sodium Yttrium Aluminium Rhodium Lithium Glucinum Platinum Chromium Thallium Cadmium Palladium Manganese Silver Mercury Lead Iron Copper Cobalt Nickel Uranium Cerium -----------+-----------+----------+-------------+------------+------------