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Angina

aniline, skin, blood, red, joint, poisoning, ankylosis, blue and colour

ANGINA PECTORIS.—See HEART, DISEASES or.

ANGIOMATA.—Morbid formations resulting from abnormally deve loped blood-vessels. A number of terms are applied to certain peculiar patches in the skin which are present at birth or developed shortly after. To the laity they are known most commonly as birthmarks, and ascribed to some mental disturbance of the mother which has become thus materially impressed on the child. This, however, is an entirely erroneous impression, as these superficial, flat patches in the skin consist of areas of abnormally developed blood-vessels. They vary in colour from red to purple or blue, are quite flat and superficially situated, and may grow rapidly after birth. The colour depends almost entirely on the preponderance of either arteries, con taining bright red blood, or of veins, containing the darker, bluish blood. They are usually located on the eyelids, lips, nose, forehead, cheeks, neck, or back, and vary in size from an area as large as the head of a pin to that involving the greater part of the face. They may be surrounded by a circle of delicate, tortuous vessels, which radiate from a uniformly red centre, or they may appear as a slightly elevated, bright red patch in the skin. At other times they may extend as a broad, blue surface over the greater portion of the face, causing a considerable degree of disfigurement, often invading in addition the mucous membranes of the lips, the cheeks, and the nasal cavity. Pressure with the finger causes a blanching, but the vessels immediately 1111 up again as soon as the pressure is removed. As already noted, the growth at first may be no larger than the head of a pin, but a further extension may be very rapid.

Growing angiomata should be removed at once. With the aid of an anesthetic, they may be excised or cauterised with the actual cautery in a very satisfactory manner. The sooner parents decide to have the matter attended to, the smaller the resulting scar. The large blue angiomata can never be entirely removed, and require the most extensive operation. Cauteri sation with acids and other substances is employed very often ; but this procedure is by no means safe, and the effect as regards the resulting scar is usually unfavourable. If left untreated, these birthmarks may some times very suddenly become transformed into thick, irregular tumours made up of the enlarged blood-vessels. In other instances, they have disap peared spontaneously, but this is an exceptional occurrence, and should not lead to false hopes in any given case.

ANILINE-POISONING.—The aniline dyes have become so widespread in their use, and so many new drugs have been put on the market which are made from aniline, that many cases of poisoning, both acute and chronic, have resulted.

It is important to remember that workers in factories in which aniline dyes are widely used may be the victims of chronic poisoning. The symp

toms, which develop slowly, are eruptions of the skin, increasing paleness, and headaches. Trembling in the muscles is very frequent, and patches of numbness are found in the arms and body. Blood changes may result with the appearance of blood pigments in the disturbances of respiration, vertigo, giddiness, and fainting. In the case of acute poisoning, which may follow the swallowing of a large close of an aniline dye, but more often after a dose of the modern headache-powders, the following symptoms have been noted : Headache, weakness, vertigo, blue colour to the skin, cold, clammy skin, and difficult respiration.

The cause of the poisoning in both instances is the formation from t he aniline compounds of a derivative, paramidophenoi, which has a special affinity for the haemoglobin of the blood and prevents its ready oxidation, or which may disintegrate the colouring !natters of the red blood-cells. Treat ment consists in withdrawal of the poison, fresh air, oxygen, artificial stimu lation, if necessary, or even bleeding and infusion of salt solution. The aniline derivatives that are mainly used in medicine are acetanilide (widely employed in the manufacture of headache-powders, neuralgic powders, menstrual pain powders, etc.), phenacetine, exalgine, lactophenine, methacetine, malarine, cosaprine, malakine, citrophene, phenocoll, apolysine, etc. ; new ones are being made yearly. Only under most exceptional circumstances should these drugs be used without medical instructions.

ANISE.—The fruit of Pimpinella anisum, a member of the parsley family (Umbellilerce), widely grown in the Mediterranean regions and in Russia. It contains an active, volatile oil, from which is derived a phenol, anethol. Anise is Nr d el y employed as an aromatic in intestinal disorders, causing a warmth in the stomach, and contraction which brings about the expulsion of gases. In children's colic it has been used for this purpose, and it is very frequently combined with other remedies, such as cathartics, etc., to avoid griping. Anise furnishes the characteristic odour of certain cordials, notably absinthe and the Russian kummel.

ANKYLOSIS.—Stiffness of a joint. Ankylosis of a joint may be either a true or a false form of the disease. In true ankylosis the bones forming the joint are grown together firmly, and the joint is absolutely immovable. In pseudo-ankylosis the ligaments of the joint and the joint-capsule are shortened, and the bones and articular cartilage are more or less grown together. In false ankylosis there is always some, if only a slight, degree of movability. These conditions of the joints are treated by manual massage, or with apparatuses and splints. For mild cases massage and medico-mechanical treatment suffice. True ankylosis can be treated only by operation.