HYPERTROPHY. 404 HYPNOTICS. goitre or bronehocele, hypertropliy of the prostate glniiil, of the spleen, etc. Tlic foUowiiij; are llie ctiolojrical factors of liyperlropliy : ( 1) It may be congenital. (2) A lo^'al iiicn-a^^c in the supply of blood to a part, whether due to increascil e.- ercise, or irritation by mechanical or chemical agents, etc. (3) It may be due to old age — the so-called senile hypertrophy, the commonest ex- ample of which is'the enlargement of the prostate gland in old men. which is said to occur in about forty per cent, of all men alter the age of fifty years. (4) .Syphilis and chronic inllammations are also very common causes of hyiH-rlrophy. See Heart, Diseases of the. HY'PHA (N'eo-Lat. nom. pi., from Gk. C^ij, hyi>hi web). An individual filament of the body of a fungus. A mass of organically related hy- phiE constitutes a mycelium. See Fu.NOi. HYPTJAL ( from Gk. irxva'/.ioc^ hiii»ialcos, causing sleep, from firwi, Iiypnos, sleep; con- nectt:d with Lat. kuduiiis, soiior. AS. sicf/Vii, Skt. svapiia, sle»'p, from sro/<, to sleep). A hypnotic of unquestionable value, combining as it does the etl'ects of chloral hydrate and antipyrine. of •which it is composed." Although it is recom- mended by some for insonmia accompanied by coughing, "its chief use is found in cases of sleep- lessness due to pain. Its only rivals in the latter field are opium, chloral hydrate, and Cannabis Indiea. (See Hashish.) The objections to using opium as a hypnotic in cases of persistent sleeplessness are well known : and the combination of the analgesic antipyrine with chloral hydrate gives great relief from pain, permitting the hypnotic action of the latter drug. HYP'NOS (Lat..from Ok. 'Y:7io£-). The Greek god of sleep, the son of Erebus and Xight, and twin brother of Death. He is represente<l as a youth with wings on bis temples, bearing a poppy branch and the horn of slumber. HYPTIOSCOPE (from Gk. D-ior, hypnos, sleep + iTariTMi', nkopein, to view). A magnet devised to measure hypnotic sensitiveness. The magnet is a slit tube .3.4 cm. in diameter by 5.5 in "length, and weighs ICO grams. It is verj- powerful, lifting 25 times its own weight. The instrument is applied by removing the armature and inserting the forefinger of the person to be tested into the magnet so as to touch both poles at once. After two minutes sensitive or objective effects will be noticed in .SO per cent, of persons tested. It is not an instrument of any value whatever. Hypnotic influences cannot be measured by any known mode at the present time. HYPNOTICS (from Lat. hiipnotinis. Gk. i-mrtn6r, InipiuiliLrm, relating to sleep, from pTimf, hypnris. sleep). Agents which are used to induce sleep. During the state of slumber, especially if deep, the functional activity of the cerebral centres is largely suspended. Medullary centres remain active, but are less alert. The brain and spinal cord are anaemic, reflex action is diminished, and the senses are dulled. The ordinary precautions of one about to sleep — the recumbent position, the darkened and quiet room, the absence of previous excitement — arc simply evidences of physiological necessity. Hypnotics act ordinarily by diminishing the functional activity of the brain, or by causing an ana-mia of it, occasionally by both methods. They may Im.' divided into four classes: (.) Mental, acting by diminishing' the functional activity of the cerebrum. This class includes the constant repetition of prayers, etc., the counting up into the hundreds or thousands, the counting imagi- nary sheep as they jump an imaginary wall, and many similar expedients. These are only of value in light grades of insomnia. (B) Divlclic. This elasB causes a congestion of the abdominal viscera by increasing their functional activity, und thus leiuls indirectly to cerebral ana'iiiia. A light supper of packers and cheese, or oysters, or soup, or bwf tea, is often of great value for inducing sleep. Frequently the addition of a little alcohol as a weak toddy, or a bottle of beer, will help. (C) MKchunical, including: (1) Hot icaln-bfig or 6ric/.- to the feet, of value when the extremities are cold. It acts by indirectly caus- ing cerebral aii:emia. (2) AJoint uurmlh to abdo- men by a poultice or hot compress covered with oilsilk. This is frequently of value. It acts by dilating the abdominal vessels, and this causes cerebral aniemia. (3) Hot bath. This acts by dilating the cutaneous vessels, and thus causing cerebral aniemia. Certain i)recautions should be observed: The bed should be well warmcil. and the room moderately cool. The bath should lie hot. and the individual ishould stay in it for sev- eral minutes. He should be dried as quickly as possilile. and in passing from the bath to the bed he should >e well wrapped up and wear warm slippers. This method is often of great value when properly applied. It should be used with caution in cases of heart disease. (41 Chnpmnn's method. This consists in the application of cold to the spine. It. indirectly causes ililatation of the abdominal vessels, and thus cerebral ana'iiiia. (5) .Vassaye. This should be general and thor- ough, especially to the abdomen. It acts by dilating the vessels of the body, and also by lessening the irritability of the scnsorj' cutaneous nerves. If the ordinary precautions of quiet and darkness are observed after the massage, this method frequently acts very well. All the preceding measures are of little value in case any acute disease is present. In such cases, and many others, we have to resort to drugs. Thesn should not lx> used for ordinary insomnia until a thorough trial has been given to the dietetic and mechanical hypnotics. None should be given except under the advice of a physician who has examined the patient. They are, of course, grouped under the class (D) Medicinal. (1) Opium and its derivatives. As simple hypnotics these are all objectionable, for they produce other marked efTects than sleep. The danger of a habit forming must also be considered. In acute diseases, espix-ially when accompanied by pain or delirium, they are of great value. Codein is the least objectionable, but it is also the most expensive and the least efficacious. Heroin, dionin. and jieronin, three new derivatives of morphine, can be utilized, but the danger of fr.rmins a habit is always present. (2) Hynxryn- mii.i and its derivatives. These are not of as much value as are ordinarj- hypnotics, for they cause other marked efTects. In cases of mania they are of great value. Hyoscine hydrobromate has the most decided hypnotic action. (3) Can- nabis Indiea. Feeble in hypnotic power. The sleep produced by it is apt to be preceded by delusions often unpleasant. (4) Chloral hydrate. This is a very valuable hypnotic. It has some
