ANATOMY 

HYSIOLOGY 

ND 
HYGIENE 

ALKER 






~ 1 




WHMIHMI 



LIBRARY OF CONGRESS. 

Cliap._.„_ Copyright No. 

Shelf__-_lii_i_.^ 



UNITED STATES OF AMERICA. 



ANATOMY, PHYSIOLOGY 
AND HYGIENE 



BY 
/ 

JEROME* WALKER, M.D. 

LECTURER UPON ANATOMY, PHYSIOLOGY, AND HYGIENE AT 

THE GIRLS' HIGH SCHOOL AND THE COMMERCIAL 

HIGH SCHOOL, BROOKLYN 



NEW EDITION, ENTIRELY REWRITTEN 
WITH ORIGINAL AND CAREFULLY SELECTED ILLUSTRATIONS 



Boston 

ALLYN AND BACON 

190 



1089/ 

Library of Con--; *«« 
TWO CtPtES ^CCElv^n 

JUN 25 1900 

Copyright witty 

second copv. 

order division, 
JUN 36 19 00 



63964 

COPYRIGHT, 1883, BY A. LOVELL & CO. 
COPYRIGHT, 1900, BY JEROME WALKER. 



Norinooti {Stress 

J. S. Cushing & Co. — Berwick & Smith 
Norwood Mass. U.S.A. 



PREFACE TO EEVISED EDITION. 

The call for a new edition of the " Anatomy, Physi- 
ology, and Hygiene" has afforded opportunity for a 
thorough revision of the text, and for the addition of 
thirty-three new illustrations and other important ma- 
terial. 

Scientists and experienced teachers have been freely 
consulted, and the book as revised represents the results 
of important modern research in the subjects treated. 

Great care has been exercised to insure accuracy of 
statement. The laws of the various States governing the 
presentation of the effects of alcohol and narcotics have 
been complied with. 

Attention is directed to the prominence given to 
hygiene. The study of human anatomy and physiology 
is of little real value unless it leads to practical sugges- 
tions for the preservation of health. 

If the pupil is not obliged to memorize the contents of 
the book in detail, but merely to grasp the salient points 
of the text, and carefully to read the footnotes and appen- 
dix in connection with it, he will not find it difficult 
to acquire knowledge which will be to him both a 

pleasure and a gain. 

iii 



iv PREFACE. 

The services of Professor At water, Dr. T. D. Cr others, 
Dr. Eliza Mosher, Dr. E. H. Bartley, Dr. T. R. French, 
Dr. A. Mathewson, Dr. R. L. Dickinson, Dr. J. Scott 
Wood, Dr. J. C. Shaw, and others, in the revision of 
various portions of the manuscript or in other ways, are 
gratefully acknowledged. 

J. W. 

Brooklyn, May, 1900. 



CONTENTS. 



CHAPTER PAGE 

I. The Human Body. — General Facts 1 

II. Bones and Joints .29 

III. The Skeleton 41 

IV. Muscles. — Fat 52 

V. Muscular Exercise 68 

VI. The Skin and Kidneys 77 

VII. Bathing 91 

VIII. Clothing . . . . . . . . .99 

IX. Digestion. — The Conversion of Food into Tissues 110 

X. The Circulation. — Blood. — Lymph . . . 143 

XL Food. — Dietetics 173 

XII. Foods . 207 

XIII. Respiration. — Animal Heat 227 

XIV. Air. —Ventilation. — Light 247 

XV. The Nervous System 271 

XVI. Nervous System {continued). — Reflex Action. — 

Nervous Energy 300 

XVII. Sensations. — The Senses: Touch, Taste, and 

Smell 313 

XVIII. Sight . .* 327 

XIX. Hearing 351 

XX. The Voice . 363 

Emergencies 376 

Appendix 117 

v 



ANATOMY, PHYSIOLOGY, AND HYGIENE. 

CHAPTER I. 

THE HUMAN BODY. -GENERAL PACTS- 

1. Scope of Study. — The study now to be pursued is 
primarily that of Health. It includes a consideration: 
1, of Human Anatomy} or a description of the form, 
structure, and location of the various parts of the human 
body ; 2, of Human Physiology, which treats of the uses 
or functions of these parts ; 3, of Hygiene, which treats 

1 The word Anatomy is derived from the Greek avarofxr), and signifies 
the act of cutting up, or dissection. Anatomical knowledge has been ob- 
tained by the dissection of bodies of the animal kingdom. The study of 
the general appearance and mutual relations of the bones, muscles, nerves, 
blood-vessels, and other parts is sometimes called "general" or "gross 
anatomy," to distinguish it from the study, by means of the microscope, 
of "minute anatomy," i.e. Histology. 

The word Physiology is derived from the Greek cpv<rio\6yia, and signi- 
fies, literally, talk about Nature. It is now confined to a description of 
" the phenomena, the aggregate of which constitutes life." Physiological 
knowledge has been obtained by closely observing the actions of the vari- 
ous parts of living bodies in a state of health, and by operations upon 
living animals. 

The word Hygiene, from the Greek i/yleta, "health," refers particularly 
to the health of man, both individually and in relation to the community. 
The application of health laws to individuals is known as •• individual 
hygiene," and to communities as "public hygiene," "sanitation," or 
" preventive medicine." 

1 



2 THE HUMAN BODY. GENERAL FACTS. . 

of the preservation and improvement of the health of 
individuals and communities. 

2. General Arrangement of the Human Body. — The human 
body is capable of more varied work than that of any 
other animal, and has therefore a more complicated struc- 
ture. The head, neck, trunk, and limbs are composed 
of many parts, differing from each other in structure 
and in the specific work that they do. but all working 
together to maintain the life and energy of the body. 
Each of these parts is composed of structural elements 
called cells. 1 Cells united or interwoven in various ways 
form tissues. Tissues variously combined form organs, 
which have specific duties to perform. For example, the 
heart is an organ of circulation, a muscle is an organ of 
motion. 

The body has been likened to a house; its organs, to the 
floors, doors, windows, and walls; its tissues, to the stone, 
wood, glass, mortar, and other building materials. It has 
also been likened to a machine. But it differs from these 
in many ways, chiefly in the possession of life and the 
association with its tissues of fluids, which afford moisture, 
nourishment, and lubrication, and carry from the body 
waste material, which, if retained, would prove poisonous. 
Among such fluids are the tears, blood, perspiration, and 
fluids in joints and other closed cavities. 

3. Cells. — In all the higher forms of life, whether of 
plants or of animals, every part of the body is composed 
principally of cells. 2 These are minute structures, visible 

1 From the Latin cello., a closet or storeroom. 

2 " Each cell may be likened to a soldier, an organ to a "brigade, the 
nervous system to headquarters and field telegraph, the digestive and cir- 
culatory systems to the commissary department of an army." 



THE HUMAN BODY. GENERAL FACTS. 



only by means of the microscope, vast in number and of 
great variety of form and struc- 
ture ; but they all conform to a 
characteristic type, and are held 
together by a delicate connecting 
material. Some of these cells are 
round, as in the blood; some flat 
and thin, as in the outer layer of 
the skin ; some elongated, like 
the fibres in the muscles. Still 
others, which line portions of vari- 
ous channels like the windpipe, 
have hair-like threads, known as 
ciliae} projecting from one end. 




Fig. 1. 

Diagram of a Cell. 

Nucleus. 

Nucleolus. 

Protoplasm or cell body. 



D. Cell wall, so called. 




W 




@ (J (g) 





1. Spheroidal. 

2. Polyhedral. 
8. Blood cells 



Fig. 2. 
Various Forms of Cells. 

4. Scaly. 

5. Columnar. 

('•. Caudate. 



7. Fusiform (fibres). 

S. Ciliated. 
9. Stellate. 



From the Latin, meaning "eyelashes.' 1 



4 THE HUMAN BODY. GENERAL FACTS. 

Cells are masses of protoplasm 1 containing a nucleus, 2 
and this sometimes contains a nucleolus . 3 

" Protoplasm is generally considered to be a viscid, 
translucent, granular substance, often forming a network 
or sponge-like structure extending through the cell bod}", 
The cell generally contains also other substances, such as 
food granules, pigment bodies, drops of oil and water, and 
excretory matters, or material to be thrown out. Pro- 
toplasm, deprived of its nucleus, may live for a time, and 
be able to move, but it has lost the power of taking into 
itself food for its growth and repair. The nucleus is for 
this reason, among others, considered as the controlling 
centre of cell activity, and hence a primary factor in the 
growth, development, and transmission of specific qualities 
from cell to cell, and so from one generation to another." 

4. Cell Life. — The various functions of the body, both 
in health and disease, are but the outward expressions of 
cell activity. " The cell is not only a unit of structure, but 
also a unit of function." 4 The lowest forms of life, as the 
amoeba, consist of a single cell, which does all the work 
of the body ; hence they are spoken of as unicellular. 

1 From the Greek irpwros, " first, 7 ' irxda/na, ''material." It has also 
been called bioplasm, i.e. "life material." 

2 Latin, nucleus, "kernel." 

3 "The living cell is not, as the word implies, a hollow chamber, sur- 
rounded by solid walls. . . . Whenever cells are said to have walls, 
probably there is only a condensation of the outer layers of protoplasm." 
— Prof. E. B. Wilson, Ph.D., The Cell, in Development and Inheritance. 

4 " It is the cell to which the consideration of every bodily function, 
sooner or later, drives us. In the muscle cell lies the riddle of the heart- 
beat, or of muscular contraction ; in the gland cell are the causes of 
secretion ; in the epithelial cell, in the white blood cell, lies the problem 
of the absorption of food ; and the secrets of the mind are slumbering in 
the ganglion cell." — Wilson. 



THE HUMAN BODY. GENERAL FACTS. 5 

In the hydra, the common fresh-water polyp of our ponds 
and marshes, there are a number of cells and a division 
of work among them, a " specialization of function." 
Higher still, where structure and function are intricate, 
cells are grouped together into " colonies," or aggrega- 
tions constituting organs. 

5. The Division of Labor. — Multi-cellular organisms, by 
dividing the labor, cause more and better work to be 
done in the maintenance of life, just as in a well-organ- 
ized community one set of persons acts as policemen, 
another distributes the mail, another cleans the street, 
and another teaches in the schools, — all working together 
for the common good. Over this community is placed 
one or more persons, whose business it is to see that har- 
mony prevails and that the public welfare is upheld ; for 
what is best for the community as a whole is best for the 
individuals that compose the community. 

A similar condition exists in the body with regard to 
physiological labor. Every cell and organ has a special 
work to do, and is constructed with reference to that 
work, but each one relies on the others for mutual sup- 
port. And Avhat is best for the body as a whole is best 
for each part of it. The red blood cells carry food and 
oxygen to all the tissues ; the muscle cells cause motion ; 
the gland cells secrete, or accumulate, material to moisten 
or lubricate ; other cells excrete, or get rid of, waste 
material; and over all preside the brain cells, to regulate 
and harmonize functions, and to receive messages from 
both inside and outside the body. This specialization of 
function is called differentiation. 

6. Phases of Life. — The human body, like thai of the 
lower animals, begins in a microscopic cell and passes 



6 THE HUMAX BODY. GEXERAL FACTS. 

through the various stages of birth, growth, develop- 
ment, decline, and death. This is also true, to a large 
extent, of each part of the body and of its structural 
elements. When cells have completed their allotted work 
they degenerate and die, and are cast out of the body by 
the skin, lungs, bowels, or kidneys. This is local death, 
as distinguished from death of the entire body, or gen- 
eral death. The entire life of cells is probably measured 
by days. Hence there is constant death of individual 
cells in the body, as well as constant birth. Continued 
activity of parts of the body is accomplished by cell 
reproduction or proliferation. Cells produce other cells 









Fig. 3. 
Cell Division — Various Stages. 




similar to themselves, mainly by what is known as cell 
division, — i.e. each cell divides into two, which are like 
the parent cell, and these two into four, and so on. In- 
definite multiplication of cells and consequent undue 
enlargement of parts of the body is prevented by some 
of the cells failing to divide, either as the result of injury 
or disease. 

So intimately are the internal parts of the body related 
to one another, that if one weakens or dies, others are 
almost sure to do likewise. This chain of vital connec- 
tions constitutes the so-called "circle of life." 

Man and other living organisms closely resemble each 
other in their birth, decline, and death ; but the capacity 



THE HUMAN BODY. GENERAL FACTS. 7 

which man possesses for development, especially of the 
brain, is the marked distinction between human beings 
and the lower animals. 

7. The Work of Life. — The pervading influence or 
inherent power that we call life (about which we know 
little except as to its effects) enables the living body to 
assert its needs through its various parts. Thus, if it 
needs nourishment, it calls for food through the stomach 
by means of the sensation of hunger ; when it needs air, 
the lungs make known a desire for breathing. If the 
strength of this pervading influence is diminished, im- 
paired health results ; if it ceases, death follows. 

The way in which the specific duty or function of an 
organ is performed is known as a process ; for example, 
the respiratory process, the digestive process. All of the 
processes carried on in the living body are essentially 
vital processes, since they cannot be performed except 
during life. But they are frequently grouped as follows : 
1. Chemical processes, such as the transformation of ma- 
terial into carbon dioxide, water, etc. 2. Mechanical pro- 
cesses, such as the grinding of food in the mouth and the 
motion of the muscles of the stomach in the digestion of 
food. 3. Vital processes, or those often considered most 
necessary to the maintenance of life, such as breathing, 
digestion, and the circulation of blood. 

Living bodies are constantly forming complex substances 
from simpler ones, thus storing energy and building up 
living material. They are also constantly taking oxygon 
from the food and the atmosphere, and transforming com- 
plex substances into simpler compounds, of which the sim- 
plest and final ones are water and carbon dioxide, which 
pass out of the body as excretions. This breaking down oi 



8 THE HUMAN BODY. GENERAL FACTS. 

complex substances is called oxidation. It sets free a 
certain amount of energy. 

The combined effect of the different kinds of work 
performed by the cells is to maintain the balance of the 
body, i.e. the proper relation between repair and waste, 
between income and outgo, which constitutes health or 
wholeness. The various changes necessary to accomplish 
this are grouped together as metabolism. 

8. Properties of Living Matter. — Living things have the 
power of reproduction, by which the species is continued. 
They have the power of assimilation, i.e. of appropriating 
from their food the materials needed for the sustenance 
and building up of their various portions. The cells of 
our bodies take from the nourishing blood the particles 
they individually need. For example, muscle cells assimi- 
late material for muscle ; bone cells, material for bone, 
and so on. With assimilation comes the power to grow 
or increase in size, to develop or increase in capability, 
and then to reproduce. Living things are also excitable, 
i.e. they — each in its own peculiar manner — respond 
to external impressions, such as cold, heat, a blow, or 
nervous force. These excitants are spoken of as stimuli. 
Some cells when stimulated secrete, others excrete, while 
in others the protoplasm alters its form. Certain cells 
in our bodies, like some of the one-cell forms of animal 
life, have the power of moving from place to place by 
the alternate protrusion and retraction of various por- 
tions of their protoplasm. Movements of this sort are 
called amoeboid movements, since they resemble those 
of the amoeba. They enable the lymph cells and the 
white blood cells to pass, through the thin walls of the 
vessels in which they float, into surrounding tissues. 



THE HUMAN BODY. GENERAL FACTS. 



9 



Such migration is known as diapedesis, 1 and the cells 
engaged in it are emigrant or migratory cells. Disease 
sometimes spreads from one tissue to another by means of 
these cells. 



e? 




Fig. 4. 
Amoeboid Movements. 

Another form of motion inherent in certain cells is the 
ciliary^ the waving to and fro by means of ciliae. Mus- 
cular motion, through the alternate contraction and relax- 
ation of muscular fibres, is also a property possessed by 
many living things. 

9. Membranes. — Fibrous, sheet-like tissues, which cover 
certain organs and connect certain parts of the body, are 
called membranes. Some membranes, placed as partitions 
between two fluids or gases, permit them to mingle. This 
process is known as osmosis. The passage of the fluid 
or gas inward is endosmosis ; outward, exosmosis. The 
absorption of a fluid by a cell or membrane is imbibition. 
Osmosis is illustrated in the changes which occur in the 
breathed air during respiration* imbibition, in the trans- 
formation of food into blood. 



1 Greek, 5ia, "through," itvidav, "to leap.' 1 



10 THE HUMAN BODY. GENERAL FACTS. 

10. The Tissues. — The tissues of the body may 1: 
classified as supporting tissues and active tissues. The foi 
mer include bone and cartilage, which provide a strong 
framework for the body. They also include connective 
tissue, which in some parts of the body is delicate and 
elastic, and in others is fibrous and strong. In the 
meshes of the connective tissue are fat, lymph, and other 
materials used for the ordinary nutrition of the body, 
or stored up for emergencies. 

Connective tissue, 1 as the name implies, connects and 
holds in place the various organs of the body. It so 
closely covers, or is so interwoven with, all the textures 
of the body that, if all other tissues could be removed and 
the connective only be left in normal position, we should 
have an almost exact model of the various organs in the 
body, even to their minutest structure. What connective 
tissue is will be best understood if we compare it with 
the inside of an orange after the juice has been sucked 
out. As motion is necessary to life, it will be appreciated 
how thickening of the connective tissue, which sometimes 
results from disease, will impair the motion and conse- 
quent health of parts. One of the evil effects of alco- 
holic drinks is a thickening of the connective tissue, 
especially in the liver and brain. 

The active tissues of the body, such as muscles and 
nerves, are those that perform its activities. Among 
them is a group known as the epithelial, 2 comprising 
mainly the outer skin and the lining of cavities and 
canals, and intimately concerned in secretion and excre- 
tion. 

1 The various kinds of connective tissue are the areolar, fibrous, 
elastic, adipose, retiforin, and lymphoid. For one form, see Fig. 34. 

2 Classified as simple, pavement, ciliated, and lining. 



THE HUMAN BODY. GENERAL FACTS. 11 

11. Value of Health. — Health enables one to do the best 
work that he is capable of. It also " brings so many 
charms and such great blessings, it is indeed a pity so 
few possess it. Health means a clear skin, a bright eye, 
a firm step, erect carriage, graceful movements, great 
powers of endurance, and the cheerful temper that waits 
on good digestion." 

Disease not only causes misery, but is expensive, as it 
interferes with the earning capacity of the person afflicted, 
and necessarily makes an increase in expenditure. Health 
boards find their most energetic opponents among the 
badly housed, the poorly fed, and those ignorant of hy- 
giene (a). 1 "Public health is public wealth." National, 
state, city, and town boards of health and other sanitary or- 
ganizations should be heartily supported, as their object is 
to prevent the spread of disease and to lessen the rate of 
mortality Much good has been accomplished by these 
associations in the past, much more may be done in the 
future. Sanitation has lessened the virulence or stopped 
the ravages of epidemics of typhoid fever, smallpox, and 
diphtheria, has improved the quarters on shipboard 
devoted to immigrants, and thus has prevented much 
sickness and many deaths. It has cut down the death 
rate of armies and public institutions over one-half. 
Experience shows that usually, where sanitation is not 
or can not be enforced, more soldiers die in wars from 
sickness than from injuries inflicted by the enemy (5). 
It will be a matter of interest to notice the increase in 
healthfulness in Cuba, Porto Rico, and the Philippine 
Islands, when civic and personal cleanliness, the prompt 
removal of sewage and other waste material, the isolation 

1 («), (6), etc., in the text refer to the Appendix. 



12 THE HUMAN BODY. GENERAL FACTS. 

and proper care of cases of contagious and infectious 
diseases, and the prevention of overcrowding in dwellings 
become the rule, not the exception. 

12. Animal Heat. — In-order to perform efficiently its 
various processes, the body must have a pervading tem- 
perature, just as ordinary machinery requires a certain 
amount of warmth to make it work well. This tempera- 
tare of the body is known as the vital or animal heat. 
Animals having a temperature generally higher than that 
of the surrounding atmosphere, as in man, quadrupeds, 
and birds, are known as warm-blooded animals ; while 
fishes and reptiles are called cold-blooded animals, their 
temperature varying but little from that of the air or 
water in which they live. The tender ature of man in 
health is 98^° to 99° F. When it is higher than this 
point, especially if above 102°, as in fever, the condition 
indicates that certain tissues are being consumed by too 
rapid functional activity. A temperature of 105° gener- 
all}' marks a severe attack of some disease, and a tempera- 
ture of 110° to 112° is very quickly fatal, unless it yields 
to medical treatment. In starvation and great prostra- 
tion the temperature is usually below the normal point ; 
if below 92°. the probability of recovery is small. The 
principal danger in high and low temperatures is from 
an accumulation of poisonous products. The "balance" 
of the body is lost. 1 

Though the average normal temperature, as ascertained 
by the thermometer, is about 98J° F., the general tem- 

1 Animal temperature is usually ascertained by means of a thermome- 
ter made for that purpose, known as a "medical," or "clinical," ther- 
mometer. When in use, the bulb of the instrument is generally placed 
in the armpit or under the tongue, the lips being closed to exclude air. 



THE HUMAN BODY. GENERAL FACTS. 13 

perature of the interior of the body is about 100°, the 
temperature of different parts of the body varying some- 
what. In the skin and lungs, by reason of the contact of 
air and the vaporization of water, the blood is cooled a 
little, and the animal temperature is slightly diminished. 
On the other hand, the temperature is raised in the mus- 
cles and glandular organs, especially daring their func- 
tional activity, and, above all, in the liver. The lowest 
body temperature in a day is usually early in the morning, 
from 2 to 6 o'clock ; the highest, from 5 to 8 p.m. Young 
children have the highest normal temperature, and old 
people the lowest. The ordinary tests of life are the 
power to assimilate food and air, the power to move or 
to be aroused, and the possession of animal heat. When 
the heart ceases to beat and breathing stops and heat 
leaves the body, a person is said to be dead. Instances 
are on record where life has been restored by the applica- 
tion of heat to the body, both externally and internally, 
by the use of stimulants, and by arousing the circulation 
and the action of the lungs by means of electricity and 
by the practice of artificial respiration. 1 

13. Sources and Loss of Heat. — Some heat enters the 
body with food, some by radiation from the sun and from 
fires. It is also produced in the body by the oxidation of 
its substances, by the transformation of food, by muscular 
action, and by other manifestations of animal life ; in short, 
by cell activity. The production of heat in living organ- 
isms is in proportion to the activity of their internal 
changes. When produced, it is carried through the body 
by the blood, and is also distributed by direct conduction 

1 Sec Emergencies, p. 384, as to artificial respiration. 



14 THE HUMAN BODY. GENERAL FACTS. 

from one part to another near by. It is controlled by a 
nervous mechanism in the brain. 

Heat escapes from the body : 1, from the surface of the 
skin, by radiation, conduction, and convection; 2, as latent 
heat in the watery vapor escaping through the skin and 
lungs ; 3, through the material excreted from the kidneys 
and bowels. 

14. Chemical Composition of the Body. — The chemical 
constituents of the body are only nineteen 1 in number, 
and are, for the most part, found in the tissues in various 
combinations. These may be divided into inorganic (i.e. 
not being or having been living organisms) and organic. 

Inorganic Constituents. The most important inorganic 
constituents of the body are water and common salt, these 
being found in all its tissues and fluids. Phosphate and 
carbonate of lime (calcium phosphate and calcium carbon- 
ate) form a large portion of the bones and teeth ; while 
free hydrochloric acid (muriatic acid) is found in the 
gastric juice, — the digestive secretion of the stomach. 

Organic Constituents. There are three principal classes 
of organic constituents, viz. proteids 2 (or albuminous sab- 
stances), carbohydrates, and fats. 

Proteids are complex compounds of nitrogen, carbon, 
hydrogen, and oxygen, with sometimes a small percentage 
of sulphur, phosphorus, and iron. They are the most 
important organic chemical compounds, as there is reason 
to believe they form the principal basis of living proto- 

1 Carbon, hydrogen, oxygen, nitrogen, sulphur, phosphorus, chlorine, 
iodine, fluorine, silicon, sodium, potassium, calcium, magnesium, lithium, 
iron, and usually traces of manganese, copper, and lead. 

2 From the fact that proteids are the only substances that contain 
nitrogen, they are sometimes called nitrogenous substances. 



THE HUMAN BODY. GENERAL FACTS. 15 

plasm in all its forms. They are not found in the hair, 
nails, or teeth. Sometimes they are called albuminous 
substances, because they resemble the white of eggs, which 
is largely albumin dissolved in water. The most im- 
portant proteids in the body are serum albumin in the 
blood ; fibrin, which forms in blood when it clots ; myosin 
in muscles, which after death coagulates, causing the 
stiffening of the body known as " rigor mortis " ; and 
casein in milk, which forms the principal ingredient of 
cheese. 

Carbohydrates, or saccharids, consist of carbon, hydro- 
gen, and oxygen (the last two in proportion necessary to 
form water), and belong to the same class of substances 
as sugar and starch. The principal carbohydrates in the 
body are glycogen (or so-called animal starch), stored up 
in the liver and muscles, glucose or grape sugar, and lactose 
or milk sugar. 

Fats, also, consist of carbon, hydrogen, and oxygen. 
The principal fats in the body (differing from each other 
mainly in their consistency) are palmitin, stearin, and 
olein. 

15. Bacteria. — Certain parasitic unicellular micro- 
organisms, known as microbes, 1 but more commonly called 
bacteria, 2 frequently enter the body with food or air. 
They differ much as to mobility and shape. Some of 
them (micrococci) are spheroidal, some (bacilli) are rod- 
shaped, and others (spirilll) spiral-shaped. They propa- 
gate by cell division, and very rapidly, if they find 
agreeable food and sufficient heat and moisture. It is 

1 Greek, (UKp6s, "little," |3fos, "life," — minute living bodies. 

2 Greek, Pcikttjplov (singular), "a staff," — a very common form of 
micro-organism. Some bacteria are less than . J, 00 of an inch in size 



16 



THE HUMAN BODY. GENERAL FACTS. 



estimated that a single bacterium in suitable locality, if 
unhindered, will in one day increase to several millions. 
Most of the bacteria which enter the body are harmless, 
as they thrive only on dead material. Many of them are 
destroyed by the acid secretion of the stomach, unless that 
organ is diseased or very much disordered, or has its inner 






Fig. 5 

1. Consumption bacilli. 

2. Pneumonia micrococci 

3. Diphtheria bacilli. 



Various Bacteria, Much Enlarged. 



4. Influenza bacilli. 

5. Typhoid fever bacilli. 

6. Cholera spirilli. 



surface wounded. In health, certain white blood cells 
also have the property of destroying bacteria. Some- 
times, however, bacteria enter the body through open 
wounds, or with the food, or in other ways, and hinder the 
work of tissue cells or clestro}* them, feeding upon their 
albuminous substances, and producing poisonous products 
known as i^omaines 1 and toxins. 2 These bacteria are 



1 Greek, tttC^o., "a dead body." 2 Greek, to^kov, " arrow poison." 



THE HUMAN BODY. GENERAL FACfS. 17 

more active than the harmless varieties, and are known as 
disease germs. 1 Diphtheria, typhoid fever, cholera, erysip- 
elas, consumption (tuberculosis), lockjaw, and the grippe 
are diseases caused and spread by disease germs, and so 
are called communicable or infectious diseases. The prin- 
cipal danger from these diseases is the contamination of 
the blood by the poisons developed through the activity 
of disease germs, and the consequent overpowering of the 
vital processes. If we do not allow ourselves to run down 
in health, if we keep ourselves and all about us clean, if 
we do not partake of food which contains ptomaines or 
poisonous bacteria, we shall be likely to escape the ravages 
of disease germs. 

Some infectious diseases, such as cholera and yellow 
fever, derived from putrefactive sources, are known as 
"filth diseases." Flies sometimes carry germs of typhoid 
fever from one person to another. It is estimated that 
more than one-third of all the deaths that occur are from 
infectious and contagions diseases. The spread of such 
diseases may usually be prevented by proper sanitary pre- 
cautions. 

16. Contagious Diseases. — These are certain infectious 
diseases that are conveyed from one individual to another, 
and are believed to be bacterial in origin. Such diseases 
are measles, scarlet fever, mumps, whooping cough, and 
small-pox. Nurses in charge of cases of contagious and 
infectious diseases should keep themselves and their cloth- 
ing clean, as well as the patient and the room, should have 
plenty of sleep and food, and should exercise daily in the 
open air. 



1 Germs — seeds. 



18 THE HUMAN BODY. GEXERAL FACTS. 

17. Immunity from Infectious Diseases. — Some infectious 
diseases, such as yellow fever or scarlet fever, are not 
likely to attack a person a second time, and one who 
has had any of these is said to be immune. During the 
Spanish-American war, a regiment of yellow fever im- 
munes was sent to the city of Santiago, in Cuba, to do 
guard duty, as }^ellow fever was prevalent there, and it 
was thought best not to expose troops not immune to 
th« danger of infection. 

From a very early period, in India and China, the virus 
or infectious material of small-pox was injected into the 
blood of those who had come in contact with persons 
afflicted with that disease. This injection produced a 
modified small-pox, much less dangerous than the original 
disease. This operation is known as inoculation, and was 
introduced into Europe in 1717. Later, Dr. Edward 
Jenner, of London, noticed that cows were subject to an 
eruptive disease similar to small-pox. This was known 
as cow-pox, or kine-pox. Injecting into the human 
system some of the clear fluid (serum) from the pocks, or 
eruptive points, upon the cow, he succeeded in exempting 
from small-pox the persons treated, or in modifying the 
disease. But as the serum of cow-pox was not easily 
obtained, he used serum from a person inoculated with 
cow-pox, with good results. This is vaccination, and was 
first tried by Jenner in 1776. The modified disease pro- 
duced is known as vaccinia, and will give immunity from 
small-pox for ten to twelve years, as a rule. Vaccination 
at present is mainly accomplished by means of " bovine 
lymph," or serum from healthy calves which have been 
vaccinated, rather than by the use of virus from the 
vaccinated spot on a human being. 

In 1885, Louis Pasteur performed a series of inocula- 



THE HUMAN BODY. GENERAL FACTS. 19 

tions upon rabbits, using the diluted poison of rabies, or 
hydrophobia. As a result he obtained a material which, 
when introduced into the human system by inoculation, 
renders harmless the bite of a mad dog. 

Good results have also been obtained by the inocula- 
tion of the attenuated or weakened virus of cholera, the 
plague, and other infectious diseases. 

Within the last few years it has been shown that if the 
toxins of diphtheria are injected into the blood of a healthy 
horse, in small quantity and from time to time, for weeks 
or months, that the horse, notwithstanding the poison, 
remains well. It is believed that a new substance has 
thus been formed in its blood, to which the name antitoxin 
(i.e. opposed to poison) has been given ; for if serum 
obtained by the coagulation of blood drawn from the 
horse is injected into a person having diphtheria, it tends 
to overcome the germs of the disease and cause a cure, 
rendering the person immune for a considerable time. 
This is the antitoxin treatment of disease ; it has also been 
used satisfactorily in poisoning from snake bites. 

18. Nature and Specific Effects of Alcohol. — Alcohol is 
justly responsible for many acute and chronic ailments, 
and for much of the misery, crime, and moral degrada- 
tion that afflict mankind. The form in which it is com- 
monly used is ethylic alcohol, or spirits of wine. This 
is a chemical combination of oxygen, carbon, and hydro- 
gen, and is usually obtained by the action of a peculiar 
ferment (yeast) upon the saccharine substances in fruits, 
cereals, and other materials. Other varieties of alcohol 
(amylic, etc.) form " fusel oils," which are very poisonous 
oily liquids, sometimes found in the poorer and cheaper 
kinds of alcoholic liquors. They arc more pronounced 



20 THE HUMAN BODY. GENERAL FACTS. 

in their immediate effects, especially upon the nervous 
system, than is ordinary alcohol. The liquors which con- 
tain them frequently produce a brutal frenzy, and a 
tendency to murder and other heinous crimes. 

Ethylic, or ordinary, alcohol is never used by itself as 
a beverage, except by the most degraded of drunkards. 
Sometimes it is used deliberately as a poison, 1 Largely 
diluted with water, it is used at times by physicians as 
a medicine, in the place of alcoholics, or alcoholic liquors, 
which are mixtures of alcohol, water, and flavoring sub- 
stances or extracts. 

Pure alcohol is a colorless, limpid liquid, with a sharp, 
burning taste and an intense affinity for water. It is 
mainly used to dissolve resins, essential oils, and medicinal 
extracts, in the manufacture of perfumes, essences, and 
medicines. Applied to albuminous animal tissues, it ab- 
stracts water from them, and so hardens them and inter- 
feres with their pliability that they perform their functions 
with difficulty. The local action of commercial alcohol 
(a liquid consisting of from 53 to 94 per cent alcohol, 
and the remainder water) is similar to that of pure alco- 
hol, but less severe. 2 

19. General Effects of Alcohol. — The effects of alcohol 
taken internally vary according to the quantity con- 
sumed, the degree of dilution, and the constitution of 



1 There is no recognized legal definition of a poison, but Quain's 
Dictionary of Medicine defines it as "any substance which when intro- 
duced into the system, or applied externally, injures health or destroys 
life, irrespective of mechanical means or direct thermal changes." 

2 The practice of preserving anatomical and other specimens in alcohol 
has been largely discontinued, owing to the hardening and distorting 
effects of the alcohol upon the specimens. 



THE HUMAN BODY. GENERAL FACTS. 21 

the consumer. 1 In small quantities, the effects are tem- 
porary stimulation or excitation, followed by depression, 
when taken in quantities beyond what for each individual 
may be termed his physiological limit. The heart beats 
more rapidly, the flow of blood is increased ; there is a tem- 
porary increase in animal heat and in mental activity. 

In larger amounts, it produces acute alcoholism, i.e. 
drunkenness, or intoxication, and acts principally upon 
the nervous system, deadening sensibility, perverting the 
reason, inducing irregular muscular action, flushing the 
face, and interfering with speech. Thus used, it is a 
paralyzer and depressant. In still larger amounts, it is a 
narcotic poison, 2 producing stupor, coma, convulsions, and 
even death. 

The habit of drinking, or the repeated use of alcohol, 
i.e. chronic alcoholism, has been shown, by investigations 
made within the last few years in Europe and this country, 
to affect the cellular protoplasm. Alcohol, so used, by 
producing inflammatory action, destroys the usefulness of 
many cells in the body, the most vulnerable being the 
nerve cells, or those having the most complex functions. 
It disturbs the relations between the normal income and 
outgo of the body, by substituting hardened (fibroid) 
material for the delicate protoplasm of cells. It delays 
oxidation, especially of fats, which accumulate in undue 
amount, particularly in the liver cells. This is especially 
true of the habitual use of ale, beer, and oilier malt liquors. 

Professor Conn says: 3 "To state that alcohol in any 
quantity is safe is a woful misinterpretation. No one ran 

1 Some physiologists consider alcohol as always injurious, and hence 
designate it as a poison. 

2 Persons so poisoned are often spoken o\' as "dead drunk.' 1 
a The Christian Advocate, July L3, L899. 



22 THE HUMAN BODY. GEXERAL FACTS. 

yet state at what point the secondary injurious effects 
begin, and no one can state what is a small and what a 
large dose. Further than this, it is certain that as com- 
monly used by the American people it is not used in 
quantities so small that its secondary abnormal effects are 
not produced. As commonly used by our people its action 
becomes abnormal, and there is thus considerable justifica- 
tion for the name of poison which is applied to it. 
Alcohol is not used as a food. It is used always for its 
influence upon the nervous system, and one of the well- 
known results is that, at least among Americans, the use 
of alcohol in small amounts is almost sure to pass speedily 
into its use in larger quantities. When used in quantities 
sufficient to produce a flushed skin, it is pretty safe to 
say that its secondary abnormal effects have begun." 

20. Alcoholics comprise, principally, malt liquors (ale, 
beer, porter, and stout) ; wines of various kinds ; and dis- 
tilled liquors, or spirits (whiskey, rum, gin, and brandy). 
There are also other powerful alcoholics, such as the 
cordials and liqueurs, and milder ones, such as fermented 
cider, kumyss, and beers made from roots. All of these 
fluids contain alcohol in varying amounts. Those which 
contain the least — i.e. from 1 to 9 per cent — are 
kumyss, 1 cider, beers, ales, and light wines, such as claret; 
heavier wines, such as sherry and port, contain 17 to 20 
per cent; wines which have been "fortified," i.e. had 
spirits added, have as high as 35 per cent ; while spirits 
contain 50 per cent or more. 

Malt liquors are made from grain (principally barley), 
germinated by heat and moisture. — then known as "malt," 



1 Kumyss, as used in this country, is fermented cows' milk, and con- 
tains from 1 to 2i per cent of alcohol. 



THE HUMAN BODY. GENERAL FACTS. 23 

— to which is added water, yeast, and flavoring substances. 
While it is true that the malt, together with some of the 
nourishing elements of the barley or other grain, if used 
occasionally, acts as a tonic, the world abounds in other 
substances that tone up the system, and which are not 
likely to be followed by depression or degenerative pro- 
cesses. Habitual drinkers of malt liquors, imbibing as 
they do considerable alcohol and very much water, are 
likely to become bloated from the thinning of their blood, 
to accumulate unhealthy fat, to become logy and stupid, 
and to be more susceptible to diseases. 

Wines result from the fermentation of the sugary juices 
of crushed or broken fruit by contact with bacteria in the 
air and on the skins of the fruit. Like the juice of apples 
(cider), wines at first contain but little, if any, alcohol, 
and are " sweet " ; but as fermentation proceeds, their 
character is changed. Old cider, which contains consider- 
able alcohol, and is known as "hard," is as intoxicating as 
some of the spirits. Light wines, ordinary cider, ginger 
beer, and similar drinks act as excitants of the nervous 
system. Frequent resort to them induces artificial tastes 
and appetites, and a desire for the stronger stimulation 
that heavy wines and spirits afford. In France, which 
a few years ago was considered a pattern for the use of 
light wines, alcoholism has become very common, so that 
the government is investigating the ravages caused by 
alcohol. 

Spirits are distilled from wines, fermented molasses, fer- 
mented juice of the sugar-cane, malt, cider, fruit juices, or 
other materials. Cordials and liqueurs are spirits mixed 
with syrup and flavoring essences. These alcoholics tend 
to impair the functional activity of cells, and to cause 
thickening and contraction of the connective tissue of the 



24 THE HUMAN BODY, GENERAL FACTS. 

liver, kidneys, and brain. A great and unnatural craving 
is often generated by their repeated use, so that men will 
drink with avidity alcohol in which are decomposing 
materials, or the bitterest substances, such as quinine, or 
will drain at one gulp the vilest and strongest liquor, 
without any attempt at dilution. 

21. General Facts as to Alcohol and Alcoholics. 

First. Pure alcohol is a powerful poison. 

Second. The tendency of alcohol in alcoholic liquids, 
if they are used repeatedly and for a considerable time, 
is to act as poison, viz. to inflame, impair, or destroy cell 
protoplasm; to harden and shrink albuminous tissues; to 
produce an undue amount of fat, some of which replaces 
muscular tissue, as in the heart; to subtract heat from the 
body; and to depress nervous energy. 

Third. Alcoholics are not needed by persons in health, 
and when used medicinally should be prescribed by phy- 
sicians only, as are other potent remedies or drugs, such 
as opium. The practice of resorting to alcoholics for the 
relief of slight ailments is apt to end in drunkenness. 

Fourth. Their use, even in moderate amount, b}^ per- 
sons of a nervous temperament, or in whom there may be 
an hereditary tendency to the drink habit, is likely to 
be followed by an intense craving for them. No one, 
whatever his temperament may be, can tell, when he 
begins to use them, whether or not he will succumb to 
their influence. Alcohol is a thing the use of which 
carries with it the temptation to abuse. 

Fifth. Even persons with strong powers of self-control 
are not safe from the danger of forming the alcoholic ap- 
petite, for alcohol possesses the power of very frequently 
impairing that function of the mind known as self- 



THE HUMAN BODY. GENERAL FACTS. 25 

restraint. The man with weak will power is readily over- 
come by this insidious adversary. Unfortunately, persons 
with strong self-control, who do not themselves drink to 
excess, may cause those of weak will to drink immod- 
erately, by associating with them and drinking in their 
presence. 1 

22. Tobacco is another substance which is largely used 
and also abused. Its moderate use may not apparently 
affect certain adults unpleasantly, 2 but the moderate use 
is apt to become immoderate. For persons of a nervous 
temperament it is usually harmful. The young should 
never use it, as their tissues are more delicate than those 
of adults, and their power of resisting the evil effects of 
all such agents is much less. It has been truly said, 
"there is no such thing as moderation in cigarette 
smoking." 

The active ingredient of tobacco, — nicotine, — like 
alcohol, has a subtle power. It tends to induce the to- 
bacco habit. This subtle power of arousing an appetite 
or intense desire for the substance used is peculiar also 
to other drugs, such as opium, chloral, and cocaine. No 
such appetite is ever aroused by the use of water, milk, 
cocoa, or any complete food. 

1 It is stated that Dr. Woolsey, formerly president of Yale College, 
made the following reply to the question, "If a young man should come 
to you for advice as to the use of wine, what would you say to him ? " : 
" I should tell him not to allow himself to have any drinking habits ; 
I should not advise him to pledge himself not to drink, but to abstain from 
principle. It is not necessary to regard drinking a glass of wine as a sin 
in itself, but every young man should see that it is better for himself, and 
especially for weak associates who may be under his influence, to use no 
strong drink, and therefore he should decide not to indulge." 

2 Experience has shown that, under certain circumstances, as with 
overworked and tired soldiers on a march, it arouses their dormant energies. 



26 THE HUMAN BODY. GENERAL FACTS. 

The habitual use of tobacco is likely to produce an 
irritable condition of the heart and brain, to destroy the 
appetite, to decrease the digestive secretions, and to seri- 
ously impair the health. " It is a pity that boys think it 
manly to smoke and that students allow themselves to be 
greatly influenced by the custom of their fellows." It is 
a deplorable fact that cigarette smoking is increasing, 
owing to the cheapness of cigarettes and their open sale. 
Within the last few years, murders and other heinous 
crimes have been committed by boys and young men, so- 
called " degenerates," the victims of confirmed cigarette 
smoking. The report of a special navy medical board, to 
the superintendent of the United States Naval Academy, 1 
" On the Use of Tobacco by the Cadets," states that 
" Even when used in small amount, the capacity for study 
and application is lessened by headache, confusion of 
intellect, loss of memory, impaired power of attention, 
lassitude, indisposition to muscular effort, nausea, want of 
appetite, dyspepsia, palpitation, tremulousness, disturbed 
sleep, impaired vision, etc." 

" It is no uncommon practice for young men who 
smoke cigarettes habitually, to consume from eight to 
twelve in an hour, and to keep this up for four or five 
hours daily. The total quantity of tobacco may not seem 
large, but, beyond question, the volume of smoke to 
which the breath organs of the smoker are exposed and 
the characteristics of that smoke as regards the propor- 
tion of nicotine introduced into the system combine to 
ulace the organism very fully under the influence of the 
tobacco. A considerable number of cases have been 
brought under our notice during the last few months, in 

1 December 3, 1875. 



THE HUMAN BODY. GENERAL FACTS. 27 

which youths and young men who have not yet completed 
the full term of physical development have had their 
health seriously impaired by the practice of smoking 
cigarettes almost incessantly. It is well that the facts 
should be known, as the impression evidently prevails 
that any number of these little 'whiffs' must needs be 
perfectly innocuous, whereas they often do infinite harm. 
A pulse-tracing, made after the subject has smoked a 
dozen cigarettes, will, as a rule, be natter and more indic- 
ative of depression than one taken after the smoking of 
cigars." 1 

23. Opium, Cocaine, etc. — Other substances besides alco- 
hol and tobacco that are largely used for their exciting 
or their narcotic 2 effects are opium, cocaine, caffeine, coca, 
and the betel nut. The habitual use of any of them 
creates a desire for more, and decreases the appetite for 
food. Opium is the most seductive of them all. " By its 
soothing and exhilarating influence it gains such a hold 
on the moral and physical nature that the strongest will 
is unable to emancipate the victim from its enchantment." 
Its frequent use in cough mixtures, soothing syrups, cor- 
dials, carminatives, and other compounds interferes with 
the assimilation of food and enervates the system. The 

1 The London Lancet. 

The evil effects of cigarettes are due in part to the fine shredding of the 
tobacco, in part to the combination of paper with tobacco, the more direct 
relation of the nicotine with the mouth and air passages than when to- 
bacco is smoked in a pipe or cigar, the frequent inhalation of cigarette 
smoke and its retention for a time in the air passages, and, finally, to the 
fact that the habit of cigarette smoking is usually begun by young chil- 
dren, though there is a law against selling cigarettes to children under 
sixteen years of age. 

2 Narcotics are substances which have the property of stupefying. 



28 THE HUMAN BODY. GENERAL FACTS. 

same effects follow the use of chloral, caffeine, etc., — 
substances too frequently employed without reason or 
discrimination. 

QUESTIONS. 

1. What is to be gained by the study of anatomy, physiology, and 

hygiene ? 

2. Define these three topics. 

3. What is health ? 

4. What is its value to individuals and communities? 

5. What is the general arrangement of the human body ? 

6. What are cells, and what is meant by cell life ? 

7. What properties are distinctive of live matter? 

8. Name the phases through which life passes. 

9. Name some of the tissues and fluids of the body. 

10. What are the sources and objects of animal heat? 

11. What are the chemical components of the body? 

12. What are bacteria and disease germs? 

13. What are the methods used to produce immunity from infec- 

tious diseases ? 

14. What is alcohol — how obtained ? 

15. What are alcoholics ? Name the several classes. 

16. What are some of the evil effects of alcohol in varying 

amounts ? 

17. What are the dangers of tobacco? 

18. What is the " tobacco habit " ? What is the danger of cigarette 

smoking ? 

19. What is said as to the use of opium, cocaine, and other 

narcotics ? 



CHAPTER II. 

BONES AND JOINTS. 

24. The Use and Number of Bones. — The general figure 
and stability of the human body are maintained by the 
bones. Associated with cartilages 1 and ligaments they 
form the framework, or skeleton. 2 In the entire skeleton 
of an adult there are two hundred distinct bones. 3 The 
relations of these to one another are shown in Fig. 6. 

25. Shape of Bones. — The bones vary in form, and 
though they are more or less irregular, they may be con- 
sidered as long, short, or flat. 4 

1 Sometimes called "gristle." 

2 Skeletons usually seen in museums and lecture rooms are sometimes 
called artificial skeletons, because cartilages and ligaments are replaced 
for the most part by wire, leather, and chamois skin. 

3 Bones of the spinal column 26 

The cranium (skull) 8 

The face 14 

Ribs, hyoid bone, and breast bone 26 

The upper extremities 64 

The lower extremities 62 

Total 200 

This enumeration includes the patellae (knee pans), but not the teeth, 
small bones of the middle ear, or certain small bones having the form of 
seeds (sesamoid), situated in the tendons or strings of certain muscles, 
where unusual pressure is exerted. Neither does it include certain super- 
numerary bones, called Wormian bones, found in incomplete joints of the 
skull. Teeth differ from bones in structure, development, and mode oi 
growth. 

4 Examples of the more irregular bones are the hyoid, to which the 
tongue and larynx are attached, the vertebrae, or most of the bones of the 

20 



30 BONES AND JOINTS. 

The long bones are hollow shafts with two extremities, 
called heads, which are generally expanded, the better 
to form joints and to afford increased surface for the at- 
tachment of muscles and ligaments (Fig. 6, right leg). 
" They represent columns for supporting the weight of the 
body, or levers of different kinds for the muscles to act 
upon." The long bones are the clavicle (collar bone), the 
humerus (arm bone), the radius and ulna (forearm bones), 
the femur (thigh bone), the tibia and fibula (leg bones), 
and some of the bones of the hands and feet. 1 

The short bones are located in those parts of the body 
where strength, compactness, and elasticity are required. 
They are strongly bound together by ligaments. Examples 
of short bones are found in the wrist and ankle. 

The flat bones afford broad surfaces for muscular attach- 
ment, and serve to protect important organs. They are 
the shoulder blades, breast bone, ribs, hip bones, and some 
of the bones of the skull. 

26. The Surfaces of Bones. — On the surfaces of bones 
are various eminences 2 and depressions. 3 The first afford 
attachment for muscles, tendons, and connective tissue; 
the latter, safe and convenient passages for blood-vessels, 
nerves, tendons, and muscles. Through the surfaces of 
the bones are openings for the passage of blood-vessels, 

spinal column, and some of the bones of the skull. These last are the 
temporal, sphenoid, ethmoid, superior maxillary (upper jaw), inferior 
maxillary (lower jaw), the palate bones in the roof of the mouth, and the 
inferior turbinated bones in the nose. 

1 These last are the phalanges, or bones of the fingers and toes, and the 
metacarpal and metatarsal bones, i.e. bones connected with the carpus, or 
wrist, and tarsus, or ankle. 

2 Tuberosities, tubercles, spines, and ridges. 

3 Grooves, furrows, fissures, and notches. 



FLAT BONES OF THE SKULL. 



NASAL BONES— 



-THE CRANIUM. 

-MALAR (CHEEK) BONE. 
•--SUPERIOR MAXILLARY BONES 
-INFERIOR MAXILLARY BONE 
-SPINAL COLUMN. CERVICAL REGION. 



SHOULDER BLADE 




Fig. 6. 



32 



BONES AND JOINTS. 



nerves, etc. These openings are especially numerous at 

the extremities of long bones. 

All bones are enveloped in a firm vascular 2 mem- 
brane (the periosteum), ex- 
cept on the surfaces of joints, 
where they are overlaid with 
a smooth elastic tissue, 
known as cartilage. The 
W8IP periosteum clings closely to 

the bone and nourishes it, 
and is capable, with the aid 
of the surrounding soft tis- 
sues, of producing new bone 
to replace that removed by 
disease or by surgical opera- 
tions. 2 Bones die when de- 
prived of periosteum. 



m 



Fig. 7. 

Posterior View of 
Femur, showing 
the ridges, de- 
pressions, and 
openings. 



27. Structure of Bones. — 
If a bone be sawn across, 
its walls will be found to be 
very hard and strong, like 
ivory. This firm tissue is 
called the compact tissue. 
In a long bone it is thicker 
in the middle of the shaft 
than at the extremities, 
where it disappears in a fine 
network tissue, called the 



^ ";.V> 



■Mm 






Fig. 8. 

Longitudinal Section 
of Femur, showing 
the compact and 
cancellous tissue 
of bone. 



1 Full of blood-vessels. 

2 Hence the surgeon, in removing dead bone, removes as little of the 
periosteum as possible, and thus has succeeded, with the aid of nature, in 
producing new lower jaws, and even arm bones. 



BONES AND JOINTS. 33 

spongy or cancellous tissue. 1 The size of the bone along 
the shaft, where the strength is mainly required, is thus 
diminished ; while at the ends the extent of surface 
which is needed is obtained without increase of weight. 2 
The more expanded and elastic spongy tissue serves also, 
both at the extremities of the long bones and in the 




Fig. 9. 

Kadiograph (X-ray) of Head of Thigh Bone, showing arched structure and can- 
cellous tissue. (Dr. J. Sherman Wight.) 

interior of the other bones, to deaden the force of con- 
cussions. It is ordinarily filled with the oily material 
known as marrow, which also nils the hollow shaft or 
tube of the long bones. This tube or central canal is 
therefore called the medullary canal {i.e. marrow canal). 

1 The tubular character of long bones with compact walls affords light- 
ness and strength. The same principle is observed in stalks of grain and 
in the construction of bicycle frames. 

2 Pupils in the engineering school at Zurich use the section of the head 
of a thigh bone for the study of ideal stress lines for bridges. 



34 



BOXES AND JOIXTS. 



It is lined with a vascular web of connective tissue, 
known as the medullary membrane, which nourishes the 
inner parts of the bone. The marrow in the spongy 
tissue of bones is of a red color, and is called red marrow, 
to distinguish it from that of a yellow color in the hollow 



s. ^ 






ii # 




Fig. 10. 



Longitudinal Canals in Compact 
Tissue of Bones, with their con- 
necting canaliculi and the lacu- 
nae. (Magnified 200 diameters.) 



tfMtfllii 



ft 







Fig. 11. 

Transverse Section of Compact Tissue of 
Bones, showing openings of longitudinal 
canals, the canahculi. and the lacunae. (Mag- 
nified 200 diameters.) The fine lines are can- 
alicuM ; the dark spots are lacunae. 



shafts of adult bones. The red marrow is one of the 
sources of the red blood corpuscles. 

Even the compact tissue, solid as it appears to the eye, 
is found, under the microscope, to contain numerous vas- 
cular canals. The larger of these run lengthwise with the 
bones, and are connected with one another and with the 
periosteum and medullary membrane by slightly oblique 



BONES AND JOINTS. 35 

transverse canals, in the course of which are enlarge- 
ments or small reservoirs. 1 In addition to blood vessels, 
nerves are found in bones, and, according to good authori- 
ties, also lymphatics. 2 

28. Nutrition of Bones. — Bones are nourished by the 
same means as other and softer tissues, and like them 
have the power of assimilation. Pupils are apt to judge 
of bones in the living body by the dried specimens in 
lecture rooms and museums; but they are as unlike as the 
green and the dead twigs of a tree. A bone of an animal 
recently killed will be found to have a pinkish, pearly- 
white hue, due to the blood it contains. 

In very early life bones are soft and cartilaginous. 
Gradually they become harder, cartilage being replaced 
by bone, as food supplies the necessary phosphatic salts. 
If proper food is not supplied during the growth and 
development of children, their bones may become so soft 
and flexible as to be distorted readily by muscular con- 
traction or by weights which they would' normally sustain. 
This diseased condition is known as rickets. 

29. Strength and Elasticity of Bones. — Bones are com- 
posed of animal matter, mostly gelatine, and mineral mat- 
ter (bone earth), chiefly calcium phosphate. 3 The animal 

1 The longitudinal canals are called Haversian canals, from Clopton 
Havers, their discoverer ; the transverse canals, canalivuU ; the reservoirs, 
lacunae. The Haversian canals, the canaliculi, and the lacunae together 
constitute the Haversian system of canals. 

' 2 Lymphatics are vessels that carry lymph. Bones arc generally not 
very sensitive; but when inflamed they become acutely sensitive, the 
nerves being pressed upon in their bony canals by the products of inflam- 
mation. 

8 If a bone be immersed in a dilute acid (muriatic, for instance) fox 
a sufficient time, the mineral matter will be dissolved, while the animal 



36 BONES AND JOINTS. 

matter renders bones tough and elastic, enabling them to 
bear ordinary shocks without injury, while the mineral 
matter makes them hard and rigid, capable of sustaining 
weights and strains without change of shape. Professor 
Robinson found that a piece of bone one inch square bore 
a weight of five thousand pounds without breaking. 1 

In youth, the animal matter constitutes more than one- 
third of the bone substance ; hence the bones of children 
are more elastic than those of adults, and less likely to be 
broken. 2 As the child grows, the bones become stronger, 
and are thus adapted to the increasing muscular strength. 
In adult life, mineral matter constitutes two-thirds of the 
bone substance. The bones are then very strong, though 
retaining considerable elasticity. In old age, the bones 
become brittle from an excess of mineral matter, and are 
likely to break from slight causes. An aged person, 
incautiously stepping even from a footstool or from a 
curbstone, may break his thigh bone. Sometimes bones 
become brittle as .the result of disease. 

30. Joints. — The junction of two or more bones con- 
stitutes a joint, or, more technically, an articulation. 

matter will remain in the perfect shape of the bone, which may now be 
bent, or even tied in a knot. If a bone be exposed to the action of fire, 
the animal matter will be burned out, and the substance remaining in the 
shape of the bone will crumble when touched. 

1 "Bone has been found by experiment to possess twice the resisting 
property of solid oak. It is also elastic, as is shown by the resiliency of 
the fibula when its shaft is pressed against its tibia ; and by Mr. Ward's 
experiment of placing the clavicle at right angles against a hard body, 
and striking the free end a smart blow with a hammer, when the bone 
will rebound a distance of two feet." — G. M. Humphrey, Treatise on 
the Skeleton. 

2 Bones of children are apt to be bent by prolonged and repeated 
weight and strain upon them. 



BONES AND JOINTS. 



37 



Joints are classified as immovable, mixed, and movable. 
The joints of the cranial bones, 1 called sutures or dovetail 
joints, are immovable ; 2 those of the vertebrae are mixed. 
Most of the other joints of the body are movable. The 
varieties of these are the ball and socket joints, of which 
the shoulder and hip are examples ; and hinge joints, to 
which class the knee and elbow belong. 




Fig. 12. 
Suture Joints of the Skull. 



Fig. 13. 
Hip Joint (Ball and Socket). 



31. The skull rests and nods upon the first vertebra, 
or atlas. It also rests upon a tooth-like process of the 
axis, or second bone of the spinal column, which projects 
upwards through a hole in the atlas and forms a pivot, or 

1 Upper bones of skull (Fig. 12). 

2 The upper bones of the skull of a baby do not unite until months 
after birth, in order to allow the brain to grow. The dovetail joints Later 
in life fasten these bones together very firmly, so that an adult can carry 
considerable weight upon the head without injury. 



38 



BONES AND JOINTS. 



swivel, upon which the head rotates, or turns from side to 
side, the atlas also turning with it. 




1, opening for spinal cord. 

3-3, transverse ligament, inclosing, with 

the bone, an opening for part of axis 

to pass up through. 
7-7, resting places for prominences on 

skull. 




Fig. 15. 

Atlas and Axis in position. 

10, projection of axis, passing through the 
atlas, upon which the skull rests. 



32. Structure of Joints. — The bones of most of the 
joints are held together by strong bands of fibrous con- 
nective tissue, called ligaments. Their connection is 




. Fe 



Ca L 



-SS 



Fig. 16. 

Longitudinal Section of Knee Joint, showing the relation of the structures which enter 
into its composition. 

T, tendon. CaL, capsular or envelop- F, fat. 

SS, synovial sac. ing ligament. L, ligament of patella. 

Fe, femur. P, patella or knee pan. Ti, tibia. 

Cr L, crucial or cross-shaped ligament between the ends of the femur and tibia. 



BONES AND JOINTS. 



39 



further strengthened by muscles and tendons, and also, in 
some degree, by the enveloping fat and skin. The articu- 
lar surfaces of these bones are protected from friction by 
thin shields of firm, elastic tissue, called cartilage, and, in 
the movable joints, by the synovial 1 membranes which 
line their cavities and which pour into the joints, as it is 
needed, a lubricating substance called the synovial fluid. 
The elasticity of these cartilages serves to diminish shocks 




A Fig. 17- B 

A. Longitudinal section of wrist joints, showing the synovial sacs and membranes (SS). 
B. Ligaments of wrist joint (L). 

from walking, running, jumping, etc., thus protecting the 
delicate structures of the body from injuries which would 
otherwise result. 

33. Injuries to Joints. — Sprains are the violent straining 
or twisting of one or more of the structures of a joint. 
So serious, sometimes, is the injury that a sprain is spoken 
of as a broken joint. A dislocation is a bone out of place, 
and is often associated with the tearing 1 or bruising of 



1 So called from the synovia or adhesive fluid within it. 



40 BOXES AXD JOIXTS. 

joint tissues. The treatment of sprains, as well as of 
dislocations and fractures, should be under the direction 
of a physician. 1 

QUESTIONS. 

1 . Of what use are bones ? 

2. How many are there in the body? How classified? 

3. Describe the long bones, and explain the use of their length. 

4. Where are the short bones located ? 

5. What is the special use of flat bones ? 

6. Why are there eminences and depressions upon bones, and 
why openings through them ? 

7. What is the periosteum, and of what use is it ? the cartilage ? 

8. Of what kinds of tissue are bones constructed? Describe 
these tissues and their respective uses. 

9. What and where is the marrow? the medullary canal the 
medullary membrane ? 

10. Of what are bones composed ? 

11. Of what different uses are the animal and mineral matter of 
bones ? What results from an excess or a deficiency of either ? 

12. How do the bones of the young and old differ? 

13. How are bones nourished, and what do they contain ? 

14. What is a joint, or articulation, and how are joints classified ? 

15. How are the nodding and rotating motions of the head 
effected? 

16. What protects the joints from friction ? 

17. How is the liability of the delicate structures of the body 
to injury from shocks in jumping, etc., diminished? 

18. How are the bones held together, and what is a dislocation ? 

1 For further information, see Emergencies, pp. 391 and 393. 



CHAPTER III. 
THE SKELETON. 1 

34. Its Uses. — The skeleton is beautifully adapted to 
support weight. 2 It affords surfaces for the attachment 
of muscles, and thus facilitates the movements of the body. 
It incloses cavities for the lodgment and protection of 
the eyes, heart, lungs, brain, and other important and 
delicate organs. 

35. The Spinal or Vertebral Column. 3 — This is the main 
support of the body, and in the adult consists of 26 bones, 
24 of which are called vertebrae. 4 The two lowest bones 

1 The skeleton of man is an internal or endo-skeleton, that of the 
oyster or lobster an external or exo-skeleton. The turtle has both an 
internal and an external framework. The sturgeon, besides an endo- 
skeleton, has an irregular outer case of superficial bony plates (dermo- 
skeleton), which enables the fish to swim more safely in search of food 
among rocks and debris. 

2 At twenty-one years of age the weight of the human skeleton is about 
one-tenth that of the entire body. It averages about 15 lbs., yet is capable 
of sustaining great weights, and can at times be subjected to great strains 
without injury. Dr. Winship, a celebrated athlete, though a small man, 
could lift a weight of 2500 lbs. 

8 It is commonly called the backbone, as though it were a single bone. 

4 From the Latin vertere, " to turn." They turn, or rotate, and at times 
incline forward, backward, or to either side, in the varied movements of 
the body. In the neck, or cervical region, there are seven vertebrae ; 
in the back, or dorsal region, twelve, and in the loin, or lumbar 
region, Jive. The sacrum and coccyx are sometimes called false vertebrae, 
for in very early life the first is composed of live rudimentary vertebrae, 
and the second of four. Hence, the number of bones in the spinal column 
is sometimes stated as 33. 

41 



42 THE SKELETON. 

are the sacrum and coccyx. The spinal column not only 
serves to bear the weight of the upper part of the body, 
but maintains it in proper relation with the lower part 
(Fig. 6). Its lower end fits in like a wedge between the 
hip bones, and unites with them to form the pelvis. Take 
the backbone away, and the skeleton collapses. 




Fig. 18. 
" Backbone Pictures," showing dependence of body upon the spinal column. 

36. Vertebrae. — Each vertebra is composed of a disk- 
like body with a bony arch projecting backward from it, 
and is tunnelled by a large opening through it extending 
up and down, or longitudinally with the body. The ver- 
tebrae are united by strong ligaments, and are so placed 
that the openings through the several vertebrae form one 
long tube or tunnel, called the spinal canal, which serves 
for the lodgment and protection of the spinal cord. 1 
Nerves pass to and from this canal, through notched 
apertures in the sides of the various vertebral arches. 
The posterior projections (spines) of the arches form the 
ridge which may be felt extending along the middle of the 
back. To diminish the shock of jars and falls, there are 
cushions of very elastic cartilage between the vertebrae. 

1 A cord-like arrangement of nerves (that is, many strands of nerves 
united together in one cord), which connect the brain with other parts of 
the body, by means of branches sent out through the spinal openings 
mentioned in the text. 



THE SKELETON. 



43 



SCa 



37. Curves of the Spinal Column. — The vertebral column 
has four curves, — the cervical, 
dorsal, lumbar, and sacral. Two 
are forward curves, and two back- 
ward. These are so nicely ad- 
justed that their relative positions 
are ordinarily maintained, what- 
ever the movements of the body 
may be. Hence, pressure is better 
distributed than would be the 
case if the column were straight. 
Still, jumping from a height upon 
a resisting surface, heavy blows 
or falls, and the prolonged and 
excessive action of special muscles 
or groups of muscles frequently 
produce spinal deformities and dis- 
ease. 1 The custom, too common 
among school children, of carrying 
a number of books on the same 
arm tends to produce lateral cur- 
vature of the spine. The man who 
habitually carries a pack on one 
shoulder becomes deformed (a). 



1 Spinal curvatures are liable to result 
from habitual sitting, standing, or even 
lying in wrong positions. The habit of 
bending over to study, write, or use the 
sewing-machine is injurious. When stand- 
ing, the body should be erect, the shoulders 
held back in an easy, comfortable manner. 
When sitting, the body or head should be 
bent but slightly forward. Constrained 
positions are always injurious. 




Loiiii'itiul 



il Section of spinal 
Column. 



CO, cervical curve. 
IK', dorsal curve, 
LC, lumbar curve. 
BC, sacral curve. 
SCa, spinal canal, 
NO. opening for nerves 
0, location of Intei 

cartilages. 
s, sacrum. 
CO, oocoyx. 



jrtebral 



44 



THE SKELETON. 



38. The Ribs. — Branching out from each side of the 
spinal column, in the dorsal region, are the twelve ribs, 

which are grooved under- 
neath for the passage of 
blood-vessels and nerves 
to the front of the body. 
The ribs slope downward 
and outward, and, with 
the dorsal vertebrae and 
breast bone, form the 
bony walls of the thorax 
or chest. This arrange- 
ment and the elasticity 
of the cartilages which 
unite most of the ribs to 
the breast bone permit 
considerable enlargement 
of the chest cavity in the 
process of breathing. 1 Free movements of the chest walls 
are necessary for the health and proper action of the 
organs within them. 

39. The Pelvis. — This consists of the sacrum and coccyx 
behind, the hip bones (innominate bones) upon the sides, 
and the pubic bone in front. By its size, strength, curves, 
and expanded upper edges (hips), it is well adapted to 
support and protect the organs within it. It also assists 
in supporting the upper part of the body, by its relation 




Lateral Curvature of Spine, caused by the habit 
of carrying books on one arm. (Moshek.) 



1 The seven upper ribs upon each side are joined directly to the breast 
bone by cartilages, and are called true ribs ; the other five are called 
false ribs. Of these five the three upper ones are joined by cartilages to 
the cartilages of the true ribs, while the two lower, having no cartilages, 
their anterior ends being free, are called floating ribs. 



THE SKELETON. 45 

to the spinal column and by the attachment which it 
affords for the powerful muscles of the trunk. Articu- 
lating (forming joints) with the pelvis are the two thigh 
bones. These are supported by the bones of the legs, 
which in turn rest upon those of the feet. 

40. The Limbs, or Extremities. — These are joined to the 
trunk at its upper part by means of the shoulders (collar 
bones and shoulder blades), and at its lower portion by 
the hip bones. The bones of each upper extremity 
are the humerus (arm bone), radius and ulna (fore- 
arm bones), and the bones of the hand. 1 Each upper ex- 
tremity is so arranged that the hand may be freely used. 2 

The lower extremities have less mobility than the 
upper, but more strength, since they bear the weight of 
the body. The bones of each lower extremity are the 
femur (thigh bone), tibia and fibula (leg bones), and the 
bones of the foot. 3 

41. The Bones of the Foot. — The bones are arranged in 
the form of an arch, the forward part of the foot and the 
heel only resting upon the ground. This arched form 
secures great elasticity, and diminishes the shocks to other 

1 The hand includes the bones of the wrist, palm, and fingers, 

2 The arm bone is longer than the forearm bones, and the forearm 
bones are longer than those of the hand. This arrangement, together with 
very pliable lingers and with the thumb, which can readily bo opposed to 
all the fingers, characterizes man as distinct from ami above all other 
forms of animal life. 

8 The foot includes the bones of the ankle, instep, and toes. The mobility 
of the toes and their power to grasp objects are very much increased by 
their frequent use without, the restriction of shoes, as has been noticed 
among certain savage tribes. Persons born without hands have learned 
to write, to use a. knife and fork in eating, and to thread a needle with 
their toes, 



46 THE SKELETON. 

parts of the body in the acts of walking, running, and 
jumping. It also affords a more secure footing in walking 
and running over uneven ground, in climbing ladders, etc. 1 




Fig. 21. 
Bones of the Foot and their Relative Location. 

42. The Principal Closed Cavities of the Skeleton. — These 
are three in number, viz. the cranial, thoracic, and pelvic 
cavities. 2 Within the cranial cavity are the brain and the 
beginning of the spinal cord, and also nerves and blood- 
vessels. 

The cranium, or skull, is a rounded bony box, admir- 
ably constructed for its particular use. 3 It has a vaulted 
dome, side walls, and very strong buttresses in the tem- 
poral bones, which inclose the delicate organs of hearing. 

1 The elastic arch of the foot assists largely in graceful movements of 
the body, if it is not hampered by improper footgear. When the liga- 
ments of the arch have lost their tone, the foot is known as a " flat foot," 
and walking becomes difficult. 

2 In addition to these cavities and the marrow cavities of long bones, 
there are cavities which contain air, such as the frontal sinuses in the 
frontal bones of the skull, which open into the upper part of the nose ; 
the antrum, in each half of the upper jaw ; and the sphenoidal and eth- 
moidal sinuses, in the sphenoid and ethmoid bones. These reservoirs of 
air are concerned in the processes of breathing and in the production of 
voice, and serve to lighten the weight of bones. 

3 The tissue of which the flat bones are composed is arranged in layers, 
or tables. On account of their character, these were by the ancients 
likened, the outer one to wood, the middle one to leather, and the inner 
one to glass (from its smoothness). 



THE SKELETON. 



47 



The base is formed of bones strongly wedged in together, 
with openings so arranged that the delicate blood-vessels 
and nerves passing through them are not easily injured. 




Fig. 22. 
Front View of the Contents of the Cavities of the Chest and Abdoni* 



B, trachea. 

C, oesophagus. 



E, diaphragm. 

F, liver. 



I, spleen. 
D, stomach. 



G, intestines. 
H, heart. 



A, lungs. 
J, bladder. 



43. The Thoracic Cavity. — This extends from the base 
of the neck above to the diaphragm 1 below, and from 
the spinal column and ribs behind to the breast bone and 
the cartilages of the ribs in front. It contains the 
lungs, the heart, some large blood-vessels, nerves, the 
thoracic duct, and the oesophagus, or gullet. 



1 A strong muscular and tendinous partition dividing the thoracic from 
the abdominal cavity (Fig. 28). 



48 



THE SKELETON. 



44. The Pelvic Cavity. - 
the pelvic bones. It con 



BRAIN 
(cerebrum) 




Fig. 23. 

Side View of the Head and Trunk ; 
the bones and soft coverings 
of the cavities being removed, 
and the face, throat, and spinal 
column given in longitudinal sec- 
tions. The organs are in relief. 

A. lungs. F. a small portion 

B. trachea. of the liver. 

C. oesophagus. G. intestines. 

D. stomach. H, heart. 

E. diaphragm. I. spleen. 

J, bladder. 



— This is the space inclosed by 
tains the bladder, the lower end 
of the large intestine, and other 
viscera. 

Between the thoracic and pel- 
vic cavities is a fourth cavity, 
the abdominal, which is partly in- 
closed hj bony walls and partly 
by muscles. It contains the 
liver on the right side, the stom- 
ach and spleen on the left, the 
intestines in front, and the pan- 
creas, kidneys, receptacle for 
chyle, and very large blood- 
vessels and nerves behind. 

45. Effects of Alcohol upon 
Bones. — The specific evil ef- 
fects of alcohol upon the tis- 
sues and organs of the body, 
either in derangement of their 
function or change of their 
structure, have been specially 
studied by scientists in con- 
nection with the muscles, skin, 
stomach, liver, kidneys, blood, 
and nervous system. Very little 
is known of any specific effects 
of alcohol upon bones and 
joints. It is believed that blood 
containing it, if brought repeat- 
edly to these parts, interferes 
with their growth and develop- 



THE SKELETON. 49 

ment, especially in the young, by hampering the activity 
of the various cells which enter into their composition. 
Fothergill states that " alcohol is used to limit the growth 
of jockeys and pet dogs." It is a fact well recognized 
by surgeons that broken bones of drunkards unite with 
great difficulty. 

As to tobacco, opium, and the other narcotics, no spe- 
cific effects upon bones and joints are known. 



QUESTIONS. 

1. Of what service is the skeleton ? 

2. What is the use of the skeleton, and what is its main support? 

3. How is the spinal column fitted to the hip bones, and of what 

does it consist ? 

4. Describe the vertebrae. How they are separated from each 

other, and why? 

5. How is the spinal canal formed, and what is its purpose? 

6. How do the nerves of the body reach it? 

7. What curves has the spinal column, and what is their object ? 

8. Describe the ribs, and explain the object of their downward 

slope. 

9. Of what bones does the pelvis consist, and what is its use? 

10. Describe the lower portion of the skeleton. 

11. How are the bones of the feet arranged, and w r hy are they so 

arranged ? 

12. Of what bones does each upper extremity, or arm, consist, and 

what is the object of their arrangement? 

13. What are the bones of the lower extremities? 

14. What cavities are in the skeleton ? 

15. Describe the cranium, and mention its contents. 

10. Describe the thoracic cavity, and mention its contents. 

17. What cavity is above the pelvic cavity, and what are its 

contents? 

18. What is said as to specific effects of alcohol, tobacco, opium, 

etc., upon bones ? 




A. — Posterior View. 



B. — Front and Side View. 



Fig. 24. 



MUSCLES. — FAT. 51 



Fig. 24. 

Muscles of the Body. Superficial layer. 



E, extensors of the hand. 

B, biceps muscle, flexor of arm and forearm. 

D, deltoid, raises the arm and moves it backwards and forwards. 

TEA, trapezius, draws back and raises shoulder. 

TKI, triceps, extensor of forearm. 

LD, latissimus dorsi, assists in respiration by moving the ribs. 

GM, gluteus maximus, moves the thigh backwards and outward 

VE, vastus externus, extends the leg. 

B, biceps of thigh, flexor of leg. 

G, gastrocnemius, extends the foot. 

F, flexors of the foot. 
TA, Tendo Achillis. 



B. 

E, extensors of the hand. 

F, flexors of the hand. 
B, biceps, etc. 

D, deltoid, etc. 

PM, pecioralis major, draws the arm forwards and inwards. 

P, pronator, rotates forearm inwards. 

SM, serratus magnus, assists in respiration. 

RA, rectus abdominis, that makes tense the abdominal walls. 

TF, tensor femoris, that makes tense the connective tissue of thigh 

and moves the thigh outwards. 
S, sartorius, flexes the leg. 
AD, adductor group of thigh muscles. 

KF, rectus femoris, one of the group of extensor muscles of thigh. 
TA, tibialis anticus, moves foot forwards. 
ET, extensors of the toes. 



CHAPTER IV. 

MUSCLES. -PAT. 

46. Uses of Muscles. — The muscles, about four hundred 
in number, are essentially organs of motion. They are of 
a deep red color, 1 and constitute what is ordinarily called 
flesh, or, in animals, lean meat. By means of muscles 
the varied and wonderful movements of the body are per- 
formed, and speech is rendered possible. Through their 
action, the heart pulsates, the blood circulates, and respi- 
ration, digestion, and other vital processes are carried on. 
They also shield blood-vessels, lymphatics, and nerves, 
assist in diminishing the force of shocks and blows, and 
give roundness to the figure. They help to hold the 
bones together and to form the walls which inclose the 
cavities of the thorax, abdomen, and pelvis. 

47. Classification of Muscles. — Certain muscles are 
grouped about the bones, to which most of them are 
attached. These are known as voluntary muscles? because 
their movements are, for the most part, governed by the 
will. Other muscles, which are within the body and form 
a large part of the walls of hollow organs, as the stomach, 
intestines, and blood-vessels, are called involuntary muscles, 

1 Muscles but little used, as in young children and in paralyzed persons, 
have a pale color. In most of the vertebrate animals the flesh is red. 
In some birds and many fishes it is colorless, yellowish, or pink. 

2 Also as muscles of animal life. Those attached to the skeleton are 
skeletal muscles ; also called muscles of organic life. 

52 



MUSCLES. — FAT. 53 

because they act independently of the will. 1 For instance, 
the simple presence of food in the stomach is sufficient to 
excite that muscular organ into its normal and involun- 
tary activity. Certain muscles, as those of breathing, are 
called mixed muscles, " as they belong partly to the volun- 
tary and partly to the involuntary classes. Ordinarily we 
breathe without exertion of the will, but to a certain 
extent it is in our power to increase or suspend the pro- 
cess.'' 

48. Connections of Muscles. — Voluntary muscles are 
connected with bones, and also with cartilages, ligaments, 
skin, and other structures, either by muscular tissue, or 
by means of white, firm but flexible, glistening masses of 
fibrous tissue, known as tendons, or sinews. 2 Tendons are 
inelastic, and serve as connecting bands or cords to hold 
muscles in position 3 and to enable their fleshy or active 
portions to move parts of the body that are remote, 
without interfering with the symmetry and beauty of its 
outline. 4 How bulky and ill-proportioned, for example, 

1 Sometimes voluntary muscles cannot be controlled by the will. For 
instance, twitching of the eyelids may not be readily stopped, and the 
drunkard cannot always prevent tremors of the hands. 

2 The more fixed or central attachment of a muscle is its origin. The 
movable point to which the force of the muscle is directed is its insertion. 
But many muscles may be made to act from either extremity. In the 
muscles of the face, one end is attached to bone, the other to movable skin. 

3 " In childhood the fleshy portions of muscles ait' relatively long and 
the tendons short. As we grow older, the tendons are relatively longer, 
and the active fleshy portions less in amount. Hence, to excel in athletic 
sports, it is needful to begin practising early in life. A baby can readily 
put its feet in its mouth, or when sitting en a bed with the legs at right 
angles with the body, can easily lift the legs to an acute angle with the 
trunk, — a feat that is impossible with an adult.*" 

4 The tendon of one of (he muscles that move the eye passes through 
a loop or pulley. A tendon under the jaw passes through a slit in the 



54 



MUSCLES. — FAT. 



would be the wrists and ankles, and how clumsy their 
movements, if the muscular tissue were extended through 
those parts (a). The largest and strongest tendon in the 




Fig. 25. 
Muscles of Left Hand. Front surface. 



FCC", flexor of ulnar side of the wrist. 

FCR, flexor of radial side of wrist. 

SH, sheath of connective tissue through 

which the tendons pass. 
OP. the opposing muscle of thumb. 
ABP, muscle that draws the thumb out-' 

ward. 
FBP, the short flexor of the thumb. 



ADP, adductor that draws the thumb in- 
wards. 

S of T, sheath of tendon in position, removed 
from other fingers to show the arrange- 
ment of tendons. 

FS, long, superficial flexor of the fingers. 

FP, the long, deep flexor of the fingers. 

AMD. muscle that pulls the little finger 
outward. 



tendon of another muscle whose direction is different. Tendons may be 
readily felt at the wrist, ankle, the bend of the elbow, and under the 
knee, when the muscles are tense. 



MUSCLES. — FAT. ^ 

body is the Tendo Achillis, which connects certain muscles 
on the back of the leg with the heel. 1 

Involuntary muscles, for the most part, are not attached 
to bones, but to other structures. 

49. Arrangement of Muscles. — Muscles vary in shape, 
and are arranged usually in layers or groups, occupying 
always the best position to facilitate their own action and 
to preserve the compactness, usefulness, and beauty of the 
parts. Those of the face are, for the most part, short and 
narrow; of the cranium, thin and flat; of the thorax, 
abdomen, and pelvis, broad and flattened ; and of the 
neck and extremities, long and rounded. Some muscles 
have a tendon at one end, or at both ends, or at one side, or 
running through the middle. Others have two tendons at 
one end, as the two-headed or biceps muscle of the front 
of the upper part of the arm ; or three tendons, as the 
triceps, at the back and upper part of the arm. The 
abdominal cavity is walled in, in front and on the sides, 
by three layers of strong, flat muscles, their respective 
fibres crossing the abdomen in different directions, but all 
centering in a strong tendinous band iii the middle line, 
called the linea alba. This strong wall is strengthened 
still further, in front, by two overlying straight muscles, 
extending one on either side of the linea alba, from the 
pelvis nearly to the breast bone. 

50. Action of Groups of Muscles. — The respective groups 
of muscles are named according to the kind of motion 
produced, their position, uses, etc. 2 Muscles that bend 

1 Tendon of Achilles, so called from the Grecian fiction that this tendon 
was the only vulnerable portion of the body of Achilles. 

2 The names of muscles have come down to us from the ancients. Their 
length is often in inverse proportion to the size of the muscle named. 



56 MUSCLES. — FAT, 

the joints are called flexors, — as, for example, those on the 
front of the arm that bend the forearm, and on the back 
of the thigh that bend the leg. Those which restore the 
bent parts to a straight condition are extensors. The 
extensors, corresponding to the above-mentioned flexors, 
are located, as the necessity of the case demands, on the 
back of the arm and on the front of the thigh. Rotator 
muscles are those which turn upon their axes the parts to 
which they are attached. Such are the oblique muscles 
of the eye and those attached to the radial bone of the 
forearm. It is by means of the latter that the forearm 
and hand can be turned around so as to present either side 
at pleasure. 

Adductors are muscles which move parts toward the 
axis of the body, and abductors those which move parts 
from the axis of the body. Of the first, the large muscles 
of the chest and back, which draw the arm to the side. 
and those which draw the lower extremities together, are 
examples ; of the latter may be named the muscles of the 
shoulder and the outer muscles of the thigh. 

Sphincters are annular, or ring, muscles which close or 
constrict certain natural openings of the body, as the eye 
and mouth. 

51. Muscles, such as the flexors and extensors, the 
abductors and adductors, which produce by their action 
entirely opposite movements, are called opposing or antago- 

For instance, a very short muscle which extends from one corner of the 
upper lip to the nostril upon the same side of the face, whose function is 
merely to raise the lip. as in sneering, is called the levator labii 
superioris alaeque nasi; while a wery long and important muscle of the 
thigh is more plainly named the sartorius. i.e. the ••tailor."' because 
it is the principal muscle by which that useful functionary assumes his 
familiar position for work. 



MUSCLES. — FAT. 57 

nistic. The result of the combined action of opposing 
muscles, when excessive, is rigidity. It is the easy com- 
bined action of the opposing muscles which enables us to 
stand, or to apply a force properly graduated to the 
necessities of the most delicate muscular work (a). The 
action of opposing muscles, when healthy, is nicely ad- 
justed, so as not to interfere with their mutually free and 
easy movements. 1 Their abnormal action is exemplified 
in the rigidity which takes place in convulsions, and in 
"lead palsy," where the unchecked contraction of the 
flexors of the forearm, through paralysis of its extensors, 
produces a falling of the hand known as "wrist drop." 

52. Muscles of Expression. — Ordinarily we show how 
we feel by our features, and by the position and move- 
ments of the body. The expression of the emotions is 
effected mainly, however, by the varied movements of the 
facial muscles, especially those which move the lips, eye- 
lids, eyebrows, and lower jaw. 2 Hence these muscles are 
spoken of as the muscles of expression. 3 The develop- 
ment of certain of them by frequent use produces the 
jovial, smiling, or laughing face ; while development of 
other groups produces the sad, sour, or disagreeable 
face. 



1 The easy picking up of a lead pencil from a table, for example, 
requires the combined harmonious action of opposing muscles of the 
shoulder, arm, forearm, and hand, as well as those of the eyes. This 
harmony of movement is sometimes spoken of as consensus of action. 
The want of it is apparent in a person having St. Yitus's dance. 

2 Some persons can move the ears by means of developed fan-shaped 
muscles attached to these organs, which in most persons are rudimentary. 

8 There are 70 pairs of muscles in the neck and face. It has been esti- 
mated that the body is capable of 5000 different movements, and the face 
of 750 different expressions. 



58 



MUSCLES. — FAT. 



53. Structure of Muscles. — A voluntary muscle is com- 
posed of bundles of striated or striped fibres called fas- 
ciculi. The muscular tissue is enveloped in a delicate 
elastic sheath of connective tissue, the perimysium} which 




Fig. 26. 
Muscles of Expression. 



also slips in between the fasciculi and incloses them. The 
fibres of a muscle generally run parallel to one another 
throughout its length, converging toward its tendinous 
attachment. Each fibre consists of a soft, contractile 



1 " Around a muscle. 



MUSCLES. — FAT. 



59 



substance, and is inclosed by a thin, elastic, transparent 
sheath, the sarcolemma. 




B, bone. 

C, connective tissue. 



Fig. 27. 

Transverse Section of a Leg. 

F, fat (adipose tissue). M, muscles. 

V, veins. BL, blood-vessels (arteries and veins). 



Involuntary muscles are 
composed of plain, smooth 
fibres, not striped, which 
contain nuclei and nucleoli. 
These fibres are contractile, 
spindle-shaped cells, which 
are held together in bun- 
dles by a cement-like sub- 
stance. These bundles com- 
pose larger bundles or flat- 
tened bands, which are held 
together by connective tis- 
sue, and frequently interlace. 




v 6 

Fig. 28. 
•tion oi Muscle (magnified 50 di 



(i, perimysium. 
b. fasciculus. 



(•, oounecti'v 
</, fibre. 



ameter 

e tis.V* 



60 



MUSCLES. — FAT. 



Nerves, blood-vessels, and lymph vessels run between 
and into muscles to stimulate them to activity, to afford 




Non-striated Fibres of Involuntary Muscles, somewhat separated from 
each other for microscopic examination. 




Fig. 30. 

. Portion of a Voluntary Fibre, 
showing the fibrillae, trans- 
verse striae, and the sarco- 
lemma detached at one point. 
Magnified 250 diameters. 



nourishment, and to carry away dead 
material. 1 Fat cells are frequently 
found among muscular fibres. 

54. Under the microscope the 
fibres of a voluntary muscle are 
found to be marked with alternate 
transverse bands, or striae, with faint 
stripes running lengthwise over 
each fibre. 2 After death, when the 
muscles are stiffened, or if a muscle 
is hardened in alcohol, the fibres 
can be broken up longitudinally 
into very fine threads, called fibrillae 
(little fibres). 

55. Chemical Composition of Mus- 
cles. — Muscle consists of about 



1 Muscles, fasciculi, fibres, connective tissue, nerves, and blood-vessels 
an be studied in the leg of a sheep. 

- 2 The transverse stripes are by some believed to be the boundary lines 
. muscle cells. 



MUSCLES. — FAT. 61 

three-fourths water, which affords softness and flexibility, 1 
the remaining one-fourth being made up of common salt, 
calcium phosphate, and albuminous substances, the chief 
of which is myosin. 2 Myosin coagulates soon after death, 
causing rigidity of the body. 

56. Properties of Muscular Tissue. — The characteristic 
property of muscles is contractility . The power of shorten- 
ing and thickening their bulk when tense, or in a state of 
action, and of becoming elongated and thinner when re- 
laxed, or in a state of rest, is peculiar to muscle fibres, and 
is sometimes spoken of as muscular irritability. Contrac- 
tility is normally excited in voluntary muscles by the will 
acting through the nervous system, but it can also be called 
into action independently of the will, by various kinds 
of stimulation, such as pinching, pricking with a needle, 
the application of an acid or electricity. In involuntary 
muscles, it ordinarily results from nervous stimulus. Con- 
tractions may be extremely gentle, as when the muscles 
of the eye or hand are engaged in delicate work ; or they 
may be powerful, as in athletic sports or in heavy lifting. 
Prolonged use, the want of use, a supply of poor or in- 
sufficient blood, and certain poisons lessen the normal 
irritability of muscles. Muscles are also elastic, and are 
said to have tone when they promptly and in a normal 
manner respond to stimuli. When repeated stimulation 
is applied to muscles, they contract in wave-like impulses. 
" When stimulation of muscular fibres is too rapid, the 

1 Muscles sometimes lose pliability and act with difficulty, when the 

fluids of the body are diminished by overwork or as the result of disease. 
Sometimes the motion of tendons, through grooves or canals of bone oi 
cartilage, may produce creaking sounds. 

2 The translucent, jelly-like substance of muscular fibres is sometimes 
called muscle-plasma. 



62 MUSCLES. — FAT. 

muscle contracts firmly, the wave movement disappears, 
and the contraction may not be followed by any relaxation 
for a considerable time, as in muscular cramps, and the 
disease known as tetanus." 1 




Same muscles in action— contracted. 



Muscles of frog's leg at rest— relaxed. 

Fig. 31. 
Contraction and Eelaxation of Muscles. 

57. Hygiene of Muscles. — For healthy growth and de- 
velopment muscles require a constant supply of good blood, 
sufficient nerve stimulus, and alternate exercise and rest. 
Without these requisites waste products accumulate and 

1 "The skeletal muscles of some insects can contract 1,000,000 times 
an hour, requiring 300 stimuli per second for complete and continued con- 
traction. In birds, 100 stimuli per second are required ; and in man, 40." 



MUSCLES. — FAT. 63 

irmscular activity is diminished. Overworked muscles 
waste away equally with idle muscles ; in the latter case, 
useless fat may take the place of the muscular fibres. 1 
In the arrangement of nature, certain muscles are intended 
to be at rest while others are in activity. Even the fibres 
of a single muscle do not all act at the same time. This 
provision does not dispense, however, with the necessity 
for additional rest in sleep. 

58. Sleep. — All parts of the body, the brain included, 
require rest, and share, directly or indirectly, in the ben- 
efits of sleep. Particularly refreshing is the first sleep, 
and that which is least disturbed by uneasy dreams, men- 
tal effort, and anxiety. Generally, the more both mind 
and body can be withdrawn from all outside influences, the 
better. The amount of sleep needed by different persons 
varies according to the age and condition of individuals. 
The greater part of infancy is generally passed in slumber ; 
and in old age, also, much sleep is required. In middle 
life, usually about eight hours a day is necessary, though 
it is reported of Frederick the Great and Napoleon that 
they slept but three or four hours out of the twenty- 
four (a). Needed restoration may often be found in a 
change of employment, whether of work or amusement, as 
well as in sleep. In such cases, if amusement be needed, 
it becomes as much one's duty to play as it was before to 
work. 

59. Fat. — This substance usually constitutes about one- 
twentieth part of the weight of the entire body. It is 

1 The wasting of muscles from non-use is shown in a broken arm 
which has been kept in splints for several weeks, or in a sound leg that 
has been idle for a long time, on account of the other leg's being disabled 
by injury or disease. 



64 



MUSCLES. — FAT. 



found in all parts of the body, with the exception of the 
bones, teeth, and fibrous tissues, either in masses or in the 
form of an emulsion, 1 or in that of globules and granules 
of oil. In the first form it is called adipose tissue, the 
most familiar example of which is that which is embedded 
in the areolar or connective tissue, between the skin and 
the muscles. Animal fat is generally a mixture of three 




Fig. 32. 

(Microscopic view.) 

AT, adipose tissue. 

C, fat in cells of cocoanuti 



Fig. 33. 

(Microscopic view.) 

M, fat globules in milk. 

E, fat globules in an emulsion. 



varieties of fat, — stearin, palmitin, and olein. Stearin 
and palmitin are more or less solid, as usually seen in the 
meat of animals ; but in the live body, at its ordinary 
temperature, they are held in solution by the olein with 
which they are associated. 

By the arrangement of the fat about the internal organs, 
between the muscles, under the skin, and about the joints, 
it acts as cushions to these structures, maintains their tem- 
perature, fills up inequalities in and about the various struc- 



1 That is, in suspension, as in milk. 



MUSCLES. — FAT. 65 

tures, and greatly enhances the beauty and symmetry of 
the human form. It also serves for nutrition in time of 
need, as is particularly to be observed in torpid animals x 
and in emaciating diseases. In fact, fat being composed 
of carbon, hydrogen, and oxygen, contains elements which 
are essential to the nutrition and growth of tissues, and is 
found in quantity whenever cell growth is rapid, especially 
in the case of healthy young children. 

60. The amount of fat in different persons depends upon 
age, race, and hereditary tendency; also upon the weather, 
climate, and occupation; yet there is probably a normal 
limit as to the amount of fat in the case of each individual. 
Any amount beyond this limit is likely to be not only 
inconvenient, but distressing and even dangerous to life, 
either by impeding the action of the heart or by taking 
the place of important tissues, thereby producing a 
diseased condition, which is known as fatty infiltration. 
Ordinarily, a steady gain of fat within the normal limit 
indicates an improving condition of the blood and better 
nutrition, while a deficiency is often the first note of alarm 
to warn us of the approach of consumption, scrofula, or 
some other serious disease which has begun its stealthy 
march in a faulty nutrition. 2 Rapid loss of fat usually 
indicates impoverishment of the blood. 3 

1 The common tortoise, for instance, burrows in the earth in the latter 
part of autumn, and does not reappear till spring has well advanced. 
Some species of bears become very fat toward tin 1 winter lime, and then, 
during the winter, while hibernating, eat no food, so far as is known. In 
the spring they come out of their hiding-places, lean and hungry. 

2 Tt has been observed that cooks, butchers, oilers, etc., are generally 
exempt from such affections, and it is believed by some authorities that 
the exemption is dvc to the fat absorbed by their skins from the materials 
which they handle. 

3 In such instances, the fat that remains seems thin ami watery. 



66 MUSCLES. — FAT. 

" Fatty tissue is the most fluctuating in bulk of all the 
tissues of the body," for within a very short time a large 
amount may appear or disappear. Its increase is promoted 
by many of the animal and vegetable substances used as 
food, and it is the result also of chemical changes that occur 
within the body, in such food as starch and sugar. It is 
often injuriously increased by impoverished blood during 
sickness or idleness, by a continued use of alcoholic drinks 
(especially ale, beer, and porter), and by fatty, sugary, 
and starchy foods. It may, therefore, be diminished some- 
times by a partial or complete omission of the articles of 
food and drink mentioned above, by proper bathing and 
attention to the excretory organs, and by systematic, 
well-adapted exercise. It can seldom, however, with 
safety, be kept below the individual's normal standard 
for a great length of time. The use of drugs or medi- 
cines as anti-fat remedies is not always safe, nor is it 
usually efficacious. 



QUESTIONS. 

1. Describe muscles. 

2. What is their chief use ? 

3. What two grand divisions of muscles are there ? 

4. How are muscles attached to the parts to be moved ? 

5. Why are tendons used for this purpose ? 

6. Why are the voluntary muscles more often attached to bones 

than the involuntary? 

7. Why do blood-vessels and nerves accompany muscles ? 

8. What is the chief constituent of muscle substance? 

9. What other uses have muscles besides being organs of motion ? 

10. To what is the moving power of muscles due ? 

11. How may the contractility of muscles be excited? 

12. How may their irritability become weakened ? 

13. What are opposing or antagonistic muscles ? Give examples. 



MUSCLES. — FAT. 67 

14. What are the respective results of their normal and abnormal 

action ? 

15. Name other kinds of muscles. 

16. What are the muscles of expression? 

17. What is necessary for muscles to be healthy and well developed? 

18. When is sleep most beneficial? 

19. What periods of life require most sleep? 

20. How may muscles be refreshed without cessation of activity ? 

21. What are the varieties of fat ? 

22. What are its uses? 

23. How does excessive fat become dangerous ? 

24. How may fat be increased ? how diminished ? 

25. What about the use of drugs to that end ? 



CHAPTER V. 

MUSCULAR EXERCISE. 

61. Physical Culture has engaged the attention of man- 
kind, in a varying degree, from the very earliest times. 
Its object, at first, was to strengthen man for defence 
against his fellow-men and wild animals. At a later date, 
in the Grecian games, athletic contests were eagerly 
entered into in a spirit of emulation, and for the culti- 
vation and exhibition of strength and beauty. Among 
the Spartans, the women, as well as the men, had their 
pl^sical training. And yet we are told by the medical 
writers of those times that the excessive exercise indulged 
in by many of the athletes rendered them " dull, sluggish, 
and torpid, and that they averaged only five years of 
(athletic) life." Still later, in the gymnasia, or schools, of 
the Greeks, efforts were first made to combine physical 
and mental education, so as to produce " a sound mind in 
a sound body." Yet, even at the present time, the true 
value of proper muscular exercise in restoring health, as 
well as in maintaining it, is not fully appreciated. 

62. Effects of Exercise. — Exercise, besides developing 
and strengthening the muscles, causes a muscular pressure 
upon the blood-vessels, and increases the force and rapidity 
of the circulation. In this way it promotes the con- 
sumption of ox} T gen by the tissues, and the elimination 
from them of carbon dioxide and other waste products. 
Through exercise the breathing power is developed, the 



MUSCULAR EXERCISE. 69 

appetite improved, digestion made stronger, the accumula- 
tion of fat diminished, and animal heat increased. The 
nervous system also shares in the general improvement, 
and, as a consequence, better mental work is made pos- 
sible. 1 In those colleges and schools where physical cul- 
ture receives attention, the mental as well as the physical 
strength of the students has been found to be improved (cl). 

63. Well-balanced Exercise. — In all cases, there should 
be, as much as possible, a corresponding development of 
the whole man. 2 Engravers, telegraph and sewing-machine 
operators, tailors, shoemakers, and all persons who, in 
plying their vocation, use one set of muscles mainly, are 
liable to paralysis of those muscles (a). Such persons 
should each day engage for a time in exercises that will 
call into action the other muscles of the body. In like 

1 At the Elmira Reformatory twelve of the dullest boys for six months 
averaged only 45 per cent in their studies. After a course in physical 
culture, their treatment in every other respect being the same, they 
reached an average of 74 per cent. Dr. Wey, the physician in charge, 
says : " With physical culture and improvement there came a mental 
awakening, a cerebral activity never before manifested in their prison 
life. Their faces parted with the dull and stolid look they had in the 
beginning, assuming a more intelligent expression, while the eye gained 
a brightness and clearness that before was conspicuous by its absence." 

2 Large persons with powerful muscles, but with little endurance, are 
not able to accomplish so much as wiry small ones, whose powers of endur- 
ance have been developed by gradual training. " A man of good physical 
capacity may be trained so that the voluntary muscles of his arms and 
chest will be powerfully developed, with a contractile force proportionate 
to their size, and yet his respiratory power may be so disproportionate 
that he cannot run a hundred yards without gasping ; and another, or the 
same individual, if possessing ordinary locomotive capacity ami fair 
development, may be trained to run ten times the distance without dis- 
tress, while the voluntary muscles of his arms and chest remain as they 
stood at the time that the training began." — McLaren, Training in 
Theory and Practice. 



70 MUSCULAR EXERCISE. 

manner those whose callings lead them to the exercise of 
their brains only, to the neglect of their muscles, make too 
large a demand upon the nervous system, and pay the 
penalty in disorders of that system. 

64. The Powers of Endurance of individuals are very 
unequal. Accordingly, what would be proper exercise for 
one person may be very improper for another. Some 
feeble persons are too ambitious and need restraint, as 
much as the lazy need urging. Exercise that is beyond 
the strength of the individual or of a kind to which he is 
unaccustomed, or attended by severe or sudden strains on 
undeveloped muscles, will be followed by bad results, — 
for example, by exhaustion, cramps, loss of appetite, over- 
strained heart, and even diseases of the blood-vessels and 
nervous system (V). The hard work necessitated by cer- 
tain occupations of life often produces serious results, even 
in very strong and well-developed men. It is especially 
important that such occupations should be carried on in 
the open air, or in well-ventilated rooms, and that the 
workers should have the proper kind and amount of food. 
Attention to these details would undoubtedly save many 
lives. 

65. Proper Muscular Exercise is that which is adapted to 
the age, health, and strength of the individual. It should 
be varied and agreeable in character, and pursued daily, 
either in the open air or in well-ventilated places, but 
never to the point of weariness. 1 Exercise — walking, 
for example — which is systematically undertaken merely 
for the sake of exercise is not only irksome and likely to 

1 The custom of years prescribes certain seasons for out-door games 
and pastimes. Unfortunately, people do not always observe them, but 
cling tenaciously to certain sports which they prefer. 



MUSCULAR EXERCISE. 71 

be given up after a time, but is not so beneficial as when 
it is associated with an agreeable visit, beautiful scenery, 
the gathering of flowers and shells, or even the purchase 
of some desired object. 1 

66. Young children, even babies, should not be carried 
more than is absolutely necessary. They will exercise 
themselves sufficiently if placed in warm but well-ventilated 
rooms, where the limbs can have free movements, unim- 
peded by tight or heavy clothing. Childhood, indeed, is 
a period of restless activity, and by the time a child is 
three years old systematic exercise becomes necessary. 
Gentle walks, running after and throwing balls, playing 
with clean sand, and the like, should be regularly per- 
mitted and encouraged. Much harm is caused by confining 
young children and putting barriers around their natural 
desires for play. In the case of older children and youth, 
no system of artificial exercise can take the place of that 
afforded by the usual out-door games, such as base-ball, 
foot-ball, leap-frog, hoop rolling, or hare and hounds, 
always provided they are not played too roughly or con- 
tinued too long. These sports may be pursued advan- 
tageously, as a rule, up to forty or forty-five years of age. 
At about this age natural degenerative changes occur in 
the body, and care is particularly necessary that the heart 

1 " I have heard that that benevolent nobleman, Lord Rosse, during 
the famine years, anxious to relieve distress, and equally anxious not to 
encourage habits of pauperism, paid men so much a day for diguing holes 
in his demesne, and paid them again for the filling of them up. The 
laborers are said to have manifested the most extreme disgust at the occu- 
pation, although the work was not harder than most useful labors. It is 
this sense of the inutility of the work done by the labor in some of the 
military prisons which constitutes much of the severity of the punishment. 
And this remark is as true of mental exercise as of bodily." — RIapother, 
Lectures on Public Health, 



72 MUSCULAR EXERCISE. 

and blood-vessels be not overstrained. Hunting (if mod- 
erate) and fishing are more suitable to this period of life. 
At sixty and upwards exercise continues necessary ; but 
the tissues having become still weaker, it should be very 
gentle in character. 

67. There is no physiological reason why girls, instead 
of being limited to a round of spiritless games which are 
of very little use in developing 'Strength, quickness of 
motion, or the power of endurance, should not engage in 
many of those sports which are the delight of boys (a). 
The opportunities of out-door exercise for girls and women 
are. unfortunately, not so many or so diversified as for 
boys and men. Sedentary habits are especially the bane 
of women in prosperous circumstances (5). 

68. Best Times for Exercise. — The early part of the day 
— not immediately on rising, however, but after the 
system has been toned up by some slight food and pre- 
liminary gentle movements — is the best time for hard 
work or exercise : for then the body has had the benefit 
of the rest of the previous night. It is not safe to 
exercise violently soon after a hearty meal, or when the 
stomach is empty, or when the body is in a state of exhaus- 
tion. At one time it was commonly believed that a long 
walk before breakfast was especially desirable, but the 
bad results following this exercise in many instances, such 
as exhaustion, faintness, dyspeptic and nervous disorders, 
have served to dispel the idea among careful observers. 
The gentle nervous stimulus given to the whole system 
bv a little light food in the stomach after its long fast is 
needed by most people, and would be beneficial to all, 
before exercising in the early morning. 



MUSCULAR EXERCISE. 73 

69. Varieties of Exercise. — The different forms of 
exercise may be classified as follows : 1. Those that 
bring into nearly equal action all the muscles of the body, 
as swimming, horseback riding, fencing, boxing, base 
ball, foot ball, lawn tennis, and military drill. 2. Those 
that exert the muscles of the upper part of the body prin- 
cipally, as bowling and shooting. 3. Those that serve to 
develop principally the muscles of the lower part of the 
body, as walking, dancing, skating, and bicycle riding. 1 

Most of these exercises are beneficial to both sexes. 
Certainly every one should learn to swim. Apart from 
its utility as a safeguard to life, it is the experience of one 
of the large swimming schools in London that carefully 
regulated swimming develops muscle, and relieves to a 
great extent backache, or pain in the lumbar muscles. 
Horseback riding also is a valuable form of exercise. As 
Dr. Holmes expresses it, " Saddle-leather is in some 
respects even preferable to sole-leather ; the principal 
objection to it is of a financial character." No exercise, 
however good, should be overdone (a). 

70. Gymnasiums. — A gymnasium is valuable for those 
persons who do not have opportunities for out-of-door 
exercise, or who need the stimulus of class instruction 
and the companionship of fellow-workers, accompanied 
with systematic drill. But too often competition is 
carried so far that the weak are injured. To effect the 
most good, the gymnasium should have a medical super- 
intendent, in order that pupils may not be taxed beyond 
their strength; that the exercise may be adapted to the 

1 Notwithstanding the fact that long distance bicycle riding is quite 
common, it should be thoroughly understood that for persons with weak 
heart, lungs, blood-vessels, or kidneys, such riding is dangerous. 



74 MUSCULAR EXERCISE. 

individual ; that proper ventilation may be maintained, 
and other hygienic rules observed ; and that assistance 
may be given promptly in case of accidents. For persons 
who cannot leave their houses, various appliances, such as 
dumb-bells, Indian clubs, rowing machines, and rubber 
bands or cords are beneficial. 

71. Passive Exercise. — Persons too feeble to use their 
own muscles in exercise will obtain benefit from carriage 
riding, the use of electricity, or the gentle daily rubbing, 
pressing, and moving of their muscles by another. This 
last procedure is known as massage, and is every day 
becoming more popular with invalids. Where the will is 
but slightly exerted, as in the above examples, the exer- 
cises are known as passive. 

72. Effects of Alcohol and Narcotics upon Muscles. — The 
tremulousness of muscles and their inability to effect any 
complicated movement, so frequently observed in persons 
under the influence of alcohol, is largely due to the dis- 
turbing effects of the drug upon the nervous system. 
However, it is true that muscles are sometimes impaired, 
i.e. lose tone and become flabby, as the result of impaired 
nutrition brought about by alcohol in the blood. When 
so weakened, they are in no condition to respond promptly 
to normal nervous impulses or stimuli. The result is that 
both voluntary and involuntary muscular movements are 
sluggish. Experience has shown that alcoholics can sel- 
dom be relied upon to sustain either nervous energy or 
muscular strength. As Professor Stewart says, " In severe 
and continuous exertion, with exposure to all weather, 
as in war and exploring expeditions, alcohol is injurious ; 
and it must be avoided in mountain climbing." 

wt The British authorities some time ago made a test of 



MUSCULAR EXERCISE. 75 

the alleged value of alcohol when men are subjected to 
unusual and exhausting labor. Experiments were made 
at different times and under varying conditions, with three 
regiments from each of several brigades. In one, every 
man was forbidden to drink any alcohol whatever while the 
test lasted; in the second, malt liquor only was taken; in 
the third, a ration of whiskey was given to each man. The 
whiskey drinkers manifested more dash at first, but gen- 
erally in about four days showed signs of weakness and 
fatigue ; those given malt liquor displayed less dash at first, 
but their endurance lasted somewhat longer; while the ab- 
stainers improved daily in alertness and staying powers." 

73. Tobacco has the power to induce through the 
nervous system a feeling of lassitude, which results in 
inefficient use of the muscles, and consequent weakening. 

Opium, chloral, and other similar drugs, used repeatedly 
or in large amount, produce even more depressing effects. 



QUESTIONS. 

1. What have been the motives for physical culture in the past, and 

by what bad effects was excessive exercise said to have been 
followed ? 

2. What is proper exercise, and what are its effects? 

3. How does it affect the mental health, and why ? 

4. What is improper exercise, and what are its effects ? 

5. What is to be said of exercise at different ages? 

6. What of the exercise of women and girls ? 

7. What of exercise in the early morning? 

8. What of the varieties of exercise ? 

9. What of the gymnasium ? 

10. What is massage, and when is it to be employed? 

11. How do alcohol, tobacco, opium, etc., affect muscles and inter- 

fere with muscular exercise ? 




Di CT 



Fig. 34. 

Longitudinal Section of Skin (partly diagrammatic), magnified about 100 diameters. Its 
structure and contents (with the exception of the lymphatics). 



E, epidermis. 
I), dermis. 
CL, color layer. 
TC, tactile corpuscle. 
N. nerve. 



A, artery. 

CT, connective tissue. 
F, adipose tissue. 
HF, hair follicle. 



PT, perspiratory tube and gland. 
SG-, sebaceous gland. 
EP, erector pilae muscle. 
H, a hair. 



CHAPTER VI. 
THE SKIN AND KIDNEYS. 

I. THE SKIN. 

74. The Skin, or external covering of the body, is strong, 
flexible, and elastic, varies in smoothness and delicacy in 
different parts of the body, and has no less than six func- 
tions. 1 It has been likened to a sentinel whose duty is to 
guard the body against attacks, both from within and 
from without. It consists of two distinct layers, — an 
inner, the dermis or true skin, and an outer, the epi- 
dermis or cuticle. 2 

75. The Dermis is composed of a dense network of 
fibrous and elastic connective tissue (a), in the meshes of 
which are blood-vessels, lymphatics, nerves, sebaceous 
glands, sweat glands, hair, hair follicles, 3 and muscular 
fibres attached to some of the hair follicles. 4 Underlying 
the dermis, and closely blended with it, is the subcutaneous 
connective {areolar") tissue, inclosing vessels, nerves, adi- 
pose tissue, 5 sweat glands, and sometimes muscular fibres. 6 

1 See Section 84. 2 Called also scarf skin ami false skin. 

3 Little bags, or pouches. 

4 Through the meshes of the connective tissue oozes nutritious watery 
material from the blood-vessels. In dropsy, this material distends the 
connective tissue. 

5 The wrinkling of the skin of old persons is due to a diminution in the 
amount of fat, as well as to a lessened elasticity of the connective tissue. 

6 Muscular fibres are abundant in the skins of many animals, enabling 
them to shake off insects by a wrinkling motion of the hide. 



78 THE SKIN. 

The surface of the dermis, upon which the epidermis is 
moulded, rises into minute eminences called papillae., 
which are arranged in groups or rows, producing ridges 
and furrows. 1 They are most numerous in the most 
sensitive parts, such as the tips of the fingers, where they 
number about thirty-five thousand to the square inch. 
The papillae are made up of connective tissue, terminal 
blood-vessels arranged in loops, nerves in fine threads, 
and oval enlargements known as tactile corpuscles, or 
little bodies with touch-power, in which the sense of touch 
resides. 2 

The extreme sensitiveness of the papillary portion of 
the skin is made apparent whenever the raised cuticle 
covering a blister is broken and anything, even air, comes 
in direct contact with the true skin. 

76. The Epidermis is composed entirely of cells, rounded 
and soft at its lower portion, flattened, hard, and horn-like 
upon its surface, where they are exposed to the atmos- 
phere and to external sources of injury. Owing to attri- 
tion and chemical action, the outer cells of the epidermis 
are constantly being removed, while the deeper ones, 
formed from the dermis, are pushed forward to take 
their place, growing harder and flatter as they approach 

1 These ridges and furrows may be distinguished by means of a good 
magnifying glass. Their arrangement upon the fingers of different per- 
sons assumes different patterns. This fact is made use of sometimes in 
the detection of criminals. 

2 In the outer portion of the dermis, and below the papillae, other 
nerves end in enlargements, but these are known as Paccinian corpuscles. 
The nerves of the skin are sometimes classified as follows : (1) nerves of 
sensation; (2) trophic nerves, or those which control the nourishment 
of the skin ; (3) secretory nerves, or those that control the action of the 
glands; and (4) vasa motor nerves, or those which regulate the action 
of the blood-vessels. 



THE SKIN. 79 

the surface. 1 Having no nerves except a few in the lower 
portion, the epidermis is not sensitive, and being without 
blood-vessels, it cannot bleed. It is well adapted, there- 
fore, to cover and protect the sensitive tissues beneath. 
It thickens in the various parts of the body that are most 
used, as on the palms of the hands, the soles of the feet, 
on the knees of the shoemaker, or on the breast of the 
burnisher of books (a). 

77. The Color of the Skin is due in part to the blood cir- 
culating through it, and in part to the pigment or coloring 
matter of the skin in the lower cells of the epidermis. 
An unusual quantity of red blood in thin portions of the 
skin causes it to blush, or redden, while blood tinged by 
the yellow coloring matter of the bile imparts a jaundiced 
or yellow color. The distinctive variations in color of 
individuals, families, and races are due to the diversified 
arrangement of the pigment. The whiteness of the skin 
of albinos is due to the absence of this pigment, while 
freckles, and the peculiar irregular discoloration seen 
upon the skin of so-called leopard boys, are owing to 
variations in its quantity, quality, or distribution. 

78. Sweat Glands. — Classified as appendages of the skin 
are the sweat glands, the sebaceous glands, the hair, and 
the nails. Sweat glands are minute tubes, 2 closed at the 
lower end, and opening upon the free surface of the epi- 
dermis. They extend downward through the epidermis 

1 A microscopic examination of water in which the hands are washed 
will almost always show an abundance of epidermal cells, even though the 
water seems quite clear. Contagious diseases sometimes spread from one 
person to another by means of epidermal cells mingled with disease 
germs. 

2 About -gl-Q of an inch in diameter and ^ of an inch in length. 



80 



THE SKIN. 




into the dermis and subcutaneous areolar tissue, where they 
end in coils, intertwined with capillary or hair-like blood- 
vessels. From the blood in these vessels the perspiration 

is constantly filtered out by 
the sweat glands. The upper 
extremity of each coil is the 
commencement of a perspira- 
tory tube. Their openings, 
together with the outer open- 
ings of the tubes of the 
sebaceous or oil glands, con- 
stitute the pores of the skin. 
Sweat glands are found 
nearly everywhere in the 
skin, but are most numerous 
in the palms, soles, and arm- 
pits, where they number from 
2685 to 2736 to the square inch. Upon the entire surface 
of the body there have been estimated to be between two 
and three millions, and the entire length of the secreting 
surface is said to be about two and a half miles. 1 The 
very great number of glands, and the coiled and twisted 
arrangement by which considerable length is attained in 
minute spaces, indicate the great importance of the work 
that they have to perform («). 

The function of the perspiratory glands is to eliminate 
the debris of used-up tissues, and to keep the body com- 
fortable in the varying temperature and conditions to 
which it is exposed. 

79. Perspiration is generally a clear liquid, containing 
water, sodium chloride, ammonia, urea, carbon dioxide, 



Fig. 35. 

Epidermis from the Palm of the Hand 
(with its pores), as viewed from the 
under surface. Magnified eight diam- 
eters. 



1 They may be considered as flexible living drain pipes or drainage tubes. 



THE SKIN. 81 

and other waste products. The importance of a free flow 
of perspiration is illustrated by the bad effects resulting 
from any sudden check of it, as in catching cold and in 
fever. In such cases extra excretory work is thrown upon 
other organs, especially upon the lungs and kidneys, and 
in this way the health is often permanently impaired. 

Most of the perspiration which is brought to the surface 
by the sweat glands is immediately evaporated in the form 
of an imperceptible vapor, and is therefore termed insen- 
sible perspiration, as distinguished from sensible per- 
spiration, or sweat, which is the result of vigorous exercise, 
over-heat, etc. The constant evaporation of perspiration 
into the surrounding air is the most powerful of all the 
means whereby the surplus heat is carried off and the 
body kept at its normal temperature. In health, when- 
ever the body begins to suffer from excess of heat, as, for 
example, during violent exercise, the skin responds to the 
urgency of the occasion, and pours out the due amount of 
insensible perspiration or of sensible sweat. 1 

80. Under ordinary circumstances the amount of per- 
spiration excreted in twenty-four hours is from two to 
three pounds, but it varies with the temperature, current, 
and moisture of the air, the depressed or excited state of 
the nervous system, or the amount of physical exercise 
taken. Workmen in gas-houses, furnaces, iron-works, 
and other places where they are subjected to great heat, 
may perspire as much as three pints in an hour. To pre- 
vent exhaustion, such persons drink freely of water, or, 

1 The value of the skin as a regulator of temperature is sometimes 
strikingly shown when, front catching cold, the body is alternately chilly 
and hot. A tepid bath taken early in this disordered condition produces 
a sweat, and the equable normal temperature is regained. 



82 



THE SKIN. 



better still, of water containing oatmeal. A hot and 
dry atmosphere accelerates perspiration, while a moist or 
muggy one retards it, producing inconvenience and some- 
times great suffering. It is related of Chabert, " the fire- 
king," that, if the air were dry, he could enter, without 
discomfort, a chamber where the temperature was 400° F., 
but could not endure a moist atmosphere of a much lower 
temperature. 1 Perspiration is also 
impeded by cold and draughts of air. 

81. The Sebaceous Glands secrete 
an oily matter, which lubricates the 
skin and hair and thus preserves 
their softness and pliancy. 2 They 
are located in the dermis, and are 
clusters of simple follicles, with tubes 
connecting with a common or main 
tube. Most of the main tubes open 
into the hair sacs (Fig. 34); others 
open directly upon the surface of the 
skin, and are especially numerous 
about the face. 




Fig. 36. 

Section of Sebaceous Gland 
having two lobules. 

1, rudimentary hair follicle, 
containing a fine (downy) 
hair. 



82. Hairs are distributed more or less abundantly over 
the surface of the body. 3 Their bulbs or root enlarge- 

1 " A temperature of 100° F. in the dry air of South Africa is quite tol- 
erable, while 85° in the moist atmosphere of Bombay may be oppres- 



2 In sebaceous glands minute (microscopic) auimalculae are sometimes 
found, but they are not so frequent or so harmful as some sensational 
publications would lead us to believe. What are often called flesh worms 
are nothing more than masses of fatty matter tipped by black points, or 
dirt, which has adhered to them at the mouths of the sebaceous glands. 

3 It has been estimated that a thin head of hair contains 90,000 hairs, 
while a thick head of hair has 133,920. 



THE SKIN. 83 

ments are inserted in special hair sacs or follicles, or, in 
the case of the fine downy hairs, in sebaceous follicles. 
The shafts of the former pass out obliquely through the 
ducts of the follicles (Fig. 34). Each hair is oval or 
somewhat flattened, and is composed of a pith-like sub- 
stance in the centre, surrounded by a fibrous tissue, and 
this by a so-called cuticle, or layer of epidermis-like 
cells. 1 The fibrous and pith-like tissues contain a pig- 
ment or coloring matter. Hairs are well supplied with 
blood at the base of the hair follicles, and also, it is 
believed, with nerves. They are living tissues, strong 
and elastic. 2 

To the hair follicles are attached muscular fibres 
(erector pilae, Fig. 34), which, under the stimulus of fear, 
horror, cold, etc., cause the follicles to be more perpen- 
dicular, and thus make the hair "stand on end." Hair is 
subject to various diseases which may shorten its length, 
change its color, or destroy it. It is affected by the same 
conditions as the skin, of which it is a part (a). 

The hair has various uses. That upon the head and face 
protects from cold and excessive heat, and diminishes the 
force of blows. The eyebrows prevent the perspiration 
from running into the eyes ; the eyelashes keep out dust ; 
while the hairs at the orifices of the nose and ears protect 
those parts from dust and insects. 

1 Under the microscope the sides of a hair seem to be roughened. The 
hair of certain animals is perceptibly rough to the touch. Human hair 
may become rough from disease. Wry flat hair is apt to curl like a 
shaving. 

2 It has been found that a hair ten inches long will stretch to thirteen 
inches; and that a hair stretched one-fifth returned to within one-seven- 
teenth of its original length; also, that a single hair of a boy, 8 years 
of age, supported a weight of 7812 grains; one of a man of 22 years. 
14,285 grains; of 57 years, 22,222 grains. 



84 



THE SKIN. 




83. Nails are modifications of the epidermis, identical 
in formation, bnt peculiar in appearance and manner of 
growth. The root of the nail rests in a matrix, which is 
a fold of the dermis, particularly rich in vascular papillae, 
from which the nail cells are produced. 1 When nails are 

destroyed, new ones 
will be formed if the 
matrix is uninjured. 
Nails are a support 
and a defence to the 
ends of the fingers and 
toes, assist in picking 
up small objects, and, 
if healthy and in good 
condition, add comeli- 
ness to the parts to 
which they are at- 
tached. The health 
of the nails is affected 
by local or general diseases. They may become rough 
or split or marked by grooves or discolorations, as the 
result of disease. They should never be bitten off, but 
carefully trimmed with scissors, a sharp knife, or a nail 
file, but never to "the quick." 2 

84. The Various Functions of the Skin. — First. The skin 
is a protective, covering. This quality is due mainly to the 
hair, the structure of the epidermis, and the strength of 

1 The pink color of a healthy nail is due to the blood beneath. The 
little white area towards the root of a nail, called lunula from its crescent 
shape, has less blood under it than other parts of the nail. 

2 Dirt under the ends of nails frequently holds disease germs. A hang- 
nail is a sliver of skin attached at one end, and should be cut off close to 
the point of attachment. 



Fig. 37. 



Two Views of the End of a Finger. In the first, part 
of the skin covering the base of the nail is cut and 
turned back to show the base of the nail. In the 
second (a perpendicular section), the relations of 
the nail to the skin, fat, muscle, and bone are 
shown. 



THE SKIN. 85 

the connective tissue. In a good-sized man the skin con- 
tains about seventeen square feet of surface, is thick and 
strong upon those parts most subject to pressure and fric- 
tion, but thinner where motion or greater elasticity is 
necessary, as on the eyelids, in the armpits, under the 
knees, and over the abdominal organs. 

Second. It is an organ of sensation. Being abundantly 
supplied with nerves, it enables us to appreciate all degrees 
and varieties of touch and temperature. The value of this 
sensitiveness is especially appreciated in the different 
trades and vocations of life, and most of all when it is 
diminished or lost. In a palsied limb it may happen that 
a severe frost-bite, burn, or other injury will even destroy 
the tissues without the knowledge of the sufferer. 

Third. It is an organ of excretion, purifying and elimi- 
nating from the blood the waste products which the per- 
spiration holds in solution. 1 

Fourth. It is the great regulator of animal temperature. 
Though the general temperature of the human body is 
about 98^° F., there is, within the limits of health, 
a normal variation of about 1° below and above that 
point. The proper regulation of the temperature de- 
pends in part upon the elimination of watery vapor by 
the lungs, but mainly upon the perspiratory function of 
the skin. 

Fifth. It is an organ of absorption. It takes up and 
passes through it into the lymph and blood vessels cer- 
tain substances with which it may come in contact. It 
has been found by experiment that the body absorbs 
water through the skin («). Certain drugs, as strychnine, 



1 It is estimated that the skin and lungs in 24 hours excrete five pounds 
of waste material. 



86 THE SKIN. 

quinine, mercury, and belladonna, produce their usual 
effects when applied to the tender parts of the skin. 
Rubbing oily preparations into the skin has long been 
practised to increase warmth and furnish nourishment. 
Careless workmen in lead works, painters, and mirror- 
silverers are often poisoned by lead or mercury absorbed 
through the skin. The evil effects which sometimes re- 
sult from using cosmetics and hair dyes are due to the 
absorption of harmful material. Friction increases the 
rapidity of absorption. 

Sixth. The skin, by virtue of its powers of absorption 
and excretion, serves as an accessory organ of breathing. 
It absorbs oxygen and gives out carbon dioxide, per- 
forming, it is estimated, from one-fortieth to one-fiftieth 
of the respiratory function. 

85. The Relation of the Skin to Other Parts of the Body. — 
Owing to the extent, structure, and variety of functions 
of the skin, its condition has much to do with the general 
health. The skin, lungs, liver, bowels, and kidneys are 
allies in physiological action. All excrete waste material, 
each in its own way. If, therefore, from any cause the 
normal action of one or more of these organs is inter- 
fered with, extra and unnatural work is thrown upon the 
others, and the excessive excretions produce discomfort, 
and often inflammatory disease of greater or less danger. 
The skin is also intimately connected with the internal 
organs by nerves and vessels. Hence, if it be severely 
injured, as by an extensive burn, these organs may become 
inflamed and death may result. Conversely, because of 
the same intimate connection, or " sympathy," as it is 
sometimes called, indigestion often causes eruptions to 
appear upon the skin. 



THE SKIN. 87 

86. The Effects of Alcohol and Narcotics upon the Skin. — 

Alcohol, taken in small quantities, temporarily flushes 
and gives a feeling of warmth to the skin, by increasing 
the flow of blood through its minute blood-vessels. By 
repeated indulgence in its use, the skin of the face 
becomes puffy and has the blotched appearance so charac- 
teristic in the confirmed drunkard. This condition is due 
partly to a paralysis of the muscles of the blood-vessels, 
the consequent dilatation of these vessels and a stag- 
nation of blood, and partly to an interference with the 
circulation of blood in other portions of the body. The 
congestion of the blood so caused interferes with the nutri- 
tion of the skin and the exercise of its functions. 

Alcoholics are frequently used under the impression 
that they afford warmth. Persons relying upon them for 
this purpose are apt to suffer intensely when exposed to 
severe cold. 1 That they temporarily furnish a feeling of 
warmth in the skin is evident, but the increased heat 
brought to the surface of the body by the increased vol- 
ume of blood disarranges the heat equilibrium of the body 
and is soon dispelled by radiation. 

As Dr. Brunton 2 puts it : "Alcohol does warm a man 
in one way : it warms his skin and warms the ends of 
the nerves in the skin, and thus conveys to his sensorium 3 
the feeling of warmth, but at the expense of internal 
organs, by dilating cutaneous vessels. Arctic observers 
do not like their men to drink alcoholics. ... A party 

1 Dr. Kane, in his Arctic Explorations, says: "Coffee in the morning 
seemed to last the men through a large part of the day, and tea soothed 
them after a day's labor and exposure. They both operated upon fatigued 
and overtaxed men like a charm, and their superiority over alcoholic 
stimulants was very marked." 

2 Lectures on the Action of Medicines, ISOT. 



THE KIDXEYS. 



of engineers were surveying in the Sierra Nevada. They 
camped at a great height above the sea level, where the 

air was very cold, and they 
were miserable. Some of 
them drank a little whis- 
key, and felt less uncom- 
fortable ; some of them 
drank a lot of whiskey, 
and went to bed feeling 
very jolly and comfort- 
able indeed. But, in the 
morning, the men who 
had not taken any whis- 
key got up all right ; 
those who had taken a 
little whiskey got up feel- 
ing very unhappy ; the 
men who had taken a lot 
of whiskey did not get 
up at all. — they were 
simply frozen to death. 
They had warmed the sur- 
face of the body at the expense of their internal organs." 

87. The habitual use of tobacco, and sometimes the oc- 
casional use, tends to interfere with the nutrition of the 
skin, and is apt to make the face pale and unhealthy- 
looking. 

Opium and other narcotic drugs have a similar tendency. 




Fig. 38. 
Section of Kidney. (Geat.) 






II. THE KIDXEYS. 

88. The Kidneys are two bean-shaped organs, lying in 
the back of the abdomen, just under the diaphragm, one 



THE KIDNEYS. 



89 



on each side of the vertebral column. They are well 
supplied with blood-vessels, nerves, and lymphatics, and 
are composed of two parts, a cortical or outer portion, and 
an inner or medullary portion, made up of small tubes 
separated by connective tissue and arranged in the form 
of pyramids. These tubes open at the apices of the pyra- 
mids into a cavity known as the pelvis, which connects 
with the bladder by means of a long duct, the ureter. 
They are known as uriniferous tubules and are lined by 
a single layer of secreting cells. The outer end of each 
tubule terminates in a dilation which contains a knot of 
capillary blood-vessels. 

89. Function of the Kidneys. — The kidneys filter water, 
salts, and most of the urea from the blood. The urea is 
the result of a final oxidation of 

the nitrogenous material of the 
body, and, if not thrown out of 
the body, it becomes exceed- 
ingly poisonous. This excre- 
tion is effected mainly by the 
urine, through the kidneys. 
The amount of this fluid should 
be slightly more than the water 
taken into the body in twenty- 
four hours. 

Severe cold, or any disease 
or stimulation that impairs the 
functional activity of the kid- 
neys, tends to an accumulation in the blood of poisonous 
nitrogenous wastes. 

90. Effects of Alcohol upon the Kidneys. — Alcohol 
excites the kidneys to increased activity, by dilation of 




Fig. 39. 
Uriniferous Tubule and Dilation. 



90 THE KIDNEYS. 

their blood-vessels and irritation of their structural cells. 
Its repeated use frequently leads to a more or less perma- 
nent dilation of the urinary tubules, destruction of the 
secreting cells, fatty infiltration of the cortical substance, 
and either contraction or enlargement of the kidneys, — 
i.e. Bright's disease and other diseases of the kidneys. 

As to tobacco, opium, and other narcotics, no special 
effects on the kidneys are noted. 



QUESTIONS. 

1. Describe the skin and name its different layers. 

2. Locate and describe the dermis. 

3. What are the papillae, and what peculiar power resides in them ? 

4. Where is the subcutaneous tissue, and what does it contain ? 

5. Where is the epidermis, of what is it composed, and what passes 

through it? What is its function? 

6. To what is the color of the skin owing? 

7. What are the appendages of the skin? 

8. Describe the sweat glands and their functions. 

9. What affects the flow of perspiration, and, if checked, what 

follows ? 

10. Describe the sebaceous glands and their uses. 

11. Describe the hair and its uses ; the nails and their uses. 

12. What are the functions of the skin? Describe each. 

13. Explain why the skin and other excretory organs are mutually 

affected by the condition of each other. 

14. What connection has the condition of the skin with the general 

health ? 

15. How does alcohol interfere with the functions of the skin? 

16. Why is it unreliable as a heat producer? 

17. Where are the kidneys, how are they arranged, and what is their 

function ? 

18. How does the repeated use of alcohol impair their function ? 



CHAPTER VII. 
BATHING. 

91. The Value of Bathing. — Though bathing has at all 
times been considered of value, its full importance as a 
sanitary measure is not even yet generally appreciated. 
The bathing establishments of the Ancients were many 
and magnificent, and were patronized by multitudes daily, 
partly for health, but largely because bathing in them was 
inexpensive, and the baths were luxuriously appointed. 
In Eastern countries, bathing has always been a religious 
rite. From time to time it has been regarded as a diver- 
sion by the devotees of fashion. It should be a religious 
duty, a sanitary measure, and a perpetual fashion. 

92. Bathing as a Sanitary Measure. — First. It assists the 
skin in the discharge of its functions, and so materially helps 
to maintain health, beauty, and endurance. It fortifies 
the body against colds, 1 fevers, certain skin eruptions, 2 and 
internal disorders. Various skin and contagious diseases 

1 Dr. C. R. Agnew, after twenty-nine years' practice in New York City, 
wrote: "Inattention to health laws produces defects in tissue building. 
There is a morbid sensibility of the skin and mucous membranes. I 
arrive at the causes by the result of treatment, for I find that by proper 
shoeing, open fires, the cold bath in the morning on rising, followed by 
brisk rubbing with a pair of English bath-mittens and the use of the 
strap, and by the exposure of the skin to the air, very many times catarrhs 
disappear without any local treatment whatever. " 

2 It is the testimony of many persons that systematic bathing prevents 
and cures chafing of the skin much better than powders, ointments, etc. 

91 



92 BATHING. 

owe their origin to, and spread most rapidly among, the 
slovenly in the crowded parts of cities. 

Second. It removes dirt, odors, and poisonous materials. 
Perspiration, ordinarily a harmless fluid, if allowed to 
accumulate upon the skin and mingle with dirt of various 
kinds, clogs the pores. It may even undergo chemical 
changes, and become an irritant or produce poisonous 
matter which may be absorbed into the system. 

Third. Skin cleanliness augments the nutritive effects of 
food. 1 In other words, the assimilation of new materials 
is promoted by a thorough removal of the old. 

93. Proper Bathing is that which is adapted to the age, 
health, peculiarities, and occupation of the individual. It 
should be performed in a comfortable atmosphere, and be 
accompanied by a brisk rubbing of the skin, with the 
hands, a flesh brush, or mittens made of coarse crash. 
It should be followed by a thorough drying with a firm, 
good-sized towel, or, in the case of old and feeble persons, 
by friction over a loose flannel gown put on the dampened 
skin. 2 As very young children lose heat rapidly, they 
should, after a bath, be very promptly but gently rubbed, 
dried, and warmed. 

94. Soap is generally necessary as an adjunct of bathing, 
to remove greasy particles by its chemical action. It should 
be made of good animal or vegetable fat, combined with 

1 The eminent English sanitarian, Mr. Chad wick, said: "It should 
therefore be preached to the poor, as an additional inducement to skin 
cleanliness, that the same food which is required to make four children 
that are kept dirty thrive, will serve to make five thrive whose skins are 
daily washed and kept clean." 

2 Considerable comfort may be derived from friction (especially of the 
upper part of the body) with mittens merely dampened, or by dry rubbing 
with mittens or with the bare hands. 



BATHING. 93 

potash or borax, as is castile, cotton-seed oil, olive oil, 
and palm oil soap. Soaps containing an excess of alkali, 
or made from poor fats or oils, or containing other impuri- 
ties, irritate the skin and produce eruptions. 1 If the skin 
is sensitive or harsh and dry, it may be well to apply a 
little vaseline or oil, rather than to use soap. 

95. Times for Bathing. — Though the very strong and 
healthy may, with impunity, bathe at almost any time, 
most persons should not take more than a sponge bath 
before breakfast, as at that time the bodily powers are 
weakest ; nor take a prolonged bath when fatigued, or 
just before or just after a hearty meal or unusual exer- 
cise. About 11 a.m. is a suitable time for most persons. 
Those who are feeble and catch cold easily can generally 
bathe more safely just before going to bed. After bath- 
ing, they need extra warm bed-clothing, but should not 
have enough to produce sweating. 2 

96. Varieties of Baths. — Ordinary fresh-water baths are 
classified as hot, warm, tepid, temperate, cool, and cold. 3 
The shower bath stimulates the skin by the force of the 
water, as well as by its temperature. Salt water baths, 

1 Among the very poor, common laundry soaps are frequently used for 
toilet purposes. Some of these soaps are injurious. The demand for 
cheap articles has brought into the market many toilet soaps, too cheap 
to be always reliable. 

2 At the seaside, only the hardiest should attempt an early morning- 
dip in the surf. Many persons are injured by bathing very soon after a 
hearty meal of clams or other shell-fish. Such food needs strong digestive 
powers and ample time for digestion. This process is interfered with by 
such bathing, and blood is diverted in increased quantity into weak blood- 
vessels, sometimes causing apoplexy and death. 

8 Hot, 08° to 112° F. Warm, 92° to 98° F. Tepid, 85° to 92° F. Tem- 
perate, 75° to 85° F. Cool, 00° to 75° F. Cold, 30° bo 60° F. 



94 BATHING. 

mineral baths, and others are resorted to either for clean- 
liness, for their supposed medicinal effects, or as a means 
of nourishment. Among these are the Russian or vapor 
bath, 1 the Turkish or hot-air bath, 2 and the cold air, broth, 
and even mud and blood baths. 

Salt-water bathiiig has much greater tonic effects than 
bathing in fresh water. At the sea-shore the air, also, 
contains particles of salt. There, too, are new scenes and 
surroundings, and the water, dashing with force against 
the body, gives occasion to vigorous muscular exercise. 
All this exercise, combined with the stimulating properties 
of the salt water itself, tends greatly to quicken the cir- 
culation, and to add value to the bath. But to obtain all 
the good effects, the bather should first thoroughly wet the 
head and shoulders, then dash into the water, move briskly 
about, and come out before feeling tired or chilly. He 
should then rub dry and dress quickly. 3 

Mineral baths are baths of water containing various 
natural or artificial mineral salts. Certain mineral springs 
— those of Arkansas and West Virginia, for example — 
are much resorted to by invalids. 

The Turkish bath is a valuable method of cleansing 
the body and equalizing the circulation, and is generally 
preferred to the Russian bath, where the air is hot and 
moist. But after the bath, the bather should remain in 
the waiting-room for a considerable time before venturing 

i 100° to 130° F. 2 110 ° to 200° F. 

3 Salt water, being more dense than fresh, is much easier to float and 
swim in, and is for this reason preferred by bathers. The weight of the 
live human body, with the lungs healthy and inflated, is generally less 
than the same bulk of water ; hence, it need not sink in either fresh or 
salt water. Sometimes persons do sink because they become alarmed, 
and, in their fright, fail to inflate the lungs, but raise the arms, thereby 
submerging the mouth and nostrils. 



BATHING. 95 

into the outer air, and then should be well wrapped up 
and should not expose himself to draughts by standing 
on street corners, or by riding in open vehicles. He may, 
to advantage, take a moderate walk. 1 

The ancients esteemed sun baths for their remedial 
effects, and had places arranged in their gardens and 
buildings where the body could be exposed to the sun's 
rays (a). At the present time, much value, in certain 
quarters, is attached to the sun bath. 2 In some parts of 
Germany, mud baths are used for their supposed medicinal 
effects. So milk, blood, broth, and oil are in some places 
applied to the skin as nourishing agents. Rubbing with 
oil or vaseline after a bath is known as a Roman bath, 
and is sometimes of value in softening harsh skins and 
increasing warmth. 3 

97. Adaptation of Baths. — Temperate and tepid baths, 
which promptly quicken the flow of blood and make the 
skin glow, agree with most persons, whatever their age 
and condition. But the tendency is, on account of the 
comfort they afford, to prolong them beyond the limit of 
safety, and then they are followed by chilliness, muscular 
debility, depression of spirits, and sometimes by inflam- 
mation of the throat or lungs. It is desirable to become 

1 In the East, where the Turkish baths are very thorough and are 
accompanied by much shampooing and friction, the "skin of only one 
week's date, when collected, is often as large as one's fist." Sydney 
Smith, in a letter from a hot bath in Germany, says : " They have already 
scraped enough off me to make a curate." 

2 Some institutions, as the New York Hospital and the Hospital for 
Crippled Children, have their Solaria, or sun-rooms, in which certain fee- 
ble persons are placed each day. 

8 The South Sea Islanders are said to anoint the body freely with the 
oil of the cocoanut before and after bathing in the sea. This is sup- 
posed to increase their powers of endurance in the water. 



96 BATHING. 

accustomed to cool water if we wish the tonic effects of 
bathing. This can often be accomplished by gradually 
lowering the temperature of the bath a little each time, 
or by following up a sponging with tepid water by one 
with cool water. 1 It should, however, be quickly per- 
formed in a warm room, and be accompanied by a brisk 
rubbing of the skin. 

For very young children, a sponge or dip bath of tepid 
water is desirable each day or on alternate days. But 
the child should gradually become accustomed to cool 
water. 

Older children who frequently exercise in the open air 
may bathe to advantage daily in very cool water, if the 
bath be a short one, and followed by brisk friction. 
Many adults are benefited by such daily bathing, and 
persons who work in a dusty atmosphere may need even 
more than one bath a day. If, from any cause, the 
entire body cannot be bathed, the bathing of the head, 
neck, chest, and feet will afford comfort and strength. 
In the case of old and feeble persons, whose circulation 
is sluggish, tepid water alone should be used. 

98. The immediate effect of very cool or cold water ap- 
plied to the skin is to chill the surface of the body (" the 
first shiver "). It lowers the temperature, produces pallor 
by driving the blood inwards, and gives rise to the appear- 
ance called " goose skin," through contraction of the skin 
muscles, especially those attached to the hair follicles. In 

1 Such bathing, lasting only from five to eight minutes, is valuable in 
the morning, on rising, for most people. Sometimes a few drops of 
ammonia-water or some salt, added to the water of a bath, renders it 
more stimulating. Children and feeble persons have repeatedly become 
accustomed to cool and even cold baths by gradual training as above. 



BATHING. 97 

a vigorous person, reaction promptly follows. The skin 
becomes warm from the blood returning to it in increased 
amount. The bather should leave the bath before the 
secondary effects ("the second shiver") appear, i.e. 
chilliness, lassitude, blueness of lips and finger nails, and 
in some instances great prostration. This second shiver 
is always a danger signal. 

99. Hot and cold baths are to be used with caution, 
especially by persons with heart disease, or far advanced 
in consumption, or when very feeble or greatly fatigued. 
Hot-water baths are more cleansing than cold-water, but 
are generally more relaxing, and have not the tonic 
properties of the latter. Hot water applied to the skin 
promptly stimulates it, and is as promptly followed by 
chilliness, lassitude, and prostration, if the bather is not 
robust and active, or if the bath-room is cool. Once a 
week is often enough to use a hot-water bath. If fre- 
quently resorted to, danger may result from over-stimula- 
tion and subsequent depression of the heart and nervous 
system. Persons in robust health may enjoy frequent 
bathing in cold water, even in cool rooms, if the bathing 
occupies but a short time and is followed by brisk fric- 
tion ; but the practice is attended with risk. 1 

QUESTIONS. 

1. Why is bathing important to health ? 

2. Upon what do the times, manner, and hours of bathing depend? 

3. What is the proper bathing for different ages? 

1 There are people, undoubtedly, who can break the ice in ponds, and 
plunge in with impunity, but most persons cannot. Sometimes bathing 
must be so nicely adapted to the individual's needs that only a physician 
can decide what kind it must be, and how and when it is to be resorted to. 



) BATHING. 

4. What effects follow proper and what improper bathing? 

5. What are the effects of cold and warm water respectively ? 

6. What are the best times for bathing? 

7. How are water baths classified, and what can you say of the 

several kinds? 

8. What other baths are there? Of what use are they? 

9. What can you say about soap ? 






CHAPTER VIII. 
CLOTHING. 

100. Uses of Clothing. — First. The great object of cloth- 
ing is to prevent the loss of animal heat. Clothing not 
only hinders too rapid evaporation from the body, but 
being non-conducting, it prevents a loss of heat from 
direct contact with the outer air and other cold objects, 
and materially checks radiation. We are thus enabled to 
bear more easily sudden changes of temperature. 

Second. It economizes the animal forces by the retention 
of heat and by the comfort it affords. An exhausting ex- 
penditure of nervous and muscular energy to create animal 
heat is thereby avoided, and the food, instead of being 
used up as fuel in supplying a constant waste, is saved for 
the construction and repair of tissue. It is well known 
that both human beings and animals, when warm, require 
less food and can do better work than when cold. 

Third. It protects the body from heat, dust, and other 
external sources of injury, particularly from the injuri- 
ous influences of the winds, damp air, rain, hail, and snow, 
and from contact with poisonous substances. 

Fourth. Clothing is a covering and an ornament for the 
body. 

101. Proper Clothing. — Nature provides the inferior ani- 
mals with a natural covering that is beautiful, complete, 
and admirably adapted for varying seasons and climates; 
but man, in this as in other respects, is left with a power 

00 



100 CLOTHING. 

of choice, and must take the consequences. " Clothing 
should be made to fit the form, and not the form the 
clothing." It should be chosen for comfort rather than 
for style, though clothing may be both comfortable and 
stylish. It should be of the quantity, quality, and color 
best adapted to the varying needs of the wearer. It 
should be light, dry, clean, and properly ventilated. 

102. Bad Effects of Tight Clothing. — We have already seen 
that freedom of movement is indispensable in the various 
forms of muscular exercise, and in the performance of vital 
processes. It follows, therefore, that any clothing which 
interferes with this freedom is to be avoided. 

Heavy or tightly fitting head coverings overheat the 
scalp and exclude the air. 1 Their pressure obstructs the 
blood supply and the free action of the nerves, inducing 
headache and baldness. Tight cravats, collars, and bands 
press upon the windpipe and the important blood-vessels, 
nerves, and other structures of the neck, thereby impeding 
the passage of air, blood, and nerve currents, and pro- 
ducing discomfort, a sense of fulness in the head, head- 
ache, and disturbance of vision. " Some years ago many 
British soldiers fell victims to close military stocks, 
which, obstructing the easy return of the blood from the 
head, produced cerebral congestions and apoplexy." 

The shoulders should bear a large part of the weight of 
clothing. The pressure of arm-hole seams and shoulder 
bands upon the arms below the shoulder-joints hinders 
the free play of those important members, and is an ob- 
struction to proper muscular exercise. 

The normal movements of the lungs, heart, and other 

1 The helmet hats now worn by soldiers are of light weight, good color, 
and well ventilated. Formerly soldiers' head-gear was tight and heavy. 



CLOTHING. 



101 



organs are disturbed when- 
ever the free movements of 
the ribs are restrained by 
tight coats, corsets, or vests 
(a). Such compression, more 
than any other, deranges 
the vital processes, and pro- 
duces suffering which is often 
referred to other causes. 
Among its effects are lassi- 
tude, headache, cold feet, 
shortness of breath when 
exercising, dyspepsia, faint- 
ness, many derangements of 
the functions of internal or- 
gans, and sometimes deform- 
ities of the chest. 1 

Tight belts impede the 
movements of the abdominal 
organs, and may cause vari- 
ous disorders. Elastic bands 
in garters and shoetops are 
sometimes so tight as to 
affect the circulation of blood 
in the parts pressed upon. 




Fig. 40. 

Composite photograph of girl in corset ami 
without corset; an exact reproduction. 
Note the two outlines at the waist. 
This is not what is called " tight lac- 
ing," but from a working' costume. 
(Dickinson). 



1 It is well known to medical examiners of life insurance companies and 
for the army and navy, that the measurement around (he middle of the 
chest, even with the clothes on, should show at least two inches difference 
between the chest expanded by full inspiration and contracted by Eorced 
expiration. The difference, in health, is from 2 to I inches, the average 
being about 3. Now, a chest that expands (after being emptied as far as 
possible of air) only 1^ to If inches with bight garments on. will often 
expand 2\ to :)\ inches with the garments removed. This latter degree of 
expansion is the normal one, and any garment that lessens it is too tight. 



102 



CLOTHING. 



103. No articles of dress, perhaps, need to be so nicely 
adjusted, for the comfort of the individual, as boots and 
shoes. 1 If too large, they cause discomfort, corns and bun- 
ions, and loss of temper; if too small, they do all this and 




Fig. 41. 

Vertical section of right foot, showing the arches and the relations of the various 
structures. 



B, bones. 
M, muscles. 



T, tendons 
F, fat. 



C, connective tissue. 
BL, blood-vessels. 



more; they interfere with muscular exercise, cause cold 
feet, pain, and deformity. 

In shoes modelled upon lasts of wrong shape the weight 
is thrown upon or toward the outer side of the foot, instead 
of being borne, as it should be, directly over a line drawn 
from the middle of the heel to the middle of the big toe. 2 



1 "It is said that the Duke of Wellington, being questioned as to the 
most essential requisite of a soldier's clothing, replied, 'A good pair of 
shoes.' What next ? ' A spare pair of good shoes ' ; and even thirdly, ' A 
spare pair of soles.' " — Mapothek, Lectures on Public Health. 

2 Unfortunately, normal feet are rare, because properly constructed 
and fitting shoes are by many not considered stylish enough. It is not a 
question of square, round, or pointed toe. The shape is a matter of fancy. 
But the selection of a shoe is a question of free motion of instep, ankle, 
and toes, and comfort from non-pressure. 






CLOTHING. 



103 



If to such shoes high heels are added, and especially 
if they are near the middle of the soles, an unnatural 
mincing gait, not 
unattended with 
danger, is the re- 
sult. The weight 
of the body being 
thrown forward 
upon the toes, the 
ligaments of the 
various joints are 
strained, especially 
those of the spi- 
nal column, knees, 
ankles, and toes. 
The muscles of 
the back of the leg are deprived of their share of work. 
Overriding and other deformities of the toes are pro- 
duced ; and in some instances, important tendons which 
pass around the outer ankles are thrown out of their 
grooves, and lameness results. 






B 

Fig. 42. 

A, normal foot, proper position of toes. 

B, normal foot, with an outline of the front part of an 

improper shoe. 

C, toes crowded out of position as result of wearing such 

an improper shoe. 




Fig-. 43. 
An improper shoe. 



Fig. 44. 
A proper shoo. 



104 CLOTHING. 

Boots and shoes should fit the feet snugly, especially 
over the instep, but should allow free movements of the 
various joints. They should have broad soles, low and 
broad heels, 1 should not cramp the toes, should be hollowed 
out but little on the inner side, and should be so shaped 
that the weight of the body may be borne where nature 
intended it to be. These simple requisites will give us 
sensible, comfortable, and good-looking foot coverings. 

104. The Quantity of Clothing should be sufficient to keep 
the body comfortably warm, and should be increased or 
diminished with the change of season or of temperature. 
It is, of course, important that the body should be able 
to bear slight changes in temperature ; but the practice 
of hardening by exjiosure (as is sometimes done with 
the limbs of little children) is attended with danger. 2 
Neither is it prudent to throw aside warm clothing before 
the actual onset of warm weather, or to delay putting it on 
till cold weather has far advanced. 

105. On the other hand, too much clothing has also its 
bad effects. It induces free perspiration, which, retained 
in contact with the skin, proves an irritant. The skin, 
from being unaccustomed to the stimulating effects of a 
tonic atmosphere, becomes susceptible to very ordinary 
changes in temperature. Hence, thick wrappings worn 
about the neck, such as tippets or fur collars, tend to 
make one subject to throat affections, especially if the 

1 Not more than half an inch high. For young children spring heels 
may be best. The shoe should be a little longer than the foot. 

2 Proper care of the skin, by systematic bathing and well-regulated 
clothing, will in reality harden, while exposure of tender skins is dan- 
gerous to health and life. 






CLOTHING. 105 

wrappings be removed where there is any draught of 
air. 1 

As far as possible, clothing should cover all parts of the 
body equally. Hence, padding a part of the clothing, 
while other portions are made quite thin, is objectionable. 
So, too, " full dress," in the fashionable sense, is not full 
enough in a cold room, or on going out of an overheated 
room in cold weather. Warmth, however, depends more 
upon the material and structure of the clothing than upon 
the quantity. 

106. Lightness, Ventilation, and Warmth are desirable 
qualities in clothing, and may be combined in a loosely 
woven cloth, the meshes of which contain confined air. 
Air is one of the best non-conductors of heat known ; but 
if left free, it abstracts heat by promoting evaporation from 
the skin, and by keeping up a continual contact of fresh 
nil warmed particles. Confined air, however, prevents rapid 
evaporation, as well as radiation and the actual contact of 
colder bodies. Hence mittens are warmer than gloves, 
because they contain more confined air, and also because 
the fingers are in contact. Two pairs of cotton stockings 
afford more warmth than one pair, because of the air 
between them. For the same reason, two undershirts 
may be better than an overcoat, and are an especial pro- 
tection against sudden exposure. So woollen stockings 

1 "A regiment of infantry, according- to Baron Percy, being on their 
march in hot and stormy weather, the soldiers became heated and out of 
breath. The colonel permitted them to take oil' their stocks. Soon after- 
wards they entered a gorge of the Vosges. exposed to the northwest wind, 
without, covering the neck. On the following day 7;» soldiers were sent 
to the hospital, the greater part attacked with inflammatory sore throat, 
and, in a few days, more than 300 others were taken sick, apparently from 
the same exposure." — Dunglison, On Human Health. 



106 CLOTHING. 

drawn over shoes are more comfortable, when walking 
through snow, than even thick shoes. Felt shoes are 
warmer than leather ones. Loosely knit head coverings 
worn by women are both light and very warm. 

107. Clothing frequently worn needs a texture that will 
admit fresh air through it, or should be so arranged that 
the air may pass beneath it. Tightly woven and close- 
fitting underclothing or impervious rubber outer gar- 
ments do not allow the impurities from the skin to escape. 
Much better are the loosely woven, net-like under-gar- 
ments now made, and the modern, gossamers, which in 
some instances are ventilated by valve-like openings under 
the arms and on the back. 1 While it is prudent to 
provide ourselves with overcoats, wraps, and rubber gar- 
ments during a storm, they should be removed, or at 
least unfastened, when indoors or when not exposed to 
inclement weather. 

108. Dryness and Cleanliness. — Wet clothing chills the 
skin, cools the air in contact with it, hinders the escape of 
impurities, and should be removed as soon as possible, the 
body made dry and warm, and dry clothing substituted. 
If caught in a storm when unprovided with wraps, the 
increased animal heat afforded by walking or other con- 
tinuous exercise will usually avert evil consequences. 

It is important that clothing for the night, including 
bed coverings, should be light, dry, airy, and warm. 2 There 

1 The oil-skin coats worn by sailors, and made of cotton cloth treated 
with alnm, linseed oil, etc. , are light, water-proof, and by their texture 
ventilated. Rubber boots and overshoes, worn frequently and for a long 
time, are likely to cause chilblains. An outside garment of leather, 
lined with wool, is comfortable for those exposed to severe cold. 

2 A few folds of newspaper put between two blankets or other covers 
will furnish sufficient bed-clothing for a bitter winter's night. In addi- 






CLOTHING. 107 

should be a complete change of clothing at night. Much 
wakefulness and feverishness is undoubtedly due, if not 
to impure air, to unaired clothing. As Miss Nightingale 
puts it : " Feverishness is generally supposed to be a 
symptom of fever, — in nine cases out of ten it is a symp- 
tom of bedding." 

Unclean clothing, besides keeping the skin in a foul 
condition, becomes a receptacle for germs of disease. 1 
Clothing worn by attendants in cases of scarlet fever, 
small-pox, or other contagious diseases should be burned 
or disinfected as soon as possible (a). 

109. Color and Dyes. — Color in dress is not merely a 
matter of taste, but is an important consideration from a 
sanitary standpoint. Benjamin Franklin demonstrated, by 
means of various colored cloths placed upon the surface 
of snow under the sun's rays, that black was the warmest 
color, and white the coolest. Dark colors are best for 
general use in cold weather, and white, gray, etc., in hot. 2 

tion to the superior non-conducting quality of paper, its porosity allows 
a ready escape of the insensible perspiration without the cooling effects of 
evaporation. The sleeper is kept, therefore, dry and warm, and never 
experiences that clammy dampness which results from thicker bed-cloth- 
ing ; nor does he suffer from an oppressing weight. He will soon accus- 
tom himself to the rattle of the paper. Paper is also used to advantage in 
the shape of undervests, and in the soles of shoes. As to bed-clothing', 
so-called "comfortables" are sometimes very uncomfortable, on account 
of their weight, which impedes the circulation and prevents the escape of 
the insensible perspiration, and the sleeper awakes in the morning damp 
and even uncomfortably cold. 

1 Skirts and trousers so long that they gather and hold tilth from the 
streets are for sanitary reasons to be deprecated. 

2 "Clothing has frequently been the agent through which infectious 
disease has been propagated. Judging from Stark's observations on the 
power of absorbing odors, the probability is that contagion is absorbed 
after the same manner. Stark found that the absorption of odors was in 



108 CLOTHING. 

Owing to the demand for cheap and bright-colored 
clothing, poor material, sometimes colored with cheap and 
poisonous dyes containing arsenic, copper, etc., is thrown 
upon the market. Clothing, such as socks, tights, or 
undershirts, is dangerous if so colored, since it usually 
comes in direct contact with the skin. 1 The dyes act with 
especial force in hot weather, when they are dissolved by 
perspiration. 

110. Material. — In our variable climate, woollen under- 
garments should be worn, of varying thicknesses for the 
different seasons. Intermediate garments, such as waists 
and vests, should be made with especial reference to wear, 
while the outer garments may be arranged with greater 
regard to the mere appearance. Woollen or silk cloth is 
a better retainer of heat than cotton or linen. Woollen 
cloth is filled with confined air, and its ability to retain 
moisture, whether from the skin or from outside, prevents 
the cooling effects of rapid evaporation. Hence flannel 
and merino, in our changeable climate, make excellent 
under, intermediate, or outer garments. 2 

proportion to the hygroscopic absorption, and that it depended in a great 
measure upon color — black absorbing most, then blue, red, green, yellow, 
and lastly white. For a nurse, a dark woollen garment is the worst and 
light-colored cotton best." — Dictionary of Hygiene and Public Health. 

1 "The symptoms produced vary somewhat; usually they consist in 
redness and staining of the part, followed by swelling, itching, and 
smarting, with the formation of little blisters or vesicles, which break 
and give exit to a discharge. The part affected then becomes decidedly 
painful, and is occasionally greatly swollen. There is also a great deal of 
constitutional disturbance, and in fact the sufferer is quite ill. The 
peculiar staining of the skin, coinciding with the particular hue and 
pattern (bars, stripes, etc.) of the colored article, at once suggests the 
cause of the mischief." — The Skin and its Troubles. Health Primer. 

2 The favorite prescription of the celebrated English physician, John 
Hunter, for the rearing of children, was "plenty of milk, plenty of 






CLOTHING. 109 

Silk is the next most suitable material, especially for 
undergarments ; then cotton ; and lastly linen. Linen 
being a good conductor, and thin and closely woven, is 
too cool for use in winter or in a changeable climate. 
Neither is it suitable for an undergarment where the wearer 
is working hard or is exposed to great heat and draughts 
of air. Linen, cotton, or silk garments may be worn next 
the skin, with flannel over them, by those whose skins are 
irritated by flannel. 1 

QUESTIONS. 

1. Why does clothing keep us comfortable, and what other use has it ? 

2. What are the evil effects of tight clothing? Illustrate. 

3. What is said of too tight and too heavy clothing, respectively? 

4. What are the three desirable qualities in clothing, and how are 

they best combined? 

5. How and why may air be made useful in our clothing? Illustrate. 

6. Why should clothing have ventilation ? 

7. What are the bad effects of wet clothing ? 

8. Of what sort should our bed covering be? 

9. What may result from unclean clothing? 

10. Of what importance is the color of clothing? 

11. What bad effects have improper dyes? 

12. AVhat is to be said of the different materials for clothing? 

sleep, and plenty of flannel. 1 ' It is stated by physicians in hot countries 
that the wearing of wide flannel bandages (doubled) over the abdomen is 
a capital safeguard against cholera, bowel affections, and a sudden check 
of the perspiration. Street laborers, soldiers, and factorymen find by 
experience that they can wear flannel with comfort when exposed to 
varying changes in the atmosphere and at hard work. It is said that in 
rainy weather sailors wring out the water from their woollen jackets and 
put them on again, seldom catching cold. 

1 Cloth or clothing should not be bought simply because it is cheap. 
Much of the cheap cloth is math 1 of odds and ends, rolled or otherwise 
pressed into shape, and is known as "shoddy." It is of little value for 
clothing. 



CHAPTER IX. 

DIGESTION. -THE CONVERSION OP POOD INTO 
TISSUES. 

111. Nutrition. — The maintenance of life, our growth 
and development, and the production and utilization of 
various forms of energy, all depend upon the vitality of 
the innumerable cells of which the body is composed. 
This vitality is largely influenced by food. kk From the 
food the blood is fed; from the blood the tissues are fed." 
For the proper nourishment of the body, there must be 
a daily income of food and oxygen, and a daily outgo of 
the refuse of food and tissues in the shape of ivastes. 
These, if retained in the body for any length of time, 
decompose and are likely to form poisons. Wastes are 
excreted inainly by the lungs, skin, and kidneys, in the 
form of water, carbon dioxide, and urea. The large intes- 
tine gets rid of such materials as skins of fruit and vege- 
tables, and food substances that have not been converted 
into blood, all associated with water and refuse secretions. 

Nutrition, which accomplishes all this, is a complex 
process. It involves the reception, digestion, and absorp- 
tion of food, the absorption of oxygen, the conveyance of 
absorbed food and oxygen to all parts of the body, the 
building up of tissues by assimilation, the breaking down 
of tissues, and the taking up of waste materials thus 
produced and conveying them to excretory organs for 
expulsion from the body. 

110 



DIGESTION. HI 

112. Digestion. — Man, being an omnivorous animal, is 
able to live on a large number of food substances. The 
conditions of his life demand that this should be so. Part 
of his food he can eat in its raw state, and dispose of with 
comfort ; the rest he must prepare by cooking. All of it 
must be in liquid form to be absorbed, and most of 
it must be transformed before it can become blood. For 
this transformation and liquefaction, mechanical and chem- 
ical agencies are necessary. 

The process by which food is converted into blood in 
the body is called digestion. The digestive organs consist 
of the alimentary canal and its accessory organs, the teeth, 
salivary glands, liver, and pancreas. 

In animal organisms whose food is of an elementary 
character, these organs are few in number and of simple 
structure. The amoeba has no specific digestive organs. 
It can take food into its body through any portion of its 
substance, and cast out the waste in the same way. In 
man, the digestive organs and the process of digestion are 
complex. His food is mechanically broken up by means 
of the teeth and the churning motion of the stomach. It 
is chemically acted upon by secretions from the salivary 
glands, stomach, liver, pancreas, and small intestine. All 
of these secretions owe their efficacy to substances within 
them called ferments. 1 Each ferment acts upon particular 
food substances. Some act best in an alkaline, some in 
an acid medium. All are most active when the body is at 
its normal temperature. 

1 That is, ingredients which, by their presence under favorable cir- 
cumstances of heat and moisture, change the chemical constitution of 
Substances for which they have an affinity. The action of yeast, in bread- 
making, is an example of the action of a ferment. Unorganized ferments 
are sometimes called enzymes. 



112 



DIGESTION. 



113. The steps by which food is converted into the 
tissues of the body are : mastication, or chewing ; vnsali- 

vation, or mixing with 
the saliva ; deglutition, or 
swallowing : stomach and 
intestinal digestion; absorp- 
tion, the taking up of 
the digested material by 
the absorbents (veins and 
lacteals) ; circulation, the 
conveyance of this mate- 
rial by the blood to all 
the tissues; and assimi- 
lation, the appropriation 
of it by the cells of the 
tissues, according to their 
needs. 

114. The Alimentary Canal 

is a musculo-membrane- 
ous tube, which extends 
from the lips downward 
throughout the trunk, and 
in adults is about thirty 
feet in length. In it the 
food is digested. It is 
lined throughout its en- 
tire length by a delicate 
but firm tissue, which is 
continuous with a similar 
lining within the air pas- 
sages, the whole being 
known as the mucous 




Fig. 45. 
The Alimentary Canal. 



M. mouth. 
P. pharynx. 
OK. oesophagus 

S, stomach. 
CO, its cardiac 

opening. 
PO, its pyloric 

opening. 
SI 



VA. vermiform appendix. 
LI, large intestine. 
E, rectum. 
GB. gall-bladder. 
BD, bile duct. 
PD. pancreatic duct. 
DO, opening of the common 
duct into small intestines. 



mall intestine. 

Accessory Digestive Organs. 
L, liver. P, pancreas. SP, spleen. 



DIGESTION. 113 

membrane. 1 This membrane is richly supplied with blood- 
vessels for its own nourishment, and, in certain parts of 
it, these vessels with lymphatics are peculiarly arranged 
to carry on the process of absorption. It is well supplied 
with nerves. In addition to the gastric and intestinal 
digestive juices which the mucous membrane secretes, 
it is supplied with a viscid fluid called mucus, which 
protects it and enables its opposing surfaces to glide 
easily upon each other in the various movements of the 
canal, incident to digestion. 2 The wall of the digestive 
tract is made up of fibrous connective tissue for strength, 
and, for the most part, of two layers of involuntary mus- 
cular fibres, one longitudinal, the other circular. These, 
by alternately contracting, push the food along. 

The alimentary canal varies in its different parts in 
size, form, and structure, thereby forming the mouth, 
oesophagus, stomach, and intestines. 



1 The mucous membrane varies in thickness and general arrangement 
in its various portions. In the nose and air passages it is thin and 
smooth, in the mouth and throat somewhat thicker ; upon the tongue it is 
covered with papillae, in the small intestine with very soft projections 
called villi ; and in the stomach.it is thrown into ridges. The cells cover- 
ing the surface of the mucous membrane are epithelial cells, and together 
constitute the epithelium. Sometimes the mucous membrane is called 
the internal skin, from a similarity to the external skin. 

2 Ordinarily, in health, there is just sufficient mucus to act as a lubri- 
cant. But in some, young children especially, whose tissues are very 
sensitive, an excess of mucus is readily induced by an irritation oi the 
mucous membrane, through indigestible food, exposure of the skin to 
sudden changes in temperature, and by other means. This excess of 
mucus may, by coating proper food, interfere with its digestion. On the 
other hand, if the mucous membrane is not torn, injured, or diseased, 
such an excess, by coating improper articles that have been swallowed, 
will generally prevent any injury that might otherwise result from 
them. 



114 



DIGESTION. 



115. The Mouth is the commencement of the canal. It 
consists of the lips in front ; a cheek on each side ; a bony 




Fig. 46. 
A Vertical Section through the Middle of the Pace, Neck, and Upper Vertebrae. 



1, Cavity in the skull. 

2, opening of left Eustachian tube. 

3, the hard palate. 

4, the soft palate. 

5, muscular wall in front of tonsil. 

6, muscular wall behind the tonsil. 



7, the left tonsil. 

S, pharynx, or throat. 

9, the epiglottis. 

10, the hyoid bone. 

11, oesophagus. 

12, the cavity of larynx. 



roof, or hard palate, separating the mouth from the cavity 
of the nose, or nasal passages ; and the tongue below. In 



DIGESTION. 



115 



the back part of the mouth is the soft palate, or cur- 
tain, that separates the mouth from the pharynx, and 
which is raised in the act of swallowing. The mouth 
contains the teeth, and is moistened by the saliva. 

116. The Pharynx, or throat, is at the first bend of the 
alimentary canal downwards. It is, in general, funnel- 
shaped, with its upper portion, 
or roof, rounded like a buggy- 
top. It is slightly constricted 
in front, on each side, by two 
muscular pillars, "the pillars of 
the fauces," between which are 
almond-shaped bodies called ton- 
sils. Above and behind the soft 
palate the pharynx communicates 
with the nose by two openings, 
known as the posterior nares, one 
for each nasal passage. In the 
upper part of the throat, on a line 
with the floor of the nose, are the 
openings of two ducts, named the 
Eustachian tubes} which connect 
the mouth with the organs of 
hearing. At the lower part of 
the throat, in front, is the larynx, 
or voice box, which opens into 
the windpipe or tube leading to 
the lungs. Surrounding the phar- 
ynx are three obliquely placed 
muscles, styled the constrictors 




Fig. 47. 

The Location of the Constrictor 
Muscles. 

L.T, the front part of lower jaw, tin 
remainder being cut away t» 
show parts beneath. 

llli. Hie hyoid bono. 

TO, thyroid cartilage of larynx. 

CC, cricoid cartilage of larynx. 

T, trachea. 

OK, oesophagus. 

CM, the constrictor muscles — 
superior, middle, and interior. 



1 Inflammation of the throat sometimes extends through one or both of 
these ducts, causing earache or deafness. 



116 



DIGESTION. 



of the pharynx. These overlap each other, and, with 
other muscles, are concerned in the act of swallowing. 

117. The Oesophagus, or gullet, is the next portion of 
the alimentary canal, and connects the pharynx with the 
stomach, passing through the neck and chest, and ending 
just below the diaphragm. It lies in front of the spinal 
column, and its upper part is immediately behind the 
windpipe. The alternate contraction and relaxation of 
the muscles of the oesophagus serve to propel its contents 
toward the stomach. The wave-like motion resulting is 
called peristalsis, and is similar to that of the intestines. 1 




Fig. 48. 
The Muscles of the Stomach, one part removed to show underlying fibres. 

118. The Stomach is somewhat pear shaped, its larger 
end being upon the left side of the body, beneath the ribs, 

1 This peculiar motion is also called vermicular, or worm-like. 



DIGESTION. 



117 



just under the diaphragm, and in contact with the spleen. 
The smaller end is on the right side of the body, under 
the liver. When moderately filled, the length of the 
stomach is about twelve inches, and its greatest diameter 
four inches. 1 Its capacity is about four pints. 

The stomach has two openings : one where the oesoph- 
agus enters, called the cardiac 2 opening, because of its 




Fig. 49. 

The Internal Surface of the Stomach, from which the epi- 
thelium has been removed, showing the openings of gastric 
glands. [Magnified '20 diameters.] 




Fig. 50. 
A Gastric Gland. 



location near the heart, from which it is separated by the 
diaphragm; the other is styled the pyloric, or gate open- 
ing, because it is provided with a muscular valve known 



1 The stomach varies in size more than any other organ in the body. 
When empty, it is shrunken and flattened, and overlapped by the liver. 
When very full, it comes close behind the abdominal wall, and the " pit of 
the stomach ,1 is no longer visible. The stomach of the glutton becomes 
distended and does not readily regain its normal shape. When very 
much distended, it often presses upon the heart, causing distress and the 
symptoms of heart disease, 

2 Derived from the Greek Kap8hj, "heart." 



118 



DIGESTION 



as the pylorus, or " gate-keeper," the object of which is to 
prevent the premature exit of food from the stomach. 1 

The lining of the stomach is very soft and delicate. 
When the cavity is almost, or entirely, empty, the lining 
is arranged in folds. It is amply supplied with mucous 
glands and with gastric follicles, i.e. glands which secrete 
a digestive fluid, — the gastric juice. 

The muscles in the walls of the stomach are involun- 
tary, and are arranged in three layers, — the oblique, the 
circular, and the longitudinal. Their alternate contraction 
and relaxation serve to agitate thoroughly the contents 
of the stomach and to mingle them with the gastric juice. 

119. The Intestines. —The 
remaining part of the ali- 
mentary canal consists of the 
intestines, or bowels, which 
lie mainly in the abdominal 
cavity, but end in the lowest 
part of the pelvic cavity. 
These are divided into the 
small and large intestines, — 
the former being from twenty 
to twenty-five feet in length 
and averaging one and a 
third inches in diameter, 
the latter about five feet in 
length and two inches in 
diameter. 




VERMIFORMIS 



Fig. 51. 

lieo-coecal Valve and Adjacent Parts. 
(Sappey.) 

1, end of small intestine in large intestine. 

2, ileo-coecal valve. 



1 When the stomach contains a large amount of indigestible food, and 
has been too long in action, its muscular tone diminishes, and the valve 
no longer prevents the exit of improper material. Thus indigestible sub- 
stances accidentally swallowed may pass the " gate-keeper, 1 ' though some- 
times their passage is greatly delayed and causes much discomfort. 



DIGESTION. 



119 



120. The Small Intestine is coiled upon itself and extends 
from the pylorus to the large intestine, which begins in 
the right lower portion of the abdomen. Its opening into 
the large intestine is guarded by the ileo-coecal valve, an 
arrangement which readily admits of the passage of refuse 
material into that intestine, but interposes a usually ser- 
viceable barrier to its return. 

The intestine is held in place principally by the mes- 
entery, a double fold of serous membrane 1 attached to 
the spinal column ; but it so envelops the intestine that 
its necessary peristaltic 
movements in the trans- 
mission of food are not 
interfered with. 

The lining of the in- 
testine is very vascular 
and velvety. Through- 
out the larger part of 
the canal it is arranged 
in transverse, shelf-like 
folds, -more or less circu- 
lar in form, which, from 
their winking motion 
as they sway backward 
and forward in the 
fluids of the intestine, 
are called valvulae con- 
niventes. There are 
about eight hundred of these delicate folds 
the passage of food, and so expose i( for 




Fig. 52. 

Section of Small Intestine, showing Valvulae Con- 
niventes (Testttt). Wide perpendicular line = 
muscle ; line on left = fibrous coat ; line on right 
= mucous membrane. 



They retard 
a lonerer time 



1 A membrane which secretes a thin whey-like thud called serum. A 
similar membrane, under the name o( the peritoneum^ incloses, for the 
most part, all the abdominal viscera, in the same way. 



120 



DIGESTION. 



to the action of the digestive fluids. They also provide 
a very large surface for secretion and absorption. 

The characteristic velvety condition of the mucous 
membrane is due to its millions of minute elevations, pre- 
senting a general appearance of plush, and known as 
intestinal villi. Through them the process of absorption is 




Fig. 53. 

Villi of Small Intestine, with their superficial arteries and veins distended. 
(Magnified 100 diameters.) 

mainly effected. Each villus is composed of a framework 
of connective tissue, upon the free surface of which is 
the epithelium, — a single layer of cells. In the centre of 
the framework is a small vessel, with a closed end near the 
upper extremity of the villus. This is called a lacteal, 1 and 
is an offshoot of a system of absorbent vessels distributed 
throughout the body, named lymphatics. 



1 So called because during digestion it is filled with a milk-white fluid, 
consisting mainly of fat, which it has taken up from the intestine. During 
the intervals of digestion these vessels are not readily seen. Sometimes 
the lacteals are double. 






DIGESTION. 



121 



The lacteals empty into the receptaculum cliyli (i.e. re- 
ceptacle of the chyle), a pouch lying upon the lumbar 
vertebrae. This pouch connects with the thoracic duct, a 
small tube which extends upwards 
and empties into the left subclavian 
vein, — -the large vein, under the left 
clavicle, or collar bone. Within each 
villus are involuntary muscular fibres 
and a network of minute blood-vessels 
(veins) that empty into a large vein, 
called the portal vein, 1 which conveys 
to the liver certain products of diges- 
tion. 

In the mucous membrane of the 
intestine are numerous follicles, some 
of which secrete mucus and some a 
digestive fluid known as intestinal 
juice. Within about three inches of 
the pylorus the duct from the gall- 
bladder of the liver and that from 
the pancreas open into the intestine, 
admitting two more digestive fluids, 
the bile and the pancreatic juice. 




A Vertical Section of an 
Intestinal Villus. 

a, epithelial cells. 

b b, blood-vessels entering 

and leaving the villus. 
d, lymphatic vessel (lacteal) 

in the centre. 



121. The Large Intestine begins as a rounded cavity, — 
the coecum, — ascends upon the right side of the abdominal 
cavity to the under surface of the liver, crosses over to 
the left, underneath the stomach, and descends upon the 
left side to the upper and left portion of the pelvis, where 
its caliber becomes smaller. It then makes a bend, enters 
the pelvis, becomes the rectum^ and ends as the lower open- 



1 So called because it enters the liver at what was once called the porta, 
or gateway. 



122 DIGESTION. 

ing of the alimentary canal. 1 The coecum has a cylin- 
drical tube, from one to five inches long, projecting 
from its lower part, which tube is known as the appendix 
vermiformis. Its uses are not known. Sometimes seeds 
of small fruit lodge in it. Usually these do no harm ; but 
occasionally an inflammation (appendicitis) is started by 
their presence in the appendix, though such inflammation 
is more often the result of excessive activity of bacteria 
upon decomposing food. It is wise, when eating fruit 
with small seeds, to eat also bread or some other food 
which will be likely to entangle the seeds and pass them 
beyond the opening of the appendix. 

While it is true that the large intestine is able, to a 
limited extent, to absorb certain food substances, it is 
essentially the sewer of the body and contains refuse. 
The daily evacuation of this waste material is a matter of 
the greatest importance, to avoid decomposition and the 
absorption of poisons into the blood («). 

122. Accessory Organs of Digestion. — The Teeth are the 
organs of mastication, and are well adapted for the break- 
ing and grinding of food, to prepare it for the softening 
and digestive action of the saliva. They assist, also, in 
the use of the voice, and in preserving the symmetry of 
the face. Each tooth has three parts : the crown, or body, 
seen in the mouth ; the root, embedded in a socket in the 
jaw ; and a neck, the constricted portion between the other 
two. This is supported by the gum, a dense fibrous 
tissue covered with mucous membrane. 2 The bulk of 

1 The ascending part of the large intestine is called the ascending 
colon; the transverse part, the transverse colon; the descending part, 
the descending colon. 

2 The gums of old people who have lost their teeth shrink and some- 
times become very hard, enabling them to munch their food. 



DIGESTION. 



123 




the tooth is composed of dentine, resembling bone, and 
sometimes called tooth-bone, or ivory. On the crown, 
covering the dentine, is the enamel, 
the hardest tissue in the body. 1 
Strong as it is, it may be broken 
and the decay of the teeth ren- 
dered probable by the cracking of 
hard-shell nuts or other hard sub- 
stances between them. Covering 
the root is a thin layer of bone, the 
cement. 

The dentine incloses a cavity in 
the tooth, which is termed the pulp 
cavity, and which contains the 
pulp, a substance consisting of con- 
nective tissue, blood-vessels, and terminal nerves. The 
nerves and blood-vessels enter this cavity through a 
small opening at the tip of each root. 2 Canals radiate 
from the pulp cavity to the outer surface of the dentine. 
Destruction of the enamel at any point, therefore, exposes 
the entire cavity, and decay results. 



Fig. 55. 
A Vertical Section of Tooth. 

E, enamel. 

C, cementum. 

O 0, openings in roots for the 
passage of nerves and blood- 
vessels into the pulp cavity, 
represented in figure by 
darkened centre. 



123. There are two sets of teeth: the temporary, or 
milk teeth, of early childhood, twenty in number, the 
first appearing usually about the seventh month of 



1 The hardness of the enamel varies in different persons. In some it 
is so soft, from a deficiency of phosphatic salts, that the teeth wear down 
almost to the gums. 

2 The pulp supplies nourishment to the tooth. When it dies, the tooth 
loses its translucency and sensibility, and is discolored, and if it be a 
tooth of the permanent set, is never replaced by a new one, or even by 
new tooth-structure, but may retain its position in the jaw and do duty 
for years. 



124 



DIGESTION. 



life, 1 the last about the twenty-fourth ; and the perma- 
nent set of youth and adult life, thirty-two in number, 
the first appearing about the sixth year, the last, or wis- 




M/2 



<> \M 



Fig. 56. 

A diagram of two upper jaws, representing the location, arrangement, and time of 
eruption of the temporary and permanent teeth. The relation of the temporary 
to the permanent teeth is indicated by their position, and by dotted lines con- 
necting them with the permanent teeth. The numerals represent, in one 
instance, the time of the appearance of the teeth in years ; in the other, in 
months. 

I, incisor teeth. C, canine teeth. B, bicuspid teeth. M, molar teeth. 

dom teeth, about the twenty-fourth year. 2 The perma- 
nent teeth originate near the roots of the temporary teeth, 
and, as they develop, press upon these roots and cause 



1 From various causes, such as sickness, hereditary peculiarities, or 
lack of proper tooth-forming food, the appearance of the teeth may be 
delayed till one year of age, or even longer. Babies are sometimes born 
with teeth. 

2 The first permanent teeth appear behind the posterior milk molars, 
before any of the milk teeth are shed, viz. , at six years, so that a child 
of six has twenty-four teeth, — twenty temporary and four permanent. 






DIGESTION. 



125 



their absorption, the temporary teeth being eventually 
shed as little conical "crowns," with convex bases. 

Teeth are classified as ificisors, canines, bicuspids, and 
molars. In the first or temporary set, there are in each 
jaw four incisors, two canines, and four molars. In the 
second or permanent set, there are in each jaw the same 
number of incisors and canines, four bicuspids, and six 
molars. The bicuspids 1 replace the molars of the tempo- 
rary set. The teeth of the permanent set are larger and 
much stronger than those of the first. 







Fig. 57. 
Section of Jaws, showing the Temporary and Permanent Teeth. 

The incisors, or cutters, are in the front of each jaw, 
and have chisel-like edges for use in cutting or biting food. 
Adjoining the incisors are the canines, 2 which are some- 

1 So called, because they have two cusps or points upon their crowns. 
2 The upper canines are sometimes called eye tooth, the lower ones 
stomach teeth, though they have no peculiar relation to these organs. 



126 DIGESTION. 

what pointed at the edges, like the teeth of dogs. They 
assist the incisors in dividing the food. The bicuspids 
are between the canines and molars. They are shorter 
and thicker than the canines, and assist the molars in 
crushing the food. The remaining teeth are the molars, 1 
or grinders. These teeth pulverize the food, and are 
especially adapted for the purpose, their grinding sur- 
faces being broad and irregular. This grinding action 
is effected by the pressure of the lower jaw against the 
stationary upper jaw, with lateral, rotary, and upward 
movements, by means of powerful muscles. 

124. The Care of the Teeth is a matter of importance. 
The condition of the teeth of children, as well as adults, 
should be carefully watched by a reliable dentist, and 
defects remedied at least twice a year. 2 Bad teeth, by 
interfering with proper chewing, are at times the cause of 
dyspeptic ailments. They also change the voice and foul 
the breath. Decay of teeth may not only cause toothache, 
but an excruciating pain in the side of the face and head 
(i.e. neuralgia) may result from an extension of the irri- 

1 From the Latin molaris, " a grindstone." 

2 The temporary teeth in children should not decay, but should fall 
out clean and white when their function is ended. If not cared for, they 
are more likely to decay than permanent teeth, on account of the larger 
amount of animal matter they contain. Cavities in the temporary as well 
as in the permanent teeth should be filled, when possible. The prema- 
ture extraction of a tooth may destroy the symmetry of the jaws, and 
allow the opposing tooth to grow to an uncomfortable length. In rabbits 
a tooth thus deprived of its opposing one grows like a tusk. Much can 
be accomplished by competent dentists toward regulating the direction 
of the teeth and the shape of the jaws. The excess of animal matter in 
the osseous tissue of young children accounts for the deformed upper 
jaws, with the projecting front teeth, which sometimes result from long- 
continued thumb-sucking. 






DIGESTION. 127 

tation from the small nerves in the tooth pulp to the 
large nerves of the face and head. 




Fig. 58. (White.) 
The Connection of the Nerves of the Teeth with the Sensitive Nerves of the Face and Head. 

Teeth to be strong must be used (#). Persons who eat 
mainly soft food (bread without crust, for example) arc 
likely to have soft teeth. Teeth, as well as bones, require 
a certain proportion of mineral matter, which is supplied 
by such food as milk, eggs, cereals, and meat. They 
should be kept clean by frequent rinsing with water, and 



128 DIGESTION". 

by the use of a tooth-brush, especially upon the inner side 
of the teeth, in the morning and before retiring. As a 
dentifrice upon the moistened brush, prepared chalk, 
chalk and orris root, common salt, or a good soap may 
be used to advantage. Acid or gritty powders, or mix- 
tures containing charcoal, are to be avoided. Every 
particle of foreign matter should be removed from 
between the teeth by a quill or wooden toothpick, or by 
drawing a thread of dental floss silk between the teeth. 1 
This is important, as the mouth is a warm, moist cavity, 
favorable to the decomposition of food retained in it, and 
to the development of acids that tend to dissolve the lime 
salts of the teeth. If a softened spot appears in a tooth, 
the bacteria of the mouth attack the dentine, and decay 
sets in. 2 

125. The Salivary Glands. — The saliva is secreted by 
three pairs of glands, the parotid, the submaxillary, and 
the sublingual, and b}^ the general mucous surface of the 
mouth. The parotids, 3 one just in front of and below 
each ear, open into the mouth by ducts opposite each 
second upper molar tooth. The submaxillary glands, 

1 Pins, knife blades, and other metallic substances should never be 
used as toothpicks, for they are likely to injure the enamel. 

2 To prevent acidity, a mouth wash of bicarbonate of soda or lime 
water may be used occasionally with good effect. To remove odors, a 
solution of common salt, or a wash of five drops of carbolic acid, one 
quarter teaspoonful of listerine, and one teaspoonful of glycerine in a 
half tumbler of water, is serviceable. Acid medicines should always be 
taken, diluted with water, through a glass tube, and the mouth thor- 
oughly rinsed afterward with water. 

3 Called parotid, from two Greek words, meaning "near the ear." 
These glands are sometimes called masticatory glands, as they are found 
only in animals furnished with grinding or masticating teeth. The disease 
known as mumps is an inflammation of one or both of these glands. 



DIGESTION. 



129 



beneath the floor of the mouth and just within the angles 
of the lower jaw, open by a common duct, under the 
tongue, at its junc- 
tion in front with 
the floor of the 
mouth. The sub- 
lingual glands lie 
under the tongue, 
and discharge their 
secretion by ducts 
near the opening 
of the canal from 
the submaxillary 
glands. 




Fig. 59. 

Diagram showing the location and relations of the sali- 
vary glands of the left side, a large part of the lower 
jaw being removed. 

T, the tongue. SLG-, the sublingual gland. 

LJ, part of the lower jaw. SMG, the submaxillary gland. 
PG-, the parotid gland. 



126. The Pancreas is a fleshy gland, about six inches 
in length, lying transversely behind the stomach and large 
intestine. It secretes the pancreatic juice, a digestive fluid 
which is poured into the upper part of the small intestine. 

127. The Liver is the largest gland in the body, weigh- 
ing in the healthy adult from three to four pounds, and 
measuring in its transverse diameter from ten to twelve 
inches. It is of a dark brown color, is situated in the 
upper part and right side of the abdomen, and receives 
all the blood from the stomach and intestines through the 
portal vein. Part of the nitrogenous digested materials 
received in this way is probably converted by the liver 
cells into serum albumin. This is carried into the blood 
current from the liver, and is distributed throughout the 
body by veins known as hepatic veins, which connect with 
a large vein (the inferior vena cava) that empties into the 
heart. An excess of these nitrogenous materials, together 



130 



DIGESTION". 



with substances brought by the return blood current to 
the liver, is converted by the liver cells into urea. These 
cells also break down old red blood corpuscles, returning 

any useful residue 
to the blood. 

The liver has 
still other func- 
tions. Some of the 
sugar which it re- 
ceives by the portal 
vein is taken out 
of the blood by 
the liver cells and 
stored up in the 
liver as glycogen, to 
be given out as 
sugar, in the inter- 
vals of digestion, 
whenever the blood 
of the body needs it. 
The liver also 
secretes bile, one of 
the digestive fluids. 
Its flow is constant, 
but increases soon 
after digestion in 
the stomach begins. 
Part of it, in the 
intervals of digestion, is stored up for future use in the 
gall-bladder — a pear-shaped bag attached to the under 
surface of the liver. Bile, when secreted, is carried by 
a multitude of fine canals within the substance of the 
liver into a main tube, which opens, together with one 




Fig. 60. 
The Portal Vein and its Branches. 



DIGESTION. 131 

from the gall-bladder, into a larger tube known as the 
common bile duct, which is joined farther on by the pan- 
creatic duct. Both the bile and pancreatic juice are then 
discharged by a common opening into the upper part of 
the small intestine. 

128. The Various Steps of Digestion. — Mastication. — " The 

amphibian bolts its fly, the bird its grain, and the fish its 
brother, without the ceremony of chewing," but in man, 
mastication is necessary for complete and comfortable 
digestion. When food has been received into the mouth 
and cut and torn into pieces by the incisors and other 
teeth, it is then chewed or ground into minute fragments. 
For this purpose, by the action of the tongue, lips, and 
cheeks, it is rolled about the mouth and placed between 
the lateral teeth, especially the molars. 

The teeth of the human being combine the characteris- 
tics of those of the carnivora and herbivora, — that is to 
say, are adapted for masticating both animal and vege- 
table food. The first appearance of teeth indicates that 
other food than milk can now be used, while the cutting 
of the permanent teeth shows that food which requires 
much chewing is to be included in a proper diet. 

129. Insalivation. — At the same time that food is being 
chewed, it is softened by insalivation, or a thorough mix- 
ture with the saliva, so that it can be easily swallowed 
and readily acted upon by the digestive fluids farther 
on in the alimentary canal. Sapid substances, such as 
sugar and salt, are also dissolved so that they can be 
tasted. Part of the cooked starch l in the food is changed 

1 The firm envelopes of unbroken raw starch granules prevenl the eon- 
tents of the starch cells from being readily acted upon by saliva. 



132 DIGESTION. 

into dextrin and then into maltose, a soluble form of 
sugar, by the ferment action of the ptyalin of the saliva. 
Saliva acts best in an alkaline medium, but when swal- 
lowed continues to act upon cooked starch for a short 
time in the acid secretion of the stomach. The conversion 
of starch is resumed with activity in the small intestine, 
under the influence of the alkaline secretion of the 
pancreas. 

130. The Saliva is a thin alkaline fluid. Besides its 
softening and transforming properties, it keeps the mouth 
moist, to enable us to speak with comfort. From one to 
three pints are secreted per day in a man of average size, 
the quantity increasing with the hardness and dryness of 
food. It is also increased by the movements of the lower 
jaw in mastication, by anything introduced into the mouth, 
and especially by those things which stimulate the nerve 
of taste. Its flow is largely under the influence of the 
nervous system. The mere thought or smell of agreeable 
food will "make the mouth water," while under the in- 
fluence of anger or fear, the tongue, in its dryness, is 
said to "cleave to the roof of the mouth." 

131. Deglutition. — The food, having been properly 
prepared, is moved toward the pharynx to be swallowed. 
The final steps in deglutition are involuntary. As the 
food or drink enters the pharynx, it is grasped by the con- 
strictor muscles and hurried on into the oesophagus, — 
the openings leading to the lungs, nasal cavities, and ears 
being usually protected from its ingress by the approxi- 
mation of their Avails and by the raising of the soft palate. 
If the mechanism of swallowing is disturbed by excessive 
laughing or talking or by rapid swallowing, food, espe- 
cially the fluid portion, is likely to enter the larynx or nose, 



DIGESTION. 133 

and cause coughing, sneezing, and sometimes serious re- 
sults unless prompt aid be furnished. 1 

The passage of food or drink to the stomach is effected 
by means of the peristaltic action of the oesophagus. 
This action is at times sufficiently powerful to overcome 
the laws of gravitation. Hence, liquids and solids may, 
by some persons, be swallowed in any position of the body, 
even standing on the head, as is done by jugglers. 

132. Stomach Digestion. — Just as soon as the food reaches 
the stomach, stomach digestion begins. The mucous mem- 
brane, which in the intervals of digestion is of a pale red 
color, now becomes bright red from its engorgement with 
blood. Its folds are obliterated, the pyloric sphincter 
closes the opening into the intestine, the muscles in the 
walls of the stomach begin to churn its contents and to 
mix them with the gastric juice, which is now abundantly 
poured out. 

133. The Gastric Juice is a thin fluid, strongly acid. It 
dissolves certain mineral salts found in the cereals and 
other food substances, dissolves the connective tissue of 
meat, releases fat from its envelopes by breaking them up, 
and transforms some of the proteids, or albuminous ma- 
terial, — such as lean meat, the gluten of wheat, and white 
of eggs, — into peptones, in which form they are liquefied 
and made capable of absorption. This transformation is 
effected by the ferment action of an ingredient of the gas- 
tric juice known as pepsin, 2 ' assisted by an acid ingredient 

1 Sometimes, for example, particles of meat, going the "wrong way." 
lodge in the larynx and cause death by suffocation. (.See Emergencies, 
p. 309.) 

2 Pepsin, obtained generally from the stomachs of pigs, is used as an 
artificial digestant in certain forms of dyspepsia. 



134 DIGESTION. 

(free hydrochloric acid). It contains also another ferment, 
rennin, 1 which curdles milk. 

Much gastric juice is secreted in 24 hours; probably 
the amount is more than five times that of the saliva. Its 
quantity is increased by stimulating substances, like mus- 
tard and catsup, in contact with the mucous membrane of 
the stomach, and its flow is facilitated by the odor and 
appearance of appetizing food. On the other hand, the 
quantity is diminished by fear, anger, anxiety, or grief, 
and also by excessive eating and drinking. 

134. While stomach digestion is going on, the fluid 
portion of the food — both that which has entered the 
stomach as fluid and that which has been liquefied in this 
organ — is rapidly taken up by the absorbents of the 
stomach and carried into the blood. 

The unabsorbed food begins slowly to leave the stomach 
about half an hour after its introduction, the pylorus 
relaxing, at intervals, to allow it to pass out 2 in the form 
of a thick, cream-like fluid, called chyme. This is a mix- 
ture of some of the sugar and salts of the food, trans- 
formed starch or maltose, softened starch, water, mucus, 
broken fat and connective tissue, peptones, and of much 
undigested material if the meal has been too hearty. 

The entire digestion of an ordinary meal in the stomach 
usually requires from two to four hours. Some foods 
are thoroughly digested, so far as the stomach is con- 
cerned, in one hour, and some require as much as five 

1 Milk is promptly curdled in the stomach, but most of it is redissolred 
later, unless the quantity of milk has been more than can be digested. 

2 Substances more or less indigestible are acted upon with difficulty. 
Sometimes they are thrown up. or pass, after many hours, into the small 
intestine, causing suffering (colic). 



DIGESTION. 135 

hours (a). The duration of stomach digestion varies 
also in different persons, and in the same persons at 
different periods. It depends not only upon the kind and 
quantity of food taken, but also upon the condition of the 
nervous system and the amount of exercise. 

135. Intestinal Digestion. — The acid chyme, upon enter- 
ing the intestine, comes in contact with the pancreatic 
juice, bile, and intestinal juice, all of which are alkaline 
in reaction, and is changed by them into a thin, milky, 
alkaline fluid, the chyle. The liquefaction and transfor- 
mation of «proteids into peptones, begun by the stomach, 
is continued by the pancreatic juice, assisted, probably, by 
the intestinal juice. The transformation of cooked starch 
into maltose, begun by the saliva, is continued by the 
pancreatic juice, which also acts upon some of the raw 
starch. Of the fats, a part is saponified ; and a part, by 
the combined action of the bile and the pancreatic juice, 
is changed into an emulsion, to be absorbed by the intes- 
tinal villi. All this is intestinal digestion. 1 

136. The Pancreatic Juice 2 is a clear, viscid fluid, resem- 
bling saliva. It has three ferments : trypsin, amylopshu 
and steapsin. 3 Trypsin acts like pepsin on proteids, 
changing them into peptones ; but, unlike pepsin, it can 
act in an alkaline medium, as well as in a slightly acid 
one, and can split peptones into other nitrogenous sub- 
stances. Amylopsin changes starch into sugar, and acts 
on raw as well as on cooked starch. Steapsin splits part 

1 The passage of the food through the small intestine is said to occupy, 
on the average, about twelve hours. 

2 " Pancreatine,' 1 obtained from the pancreas of animals, is much used 
as an artificial digestant. 

8 It is said to have also a milk-curdling ferment, practically not used. 



136 DIGESTION. 

of the fats into glycerine and fatty acids. The acids 
unite with the alkalies of the pancreatic juice and the 
bile, to form soaps, which aid in emulsifying the fat not 
split into glycerine and fatty acids. 

137. The Bile is of a color varying from green to a 
golden yellow. About two and a half pints are secreted 
in twenty-four hours. The principal action of the bile 
is to assist the pancreatic juice to emulsify fat. Probably 
it prevents the decomposition and putrefaction of food 
during its passage through the intestines, and perhaps 
increases the muscular action of the intestines and lessens 
constipation. Part of the bile is thrown off as an excre- 
tion, and part of it is reabsorbed by the portal vein, to be 
again secreted. If the bile is not secreted, or is prevented 
from entering the small intestine, an animal will become 
very feeble and emaciated, and may die. 1 

138. The Intestinal Juice is a thin, yellowish secretion, 
from the glands of the intestines. It plays a subordinate 
part in digestion, but its action is not thoroughly under- 
stood. It may aid, by its alkalinity, in the emulsification 
of fat and the transformation of proteids. It may change 
some of the maltose into dextrose, another form of soluble 
sugar. It has but little action on starch. 

139. Absorption is the process by which liquefied and 
transformed food is taken up by the venous capillaries 
and lacteals and carried into the blood. By the blood 
it is conveyed to the heart, and from the heart it is dis- 
tributed to every part of the body by means of the circu- 
lation. Then assimilation occurs. 

1 Biliousness is not due to an excess of bile, but to deranged secretion 
or action of it. 



DIGESTION. 



137 



As the entire mucous membrane of the alimentary canal 
is well supplied with blood-vessels and lymph-vessels, it 
is probable that, in a small 
degree, absorption of water, 
common salt, and sugar oc- 
curs in the mouth, pharynx, 
and oesophagus. While there 
is some absorption from the 
stomach, it mostly occurs in 
the small intestine, with its 
immense surface and innu- 
merable villi. Here much 
of the sugar and peptone and 
most of the fat are absorbed. 

The lining cells of the ali- 
mentary canal have a select- 
ing power not understood. 
This is aided by the pushing 
action of the intestine, and 
by the process of osmosis, — 
i.e. the interchange of liq- 
uids (or gases), separated 
from each other by a moist 
animal membrane, which has 
no visible pores. The di- 
gested materials are soaked 
up by the membrane in a 
manner similar to the action 
of blotting paper. 




Fig. 61. 

A Diagrammatic Repi-esentation of the 
Various Organs concerned in the Con- 
version of Food into Blood. 

1, mouth and salivary glands. 

2, the oesophagus. 3, the stomach. 

4, a portion of the small intestine. 

5, the pancreas. 6, the liver. 

7, mesentery with lacteals. 

8, receptacle of chyle. 

9, the thoracic duct emptying its contents 

into the left subclavian vein. 

10, branches of portal vein leading to liver. 

11, an hepatic vein leading from the liver 

to the large ascending vein. 

12, the large ascending vein cut off at its 

junction with the heart. 

13, the large descending vein cut off in like 

manner. 



140. Emulsified fats are absorbed by the epithelial colls 
of the villi, from which they find their way into the 
lacteals, and thence to the thoracic duct and the heart . 



138 DIGESTION. 

Water, salts, and sugars pass into the rootlets of the 
portal vein, and thence to the heart. The peptones are 
taken up by both lacteals and blood-vessels. In the large 
intestine, water and soluble salts are the main substances 
absorbed, though artificially prepared food introduced 
into the rectum may be absorbed to a limited extent, and 
maintain life for a few weeks. 

141. The Fate of Absorbed Food. — Water, sugars, and 
some salts are ready for absorption when taken into the 
body. Indiffusible carbohydrates, like starch and dextrin, 
are changed by digestion into diffusible sugar, and indif- 
fusible proteids into diffusible peptones. Fats, for the 
most part, are mechanically altered. Diffusible peptones 
in the blood current are changed into non-diffusible pro- 
teids, serum albumin, and serum globulin, which are used 
to build up the albuminous tissues, the waste of which is 
discharged from the body as urea, creatinin, etc. The fat 
disappears soon after entering the blood. Some of it is 
stored up as the fat of the body, but probably the greater 
part of it is changed into water and carbon dioxide, 
evolving, in the process, heat or other forms of energy. 
The proteids of the body are formed only from the pro- 
teids of food, but fat can be formed from both the proteids 
and carbohydrates of food. Probably most of the sugar 
absorbed is destroyed in the active tissues of the body, 
especially the muscles, and eliminated as carbon dioxide 
and water. A small part is changed into fat, while con- 
siderable (especially after a hearty meal) is stored in the 
liver as glycogen, and, when needed, given to the blood as 
sugar in the intervals of digestion. 1 Water and the min- 

1 When the sugar in the body cannot be utilized by the tissues, part of it 
is excreted by the lungs and kidneys, causing a condition known as diabetes. 



DIGESTION. 139 

eral ingredients of food, as a rule, pass through the system 
unchanged, affording necessary fluidity, strength, or alka- 
linity to various tissues and fluids. 

142. In healthy digestion the food which cannot be as- 
similated or converted into heat, energy, and strength is 
ordinarily eliminated with ease by the excretory organs. 
But if the bodily powers be overtaxed by food inappro- 
priate as to quantity or quality, the extra eliminating 
work demanded, especially of the kidneys and liver, may 
seriously derange these organs. 

143. Requisites for Normal Digestion. — In order to do 
their work, the digestive organs must be normal in 
structure and capable of the necessary muscular move- 
ments. Their secretions must be perfect as to quality 
and quantity. Gastric juice, for example, will not act as 
a solvent if its acid is neutralized by an alkali. Nor will 
the pancreatic and intestinal juices perforin their functions 
if their alkaline nature is destroyed by acids. 1 

The food also must be just sufficient, and so cooked or 
otherwise prepared that it can be acted upon with ease 
by the digestive organs and their secretions. It must 
be taken at regular intervals, thoroughly chewed, and 
slowly swallowed. It should not be taken immediatel} T 
before or after great physical or mental effort. Broken 
or decayed teeth, or a defective number of them, sore 
mouth or throat, neuralgia of the face, the waste of saliva 
by the habit of expectoration, torpidity of the muscles 
of the alimentary canal, defective action of the glands 
concerned in digestion, impediments in ducts, and undue 

lr rhe lesson of moderation in the use of alkalies and acids is evident. 



140 DIGESTION. 

anxiety of mind, all interfere with proper digestion and 
nutrition. 1 

144. Effects of Alcohol and Narcotics upon the Digestive 
Organs and Digestion. — Alcohol, taken in small quantity, 
produces a feeling of warmth in the stomach, accelerates 
its muscular action, and increases the functional activity 
of the other digestive organs. When it aids digestion it 
is "probably not through any inherent powers of its own, 
but by virtue of its irritant properties, inducing an in- 
creased flow of gastric juice." Larger amounts interfere 
with the digestive process, partly by rendering the albumi- 
noids less soluble, and partly by producing, as a secondary 
effect, constriction of the minute blood-vessels, thus caus- 
ing a decrease in the digestive secretions. Frequently, 
people who call themselves moderate drinkers, and who 
are never intoxicated, suffer from an obstinate dyspepsia, 
loss of appetite, and nausea, especially in the morning. 
To allay these uncomfortable sensations, they resort to an 
early alcoholic drink, which only increases the trouble. 

When alcohol is taken in still larger amount and used 
frequently, the stomach becomes inflamed, hardened, and 
contracted. The liver is frequently altered in shape, 
becoming either contracted (i.e. fibroid degeneration, 
causing cirrhosis or "hobnail" liver), or enlarged from 
fatty degeneration, causing "fatty liver." When the liver 
is contracted, the vessels leading to that organ are com- 
pressed, and congestion of the stomach, rectum, pharynx, 
oesophagus, and face is likely to result, while indirectly the 
functions of the heart and kidneys are disturbed. These 
changes in the digestive organs of course interfere with 

1 Difficult digestion, or "dyspepsia," demands, therefore, a careful 
study of the causes in each case, before medicinal measures are used. 



DIGESTION. 141 

their functions ; food is not properly digested, the blood 
is poor, and the liver fails to excrete the wastes that come 
to it and that originate in it. 

145. Tobacco, opium, etc., while acting mainly on the 
nervous system, frequently produce loss of appetite, nausea, 
and a persistent dyspepsia, by deranging the gastric juice. 



QUESTIONS. 

1. What is meant by nutrition? 

2. What are the wastes of the body, and how are they disposed of ? 

3. What is digestion, and what are the digestive organs? 

4. Describe the alimentary canal, and name its different portions. 

5. What begins the alimentary canal, and what is there secreted? 

6. Describe the pharynx, and state what opens into it. 

7. What are the constrictors of the pharynx, and their object? 

8. Describe the oesophagus, its object, and mode of action. 

9. Describe the stomach and its openings. 

10. How are the intestines divided? Describe the small intestine. 

11. What is the mesentery, and its use? 

12. How is the movement of the food in the intestine effected? 

13. What is the mucous membrane of the intestine? 

14. Describe the lacteals. 

15. What secretions enter the intestine near the pylorus, and from 

what? 

16. Describe the large intestine, the coecum and its appendage. 

17. What are the accessory organs of digestion ? 

18. Describe the teeth, and their uses. 

19. What do human teeth indicate as to the proper- food of man ? 

20. Why should care be taken of the temporary or first set of fceeth? 

21. How should teeth be preserved? 

22. Describe the salivary glands, and their secretion. 

23. Describe the pancreas and i(s secretion. 

24. Describe the liver and state its functions. 

25. What is the process of the conversion o( food into tissue? 



142 DIGESTION. 

26. What is the chyme ? The chyle ? 

27. How are the fatty matters in food converted into an emulsion ? 

28. What is absorption, and where does it occur ? 

29. How do the absorbed products of digestion reach the general 

circulation ? 

30. What changes are effected after they have reached the blood? 

31. What is assimilation ? 

32. What is necessary to healthy digestion ? 

33. What are the effects of alcohol on digestion and the digestive 

organs ? 

34. What are the effects of tobacco, opium, etc. ? 



CHAPTER X. 
THE CIRCULATION. -BLOOD. -LYMPH. 

146. The Organs of Circulation. — The blood, as we have 
seen, is the form which the nutritive constituents of food 
take after digestion. It flows as pure blood in one set of 
currents from the heart to the tissues for their nourish- 
ment, and returns in another set of currents to the heart, 
laden with waste products, which are expelled from the 
body through the lungs and other excretory organs. This 
flow of the blood to and from the various parts of the body 
is the circulation, and the organs through which it is pro- 
pelled are the organs of circulation. These organs are the 
heart and the blood-vessels, the latter consisting of the 
arteries, capillaries, and veins. There is in reality only 
one circulation, but the heart sends out two streams of 
blood : one to the lungs, which returns again to the heart, 
sometimes called the pulmonary, respiratory, or lesser, circu- 
lation ; the other through the rest of the body and back 
to the heart, called the systemic, or greater, circulation. 

147. The Heart is a hollow, muscular, conical-shaped 
organ, in adults about five inches long. It is situated 
obliquely in the chest, between the two lungs, and behind 
the lower two-thirds of the breast bone, its posterior por- 
tion in part resting upon the diaphragm. It is chiefly on 
the left side of the body. Its tip, or apex, is directed 
forward and downward, striking against the walls of the 
thorax, between the fifth and sixth ribs, a little to the left 

143 



144 THE CIRCULATION. -BLOOD. — LYMPH. 




Fig. 62. 
Front View of the Organs of Circulation. - Veins, black ; arteries, with transverse 
lines Parts on the right side of figure are removed to show some of the deep 
vessels, while the left side shows superficial vessels. 



THE CIRCULATION. — BLOOD. — LYMPH. 



145 



of the breast bone, at which point we can usually best 
feel the impulse of the organ. Its broad attached end, 




Fig. 63. 
Heart, Front View. 



1, right ventricle. 

2, left ventricle. 
4, right auricle. 
6, left an ride. 



7, pulmonary artery. 

8, the aorta. 

9, superior vena cava. 



10 and 11, front coronary artery and 
vein which In part control the blood- 
supply of the substance o( the heart. 

12, lymphatic vesSels. 



or base, is directed upwards and backwards and to the 
right. Owing to its surroundings, this end of the heart 
has comparatively little motion. 



146 



THE CIRCULATION. — BLOOD. — LYMPH. 



148. The whole organ, with about two inches of the 
great blood-vessels which arise from it, is enveloped in a 
fibrous sac known as the pericardium. 1 This sac is lined 
with a smooth, glistening membrane, which secretes a 
lubricating fluid called serum, thus permitting the heart 
to move freely and without friction. The interior of the 
heart is also lined with a smooth, serous membrane, called 
the endocardium? which is similar to and continuous with 
the lining membrane of the blood-vessels. 



J)V... 



AV 




LV 



RV- 






The Heart and Some of its Vessels. The ventricles are laid open to show their structure. 
The relative thickness of the walls of the ventricles are shown, also the muscle columns 
and their tendons, together with the curtain-like valves. 



A, aorta. 

P A, pulmonary artery. 

P V, pulmonary veinsof left auricle. 



E V, right ventricle. 
L A, left auricle. 
D V, descending vein, 
superior vena cava. 



A V, ascending vein, 
inferior vena cava. 
L V, left ventricle. 



149. Component Parts of the Heart. — The heart is divided 
by muscular walls into four compartments or cavities, the 



1 Derived from the Greek, signifying " around the heart. 

2 Derived from the Greek, signifying " within the heart.' 



THE CIRCULATION. — BLOOD. — LYMPH. 147 

two upper ones called auricles, 1 and the two lower, ven- 
tricles. 2 Into the auricle on the right side of the heart — 
i.e. the right auricle — open small veins, which take the 
venous or impure blood from the substance of the heart, 
and also two large veins, 3 one of which brings the same 
kind of blood from the upper half of the body, the other, 
that from the lower half. Into the auricle on the left 
side of the heart — i.e. the left auricle — four 'pulmo- 
nary veins open (two from each lung), bringing blood 
that has been purified in the lungs. When the auricles 
are full of blood, they contract simultaneously and force 
it into their respective ventricles, through openings (one 
between each auricle and its ventricle) that are known 
as the auriculo-ventricular openings. From the right 
ventricle arises the pulmonary artery, which carries 
venous blood to the lungs to be purified. From the left 
ventricle arises the aorta, which carries pure blood to all 
parts of the body. When the ventricles are full, they 
contract simultaneously and expel the blood into these 
arteries. 

The openings between the auricles and ventricles, and 
those between the ventricles and the arteries which con- 
nect with them, are guarded by little doors or valves, 
composed of delicate but strong fibrous tissue. These 
open to allow the blood to pass onward in its natural 
course, and then close, thus preventing the blood from 
regurgitating, i.e. flowing back. The cavities of the left 
side of the heart are respectively smaller than those of the 
right, but their walls are stronger. Especially is this true 

1 From the Latin, meaning "little ears," so called, it is said, from 
their resemblance to dogs' ears. 

2 Literally, the diminutive of stomach. 

8 Called the superior and inferior vena cavac. 



148 THE CIRCULATION. — BLOOD. — LYMPH. 

of the left ventricle, whose function it is to send blood 
through the entire body (Fig. 64). 1 

150. The Valves of the Heart are arranged as follows : 
the mitral 2 valve, between the left auricle and left ven- 
tricle, is composed of two curtains, or flaps ; and the 
tricuspid, 8 between the right auricle and right ventricle, of 
three flaps. These curtains in each opening are attached 
on one side to the margin of the opening, and hang 
suspended in the ventricles when blood is passing into 
these cavities. To their free edges are fastened delicate 
but strong tendons (chordae tendineae), which are at- 
tached to muscular prolongations from the inside of the 
walls of the ventricles, known as papillary muscles. The 
alternate contraction and relaxation of these muscles, as- 
sisted by the action of other muscle fibres in the ventri- 
cles, open and close the valves. When the ventricles are 
filled with blood, these muscles relax, and the free edges 
of the curtains come together. 

The three valves at the beginning of the pulmonary 
artery and of the aorta, known as semilunar valves, are 
crescent-shaped pouches attached to the margins of the 
openings. When blood is forced from the ventricles by 
their muscular walls, these valves are pushed against the 
sides of the arteries named, but immediately afterwards 
they come together. The closure is effected by the con- 
traction of the muscular fibres in the walls of the vessels, 
and by the backward pressure of the blood current. 

1 Sometimes the heart is considered as a double organ ; the right side, 
transmitting venous blood, is spoken of as the right heart, and the left side, 
transmitting arterial blood, as the left heart. 

2 From a supposed resemblance, when it is open, to a bishop's mitre. 

3 Having three points. 



THE CIRCULATION. — BLOOD. — LYMPH. 149 

151. Action of the Heart. — The heart acts like a force 
pump, and is the principal instrument by which the blood 
is kept moving through the blood-vessels. Its muscular 
walls are well adapted for this persistent and difficult 
work, the fibres being strong and interlaced. The auricles 
have two layers of fibres, and the ventricles, which do 
much harder work, have several layers, one of them 
spiral. 1 When the auricles have emptied themselves, they 
relax, and again fill with blood. The contraction of the 
ventricles begins toward the end of the contraction of 
the auricles, the auriculo- ventricular valves closing and the 
semilunar valves opening. When the blood is discharged 
from the ventricles, they relax and the semilunar valves 
close. The contraction of the ventricles follows so closely 
that of the auricles, and is so much more pronounced, that 
the whole heart seems to contract at one time. 2 

152. The alternate contractions and relaxations of the 
auricles and ventricles cause the heart to roll somewhat, 
and to elongate, pushing its apex against the chest wall. 
These movements constitute the pulsations, or throb- 
bing, of the heart. They are so constant that the organ 
seems never to have rest ; but the alternate periods of 
relaxation, short as they are, afford in the aggregate con- 
siderable rest to the busy muscles of the heart. 

The contraction of the muscles, especially those of the 
ventricles, and the closure of the valves of the heart give 
rise to what are known as heart sounds, which can be 
heard by placing one's ear over the heart of another and 

1 The valves, vessels, walls, and internal muscles may bo studied in a 
beef's heart, In a boiled heart, the muscles of the walls can be separated. 

2 The contraction of the heart is known as its systole, the relaxation as 
its diastole. 



150 THE CIRCULATION. — BLOOD. — LYMPH. 

m contact with the chest, or by means of an instrument 
called the stethoscope. These sounds are termed the first 
and second sounds, and changes in their rhythm, intensity, 
or pitch are indications to the physician of the character 
of any disturbance or disease in the heart. 1 

153. Nervous Control of the Heart. — The steady, rhyth- 
mical pulsations are controlled by a nervous mechanism 
within the heart. In addition, the action of the heart is 
regulated to the varying needs of the body, by one set 
of nerves that originate in the brain and by another from 
the spinal cord, which decrease or increase the pulsations, 
as may be necessary. Influences which operate upon the 
nervous system operate also upon the heart. Its move- 
ments are decreased in frequenc}^ by sorrow or depres- 
sion of spirits, and quickened by mental excitement, joy, 
or anger ; hence the expressions, " one can hear his 
heart beat," or "his heart is in his throat," or "it beats 
like a trip-hammer." The temperature of the surround- 
ing atmosphere, the quantity of food eaten, the age, sex, 
and muscular activity also affect the rapidity of the 
heart's action. 2 

154. Heart Beats. — At birth the number of beats is 
normally about 140 per minute, at the end of the first year 
120, at the end of the second year 110 ; during middle 

1 Normally, these sounds are nearly on the same key, and resemble the 
syllables lub dup. 

2 Functional derangement of the heart, causing pain and violent pal- 
pitations, may readily occur by repeated nervous excitement in feeble 
persons or those who, though physically strong, lack self-control. The 
heart is sometimes strained and injured in some one or more of its struc- 
tures by excessive muscular exercise, especially in rowing, bicycle riding, 
prolonged marches, and fighting. Its action is sometimes enfeebled by 
the deposit of fat in its walls, as the result of a sedentary life or the 
repeated over-indulgence in alcoholics or fat-making foods. 



THE CIRCULATION. — BLOOD. — LYMPH. 151 

life it varies from 70 to 80, being about 10 more in women 
than men, and in old age is about 60. 

The normal frequency of the heart's action varies with 
the temperament, family tendency, and mode of living of 
the individual. Of Napoleon I. and the Duke of Wel- 
lington it is said the pulsations were but 40 per minute. 
In some persons, especially those with excitable, nervous 
temperaments, they number 90 or even more. Very rapid 
action tends to exhaust the heart ; yet the vitality of the 
organ is remarkable. In man and other warm-blooded 
animals it is the last organ to cease giving signs of life, 
and even when it has ceased to beat, electricity has again 
aroused its action. 1 In cold-blooded animals, such as 
the frog and snake, whose heart-action is comparatively 
slow, the heart will continue to throb after the animal has 
been beheaded, and even after the heart itself has been 
removed from the body. 

155. The Arteries 2 are a series of cylindrical, firm, but 
elastic canals, which commence with the aorta, and by 
divisions and subdivisions convey the blood to all the vas- 
cular parts of the body. 3 The larger arteries are com- 



1 The ancients regarded various organs of the body as seats of the 
emotions. The spleen was the seat of anger and melancholy, hence the 
term "splenetic " ; while the heart was the seat of joy, love, harmony, and 
the like. The words "courage, 1 ' "cordiality," "heart-felt,'' "hearty" 
"heartiness," etc., have their derivation in this idea. 

2 So named from two Greek words, meaning "receptacle of air," 
since the ancients believed that these blood-vessels contained air only, — 
probably because they generally found them empty in the dead body. 
Arteries do not collapse when cut, as veins do. A firm tube of rubber 
will give a fair idea of what an artery is ; while a tube with thin, flexible 
walls represents a vein. 

3 Arteries are found in every tissue except the hair, nails, epidermis, car- 
tilages, and the cornea of the eye. Bui blood reaches the cells ofthese tissues 
by a peculiar process of absorption known as imbibition, or •• drinking in." 



152 



THE CIRCULATION. — BLOOD. — LYMPH. 



posed of three coats : first, a smooth, delicate, and slightly 
elastic inner wall, similar to, and continuous with, the 
endocardium and the lining of the veins and the capil- 
laries ; next, a middle coat, composed of 
elastic and muscular tissue ; and lastly, 
a very strong outer coat, composed of 
fibrous and elastic tissue with some 
muscular fibres. 1 As the arteries be- 
come smaller, the external coat disap- 
pears ; hence the very small arteries 
(arterioles) have but two coats. In the 
capillaries (which connect the smaller 
arteries with the rootlets of the veins) 
the middle coat also disappears, and the 
thin, delicate, circular wall that remains 
is well adapted for the transudation of 
gases and fluids. 2 
The smoothness of the lining wall prevents friction. The 
elasticity of the arteries permits them to yield without 
danger of bursting, as the blood is thrown into them with 
each stroke of the heart, and also enables them to accom- 
modate themselves to the various movements of the bodv. 




Fig. 65. 



En- 
lvm- 



A Part of an A rtery 
veloping it are 
phatics and lymphatic 
glands. 



1 The outer coat is so strong that when a surgeon ties (ligatures) an 
artery, it is not broken. The two broken internal coats arrest and clot 
the blood and stop bleeding. Very seldom does a healthy artery rup- 
ture from the force of the blood current. The walls of the arteries 
are nourished by blood conveyed to them by little arteries called vasa 
vasorum. Corresponding vessels also supply the heart. The elasticity 
of the larger arteries will be best appreciated in the aorta of an ox or 
sheep. Like a piece of india-rubber, it yields when stretched, and imme- 
diately thereafter recovers itself. 

2 If a large artery is ligatured, the small arteries which connect the 
portion of the artery below the ligature with that above, or with another 
artery, become enlarged and establish a collateral circulation. 



THE CIRCULATION. — BLOOD. — LYMPH. 153 

Their contractility affords them the power of adapting 
themselves to the variable quantities of blood which they 
contain, and which must be supplied to the tissues as 
required. As the blood is sent into the large arteries 
from the heart, the flow is intermittent. The caliber of 
the arteries, as they divide and subdivide, becomes smaller 
and smaller. But in the aggregate that caliber is greatly 
increased, and, owing to this and to their elasticity and 
contractility, the pulsations in the arteries are less inter- 
mittent as the arteries become smaller, and finally, in the 
capillaries, the blood current is uniform and constant, but 
slow. It thus becomes well adapted to furnish to each 
cell its appropriate nourishment, and to abstract from each 
its waste products. 1 

156. The Pulse. — With each beat of the heart, the 
arteries, already quite full of blood, are dilated by the 
additional blood sent into them. As the semilunar valves 



Fig. 66. 
Portions of Four Traces taken by the Sphygmograph, in Different Conditions of the Pulse. 

close, the arteries contract to assist the onward flow of 
blood. The pulsations thus produced constitute the 
pulse, or wave, in the arteries. This is usually felt at 

1 The motion of the blood in the arteries may be illustrated by con- 
necting a syringe, representing the left ventricle, with a large rubber tube, 
representing the aorta, which is connected with various tubes of gradually 
decreasing size, representing the subdividing arteries and the capillaries. 
The water is injected into the large tube in an intermittent and forcible 
current, which abates in the smaller tubes, and becomes continuous in 
the smallest. 



154 THE CIRCULATION. — BLOOD. — LYMPH. 

the wrist, but may be felt over any artery which is located 
near the surface, as in the upper lip, the chin, temples, 
elbows, and inner side of the ankles. To determine the 
character of the pulse more accurately than by the sense 
of touch alone, an ingenious registering instrument, called 
the sphygmograph, may be attached to the forearm, and 
by means of a lever lightly resting on the pulse there will 
be registered with a pencil on prepared paper the char- 
acter of the pulsations. The character of the pulse is a 
fair indication of the action and strength of the heart, 
and is modified or altered by the same causes that affect 
the action of the heart. 1 

157. The Capillaries are hair-like blood-vessels, which 
permeate the vascular organs in networks variously 
arranged, and bring the blood into close contact with 
the cells of the tissues, but none of them enter the 
cells. 2 Though very small tubes, their number is great. 
Through them the blood is propelled very slowly and 
gently. Its nutritious ingredients ooze through the 
walls of these vessels into the surrounding cells, and 
some of the waste material from the tissues finds its way 
into the capillaries in the same manner. 3 In the glandu- 

1 Though the pulse generally averages a certain number of beats per 
minute (see § 154), it is increased or diminished at times by apparently 
slight causes, especially in young children. Thus, after crying, the pulse 
rises 10 to 20 beats, and is lowered the same amount during sleep. After 
a meal the pulse of an adult has from 5 to 10 beats more per minute than 
before ; 5 beats more when sitting than when lying down ; 10 beats more 
when standing than when sitting ; and 10 to 50 more beats when in 
motion than when at rest. 

2 Capillaries are about y^- of an inch in diameter, and are composed 
of thin, flat cells, united at their edges. 

3 The irrigation system in use in the western part of the United States 
seems to be modelled after the plan of the capillary circulation. Large 






THE CIRCULATION. — BLOOD. — LYMPH. 



155 



lar organs the capillaries supply the substance requisite 
for secretion ; in the villi of the intestine they take up 
the elements of the digested food ; in the lungs they ab- 
sorb oxygen and exhale carbon dioxide ; in the kidneys 
they discharge waste products collected from other parts. 




Fig. 67. 

Injected Cross-section of a Lobule of the Liver, showing' the capillary network between 
the portal and hepatic veins. Magnified 60 diameters. 

1, section of intra -lobular vein. 2, its branches collecting- blood from the capillaries. 
3, inte /'-lobular branches of the portal vein connecting with the capillary network, and 
supplying the lobule with blood for its nourishment. 



The capillary circulation thus furnishes, directly or indi- 
rectly, the materials for the growth and renovation of the 
entire body. This circulation is usually studied in a 
tissue which is transparent and vascular, such as the web 



ditches bring water from a reservoir into smaller ditches, ami these into 
still smaller ones, which pass between the plants. The water in these 
very small ditches moves slowly, oozing into the soil and among the 
rootlets. 



156 



THE CIRCULATION. — BLOOD. — LYMPH. 




V «-/ G 

Fig. 68. 

A Diagram of the Capillary Circulation, with 
arteries in white, veins in black. 

T, trachea, arrows representing incoming and 

outgoing air. 
D, the diaphragm. 
A, artery (the aorta). Y, vein. 

1, capillary circulation of head. 

2, vessels "of upper extremities. 

3, capillaries of the lungs. 

4, of the stomach. 6, of the spleen. 

5, of the liver. 7, of the pancreas. 

8, of a portion of small intestine. 

9, of the kidneys. 

10, vessels of lower extremities. 



of a frog's foot, or of a 
bat's wing, and is an 
exceedingly beautiful and 
interesting sight. 1 

158. The capillaries, 
having very thin and 
somewhat elastic walls, 
vary in size, at different 
times, in response to any 
exciting cause. They are 
largest when the part to 
which they are distribut- 
ed is functionally active. 

1 ' ' We see the great arterial 
rivers, in which the blood flows 
with wonderful rapidity, branch- 
ing and subdividing until the 
circulating fluid is brought to 
the network of fine capillaries, 
where the corpuscles dart along- 
one by one. The blood is then 
collected by the veins and carried 
in great currents to the heart. 
This exhibition to the student 
of Nature is of inexpressible 
grandeur ; and our admiration is 
not diminished when we come to 
study the phenomena in detail. 
... It can be seen how the 
arterioles regulate the supply of 
blood to the tissues ; how the 
blood distributes itself by the 
capillaries ; and finally, having 
performed its office, how it is 
collected and carried off by the 
veins." — Flint, Text-book of 
Physiology. 



THE CIRCULATION. — BLOOD. — LYMPH. 157 

Emotion and exposure to warmth dilate the small arteries 
by relaxing their muscular fibres ; and more blood at such 
times fills the capillaries in connection with them, so that 
the parts to which they are distributed " blush," or become 
ruddy. On the other hand, pallor is produced by con- 
tinued cold, anger, or fear, which cause the muscles to 
contract and the amount of blood in the small arteries 
and capillaries to be diminished. So numerous are the 
capillaries that their entire capacity is said to be " from 
five hundred to eight hundred times that of the arteries." 
Their extensive distribution may be appreciated when Ave 
consider that the slightest cut upon any part of the skin 
or mucous membrane which is sufficient to induce bleed- 
ing must cut across many capillaries. They are most 
numerous wherever the nutritive processes are most 
active, as in the lungs and glands and in the mucous 
membrane of the small intestine, and, during the func- 
tional activity of these parts, may be said to bathe them 
in blood. 1 

159. The Veins. — After the blood has parted with 
nutriment to the tissues, and absorbed waste products 
from them, it passes on from the capillaries into larger 
channels, called small veins or veinlets, and then into still 
larger ones known as veins. Waste products not so taken 
up are carried into the blood by another set of vessels, 
called the lymphatics, described in § 169. 

1 Blood carried to a part for a length of time, in larger quantity than 
is necessary for its nourishment, is liable to cause its inflammation and 
even its death. When the supply of blood is for a lengthened period 
much smaller than is demanded, failure in nutrition and death of the part 
may result; or, if a part has been long contracted, as by frost-bite, and 
blood is too suddenly brought into it, inflammation and death of the part 
may ensue. 



158 



THE CIRCULATIOX. — BLOOD. — LYMPH. 




Veins, like arteries, are composed of three coats, but 
they contain a smaller quantity of muscular and elastic 
fibres, and a larger proportion of firm 
connective tissue. They are conse- 
quently less elastic and contractile, and 
more compressible, though they have 
considerable capacity for resistance to 
pressure. They are also distinguished, 
in the limbs and in the external parts 
of the head and neck, by being pro- 
vided with valves so arranged that their 
closure prevents a backward flow of 
blood. The position of these valves 
may be seen by the little prominences 
that appear in the course of the superficial veins, if we 
tie a cord around the wrist or arm. 

The capacity of the venous system is greater than that 
of the arterial, owing to its numerous intercommunica- 
tions. If an obstruction occurs in a vein, the blood can 
therefore be diverted into one or more branches more 
readily than in the case of the arteries ; but the encircling 
of an entire limb with a tight band would obstruct the 
circulation in all the vessels of that region, and induce 
swelling below the band. 1 



Fig. 69. 

A Part of a Vein, with its 
branches laid open, 
showing the valves. 



160. The Circulation of the Blood. — The movements of the 
blood will probably be best understood if we follow it 
from point to point in its circuit. 

In the first place, the venous or impure blood, collected 



1 Such is sometimes the effect of tight garters. Persons whose vocation 
necessitates much standing sometimes have "varicose veins," or knotted 
veins of the legs, due to impeded flow of blood through these vessels. 
In such cases, elastic stockings should be worn to support the vessels. 




Fig. 70. 

Diagrammatic Representation of the Circulation through the Heart and Body. Arrows 
show the direction of blood currents. 



RA, right auricle. 

LA, left auricle. 

RV, risrht ventricle. 

LV, left ventricle. 

1,1, superior and inferior vena-cavae. 

2, pulmonary artery. 



3, 3, branches of pulmonary artery. 

4, 4, pulmonary veins. 

5, arch of aorta. 

6, branch to upper part of body. 

7, branch to lower part of body. 

8, heart. 



THE CIRCULATION. — BLOOD. — LYMPH. 159 

by the smaller veins from the various parts of the body, is 
poured into two great veins, which open into the right 
auricle. When the auricle is dilated and filled to its nor- 
mal limit, its walls contract and expel the blood through 
the right ventricular opening into the right ventricle. 
This ventricle, thus dilated and filled, contracts, and 
expels its contents through the pulmonary artery into the 
lungs, where the blood is thoroughly distributed among 
the air cells by numerous capillaries, and is purified by 
exchanging its waste products for the oxygen of the air. 
From the lungs it is carried as pure blood by the pul- 
monary veins into the left auricle. When this auricle is 
normally dilated and filled, it contracts, and the blood is 
forced through the left ventricular opening into the left 
ventricle. This ventricle, when dilated and filled, con- 
tracts, and sends the blood into the aorta, and through its 
branches to the capillaries for the nourishment of the tis- 
sues. Having parted with much of its life-giving prin- 
ciples and acquired the results of decay and disintegration 
in the tissues, the blood requires to be again purified, and 
commences, at the extremities or sources of the venous 
system, its return to the heart. Passing successively 
through the enlarging veins, as though it were a river 
system, with its springs, brooks, and rivulets, or like the 
rootlets enlarging into the roots of a tree, it finally again 
reaches the right auricle. 1 

1 From 1545 to 1586 several persons described portions of the circu- 
latory apparatus and their function. In 1602 Harvey began his investiga- 
tions upon living animals, and in 1616 discovered the circulation of the 
blood. His description of the movements of the heart is forcible, clear. 
and accurate. Of the heart, he says, "by an admirable adjustment all 
the internal surfaces are drawn together, as if with cords, and so is the 
charge of blood expelled with force." Like other investigators in the 
same field, Harvey was subjected to much persecution. 



160 THE CIRCULATION — BLOOD. — LYMPH. 

161. The force and rapidity of the circulation are very 
great, but differ widely in the various sets of vessels and 
in the different organs. The average time required for 
the passage of the blood from the heart to the tissues 
and back is about twenty seconds. 1 The flow into the 
arteries and through the capillaries is effected by the 
powerful contractions of the heart, aided by the contrac- 
tility and elasticity of the arteries, and, in the case of the 
capillaries, also by the elasticity of the surrounding tis- 
sues. So great is the force exerted, that if a large artery 
be cut across, the blood spirts to a distance of several feet. 

In health, both arteries and veins readily withstand 
the force of the circulation ; but when weakened by age, 
injury, or disease, they may burst under unusual exer- 
tion, such as fast Avalking or running, the lifting of heavy 
weights, or even by a sudden change of position, as in the 
quick rising from a recumbent posture. If vessels of the 
brain give way, paralysis or death may occur from the 
pressure of the escaped blood upon the brain. This con- 
dition is known as apoplexy. 

The flow of blood through the veins is more rapid than 
that through the capillaries, but considerably slower than 
the arterial current. It is effected by the pressure from 
the capillary circulation, by the contraction of the volun- 
tary muscles through which the veins pass, and by the act 
of inspiration, whereby the chest is expanded. This ex- 
pansion not only tends to draw air into the lungs, but also 
blood from the veins. 2 

1 Dalton estimates that the average rapidity of an arterial current is 12 
inches per second, of a venous current 8 inches per second, and the rate 
through the capillaries is rather less than -^ of an inch per second. 

2 If a vein, especially in the lower part of the neck, be wounded, and 
considerable air enters the blood, death is likely to result. "The air finds 



THE CIRCULATION. — BLOOD. — LYMPH. 161 

162. The Blood is eminently the "vital fluid." If from 
any cause much blood is lost, great weakness follows, 
and if the flow is not checked, death results. On the 
other hand, if fresh blood from a living person or animal 
be injected into the veins of one much prostrated, or even 
apparently dead, especially if this condition be the result 
of loss of blood, he may be revived. This operation is 
known as the transfusion of blood. 1 

163. To the eye, the blood seems to be merely a homo- 
geneous reel, scarlet, or dark-blue liquid, according as it is 
drawn from the capillaries, arteries, or veins. Blood has 
a salty taste, and a very small quantity of it is capable of 
staining a large amount of water. As shown by a micro- 
scopic examination, it consists of two parts, the plasma 
and the corpuscles. The first is an alkaline, transparent, 
and nearly colorless fluid, in which the corpuscles swim 
in countless numbers. 

164. Red Blood Corpuscles. — Blood corpuscles are of two 
kinds, the red and the white. The red are smaller than 
the white, and much more numerous. 2 The red color is 

its way to the right ventricle, is mixed with the blood in the form of 
minute bubbles, and is carried into the pulmonary artery ; once in this 
vessel it is impossible for it to pass through the capillaries of the lungs, 
and death by suffocation is the inevitable result." — Flint. 

1 The operation originated in the 17th century, and much was expected 
from its use, some believing that old people could be rejuvenated by using 
the blood of the young; but, after a number of deaths had resulted, it 
fell into disrepute. The operation has been revived, and. owing to im- 
proved surgical appliances and to a better knowledge oi the subject, 
excellent results have been obtained. Warm milk of cows lias been 
successfully used instead of blood. 

2 Tied corpuscles are about .,-' 00 of an inch in diameter, and about 
Joo of an 

in diameter. 



162 



THE CIRCULATION. — BLOOD. — LYMPH. 




'ws 

Fig. 71. 
Blood Corpuscles. 



due to the globules en masse; if viewed separately by 
transmitted light, they are of a light amber color. It has 
been estimated that there are five million red corpuscles 

in a minute drop (a cubic 
millimetre) of blood. 1 In 
form they are flattened, cir- 
cular disks, slightly hol- 
lowed out on each side, and 
under the microscope are 
seen to arrange themselves 
in rows, adhering together 
side by side like a roll of 
coins. They are of jelly- 
like consistency, very elastic 
and extensile, easily bent 
and distorted, and can be 
pushed through the walls of 
the capillaries. They con- 
tain water, salts of phosphorus, and potassium, but their 
most important ingredient is a reddish proteid substance 
containing iron, which gives the color to blood. This 
substance, called haemoglobin, has a strong affinity for 
oxygen, and unites with it; but the tissues, which have a 
stronger affinity, absorb a large part of the oxygen in 
combination with the coloring matter, and replace it with 
carbon dioxide. This changes the color of the blood from 
red or scarlet (depending on the amount of oxygen 
present) to a dark blue. On account of the life-giving 
oxygen thus carried by the red globules, they are some- 
times spoken of as "little boats laden with precious 

1 In persons who are very pale and have poor, thin hlood, the number 
of red corpuscles is estimated to be one-third less than the normal amount, 
which is from 300 to 400 of the red to every white corpuscle. 



M, of man. 
F, of the frog. 
WS. of the water sala- 
mander. 



S, of a shark. 
D, of the dove. 
0, of the camel. 



THE CIRCULATION. — BLOOD. — LYMPH. 163 

freight," which are in health despatched at the right time, 
to the right place, in the right quantity. 1 

The red globules of the blood of all vertebrate animals 
contain a coloring matter similar to, if not identical with, 
that of man, but differ from the globules of human blood 
as to form, size, and structure. The detection of this 
difference is sometimes of importance in courts of law in 
the decision of questions relating to the stains upon mur- 
derous weapons, or upon garments, floors, etc. 

165. The White Corpuscles, or leucocytes, are rounded, 
colorless cells, each containing a nucleus. They are com- 
posed of protoplasm, and have the power of amoeboid 
movement. 2 They move from place to place, and also 
"migrate," i.e. escape from the capillaries into the sur- 
rounding tissues. Powers says of this migration, or dia- 
pedesis, as it is technically called : " Under certain 
circumstances, both white and red corpuscles may escape 
from the vessels, and pass or wander into the adjoining 
lymphatics. The escape of the white corpuscles appears 
to occur normally, whilst the escape of the red occurs 
only when the pressure of the blood against the walls 
of the capillaries is much increased, or when there is 
retardation of the blood current, as in inflammation. In 
the case of the white corpuscles, the attraction between 
the corpuscle and the capillary wall seems to be increased, 
the corpuscle begins to bore its way through the wall, 
assumes an hour-glass form, part being within and part 



1 The red corpuscles are believed to be formed in the rod marrow of 
.bones, the lymphatic glands, and the spleen. After fulfilling their allot- 
ted task they are for the most part dost roved in the liver. 

2 These corpuscles are not peculiar to blood, but are found in lymph, 
chyle, and other fluids. 



164 THE CIRCULATION. — BLOOD. — LYMPH. 

without the lumen of the vessel, and it finally escapes 
altogether into the adjoining tissues." How far the 
nutritive processes are influenced by the migration of 
blood corpuscles is not definitely known. 

There is reason to believe that certain of the white 
corpuscles have the power of eating up bacteria and other 
noxious matter with which they come in contact, as the 
amoeba takes its food. Such cells are called phagocytes, 
and their principal function seems to be to destroy disease- 
producing bacteria which may have entered the body by 
the lungs, alimentary canal, or torn skin. Their number 
is probably decreased by fasting, and increased by good 
living, as are the white corpuscles in general. Successful 
resistance to infectious diseases is believed to depend 
largely upon the power and activity of the phagocytes. 
If they are overpowered by the number and strength of 
the bacteria, the invaded tissues die, and may slough 
away. 

166. Coagulation of Blood. — Blood coagulates, or clots, 
spontaneously when exposed to atmospheric air. This 
property is peculiar to blood. If it were not for this 
coagulation, we should be liable to bleed to death from 
even a slight cut. In most of the other warm-blooded 
animals, coagulation is more prompt and thorough than 
in man, and there may be extensive injury to blood-vessels 
without fatal results to the helpless animals. But man is 
able, by pressure for a time upon a bleeding vessel or by 
tjung the two cut ends, to cause coagulation, and so 
lessen the danger from extensive hemorrhage. 

Seldom does the blood clot in the living body, unless the 
circulation is impeded or arrested by some disease or by 
an injury to the inner coat of a blood-vessel. A clot 



THE CIRCULATION. — BLOOD. — LYMPH. 165 

formed in a blood-vessel may interrupt the blood supply 
to a part of the body and cause the death of that part, 
or it may be sent in the blood current to the brain, and 
cause paralysis of a portion of the body, or death of the 
entire body. A " bruise-spot " is the discoloration pro- 
duced by blood escaping from injured capillaries and 
coagulating in or under the skin. The rapidity with 
which it disappears depends upon the severity of the in- 
jury, the relative thickness of the skin, the vascularity of 
the part injured, and the health of the person. When 
blood is poor and thin, as in scurvy and other blood 
diseases, it flows readily from wounds or from the im- 
poverished tissues, producing dangerous hemorrhages and 
many bruised spots. The drawing of a tooth or the 
scratch of a pin in such cases is liable to result in severe 
bleeding. 

Coagulation is essentially the formation of fibrin, from 
the fibrinogen, a proteid constituent of the plasma, by the 
action of a fibrin ferment. The fibrin forms in inter- 
lacing threads, which entangle the corpuscles. Soon this 
network shrinks in all directions and squeezes out a 
pale yellowish fluid, the serum, which consists essentially 
of all the ingredients of the blood, except the corpuscles 
and fibrin. The semi-solid mass which remains is the 
coagulum, or clot, and retains most of the corpuscles. 1 

167. The Quantity and Quality of Blood. — The entire 
quantity of blood of an individual is about ten per cent of 

1 Fibrin may be seen in the fibrous filaments remaining after thor- 
oughly washing a clot of blood, or in the tine threads which cling to a 
bundle of twigs with which fresh blood has been thoroughly beaten for 
a time. Such blood remains uncoagulable, and is said to be detibrinated. 
Fibrin is so tough that buttons and door handles have been made from 
the blood of animals. 



166 



THE CIRCULATION. — BLOOD. — LYMPH. 



the weight of the body. Of this quantity about one-fourth 
is distributed to the heart, lungs, large arteries, and veins, 
one-fourth to the liver, one-fourth to the muscles, and 
one-fourth to the remaining organs and tissues. The 
brain utilizes one-fifth of the entire quantity of blood. 

The quality of blood varies much in different individuals. 
The old expressions, " rich blood," " poor blood," and 
" blood will tell " have much of truth in them in a physio- 
logical sense, for so-called " blood diseases " are often 
handed down from one generation to another. Blood 
may become so poor (thin and watery) from inattention to 
hygienic requirements that health is impossible. On the 
other hand, chilliness and pallor of countenance will dis- 
appear, strength and 

1 

m 




energy will return to the 
feeble, when poor blood 
has been enriched by 
good food, abundance of 
sleep, by warmth, clean- 
liness, and frequent ex- 
ercise in the open air. 



Fig. 72. 

Lymphatic Vessels ctf a Papilla of the Palm of the 
Hand, greatly magnified. 



168. The Lymph. —In 

addition to the blood, 
the lymph is widely dis- 
tributed throughout the 
body. It is, in fact, 
blood plasma (without 
the red corpuscles), 
which constantly exudes 
from the capillaries to 
bathe the cells of the 
tissues, bringing nutri- 



THE CIRCULATION. — BLOOD. — LYMPH. 



167 



tive material directly to them. From the cells it receives 
waste products and conveys them into minute and delicate 
vessels, called lymphatics, which drain the intercellular 
spaces, and finally empty into the blood current. 1 

169. The Lymphatics are most abun- 
dant in organs well supplied with 
blood-vessels, such as the glandular 
organs, the mucous membrane, and 
the skin (particularly that of the 
soles of the feet and the palms of 
the hands), and are absent in the 
non-vascular tissues. 2 

The lymphatic capillaries converge 
after leaving the various tissues, the 
tubes becoming larger as they ap- 
proach the heart. Those from the 
right side of the head and neck and 
from the right upper extremity form 
the right lymphatic duct, which opens 
into the venous system at the junc- 
tion of the right subclavian vein with 
the right internal jugular vein. The 
lymphatics of the lower extremities 
enter the abdominal cavity, and with 
the abdominal lymphatics (including 
the lacteals) form the beginning 
of the thoracic duct. At the base 
of the neck, before this duct empties 

1 These vessels are so small that they cannot bo readily soon unless 
injected with quicksilver. 

2 Those instances related of blood poisoning, by mere contact of poison- 
ous material with the tender parts of the skin or mucous membrane, are 
probably due to the absorption of the poison by the lymphatics. 




Fig. 73. 

Superficial Lymphatics of the 
Hand and Forearm. 

G, lymphatic eland. 



168 



THE CIRCULATION. — BLOOD. — LYMPH. 



into the left subclavian vein at its junction with the left 
internal jugular, it is joined b} T the lymphatics from the 



Lym r 



rij 

RSV 



RC 




Lym L 



■TD 
LSV 



TD 



Lac 



Lym L Ex - 



Fig. 74. 

Thoracic Duct. 

Lym R, lymphatics of right side of head and neck. 
Lym L, lymphatics of left side of head and neck. 
RIJ, right internal jugular vein. 
RSV, right subclavian vein. 
LSV, left subclavian vein. 



Lym L Ex 



TD, thoracic duct. 
RC, receptacle of the chyle. 
Lac, lacteals. 

Lym L Ex, lymphatics of 
lower extremities. 



left side of the head and neck and from the left upper 
extremity. Thus the lymph is mingled with the venous 



THE CIRCULATION. — BLOOD. — LYMPH. 169 

blood before its arrival at the right side of the heart. 1 
The flow of lymph is aided by valves in the lymphatics, 
similar to those in veins. 

170. Lymphatic Glands. — In the course of the lymphat- 
ics everywhere in the body are numerous little knots, 
called lymphatic glands. 2 These are spongy networks, 
which filter injurious bodies, such as bacteria, from the 
slowly moving lymph, and destroy them, if their number 
is not too great. It is believed that these glands also 
supply leucocytes to the blood. When many of them are 
hardened or otherwise altered, as in scrofula, health fails 
and the person grows thin, though the food may be suit- 
able in quality and abundant in quantity. 3 

171. Intimately connected with the circulation of blood 
and the conveyance of lymph are the operations of secre- 
tion, transudation, and absorption, which form a large part 
of the processes of nutrition. Though the various parts 
of the body are constantly changing, the general normal 
condition is maintained, through the movement and reno- 
vation of the blood and lymph. 4 

1 About the year 1600 the thoracic duct was discovered; in 1622 the 
lacteals, but until 1649 they were supposed to empty into the liver ; in 
that year (1649) the receptacle for chyle was discovered, and the fact that 
chyle was carried into it, and thence into the venous system. It was not 
until 1650 that the other absorbent vessels, i.e. lymphatics, were dis- 
covered, first in the liver, and then in the other parts of the body. 

2 About 700 in number. These glands are not infrequently enlarged, 
— for instance, upon the head, or in the neck, from some irritation of 
the skin, from a sore throat, etc., — and can then be readily felt. 

8 The lymph current is a very slow side-stream to the blood current, 
and seems to provide for emergencies, absorbing the excess of plasma 
and the excess of wastes. 

4 The spleen, thymus gland (a gland found in children upon the front 
of the neck), and other ductless glands, in connection with the blood- 



170 THE CIRCULATION.— BLOOD. — LYMPH. 

172. The Spleen is a dark, purplish organ, situated in 
the left side of the abdomen, near the stomach. It has 
a firm capsule, but its interior is a sponge-like tissue, 
containing in its meshes the spleen pulp. This pulp is 
composed of red and white blood corpuscles. The blood 
circulates abundantly through the spongy tissue, but not 
in firm tubes. The spleen becomes gradually distended 
with blood after a hearty meal or after severe exercise, 
and then shrinks. It also enlarges and hardens when the 
blood has an excess of white corpuscles, as in malarial 
and other diseases. 1 The function of the spleen seems 
to be to supply leucocytes to the blood, and to renovate 
or destroy some of the old and worn-out red corpuscles. 

173. Effects of Alcohol and Narcotics upon the Organs of 
Circulation and the Blood. — Diluted alcohol, taken inter- 
nally, is readily absorbed by the blood. In small amount, 
it slightly increases the action of the heart and the flow 
of blood, produces flushing of the face, glistening of the 
eyes, and a general stimulating effect. Repetitions of this 
excitation frequently lead to the taking of larger and 
larger amounts. These tend to tire the heart and blood- 
vessels, and to weaken their walls by the deposit of fat or 
of calcareous matter, especially in the arteries. A heart 
so weakened gradually becomes too feeble to pump the 
amount of blood necessary to sustain more than ordinary 
muscular exertion, and may give out when overtaxed. 
The diseased arteries from the same cause may rupture, 
and paralysis or death result. 

vessels, elaborate in a similar manner formative constituents of the blood. 
When these glands are diseased, the blood is likely to be more or less 
white and watery. 

1 So enlarged and hardened it is known as " ague cake." 



THE CIRCULATION. — BLOOD. — LYMPH. 171 

174. Tobacco, used habitually, may produce through 
the nervous system functional derangement of the heart, 
known as "tobacco heart," attended by pain, faintness, 
and severe palpitations. This functional derangement, in 
a naturally weak organ, may lead to structural or organic 
disease of the heart. 

175. While opium and other narcotics readily enter the 
blood and impair it, their action in the body is manifested 
principally in derangement of the general nervous system. 



QUESTIONS. 

1. State what is meant by the circulation, and what is its object. 

2. "What are the organs of circulation ? 

3. What is the chief organ, where situated, and what is its structure ? 

4. How does the blood pass from the auricles to the ventricles ? 

5. What keeps it from returning from the ventricles to the auricles? 

6. What other valves are there in the circulation, and where ? 

7. By which side and parts of the heart is pure blood transmitted? 

8. Describe the circulation of the blood. 

9. Does the heart, like other muscles, have rest ? 

10. How are the movements of the heart effected? How affected? 

11. What can you say as to its vitality? 

12. Describe the arteries and their function. 

13. What is the pulse and its rate ? 

14. What causes blushing and pallor ? Apoplexy ? 

15. Describe the capillaries. 

16. How are the nails, cartilage, etc., nourished? 

17. Describe the veins. 

18. Where, then, would you compress a bleeding artery to stop its 

flow ? Where a vein ? 

10. What facts show the importance of blood? 

20. Of what is blood composed? 

21. How does it appear under the microscope? 

22. What is the function of the red corpuscles? 



172 THE CIRCULATION. — BLOOD. — LYMPH. 

23. What is the coagulation of the blood, its cause, and value ? 

24. When does blood clot in the blood-vessels ? 

25. What is paralysis ? A bruise ? A hemorrhage ? 

26. What proportion, in weight, of the body is blood ? 

27. Describe lymph, lymphatics, and the lymphatic glands. 

28. Where do the lymphatics empty ? 

29. What processes of nutrition are intimately connected with the 

circulation of blood and lymph ? 

30. What are the effects of alcohol, tobacco, etc., upon the blood and 

organs of circulation ? 



i 



CHAPTER XI. 
POOD. -DIETETICS. 

176. The Uses of Food. — Food, in a physiological sense, 
is anything which, when introduced into the system, will 
nourish some part of the body, supply heat or other form 
of energy, or aid in the discharge of the various processes 
which take place in the body. Some indigestible and in- 
nutritious materials (such as bran and the skins of small 
fruits), when associated with food substances, are impor- 
tant aids, if taken in moderate amount, in stimulating the 
alimentary canal. Substances too much refined are not 
the best adapted to persons in health. 

Food that produces heat or other forms of energy in 
the body may be considered as fuel, for it is literally 
burned, just as coal is burned in an engine to produce 
heat and work. This is accomplished by its combination 
with the oxygen of the atmosphere, which we inhale in 
breathing. Though we do not call oxygen a food, it is 
such in reality, as without its aid, food substances would 
be of no service in the body. 

Food which is used in excess of the daily requirements 
of the body is stored in the system for future needs, prin- 
cipally in the form of fat. When a person is starving, 
the body uses this reserve fat, before it feeds upon its 
muscles and other albuminous tissues. As these tissues 
are consumed, the body becomes weaker and weaker, until 
death results. How long a person can live, absolutely de- 

173 



174 FOOD. — DIETETICS. 

prived of food, depends upon how much reserve material 
he has, and also upon how warm he can be kept and the 
amount of exercise he takes. 

177. Sources of Food. — Food is furnished to us by all 
the kingdoms of nature ; and as our knowledge extends, 
new food products are discovered. It is worthy of note 
that the ordinary food supply of different countries varies 
in kind and quantity, and that substances highly esteemed 
by some parts of our race are repulsive to us, while 
some of our most valued foods are considered by others as 
even poisonous (a). Unlike the lower animals, man can 
prepare, by sifting, grinding, cooking, etc., such food as he 
cannot or does not care to eat in its natural state. He is 
thus able to remove what may be hurtful, and to retain 
what is beneficial. 

178. The Food Elements 1 needed by the body are proteids, 
carhohydrates, fats, salts, and water. No one of these food 
elements alone can support life. Experience has shown 
that they are all needed, the proportion of each vary- 
ing, according to the requirements of the individual, for 
warmth, for repair of tissues, and for energy in mental, 
muscular, or other work. 

179. Proteids contain nitrogen, carbon, hydrogen, and 
oxygen, and some of them also sulphur and phosphorus. 
Being the only food elements which contain nitrogen, they 
are specified as nitrogenous, and the foods of which they 
form the principal part are nitrogenous foods. From 
their resemblance to albumin — the most prominent of 

1 Sometimes called nutritive ingredients, alimentary principles, food 
principles, or proximate principles. 



FOOD. — DIETETICS. 175 

the proteid elements — they are also called albuminoids, 
and the foods which contain them in large amount are 
known as albuminous or albuminoid foods. 

180. Sources of Proteids. — The proteids of food are 
obtained from both the animal and the vegetable king- 
doms, for albuminous compounds exist not only in nearly 
every animal fluid and tissue, but also in vegetables, espe- 
cially the cereal grains. These grains, and such vege- 
tables as beans and peas, which are rich in proteids, may 
sometimes be substituted for animal food. While the 
nitrogenous constituents of vegetable food are similar to 
those of animal food, their relative quantity is much 
smaller, and the indigestible residue of vegetable food is 
much larger in amount. 

The principal proteids of animal food are albumin, 
myosin, fibrin, and casein ; of vegetable food, albumin, 
gluten, and casein. 

Albumin is found in flesh, blood, milk, in many vege- 
table juices and solids, and in its purest form in the 
white of eggs. 

Myosin is the basis of lean meat, and fibrin is found in 
its fibrous portion. 

Gluten exists in variable quantity in the cereal grains, 
being most abundant in wheat. It is a highly nutritious 
compound, composed of several albuminoids, together 
with oil and inorganic matter. 1 Gluten gives to dough 
its adhesive character. 

Casein exists in milk, and in a coagulated form in 
cheese. It is also extracted from beans, peas, and similar 

1 Gluten is easy of digestion, and substances which contain it in con- 
siderable amount are readily digested, even by invalids and dyspeptics. 



1 76 FOOD. — DIETETICS. 

vegetables, and is then known as vegetable casein, or 
legumin. 1 



181. Value of Proteids. — Proteids are the 
tissue-forming elements of food. They build up the nitroge- 
nous materials of the bod}^, — i.e. muscles, tendons, etc., — 
and supply the albuminoids of blood, milk, and other fluids. 

From the presence of albuminous substances in the 
animal economy, the necessity of a sufficient supply of 
albuminoids in food is evident, yet they cannot of themselves 
alone support life. Animals fed exclusively on them lose 
appetite, become emaciated, and die of starvation. Though 
they are of great importance, and exhaustion follows more 
rapidly when they are withheld than when the body is 
deprived of certain other food constituents, yet to dis- 
tinguish them as " the nutritious " elements of food is 
misleading. This misunderstanding as to their value is to 
be regretted, for the value of other food constituents is 
thereby lost sight of. When proteids are used in larger 
amount than is needed to build and repair the tissues, some 
of them are burned to produce energy ; others are probably 
converted into fat. In a way not thoroughly understood, 
more fat is stored in the body when proteids (especially 
meat) are eaten with fatty food, than when the latter 
alone is eaten. 

182. Excessive Use of Proteids. — Albuminous substances 
can be eaten for a longer time without loathing than most 
other food constituents. The foods which contain them, 
especially meat, are for the most part palatable, and give 
us the " sensations of energy, of feeling up to the mark, 

1 " The article called tao-foo, made by the Chinese from peas, is 
apparently identical with cheese." — Flint, Text-book of Physiology. 



FOOD. — DIETETICS. 177 

of being equal to work, which are so pleasant to all." 
Hence they are apt to be consumed in too large quan- 
tities, and the stimulus afforded by such food is quite 
often obtained at the risk of biliousness and gout, for the 
waste products resulting from the digestion of so much 
nitrogenous food are not thoroughly eliminated from the 
body, and act as poisons in the blood. Especially is this 
the case if there is insufficient exercise, if the digestive 
secretions are not sufficiently abundant or active, or if the 
liver and kidneys are not in healthy working order. 1 

183. Nitrogenous, Non-albuminous Food Elements are asso- 
ciated with some food substances. They are known as 
gelatinoids, nitrogenous extractions, and amids. They can- 
not take the place of albuminoids, but afford some heat and 
energy. Examples of such substances are the gelatinous 
material of connective tissue, collogen of tendon, ossein 
of bone, kreatin, and allied compounds, which are the 
chief ingredients of beef teas and of most beef extracts. 
Combined with fats and carbohydrates these substances 
enable the body to do with less proteids. Gelatine, often 
given to invalids in the form of jelly, does not act as a 
body builder and restorer. 2 



1 Luxurious and well-to-do people frequently eat too much, especially 
of rich, albuminous food, and take too little exercise. A business reverse 
which compels them to live on simpler food and to take more exercise is, 
so far as their health is concerned, a blessing- in disguise. 

2 In 1841 the physiologist Magendie, in connection with a French com- 
mittee of investigation, showed that animals fed on pure albumin, fibrin, 
or gelatine lost their appetites and died, with all the evidences of starva- 
tion, about the twentieth day. On the other hand, raw bones, containing. 
as they do, fat, albumin, water, and salts, as well ns gelatine, are capable 
of supporting life. The same committee fonnd that dogs could live and 
be nourished for a considerable time on gluten alone. 



178 FOOD. — DIETETICS. 

184. Carbohydrates and Fats consist of carbon, hydro- 
gen, and oxygen, but the amount of ox} T gen is greater in 
the carbohydrates than in the fats. Carbohydrates of 
vegetable origin are the starches, cane and grape sugar, 
dextrin, gums, and cellulose (woody fibre). Those of 
animal origin are lactose, or sugar of milk, and glycogen 
(animal starch). Carbohydrates constitute a large pro- 
portion of all cereal grains. 

185. Value of Carbohydrates. — Carbohydrates and fats 
are the chief fuel constituents of food. Both are readily 
oxidized in the body, giving off water and carbon dioxide. 
Their oxidation produces proportionately more heat and 
muscular power than that of proteids. Both are trans- 
formed into the fat of the body, and are mainly re- 
sponsible for the storage of fat. The Tyrolese chamois 
hunters, it is said, find that they can endure greater 
fatigue with beef fat as their food than with the same 
weight of lean meat. The strength of the Hindoo and of 
the Irishman, the one living mainly on rice and the other 
on potatoes, is well known. Still, the amount necessary 
of such foods to furnish that strength is very large in 
comparison with that required by a mixed animal and 
vegetable diet. Necessary as are the carbohydrates and 
fats, like the albuminoids and other alimentary principles, 
none of them alone will support life. 

Either carbohydrates or fats, if used frequently or in 
large quantities to the exclusion of other food elements, 
are not easily digested, and may prove injurious. Vege- 
tables which contain a considerable amount of carbo- 
hydrates need to be well cooked, especially if they are old 
or hard, in order to soften the tough cellulose and break 
up the starch granules. We can readily digest a large 



FOOD. — DIETETICS. 



179 



part of the cellulose of young and tender plants, like let- 
tuce, celery, asparagus, and carrots. 1 

186. Starch is the principal carbohydrate in vegetable 
food, and though ordinarily a fine white powder, under 
the microscope it is seen to consist of granules. These 
vary in size and form, according to the kind of starch. 2 

Starch is distributed through the vegetable kingdom 
in the form of thin cells, in tubers, seeds, stems, and fruit. 




A B 

Fig. 75. 
A, Cells of raw potato, starch B, Cells of partially cooked 



granules in natural condi- 



potato. 



C, Cells of a thoroughly- 
cooked potato. 



tion. 



It is especially abundant in the cereals, and in potatoes, 
chestnuts, beans, rice, and peas. Arrowroot, tapioca, and 
sago, which are extractions from various plants, are nearly 
pure specimens of starch. 

1 "The different nutrients can, to a greater or less extent, do one 
another's work. If the body has not enough of one for fuel, it can use 
another. But, while the protein can be burned in the place of fats ami 
carbohydrates, neither of the latter can take the place of the albuminoids 
in building and repairing the tissues. At the same time the gelatinoids, 
fats, and carbohydrates, by being consumed themselves, protect the 
albuminoids from consumption." — Prof. W. 0. Atwater. 

2 "They cannot be distinctly seen with the naked eye, ami are so ex- 
tremely minute that wheat Hour, ground to an impalpable dust, contains 
its starch granules mostly unbroken and perfect." 



180 FOOD. — DIETETICS. 

Cooked starch is more readily digested than raw, as 
cooking causes the granules to swell and burst. A homo- 
geneous jelly-like mass results, composed mainly of dex- 
trin, or transformed starch, which is readily changed into 
maltose by the digestive secretions. A crust of bread, 
with its starch changed into dextrin by thorough cooking, 
is more digestible than the inside of the loaf, where the 
starch is too frequently not sufficiently cooked. During 
the process of maturing, a part of the starchy contents of 
fruits and vegetables is changed into dextrin by the fer- 
ment action of a peculiar vegetable substance known as 
diastase. This is the principal reason why ripe fruit is 
more digestible than unripe. 1 

Though cooked starch is in general promptly trans- 
formed by the digestive process, if taken in excess, to the 
exclusion of other food material, fermentation results, the 
appetite is weakened, and digestion is impaired. There- 
fore, persons living chiefly on bread and tea, or on bread 
and potatoes, or, as sometimes happens in the case of 
young children, upon arrowroot and corn starch, often 
suffer from an acid stomach. 2 

187. Sugar is closely related to starch in chemical com- 
position, but is distinguished by its sweet taste, its solu- 
bility in water, and the crystallization which occurs upon 
boiling a watery solution. Some varieties of sugar read- 
ily ferment — that is to say, decompose, and are converted 
into alcohol and carbon dioxide — on exposure to heat and 

1 Gums, mucilages, and other substances known as amyloids, and 
associated with starch in certain vegetables, have comparatively little 
food value. 

2 Starchy foods should be given sparingly to very young children, in 
whom the saliva and pancreatic juice are not very efficient. 



FOOD. — DIETETICS. 181 

moisture, or in the presence of an organized substance 
known as yeast. 

There are several varieties of sugar. The most im- 
portant of these are cane sugar, glucose or grape sugar, 
and milk sugar. 1 Of these varieties, cane sugar is the 
sweetest and most soluble. 

Sugar has a high fuel value, and renders other food 
more palatable. It is absorbed into the system almost as 
quickly as water, acts promptly, and is especially service- 
able when the diet is deficient in starch and fat (a). But 
if used immoderately it may make the consumer unduly 
fat, interfere with the appetite for more substantial food, 
and cause acidity of the stomach and decay of the teeth. 
Good candy — i.e. candy not impaired by deleterious 
coloring matter or other substances — can be safely used 
by most persons, if eaten in moderation. 

188. Fats are obtained principally from the fatty tissue 
of animals and from cream. Many vegetable substances 
also contain fat, especially oats and Indian corn, cocoa, 
beans, nuts, and olives. The digestibility of fat varies 
with individuals, and with the kind eaten ; some persons 
dispose easily of that of bacon or beef, while others readily 
digest fresh butter only. Animal fat is, as a rule, not so 
easily digested as vegetable oils. Some kinds of fat, not 
being pure, easily decompose on exposure to air ; or, on 
being heated, produce acids, which prove very indigestible 
and irritating. 

1 Cane sugar is obtained from sugar cane, beet root, sugar maple, etc. 
Glucose is combined with cane sugar and fruit sugar in poaches, pine- 
apples, and strawberries ; with fruit sugar in honey, grapes, cherries, and 
dried fruit ; and is frequently found in the animal fluids. Milk sugar is 
the saccharine ingredient of milk. 



182 FOOD. — DIETETICS. 

189. Value of Fat. — Fat is essential to cell growth and 
to general nutrition of the body. A diet free from fat will 
not support life. Eaten in sufficient quantity, it is a 
preventive of that defective nutrition which finally ends 
in chronic nervous diseases and in scrofula and allied 
affections. 1 On the other hand, too much fat is not readily 
disposed of in the body, but produces skin eruptions, 
unduly increases the adipose tissue, especially about the 
heart and other organs, and thus impairs health. 

The fuel value of fat is more than twice that of proteids 
or carbohydrates. We need proteids; but fat, coupled with 
enough of the carbohydrates, decreases the amount of 
proteids necessary to maintain the nitrogenous equilibrium 
of the body. This is a matter of importance, especially 
for the poor, or when proteids are not readily obtained or 
not easily digested. Fat is much used in hot countries 
in the shape of vegetable and fish oils, when meat is scarce 
or is prohibited by religious opinions (a). The diet of 
the inhabitants of these countries is mainly a cereal one, 
and usually affords sufficient albuminoids for the building 
and repair of tissues. 

190. Not only does fat, coupled with carbohydrates, 
save the consumption of proteids, but " when we wish to 
get our food in a more condensed form, we can use fats 
freely in connection with proteids, and lessen the amount 
of carbohydrates. In army dietaries the amount of fat 

1 ' ; This is probably one of the reasons of the craving of children in our 
climate for butter, which presents oily matter to the digestion in an easily 
assimilable form, and is evidently a valuable dietetic agent." 

It is probably true that most of the persons who are benefited in this 
country by cod-liver oil, in Switzerland by neat's-foot oil, and in Kussia 
by train-oil, would not need these oils as medicine if their food had con- 
tained sufficient oil or fat. 



FOOD. — DIETETICS. 183 

is largely increased for marching and for great exertion, 
the quantity being three times more than that allotted to 
garrison life." 

Experience seems to show that we should not consume 
less than two ounces of fat per day, but we may increase it 
to eight or nine ounces if we decrease one or both of the 
other two great constituents of food. 

191. The heat-producing property of fat renders it 
especially valuable in cold weather and in cold climates, 
where it is eaten by the inhabitants in enormous quanti- 
ties, four to rive pounds per day being the ordinary 
amount for the average adult (a). Sailors who may be 
averse to fatty food learn to drink freely of oil when 
wintering in the Arctic regions, and enjoy the fat portions 
of the seal, walrus, and other marine animals. 1 

192. Water. — The inorganic constituents of food are 
water and the chemical salts. Of all substances, a regular 
supply of water is the most essential to the maintenance of 
life. If deprived of it for eight or ten hours, far greater 
inconvenience, pain, and debility is suffered than upon a 

1 "People belonging to the well-to-do classes, unless they have given 
special study to the subject, seldom realize the importance of fat in our 
economy. Fat means to them fat meat, suet, lard, and the like, and the 
much eating of these is considered proof of a gross appetite ; they do not 
consider how much fat they take in eggs, in milk, in grains like oatmeal 
and maize, in the seasoning of their varied dishes, and in their well- 
fattened meats, where, as in an average piece from a very fat mutton, 
they eat twice as much fat as proteid, without knowing it. Indeed, a 
well-fed man of the upper classes may have more fat in his daily diet 
than has the freshly arrived Michlenburg laborer, who spreads a quarter- 
Inch layer of lard on his bread. The latter cannot take his fat in unsus- 
pected forms; he craves this principle with his plain vegetable diet, and 
must take it as he can get it." — Mrs. Abel, Practical and Sanitary 
Cooking, etc. 



184 FOOD. — DIETETICS. 

similar deprivation of solid food. With water, life may 
be sustained without the aid of other food for several 
weeks ; but, if it is entirety withheld, death is likely to 
result in a few days («). 

Water is present in all the tissues and fluids, and con- 
stitutes about 70 per cent of the entire weight of the 
body. 1 It dissolves certain food substances, and gives 
fluidity to the blood, lymph, and secretions, enabling 
them to perform their functions of introducing into the 
body and discharging from it substances held by them 
in solution. The elasticity of bones, cartilages, and 
muscles, and the flexibility of tendons and other tissues, 
are largely due to its presence. After performing its 
part in the various nutritive processes carried on in the 
body, about 20 per cent is exhaled from the lungs, 30 per 
cent discharged by the skin, and 50 per cent by the kid- 
neys and intestines. 

193. About 2\ quarts of water are required per day 
by the average adult, in temperate climates and doing 
moderate work, to replace the water lost by excretion. 
During severe labor, especially in warm weather or in hot 
quarters, .the amount required is very much more. Prob- 
ably about one-half of the water usually needed is obtained 
in the food we consume. Every kind of food contains 
water ; for example, fat beef has about 50 per cent ; pota- 
toes, 75 per cent ; bread, 35 per cent ; peas and oatmeal, 
15 per cent. 

194. Salts are, next to water, the most important inor- 
ganic elements of the body and of food. They consist of 

1 The necessity of water in food may be inferred from the statement 
that we are " two-thirds water and one-third land." 



FOOD. — DIETETICS. 185 

sodium chloride or common salt, iron, and the chlorides, 
phosphates, and sulphates of potassium, magnesium, and 
calcium. Salines influence solubility, and have much to 
do with the chemical changes of food substances. 

Common Salt is essential to the life of animals, and is 
found in their every tissue, with the exception of the 
enamel of the teeth. It is also a constituent of nearly all 
food, and exists in small quantities in almost every spring, 
soil, and plant. The quantity taken with food as fur- 
nished by nature is generally insufficient for the needs of 
the body, and hence its use as a condiment. It assists in 
regulating the processes of endosmosis and exosmosis, and 
excites the digestive secretions, thus stimulating the appe- 
tite. Its value is indicated by the natural craving of the 
system for it, and by the results of experiments upon the 
lower animals. Without it, digestion would be imperfect 
and health could not be long maintained. We are told 
that the ancient laws of Holland " ordained men to be 
kept on bread alone, unmixed with salt, as the severest 
punishment that could be inflicted upon them in their 
moist climate." Animals will go long distances in search 
of salt, and if deprived of it, their hides become rough, 
their spirits dull, and they finally lose health and strength. 
In countries where salt is scarce, it is sold at fabulous 
prices (a). 

Lime occurs principally as calcium phosphate and cal- 
cium carbonate, the first being most abundant. Lime is 
an ingredient of every tissue and fluid of the body, but is 
especially necessary in the bones and teeth, where it affords 
strength and consistency. A deficiency of lime salts 
renders the bones soft, so that they easily bend ; hence, 
during early life, when the tissues arc developing, lime 
salts should be supplied in comparatively large quantities. 



186 FOOD. — DIETETICS. 

Of all articles of food, meat, milk, and vegetable grains 
contain lime in the largest amount. 

Of iron about one-third of an ounce exists in the body 
in connection with the coloring matter of the blood, of 
which fluid it forms about one one-thousandth part. Iron 
is a constituent of milk and eggs, and is sometimes found 
in water. Its importance to health is easily recognized, 
when, as a medicine, it restores color to the skin and 
enriches the blood. 

Phosphorus and sulphur, in the form of phosphates and 
sulphates, are introduced into the body with proteid food 
substances, and enter into the composition of muscles and 
other tissues. 

195. The Vegetable Acids — malic, citric, tartaric, etc. — 
are found in fruits and vegetables, combined with lime, 
soda, and potassa, forming salts known as malates, citrates, 
etc. These salts are indispensable in food, for in the body 
they are converted into carbonates, and assist in furnish- 
ing alkalies to the blood and other fluids. 

196. Fuel Value of Food. — By the expression " fuel 
value of food " is meant the amount of heat power and of 
muscular and other forms of energy that various foods 
produce when oxidized in the body. Undoubtedly, intel- 
lectual activity is somewhat dependent upon the utiliza- 
tion of food material by the brain and nerves, but exactly 
what food substances produce this form of energy is not 
definitely known. Fats and carbohydrates are the chief 
producers of energy, but proteids sometimes act as fuel. 
The first two, by reason of their lack of nitrogen, cannot 
build and repair nitrogenous tissues, but they build and 
repair fatty tissue. 



FOOD. — DIETETICS. 187 

197. The energy of food in the body is estimated by 
physiologists just as if the food were burned outside the 
body, i.e. in heat units or calories. 1 "Taking ordinary 
food materials as they come, the following general esti- 
mate has been made for the average amount of heat and 
energy in one pound of each of the classes of nutrients : — 

Calories 

In one pound of protein 2 . <,.... 1.860 

In one pound of fats 4.220 

In one pound of carbohydrates .... 1.860 

In other words, when we compare the nutrients in respect 
to their fuel values (their capacities for yielding heat and 
mechanical power), a pound of protein of lean meat or 
albumin of eggs is just about equivalent to a pound of 
sugar or starch, and a little over two pounds of either 
would be required to equal a pound of the fat of meat or 
butter, or the body fat." 

198. Relative Value of Food Substances. — The table 3 on 
page 188 gives the composition of a few food materials. 

1 The calorie is the amount of heat necessary to raise the temperature 
of one kilogram (2.2 pounds avoirdupois) of water 1° C, or one pound of 
water about 4° F. A foot ton is the energy (power) which would lift 
one ton, one foot. One calorie is equivalent in mechanical energy to 
1.53 foot tons. 

2 The term protein, as used in this chapter, includes all the nitroge- 
nous food constituents, — the nutritious proteids, and the materials which 
have little nutritive value, like kreatin of muscle tissue and amids of 
vegetable tissue. 

3 It represents the food materials in the form in which we buy them, 
including water and refuse, like bones and the skins of potatoes. It was 
prepared by Prof. W. 0. Atwater, special agent of the United States in 
nutrition investigations, and published by the Department of Agriculture. 
Much of the material in this chapter is from recent publications by the 
government on food and diet. 



188 



FOOD. — DIETETICS. 



Composition of Food Material. 

Nutrients. Non Nutrients. 

— -s Fuel value. 



Proteii 



rryrm c 



Fats Carbo- Mineral 
Hydrates Matters 



L^w^rvJ E8B9 

Water Refuse 



Calories 



Nutrients, Etc., P.ot. 



10 20 30 40 50 00 70 SO 00 100 



Fuel Value of 1 Lb. 



400 800 1200 1600 2000 2400 2800 3200 3000 4000 




Codfish, salt 



Oysters 




E ggs 



nai^ 



/VXy^/V^V^^A /~\./~\./~>*S*J 



Wheat bread 



r • £•• 



l^^v> 



Wmmw :::::v.:::::: :::::::::::: :::::!T^ 



Wheat flour 



Cornmeal 



1L 



E 



Oatmeal 



rE 



Beans, dried 



IM: 



ice 






Potatoes 



/~\ /-\ /~\ r\ /-n ^-\ ^n. /~s^^-v J ^-y_ / '-v_ 



Sugar 



* Without bone 



Fig. 76. 



FOOD. — DIETETICS. 189 

Animal foods in general, 1 especially beef, have the most 
proteicls ; among the vegetable foods, wheat, oatmeal, 
peas, and beans head the list. These, therefore, are 
the foods best adapted to build and repair the tissues. 
The foods which have the most fats, such as butter and 
its substitutes and fat meats, have the highest fuel value. 
Grains, meal, and good flour have also a high fuel value 
on account of their carbohydrates. Fresh vegetables, 
such as turnips and cabbages, contain much water, and 
are mainly useful for their salts. The principal value of 
fresh fruits is in their salts and acids. 

Milk comes nearest to being a perfect, or normal, food, 
because it contains all the food elements in about the 
right proportion ; but by adults it must be taken in con- 
siderable quantity to afford of itself sufficient nutriment 
and fuel. 

199. The Importance of a Mixed Diet. — After the first 
year or two of life, a mixed diet is best for all. One 
could live on bread or meat alone, but the exclusive use 
of either of these foods would entail great labor on cer- 
tain digestive organs, and would make the disposition 
of a large amount of refuse of one kind very uncertain. 
And also, after a time, the food would become distasteful. 
The system of an adult doing moderate work requires 
daily about 20 grams 2 of nitrogen and 280 grams of car- 
bon. Wheat bread contains 1 per cent of nitrogen and 30 

1 Fish, as a rule, have so much refuse and water that they must be 
eaten in larger amount than other meat to afford the same amount of 
nutrients. Eggs contain more fat and proteids than milk, and about the 
same amount of mineral matter, but no carbohydrates. " A quart of 
milk, three-quarters of a pound oi moderately tat beef, and five ounces 
of wheat flour contain about the same amount of nutritive material." 

2 A gram = 15.43 troy grains. 



190 FOOD. — DIETETICS. 

per cent of carbon, while meat has 3 per cent of nitrogen 
and 11 per cent of carbon. In order, therefore, to obtain 
the required amount of nitrogen, if bread alone is eaten, 
it will be necessary to eat about four pounds a day ; in 
doing this, twice the necessary amount of carbon will be 
consumed. On the other hand, to obtain sufficient car- 
bon from an exclusive meat diet, a man must eat about 
six pounds of meat a day, and then he would be taking 
six times the necessary amount of nitrogen. 

Combinations of foods, such as meat and bread, bread 
and milk, meat and potatoes, pork and beans, crackers and 
cheese, are scientifically correct, and the results of experi- 
ence show that they may be used as the essentials of each 
day's food. In addition to the flesh foods, heat foods, 
and work foods, we need water, air, mineral matters, and 
the flavors resulting from the cooking of food, or those 
which are added to foods to make them taste good. 1 

200. The Quantity of Food needed varies greatly, depend- 
ing upon age, health, occupation, digestive powers, and 
other peculiarities, as well as upon the climate and season, 
the amount of clothing worn, the kind of food used, and 

1 " Surely the economical housekeeper who would throw out of the 
list of necessaries all the things that tickle the palate, that rouse the 
sense of smell, that please the eye and stimulate overtired nerves, just 
because these things contain but little food, would make a grave mistake. 
She may know just what cuts of meat to buy, what vegetables are most 
healthful and economical, but, if she does not understand how to make 
'the mouth water,' her labor is largely lost. Especially if she has but 
little money should she pay great attention to this subject, for it is the 
only way to induce the body to take up plain food with relish. The list 
of these spices, flavors, harmless drinks, and the like is a long one. Un- 
fortunately, we have no comprehensive word that will include everything 
of the sort, from a sprig of parsley to a cup of coffee. The Germans call 
them genuss Mittel, pleasure-giving things." —Mrs. Mary Hinman Abel. 



FOOD. — DIETETICS. 191 

other circumstances. In infancy, a period of rapid growth 
and development, a proportionately larger amount of food 
is needed than at any other period of life. 1 

A healthy, growing boy, with the muscular strength 
and nervous energy of youth, will often eat, and perhaps 
requires, as much food as the average man ; while old, 
feeble, and inactive persons require but very little food. 

Active mental or physical work renders an abundance 
of substantial food necessary. Proper work cannot be 
accomplished on an insufficient or improper diet. It 
happens sometimes that in prisons, and even in charitable 
institutions, the daily ration is diminished below the 
physiological standard, for the sake of economy. If there 
is but little activity of mind or body, some diminution 
may not be attended with actual disease ; but if active, 
healthy children are scantily fed, or convicts in prison are 
compelled to do hard work on a light-labor diet, sickness, 
great feebleness, and even death result. 

Size alone does not determine the amount of food 
required. In fact, large and fat people often thrive on a 
scant diet, especially if there be a great indisposition to 
muscular exertion, while thin and diminutive persons, 
particularly hard workers, may eat and digest a very large 
amount. As people become better supplied with this 
world's goods, the tendency is to eat too much. Persons 
in moderate circumstances often thrive on what is con- 



1 Daring the first year of life a child should grow from six to eight 
inches, and should weigh at the end of the year two or throe times as 
much as at birth. In the second year, the growth should be only about 
half as much as in the first. In the third year, only about a third as 
much. After the third year the weight and growth are more uniform. 
To meet these demands it is generally necessary to feed babies every 
two, three, or four hours. 



192 FOOD. — DIETETICS. 

sidered by many an insufficient amount of food. The 
body exposed to a cool, bracing atmosphere, or to extreme 
cold, demands an increased supply of food. 1 According 
to Dr. Hayes, the Arctic explorer, the daily ration of the 
Esquimaux is from twelve to fifteen pounds of meat, 
about one-third of which is fat. 

201. Dietaries. — The knowledge of the kind and daily 
amount of food required by the average individual, in 
an aggregation of persons whose social and hygienic sur- 
roundings are about the same, — as in an army, on ship- 
board, or in an institution, — affords a basis upon which to 
calculate the kind and amount needed by a number of 
persons. From such estimates Dietaries or Diet Tables 
are constructed. 

The dietary standards 2 most commonly adopted in 
Europe are those prepared by Professor Yoit of Munich, 
based largely upon observations and experiments among 
people in Bavaria. Voit's standard for a man performing 
moderately hard work, as a mason or a carpenter working 

1 The ravenous appetite noticed amongst the inhabitants of cold cli- 
mates may be due, in part, to the fact that their food supply is very 
irregular, so that when food is obtained they eat to excess. 

2 "The term 'dietary' is used as representing the daily food actually 
used, while the term ' dietary standard ' is applied to the quantities of 
nutrients assumed to be appropriate for the daily food in the given case. 
The standard being once decided, dietary tables may be calculated by 
combining various food materials, which, according to their chemical 
composition, will furnish the quantities of nutrients which the standard 
calls for. Standards have been obtained by dietary studies of the actual 
food consumption of individuals, or groups of persons of different age, 
sex, occupation, and condition of life, and by so-called metabolism ex- 
periments with individuals, in which the income and outgo of the body 
are measured, and the effects of different kinds and amounts of food 
materials are learned," 



FOOD. — DIETETICS. 193 

actively ten hours a day, calls for 0.25 pound (118 grams) 
of protein, 1 and fats and carbohydrates in quantities suf- 
ficient with the protein to yield 3050 calories of energy. 
Professor At water suggests an American standard, some- 
what higher than the European, allowing 0.28 pound 
(125 grams) of protein and 3500 calories of energy. 2 

202. " The American standard for a man of moderate 
work may be obtained approximately from 

12 oz. of Bound Steak, containing 0.14 lb. protein, and 680 cal. of energy 

4 oz. of Butter, containing 0.00 lb. protein, and 900 cal. of energy 

16 oz. of Potatoes, containing 0.02 lb. protein, and 310 cal. of energy 

21 oz. of Wheat Bread, containing 0.12 lb. protein, and 1590 cal. of energy 

53 oz., i.e. 3f lbs., of nutrients. 0.28 3480 

To this 53 oz., to afford a complete daily diet, is to be 
added from 50 to 80 oz. of water, and about 2 oz. of 
salt, etc." («). 

Hard muscular or mental labor requires more nutrients 
than are here shown ; less work and sedentary occupations 
require a smaller amount. Women and children in gen- 
eral need less than men (6). The amount required for 
mere physical existence is very small. 3 

1 As protein includes all nitrogenous food elements, the amounts of 
proteids required are not as large as the above figures would indicate. 

2 " The reason for the more liberal allowance is that investigations 
carried on in many parts of the United States indicate that the ' standard 
of living' is higher in this country than it is in Europe. People hero are 
housed, clothed, and fed better than they are there. They have more of 
the comforts and opportunities of life, and make more of themselves. 
They work harder, accomplish more, and earn more wherewith to pay 
for better living. One essential, then, of this higher standard of living is 
better nutrition." 

3 "The first and most important principle established by Chossat is 
that absolute deprivation of food, and deficiency of food, are physio- 
logically identical in their action on animal life. One acts quicker than 



194 FOOD. — DIETETICS. 

203. Experience, especially in armies, shows that the 
amount of lean meat required daily throughout the year is 
about the same. The fats and fat-forming elements 
should be apportioned to the amount of heat and work 
demanded. The body is not wholly dependent upon 
the food eaten any particular day, but rather on the 
nutrients as a whole taken during longer periods, for 
the system is probably storing nutritive material almost 
constantly. 

204. The Digestibility of Food must, to a large extent, 
regulate the quantity to be eaten by each individual, 
especially of such kinds as beans, cheese, and rice. " We 
do not live upon what we eat, but what we digest and 
make use of." A healthy appetite is a good indication as 
to quantity and quality. Appetite normally asserts itself 
at regular intervals, or what we call meal-times, and may 
then be appeased by a moderate quantity of food. But 
an undue excitation of the muscles and mucous membrane 
of the stomach by irregular eating will produce in time 
the habit of an irregular secretion of the gastric juice, a 
consequent variable appetite, or a frequent and glutton- 
ous desire for unnecessary food. The excessive amount 

the other, but the difference is merely one of duration and degree. Both 
are equally fatal in the end ; and the end in both is regulated by the 
same law. Death arrives when the body has lost six-tenths of its weight, 
whether that happens after days, or months, or years." — Chambers's 
JIanual of Diet. 

In an overcrowded military prison, a diet of one-third of a pound of 
bacon and one and three-fourths pounds of unbolted meal daily caused 
much sickness and very many deaths. 

During the siege of Paris, when the inhabitants were inactive, a diet 
which barely supported life consisted of ten ounces of bread and one 
ounce of meat daily. 



FOOD. — DIETETICS. 195 

of food thus eaten disorders the processes of secretion, 
assimilation, and excretion, and induces disease. 1 

The appetite may be aroused by attention to hygienic 
measures, such as proper mental and physical exercise, 
bathing, rest, and the proper selection, cooking, and 
presentation of food; also, by vegetable bitters and by 
condiments. It is diminished, on the other hand, by 
inattention to hygiene, by worry, by opium and other 
drugs, and by an abuse of alcoholic stimulants. 

205. Variety of Food. — The system craves a varied diet, 
and the living for a length of time on even an abundance 
of food, if it be unvaried from day to day, will generally 
result in loss of appetite and in disease. The condition 
known as scurvy, exhibited by thin blood settled in spots 
under the skin, spongy and bleeding gums, and general 
debility, was formerly not uncommon on long sea voyages, 
especially in the Arctic regions, where the diet consisted 
largely of bread, tea, and salt meat. At the present time 
most vessels going on such voyages are supplied with lem- 
ons, lime juice, canned meats, fruits, and vegetables 2 (a). 

1 " A voracious appetite is a condition which I suppose may be due to 
a very irritable state of the nerves of the stomach. . . . The voracious 
appetite, as we see it existing in children and young people, usually comes 
from undue encouragement. The greater the desire for food the more 
food the individual eats, and so he goes on, until he succeeds in consum- 
ing several times as much food as his system requires. Thus is thrown 
upon important organs the task of eliminating a quantity of useless mate- 
rial which ought not to have been taken. ... A child perhaps is rather 
thin, and therefore encouraged to stuff, and by degrees the habit of 
taking enormous quantities of food is acquired, with the not uncommon 
result to the patient of getting thinner, instead of gaining in weight." — 
Dr. Lionel S. Beale, Slight Ailments. 

2 It is required by law that lime juice be carried on board English ships, 
and served out to the sailors; hence. English ships are sometimes called 
'Mime-juicers 11 by American sailors. 



196 FOOD. — DIETETICS. 

A similar condition is also seen on land in persons who are 
restricted to a diet in which fresh vegetables and fruit are 
lacking, or whose food consists mainly of potatoes or bread 
and tea, with little or no butter, meat, or milk. Soldiers 
in active service, with restricted and unvarying rations, 
often have an intense craving for fresh vegetables, such as 
onions and raw potatoes, which are excellent anti-scorbutics. 

When a variety of articles cannot be obtained, varied 
methods of preparing and cooking the limited supply 
should be resorted to. " Good cookery means economy ; 
bad cookery means waste." 

On the other hand, however, there may be such a thing 
as too great a variety, and this also will destroy the appe- 
tite. People living in large hotels, and travellers eating 
frequently in bountifully supplied cars and restaurants, 
often suffer from dyspepsia and disturbed action of the 
liver and other digestive organs, especially if little exercise 
is taken. Epicures are apt to resort to alcoholic stimu- 
lants and to condiments, to excite their jaded appetites. 
In like manner, the under-fed and those living on a very 
small variety of food often fancy they need the assistance 
of alcohol in some form. In the former case the practice 
of abstemiousness, and in the latter a more bountiful and 
varied diet, is really what is needed. 1 

206. Adulteration, Freshness, and Maturity of Food. — 

Articles of food are often robbed of their value, and are 
sometimes positively harmful or even poisonous, in con- 
sequence of adulteration, 2 or of being immature, or stale, 

1 Coffee-houses, holly-tree inns, and diet dispensaries, by furnishing 
suitable food, can do much to avert a taste for liquor. 

2 Adulteration is very common, and laws to control it are evaded. 
Frauds in food consist, first, in the addition of deleterious substances, 



FOOD. — DIETETICS. 1 97 

or over-ripe. Milk diluted with water, or skimmed of a 
large part of its cream, or that taken from unhealthy 
cows, is a common evil. " Measly meat," that is, meat 
containing animalcula, such as trichinae, is occasionally 
the cause of sickness and death. 

Vegetables and meat of coarse texture, which are pur- 
chased for economical reasons, are usually tough and in- 
digestible. Garden produce, especially corn, cucumbers, 
celery, and lettuce, when fresh, are desirable additions 
to the table, but may become indigestible and a source of 
disease, if allowed to become dry and stale. Immature 
fruits and vegetables lack the fully formed juices and salts, 
which are indispensable to make them serviceable as food. 
In over-ripe fruit and vegetables the juices and salts have 
decomposed, giving rise to new combinations which are 
hurtful. 

207. Cost and Waste of Food. — " Half of the struggle of 
life is a struggle for food." With many people, one of 
the great problems is to obtain varied and sufficient food, 
leaving enough of the week's wages to pay for rent, fuel, 
light, clothing, and other necessaries. Investigations by 
the government show that in many families, from 50 to Q5 
per cent, or more, of the income is spent for food alone, 
and that the waste of food is enormous. It is estimated 
that frequently one-half of the food bought would be 
sufficient, if properly used. 1 

such as salt of copper to pickles, and red lead to cayenne pepper ; second, 
in the sale of fraudulent materials, such as cotton-seed oil for olive oil, of 
flour and a little mustard with turmeric for pure mustard, or of oleomar- 
garine for butter; third, in the sale of substances not so fresh or in so 
good a condition as they are represented to be by the seller. 

1 In factory boarding houses where economical and healthful food 
was bought, properly cooked, and but little waste allowed, the cost of 



198 FOOD. — DIETETICS. 

The cost of food varies greatly in different parts of the 
same city. A knowledge of where to buy to the best 
advantage, of what to brry, and how to prepare and cook 
materials bought, Avill furnish a variety of good, sub- 
stantial food at much less cost than is generally thought 
possible (a). Good home-made bread is cheaper than 
baker's bread. The tenderest meat, the finest fish, the 
highest-priced butter, and the most delicate vegetables 
have no greater food value than many of the less costly 
foods. Among such foods are milk, flour, cornmeal, oat- 
meal, beans, potatoes, substitutes for butter, the commoner 
kinds of fish, and cheaper meats. 

208. Investigations show that even where considerable 
care is observed, one-tenth of the food bought is thrown 
away with the table and kitchen refuse. In most fami- 
lies, a much larger proportion is wasted. If the waste 
food of our cities could be utilized, it would nourish every 
hungry person in these cities. 

Besides the household waste of food, there is another 
form, especially in this country, viz., the "trimming out" 
of the bones and fat of meat by the butcher. The bones 
could be used in valuable soups, and the fat for cooking 
purposes or for eating. 

209. Proper Preparation and Cooking may render food 
of medium quality very serviceable. For example, the 
coarser and tougher parts of meat, and also vegetables 
of coarse fibre, can be rendered quite tender by pro- 
longed boiling. On the other hand, the best food may be 

meals per week for women was from $1.60 to 81.75; for men $2.00 to 
$2.25. The eaters, though hard workers, were satisfied. Some of the 
foreign-horn residents in our large cities manage to live and work at a 
cost of 11 to 18 cents per day for food for each person. 



FOOD. — DIETETICS. 



199 




Protein 



Carbon 



Fuel value 



Fig. 77- (Mayo.) 
Table Bhowing the Relative Nutritive Value oi'-io Coats' Worth of Various Foods 



200 FOOD. — DIETETICS. 

made useless, unwholesome, and even dangerous, by im- 
proper preparatory treatment (a). 

An important rule in roasting, boiling, or broiling meat 
is to produce at the start a rapid coagulation of albumin 
on the outer surface of the meat, so as to form a crust that 
may prevent the juices from escaping. This is done by 
subjecting the meat at first to a great heat, after which 
the cooking should proceed more slowly. 1 In like manner, 
the boiling of potatoes with at least the larger part of their 
skins on prevents the escape of much that is nutritious. 

Frying, if not rightly conducted, is the most objec- 
tionable of all methods of cooking. Slowly heated fat 
evolves fatty acids which are more or less injurious, 
and, by penetrating the frying food, envelops its parti- 
cles in grease. As fats are not digestible in the stom- 
ach, it follows that food so fried cannot be properly 
dissolved by the gastric juice, but becomes an irritant. 
To fry properly, the fat should be boiling hot before the 
food is put into it, that an outer crust may be formed, 
which will prevent the fats from penetrating to the in- 
terior. After this crust is formed, the temperature of 
the fat may be somewhat lowered. 

210. Preservation of Food. — The processes of souring 
and putrefaction, by which food substances decompose, 

1 On the other hand, the process of soup-making is facilitated if the 
meat is cut into small pieces and put into cold water, and the temperature 
slowly raised. 

' ' The true science of cooking consists in the regulated and controlled 
application of heat, by which flavors are developed and the work of con- 
verting raw and indigestible material into nutritious food is accomplished, 
. . . High heat, common in iron stoves and ranges, renders much of the 
fat of food indigestible. The flavor of wheat bread, of white kinds of 
fish, etc., is best developed by a low and prolonged heat." — Atkinson. 



FOOD. — DIETETICS. 



201 



require the presence of moisture, a moderately elevated 
temperature, and access of atmospheric air or of some 
fluid containing oxygen. Decomposition is accomplished 
by the growth and multiplication of bacteria. The meth- 
ods by which the decomposition of albuminoid matter 
and the activity of bacteria can be prevented, and the 




Fig. 78. 

" Open grates in cellars are often untrapped, and, when trapped, the traps are usually 
ineffective from want of water, or from being broken ; and even if sealed by water, 
they are still an inefficient barrier to sewer gases, which can pass by absorption 
through water." — Teale, Dangers to Health. 

preservation of food effected, are canning, desiccation, 
freezing, or heating to about the temperature of boiling 
water 1 (a). 

Food preserved in cans made of so-called tin, but which 
is in fact a compound of tin and lead, or in cans badly 



1 The smoking of meat and pickling in brine do not always kill the 
bacteria. Salicylic andboracic acids, though good preservatives of moat, 
are not desirable, as they sometimes produce digestive ailments. Dry 

cold and the injection of a solution of common salt are probably the best 
means of preserving meat. 



202 FOOD,. — DIETETICS. 

soldered with lead, may become poisonous, especially if 
such food contain an acid, as is the case with tomatoes. 1 

Food cooked or left standing in brass or copper vessels 
that are not clean is dangerous to life. Ice boxes, store- 
rooms, or cellars, which are not clean and dry or are 
imperfectly connected with drains, are constant sources of 
poison to milk, water, fats, and other foods which readily 
absorb poisons from the atmosphere. 

211. Alcohol as Food. — Alcohol does not build or repair 
tissues, but evidence goes to show that, in a small amount, 
it may act as a partial food, like starch, sugar, and fat, by 
affording energy. It requires no digestion, and is readily 
absorbed, but it cannot be stored in the bod}- for future 
use, as are starch, sugar, and fat. If taken in more than 
moderate amount, it impairs the working power of the 
brain and other parts of the body. Practically, therefore, 
it cannot be relied upon for food purposes, except by 
persons too ill to digest other substances, or by those at 
the point of starvation. 

Leading physiologists of Europe, in a recent statement, 
say: "Thus far the results of careful experiments show 
that alcohol so taken, i.e. in a diluted form, in small doses, is 
oxidized within the body, and so supplies energy, like com- 
mon articles of food. 5 ' Professor W. O. At water, after a 
series of very careful experiments, corroborates the above 
statement. 2 Pure alcohol, and its equivalent in whiskey 

1 Much of the harm arising from eating canned fruits, vegetables, 
and meat would be obviated if these goods were preserved in glass jars. 
Canned fish should be warmed through before being eaten, by placing 
the opened can in a basin of hot water. Failure to do this may cause 
sickness. 

2 These experiments were made by Professor Atwater and assistants 
at Wesleyan University, and the Storrs Experiment Station, for the 



FOOD. — DIETETICS. 203 

and brandy, were administered in water or coffee to 
healthy men, both at rest and doing active work, in 
divided amounts, six times a day, — three times with an 
ordinary diet of meat, bread, butter, and the like, and 
three times between meals. These experiments demon- 
strated : " 1st. That the alcohol was oxidized, i.e. burned, 
as completely as bread and other ordinary foods, in the 
body and in the same way. 2d. In the oxidation the body 
transformed and utilized the energy of the alcohol, just as 
it did that of sugar, starch, and fat. 3d. The body, 
whether at work or rest, held its own just as w T ell with 
the alcohol a part of the diet, as it did with a diet without 
alcohol." l 

United States Department of Agriculture, " at the instigation of the Com- 
mittee of Fifty for the investigation of the Drink Problem for the purpose 
of securing more accurate and scientific knowledge of the physiological 
action of alcohol." This committee is composed of presidents and pro- 
fessors of colleges, and other scientific men. 

1 "These experiments mark only a single step toward the settlement 
of the broad questions involved in the use of alcoholic beverages. They 
did not treat of the influence of alcohol upon the circulatory and nervous 
functions." — From a Government publication. 

" It has been shown that when alcohol is taken in small quantities by 
certain persons, it is oxidized in the body and gives rise to heat and 
energy just as starch would, and is, therefore, a partial food. It must 
be noticed that it has been distinctly denied that it is a complete food, 
and stated that it cannot replace body tissue. But the experiments have 
been immediately seized upon by newspaper sensationalism and inter- 
preted to mean that the use of alcohol in these small quantities is per- 
fectly safe, and is, perhaps, to be recommended. The fact that it may 
thus be a partial food is taken to mean that it is a complete food, and in 
general the inference is drawn that physiologically alcohol is not injurious. 
Now nothing could be a more woeful misconception of scientific experi- 
ment. . . . The early experiments, upon which one class of statements 
is based, were made with the use of alcohol in large doses, while the later 
experiments, which form the basis of the other class of statements, have 
been made with small doses. In large doses there is no doubt that rhe 



•204 FOOD. — DIETETICS. 

212. Professor Atwater saj^s: 1 "In some experiments 
here 2 men have taken alcohol to the extent of two and a 
half ounces or thereabouts per day, the amount being di- 
vided into several doses, and practically the whole amount 
has been oxidized. In being oxidized, the alcohol has evi- 
dently performed one of the functions of food, — viz. that 
of serving as fuel for the body. But I certainly have 
never said that alcohol in that or any other daily quantity 
may not be injurious or dangerous. I have no doubt 
there are countless cases in which people take small quan- 
tities of alcohol, and do so habitually, without harm to 
health. But there are so many instances in which 
moderate use leads to excessive use, and men are ruined 
physically, mentally, and morally by that excess, that I 
could not say, and I do not see how any thoughtful man 
could say, that no harm comes from moderate drinking. 
Indeed, the exact opposite seems to me one of the most 
serious facts with which the physiologists, economists, 
sociologists, and moralists of our day have to deal." 

213. To take alcohol regularly as a food is expensive, 
and attended ultimately with well-marked disadvantages 
and injurious effects, especially upon the nervous system, 
the digestive organs, and the blood. To obtain two and 
one-half ounces of alcohol a man would have to drink 
about two quarts of ordinary cider or lager beer, or nearly 



effects of alcohol are abnormal. Based upon experiments with small 
quantities, the statement is made that it is a food, and herein is the 
reason for the contradiction of statement" [as to whether alcohol is or 
is not a food]. — Professor Conn. 

1 In a letter to the author. 

2 See detailed report, Bulletin No. 69, published by the United States 
Department of Agriculture. 






FOOD. — DIETETICS. 205 

a bottle of claret or Rhine wine, or three average glasses 
of whiskey, two ounces each. 

Professor Bartley 1 thus estimates the expensiveness of 
alcohol as food: U A quart of beer costs, by the glass, 
20 cts. ; by the pint, 14 cts. An equivalent amount of 
proteid matter in the form of milk (4 oz.) costs 1 ct., and 
in the form of meat about 1^ cts., while an equivalent 
amount of carbohydrates in the form of bread (4 oz.) 
costs about 1^ cts. Assuming that the alcohol of the 
beer is all burned, and that it does no harm to any of 
the normal processes, we find that in calculated heat- 
value, one litre (one quart) of beer is equivalent to 5 J oz. 
of bread costing 1J cts., or to 23 oz. of milk costing 6 cts., 
or to 13 oz. of meat costing 13 cts." 



QUESTIONS. 

1. Define food. 

2. How do certain food substances act as fuel? 

3. In what form is food stored in the body, and why? 

4. Of what value are the coarser and sometimes indigestible portions 

of food ? 

5. Name the necessary food elements. 

6. What are the chemical components of proteids? 

7. What is the value of the proteids of food? 

8. What are the carbohydrates? What is their food value? 

9. Name some of the nitrogenous non-albuminous food substances. 

10. From what sources are the proteids derived? from what the 

carbohydrates ? 

11. Of what value as food are water and mineral salts? 

12. Where is starch found? 

1 Proceedings of the American Pharmaceutical Association, 1898, 
Prof. E. II. Bartley, Professor of Chemistry, Long Island College Hos- 
pital. 



206 FOOD. — DIETETICS. 

13. When is starch most digestible ? 

14. Why is ripe fruit more digestible than unripe fruit? 

15. Of what value is sugar hi food? 

16. Of what value is fat in food? 

17. Xame some of the fats that can be used as food. 

18. What is meant by the " fuel value " of food? 

19. How is it estimated ? 

20. What vegetable foods resemble the animal foods as tissue builders? 

21. To what extent is water found in the body? 

22. Why is a mixed diet important ? 

23. Upon what does the necessary quantity of food depend? 

24. What are dietaries ? What is their value ? 

25. What is meant by a " healthy appetite " ? 

26. Why should the diet be varied? 

27. What may be the consequences of a too varied diet ? 

28. What is said of the resort to stimulants by the over-fed? By 

the under-fed? 

29. Is it possible to select and use food that is both economical and 

nutritious ? How ? 

30. What is meant by the proper preparation and cooking of food? 

31. In what sense can alcohol be considered as food ? 

32. Why is it not a safe article to use as food ? 






CHAPTER XII. 
FOODS. 

214. Animal Foods. — The various articles of food may 
be classified as animal, vegetable, and mineral. Animal 
foods comprise the flesh of animals, their blood, secretions 
(milk, eggs, etc.), and also their various organs, which, 
though not containing so much nitrogen as flesh, are often 
more serviceable if eaten with proper vegetable food. 1 

Flesh, or meat, consists of muscular, connective, and 
adipose tissues, and contains albuminoids, water, fat, 
and salts. On account of its abundant supply of nitroge- 
nous ingredients, its stimulating properties and pleas- 
ant taste, meat is usually ranked as a very nutritious 
food ; and is therefore frequently eaten to excess, espe- 
cially by little children, old people, the feeble, and the 

1 The organs most commonly used as food are the heart, the liver, the 
pancreas, or sweet-bread, the thymus gland, and the stomach, or tripe. 
Pigs' feet and ox-tails are highly esteemed by many. The heart — though 
composed almost entirely of muscle — is not always easily digested, while 
tripe is in general readily digested. The majority of the internal organs 
do not contain a large amount of nitrogen, and should be eaten, therefore, 
with grain food or vegetables comparatively rich in nitrogen. Bones, which 
are thrown away by many housekeepers because they are thought to be of 
no use, if well broken up, and submitted to prolonged boiling, will yield 
fat and gelatine which may form the basis, or "stock," for nutritious 
soups (a). When meat is roasted, the drippings contain much nutri- 
ment, and if hoiled or submitted to prolonged simmering, as in the mak- 
ing of soup, much of the juice of the meat goes into the broth, leaving the 
meat quite hard. Such drippings and broth should be eaten with vege- 
tables or cereals. 

•JOT 



208 FOODS. 

inactive (a). It requires to be properly prepared and 
thoroughly chewed before it can be safely swallowed or 
readily digested (5). 

215. The various kinds of meat differ as to their digesti- 
bility and nutritive value. Beef, mutton, lamb, poultry, 
the flesh of many fishes, venison and other game are 
generally more easily digested than pork, veal, and salted 
or pickled meats. 1 Different parts of the same animal 
vary as to flavor and tenderness ; but the cheaper por- 
tions may be rendered nutritious and palatable by proper 
cooking and seasoning. 2 

The age of animals, the kind of feeding, and the care 
observed in their housing and transportation influence 
the flavor and nutritiousness of the meat obtained from 
them. As. a rule, the flesh of young animals is more ten- 
der than that of old ones; but meat, especially veal, from 
very young animals is unwholesome. Salted food, whether 
meat or fish, in small quantity, will stimulate the appetite, 
and is useful as an occasional article of diet. 

Of all varieties of meat, beef is most often used, and 
is least likely to pall upon the appetite (#). 

Pork, owing to the quality and quantity of its fat and 
the compactness of its lean meat, is not readily digested 
by many persons ; but if obtained from animals properly 
fed and cared for, it is serviceable. 

1 Hippophagy, or the eating of horse flesh, is advocated by good authori- 
ties, especially when beef is hard to obtain. ' ' Such food is a valuable 
resource in France, where many of the people scarcely ever touch meat, 
in consequence of the enormous disproportion between the production of 
cattle and the population of the country. ' ' 

2 The lactic acid, which develops in raw meat a few days old, tends to 
soften the tough fibrous tissue and make the meat more tender. Dilute 
vinegar is sometimes applied to meat for this purpose. 



FOODS. 209 

As to poultry and game, tenderness and flavor are the 
most desirable characteristics. Old birds and old game- 
animals are generally tongh and indigestible, and their 
flesh is often rank. 1 If there is any odor of decomposi- 
tion, a bluish color, or spotting of the skin, poultry and 
game should not be used. 

. 216. Fish should be eaten oftener than it is, as it fur- 
nishes an economical source of proteids and affords variety 
to the diet. 2 But the constituents of the meat of different 
kinds of fish vary considerably. Salmon, eels, mackerel, 
and halibut contain much fat and nitrogenous material. 
The following fish, in the order named, contain the largest 
amount of protein : cod, salmon, halibut, eels, mackerel, 
whitefish, perch, bluefish, and shad. 3 The custom of allow- 

1 Experienced poulterers and butchers claim that every variety of fowl 
and game has its particular season, and at such times the flesh, even of 
old birds, will be found tender and palatable, just as fruit eaten in 
season is far preferable to that which is forced for an early market. 

2 Investigations show that in the United States generally from one- 
half to two-thirds of the protein of the food is obtained from animal 
sources, i.e. meats, milk, eggs, and fish, but that less than 5 per cent is 
furnished by fish. " Laborers employed in the fisheries of Russia con- 
sume from 26 to 62 ounces of fish daily. This, with some bread, millet 
meal, and tea, constitutes the diet throughout the fishing season. These 
quantities are unusually large, but no bad effects are mentioned as fol- 
lowing the diet. There is a widespread notion that fish contains large 
proportions of phosphorus, and on that account is particularly valuable 
as brain food. The percentages of phosphorus in specimens thus far 
analyzed are not larger than are found in the flesh of other animals used 
for food. But, even if the flesh be richer in phosphorus, there is no ex- 
perimental evidence to warrant the assumption that fish is more valuable 
than meats or other food material for the nourishmenl of the brain." — 
C. T. LanctWortiiv, Ph.D. (United States Department of Agriculture), 
Fish as Food. 

8 Fish such as the skate and sea-robin, known to be wholesome, are 
seldom eaten, owing to prejudice. 



210 FOODS. 

ing fish to die slowly, when caught, is not only inhuman, 
but it also lessens their food value. 

All fish are best when in season, and should be se- 
lected with care. The freshness of a fish is determined by 
the fulness and brightness of the eyeballs, and the vivid 
color of the gills. The sense of smell cannot always be 
relied on in selecting fish, since packing in ice prevents, 
to a large extent, the escape of odor. 

Shell fish and the flesh from the hind legs of frogs 
are valuable edibles, though some of these foods at 
times prove more or less indigestible, and excite redden- 
ing and an almost unbearable itching of the skin, known 
as " hives " or " nettlerash " 1 («). 

217. Harmful Meat. — Though meat partially decomposed 
may be eaten with apparent impunity by some persons, in 
the majority of cases it either causes indigestion and 
severe sickness, or deteriorates the system so that it easily 
succumbs to infectious diseases (a). It sometimes hap- 
pens, notwithstanding the vigilance of health authorities, 
that unwholesome meat is sold in the shops. Therefore 
it is important that buyers should know what constitutes 
good meat (5). 

Meat eaten raw, or but just warmed through, may prove 
dangerous to health from the trichinae or other animal 
parasites it sometimes contains. 2 This is especially the 
case with pork and fish. Certain diseases of animals, such 
as glanders, splenic fever, and tuberculosis of cattle and 

1 Fish should be fresh and well-cooked. Oysters obtained where 
filth abounds should never be eaten, as they are apt to contain harmful 
bacteria. 

2 Parasite poisoning generally occurs in people who have eaten raw or 
underdone meat, in sausages, pork or veal pies, or from the inner parts 
of a roast. A heat of nearly 212° is necessary to destroy parasites. 



FOODS. 211 

hogs, render their meat dangerous. Meat should be 
cooked enough to coagulate its albumin and blood, de- 
velop its flavor, kill bacteria, and render it tender. 
Overdone meat is generally more or less insipid and 
indigestible. 

218. Milk is an emulsion of fat (i.e. cream) in water, 
and contains albumin casein, sugar, and salts. Many 
persons consider it only a beverage, whereas it is an im- 
portant article of diet, even for adults, since it contains all 
the necessary food elements in the most digestible form. 
It sustains the life of infants at a time when the digestive 
organs are most sensitive. It should be the principal 
food of children. Contrary to a popular belief, milk is of 
decided value in fevers and many other ailments. Per- 
sons with whom milk does not agree, or whom it is said 
to make " bilious," will often be able to digest it if it is 
taken in small quantities hot, or fresh from the animal, or 
with the addition of lime or seltzer water. 1 

Milk is sometimes deprived of its cream, diluted with 
water, or otherwise adulterated by dishonest dealers. 2 It 
is also capable of absorbing noxious odors and emanations, 
and may convey the infection of scarlet and typhoid fevers 
from infected milk rooms. Even the very best milk is so 
susceptible to change, that a thunder storm, or exposure to 

1 For an adult to obtain, from milk alone, 8500 calories fuel value, it 
would be necessary to consume a large quantity per day, and this would 
furnish too much water and protein. Goat's milk is a good substitute for 
cow's milk, though not so readily digested. 

2 Milk may appear rich (owing to its cream, or fat, which vises to the 
surface), and yet be deficient in albumin ami salts. In large cities, 
unwholesome milk is largely consumed by the children of the poor, to 
the exclusion of other food, and is responsible for many deaths among 
them. 



212 FOODS. 

the heat of the sun, or contact with the smallest particle 
of sour milk, may render it unfit for use. 

Great care should be observed in milking and in the 
keeping of milk (a). The store rooms, as well as the 
vessels which contain it, should be clean and free from 
odors. The udder of the cow should be cleansed before 
milking, and the hands of the milker should be clean. 
The milk from healthy animals only should be used. 
Tuberculosis is too frequently spread among human 
beings by the milk of consumptive cows. 

Buttermilk, or milk deprived of most of its fat in the 
process of butter-making, is a wholesome drink, pleasant 
for summer use. It is sometimes prescribed for invalids. 
Skim-milk, or that from which the cream has been in part 
removed, is more valuable than buttermilk, as it contains 
more of the various ingredients of milk. Whey, or milk 
from which most of the casein has been removed in the 
process of cheese-making, is readily digested, even when 
slightly sour, and can be made palatable by the addition 
of a little nutmeg and sugar. 1 

219. Butter is an important food, if fresh and sweet, 
and is considered the most digestible of animal fats, as 
it is the most palatable; but it is expensive. It consists 
principally of the fat of milk, with water and a small 
quantity of casein and salts. Artificial butters, such as 

1 In referring to buttermilk, Dr. Chambers says, "It is refreshing and 
nutritious, and to see it given to pigs, instead of being distributed to the 
neighbors, makes the philanthropist's heart bleed." "Some think that 
skim-milk is worth very little, and buttermilk still less, whilst they give 
whey (if at all) only to the sick. This is a very great mistake, and the 
poor should get all the buttermilk and skim-milk they can obtain ; they 
may be purchased when new milk cannot be afforded." — Edward 
Smith, Foods. 



FOODS. 213 

oleomargarine and butterine, are made of animal fat, with 
perhaps a trace of butter. If the fat is fresh and clean, 
these substitutes have practically the nutritious value of 
butter. Marrow, olive oil, cottonseed oil, and the crisp 
fat of cooked bacon or beef are also good substitutes for 
butter. 1 

220. Cheese contains the nitrogenous elements as well 
as some of the fat of milk, in a concentrated form. It is 
a valuable food, if eaten in moderation and combined with 
starchy articles of food. Soft cheese, such as is used 
largely in Europe, and new cheese are in general most 
digestible. Old cheese in small quantity is an appe- 
tizer. Skim-milk cheese is almost pure casein and hard 
to digest. 

Cheese should not be eaten in large quantities by any 
one, and for children and persons with weak digestion a 
very small amount should suffice. Very young children 
should never eat it. 

221. Eggs consist of water, fats, albumin, and salts. 
They afford much nourishment, and may occasionally 
take the place of meat. They are most digestible when 
soft boiled, or in omelets, or incorporated with starch or 
flour in plain puddings. 2 The yolk of eggs, boiled hard 
and powdered very fine, is digestible, but hard-boiled eggs 
do not agree with most persons. 



1 Beef suet, if chopped fine, combines well with bread, rice, etc., in 
puddings, and affords fat in a digestible form. 

2 Eggs as ordinarily fried are particularly hard to digest. A poached 
egg, in which the albumin is coagulated to a bluish while color, is readily 
digested. So also is an egg broken into a hot dish (containing a piece of 
good butter) over a hot fire, and served when just coagulated. 



214 FOODS, 

222. Vegetable Foods include the cereals, or bread-stuffs, 
garden produce, and fruits. 

The cereal grains most commonly used as food are 
wheat, barley, oats, corn, rye, and rice. Wheat is rich in 
nitrogenous matter, salts, and starch, and is generally con- 
sidered to be, among the cereal foods, — like beef among 
meats, — the foremost in nutritive value. Barle}^ ranks 
next. Rye, though containing a large amount of nitrogen, 
is not as a rule so readity digested as wheat and barley. 
Oatmeal and corn contain much nitrogen and more fat 
than the other cereal grains, and are valuable to persons 
not troubled with weak digestion. Rice, though easily 
digested, contains a large amount of starch, and but little 
nitrogen ; hence, to satisfy the appetite, it must be eaten 
in large quantity, if taken alone. 

Cereals resemble each other, in that each kind con- 
sists of a starchy body inclosed in a skin or husk (some- 
times of several layers), which, when detached from 
the kernel, is known as bran. Immediately beneath 
this husk is a layer rich in gluten, oil, and salts. The 
husk is generally woody, fibrous, and indigestible. When 
the husk is removed by any process, the whole grains 
may be used ; in the case of oatmeal or wheaten grits, 
the grains are simply crushed ; in that of wheaten flour, 
they are ground fine. The finest and whitest wheat 
flour often contains much starch and but very little 
gluten. Flour best adapted for family use is that which 
has a slight yellowish tinge, is not very fine, and con- 
tains sufficient gluten to form a coherent ductile dough 
when mixed with a little water. 1 It will make darker 

1 The old-time custom of squeezing the dry flour in the hand, for the 
purpose of testing the proportion of gluten as shown hy its cohesive quali- 
ties, will not hold good with flour made by the ,; new process" ; and even 



FOODS. 215 

looking bread than pastry flour, but is sweeter and more 
nutritious. 1 

223. Bread is ordinarily made from wheat flour, since 
other flours do not contain sufficient gluten to make a 
dough through which gas can permeate to make light 
bread. Rye, maize, and oatmeal may be combined in 
varying proportions with wheat flour for various kinds 
of bread. Good bread may well be called the "staff of 
life," the only nutritious element deficient in it being fat. 
This is commonly supplied by butter or oil. 2 

Hot, poorly cooked, or very moist bread is not digested 
with ease. Leavened bread, i.e. bread made light and 
spongy by means of carbon dioxide distributed through 
the doughy mass, is much more easily digested than un- 
leavened bread, such as pilot biscuit and hardtack, which 
are merely mixtures of flour, water, and salt. Leavening 
is generally effected by means of a fermentation generated 
in dough by yeast. 3 Carbon dioxide, forced through 
dough by machinery, makes what is called "aerated 
bread." This gas is generated in the making of bread, 

the test of pulling the moist flour between the fingers does not always 
prove true. In fact, the only absolute proof of good flour seems to be in 
the cooking, though it is said that flour rich in gluten takes up a great 
deal of water in proportion to its bulk. 

1 Oatmeal and barley are sometimes not relished, because of a burnt 
taste given in the process of kiln drying, or a musty odor and taste from 
having been kept in a moist state. "The steam-cooked cereals," being 
partly cooked, are easily prepared for the table, and, owing to the partial 
change of starch into dextrine, are quite readily digested. Eye should be 
selected with care, as diseased or spurred rye — known as ergot — may 
cause severe sickness and even death. Mouldy maize is capable of pro- 
ducing a serious skin disease known as pellagra. 

2 Butter, therefore, is the "golden head" of the "staff." 
8 It may also be effected by a piece of fermented dough, 



216 FOODS. 

biscuit, etc., by the proper combination of soda and cream 
of tartar, or other substances. Graham bread 1 is made of 
unbolted wheat flour. Such bread is wholesome, but con- 
tains so much bran that it should be eaten with caution 
by persons of weak digestion. 2 

224. Vegetables are furnished by our best markets in 
greater or less variety throughout the entire year. 3 Not- 
withstanding this supply, they are comparatively but 
little used, or certain kinds are used to the exclusion of 
others (a). No vegetable is more useful than the white, 
or so-called Irish, potato (6). It may well be called the 
king of vegetables, for it agrees with the majority of per- 
sons, and can be obtained in every season of the year. 
And yet hardly 2-^ of its 25 per cent of solid matters is 
nitrogenous. Potatoes are deficient also in fat and salts, 
and should be eaten with butter and salt, pot liquor, meat 
gravy, or fat meat. They resemble rice in the large amount 
of starch they contain, and, like rice, must be consumed 
in considerable quantity if they form the main ingredient 
of the diet. 4 Mapother claims that the almost exclusive 
reliance upon the potato in certain parts of Ireland has 
depressed the spirit and energy of the inhabitants, and 
he urges them to raise and use more of other vegetables. 5 

1 Named after Mr. Graham, the founder of so-called " Grahamism." 

2 The brown bread made of flour from which bran is almost entirely 
excluded is readily digested. 

3 About 50 different kinds of vegetables are for sale throughout the year, 
in the large public markets of cities, yet most families use but 12 or 15. 

4 Potatoes, peeled and soaked in cold water before boiling, lose one- 
fourth of their albuminoid material, besides much mineral matter and 
nearly 3 per cent of their carbohydrates. 

5 Mapother undoubtedly refers to the poorest classes, who cannot obtain 
sufficient nitrogenous food, — even milk to use with their potatoes, —and 
who are also depressed by the want of variety in food. 



FOODS. 217 

Sweet potatoes, though not quite so digestible as white, 
are wholesome. The yam varieties, which are eaten so 
much in warm countries, are sometimes mixed in corn meal 
bread. Beets, carrots, parsnips, onions, leeks, oyster plant, 
squash, and other vegetables are valuable additions to the 
table. 1 Potatoes and onions, together with fresh salad 
vegetables, — such as tomatoes, cabbage, greens, lettuce, 
celery, corn, and cucumbers, — are excellent preventives 
of scurvy, as we have already seen ; and in the spring their 
juices and salts are eminently beneficial 2 (e). 

Peas, beans, and lentils contain considerable starch and 
a large amount of albuminoid material. When dried, they 
are not easily digested by persons leading a sedentary life. 
Yet, on account of the ease with which they can be trans- 
ported and preserved, these foods are valuable wherever 
large numbers are to be provided for. As is the case 
with some other vegetable foods, they require more 
thorough cooking and mastication than meat, though 
there is a popular belief to the contrary 3 (d). 

1 Carrots and some other vegetables are considered by many persons 
as fit only for cattle ; but if the same attention was paid to their prepara- 
tion and cooking as is spent upon other foods, they would be considered 
delicious. 

2 Such vegetables, together with fruits, are preferable to sulphur and 
molasses, or so-called " spring medicines." 

3 The statement credited to General Scott, viz., that "Beans have 
killed more soldiers than bullets," has been misunderstood. The bad 
effects following their use by soldiers have been due mainly to their being 
insufficiently cooked. The red native bean of the tropics, like the 
white bean of this country in shape, is to be tried for our soldiers in hot 
countries. Its hull is thinner, and the bean is broken up more thoroughly 
by cooking than the white bean. It is more readily digested, and does 
not irritate. "This bean, together with the tortilla, practically made 
from hominy, forms almost the entire diet of the Mexican army, and there 
are few, if any, soldiers who can endure greater fatigue, or among whom 
is less sickness from dietary causes." 



218 FOODS. 

225. Fruits are particularly esteemed for their juices, 
which consist of water, sugar, and vegetable acids (a). 
They are most wholesome when eaten in season in the 
part of the country where they grow. 1 Over-ripe or 
under-ripe fruit may be harmful. Bacteria flourish on 
unclean fruit. The quantity of albuminoids contained in 
fruits is generally very small. 2 Fresh fruits serve to 
quench the thirst, to supply acids, sugar, etc., to stimulate 
the appetite for more substantial food, and to assist in its 
digestion. 3 Grapes, peaches, oranges, strawberries, cher- 
ries, blackberries, raspberries, plums, bananas, apples, 
pears, and apricots are considered the most digestible. 
On the other hand, melons and other cold, watery fruits 
are likely to interfere with digestion, especially if eaten 
abundantly at meal times. 

Fruit is said to be " gold in the morning, silver at noon, 
and lead at night." Cooked fruits may be eaten with 
benefit at any meal. Dried fruits, raisins, dates, etc., con- 
tain much sugar, and should be eaten in smaller quantit}^ 
than fresh fruits. 

JS T uts contain a large amount of nitrogenous and more 
or less fatty material. They should be thoroughly chewed, 
and eaten in moderation. 



1 Strawberries, for instance, which are brought to cities early in the 
year, are frequently ripened artificially, and contain much acid, which at 
times causes dyspeptic ailments. 

2 Bananas contain over 4 per cent, and furnish a valuable food, if 
they are naturally ripened and are eaten in moderation. 

3 " In hot climates these refreshing fruits grow in great abundance, 
and render a residence in the tropics tolerable. A slice of melon or other 
fruit is the common gratuity given in addition to the regular charge for 
any service in hot climates, and forms a contrast to the lump of fat which 
is its equivalent with the Esquimaux." — Fothergill, Maintenance of 
Health. 






FOODS. 219 

226. Condiments are substances which sharpen the appe- 
tite, give a relish to food, and stimulate the digestive 
organs. Of these, salt, pepper (especially the red), mus- 
tard, vinegar, ginger, and horse-radish are the most impor- 
tant. 1 Pickles, olives, lemon juice, and sauces also belong 
to this class of accessory foods. An immoderate use of 
condiments is injurious, for it causes the consumption of 
more food than the system requires, and perverts the 
appetite. Savory herbs, such as sage, thyme, and parsley, 
make certain foods palatable, and can often be substituted 
with advantage for more stimulating condiments (a). 

227. Water. — Drinks may be divided into natural and 
artificial. The first class includes water and milk ; while 
the second embraces tea, coffee, cocoa, and alcoholics. 

Water is in reality the most important of all foods, as 
it is a necessary constituent of all parts of the body («). 
Pure water, chemically speaking, consists only of hydro- 
gen and oxygen. It is probably never found in nature, 
but may be obtained by distillation. It has a flat taste 
and is not palatable. Rain water, especially that which 
falls at the end of a shower, is nearly pure, and is more 
palatable than distilled water, on account of the air 
which it contains. 

228. The best drinking water is that which is clean, soft, 
colorless, without odor even after boiling, and which has 
just enough salt, air, and carbon dioxide in it to make it 
palatable. Water may be clear and sparkling, and still 

1 " Hard work and attendant good appetite require little else than com- 
mon salt as a condiment, which should be plentifully used. It was said 
by Plutarch that hunger and salt were the only sauces known to the 
ancients; and the very word 'sauce'' is derived from the Latin word 
salsus, 'salted.' " — McSueiuu, Health, and How to Promote It. 



220 FOODS, 

be impure and dangerous. This is especially the case in 
well water that has filtered through graveyards or soils 
polluted by cesspools, barnyards, etc. That dirty-looking 
waters are not necessarily unfit for drinking is shown by 
the fact that the muddy water of the Mississippi is drunk 
with impunity by those accustomed to it. 

The green scum found on ponds and along the edges 
of some streams consists mainly of plants of low organism, 
such as algae. In small quantity they are not injurious; 
but if luxuriant, their growth indicates the presence of 
organic matter which is hurtful. If they die and decay, 
they tend to spoil the water (a). Water from melting 
ice is usually purer than that from which the ice was 
formed, for freezing is a purifying process ; but ice from 
stagnant ponds, or from water which contains much or- 
ganic matter, is unfit for use. Whenever there is reason 
to believe that water is unwholesome, it should be exam- 
ined, both microscopically and chemically, by competent 
persons (6). 

229. Sources of Drinking Water. — Good drinking water 
is usually obtained from rivers, lakes, deep wells, and 
springs. Water from shallow wells, the surface of the 
ground, and most brooks should not be used for drinking 
purposes. In places where the water supply is not abun- 
dant, rain water may be used for drinking, if carefully 
collected and filtered ; but if allowed to run over dirty 
roofs, or over decaying leaves and other vegetable growths, 
it acquires an unpleasant taste and may prove hurtful. 
Probably the best form of drinking water is good spring 
water, — that is, from rain or snow, which, after filtering 
through rocks and gravelly soil, gushes forth clear and 
sparkling into the air (a). Water from deep wells, fed 






FOODS. 221 

as they are by underground streams, is much purer than 
that from shallow wells, which is largely the drainage 
from the upper or impurer layers of the soil and has less 
chance of being thoroughly filtered by percolation through 
a great depth of soil. 1 Examples of deep wells are arte- 
sian and driven wells, 2 and such immense wells as those 
at Garden City, L.I., and at Prospect Park, Brooklyn. 
Some of these wells furnish millions of gallons of drinking 
water daily. 

230. Hard and Soft Water. — Ordinary drinking waters 
usually contain, in various proportions, common salt, 
sodium, lime, magnesium carbonates, and air, as well as 
carbon dioxide, which last gives a sparkling appearance 
and an agreeable taste to water. Mineral waters contain, 
in addition, other mineral ingredients. 

Water containing an excess of salts, especially of lime 
and magnesia, is known as hard water. It makes the 
hands feel rough. Water containing little or no lime 
and magnesia is soft ivater. The hardness may be tempo- 
rary or permanent; if temporary, it is due to calcium 
bicarbonates and magnesium bicarbonates, which may be 
precipitated by boiling, thus rendering the water soft and 
suitable for drinking. If permanent, the hardness is due 
to calcium sulphate and magnesium sulphate, which can- 

1 Examinations made from time to time of the water from shallow 
wells, in cities and towns, have shown it to he frequently contaminated 
by filth from cesspools and other sources, which in many instances wore 
but from 25 to 30 feet distant, and sometimes on a higher plane than the 
wells. According to good authorities, they should be at least 100 feet 
away from drinking wells. 

2 Artesian wells vary in depth from one to three or more thousand 
feet. Such wells are used in abattoirs, breweries, and other large estab- 
lishments, where larger quantities of water are needed than can be fur- 
nished by the ordinary water supply of cities. 



222 FOODS. 

not be precipitated by boiling. 1 Hard water is not suit- 
able for cleansing purposes, as it forms, with the fats of 
the soap used, an insoluble compound, which floats as a 
scum upon the surface of the water. 2 

231. Impure Drinking Water. — Stagnant water or that 
containing any decaying animal or vegetable matter is 
unfit to drink. 3 Sometimes water is a fruitful source of 
infectious diseases, such as typhoid fever and cholera, by 
reason of the disease germs which it contains, and which 
may be carried long distances in it. Impurities are more 
likely to continue in deep and sluggish streams than in 
brooks and shallow, active streams, where the water is 
more freely exposed to the purifying influences of the 
atmosphere. Yet the larger streams, on account of the 
abundance of water they furnish and the ease with which 
it can be obtained, are mainly relied upon for the water 
supply of cities and large towns. Water for drinking pur- 
poses should be taken from the middle of the stream and 
somewhat below the surface, as the refuse from factories, 
drains, and sewers, which finds its way to a greater or less 
extent into rivers and creeks, is most apt to flow along 
the sides. 4 

1 Hard water may frequently be softened by the addition of wood ashes, 
sodium carbonate, or borax. 

2 It is said that in Glasgow, by the introduction of water from Loch 
Katrine, the inhabitants saved in one year thousands of dollars in soap, 
the water used before having been very hard. 

3 The water of shallow wells and defective cisterns may cause malarial 
affections which are often credited to a marsh or mill pond near by. 

4 " The river Rhine, it is Avell known, 
Doth wash your city of Cologne ; 
But tell me, nymphs ! what power divine 
Shall henceforth wash the river Rhine ? " — Coleridge. 
The answer is, — the oxidizing influences of the atmosphere. It has 
been shown that the farther away from the source of the impurities, the 



FOODS. 223 

232. The mode of conveying drinking water from its 
source of supply is a matter of great importance. Usually 
wood, lead, or iron pipes are used for this purpose. Rain 
water, or any water deficient in saline ingredients, flowing 
through lead pipes, may dissolve enough lead to render it 
poisonous. Saline ingredients in river, well, and spring 
waters, by partial decomposition, line the pipes with a 
crust, and generally prevent this absorption. Sometimes 
water, especially if hot, will dissolve enough lead to be- 
come injurious. 1 It is wise to let either hot or cold 
water run awhile before using it for drinking or cook- 
ing. Hot water running through iron pipes acquires a 
disagreeable taste. To obviate the risks above referred 
to, block tin pipes, tin-lined lead pipes, and glass-lined iron 
pipes are recommended by sanitary authorities. 

Sometimes water that is kept in copper vessels absorbs 
copper and is harmful. The presence of iron salts in 
water in large quantity is undesirable. So, too, are alka- 
lies, as in the dry region far west of the Mississippi River. 

233. Purification of Water. — Water may be freed, by vari- 
ous methods, of much of its injurious matter. Boiling will 
destroy dangerous disease germs and precipitate the bicar- 
bonate of lime and some of the coagulable organic matter. 
Aeration will render stale or confined waters palatable. 
Allowing them to settle will render some muddy waters 

better is the water for drinking purposes. This is true of ordinary organic 
impurities, but there is reason to believe that the germs of disease are not 
so readily rendered harmless. 

1 Lead pipes should not be used for soda-water fountains, as the car- 
bonated water dissolves lead readily. The presence of lead in water may 
be detected by adding a few drops of a solution of sulphuretted hydrogen. 
If lead be present, it renders the water black, or dark brown, owing to 
the sulphuret of lead formed. 



224 FOODS. 

fit for drinking. This settling may be facilitated by pre- 
viously stirring a little alum into the water. Proper 
filtration will partially remove not only suspended organic 
impurities, but even some dissolved ones. The filtrating 
substance maybe porous earth, sand, charcoal, certain insol- 
uble powders, fine gravel, sponge, etc., either alone or vari- 
ously combined. Charcoal, oxide of iron, and sand are the 
most active. Filters act partly by sifting out solid parti- 
cles, and partly b} r oxidation of the organic substances by 
means of the oxygen in the pores of the material used 1 (a). 

234. Coffee and Tea neither form tissue nor act as fuel. 
In moderate quantity, they stimulate the nervous system, 
arouse dormant energies, tend to retard undue waste, and 
assist in the digestion of food. Hence they are best 
adapted for use after a hearty meal, but cannot take the 
place of food. As stimulants they are frequently superior 
to alcoholics, and have been found to be especially valuable 
in armies and on board ships, among soldiers and sailors 
exhausted by hard work. 2 They should not be. used by 

1 Suspected water in houses should be first strained through clean 
flannel, then boiled, and in summer kept in bottles in the ice box. Pipe- 
clay filters are serviceable, but, like all filters and strainers, must be kept 
clean, else they do more harm than good. "Probably the best filter is 
one composed of finely divided silicon and carbon, pressed into a solid 
cake. This filter, when dry and clean, will remove a large quantity of 
organic impurity, as well as lead, from the water passed through it. 
Prepared for soldiers' use, it was carried by the English soldiers in the 
late war in Egypt, and found to be of great service. Placed in even the 
dirtiest water, the fluid was sucked through the filtering mass by means 
of a rubber tube and mouth-piece, and was rendered fit for drinking." 

2 Rations of coffee are given with advantage to sailors in the United 
States navy and on some of the great ocean steamers, in place of their 
"grog." Coffee, more than tea, lessens the craving for alcohol. In the 
Spanish- American War, tea was of great benefit to soldiers in active 
service. 



FOODS. 225 

children, except when very much diluted with milk ; nor 
should they be taken in large amount, or very strong, by 
any one. Thus taken, they cause the heart to act irregu- 
larly and depress the nervous system. If relied upon to 
supply, by their stimulating properties, the place of nourish- 
ing food, they produce indigestion. 1 Tea and coffee are 
similar in action, though they affect people differently at 
times. Each contains a volatile oil, which gives odor and 
flavor, an astringent (tannic acid), and an active principle 
— theine in tea, and caffeine in coffee. 

235. Chocolate and Cocoa contain fatty matter, albumi- 
nous and starchy materials, and a substance similar to 
theine and caffeine, known as theobromine. They are not 
so stimulating as coffee and tea, but are much better as 
food. As Dr. Edward Smith remarks, in his valuable 
book on Health, " Perhaps few foods are so nutritious or 
will satisfy the appetite so well as cocoa and milk, if 
plenty of cocoa be used, and it is equally good for all 
ages, classes, and circumstances." 2 

236. Alcoholic Beverages. — While, as we have seen, malt 
liquors may contain some of the nourishing elements of 
the grain, and all alcoholic beverages in small amount 

1 Investigations show that much of the ill health — viz. dyspepsia, bad 
feelings, and nervous ailments — among certain classes in this country 
and England is due to the excessive use of tea and coffee. Many women 
live upon tea and bread when alone throughout the day, rather than take 
the trouble to cook suitable food. Among the poor, tea is largely used, 
because it is considered by them cheap and nutritious. 

2 The fresher cocoa and chocolate are, the better. Cocoa, especially if 
retained in tight packages in close apartments, becomes musty ; and, if 
exposed to the air for a long time, loses its flavor; hence, in some cities, 
it is freshly prepared every day by dealers. Unlike coffee and tea, there 
should be no grounds which cannot be eaten. 



226 FOODS. 

yield some energy to the body, they are likely to do so at 
the expense of working ability. Frequently their use is 
followed by depression, which, as a rule, is not the case 
with hot tea, coffee, cocoa, or soups. Neither do these, 
like the alcoholic beverages, produce a craving for more. 
When the system obtains food which is digested and 
is also sufficient for all the needs of nutrition, alcoholic 
beverages are unnecessary. The use of alcohol does not 
lessen the need of the healthy system for complete food, 
like bread, meat, and milk. 

QUESTIONS. 

1. How may foods be classified? 

2. What do animal foods comprise ? 

3. Why is animal food frequently used to excess? 

4. What meats are least digestible, and why? 

5. What is to be said of poultry ? Game? Fish? 

6. Why should partially decomposed meat be avoided ? 

7. What are the reasons for cooking meat? 

8. What is considered the " model" food, and why is it so called? 

9. How should milk be protected from impurities? 

10. Why are skim-milk, buttermilk, and whey useful? 

11. What is said of butter and its substitutes? 

12. What is to be said of cheese? Eggs? 

13. What do vegetable foods include ? What cereal grains are most 

used ? 

14. What is to be said of wheat and other cereals ? 

15. Which is the best flour for family use? 

16. Wnat kinds of flour are used for bread, and how is it raised? 

17. Why are potatoes especially commended ? 

18. Why should other vegetables be used? 

19. What is said of peas, beans, and lentils? What of fruits ? 

20. What are condiments, and how should they be used? 

21. How may drinks be classified? What is to be said of water, and 

of the different kinds, and how may it be purified? 

22. What benefit is derived from tea? Coffee? Chocolate and cocoa? 

23. What is said of the use of alcoholic beverages in comparison? 



CHAPTER XIII. 
RESPIRATION. -ANIMAL HEAT. 

237. Object of Respiration. — Blood, to nourish the tis- 
sues effectually, must contain oxygen. This is supplied 
by the atmosphere and by various foods, the largest 
amount being furnished by the air which we breathe. 
Simultaneously with the absorption of oxygen, the blood 
parts with its carbon dioxide and other impurities. This 
process is effected by respiration, or breathing. 

238. The Organs of Respiration comprise the lungs and 
the air passages leading to them. Also concerned in the 
act of breathing are the ribs and their cartilages, the 
diaphragm, and those muscles of the chest which assist 
in expanding and contracting the chest walls. 

239. The Air Passages include the interior of the nose, 
mouth, pharynx, larynx, trachea, the bronchi, and bron- 
chial tubes. These passages not only afford transit for 
the air, but they serve also to warm, cleanse, and moisten 
it on its way to the lungs. 

Though air enters the mouth to a greater or less extent, 
the nose is the proper channel of respiration. It is lined 
with mucous membrane, and is divided by a middle wall 
of cartilage and bone into separate nostrils, in each of 
which are three thin, projecting plates of bone, one above 
the other (Fig. 46). These curve downward, and are 




228 RESPIRATION. — ANIMAL HEAT. 

covered by mucous membrane. 1 The air, therefore, in its 
passage through the nostrils, comes by a circuitous route 
into contact with a large extent of moist and warm mu- 
cous membrane. The membrane is kept moist by the 
secretions of its mucous glands, and warm by being richly 
supplied with blood. 2 In addition to these arrangements 
for warming the air, retarding its pas- 
sage, and ridding it of dust, there are 
hairs just within the nostrils, and cili- 
ated cells upon a part of the surface 
of the mucous membrane of the nose. 
Similar cells are also found upon the 
posterior surface of the soft palate, in 
Fig. 79. the windpipe, and in other portions of 

Diagram of a Vertical Sec- the air passages. Their hairlike Dila- 
tion of the Bronchial ^ b 

Mucous Membrane. ments are constantly vibrating, but 

1, cmatedepitMMceUs. with greater f orce i n opposition to 

5, bSmfnt membrane. the entering current of air, or from 
e, fibrous layer. within, outward. Their united move- 

ment somewhat resembles that of a field of wheat when 
moved by the wind. The effect of such an organism op- 
posing itself to the entering air current is to catch foreign 
particles which may be intermingled with the air, and 
gradually carry them out of the air passages by an unceas- 
ing counter movement. 

240. Mouth Breathing. — On the other hand, when we 
breathe through the mouth, foreign particles are forced 
into the throat and lungs and act as irritants, the mouth 

1 These bones are known as the turbinated bones, from their fancied 
resemblance to tops. 

2 It is said that the nasal cavities are a degree or two warmer than the 
cavity of the mouth. 



RESPIRATION. — ANIMAL HEAT. 229 

and throat become dry, and so imperative is the necessity 
for breathing that sufficient time is not taken for the 
mastication of food. In the habitual mouth breather, the 
nasal mucous membrane, being insufficiently used, dries 
and shrinks, causing discomfort. 1 The efforts that are nec- 
essary to breathe eventually result in unpleasant expres- 
sions of the face ; the mucous membrane is likely to become 
more or less inflamed, and thus to obstruct the nasal 
passages ; hearing is interfered with by partial or entire 
closure of the Eustachian tubes, whose function it is to 
convey air to the organs of hearing ; the voice loses its 
resonance ; and the lungs are imperfectly developed. 
Sometimes the tonsils enlarge, and obstruct the free 
movement of air through the nasal cavities and Eusta- 
chian tubes 2 (Fig. 46). If the trouble is long-continued 
in the case of babies and young children whose bones are 
deficient in mineral ingredients, there results, from the 
repeated violent efforts made necessary in breathing, 
more or less sinking of the lateral chest walls, thus 
causing an unnatural protrusion in front. This condition 
is popularly known as the "pigeon breast" («). 

1 Healthy babies breathe, for the greater part of the time, through the 
nose, with the mouth shut ; and, if a baby is in the habit of breathing 
with the mouth open, there is reason to suspect the presence of enlarged 
tonsils, or some disease of the nostrils. A Scotch physician, fully appre- 
ciating the importance of proper breathing, has written a valuable medical 
paper entitled " Shut your Mouth and save your Life." Wo are told that 
some Indian tribes understand the importance of breathing through the 
nose, and that the squaw, before retiring for the night, sees that the mouth 
of her baby is shut. Some of the most careful trainers insist that walking 
and running should be, as far as possible, with the mouth closed. 

2 Enlargement of portions of the mucous membrane, behind the poste- 
rior nares, due frequently to elm >nic nasal catarrh, and known as •• adenoid 
growths," are associated sometimes with mouth breathing. These growths 
should be removed by the surgeon, as they impair the voice, the respirator) 
power, and the general health. 



230 RESPIRATIOX. — AXJMAL HEAT. 

241. The Larynx. — The pharynx, as we have seen, is 
a passage for air as well as food, but the larynx is for air 
alone. This latter organ is located in front of and adjoin- 
ing the upper end of the oesophagus (Fig. 46), and opens 
into and is continuous with the trachea. It is composed 
of several cartilages controlled by muscles, and is so ar- 
ranged as to form a kind of box. Near the middle of 
it is a dilatable opening called the glottis, through which 
respiration is performed, and by means of which articu- 
late sounds are produced. Air enters the nose and mouth, 
passes through the pharynx, and thence into the larynx, 
trachea, bronchi, bronchial tubes, and the air-cells of the 
lungs. 

242. The Trachea, Bronchi, and Large Bronchial Tubes, 

like the larynx and the air-cells, are lined with mucous 
membrane. They are tubes, kept open by a series of in- 
complete cartilaginous rings embedded in their walls and 
placed at nearly equal distances. These cartilages are 
bound together by strong connective tissue, and do not 
meet posteriorly, — an arrangement which gives the air 
tubes elasticity and pliancy, and in the case of the trachea 
allows the oesophagus to expand readily in swallowing. 

The trachea is about an inch in diameter and four and 
a half inches in length, and has some muscular fibres in 
its walls. Before entering the chest, it is near the sur- 
face, and generally can be felt by the fingers. Nearly 
opposite the third dorsal vertebra it divides into two 
smaller tubes, the right and left bronchus. 1 Each bronchus 

1 Bronchitis, or " cold on the chest," is an inflammation of the lining 
membrane of the bronchi and bronchial tubes, attended by swelling of 
the membrane and increased secretion of mucus. If this is considerable, 
the passage of air is impeded and difficulty in breathing results. 



RESPIRATION. — ANIMAL HEAT. 



231 



on entering the lung divides, like the branches and twigs 
of a tree, into bronchial tubes, which become smaller and 
smaller and finally end in lobules. 




Fig. 80. 

Lungs In outline, showing relations of the larynx, trachea, bronchi, and the bronchial tubes 
and their branches. 



1, thyroid cartilage of the larynx. 

2, cricoid cartilage. 



8, trachea. 

4, its point of bifurcation. 



5, right bronchus. 

6, left bronchus. 



243. The Small Bronchial Tubes and the Air-cells. — The 
smallest bronchial tubes (bronchioles) contain no oarti- 



232 RESPIRATION. — ANIMAL HEAT. 

lages, but are delicate, elastic, and membranous, and have 
circular muscular fibres in their Avails. The lobules, or 
dilated membranous terminations of these tubes, bound 
together by elastic connective tissue, are divided by the 
inward projection of portions of their walls into a num- 
ber of pouch-like compartments, called alveoli, or air- 
cells. Each air-cell has very thin, elastic, and disten- 
sible walls, and is only about yj-g- of an inch in diameter. 
Covering the lobules, and dipping down between the 
adjoining walls of the air-cells, is a close network of 
capillaries, intermingled with nerves and lymphatics. 
The capillaries are supplied by the pulmonary artery, 
and empty into the pulmonary veins. The convoluted 
arrangement of the walls of the lobules affords an exten- 
sive surface of very delicate membrane for the aeration 
of blood, — a surface much greater than that of the entire 
exterior of the body. 1 

244. The Lungs consist of bronchial tubes, air-cells, 
blood-vessels, lymphatics, and nerves, all bound together 
by elastic connective tissue. There are two lungs, lo- 
cated in the thoracic cavity, one on each side of the 
median line, and separated from each other by the heart 
and its great blood-vessels and by the bronchi. Each 
lung is cone-like in shape. Its upper end, or apex, ex- 
tends about an inch above the level of the first rib. 2 Its 



1 It is estimated that the extent of surface of all the sacs is about 2600 
square feet, and that "in the course of twenty -four hours about 20,000 
litres (35,000 pints) of blood traverse the capillaries, the blood corpuscles 
passing in single file and being exposed to air on both surfaces." 

2 This part is not inflated fully in mouth breathers, or by other persons 
having poor respiratory power, and is most susceptible to tubercular 
disease, probably because it is not actively used. 



RESPIRATION. — ANIMAL HEAT. 



233 



broadened lower surface is concave in form, and rests 
upon the upper convex surface of the diaphragm. The 

remaining surfaces of the lungs 
are convex in form, and fit into 
the concave interior of the chest 
walls. 



^3 





Fig. 81. 

Ultimate Bronchial Tubes and their Lobules. 
Connective tissue removed. 



Fig. 82. 

Lobules laid open, showing- 
alveoli. 



245. Movements of the Lungs. — Free movements of the 
lungs are absolutely necessary for the full performance of 
their functions. For this work they are well adapted by 
their structure and coverings, and by the arrangement 
and mobility of the chest walls. Covering each lung, 
except where the large blood-vessels and air tubes enter, 
is a strong but delicately constructed closed sac, known as 
the pleural sac. These sacs together constitute the pleura. 1 
The space inclosed by each sac is the pleural cavity. One 
wall of each sac is closely adherent to the lung, and the other 
to the concave inner wall of the chest. The lining, or inner 



1 The word pleura is derived from the Greek, and means "rib' 1 or 
side." 



234 RESPIRATION. — ANIMAL HEAT. 

surface, of each sac secretes in health just enough lubricat- 
ing fluid to allow the inner surfaces of its walls to glide 
readily upon each other in the process of breathing. 1 

246. The lung substance is elastic, like a sponge, and 
is filled with inclosures containing air. If a piece of the 
healthy lung of an ox or sheep be pressed between the 
ringers, it makes a peculiar crackling, due to the partial 
dislodgment of air. If the piece be tightly squeezed, or 
even bruised between heavy rollers, sufficient air will still 
remain in it to cause it to float in water. In fact, the lungs 
are the only organs in the body that will float. 

247. Mechanism of Respiration. — The process of respira- 
tion consists of inspiration, or breathing in, and expiration, 
or breathing out. Inspiration requires considerable mus- 
cular effort. The glottis is more or less widely opened, 
the chest walls are drawn outward and upward by mus- 
cles overlying the chest and by muscular fibres between 
the ribs, 2 and the diaphragm is made to descend by the 
contraction of its muscles. The thorax is thus dilated, 
and in consequence the elastic air sacs are filled with air 
forcibly sucked in. The normal enlargement of the thorax 
is in three directions; viz., vertical, from side to side, 
and from the back forwards. The first — due mainly to 

1 When the gliding motions are hindered by the adhesion of the se- 
creting surfaces of a pleural sac, as in pleurisy, anything more than the 
quietest breathing is attended with acute pain. 

2 There are two sets of muscular fibres between the ribs, placed 
diagonally and crossing each other, viz., the external and internal inter- 
costal muscles. The first assists in pulling the ribs down, the second 
serves to pull them up. "The lungs lie in an air-tight chest with movable 
walls. When, by muscular contraction, the size of the chest is increased, 
the surface of the lungs must remain in contact with that of the chest ; 
and air thus passively enters the lungs to occupy the increasing space." 



RESPIRATION. — ANIMAL HEAT. 



235 



the descent of the diaphragm, and the pushing outward 
of the walls of the abdomen — is the greatest, and is most 
common in men. It is often spoken of as " abdominal 




PLS 



Fig. 83. 

Diagram. Lungs in Inspiration and Expiration. —1, lungs contracted in expiration; 

2, lungs expanded in inspiration. 
T, trachea. L, the lung substance. D, the diaphragm. 

CW, chest walls. PLS, pleural sacs (the walls separated). 

breathing," or the " abdominal type of respiration," to 
distinguish it from breathing mainly by the elevation of 
the ribs, i.e. "costal breathing," or the "thoracic type of 
respiration." 1 This latter form of breathing is most 
common in women, especially those who take insufficient 

1 The action of the diaphragm in respiration may be illustrated with 
an open bell jar, whose lower and larger opening is covered by thin 
rubber. Place a snugly fitting cork in the neck of the jar, and through it 
put a glass tube, one end projecting above the opening of the neck, and 
the other end, with a thin rubber bag or pouch firmly secured to it, nearly 
midway into the body of the jar. If the rubber covering of the jar is 
pulled downwards, air will enter the tube at its upper end, ami distend 
the bag (as in inspiration). Air will be forced out of the bag v as in 
expiration) when the rubber covering resumes its first position. 



236 RESPIRATION. — ANIMAL HEAT. 

muscular exercise. The enlargement of the upper part 
of the chest is generally pronounced in women who re- 
strict the free movements of the chest and abdomen by 
tight clothing. Indian women breathe as men do. 

In both sexes, and at all periods of life, the free action 
of the diaphragm is necessary for health and energy. 
Though mainly composed of involuntary muscular fibres, 
the diaphragm is, to a certain extent, under the control of 
the will, and its strength, like that of the other respiratory 
muscles, can be increased by proper exercise, such as sing- 
ing, reading aloud, oratory, etc. 1 Hiccoughing, sobbing, 
and laughter are occasioned by the spasmodic action of 
the respiratory muscles, especially of the diaphragm. 
Laughter, crying, and sobbing, though generally under 
the control of the will, may become violent and uncon- 
trollable, as is sometimes witnessed in the anger or sorrow 
of children. 2 

248. Expiration immediately follows inspiration. It is 
a passive movement, and consists in the gentle expulsion 
of the air outward through the air passages, by the elastic 
recoil of the respiratory apparatus. 3 After each expiration 

1 Physicians frequently meet with persons, especially those of sedentary 
occupations, whose breathing is shallow, the air-cells of the lungs expand- 
ing but very little. Oftentimes by proper exercise of the muscles of the 
chest and diaphragm (i.e. by so-called lung gymnastics), the respiratory 
power can be increased to a marked extent, and incipient disease of the 
lungs warded off. 

2 It sometimes happens that persons having the charge of children are 
very severe with them for sobbing persistently, when it is utterly out of 
their power to stop. 

3 By placing the ear over a healthy lung, we can hear the strong move- 
ment of the air as it enters the chest. Expired, it gives a low-pitched 
sound, as of a very gentle wind. Variations in the pitch, volume, and 
quality of these respiratory sounds, or " murmurs," enable the physician 
to detect diseases or disturbances. 



RESPIRATION. — ANIMAL HEAT. 237 

there is a short period of rest. When more than ordinary 
respiratory efforts are necessary, as in oratory, singing, 
blowing upon wind instruments, etc., increased expiratory 
force is created, and the elastic recoil is aided by the power- 
ful contractions of large abdominal muscles. These, pull- 
ing down the ribs and pressing upon the contents of the 
abdomen, push up the diaphragm, and thus squeeze out the 
air from the lungs. Corresponding inspiratory power re- 
sults from a forcible contraction of the muscles of the 
diaphragm and of the respiratory muscles of the chest. 1 

249. The Number of Respirations varies from about forty 
per minute soon after birth to eighteen per minute in 
persons from thirty to fifty years of age. The rate is 
naturally more rapid where there is small lung capacity, 
when breathing rarefied air at great heights, or when 
taking exercise. Of course, where the opposite conditions 
exist, the rapidity is decreased. 

250. The Quantity of Air breathed varies. In ordinary 
quiet breathing, during each act of respiration we inhale 
and exhale about thirty cubic inches of air (about a 
pint). This is called tidal air. because it is the ordinary 
amount which ebbs and flows in breathing. It is said 
not to penetrate, in such respiration, farther than the 
large bronchial tubes. But by the process known as 
gaseous diffusion, the heavier carbon dioxide in the air- 
cells and the vivifying and lighter oxygen in the bron- 
chial tubes are intermingled, and the air in various parts 

1 In violent inspiratory efforts, following severe physical exercise, or 
when the action of the lungs is much impeded by disease, nearly all the 
muscles of the hody may assist the respiratory muscles proper, by placing 
various parts of the body so that the respiratory muscles may have the 
best opportunities for work. 



238 RESPIRATION. — ANIMAL HEAT. 

of the lungs is partially renovated. It is estimated that 
from eight to ten respirations are necessary to change the 
whole quantity of air in the chest cavity. Though about 
ninety gallons of air per hour pass into and out of the 
lungs in quiet breathing, such as is common among per- 
sons engaged in sedentary occupations, continued tidal air 
breathing is insufficient for the healthy development of the 
lungs. It does not meet the requirements of persons 
doing heavy work, nor is it suitable for any one if the 
atmosphere is vitiated by impurities. 1 For these reasons, 
among others, systematic exercise in the open air is im- 
portant. After an ordinary expiration a healthy per- 
son can, by a forced effort, exhale from 75 to 100 cubic 
inches of air. This is termed reserve or supplemental air. 
There still remain in a healthy lung from 75 to 100 cubic 
inches of air that cannot be expelled. This is residual 
air. It is possible, by a forced inspiration, to inhale from 
100 to 120 cubic inches of air in addition to the tidal air. 
This is known as complemental air. 

251. The amount of air which can be forced from the 
lungs after the deepest possible inspiration constitutes the 
breathing or vital capacity. It is the sum of the reserve, 
the tidal, and the complemental air. It may be de- 
termined by an instrument known as the spirometer, and 
is found to be about 230 cubic inches in a person of aver- 
age stature (p feet, 8 inches) ; but the vital capacity is no 

1 Persons whose breathing is generally of this type — i. e. who have 
" shallow respirations " — have also a sluggish circulation, and are most 
likely to suffer from consumption and other lung diseases, especially if 
the air breathed is impure. Were it not for the increased amount of air 
carried into and out of the lungs at about every fifth or sixth act of res- 
piration, such persons would suffer more than they do from the excess of 
carbon dioxide not eliminated. 



RESPIRATION. — ANIMAL HEAT. 



239 



evidence in itself of vitality, or endurance, or so-called 
" wind," for it bears a definite relation to stature, without 
being affected in a marked degree by weight or the cir- 



Vital 
Capacity 



Complemental air . 100 to 120 cubic inches. 



TMal air . . . 


. 20 to 30 


Reserve air . . 


. 75 to 100 


Residual air . . 


. 75 to 100 



Fig. 84. 

This diagram represents approximately the vital capacity, and the relative amounts of com- 
plemental, tidal, reserve, and residual air. 



cumference of the chest. 1 It is diminished by severe 
thoracic and abdominal diseases ; but the vitality of a 
person depends more upon the condition of the heart 
than upon the expansive capacity of the lungs. 

252. Relation of Respiration to Circulation. — The move- 
ments of respiration are for the most part involuntary. 
From birth until death, asleep and awake, breathing, like 
the circulation, goes on involuntarily. There should be in 
adults one act of respiration to every four or five beats of 
the heart, and, in children, one to every three or three and 
one-half beats. But one can increase somewhat the ra- 
pidity of the respiratory movement up to his limit by 



1 It has been shown by Hutchinson of England, who has made the 
most numerous investigations in this direction, and who makes the above 
statement, that for every inch in height between five and six feet, the 
vital capacity is increased eight cubic inches. It increases up to the age 
of thirty-five, and then diminishes. 



240 RESPIRATION. — ANIMAL HEAT. 

various forms of exercise. With such increase, the heart's 
movements must increase proportionately, or exhaustion 
and suffering ensue from shortness of breath. On the 
other hand, the same effect is produced when the heart 
beats rapidly from severe exercise, and the movements of 
the lungs do not increase proportionately. Few persons 
can, without great effort, suspend respiration for more than 
thirty or forty seconds at a time. The desire for breath 
soon becomes imperative, owing to the circulation of blood 
of rapidly increasing impurity, especially in the lungs and 
brain. By breathing forcibly a few times, then taking 
a forced inspiration, respiration may be suspended for a 
minute, or even longer, thus enabling one to pass quickly 
through a cloud of dust, smoke, or other injurious matters 
in the atmosphere, or to remain for a short time under 
water. 1 

253. Changes in the Air and Blood during Respiration 

occur in the air-cells of the lungs. Through their thin 
walls, and those of the capillaries, simultaneously the 
oxygen of the air is absorbed by the blood, and some of 
the wastes of the blood pass into the air in the air sacs. 
Inspired air is robbed of a large part of its oxygen, and 
expired air is charged with noxious materials, and will not 
support combustion or maintain life. Animals and human 
beings obliged to breathe it exclusively soon die. It con- 
tains carbon dioxide 2 in excess, and small quantities of 



1 This ability to hold the breath can be increased by systematic practice, 
as in the case of the so-called water kings and queens, who sew, write, 
and eat under water. 

2 The amount of carbon dioxide exhaled per day by a healthy adult is 
estimated at about 20,000 cubic inches, while the amount of oxygen con- 
sumed per day is estimated at about 40,000 cubic inches. 



RESPIRATION. — ANIMAL HEAT. 241 

various excretory products similar to those excreted by the 
skin and kidneys ; * also, an animal product which is 
offensive and prone to putrefy. It also differs from in- 
spired air in that its temperature, especially in slow and 
tranquil breathing, is raised nearly to that of the blood, 
and because it contains an excess of watery vapor. 2 This 
vapor- is especially noticeable when the breath is exhaled 
upon a mirror or window pane, or when it condenses in 
winter, as it issues from the mouth and nostrils. 3 Carbon 
dioxide is heavier than air, and is very poisonous to 
breathe. It constitutes about one twenty-fifth of the air 
that passes out of the lungs, and tends to make the atmos- 
phere impure. The amount of carbon dioxide expelled is 
increased by exercise, and during and after a hearty 
meal. It is greatest in winter and damp weather, is 
especially abundant in the early morning, and is least at 
midnight 4 (a) . 

1 " Chloride of sodium, uric acid, and urates of soda and ammonia. It 
also sometimes contains carbonate and hydrochlorate of ammonia, and 
carburetted hydrogen and various odorous substances from the food and 
drink consumed." 

2 The air exhaled per day contains an average amount of nine or ten 
ounces of water, but the amount varies with the temperature of the 
atmosphere. 

3 In cases of suspected death, the condensation of the watery vapor of 
the breath upon the glass of a watch or a hand-mirror is an important 
evidence that life is still present in the body. 

4 The presence of carbon dioxide in the breath may be illustrated by the 
following experiment, which is all the more striking if tried after one has 
talked or sung awhile, or after a hearty meal. First, the gas, being acid, 
will change the blue color of a solution of litmus to red, when the breath 
is gently blown into the solution through a glass tube for a variable length 
of time. Second, that the expired air contains carbon dioxide will be shown 
by its changing clear lime-water, in the same manner as above, to a 
cloudy white liquid, due to the carbonate of lime formed. 



242 RESPIRATION. — ANIMAL HEAT. 

254. The ancients believed that the function of the air, 
so regularly introduced into the lungs, was to cool the 
blood. But physiologists have ascertained that associated 
with the changes in the air, just studied, is the striking 
change in the color of the blood from blue in the pulmo- 
nary veins to scarlet in the capillaries of the lungs ; and, 
also, that this change is due to the inhaled oxygen. If 
the breathing is seriously obstructed, the lips and face 
turn a purplish blue. If the obstruction is removed, the 
blood resumes its bright color, and the parts renew their 
functions. If the obstruction is not removed, the change 
in color is noticeable in other parts of the body, impure 
blood is circulated through the brain, and the individual 
becomes drowsy and unconscious, and death ensues. There 
is constantly going on in the blood a double change, — a 
loss of oxygen and a gain of carbon dioxide in the tissues, 
and a loss of carbon dioxide and a gain of oxygen in the 
lungs. 

The urgent appeal of the lungs for pure air, when the 
breathing has been carried on in an impure atmosphere, or 
where the lungs are in a diseased or abnormal condition, 
is like the appetite for food on the part of the digestive 
organs. The cry originates in the tissues, which demand 
in the one case the food and in the other the oxygen, 
both of which are necessary to life. 

255. Nervous Control of Respiration. — The movements 
of the diaphragm and the respiratory muscles of the chest 
are controlled by nerves. The impulses which stimu- 
late these nerves to action originate in a part of the 
brain known as the respiratory centre. If this centre is 
destroyed, breathing stops, never to be renewed. Its ac- 
tivity seems to depend largely upon the condition of the 



RESPIRATION. — ANIMAL HEAT. 243 

blood which circulates in it. The poorer the blood, the 
greater is the effort required on the part of this nerve 
centre to insure increased activity of the respiratory 
muscles. 

256. Relation of Circulation, Respiration, and Animal 
Heat. — The changes which living tissues undergo in the 
production of animal heat are especially indicated by the 
absorption of oxygen and the exhalation of carbon dioxide. 
The more rapid the respiration and circulation, the higher 
is the temperature. On the other hand, if the temperature 
of the body is lowered by insufficient food or the use of 
alcoholics, and secretion and other processes are interfered 
with, respiration and circulation, at first accelerated, are 
gradually lowered below the normal standard. Animal 
heat remains in the body for a variable period after the 
blood has ceased to flow and respiration has stopped. 

257. Exposure to moisture and a high degree of heat, 
especially if accompanied with exercise, is apt to cause 
death, which is then said to be the result of sunstroke, or 
heatstroke. 1 The old, the feeble, and the inactive are most 
affected by high temperatures, and in them also animal 
heat is maintained at its normal point with the greatest 
difficulty. With them the blood circulates more slowly, 
respiratory power is decreased, the chemical and mechani- 
cal processes take place less rapidly, and heat is generated 
in smaller amount than in robust health. " Thence it is," 
says Bennett, " that the old man seeks the sun, and that 
we find him in the country sitting at his door for hours, 

1 No case of spontaneous combustion -i.e. the rapid destruction of 
the human body by fire, as the result of excessive animal heat — has boon 
proved, though sometimes reported. 



244 RESPIRATION. — ANIMAL HEAT. 

basking in the sun, seeking from its genial rays the warmth 
which the organic processes no longer afford, as in former 
days — the days of his youth and of his organic vigor." 

258. In summer and in hot countries perspiration and a 
decreased amount of clothing moderate the animal tem- 
perature ; in cold climates and seasons the heat of the 
body is preserved by extra clothing, by warming the at- 
mosphere with artificial heat, by more exercise, and by an 
increased amount of food. It is the testimony of many 
observant travellers, that the health of persons journeying 
from one climate to another is best preserved when the 
customs of the inhabitants of these climates are followed, 
in regard to food, exercise, and clothing (a). 

259. Effects of Alcohol and Narcotics on Respiration and 
the Respiratory Organs. — In habitual drunkards, the blood 
is practically an alcoholized fluid. Part of the alcohol is 
excreted by the lungs, kidneys, and skin, and part is 
broken up in the blood into other substances. Such 
blood tends to congest the capillaries of the lungs, and 
by getting rid of an undue amount of heat, to produce a 
sensitiveness of the lungs to cold, which is quite frequently 
followed by obstinate attacks of bronchitis. Repeated 
congestion of the lungs, by thickening their lining mem- 
brane and thus interfering with the diffusion of gases, re- 
tards the change of impure blood into pure blood, and 
permits carbon dioxide to be retained in undue amount. 
The heart is compelled to work harder to overcome the 
obstacle to the free propulsion of its contents. 

Probably one of the most constant effects of alcohol 
and alcoholic liquors, especially in considerable amount, 
is to produce a depression of both rate and depth of 



RESPIRATION. — ANIMAL HEAT. 245 

respiration through direct action on the respiratory nerve 
centre, and to diminish the exhalation of carbon dioxide. 
This substance, retained in the blood and tissues, produces 
a feeling of depression. For the oxidation of alcohol in 
the body, some oxygen is consumed, which otherwise 
would be used by the food and tissues. 

260. The evil effects of tobacco, either chewed or 
smoked, are due mostly to nicotine. Tobacco smoke, 
however, sometimes acts as an irritant to the throat, nasal 
passages, larynx, and Eustachian tubes, producing either 
an obstinate catarrh, or a very dry condition of the 
throat, known as " smoker's throat." This is attended 
by coughing, hawking, and expectoration, and, when the 
Eustachian tubes are inflamed, produces deafness also. 
These bad results are most likely to occur when to- 
bacco smoke is inhaled, and are common among cigarette 
smokers, of whom it is estimated about 90 per cent inhale 
the smoke. 

261. The local effects of opium and other narcotic 
drugs upon the respiratory organs is usually to diminish 
their secretion of mucus, and so interfere with their func- 
tions. 

QUESTIONS. 

1. What is the object of respiration, and what are its organs? 

2. Describe the lungs. How are their free movements secured? 

3. Name the air passages and their four functions. 

4. Describe the nose, and its advantages over the mouth as an air 

passage. 

5. What are some of the evils of mouth breathing? 

6. With what passage do the nasal cavities connect, and what 

tubes and glands are there Located? Slate the object oi the 
tubes. 



246 RESPIRATION. — ANIMAL HEAT. 

7. What is situated below the pharynx, and of what air passage is 

it the commencement ? 

8. Describe the larynx; the trachea; the bronchial tubes; the 

lobules. 

9. How are the trachea and other air tubes kept open ? How the 

smaller tubes ? 

10. Why do these tubes terminate in convoluted lobules, and what 

blood-vessels are there placed ? 

11. Of what does the mechanical act of respiration consist? Describe 

each process. 

12. What may aid powerful respiratory efforts ? Describe the action 

of the diaphragm. 

13. What connection has the will with respiration? the heart? the 

condition of the blood? 

14. Explain what is meant by tidal air; by residual air; by reserve 

air; by complemental air; by vital capacity. 

15. What changes take place in the air during respiration ? in the 

blood? 

16. Where does the appeal for fresh air originate, and how is the 

needed oxygen supplied through the lungs? 

17. By what nervous influence are the respiratory movements 

effected? 

18. What are the relations between respiration, circulation, and 

animal heat? 

19. What are the effects of alcohol and narcotics upon the lungs and 

respiration ? 



CHAPTER XIV. 
AIR. - VENTILATION. - LIGHT. 

262. Relation of the Body to Atmospheric Pressure. — So 

well is man adapted to the atmosphere, that its density 
cannot be much increased or diminished without inter- 
ference with the circulation, respiration, and other vital 
processes. The thickness of the atmosphere is supposed 
to be not less than 45, and not more than 200 miles, and 
the pressure of this immense mass at the sea level is com- 
puted to be 15 pounds upon every square inch of sur- 
face. Upon the body of a man, therefore, of average size, 
it is more than 16 tons. This pressure, enormous as it 
appears, is of vital importance to the animal economy. At 
great heights, where atmospheric pressure is diminished, 
breathing becomes exceedingly difficult, or impossible. 
Not only does the rarefied air not furnish sufficient oxygen 
to the lungs, but carbon dioxide is imperfectly eliminated, 
and owing to diminished pressure upon the blood-vessels, 
bleeding may occur from the nose, mouth, and ears. 1 

In deep subterranean and submarine excavations, such 
as mines and tunnels, the atmospheric pressure is so 
increased that the workers in them are often disabled. 
Sometimes in the construction of the piers of such large 
bridges as that over the East River, between New York 
and Brooklyn, it is necessary to sink an immense inverted 

1 " At an altitude of a little under 11,500 feet, we find that the press- 
ure is only two-thirds of that at the sea level.' 1 

2-47 



248 AIR. — VENTIL ATION. — LIGHT. 

box, or caisson, in which men work, digging out the 
earth for the foundations. As the earth is excavated, the 
caisson sinks, and the air which it is necessary to pump 
in becomes exceedingly dense, as its pressure equals the 
pressure of the water without. 1 Such dense air is as 
injurious as exceedingly rarefied air, producing severe neu- 
ralgic pains, great prostration, hemorrhages, or paralysis. 

263. Composition of Air. — Atmospheric air is in gen- 
eral a mixture of one part in bulk of oxygen to four parts 
of nitrogen, associated with a varying quantity of carbon 
dioxide, ammonia, watery vapor, inorganic and organic 
matter. The amount of carbon dioxide is usually very 
small at ordinary elevations, — only about four parts in 
every 10,000 of air. It is utilized by vegetation, most of 
the carbon being solidified in the vegetable tissues. Its 
presence in the atmosphere is shown by the film of carbo- 
nate of lime that forms upon lime water when exposed to 
the air. The amount of ammonia is usually about one 
grain to 23,000 cubic feet of air. It emanates from 
putrefactive processes in progress on the surface of the 
earth, and is also produced from the nitrogen of the 
atmosphere by electric agency during thunder storms. 
It furnishes to vegetation nitrogen, much of which is 
consumed by, and enters into the tissues of, animals. 

1 "Caisson disease" seriously impaired the health of the chief en- 
gineer of the East River Bridge, and also that of some of the workmen. 
At the St. Louis Bridge, when one of the caissons touched a rocky bed, 
the atmospheric pressure was 45 lbs. to the square inch, and by the rise 
of the river it was increased to 50 lbs. When the pressure was 34 lbs., 
severe suffering began. It was found that the men could work only one 
or two hours at a time. They were generally taken sick on coming 
out of the air-lock into the normal atmosphere, seldom in the air-lock 
itself. This sudden exposure to air at the normal pressure was "equiva- 
lent to the application of a gigantic cupping glass to the whole body." 



AIR. — VENTILATION. — LIGHT. 249 

The amount of watery vapor depends largely upon the 
temperature of the air. It seldom forms more than ^, or 
less than ^ -J-q, of the bulk of the air, and preserves the 
general purity of the atmosphere. 1 If in considerable 
amount, it prevents desiccation, and maintains the vital- 
ity of organisms submerged in it. Inorganic matter and 
vegetable and animal organic matters are found in most 
specimens of air examined, the amount varying in differ- 
ent localities. Rain, called sometimes the sewage of the 
atmosphere, carries to the earth these and other substances, 
which otherwise would accumulate without end. The 
clearness of the atmosphere after a rain storm is a matter 
of common observation. 

264. Oxygen and Nitrogen. — Oxygen, as we have seen, 
is necessary to purify the blood and sustain life. Animals 
usually die when the quantity of oxygen in the atmosphere 
is reduced from three to five per cent. Without it, com- 
bustible bodies would not burn. Just as we find the most 
valuable food constituents become less valuable when used 
alone, so oxygen requires to be diluted with the other 
ordinary constituents of the air, in order to become even 
respirable. Its dilution with nitrogen, which is a harm- 
less, inert gas, is in the exact proportion which serves 
best to support life and to maintain that degree of com- 
bustion which is most useful to the ordinary purposes 
of mankind. Any diminution of its normal amount is 

1 That water is present in the air is seen by its condensation in chops 
upon an ice-cold vessel — a pitcher or tumbler of ice-water — in hot 
weather ; also in the dew, hoar frost, fog, rain, and snow, and in its 
effect on certain solid substances which have the property of combining 
with water and becoming liquid. Such substances, of which calcium 
chloride is an example, are said to be deliquescent. 



250 AIR. — VENTILATION. — LIGHT. 

attended with as bad results as is the addition to air of 
harmful substances. On the other hand, were the oxygen 
in excess, it would become a very destructive agent, in 
proportion to that excess. In such cases the tissues of 
animals would be rapidly consumed, together with all 
bodies having any chemical affinity for oxygen, and such 
as were set on fire would burn beyond control. 

265. Ozone is a form of oxygen, but has greater chemi- 
cal activity as an oxidizing agent than other forms ; hence 
it is a powerful disinfectant, and is recommended for the 
purification of sick rooms. It exists in very minute quan- 
tity in the air, and, thus diffused, is considered a stimulat- 
ing agent in debilitated conditions of the system. It is 
much more abundant in the country than in towns, and 
its quantity is increased just after a thunder storm. 1 Air 
highly charged with ozone is not breathable, and is capable 
of bleaching and destroying vegetable coloring matters. 

266. Harmful Air. — Suspended Matters. It sometimes 
happens that air is rendered more or less injurious by the 
accumulation of dust and other suspended matters, or by 
an undue proportion of one or more of its normal con- 
stituents, or by the addition to it of poisonous gases. 

A ray of sunlight in a darkened room, or in the open 
air upon a foggy day, reveals in its track myriads of shin- 
ing particles of dust, however clear the atmosphere may 
otherwise seem. This dust consists, in varying propor- 
tions, of starch granules, cotton fibres, spores, seeds, pollen, 

1 The quantity varies at different times and places, but it is said to be, 
at the most, about one volume in 700,000 of air, and is quite constant in 
the atmosphere among pine trees. Ozone passed through a mass of putre- 
fying material will rid it of noxious odors. 



AIR. — VENTILATION. — LIGHT. 251 

and cellular tissue, of wool, hair, epidermal cells, and other 
animal substances, of flintlike particles, and of microscopic 
organisms in a living state. 

From hundreds of sources suspended matters are wafted 
by the winds, and some of them are also carried by flies, 
mosquitoes, and other insects. They are found almost 
everywhere, even penetrating close joints of carpentry 
work. When in large quantity in the air, as at times 
in cities, they are irritating to the respiratory organs, 
especially of feeble people. In such cases it is advis- 
able to protect the mouth and nostrils by a handkerchief 
or veil, or any other object through which the air can be 
breathed and which at the same time prevents the dust 
from entering the air passages. 1 In the same way the 
temperature of very cold air may be mitigated. 

267. Disease Germs are at certain times wafted through 
the air, and are capable of producing dangerous infectious 
diseases, each according to its kind. Eight of these dis- 
eases, named in the order of their general prevalence, are : 
consumption, pneumonia, diphtheria, typhoid fever, scar- 
let fever, measles, whooping-cough, and small-pox. The 
relative importance of these diseases is shown by the fol- 
lowing diagram : 2 — 



1 In certain occupations, such as stone cutting, metal polishing, knife 
and glass grinding, or in white-lead works and other manufactories, the 
dust is so plentiful and irritating at times that "respirators" are worn, 
consisting of frameworks of wire gauze, made to fasten over the mouth 
and nostrils, containing a piece of sponge, cotton, wool, or other similar 
substance, slightly dampened. 

2 The Teachers' Sanitary Bulletin, No. 0, issued by the Michigan 
State Board of Health, from which the diagram was taken, states: "The 
mortality in Michigan is as low as that of any state of the Union, and 
much lower than in many states. 1 ' 



252 AIR. — VENTILATION. — LIGHT. 

DEATHS IN MICHIGAN, 10 YEARS, 1887-96. 



MMWMirriWBgyaBM CONSUMPTION. 
PNEUMONIA. 



■Ill I H I i DIPHTHERIA. 
TYPHOID FEVER, 
SCARLET FEVER. 
H MEASLES. 
« WHOOPING-COUGH. 

! SMALL-POX. 

Fig. 85. 

Disease germs retained in mud and upon moist surfaces 
may do no harm ; but the mud of to-day is the dust of 
to-morrow, which will be scattered far and near, infecting 
the lungs of very susceptible people. Mud may also be a 
source of infection if brought into houses upon skirts and 
shoes. In buildings, conveyances, and in the streets, spit- 
ting should be refrained from, except into receptacles that 
can and will be disinfected. Dusting and sweeping should 
mean the removal of dust and dirt, and not merely its 
transference from one place to another. 1 

268. Consumption, once believed to be solely an hered- 
itary disease, is recognized now as frequently the result 
of infection from specific germs in the sputum, or spittle, 
emanating from consumptives and mingled with the dust 
of the atmosphere. 2 Fortunately, the mortality from 

1 Dusting is best effected by gently wiping surfaces with a slightly 
dampened piece of cheese-cloth. Moistened tea leaves, salt, oatmeal, or 
sawdust entangles dirt upon floors, so that it can be readily removed. 
Streets should be sprinkled before being swept. The amount of dirt or dust 
which accumulates each day in houses and schools is not generally appre- 
ciated. In one school, the janitor reports about one and a half bushels. 

2 " To examine the dust of the air microscopically, a small drop of 
glycerine, put in the middle of a glass slide, may be left lying, or be moved 



AIR. — VENTILATION. — LIGHT. 253 

this disease may be lessened, if its specific germs can be 
prevented from entering the air passages, and if infected 
persons can be isolated, breathe pure air, have proper food, 
exercise, and warmth, and be properly clad. 

269. Observation of the diffusion of seeds of the thistle 
and other plants by the winds suggested that infection is 
spread by similar methods. The development of disease 
germs is believed to be as rapid as is that of the spores of 
the yeast plant. Both need for their development favor- 
able conditions of warmth and moisture, the former, also 
a feeble human body, and the latter, fermenting material. 
Disease germs may lie dormant in cold weather, or where 
their surroundings are clean, only to grow and develop in 
the presence of moisture and filth, and may be carried 
long distances in merchandise and clothing, especially in 
woollen materials. They may be conveyed also by milk, 
water, insects, or mail matter. Children and feeble per- 
sons are most susceptible to their influence. 1 Quarantine 
— i.e. complete isolation and cleanly surroundings of per- 
sons with infectious diseases — will usually prevent the 
spread of infection 2 (a). 

for a given time against the air. Then a cover glass is laid upon this, 
and it is ready to be examined. Solidified flat surfaces of gelatine or 
other bacterial culture medium, exposed to the air for a time, and then 
covered and set aside for development of bacteria and moulds that may 
have fallen, give a fair idea of the varieties, and a rough, comparative idea 
of the numbers." — Currieh. 

1 Disease germs are dangerous ingredients of the air of drains and cess- 
pools, and only need the proper surroundings for their development 

2 It is related that in the Scilly Isles, for ten consecutive years there 
was not a death from measles, scarlet fever, or small-pox. and only mi' 1 
cases, if any at all, though such diseases wen 1 very prevalent upon the 
mainland, with which there was little communication. 



254 AIR. — VENTILATION. — LIGHT. 

270. Malaria. — The term malaria literally means " bad 
air." By physicians and sanitarians it is applied to malaise, 
or a diseased condition called intermittent or remittent 
fever. This condition is supposed to be due to impure air 
from low and swampy regions containing poisonous micro- 
organisms, 1 which come from vegetable matter in process 
of decay, but it may occur even in deserts. Malaria is 
often caused by the breaking up and overturning of soil 
not thoroughly drained. 2 The eucalyptus tree and the 
sunflower, on account of the power they possess of absorb- 
ing moisture by their roots, are valuable in drying the soil 
and preventing malaria (a). 

271. The Organic Nitrogenous Matter which is thrown off 
from the lungs mingled with carbon dioxide and watery 
vapor, does much toward vitiating the atmosphere. Its 
exact composition has not been ascertained. It has a dis- 
agreeable, persistent odor, and is known to be poisonous. 3 
Combined with the emanations from the skin and other im- 
purities, the mixture gives to the atmosphere of a crowded 
room that odor which is so disagreeable to those who enter 
the room from the outer air. It is also the cause of that 
close, oppressive sensation perceived so often in the un- 
ventilated rooms of tenement houses. 

Air containing such ingredients ordinarily acts as a 

1 These cannot be cultivated artificially like bacteria, hence less is 
known of them. 

2 The deep upturning of the ground, as in the building of large sewers 
and displacement of muddy soil to construct railroad beds, has produced 
malarial poison in localities where it had not been before. 

3 In an experiment by Dr. Hammond, a mouse confined in an atmos- 
phere of carbon dioxide breathed with difficulty. When some of the 
organic matter was removed from the atmosphere, although the air was 
still loaded with carbon dioxide, the mouse breathed more freely. 



AIR. — VENTILATION. — LIGHT. 255 

subtle poison, undermining the health, and changing the 
character of the blood, especially of those who are obliged 
to spend much of their time in it and who do not exer- 
cise in the open air. It becomes exceedingly poisonous if 
breathed and rebreathed by a large number of persons in 
close quarters, and the condition produced is known as 
ochlesis, or "crowd poisoning." 

The history of the past gives fearful instances of such 
poisoning, and to a greater or less extent it is still to be 
found in many tenement and cheap lodging houses, in the 
holds of some emigrant vessels, in overcrowded schools, 
churches, and theatres, and especially in cheap places of 
amusement (a). Formerly, overcrowding, with its con- 
sequent filth, was the cause of many deaths from jail, ship, 
or typhus fever ; and it is still the prolific source of many 
subtle diseases, especially in cities and large towns (6). 

272. Gaseous Matters. — The gases which most often, 
either alone or in combination with suspended matters, 
make air impure and dangerous to life are carbon dioxide, 
carbon monoxide, illuminating gas, hydrogen sulphide, and 
sewer gas. 

273. Carbon Dioxide, or carbonic acid gas, is the most 
constant gaseous impurity in the atmosphere. It is a 
heavy, invisible gas resulting from the combustion of any 
substance containing carbon, from the decay and putre- 
faction of any animal or vegetable substance, or from 
fermentation, and is given off during the respiration of 
animals. In nature it is diffused throughout the atmos- 
phere, and is absorbed by trees and plants. In them the 
gas is decomposed, the carbon being retained for their 
growth, while the oxygen is returned to the atmosphere. 



256 AIR. — VENTILATION. — LIGHT. 

That there is a compensating interchange of oxygen and 
carbon dioxide between plants and animals is shown in 
a well-arranged aquarium. The fish give off the neces- 
sary amount of carbon dioxide for the health of the plants, 
and the plants furnish enough oxygen for the fish. 

Notwithstanding the diffusive power of gases and the 
absorption of carbon dioxide by plants, it occasionally 
accumulates in such quantities as to x^oison the atmos- 
phere in various places. When the moisture in the at- 
mosphere is in excess, as in foggy weather, the ajnount of 
carbon dioxide may increase from about four volumes in 
ten thousand to eight volumes. In manufacturing districts 
the accumulation is very great. When generated in low, 
confined places, such as cellars, beer vats, cesspools, caves, 
and mines, it may be retained for a considerable time, 
partly by its weight and partly because it is generated 
faster than it can be diffused in these places. The air in 
such places, especially in the lower stratum, is dangerous 
to breathe and incapable of supporting combustion. In 
the " Dog's Grotto," near Naples, and in various other 
places, carbon dioxide is continually generated (a). This 
gas, if in considerable amount, may be detected by the 
extinction of a lighted candle introduced into the place 
to be tested. 1 

274. The investigation of the air as to organic impuri- 
ties is necessarily prolonged and tedious, but the amount 
of carbon dioxide in the atmosphere is readily ascer- 
tained. As these impurities are generally associated with 
carbon dioxide, the amount of the gas present is a guide to 
the respiratory impurity of the air. 

1 " Choke damp" is the term given by miners to the carbon dioxide 
generated in mines. 



AIR. — VENTILATION. — LIGHT. 257 

It is said that the odor of crowd poison becomes gener- 
ally perceptible when the carbon dioxide in a room exceeds 
six parts in 10,000 volumes of air. This is the amount 
mentioned by Dr. Parkes, the eminent sanitarian, as the 
" limit of permissible impurity," yet a much larger amount 
is often found in the air of houses, schools, etc. But 
though the odor of crowd poison be perceptible, carbon 
dioxide itself has no odor. Usually, therefore, its subtle 
effects are upon us before any warning has been given. 
It accumulates in houses not well aired, from illuminating 
gas, lamps, furnaces, stoves, decaying vegetables and wood, 
and from our own breathing (a). The results of breath- 
ing it in any considerable quantity for a length of time 
are headache, dulness, giddiness, nausea, chilliness, and 
even unconsciousness and death. 

275. Carbon Monoxide, or carbonic oxide, is a much 
more poisonous, gas than carbon dioxide, for it not only 
robs the air of oxygen, but destroys the blood corpus- 
cles, and its evil effects are not readily dissipated by 
fresh air, as is the case with carbon dioxide. It is color- 
less, has but little odor, and when not combined with 
gases that have odor may slowly insinuate itself into a 
room and gradually undermine the health of the occupant. 
It is one of the ingredients of illuminating gas, and also 
results from imperfect combustion of coal. It sometimes 
passes through ill-fitting joints in furnaces and stoves, 
and even through cast iron when it is very hot. This 
is most likely to happen when the supply of cold air is 
insufficient, or the escape of the products of combustion 
is largely prevented by dampers, or by smoke-pipes that 
are too small. A stove or furnace should therefore be so 
large that it can warm the room without being itself very 



258 AIR. — VENTILATION. — LIGHT. 

hot. Smoke-pipes should be large, and with perforated 
dampers. More coal will thus be consumed, but the dan- 
ger will be lessened. 1 Combined with sulphur compounds 
in the imperfect combustion of coal, carbonic oxide has 
the peculiarly disagreeable odor known as that of " stove 
gas." This gas is irritating to the nostrils and throat, 
causing dryness, constriction, and a disagreeable taste. 

276. Illuminating Gas, as ordinarily delivered to the 
consumer, is mainly a mixture of marsh gas 2 (about one- 
third), sulphur, and carbon monoxide. The very best 
kind of illuminating gas poisons the air into which it may 
escape ; but if the gas has not been thoroughly purified, it 
contains other and much more poisonous ingredients than 
those already named. The old, the very young, and all 
whose sense of smell is not acute, may be gradually poi- 
soned by the slow escape of gas from a leaky gas pipe, 
without perceiving the odor of the gas. 3 

277. Hydrogen Sulphide, or sulphuretted hydrogen, is a 
colorless gas, with the odor of putrefying eggs. It is very 
poisonous. When breathed in a pure state, it quickly 
proves fatal, destroying the blood corpuscles, and is dan- 

1 It is much better to regulate the supply of air admitted to stoves and 
furnaces for draught, than to rely upon dampers. Truly, "it needs a 
philosopher to run a furnace properly." 

2 It is so called because in hot weather it may be evolved from the 
putrefaction of vegetable matter in the mud at the bottom of stagnant 
pools, and is the same as the "fire damp" of the coal mines. It is a 
compound of carbon and hydrogen, and is colorless, explosive, and 
poisonous. 

3 To detect leaks in gas pipes, apply soap-suds to the suspected leaky 
joint. The formation of bubbles will show an escape. This is safer than 
trying the joint with a lighted match. 



AIR. — VEN TIL ALTON. - LIGHT. 259 

gerous even when diluted with atmospheric air. 1 It is a 
component of sewer gas ; and in houses and other build- 
ings it emanates from decomposing refuse in garbage 
receptacles, from cesspools and drains. 

278. Sewer Gas, 2 especially of late years, has been held 
responsible for much of the sickness in houses connected 
with drains and sewers. Sewer-gas poisoning, from de- 
fective plumbing of houses and insufficient airing of 
the sewers, undoubtedly exists, but the plumber is fre- 
quently blamed for sickness which is due to other causes. 
Sewer gas may be odorless and escape into a room without 
its presence being known, or it may have a faint, sickly 
odor, or an odor like that of sulphuretted hydrogen. In 
either case it may lower the vitality, thus making us sus- 
ceptible to disease. Its presence should be excluded by 
well-ventilated sewers, and drains with tight joints ; the 
pipes, closets, and basins should be so placed that, if a leak 
occurs, it will not imperil the health of the inmates of the 
house. 3 Sewers and drains should be thoroughly cleansed 
and disinfected from time to time. 



1 One eight-hundredth part in the air is sufficient to kill a mouse. 

2 A compound of carbon dioxide, nitrogen, sulphuretted hydrogen, 
ammonium sulphide, disease germs, and other substances. 

3 A refrigerator connected with the sewer leads to the tainting of 
articles kept in it. Pipes which convey water from roofs and connect with 
the sewer may convey sewer gas into the upper part of the house, if these 
pipes open under windows, as is sometimes the case with mansard roofs. 
Occasionally rats gnaw through lead pipes, and thus sewer gas escapes 
into houses; or the roots of trees penetrate faulty joints of drain pipe. 
Workmen have lost their lives in the opening of old cesspools, when the 
contents were stirred, though before that operation a candle would burn 
if lowered into the vat. During and after heavy rains, swollen rivers and 
streams often prevent sewage from escaping into them, and sewer gas 
"backs up 1 ' into houses, causing discomfort and sickness. 



260 AIR. — VENTILATION. — LIGHT. 

279. Devitalized Air is a term which is applied to air 
that has been robbed of much of its life-sustaining prop- 
erty by various means, as by mixture with the emana- 
tions from decaying lumber in cellars, from musty clothes 
stored in closets, from poisonous wall papers (a) or de- 
composing paste between the layers of wall paper, from 
decomposing food in pantries, or from tobacco smoke (5). 
Houses built upon ground made by filling depressions 
with dirt and ashes mingled with decaying animal and 
vegetable matter are sometimes permeated by deleterious 
gases, which give rise to symptoms of malarial poison 
among the inmates. 1 

280. It has been shown by Pettenkofer and others that 
bricks, ordinary mortar, cement, and sandstone are perme- 
able by air and moisture. 2 Moisture also collects upon the 
walls of new houses or those in damp situations, and is a 
source of disease (V). Newly built houses should not be 
occupied as dwellings until the mortar, cement, etc., be- 
come thoroughly dry. It is also a matter of great impor- 
tance that the ground upon which houses are built should 
be thoroughly drained and dry, else the dampness will 
be apt to cause rheumatism and other severe afTee- 

1 Such land should not be built upon until three years after filling in. 

2 " A remarkable case in a London house has come to my knowledge, 
which gives a distinct proof of the much greater passage of gas through 
the walls in winter than in summer. A small room occasionally used was 
noticed sometimes to have an unbearably bad smell. This was never 
noticed in summer, nor in winter unless a fire was lighted in the room. 
The drainage was suspected and examined, but was found perfect ; yet 
here was this extraordinarily foul air making its way into the room when- 
ever the interior was warm and the exterior cold. The cause was a dust 
bin built against one of the walls, and the filtration of the air through 
this and the house wall into the room." — Hartley, Air and its Bela- 
tions to Life. 









AIR. — VENTILATION. — LIGHT. 261 

tions. 1 Harmful gases may be conveyed, even by the 
best soil, from leaky drains, sewers, gas pipes, and other 
sources of impurities. Pettenkofer mentions an instance 
of death from illuminating gas, which had penetrated 
through the earth a distance of twenty feet, from a 
leaky pipe, into a basement. 

281. Country and City Air. — Cowper says, " God made 
the country, and man made the town." Undoubtedly 
the air is very pure in those country districts where the 
inhabitants are not crowded together ; where there are no 
factories or nuisances, no decomposing garbage or other 
refuse ; where the water supply is abundant, and no stag- 
nant water exists ; where the houses are well drained, and 
so placed that the sunlight enters the rooms ; and where 
the dwellings and out-houses are at least one hundred feet 
apart. But where these conditions do not exist, the bet- 
ter portions of most towns and cities are preferable. 
Moreover, in the country there are not so apt to be health 
boards and sanitary associations to remedy evils. 2 

1 Sand absorbs and retains but little water ; clay, ten to twenty times 
as much as sand ; while rich earth absorbs and retains, it is said, forty or 
fifty times as much. Hard, rocky soils allow but little water to pass 
through them. An ideal building site is upon the side of a gently sloping 
hill (with a rocky and sandy soil), looking toward the south, not near a 
marsh or sluggish stream, with good drinking water, and enough trees 
to protect it from the strong sunlight and to absorb any excess of mois- 
ture there may be in the soil. On the other hand, very many trees, by 
affording too much shade, make the surroundings of a house damp and 
assist in the production of malaria. It is of importance that the trees 
should be of such kinds as to afford ample shade, ami at the same time 
have no unpleasant odor. The trees which best meet these requirements, 
and are most pleasing to the eye, are the oak, elm, maple, tulip tree, 
ash, mulberry, linden, horse-chestnut, and walnut, 

- By the enlightened and active work of siu'h bodies much good has 
been done. By proper drainage of low, swampy, or submerged lands. 



262 AIR. — VENTILATIOX. — LIGHT. 

On the other hand, the numerous overcrowded and dirty 
tenement houses in the large cities are productive of very 
great mortality, 1 and are often sources of danger to the 
better portions, being the starting-points of infectious 
diseases and low forms of fever (a). Of late years model 
tenement houses have been erected in some of our cities, 
in which overcrowding and uncleanliness are prohibited 
by the owners (6). 

282. Fresh Air. — The importance of an abundance of fresh 
and pure air will be appreciated when we consider that wild 
animals kept in confinement frequently die from diseases 
due to confined air or an insufficient amount of air (a). As 
Dr. Richardson puts it, " Open air is a powerful disinfect- 
ant, protecting the gypsy from germs which we vainly 
fight with all the aid of science." Some of the impurities 
in the air act harmfully by lessening the amount of oxygen, 
some irritate the air passages and lungs, and others poison 
the blood directly by being absorbed by the air-cells. 
The general effect of most of the impurities is to produce 
pallor, headache, drowsiness, loss of appetite and strength. 

malarial fevers have been crowded out, and the soil redeemed for cultiva- 
tion or for building purposes. The health tracts and reports published 
by such organizations contain much valuable information. 

1 The density of population in the tenement districts of large cities is 
not generally understood. In one of the largest cities in this country the 
police census of 1895 reports one block, size 375 x 200 feet, with a popu- 
lation of 2628, rate per acre 1526 ; another block, size 200 x 300 feet, 
population 2244, rate per acre 1774; and many districts containing 400, 
500, and 600 persons per acre. In Bethnal Green, London, there are 
365.3 people per acre ; in Whitechapel, 303.5. In Bombay, where there 
is an average of 57.7 persons per acre, there are three districts in which 
there are 680, 715, and 750. It will be difficult for any person living in 
the genuine country to imagine so large a population per acre as these 
mentioned. 



AIR. — VENTILATION. — LIGHT. 263 

They undermine the health, and so increase the suscepti- 
bility to organic and infectious diseases. If the impurities 
are in large amount, vomiting, marked prostration, and 
even death may result. 1 

283. Purification of Air. — Ventilation. Many of the 
dangers arising from impure air may be obviated by suit- 
able ventilation, purification by means of chemicals, by 
heat, or by steam. 

By suitable ventilation is meant the free admixture of 
out-door air with that of buildings and apartments, but 
so modified as to temperature and velocity of current, in 
its admission into rooms, that draughts are prevented. 
Suitable ventilation should take place by night as well as 
by day. The airing of one room by introducing the con- 
fined air from another is not suitable ventilation ; neither 
is it right to exclude from our sleeping rooms the night 
air, of which so many live in fear. In fact, night air 
generally contains less carbon dioxide than day air. 2 But 
draughts of cold air, either by night or by day, are injuri- 
ous to all, especially to the feeble, the very young, and 

1 What will poison one person may have but little effect upon another 
less susceptible. There are some people who seem to catch everything, 
while others can expose themselves to impure air and sustain no apparent 
injury. In cities, noxious gases from factories sometimes poison sus- 
ceptible people, and remain for some time undetected. 

Living in a pure atmosphere, good food, suitable exercise, sufficient 
warmth, and agreeable surroundings have a marvellously good effect upon 
feeble and many sick persons. Homes for consumptives have been estab- 
lished in Europe and in some of our states, where these sanitary measures 
can be carried out, The United States Government has established a 
similar resort at the far West for consumptive soldiers. 

2 Thousands of soldiers, hunters, and lumbermen sleep every night in 
tents, open sheds, and even in the open air, without injurious conse- 
quences. 



264 AIR. — VENTILATION. — LIGHT. 

the aged. They lower the temperature of the body, and 
induce internal congestions. " A cold draught of air cuts 
like a knife." 1 

284. In buildings having furnaces or stoves connected 
through their air-chambers with the out-door air by means 
of air-boxes or flues, the air that enters in cold weather is 
warmed and its velocity somewhat diminished by contact 
with the heated iron of the furnaces or stoves. All fur- 
naces should have roomy air-boxes, covered at their inlet 
with cheese-cloth, to catch dust. 2 If possible, the air 
should be drawn from above the street level, in order to be 
comparatively free from dust and other suspended matters. 

Cold air may likewise be better adapted to our use by 
its passage through one or more layers of fine wire gauze, 
woollen, cotton, or linen cloth fitted in frames into the 
windows, or arranged as screens before the open windows. 
In very warm weather the air may be made more comfort- 
able by suspending dampened cloths in the rooms. 

285. Ventilators are appliances for the free passage of 
air into and out of ships, mines, dwellings, etc. They 
differ very much in structure and mode of action. In 
large ships (such as war-vessels) and in great mines, the 
fresh air is sucked in and the foul air forced out by 
engines. In dwellings, in very cold weather and when 
the wind is blowing hard, sufficient out-door air for ven- 
tilating purposes may be sucked in through the air-flues 

1 " If cold wind reach you through a hole, 

Go make your will and mind your soul." — Old proverb, 
2 It is shameful to have to state that, at the present day, houses are 
sometimes built without air-boxes, or with boxes that open into cellars 
instead of out of doors. Occasionally foul air is sucked into apartments 
from cellars, through defective air-boxes, causing much sickness. 



AIR. — VENTILATION. — LIGHT. 265 

of furnaces, or by the sides of window sashes. A current 
is created by the impure air escaping through open fire- 
places and chimneys, especially when fires are burning in 
the grates, stoves, and furnaces. 1 

286. Ordinarily it is necessary to obtain air in larger 
quantities (a). This may be effected through cotton 
cloth, etc., as before described, through revolving metal 
wheels inserted into window-panes, through small diagonal 
openings in the window-sashes, or by placing under the 
lower window-sash a board, occupying the whole width of 
the sash, and from three to six or more inches high. 2 The 
air thus passing in is not deflected directly downward 
upon the occupants of the room. In factories, institu- 
tions, schools, vehicles, and similar places where ventila- 
tion is to be provided for many persons, it should be 
automatic ; for if regulated by the varied judgment of 
the numerous inmates, it will prove ineffective (6). 

287. The Amount of Fresh Air needed for Each Person in a 
Room. — Estimates of the necessary amount of air and 

1 Fireplaces should not be entirely closed ; neither is it well to have 
them so large and open that a great draught is created, thereby drawing 
the air too strongly out of the room and too much heat up the chimney. 
Such fireplaces must needs consume a large quantity of fuel in order to 
radiate sufficient heat to be equally diffused throughout the room. Stoves 
with outer jackets or envelopes, which receive and warm cold air as it 
passes through them into rooms, are preferable to ordinary stoves, which 
throw out dry and superheated air. 

2 A simple and effectual arrangement is that of Dr. Keen, viz.. fastening 
"with tacks or loops a piece of paper or cloth across the lower ten or 
twelve inches of the window-frame, and then raising the lower sash mere 
or less, according to the weather." It will probably occur to the reader 
that the cloth so placed may be suitably ornamented on one or both 
sides. 



266 AIR. — VENTILATION. — LIGHT. 

cubic space which each inmate of a room requires, under 
varying circumstances, have been made by sanitarians as 
guides to proper ventilation, — since the detection by 
smell of harmful odors or a sense of closeness is not 
always certain. 1 

When the amount of carbon dioxide in the air of an 
occupied room is beyond six parts in ten thousand, the air 
becomes oppressive and dangerous, not only on account 
of the carbon dioxide present, bat also on account of the 
poisonous organic matter exhaled by the lungs. The air 
is also vitiated by gas jets and lamp flames. 2 To main- 
tain air sufficiently pure for respiratoiy purposes in a room, 
at least 3000 cubic feet of fresh air must be introduced 
every hour for each individual. For each adult, 3 at least 
600 cubic feet of air space are needed in an ordinary 
room to insure the requisite change of air without 
draughts, since the air should be completely changed 
three or four times an hour (a). 

288. Disinfection. — Any substance that will destroy the 
infecting power of infectious material is a disinfectant. 
An agent which destroys bad odors is a deodorant, or 
deodorize?-. An agent which arrests putrefactive decom- 
position is an antiseptic. An abundance of fresh air not 

1 Especially by persons who are mouth breathers, who have nasal 
catarrh, or whose sense of smell is blunted by living in a close and 
polluted atmosphere. 

2 According to Pettenkofer, a burner consuming five feet of gas per 
hour gives off as much heat as eight men, more carbon dioxide than 
three men, and as much watery vapor as five men. One of the claims 
made for electric lights is that they give out very little heat and carbon 
dioxide. 

3 It is claimed by some sanitarians that there should be no distinction 
between adults and children, as to the necessary amount of air space. 



AIR. — VENTILATION. — LIGHT. 267 

only dispels disagreeable odors, but frequently acts as a 
disinfectant by virtue of its oxygen. 1 Smouldering paper, 
burning coffee, cologne water, and other things commonly 
used as purifiers act only as deodorants, simply replacing 
one odor with another that is stronger. They have abso- 
lutely no value as disinfectants. 

Charcoal, dry loam, and ashes are valuable deodorants 
to use in out-houses and cesspools. The material so deodor- 
ized, when exposed to the sun, air, and light (as it should 
be, at a considerable distance from dwellings), will be 
disinfected by these agencies. Slaked lime, added to the 
compost heap, will hasten the antiseptic and disinfectant 
processes begun by the sun, light, and air. The coating 
of walls, especially cellar-walls, with lime-wash is a use- 
ful method of sweetening the atmosphere, and should be 
frequently repeated. Cold arrests putrefaction, but does 
not destroy germs ; whereas steam under pressure (221° F.) 
for ten minutes, or boiling water for half an hour, will do 
so. Certain chemicals, such as chloride of lime and mer- 
curic chloride, in a strong solution, will destroy germs. 
In a weak solution they prevent putrefaction («). 

289. Sunlight. — In addition to an abundance of air of 
the right kind, animals need sunlight. Without this the 
blood is impoverished and vital energy is diminished (a). 
Secluded from the light, human beings become pale and 
sickly, just as plants do in cellars; and, like plants, they 
grow stronger and healthier on removal into the light. 



1 Rigorous cleanliness, sunlight, and an abundance of fresh air will not 
only keep away the visible and obnoxious tilth, but will lessen the viru- 
lence of typhoid fever, cholera, ami other infectious diseases which are 
sometimes classed as tilth diseases. 



268 AIR. — VENTILATION. — LIGHT. 

Bacteria thrive best in darkness and in moist places. 1 
Most of them are killed by strong sunlight (6). 

During the prevalence of epidemics in some of our 
southern cities, it has been noticed that there is more sick- 
ness on the shady than on the sunny side of the streets. 
Houses should be so constructed that the sun can shine 
into every room during some part of each day. But just 
as we have found to be the case with the other vital 
requisites of man, so there may be an excess of light, and 
of its accompanying heat. Too great exposure, in warm 
weather, to the direct rays of the sun may induce sun- 
stroke. Even in the frigid zone the glare of the light on 
the snowy landscape is attended with danger to the sight, 
— a danger which is also incurred by those who have the 
sun's rays reflected upon them from white sand and other 
reflecting objects. 2 



QUESTIONS. 

1. Of what service to man is the pressure of the atmosphere? 

2. What is the ordinary composition of air? 

3. What is said of the relative proportions and uses of nitrogen and 

oxygen? 

4. Of what use are the other ingredients of the air ? 

5. Of what does the dust in the air consist, and from what sources 

does it come ? 

6. How should we protect ourselves from its evil effects? 

7. What is to be said of " disease germs " and of their development ? 

1 The virulence of most disease germs is preserved in dust, but the 
bacteria of cholera die when dry. 

2 " To obviate the dangers of an excess of light, nature carpets the earth 
with green, and either vaults the heavens with blue, or draws over them 
her gray curtain of cloud, and at proper intervals spreads over us the 
black pall of night, bringing with it refreshment and rest." 



AIR. — VENTILATION. — LIGHT. 269 

8. What of the organic nitrogenous matters thrown off by the lungs? 

9. To what is the term malaria applied, and what are some of the 

causes of malaria? 

10. What gases corrupt the atmosphere, and which one is constantly 

present therein ? 

11. Whence does the atmosphere derive its carbon di®xide, and why 

should so poisonous a gas be an essential ingredient of the 
atmosphere ? 

12. W T hen and where is it apt to be in excess, and what are the effects ? 

13. What is to be said of carbon monoxide? of illuminating gas? 

of sulphuretted hydrogen ? of sewer gas ? 

14. What other emanations than the above gases devitalize the air? 

15. What is to be said of damp building sites and of leaky drains and 

gas pipes ? 

16. State the relative advantages of city and country life. 

17. What are the effects of an impure atmosphere upon the health, 

and how may they be obviated ? Illustrate as to ventilation ; 
as to the use of chemicals. 

18. What effects follow a deprivation of light ? What its excess ? 



270 



THE NERVOUS SYSTEM. 




Fig. 86. 

Posterior view of the spinal cord, a portion of the cerebrum and cerebellum, and some of the 
nerve* of the cerebro-spinal system. On the left side of the body some of the tissues are 
removed to show the deeper nerves, while the right side shows certain superficial ones. 

CE. cerebrum. B, nerves distributed to the arm. SN, sciatic nerve. 

CEE, cerebellum. SC. spinal cord. 



CHAPTER XV. 

THE NERVOUS SYSTEM. 

290. Predominance of Nervous Processes in Man. — Some 
of the processes already studied, viz., digestion, circula- 
tion, absorption, and respiration, are common to both 
animals and vegetables ; but the processes by which con- 
sciousness, will power, voluntary motion, sight, hearing, 
etc., are accomplished are, so far as is known at present, 
peculiar to animals. One animal is superior to another 
in proportion to the number and development of these 
functions. In man their number is the greatest and 
their development the highest, so that man maintains 
supremacy over all other forms of creation. 

291. Use of the Nervous System. — In health, all the or- 
gans of the human body possess a peculiar property 
known as irritability, 1 which enables each one to perform 
its function at the right time, in the right way, and in 
accord with the functions of other organs. Thus the 
gastric juice is secreted whenever any substance is intro- 
duced into the stomach, and the number of the pulsations 
of the heart bears a definite relation to the frequency o{ 
the respiratory movements. This irritability, or normal 

1 "Irritability (irrito, I provoke). In physiology, this word signifies 
the power of responding to a, stimulus, as exemplified by (be contractility 
of muscular tissue. In medicine, irritability implies an undue excitability 
of an organ or tissue, from disease or disorder, such as of the brain, spinal 
cord, stomach, eye, or bladder." — Quain, Dictionary of Medicine. 

271 



272 THE NERVOUS SYSTEM. 

excitability, of tissues, together with the performance of 
all vital functions, is made possible by the nervous system, 
through which all impressions are received, and by means 
of which motion, sensation, thought, etc., are produced. 
This system regulates all the movements of the body, 
both voluntary and involuntary, and all the processes, 
and harmonizes the functions of the various organs. 

-292. Everywhere in the healthy body there is coopera- 
tion for the common good. Were it not so, man would be 
a collection of disorderly organs, each one trying to live 
to itself, and to act for itself. The heart varies its rapid- 
ity of action to keep pace with the muscular activity of 
the individual. The muscles work together to produce 
varied movements of the bod}^. 

The various organs of the body are connected with the 
brain — the centre of operations — by means of nerves, 
which are like so many electric wires running to and from 
the seat of government of the community. By this ar- 
rangement, notice of any disturbance is immediately com- 
municated to headquarters, so that a remedy may be 
promptly furnished. The importance of the nervous sys- 
tem, with its harmonizing influence, is obvious when we 
witness the results of disturbances therein, such as irregu- 
lar action of the muscles of the extremities in spasms and 
cramps, fluttering of the heart, or convulsions. 

293. General Arrangement of the Nervous System. — Owing 
to the difference in location and function of its various 
parts, there are two divisions of the nervous system; viz., 
the cerebrospinal nervous system, and the sympathetic 1 

1 At one time it was believed that one part of the body became 
diseased through sj'mpathy with another part. As the second of the 



THE NERVOUS SYSTEM. 273 

nervous system. The first-named division includes all that 
portion of the nervous system contained within the cranial 
cavity and the spinal canal; viz., the brain and the spinal 
cord, together with the nerves which branch off from 
each. This system presides over the functions of animal 
life, as volition, sensation, etc. 

The second-named division includes all that portion of 
the nervous system located principally in the thoracic, 
abdominal, and pelvic cavities, and distributed to the in- 
ternal organs. Its special function is the regulation of 
involuntary processes, like growth and nutrition. It is 
connected with the cerebro-spinal system. 

294. Nervous Tissue. — Nerve fibres and cells. The ner- 
vous system, whether simple in arrangement, as in the 
starfish, or more complicated, as in the higher animals, 
consists of two different kinds of tissue, the one white and 
the other gray. These differ from each other not only in 
color, but in structure and mode of action. 

The white matter constitutes the bulk of the nervous 
tissue, and is in large quantity on the exterior of the spinal 
cord and in the interior of the brain. To the unaided 
eye, it seems to be a homogeneous mass of white, semi- 
solid material. In reality it consists of slender threads, 
called nerve fibres, 1 Avhich for the most part lie parallel 
to one another, and are kept in place by delicate con- 
nective tissue. Nerve fibres, united in bundles large 

above-named divisions of the nervous system is largely responsible for 
the spread of disorder and disease, it has been called sympathetic, in 
deference to the old belief. It is also sometimes called ganglionic^ owing 
to the fact that it is largely composed of ganglia, or masses of gray 
nervous matter. 

1 They vary in breadth from .-, l 00 of an inch in nerves, to llU ' s , of an 
inch in the brain. 



274 



THE NERVOUS SYSTEM. 



enough to be seen with the naked eye, form nerves. The 
sole fundi 'on of nerves and nerve fibres is to convey nervous 



295. The gray matter of the nervous system is of an 
ashen-gray color, and constitutes the cortex — the ex- 
ternal or convoluted layer of the brain — and various 
deposits in the substance of that organ. It also forms 

the centre of the spinal cord, 
and the masses of varying size, 
called ganglia} which are con- 
nected with certain nerves and 
are especially numerous in the 
sympathetic system. 

Under the microscope, the gray 
matter is seen to consist mainly 
of cells of peculiar shape, called 
nerve cells, intermingled with 
connective tissue and very small 
nerve fibres, the smallest of 
which are nerve filaments. These 
cells vary in form and size. 2 
Each one consists of granular ma- 
terial containing a large nucleus 
and a nucleolus, and has several branches or processes, 
one of which connects with the axis cylinder — the central 
conveying portion of a nerve fibre 3 (a). 

Each collection of gray matter, consisting, as it does, 




Fig. 87. (Gray.) 

Nerve Cells from Spinal Cord. 
(Magnified.) 



1 From the Greek y&yyXiov, "a knot." 

2 Viz., from ^-^ to ^ of an inch in diameter. The cells in ganglia 
are known as "ganglionic cells." The term is sometimes used to include 
all nerve cells. 

3 The connecting process of the cell is sometimes called the neuron. 



THE NERVOUS SYSTEM. 



275 



of groups of nerve cells, is a nerve centre. Its function is 
to receive nervous impressions, to originate and impart ner- 
vous force or impulses, and also to transmit them from one 
nerve cell to another. 1 

296. Nerves are bundles of nerve fibres, between which 
is connective tissue for support and as a framework for 
capillaries and lymphatics which 
nourish the parts and carry away 
wastes. Each fibre is distinct and 
may act independently of every 
other. Most fibres are, in fact, 
insulated by connective tissue and 
fatty matter, as are the wires of 
a cable by rubber. 2 

The nerves connected with the 
brain and spinal cord are divided, 
as to function, into sensory, or 
afferent, which convey sensory im- 
pressions or impulses to these 
nerve centres, and motor, or effer- 
ent, which convey motor impulses 
from these nerve centres. 

The largest nerves, or those near 




Fig. 88- (Leidy.) 
Mode of Branching of Nerves. 

1, 2, two bundles of nerve fibres. 

3, a branch of three fibres. 

4, branch of two fibres. 

5, 6, branches of single fibres. 
7, decussation between two 

nerves. 



1 A nerve centre may be likened to a switchboard of a telephone ex- 
change (which might be called a telephone centre), receiving messages 
from one quarter, originating and sending out messages to another, or 
transmitting a message received from one place to another. In a telephone 
exchange the message is transmitted by connecting the wire from the 
sender with the wire to the receiver. In the body the message probably 
leaps from one nerve cell to another, as these cells in a nerve centre are 
not all connected with one another. 

2 If this insulating material disappears or softens [o such an extent as 
to allow the conducting portion of adjoining fibres to touch, nervous im- 
pulses will be sent to portions of the bodj tor which they were not 
intended, just as telephone messages go astray if wires are crossed, 



276 



THE NERVOUS SYSTEM. 



the nerve centres, are composed of both afferent and 
efferent fibres, and are known as nerve trunks. As they 
go to the tissues, these trunks separate into smaller nerves 
(consisting of either afferent or efferent fibres, as the case 
may be), and these into still smaller ones, and finally they 
end in or among the cells of the body as nerve filaments so 
small that they cannot be seen except with a microscope. 1 
When nerves branch, or decussate (i.e. cross each 
other), some of the fibres of which they 
are composed leave the nerves, and 
branch off. 2 




297. Structure of Nerve Fibres. — Nerve 
fibres are of two kinds, medullated and 
non-medullated. Each has in its centre, 
from end to end, a delicate core, the 
axis cylinder, which connects with a 
nerve cell, and is the essential or con- 
ducting portion of the fibre. Covering 
this core, in medullated fibres, is a sheath 
of white fatty material, the medullary 
sheath (having nuclei in its course), and 
outside of this is a thin, delicate covering of connective 
tissue, the neurilemma, or primitive sheath. These sheaths 
are frequently absent in nerve filaments. 



2V- 



K. 



Fig. 89. 

Diagram of Structure of 
Medullated Nerve-fibre. 

N", neurilemma. 

M, medullary sheath. 

A, axis cylinder. 



1 The sciatic nerve, located in the back part of the thigh, is a very large 
nerve, as large round as the tip of the little finger. The painful affection 
sciatica results from an irritation or inflammation of this nerve. 

2 Nerves distributed to the walls of blood-vessels are vaso-motor nerves ; 
those which stimulate gland cells to action are secretory nerves ; those 
which check the action of certain organs are inhibitory. The nerve fibres 
which connect the brain and. spinal cord with distant organs are called 
peripheral nerve fibres, to distinguish them from those within the brain 
and spinal cord. The end of a nerve or nerve fibre nearest its nerve centre 
is the inner, or proximal, end ; the other is the distal, ov peripheral, end. 



THE NERVOUS SYSTEM. 277 

The non-medullated fibres, sometimes called gray fibres, 
have no medullary sheath, only the axis cylinder and the 
neurilemma. These fibres are found mainly in the sym- 
pathetic system. The medullated fibres are found in the 
brain, spinal cord, and in large nerves. 

298. Interdependence of Nerve Fibres and Cells. — A nerve 
fibre, connected by its axis cylinder with a nerve cell, is in 
reality an elongated process of the cell. Taken together, 
the cell and its fibre may be considered an anatomical 
unit. Each depends upon the other. A nerve fibre sev- 
ered from the cell it is connected with degenerates and is 
no longer capable of conveying any message. The muscle 
or other part of the body to which it goes, or from which 
it comes, also degenerates and cannot do its work. The 
cell, deprived of needed nerve stimulus, grows feeble from 
inactivity. 1 

299. Nervous Impulse, or nerve force, the peculiar power 
transmitted by the nerves, is believed to be of a molec- 
ular nature, and in the form of a wave. 2 Its velocity is 
so rapid (usually 100 feet per second) that its transmission 
seems to be instantaneous. 3 Nervous impulses are put in 

1 Some physiologists state that if a fibre dies as the result of an injury, 
its connecting cell can produce a new fibre growing out from the cell body. 

2 The ancients, believing nerve force to be a fluid, called it the ner- 
vous fluid. It was once supposed to be of an electric nature ; but elec- 
tricity travels 1000 miles per second, and the nerve current never more 
than 200 feet. 

8 An act of volition is said to require 2 * s of a second ; a simple distinction 
or recognition of an impression, ^of a second. 

"In the case of the ear, when the sound attended to is that of two 
electrical sparks quickly succeeding- each other, it can be perceived that 
there are two, and that one is earlier than the other, when it precedes it 
by no more than 0.002 see. 1 ' — Poweks, Physiology, 



278 THE NERVOUS SYSTEM. 

motion by stimuli, either from within or from without the 
body, such as food, waves of light and sound, the emotions, 
the application of electricity or other agents. These im- 
pulses, when aroused, produce the various motions, sensa- 
tions, and functions incident to the body. Normally 
they rarely, if ever, originate in the course of nerve 
fibres, but are produced either at the outer ends of fibres 
in special structures like the sense organs, or at their 
inner endings in nerve cells. On the other hand, artificial 
stimulation, such as electricity applied in the course of 
a fibre, will produce impulses, just as an electric wire 
can be tapped. Heat increases the conductive power of 
nerves, and cold diminishes it. 

300. Nerves kept in action (i.e. strained, or put on the 
stretch) for a considerable time, as in the repeated con- 
traction of the same group of muscles, become fatigued 
and need rest. The nerve fibres, their connecting cells, 
and their capillary blood-vessels become weakened by such 
abuse, and accumulate carbon dioxide and other wastes. 
Pitiful examples of fatigued and poisoned nerves and 
muscles are seen in some of the competitors in long- 
continued walking and bicycle contests. 

301. The Brain and Spinal Cord; their Relation and Mem- 
branes. — The brain is the great mass of nerve tissue which 
occupies the cranial cavity, and is continuous (through a 
large opening in the base of the skull) with the spinal 
cord. 1 Both are divided by a longitudinal furrow into 
two portions, right and left. 



1 The spinal cord is sometimes considered as a part of the brain, the 
two constituting the great cerebro-spinal centre. 



THE NERVOUS SYSTEM. 279 

The brain and the spinal cord are protected from 
various injuries by their strong, bony encasements, and 
from friction against these walls by three coverings, or 
membranes, by connective tissue, and by fluid between 
two of the coverings. The outermost membrane, the 
dura mater, 1 is fibrous and strong. It lines the cranial 
cavity and spinal canal, and has various shelf -like expan- 
sions in the former for the support of different portions of 
the brain. The innermost membrane, the pia mater, 2 — 
in reality a fine network of capillaries in the meshes of a 
delicate connective tissue, — is in close contact with the 
brain and spinal cord, dipping down into their furrows. 
Between the dura mater and pia mater is a delicate sac- 
like membrane, the arachnoid, 3 containing a fluid known 
as the cerebro-spinal fluid. The protection and freedom 
of motion afforded by this sac, with its soft and yielding 
liquid contents, are evident. 

302. Divisions of the Brain. — The brain consists of three 
masses, or divisions : 4 first, the cerebrum, or brain proper, 
which is the largest, and occupies nearly the upper two- 
thirds of the cranial cavity ; next, the cerebellum, or little 
brain, which about fills the lower and back portion of 
the cavity ; and third, the medulla oblongata!* This last is 

} "'Hard mother' ; called dura because of its great resistance, and 
mater because it was believed to give rise to every membrane of the 
body." — Dunglison, 3Iedical Dictionary. 

2 " Delicate mother. " 

3 A name originally applied to delicate membranes resembling spiders' 
webs. The term arachnoid is from a Greek word, meaning "spider.'' 

4 These are sometimes spoken of as i\w fore-brain, mid-brain, and hind- 
brain. 

6 I.e. "oblong pith" or "marrow." It is sometimes called the bulb, 
oblong cord, or spinal bulb. 



280 



THE NERVOUS SYSTEM. 



the smallest part, and is the broadened commencement of 
the spinal cord (Fig. 90). These three parts of the brain 




cer - - - 



Fig. 90. 
Vertical Section of Brain. 



CE, cerebrum, left hemisphere. 
CEB, cerebellum, left portion. 



MO, medulla oblongata. 
SC, spinal cord. 



are connected with one another, and all contain both 
white and gray matter. 

303. The Size and Weight of the Brain depend somewhat 
on the size of the individual, but they also bear consid- 
erable relation to his intellectual capacity (a). In the 
lower animals the cerebellum and the ganglia at the base 
of the brain are the largest ; but in the higher animals 
the cerebrum, as a rule, increases in size in proportion 
to the degree of intelligence. In man the size is very 
much greater in proportion to that of the entire body than 
in any of the lower animals. The quality of the brain 
material is also undoubtedly a matter of importance, for 



THE NERVOUS SYSTEM. 281 

the brains of some very intelligent persons have been 
found to be comparatively small. 

304. The Cerebrum is rounded upon its upper and lateral 
surfaces, where its shape conforms to that of the skull, 
while its base or lower surface is more flattened, and rests 
in front upon the floor of the cranial cavity, and at the 
back upon a membranous expansion of the dura mater, 
which separates it from the cerebellum. The longitudinal 
fissure before referred to divides the cerebrum into two 
nearly equal parts, called hemispheres. These, however, 
are connected toward their lower portions by a trans- 
verse band of nerve fibres called a commissure} and also 
by two columns of fibres 2 which extend upward from the 
bulb, diverging as they enter the hemispheres. 

305. Each hemisphere is everywhere marked, on its 
outer surface, or cortex, with irregular grooves and ridges, 
and is covered by gray matter. The undulations thus 
formed are termed convolutions. This convoluted arrange- 
ment provides, in a small space, a large amount of gray 
matter, the source of nervous power. The convolutions, 
in proportion to their number and well-marked character, 
indicate the degree of intelligence in animals and man. 
In young children, especially before the age of seven 
years, when the brain is very soft and imperfect!}' devel- 
oped, and the mental powers are not strong, the convolu- 
tions are not well marked. Such is also the case in the 
lower animals and in the uncivilized races of mankind. 3 

1 I.e. " point of union of two parts." - These are the crura cerebri. 

8 "There are exceptions, however, as in the whale and elephant, in 
which the convolutions are exceedingly intricate and beautiful. The par- 
ticular arrangement of the fissures and convolutions differs as the brain 
ascends through the half apes, the apes, and man." 



282 THE NERVOUS SYSTEM. 

The white matter of the hemispheres is large in amount, 
and consists of nerve fibres prolonged from various tissues 
and organs of the body. These fibres terminate in the 
gray matter of the convolutions and in the ganglia of the 
brain. 1 

306. The cerebrum is a single organ, as far as the intel- 
lect is concerned, but a double one with relation to the 
two sides of the body. Impressions from either side of 
the body are appreciated through the hemisphere on the 
opposite side, owing to the crossing, in the course of 
the spinal cord, of nerve filaments which convey sensa- 
tions. So, too, the bursting of one or more blood-vessels 
(i.e. apoplexy) or the stoppage of a blood-vessel by a 
clot, on one side of the cerebrum, injures the nervous 
tissue and produces complete or j)artial paralysis upon the 
opposite side of the body, owing to the crossing in the 
medulla oblongata of nerve filaments that convey motor 
impulses. 

307. Functions of the Cerebrum. — The cerebrum is the 
organ of the mind. It enables one to know, think, origi- 
nate, and act. It is connected, directly or indirectly, with 
all parts of the body, and acts as a superintendent. It is 
that part of the nervous system through which the intellec- 
tual and moral powers, or faculties, act. 2 These faculties, 

1 In the cerebrum are many curious and interesting anatomical arrange- 
ments, — cavities, ventricles or water beds, passageways, and curtains, — 
which, though important to the anatomist and physician, are too intricate 
and complex to be described here. 

2 Facts in regard to the functions of the nervous system are ascertained 
from the study of the lower animals, and by experiments made upon them, 
and also by studying the results of disease and injury in the human being. 
It is a curious fact that the cerebral substance is not sensitive, but can be 



THE NERVOUS SYSTEM. 283 

rightly used, make man the " noblest work of God " ; for 
his is the highest organism, and the one which best 
adapts itself to its environments (a). 

308. The principal faculties are memory, reason, and 
judgment. A good memory is essential to healthy de- 
velopment of the intellect. It not only retains facts, 
but produces them, when wanted, with their connections 
and relations : (a). Reason enables us to appreciate the 
true relation between cause and effect. Judgment requires 
both memory and reason, and is that faculty by which 
appropriate means are adapted for the accomplishment of 
a particular end. 

The vigor of the intellect depends more upon the 
quality than the quantity of the cerebral tissue. The 
quality is improved by proper use of the mental faculties. 
It is inferior in those who do not strengthen the memory 
and the power to reason correctly and to judge aright. 

309. Brain Localization. — The attempts made from time 
to time to locate accurately in the cerebrum the centres 
of the various mental faculties have not been fully suc- 
cessful. This is probably due to the fact that these 

cut or torn without pain. In general, loss of cerebral substance by dis- 
ease or severe injury causes impaired memory, tardy, inaccurate, and 
feeble connection of ideas, irritability of temper, and easily excited 
emotional manifestations. 

1 " We are apt to be carried away by a vague notion that there is no 
limit to acquirement, except our defect of application or some other curable 
weakness of our own. There are, however, very manifest limits. We are 
all blockheads in something ; some of us fail in mechanical aptitude, some 
in music, some in languages, some in science; memory in one of those 
lines of incapacity is a rope of sand ; there must be in each case a defi- 
ciency of cerebral substance for that class of connections. " — Bain, Mind 
and Body. 



284 



THE NERVOUS SYSTEM. 



faculties are of a complex nature, and are produced by a 
coalition of a number of impressions. 

The functions of the rounded masses near the base of 
the cerebrum, called basal ganglia, are not settled, owing 
to experimental difficulties. But the centres or areas of 

motion, sight, smell, and hear- 
ing are quite clearly localized. 1 
The motor areas, or those 
which are associated with def- 
inite motions of the voluntary 
muscles, are in the upper and 
side portions of the cerebral 
cortex, and usually on the 
opposite side of the body from 
the muscles moved. 

The surgeon, by the removal 
of tumors or clots of blood 
from certain motor areas, has 
relieved cases of epilepsy and 
paralysis. Studies of diseased conditions of the brain 
indicate " that the removal of certain portions of the brain, 
respectively, or injury to them, will produce blindness, 
deafness, or lack of smell, etc., as the case may be." The 




Fig. 91. 

Brain Localization. 

P, pons. M, medulla. 

CEE, cerebellum. 



1 Investigations seem to show that the centres for motion, sensation, 
and the mental faculties are not so isolated as has been hitherto supposed, 
but that they are more diffused and shade off into each other. Thus 
a wonderful provision is made for emergencies. If the very heart of a 
centre or area be injured, there will be oftentimes sufficient nervous tissue 
remaining to perform the work in a more or less perfect manner. 

"The faculty of articulate language appears to reside in the third or 
inferior frontal convolution of the left side, which convolution would con- 
tain both the centre for the memory of words, and the centre for the co- 
ordination or combination of the movements of speech." — Cooke, 
Tablets of Physiology. 



THE NERVOUS SYSTEM. 285 

centres for sight are in the occipital lobes of the cerebrum ; 
the centres for hearing, near and behind each ear ; for 
smell, on the sides of the cerebrum in front of the ear. 

310. The Cerebellum ; its Functions. — The cerebellum 
has no convolutions. Its surface, or cortex, is of gray 
matter, arranged in nearly parallel ridges of irregular 
depth. 1 Its two lobes are connected by nerve fibres, which 
pass from side to side across the upper and front part of 
the medulla oblongata. This is called the pons, from its 
resemblance to a bridge. 2 

Like the cerebrum, the cerebellum is without feeling. 
Its function is the coordination, or harmonious regulation, 
of the movements of the voluntary muscles. The neces- 
sity of its directing power is made manifest whenever that 
power is interfered with, as is shown in the unsteady gait 
of the drunkard, or in cases of injury or disease of the 
cerebellum. 

311. The Medulla Oblongata. — The medulla resembles 
the spinal cord in the arrangement of the white and gray 
matter. Through it run nerve fibres on their way to 
and from the upper portions of the brain, those that con- 
vey motor impulses crossing within the medulla. Fibres 
also enter it from the cerebellum. From its interior and 
from the under surface of the cerebrum rise what are 
known as the cranial nerves. These emerge Prom the 
cranial cavity through openings in the base of the skull, 
and are distributed to various parts of the head and neck, 
to the organs of special sense, and to some of the thoracic 

1 From the peculiar branching' appearance of the gray matter in a per- 
pendicular section of the cerebellum, it is called arbor vitac, or tree of life. 

2 Also pons Varolii, after its discoverer, Yarolius. 



286 THE NERVOUS SYSTEM. 

and abdominal organs. A still more essential feature of 
the medulla oblongata is the possession of nerve centres 
that control respiration, the pulsations of the heart, and 
the size of the small arteries. 1 

The mental faculties may become almost useless, and 
sensation and the power of voluntary motion may be lost, 
by disease or injury of the cerebrum or cerebellum ; but 
life itself remains if the respiratory and heart centres 
(vital knots, or points, as they are sometimes called) are 
intact. If these centres are injured, breathing is impaired; 
if destroyed, death necessarily results. Hence, nature has 
provided protection for the medulla, by burying it so 
deeply within the skull that it is seldom injured by blows 
or falls. Sometimes, however, in fracture of the spinal 
column near its articulation with the skull, particles of 
bone are driven into the medulla oblongata, causing 
instant death. 2 Apoplexy in this part of the brain is 
also of rare occurrence. 

" To the centres of the medulla come impulses from all 
parts of the body, which may never give rise to conscious 
sensation, but which so stimulate these centres as to keep 
them alert (like watch-dogs) to the needs of the organism. 
Ordinarily, whether asleep or awake, these centres pursue 
the even tenor of their way. Under some great emotion, 
when all the energy of our being is centred on one thought 

1 Other portions of the medulla are said to regulate mastication, swal- 
lowing, vocal utterance, and the secretion of saliva and sweat. 

2 Instantaneous death may result from injury to the medulla oblongata 
without the neck's being broken, as when the atlas is dislocated by the 
striking of the head upon the bed of a stream in diving from a height into 
shallow water — a proceeding always attended with danger. Occasionally 
animals fall dead from sudden injury to the vital point. For instance, 
a clumsy shanghai rooster, in full pursuit of another, fell over a wooden 
pail, striking the back of his head, and died instantly. 



THE NERVOUS SYSTEM. 



287 



or supreme effort, these centres may stand in abeyance, 
or the pang may be so great as to break the vital chain. 
Higher life is only possible by freedom from the necessity 
of watching over these functions." 



CE 




CE 



CER 

Fig. 92. 

The Lower Surface or Base of the Brain. 

CE, cerebrum, right and left hemispheres ; CEE, cerebellum, right ami left portions. Pass- 
ing from one hemisphere to another is a white, broad, transverse band of fibres, like a 
bridge. This is the pons Varolii (bridge of Yarolius), and is a bond of union between 
the various segments of the brain. Underlying it is the upper portion of the medulla 
oblongata. The cranial nerves are shown' branching out from under the front and 
middle portions of the hemispheres, and from the sides of the medulla oblongata. 



312. The Cranial Nerves. — Of these there are twelve 
pairs (Fig. 92), numbered from one to twelve in the 
order in which they rise from the base of the brain, the 



288 THE NERVOUS SYSTEM. 

enumeration beginning at the front of the cerebrum and 
continuing backwards. These nerves, with the exception 
of those distributed to the interior of the nose, eye, and 
ear (termed nerves of special sense), are either motor or 
sensory, or are mixed nerves and convey both sensory and 
motor impulses. 1 The fifth, seventh, and tenth pair of 
cranial nerves are briefly described in the three following 
sections. 

313. The Fifth Pair of Nerves are the great sensitive 
nerves of the face and the side of the head. They possess 
also motor fibres (derived from distinct roots), which are 
distributed to the muscles of mastication. Each of the 
nerves of this pair has three main trunks. The upper one 
passes from the cranial cavity into the orbital cavity, 2 
sending filaments to the eye and adjacent parts, then out 
through a notched opening in the skull underneath the 
eyebrow, toward its inner side, 3 and is distributed to the 
forehead and top of the head. The second branch, after 
leaving the cranial cavity, runs along the floor of the 
orbit, giving off branches to the upper teeth, gums, and 
mucous membrane of the upper jaw. Then, through an 

1 Eirst pair, olfactory nerves, or nerves of smell ; 2d, optic nerves,' or 
nerves of sight ; 3d, motor nerves to three of the muscles that move the 
eyeballs, and to the iris and ciliary muscle of the eye ; 4th, pathetic nerves, 
each of which moves one muscle of the eyeball, pulling the eyeball up- 
ward and outward ; 6th, motor nerve to one of the straight muscles of the 
eyeball ; 8th, auditory nerves, or nerves of hearing ; 9th, glossopharyn- 
geal nerves, nerves of sensation to pharynx, fauces, and tonsil, and special 
nerve of taste to certain parts of the tongue ; the 11th joins the 10th, 
and is also distributed to muscles about the neck ; 12th, hypo-glossal 
nerves, mainly to muscles of tongue. 

2 The cavity in which the eye rests. 

3 This point is very sensitive to pressure. Where the other branches 
of the nerve emerge, sensitiveness is less. 



THE NERVOUS SYSTEM. 



289 



opening just below the front lower edge of the orbital 
cavity, it is distributed to the middle portion of the face, 
the nose, cheeks, and upper lip. The third branch, with 




Fig. 93. 
Superficial Branches of the Seventh and the Fi 



Fairs of Cranial Nerves, 



which the motor-nerve filaments are associated, supplies 
sensitive fibres to the mucous membrane of the cheeks, 
lips, and front part of the tongue, and to the lower teeth. 
It emerges at an opening in the front part o( the lower jaw. 



290 



THE NERVOUS SYSTEM. 



to be distributed to the lower lip, chin, and adjacent parts 
(Fig. 93). Irritation of this nerve by disease or other 

cause produces intense pain, as 
in neuralgia, headache, or tooth- 
ache. 

314. The Facial or Seventh Pair 
of Nerves are the great motor 
nerves of the face, the nerves 
of expression, by which the fea- 
tures are animated by various 
movements, in response to the 
emotions. One nerve of the pair 
emerges from the skull near the 
external opening of each ear, and 
is distributed to the muscles of 
the face. When these nerves 
are irritated or diseased, convul- 
sive twitchings of the face and 
unusual exj)ressions result. If 
the injury is confined to the 
nerve of one side of the face, 
only the facial movements upon 
that side will be disturbed. 

315. The Pneumogastric or 
Tenth Pair of Nerves are mixed 
nerves. Their distribution is 
wider than that of any other 

Fig. 94. (Dalton.) nerves in the body, and their 

Diagram of Pneumogastric Nerve, influence greater, f or they supply 

with its principal branches. ° , . 

1, pharyngeal branch. the OT g anS ° f V01Ce aild ^Spira- 

I: fnS larTgfa? 1 - tioii with motor and sensory mi- 

s'; ?^" yb ™tW pulses, and the pharynx, gullet, 




THE NERVOUS SYSTEM. 



291 



stomach, and heart with motor influence. They are con- 
nected at various points with the sympathetic system of 



nerves. 



316. The Spinal Cord extends downwards from the 
medulla oblongata about eighteen inches, and ends in a 
point opposite the second lumbar vertebra. It is a some- 
what cylindrical mass of nerve tissue, and is fissured in 
front and behind. It becomes enlarged in the cervical and 
lumbar regions, at the points where the nerves supplying 
the upper and lower ex- 
tremities are given off. 
Toward the lower end, it 
sends out prolongations 
through the sacrum 
which, from their fancied 
resemblance to the hairs 
of a horse's tail, are called 
the cauda equina. 

The centre of the spinal 
cord, for nearly its entire 
length, is composed of 
gray matter, arranged 
somewhat like two cres- 
cents (one in each half 
of the cord), united back 
to back by a band of gray 
matter. The extremities 
of these crescents, directed toward the front o( the cord, 
are called anterior horns; those directed backward, pos- 
terior horns. Opposite them, at regular intervals, fibres 
of the spinal nerves emerge from the cord. The gray 
matter of the cord is surrounded by longitudinal nerve 




N.C. 



Trans vers 



Fig. 95. 

Section of Ooe-half of SpiDal Cord. 
(Partly diagrammatic.) 

AF, anterior fissure. PM. pia mater. 

PF, posterior fissure. XF. nerve fibres. 

NO, nerve cells. 



292 THE NERVOUS SYSTEM. 

fibres, which pass up and down the cord in well-defined 
tracts or columns. The white matter of the cord lying 
between the posterior horns and posterior fissure con- 
stitutes the right and left posterior columns ; that be- 
tween the posterior horns and anterior horns, the right 
and left lateral columns ; that between the anterior horns 
and anterior fissure, the anterior columns. These columns 
are connected with fibres of the spinal nerves. 

317. The Spinal Nerves consist of thirty-one symmet- 
rical pairs of nerves, which are connected with the spinal 
cord by so-called roots. Each nerve has an anterior and 
a posterior root. The posterior roots (upon each of which 
is a ganglion), 1 with their respective nerves, are known 
as sensory roots and nerves, because they convey sensory 
impressions ; while the anterior roots, with their nerves, 
are the motor roots and nerves, because they convey motor 
impulses. Just beyond or outside of their junction with 
their respective roots the motor and sensory fibres are 
inclosed in the same sheath, but their functions always 
remain distinct. The spinal nerves are mainly distributed 
to the skin and muscles upon the corresponding sides of 
the body, and convey nervous force and impressions to 
and from the trunk and the extremities. 

318. Functions of the Spinal Cord. — The spinal cord is 
a conducting medium, as well as a nerve centre. The 
posterior columns of the spinal cord convey sensory im- 
pressions to the brain, and the antero-lateral columns 
convey motor impulses from the brain. 

319. Sensory impressions, such as the perception of heat 
and cold, or of the size, location, and character of objects, 

1 Called sometimes spinal ganglion. 



THE NERVOUS SYSTEM. 293 

are conveyed by the sensory nerve fibres of the body to 
the sensory roots of the spinal nerves. By these roots 
they are conveyed either to the gray matter of the cord 
or to its posterior columns of the opposite side, to be 
transmitted by them to the cerebrum. We become con- 




Fig. 96. (Westbkook.) 

A diagram to represent the passage of the nerve fibres from the spinal cord upward to the 
different parts of the brain, and some of the more important ganglionic masses with 
which they are associated. 

1, the gray matter of the cerebral convolutions. 

2, the white matter of the interior of the cerebrum, through which the fibres pass on their 
way to the convolutions. 

3, the corpus striatum, or anterior basal ganglion ; the fibres passing through it run in 
three principal directions : viz., to the anterior, middle, and posterior regions of the 
cerebrum ; they are represented by the three continuous lines. 

4, the space between the two basal ganglia, through which fibres pass directly from below 
upward ; these fibres appear in the cerebrum as broken lines, running toward the 
three principal regions. 

5, the optic thalamus, or posterior basal ganglion, with fibres (represented by dotted lines) 
traversing it on their way from below upward. 

6, the pons Varolii, made up of horizontal fibres which cross from one side of the cere- 
bellum to the other. 

7, corpora quadrigemina, from which the optic nerves, in part, take their origin. 

8, the cerebellum, with a ganglionic mass in its interior, and fibres passing into it from 
the brain above and the medulla oblongata (9) below. 

10, the dark convoluted line indicates the ganglionic matter of the spinal cord reaching up 
into the medulla oblongata and pons Varolii. 

scions of sensations only when they are thus carried to the 
brain. If the posterior root of a spinal nerve is severed, 
irritation of the skin supplied by its fibres will not cause 
discomfort or pain, because that part of the skin is no 
longer connected with the brain. In proportion as an 
object becomes painful, whether by reason of great heat, 



294 THE NERVOUS SYSTEM. 

pressure, or other cause, the sensory nerves lose their 
power of enabling us to perceive the ordinary properties 
of the object, and we become aware only of suffering. 

An injury to a sensory nerve in any part of its course is 
not felt at the point of injury, but at the terminal points 
of the nerve filaments, where impressions are usually felt. 
This explains why, when the ulnar nerve, or "funny 
bone," at the elbow is struck sharply, numbness or pain 
is referred to the outer side of the hand and the little 
finger, which parts are supplied by this nerve. Oftentimes, 
after a limb lias been amputated, the patient claims that he 
suffers pain in the part removed, or that his toes or fingers, 
as the case may be, are being tampered with. The cause 
of this distress is generally found to be some irritation of 
the nerve in the wound. When the force of the nervous 
current is diminished in sensory and motor nerves by 
pressure, as when one leg is kept crossed over the other in 
a constrained position for a length of time, or the arm is 
lain upon in sleep, temporary numbness of the limb and 
loss of motion result, and the part is said to be asleep. 
Under such circumstances, attempts to move the arm or 
leg will prove futile for a minute or two, as the motor 
nerves supplying these extremities cannot act in obedi- 
ence to the orders of the brain until they have regained 
their tone. The irritation of a motor nerve in its course 
results in motion of the part to which its filaments are 
distributed, while a severe injury produces loss of motion. 

320. Motor impulses for the voluntary muscles origi- 
nate, for the most part, in the gray matter of the cerebro- 
spinal nervous system. 1 From the cerebral gray matter 

1 The involuntary muscles are moved through the sympathetic system 
of nerves. 



THE NERVOUS SYSTEM. 295 

they are carried by motor-nerve filaments to the anterior 
columns of the spinal cord on the same side of the 
body, or to the antero-posterior columns on the opposite 
side, and thence to the motor nerves communicating with 
these columns. 1 From the gray matter of the cord, motor 
power passes out through the anterior horns, to be dis- 
tributed by the motor nerves in connection with them. 
Only those motions can be considered as voluntary ivhich 
emanate from the brain. If an anterior root of a spinal 
nerve be severed, motor impulses cannot be conveyed 
to the muscles usually moved by its nerve fibres when 
intact. 

When the spinal column is fractured at its middle, the 
lower extremities are paralyzed, the upper remaining un- 
affected. 2 When the injury is in the neck region, the 
upper extremities are also paralyzed, for the cord is 
damaged above the point at which the nerves distributed 
to them are given off. Sometimes injuries to the spine 
result in loss of power only or sensation only ; but, if 
severe, the parts below are deprived of both sensation and 
voluntary motion. 

321. The Sympathetic Nervous System consists of a double 
chain of ganglia on the sides of the spinal column. These 
ganglia are connected with one another by nerves, and with 
the cerebro-spinal nervous system by motor and sensitive 
fibres. From them numerous and very delicate fibres are 

1 Many fibres passing to and from the cerebral cortex pass through the 
basal ganglia. Of these, the optic thalami (one in each hemisphere) are 
believed to be sensory centres, and the corpora Striata (one in each hemi- 
sphere), motor centres. 

2 Such paralysis is called paraplegia, while that which results in one 
side of the body, from injury to one cerebral hemisphere, is known as 
hemiplegia. 



296 



THE XERVOUS SYSTEM. 




Fig. 97. 

Vertical section of body, showing sympathetic nerves and ganglia of right side, and their 
connection with the cerebrospinal nerves. — Cerebrospinal system: CN, cervical 
nerves ; B, nerves distributed to the arm ; D57, dorsal nerves ; SN, sacral nerves, some 
of which are distributed to the leg ; PN, pneumogastric nerve. Sympathetic system.: 
P, plexus in the head ; PP, pharyngeal plexus ; CP, cardiac plexus ; OP, oesophageal 
plexus ; SoP, solar plexus ; AP, aortic plexus ; MP, mesenteric plexus ; SP, sacral 
plexus ; G, some of the ganglia of the sympathetic system. 



THE NERVOUS SYSTEM. 297 

distributed, chiefly to the alimentary canal and its append- 
ages, the heart, blood-vessels, and certain other organs. 1 
At various points the sympathetic nerves, with their 
ganglia, form matted nets, or plexuses, about certain 
large arteries. A typical one is the solar plexus, so called 
because its radiating nerves branch out like the solar rays. 
This is situated in the abdomen, some of its filaments 
accompanying the branches of the aorta distributed to the 
stomach, intestine, spleen, pancreas, liver, and other organs. 
An injury to this plexus, as by a severe blow upon the 
abdomen, is likely to result in sudden death. When 
persons are said to die of concussion or shock, death 
results from a severe disturbance of the sympathetic 
system. Soldiers have been known to die suddenly, 
without any mark of injury being found upon their 
bodies, from the passage of cannon-balls very near them. 
Squirrels and other small game are sometimes killed by 
bullets fired close to the head. Fish have been stunned 
or killed, when within a few inches of the surface of the 
water, by a sharp blow struck upon the water just above 
them, or by the close contact of a pistol ball. 

322. Ordinarily, in health we do not notice that we 
have a heart, lungs, and stomach, so quietly does the vital 
machinery work. Yet, owing to the connection of the 
sympathetic with the cerebro-spinal nerves, the functions 
of the internal organs may be disarranged by apparently 
slight causes. For example, emotional disturbances, such 
as terror and fear, will contract the arterioles, and thus 

1 These nerves, distributed to the blood-vessels, are known as vasomotor 

nerves, and the continuous muscular action they furnish is called the 
tone of the arteries. 



298 THE NERVOUS SYSTEM. 

cause paleness, while shame and joy will cause blushing 
by the dilation of these vessels. Even unpleasant sounds, 
odors, or events will sometimes interfere with digestion, 
the action of the heart, and the secretion of tears. 



QUESTIONS. 

1. How is man especially distinguished from the lower animals? 

2. What is the use and general arrangement of the nervous system ? 

3. What two kinds of nervous tissue are there? What is their func- 

tion ? What are nerves ? 

4. Describe nerve force and its rapidity. 

5. How is it aroused? 

6. What three divisions has the brain ? How are the brain and 

spinal cord divided longitudinally ? 

7. Name and describe the three coverings of the brain and spinal cord. 

8. On what does the working capacity of the brain depend? 

9. Describe the cerebrum and its hemispheres. What do the convo- 

lutions indicate? 

10. What relation do the hemispheres bear to each other and to 

the body? 

11. What is the office of the cerebrum? of memory? of judgment 

and reason ? 

12. What effect has mental exercise upon the cerebral substance? 

13. Describe the cerebellum and its function. The medulla oblongata. 

14. State the importance of the medulla oblongata. How is it pro- 

tected ? 

15. Describe the spinal cord ; its conveyance of sensations and motor 

impulses. 

16. What are the spinal nerves? Which of their roots convey sensa- 

tions? which motor impulses? 

17. How are sensations conveyed to the brain ? 

18. How is motion produced ? where originated ? How is the motor 

impulse transmitted? 

19. What is the effect of irritating nerves midway in their course? 

20. What follows the severing of nerves or of the spinal cord ? 

21. How many and what are the cranial nerves ? Whence do they 

issue ? 



THE NERVOUS SYSTEM. 299 

22. How many and what branches has the fifth pair? What causes 

toothache V 

23. What pair constitutes the facial nerves ? What follows their use ? 

their injury? 

24. Describe the tenth or pneumogastric nerve. 

25. Describe the sympathetic system, and its ganglia and plexuses. 

26. Over what processes does this system preside? What is its normal 

action ? What may ensue from a sudden shock to a plexus? 



CHAPTER XVI. 

NERVOUS SYSTEM (continued). — REFLEX 
ACTION.— NERVOUS ENERGY. 



323. Reflex Action. — Many of the movements of our 
bodies are automatic. These are the result of what is 
known as reflex action, i.e. an action (secretion or muscular 

movement) produced 
by the transmission 
of an afferent impulse 
to a nerve centre and 
its reflection thence as 
an efferent impulse. 
In some way a sen- 
sory current, received 
by certain nerve cells, 
stimulates other nerve 
cells to produce a mo- 
tor current. Reflex 
action is especially 
distinctive of the gray 
matter of the spinal 
cord, which is a long 
series of nerve centres. 
Other movements that 
are sometimes called automatic, such as walking and eating 
while we are in deep thought, are first started by the will, 
and then continued apparently by reflex action through 
the cerebellum or spinal cord. 

300 




Fig. 98. 

Section of Spinal Cord and Diagram of Spinal Nerve, 
motor fibres ending in muscle of abdomen, sensory 
fibres beginning in skin overlying the muscle. 

1, 1, anterior columns. 2, 2, lateral columns. 

3, 3, posterior columns. 



REFLEX ACTION. — NERVOUS ENERGY. 301 

For the performance of reflex action, it is essential that 
the continuity of the sensory nerve be intact between the 
terminal point irritated and the nerve centre, that the 
nerve centre be healthy and uninjured, and that the con- 
tinuity of the motor nerve be intact from the nerve centre 
to the glands or muscles acted upon. 

324. Examples of Reflex Action. — If the spinal cord be 
severed at any point, the power of voluntary motion is at 
once lost in all parts below that point. But if the reflex 
activity of the spinal cord below the severed portion re- 
mains intact, and the foot be tickled, the foot and leg 
will be hastily drawn away. In the same way a hand 
or foot accidentally coming in contact with a hot sub- 
stance is instantly snatched away before the brain has 
had time to take cognizance of the danger. The in- 
stinctive efforts made to hold or regain one's footing, 
when jostled in a crowded conveyance or slipping upon 
the pavement, are also due to like reflex impulses. If the 
spinal cord is inflamed, or is under the influence of strych- 
nine or any other stimulating substance, the sensitiveness 
of the gray matter of the cord to impressions is greatly 
increased. In such instances convulsions readily occur 
by contact of the body with a draught of air, or by 
the noise caused by the sudden shutting of a door. In 
cold-blooded animals, the reflex activity of the cord re- 
mains for a considerable length of time even after the 
brain has been removed and the animal is practically 
dead. A decapitated frog will jump in a natural manner 
when the feet are pinched or irritated. 

325. For the most part, reflex action is performed 
without the knowledge of the individual, but it some- 
times may be voluntarily aided. Swallowing, ordinarily 



302 REFLEX ACTION. — NERVOUS ENERGY. 

the result of unconscious reflex action by contact of sub- 
stances with the pharynx, becomes voluntary if a substance 
lodges in it. A minute particle lodging in the larynx, by 
its irritation induces coughing and involuntary efforts of 
this organ for its expulsion. These, if unsuccessful, are 
aided by the voluntary efforts of the individual, sometimes 
many of the muscles of the body uniting to get rid of the 
insignificant particle. The act of winking is the result of 
a reflex action, and occurs generally without our knowl- 
edge, but may also be performed at will. 

326. There are certain reflex actions effected through 
the cerebro-spinal nerves, in conjunction with those of the 
sympathetic system, of which we are conscious, but over 
which we have ordinarily no control. Of these may be 
mentioned coughing, vomiting, blushing, the secretion of 
tears from irritation of the eyes by dust, the closure of the 
eyelids at a sudden flash of light, and the grimace on sud- 
denly inhaling an unpleasant odor. 1 

327. The Reflex Actions of the Sympathetic System we 

are not even conscious of, except in some diseased con- 
ditions of the body. Such actions result in secretion, 
excretion, absorption, peristaltic movements, the contrac- 
tion and dilatation of the pupil of the eye in regulating 
the admission of light, and the variations from time to 
time in the volume and rapidity of the blood current in 
the numberless capillaries of the body. 

1 Sometimes pressure upon the upper lip will prevent sneezing, and di- 
version of the mind by new scenes or objects may stop an irritating cough, 
or even prevent vomiting. A surgeon, after taking an active emetic, was 
almost immediately called upon to perform an important surgical opera- 
tion. Not till after the operation was performed and the anxiety was 
over did the emetic take effect. 



REFLEX ACTION. — NERVOUS ENERGY. 



303 



328. Sometimes during sleep voluntary actions are per- 
formed without the mind's being conscious of them, even of 
their inception ; such, for example, are walking and writ- 
ing, or even intellectual efforts of a high order. Sleep- 
walkers, or somnambulists, have been found carefully 
balancing themselves on the ridges of housetops, or en- 
gaged in other perilous feats. To awaken them suddenly, 
and so disarrange the nervous control of the muscular 
movements, may prove dangerous. 

329. Artificial Reflex Actions: Habits. — The voluntary 
faculties may be educated to act, as it were, in a reflex 
manner. Actions which at first are purely voluntary and 
consciously performed 
may, by frequent repe- 
tition, become habitual 
and apparently be per- 
formed unconsciously. 
Such actions are com- 
mon, and are called arti- 
ficial reflex actions. The 
expert pianist plays the 
most intricate music 
without any apparent 
thought upon his part 
as to how his fingers 
are to move; and it is a 
common experience for 
persons to walk, eat, and even read in an automatic man- 
ner while their thoughts are occupied by other matters. 1 




Sphial Centre 

for 
Hcuid Writing 



Fig. 99. (Brown.) 
Nerve Centres in Relation to Speech and Writing, 



1 It is said that a soldier, while carrying a bowl of soup, suddenly 
dropped it, on hearing- some one call " attention," so accustomed was he at 
that word of command to stand erect with his hands by his sides. Con- 



304 REFLEX ACTION. — NERVOUS ENERGY. 

Children, by imitating the odd habits or actions of others, 
sometimes acquire similar habits, which may be very diffi- 
cult for them to eradicate. 1 

330. The Use of Reflex Actions. — Were it not for reflex 
actions, every movement of the body and all the functions 
of the internal organs would have to be planned by the 
cerebrum. Harmonious cooperation of the various parts 
of the body would be impossible, and the mind would be so 
overburdened with details that there could be no intel- 
lectual development. It is only in some disordered or 
diseased condition of the body that we appreciate any 
irregularity or want of harmonious nervous action. Hence 
it is that the healthy, robust man or woman often fails to 
have any sympathy with the ailing person subject to 
irregular reflex nervous actions which cause pain, uneasi- 
ness, nausea, and discomfort. 

A strong will may control many of these actions, and 
a weak one is more or less controlled by them. For ex- 
ample, the reflex action of crying out when in pain is 
sometimes prevented by biting the tongue, clenching the 
teeth, or by holding some object very tightly. So, too, 
the yielding to the sensation of tickling, or to the involun- 
tary closing of the eyes when a blow is aimed at the head, 
may, in a similar way, be prevented. But Mr. Darwin 



valescing soldiers in military hospitals have been known to jump out of 
warm beds and stand erect, at hearing the word "attention" shouted 
in through the door by a would-be joker. A gentleman, accustomed to 
eat apples while reading, often reached out his hand for an apple while 
his thoughts w T ere busy on the book. One evening a friend, unperceived, 
added a number of apples to those already in the dish ; and the reader 
unconsciously ate apple after apple until all were gone. 

1 The unconscious performance of ordinarily conscious actions has been 
termed "unconscious cerebration." 



REFLEX ACTION. — NERVOUS ENERGY. 305 

gives a striking example of an instinctive reflex act over- 
riding a very strong effort of the will : " He placed his 
face against the glass of the cobra's cage, in the reptile 
house of the Zoological Gardens, and though, of course, 
thoroughly convinced of his perfect security, could not, by 
any effort of the will, prevent himself from starting back 
Avhen the snake struck with fury at the glass." 

In young children the nervous system is delicate and 
very susceptible to impressions. Reflex actions are espe- 
cially frequent, and sometimes attended with danger, in 
children of excitable temperaments and those who have a 
tendency to nervous disorders. In such children, indigest- 
ible food, dentition, or fright may cause convulsions, 
epilepsy, or even death. 

331. Nervous Energy. — The quantity of nerve force and 
the amount of nervous energy which each person possesses 
cannot be definitely stated. Most individuals have more 
than is required for the ordinary necessities of life. The 
surplus constitutes a reserve force, which is stored away 
for emergencies. In times of trial, feeble and apparently 
inefficient persons sometimes have more nervous energy 
than those whose ordinary physical powers are much 
greater ; while, on the other hand, persons of robust 
appearance may prove almost valueless on such occasions. 

Some persons, especially those not in robust health, are 
particularly susceptible to nervous impressions, and in 
them the reserve nervous force is likely to be recklessly 
drawn upon. Even persons of strong physical and mental 
powers, who do not readily succumb to the effects o( various 
forms of dissipation, and who freely indulge in excessive 
exercise, over-eating, over-drinking, or late hours, may 
unduly tax their reserve supply of nervous force, while 



306 REFLEX ACTION. — NERVOUS ENERGY. 

believing that they are too strong and well to be affected 
by the drain. The persistent overtaxing of our powers, 
whether mental or physical, will sooner or later exhaust 
the nervous system, and reduce us to mental and physical 
bankruptcy (a). 

332. Perverted Nerve Force : Nervousness. — Disease, 
the excessive concentration of the thoughts upon one's 
self, severe mental or physical work, and, above all, worry, 
especially if associated with lack of rest, of pure air, and 
of suitable food, create a disturbance or perversion of 
nerve force, even in those who are considered strong, 
mentally and physically (a). Such perversion produces 
nervous prostration and hysteria (£>), attended by over- 
sensitiveness of various parts of the body, or a numbness 
or diminished sensitiveness. There is also increased ex- 
citability of the emotions, with a tendency to spasms of 
voluntary and involuntary muscles, and to sudden con- 
gestions of blood. 1 

333. Hygiene of the Nervous System. — Many of the ner- 
vous disturbances to which all are more or less subject 
can be warded off and nerve force and energy strengthened 
by systematic and proper exercise and rest of the nervous 
system, just as muscles and other organs are developed 
by regular and appropriate exercise and rest. Exercise 
improperly adapted, however, to the age, health, and 
condition of the individual results in a loss of nerve 
power. Like other parts of the body, the nervous system 

1 To say that one is nervous too often means that the person of whom 
it is said is weak-minded and has lost self-control, due to thinking too 
much of himself, rather than of the welfare of others. The use of the 
term as an excuse for failure to do one's duty is very common. 



REFLEX ACTION. — NERVOUS ENERGY. 307 

needs also for its maintenance and health sufficient and 
wholesome food, and all other hygienic necessities. 

The brain, usually, has not more than one-fortieth oi the 
weight of the body, yet it receives about one-fifth of the 
whole volume of the blood. This large proportion of blood 
indicates that the brain is intended for active work; but 
its working capacity, like that of other organs, is dependent 
not only upon the quantity, but also upon the quality, of 
the blood which it receives. If it is ill developed or badly 
nourished, sensations and will power will be feeble. If 
one faculty or set of faculties has been overtaxed, rest 
and the use of other faculties instead are demanded. The 
most vigorous intellect is generally found in the most 
evenly developed body ; and so closely are mind and body 
related that if the health of one fails, that of the other, 
also, is likely to be impaired. 

Mental labor in excess is, contrary to the belief of some 
persons, as exhausting as excessive physical labor, and 
cannot, as a rule, be pursued for so long a time. The 
amount of nervous energy which each person should ex- 
pend depends upon the capacity of the individual. No 
person, however, should work up to the full measure of 
his ability. Such work is attended with danger, and has 
been responsible for the death of many otherwise intelli- 
gent persons. Moderate labor, regularly and systemati- 
cally pursued, will accomplish more than any amount of 
spasmodic effort, and will not be attended with such 
danger to the system. As far as possible, therefore, regu- 
lar mental and nervous work should supersede irregular 
work, and monotonous labor be replaced by varied exer- 
tion, if we are to gain and maintain a sound mind in a 
sound body. Gradually increasing and systematic men- 
tal work, proportionate to (he health ami nervous power, 



308 REFLEX ACTION. — NERVOUS ENERGY. 

does not pull down the average man. It is the spasmodic 
overwork in the struggle for wealth or fame, the per- 
plexities which result from suddenly assuming duties one 
is not capable of performing without a course of prepara- 
tory training, that do the mischief. The worry which all 
such work excites is a bar to sound mental and nervous 
health, and is oftentimes the factor which turns sanity 
into insanitw. 1 In the turmoil and bustle of modern life, 
especially in our large cities, the danger to the nervous 
system is great. The remedy is to practise self-control, 
for "he that ruleth his own spirit is greater than he 
that taketh a city." One cannot afford to be unstable, to 
shift from fancy to fancy, if he wishes his brain to act 
promptly, vigorously, and intelligently. 2 

334. Effects of Alcohol and Narcotics on the Nervous Sys- 
tem. — The tendency of the indulgence in any form of 

1 The chief enemies of the brain are worry, which disorganizes the 
machinery, and shock, which paralyzes the brain. " Worry or excitement 
causes irregular nerve action ; we call it confusion of ideas, or nervosity. 
The optic brain centres throw up a series of depressing mental photo- 
graphs, exaggerating existing trouble. This continues to depress the cells 
in the fore-brain, resulting in complete failure to judge aright or analyze 
correctly. Slight annoyances are likely to grow into quarrels in this 
way, for by brooding over them brain fatigue occurs. Then the imagina- 
tion sees exaggerated views, until spite and hatred and kindred passions 
exhaust the fore-brain, and misguided actions result. The stronger the 
quarrel grows, the weaker the finer perceptions become. This explains 
the disease of the age — worry — and its results." — Dr. Albert Wilson, 
The Brain Machine, its Power and Weakness. 

2 " Who is brave ? He that masters his passions. Who is free ? He 
that has self-control." 

'•Teach them to strive after self-effacement, to aim at some higher 
ideal than themselves, subsequently to find in labor, strength, and through 
suffering, tranquillity, and so transfigure their lives to discover therein 
sacrifice instead of selfishness, and gladness instead of gloom." 



REFLEX ACTION. — NERVOUS ENERGY. 309 

alcoholic drink is to interfere with the various functions of 
the nervous system and the parts of the body dependent 
upon it for activity, and to weaken, and at last destroy, the 
control of the moral nature. These effects are not under- 
stood by people in general. " The gradual changes in- 
duced in the nervous system, the slow poisoning of the 
great centres of thought, — the transmission from parent 
to child, from generation to generation, of nervous ten- 
dencies, progressive mental weakness, imbecility, insanity, 
idiocy, — are evils which far outweigh the results of the 
midnight brawl, the mother's sorrow, and the orphan's 
tears." As a medicine, alcohol should be dealt with like 
opium, — that is, recognized as an agent which, unless 
properly employed, will do harm instead of good. Like 
tea and coffee, it ranks as an excitant or stimulant, but 
its effects on the nervous system are unlike those of tea 
and coffee, since it must be taken in gradually increasing 
amount to afford the desired effects, and little by little 
an "alcohol habit " is formed. This tendency of moderate 
drinking to become immoderate is tersely expressed by a 
Japanese proverb, "A man takes a drink, the drink takes 
a drink, and then, — the drink takes the man." 

An alcoholic is first used as an experiment, or to please 
a friend, 1 then comes the feeling of necessity for it, a 
craving that gradually demands a larger amount. It is 
used more frequently, until body and mind are poisoned 
by it. This is the history of most drunkards. When a 
man loses control of himself from the effects of alcoholics, 
when he lies and resorts to the basest of tricks to obtain 
a drink, when his judgment becomes clouded, and his evil 

1 The custom of treating to drinks is unfortunately an American one, 
and unbiassed students of the evils of alcoholic intemperance in this 
country agree that it is largely responsible for such Intemperance. 



310 REFLEX ACTION. — NERVOUS ENERGY. 

passions assert themselves, when he is no longer a rep- 
utable member of society, he must be considered a dis- 
eased person, and should be removed to an asylum or 
reformatory for treatment. 1 This is the only chance for 
a cure. Life-insurance companies consider persons sub- 
ject to the drink habit as " extra hazardous risks." Great 
business interests of this country recognize that alcohol 
unfits men for doing the best work, and will not employ 
persons addicted to its use. Professional athletes, such 
as prize-fighters, ball-players, and oarsmen, understand 
that they must stop drinking if they wish to excel. Ex- 
periments show that more than thirty per cent of muscular 
strength is diminished by the use of alcohol, — i.e. that 
the nerve power which operates muscles is diminished. 

Briefly, the recognized effects of alcohol on the nervous 
system are as follows : 1, excitation of the functional activ- 
ity of the brain, and later of the spinal cord and sympa- 
thetic system ; 2, a general lack of coordination, ■ — the 
tongue refuses to give correct expression, ideas are con- 
fused, mental hallucinations 2 and even insanity may re- 
sult. This state is followed, or may be accompanied, by 
vasomotor paralysis, impaired reflex action, depression, 
coma, and even death. Many of these conditions are due 
to degenerative changes in the nerve cells, and to thicken- 
ing of the nervous connective tissue. 

" Alcohol makes the person who indulges in it believe 

1 In England, on January 1, 1899, the "Inebriates Act" went into 
operation, giving magistrates the right to sentence criminal habitual 
drunkards to a reformatory instead of to a penal institution. Australia 
has a similar law, and legislation to the same effect is being brought about 
in this country, — a step in the right direction. 

2 Viz., delirium tremens. Excellent authorities agree that dipsomania, 
or intense craving for alcohol, is frequently an hereditary neurosis, i.e. 
a disease of the nervous system. 



REFLEX ACTION. — NERVOUS ENERGY. 3H 

his condition is very different from what it really is. . . . 
While he may believe that his senses are keener and his 
powers of endurance greater, experiments with scientific 
instruments of precision have demonstrated that his acuity 
of vision is lowered, his power of hearing reduced, his 
sense of smell blunted, and his taste so obtunded that he 
can swallow fiery and even caustic liquids without winc- 
ing, and his muscular strength, which he believes to be 
greatly augmented, is shown by the dynamometer to be 
materially reduced. Even his soul-stirring eloquence and 
poetic flights are largely discounted in the estimation of 
the man who has not been imbibing." 

335. Tobacco is a narcotic, but used occasionally, in 
small amount, may be a stimulant. The tobacco habit, 
by inducing lassitude and an indisposition to exertion, 
may cripple one's energies, and unfit him for the neces- 
sary competition of business life. 

336. Opium, chloral, cocaine, etc., are essentially narcotic 
drugs, and what has been said as to the causes and effects 
of the alcohol habit may be said even more strongly in 
regard to those of the opium, chloral, and cocaine habit. 
The moral deterioration from the frequent use of these 
drugs is even greater than that from alcohol. 

To sell liquor to minors or to persons already under 
its influence and to sell narcotic drugs without the pre- 
scription of a physician should be criminal offences. 

QUESTIONS. 

1. State the three conclusions at the commencement of this chapter. 

2. What is reflex action ? 

3. Give an example of a really automatic action, and of an appar- 

ently automatic one. 



312 REFLEX ACTION. — NERVOUS ENERGY. 

4. Give examples of reflex action of the spinal cord; of one aided by 

the will; examples of reflex action of the sympathetic system. 

5. Of what value are reflex actions ? 

6. When are reflex actions recognized by the person in w r hom they 

occur ? 

7. What is said as to the quantity of nerve force and nervous energy 

which each person possesses ? 

8. What is meant by perverted nerve force ? 

9. How can the nervous system be kept in good working order ? 

10. What is said as to the proper use of nervous energy? 

11. What is the value of self-control? 

12. What are the effects of alcohol on the nervous system ? on the 

moral nature? 

13. What are the effects of opium, chloral, etc., and of tobacco? 



CHAPTER XVII. 

SENSATIONS. -THE SENSES : TOUCH, TASTE, 
AND SMELL. 

337. Common and Special Sensations. — By means of 
sensations, the mind obtains a knowledge, first, of the 
condition of the various parts of the body ; and, second, 
of external objects and phenomena. The first-named 
class may be termed common sensations y 1 the second, the 
special sensations, or the senses. Under the first head 
are those which cannot be distinctly localized, such as 
fatigue, discomfort, faintness, and also itching, creeping, 
tickling, aching, and burning, 

Tactile sensation constitutes what is commonly known 
as the sense of touch. The line of demarkation between 
many of the common sensations and this sense is not a 
clear one. In fact, as Kirke 2 says, " though touch is 
usually classed with the special senses, ... it forms the 
connecting link between the general and special sen- 
sations.," The sensations produced by stimulation of 
the nerves of the skin and of certain portions of the 
mucous membrane are numerous. Of these may be 
named the sensations of ordinary touch, of weight, heat, 
cold, and tickling, and, if the stimulation is strong, of 
pain. Some parts of the skin are more sensitive to cer- 
tain impressions than to others, and at times one sensation 
in a part is experienced after others are lost. Pain is 

1 Sometimes called general sensations. '-' Handbook of Physiology. 

313 



314 SENSATIONS. 

probably more easily induced in the face than elsewhere. 
The cheeks and ears seem to be more sensitive to the 
changes of atmospheric temperature than other parts of 
the face. The soles of the feet, the knees, and the arm- 
pits are particularly sensitive to tickling. The power of 
distinguishing heat and cold may be lost in a part, as in 
paralysis, and yet the sensations of touch and pain remain ; 
or pain may be prevented by anaesthetics before the sensa- 
tion of touch disappears. 

338. Muscular Sensations, or Sense. — The sensation of 
weight, resistance, etc., is called by some physiologists 
the muscular sense, from a belief that to a great extent it 
is dependent upon the muscular nerves, and is, therefore, 
a peculiar property of muscles. It is most developed in 
those parts of the body where the tactile sensibility is 
the keenest, and is probably due to the relative amount 
of the pressure of bodies upon those parts, and also to 
the relative amount of nervous and muscular energy 
expended in sustaining or resisting bodies. It is an aid 
in enabling us to appreciate the "resistance, immobility, 
and elasticity of substances that are grasped, or on which 
we tread, or which by their weight are opposed to the 
exertion of muscular power." Habit and education have 
a great deal to do with this sensation. It is astonish- 
ing with what accuracy experts will detect a departure 
from the standard weight in handling barrels of flour and 
other packages, or even in such light articles as coins. 

339. Pain. — Fortunately, in health, the application of 
stimuli beyond what may be considered in each individual 
the natural limit of stimulation is attended by discomfort or 
pain. For example, tickling may not be unpleasant at 



THE SENSES: TOUCH, TASTE, AND SMELL. 315 

first, but if persisted in, it is likely to become exceed- 
ingly disagreeable and painful, and may be carried to 
such a point as to be dangerous. " The muscles, though 
they are not very sensitive organs to ordinary stimuli, 
yet when contracted spasmodically occasion severe pain. 
They ache when fatigued, and pain is felt when they are 
contused or cut." Sunlight, so necessary for health and 
comfort, if intense and shining into one's eyes, will pro- 
duce pain and blindness. Similarly, long-continued and 
high-pitched sounds fail at length to be appreciated as 
sounds, and produce only painful sensations. This sensi- 
bility to pain guards us from many and great dangers. 
Those parts of the body which are the most subject to 
injury are supplied with nerves in the largest quantity, 
and are most sensitive. A cut into the skin, or the ap- 
plication of an irritant, ordinarily causes pain ; but the 
structures beneath the skin are comparatively insensitive. 1 

340. Were it not for this sensibility to pain, important 
parts of the body might be irreparably injured with- 
out the knowledge of the individual. Thus, the skin 
might be almost boiled by the hot water of a bath, or 
the eye might become intensely inflamed by long exposure 
to bright sunlight, if pain did not warn us of the danger. 
This sensibility undoubtedly differs in degree in both men 
and animals. 

341. The Senses. — The special sensations, or the senses, 
are generally spoken of as five in number ; viz., touch, 

1 In a surgical operation, cutting through the skin is the most painful 
step, but this pain is very frequently diminished or avoided by the applica- 
tion of cold to the part, by means of ether spray or other quickly evaporat- 
ing material. 



316 SENSATIONS. 

taste, smell, sight, and hearing. 1 All the organs of special 
sense are, however, but the working tools of the brain. 
Hence, not only should they be perfect in structure, but 
also the brain, and the special nerves which connect these 
organs with the brain, should be in an alert and healthy 
condition. 2 During deep sleep, impressions of sound may 
be presented to the ear, or of chilliness to the skin, and 
they will not be perceived. During the sleep usually 
produced by anaesthetics, great surgical operations are 
performed without the knowledge of the individual oper- 
ated upon. But when the sleep is not profound, the 
various steps of an operation may be recognized and 
afterward remembered, though the ability to move and 
the perception of pain may be absent. 

It is to be especially noted, first, that each nerve of sense 
is capable of performing only the function designed for it; 
the nerve of sight does not enable us to hear, and the nerve 
of smell enables us to appreciate only odors. Second, that 
cultivation of the senses, especially if begun in early life, 
will develop their usefulness. Cultivation furnishes the 
accurate hearing of the educated musician, the keen e}^e- 
sight of the pilot, engineer, and expert microscopist, and 
the accurate touch of the blind (a). But the training may 
be carried to the extent of making these senses sources of 

1 Some physiologists, believing that the several sensations produced by 
stimulation of the cutaneous nerves, and of those of certain portions of the 
mucous membrane, are effected through distinct sets of nerve fibres, enu- 
merate as among the senses the sense of pressure, of temperature, of 
pain, etc. Others claim that all the senses are but modifications of tha 
sense of touch. 

2 As sight, hearing, and touch seem to be most concerned with the 
wants of the intellect, they are sometimes spoken of as the intellectual 
senses ; while taste and smell, being intimately connected with nutrition, 
are known as the corporeal senses. 



THE SENSES: TOUCH, TASTE, AND SMELL. 317 

misery. Certain persons are painfully conscious of the 
slightest discord ; others almost instantaneously detect, 
with a feeling of disgust, the inharmonious blending of 
tints which, to the average person, are all in harmony ; 
still others are made uncomfortable by an odor perceptible 
to no one but themselves. 

342. Touch is that provision by which we appreciate, by 
actual contact, the size, form, and character of the surface 
of objects. It is most sensitive where the nerve endings 
are the most numerous and their covering the thinnest, as 
in the margin of the lips, tip of the tongue, palms of the 
hand, and under surface of the fingers. It is least acute 
in the middle of the back. 1 

343. The human hands, with their long, flexible fingers 
and adjustable thumbs, with their beautiful adaptation 
to the wants of the whole upper extremity, and with their 
average of 20,000 papillae to each square inch of surface, 
are the parts of the body most usually employed in the 
exercise of the sense of touch. 2 The sensitive tips of the 
fingers enable us to feel accurately, while their protec- 
tion by epidermis, nails, and cushions of fat save us from 



1 The delicacy of the tactile sensation may be measured by lightly 
applying at one time the two points of a pair of compasses to any part of 
the skin, the eyes being closed. In proportion as the parts tested are 
sensitive will the two points be perceived as two points when brought 
very close together. In this way it has been ascertained that the palmar 
surfaces of fingers and hands are more sensitive than the dorsal surfaces, 
the front of the body than the back. 

2 In the cat and seal, feeling is in part effected through the long bristles 
upon the lips, which are connected at their bases with nerve papillae. In 
some monkeys the extreme end of the tail, and in the elephant the trunk, 
are organs of touch. 



318 SENSATIONS. 

much of the pain that would ensue, if the fingers were not 
so protected. If the cuticle is removed and the ends of 
the sensitive nerves are exposed to the air, pain results, 
and the sense of touch is lost. 

344. Touch is the simplest of all the senses, and the 
one which is apparently first developed in the infant. 
Simple as the sense is, it is capable of wonderful develop- 
ment, especially in persons deprived of one or more of the 
other senses. The blind learn to read by means of slightly 
raised letters or points, and to recognize persons by feel- 
ing their faces. They distinguish by touch different 
plants, the minute markings upon precious stones, the 
delicate tracery upon works of art, and, assisted by the 
sense of smell, even the color of fabrics. 1 They may 
become expert musicians and good sculptors; for it is 
related of the blind sculptor, Giovanni Gonelli, that he 
could model the most striking likenesses, entirely by 
the sense of touch. 

Physicians, by practice, acquire the tactus emditus, or 
discriminating touch, which is so valuable in detecting 
any unusual thickening, swelling, or heat of parts. 2 The 
expert pianist acquires the ability to strike with precision 
many keys in a few seconds of time. 

345. Taste is the sense by which we discover and recog- 
nize the flavors of substances. It is made possible through 

1 It is said that a blind country merchant was in the habit of select- 
ing shawls and dress goods for various customers, whenever he went to 
the city for stock, and that he seldom failed in taste and judgment. 

2 A well-known surgeon, now dead, performed the most delicate opera- 
tions, which required the keenest sense of touch, though his hands were 
very large and clumsy-looking. 



THE SENSES: TOUCH, TASTE, AND SMELL. 319 



the mucous membrane of the tongue, of the soft palate, 
and of the back part of the throat, these being, in fact, the 
organs of taste. The tongue is also an organ of touch, 
and being composed of muscles capable of moving it in 
various directions, it is well 
adapted to bring material to 
be tasted in contact with all 
parts of the mouth. 

The mucous membrane of the 
tongue is especially adapted to 
the detection of flavors. It is 
abundantly supplied with both 
vascular and nervous papillae, 
similar to those of the skin. 
There are, in addition, large 
compound papillae on the back 
part of the tongue, arranged 
in a V-shape, and also smaller 

ones toward the front part. The papillae are covered 
with a delicate plush-like epithelium, permeable by 
fluids. 1 




Fig. 100. 

Papillae of the Tongue. (Magnified 
20 diameters.) 



346. The tongue possesses, as Ave have seen, general 
sensibility ; but the sense of taste has no distinct nerve, 
as in the case of the senses of siffht and hearing. The 
lingual or gustatory branch of the fifth pair of cranial 
nerves supplies about two-thirds of the tongue, while the 
lingual branch of the glosso-pharyngeal is distributed to 



1 Some of the filaments of the nerves of taste end in the papillae in 
enlargements known as fasti' Inuls, or taste goblets. Some of the fila- 
ments probably end in the epithelium, but the sense of taste is most 
acute where the buds are numerous. If the glosso-pharyngeal nerve is 
severed, degeneration of taste buds ensues. 



320 SENSATIONS. 

the posterior third. These nerves convey sensations of 
taste to the brain. The tip of the tongue seems to pos- 




Fig. 101. (Daltox.) 

Diagram of Tongue, showing the nerves and papillae, and by dotted lines the 
direction of the muscles. 

sess the greatest sensibility to savors ; the base is less 
sensitive, and the sides least of all. 

347. Only those substances can he tasted which are dis- 
solved. These by endosmosis penetrate the mucous mem- 
brane, thus reaching the nerves of taste. Dry sugar or 
salt, placed upon the tongue, is not tasted till it begins to 
dissolve. The finer the comminution of food, the sooner 
is it tasted. The dissolving process is much facilitated 
by the varied movements of the tongue. 

348. Taste is one of the means by which we distin- 
guish between proper and improper articles of food. But 
in determining the nature of such articles, it is assisted 
by the other senses. Undoubtedly much pleasure is lent 
to the taste of certain substances by their appearance 
and odor. A cold in the head will interfere with the 
taste. The practice of swallowing disagreeable medi- 
cines with the nostrils closed is quite common. It has 



THE SENSES: TOUCH, TASTE, AND SMELL. 321 

even been affirmed that, if the nostrils are closed and the 
eyes shut, the taste of an onion may be mistaken for that 
of an apple. The sense of taste, which in man is naturally 
more acute than that of smell, is more easily perverted. 
In some of the lower animals — dogs, for example- — the 
sense of smell is more acute, and these animals generally 
smell before they taste. 

349. Such qualities as watery, astringent, viscid, oily, 
burning, mild, and sharp are appreciated by the ordinary 
sensory nerves. Sweet and sour qualities are best appre- 
ciated by the gustatory nerve at the front of the tongue ; 
salt and bitter qualities, by the glossopharyngeal nerve 
toward the back of the tongue. 1 

350. Taste in the human being, and also in some of the 
lower animals, is more or less influenced by imitation, 
habit, surroundings, and training. 2 The young baby does 
not readily distinguish between the taste of oil and that 
of sugar, but learns the difference by degrees. Children 
fancy certain articles of food and dislike others, because 
other members of the family or their schoolmates do the 



1 "Sweet, bitter, sour, and salt are the four tastes with which it is 
supposed the taste .Aids have to do. There is also an alkaline and per- 
haps a metallic true taste. A tap on the tongue may excite a taste. A 
"constant" current of electricity through the tongue produces acidity at 
the positive pole and alkalinity at the negative. . . . Rinsing the mouth 
with very hot or cold water is said to blunt the taste of quinine. Certain 
diseases produce tastes. Biliary products retained in the blood give a 
bitter taste to the mouth, and in diabetes the mouth sometimes has a 
sweet taste. 1 ' 

2 When tomatoes were first introduced into this country, they were gen- 
erally disliked. Many a man who will not eat fat salt pork at home will 
relish it at sea or in the army. 



322 SENSATIONS. 

same. Persons living in malarious regions have been 
known to like the bitter taste of quinine. Inhabitants 
of certain parts of the world enjoy rancid fats. Morbid 
tastes are sometimes the result of disease, or disorders of 
the brain or of the blood. Persons so afflicted will eat 
with avidity slate pencils and jolaster, or drink vinegar. 
That taste may be developed, especially when assisted by 
the sense of smell, is seen in expert tea and wine tasters. 
The too frequent tasting of strong condiments or spices 
blunts the sense of taste for more delicate flavors, just as 
the frequent tasting of any one article dulls the taste for 
others. The nerves of taste fully appreciate but one flavor 
at any one time, so that if one is presented before another 
has disappeared, the result is a mixed or confused taste. 

351. Smell. — In man the sense of smell is not so acute 
as the other senses, and its impressions often need to be 
confirmed by the others (a). In dogs, on the contrary, 
it is very acute, enabling them to track their prey or 
find their masters by scent alone. It is said that the 
Esquimaux dogs in the Arctic regions are of great value, 
because they can detect, by the sense of smell, supplies of 
food stored in the ice long distances away. By this sense 
animals also detect the presence of pursuers, if the latter 
approach from the windward side. 

352. The essential organ of smell is the upper half of 
the mucous membrane of the nasal fossae, or nose cavi- 
ties. 1 These are separated from each other by a verti- 

1 The lower part of each nasal cavity is the respiratory part ; its epi- 
thelium, like that of the trachea, consists of ciliated cells. The upper 
portion is the olfactory part ; it has no ciliated cells, but has many rod- 
shaped cells, in which the filaments of the olfactory nerves end. 



THE SENSES: TOUCH, TASTE, AND SMELL. 323 



cal wall of cartilage and bone, called the septum. In the 
mucous membrane which covers part of the septum and 
on the two upper turbinated bones are distributed the 
terminal filaments of the olfactory nerve, or nerve of smell. 
These filaments come through the roof of the fossae, as 
through a sieve, from the olfactory bulbs, which are the 




Fig. 102. 

Left Nasal Cavity. 

1, left olfactory bulb with its nerve branches. 2, the nasal nerve. 

3, a gang-lion, and nerves of the sympathetic nervous system. 

terminations of the olfactory nerves. These bulbs lie 
under the anterior portion of the cerebrum and upon the 
bony floor of the cranial cavity (Fig. 102). The lower 
half of the mucous membrane of the nose is supplied with 
ordinary sensibility by a nasal branch o[' the fifth pair of 
cranial nerves. Its irritation causes sneezing. 

353. Odors, to be recognized, must be presented in a 
gaseous or vaporous form to the mucous membrane con- 
taining the olfactory nerve filaments. The most minute 



324 SENSATIONS. 

portion of such a substance as musk will be readily per- 
ceived, if it be forcibly drawn up during inspiration into 
the higher portions of the nasal fossae. Some persons are 
so susceptible to odors and emanations that the smell of 
certain substances — of roses, for example, or of new-mown 
hay, or of certain drugs in a powdered state — may excite 
in them an inflammation of the nasal passages. 1 Sharp 
and pungent vapors, such as that of ammonia, are per- 
ceived by the lower portions of the nasal passages (V). 

354. The sense of smell may be highly developed, espe- 
cially where there is deficiency in other senses. 2 Cer- 
tain blind and deaf mutes are able to recognize by the 
sense of smell any person with whom they have previously 
come in contact. Dryness of the nasal mucous mem- 
brane, or its frequent irritation, tends to blunt the sense 
of smell. 



1 Hay-fever is one form of such inflammation. 

2 "Taste is at the gateway of the alimentary canal, just as smell is the 
sentinel of the respiratory tract ; and just as taste, when combined with 
smell to give the sensation we call flavor, influences the digestive process, 
and is influenced by it, so smell influences the respiratory process. This 
has been recently shown by Ch. Henry. He has recorded the entrance 
and exit of air by the nose with and without odors (the quantity of odorifer- 
ous substance being noted), and he finds that the presence of odors influ- 
ences both the amplitude and the number of the respiratory movements. 
Thus the smell of wintergreen notably increased the respiratory work ; 
next came ylang-ylang, and last, rosemary. The breathing of a fine odor 
is therefore not only a pleasure, but it increases the amplitude of the 
respiratory movements. Just as taste and flavor influence nutrition by 
affecting the digestive process, and as the sight of agreeable or beautiful 
objects and the hearing of melodious and harmonious sounds react on 
the body and help physiological well-being, so the odors of the country, 
or even those of the perfumer, play a beneficent r61e in the economy 
of life. 1 ' — Dr. John Gray McKendrick and William Snodgrass, The 
Physiology of the Senses. 



THE SENSES: TOUCH, TASTE, AND SMELL. 325 

355. Effects of Alcohol and Narcotics on Touch, Taste, and 
Smell. — Undoubtedly, these agents quite frequently lessen 
the sensitiveness of touch, taste, and smell. Tobacco smoke 
dries the nostrils, and by irritation of the tongue leads, in 
some cases, to a taste for alcoholics. Cocaine paralyzes 
the tactile sensibility of the tongue, and opium, by drying 
the tongue, interferes with taste. 

QUESTIONS. 

1. How are sensations valuable ? 

2. How may they be classified ? 

3. What is the effect of excessive stimulation of nerves ? 

4. What useful purpose has pain ? Give examples. 

5. What parts of the body are in general most sensitive? 

6. Name sensations experienced through the nerves of the skin. 

7. How many special senses are usually reckoned ? 

8. To what is the sensation of weight probably due ? 

9. What is necessary to a healthy exercise of all the senses ? 

10. Are the functions of the nerves of the special senses distinct from 

one another? 

11. Can these senses be cultivated ? How do we know this? 

12. AVhat are the objects of the sense of touch ? 

13. In what part of the body is touch most delicate ? 

14. What have you to say as to its capacity for varied application and 

training? Illustrate. 

15. What are the organs of taste ? 

16. How is the mucous membrane of the tongue adapted to the exer- 

cise of this function ? 

17. Is there a distinct nerve of taste? 

18. What takes the place of such a nerve ? 

19. Where is there the greatest sensibility to savors? 

20. In what form must substances be to be tasted? Why? 

21. What relation has this fact to the chewing o[ food? 

22. Of what use is taste, in addition to its appetizing quality? 

23. Do the other senses lend any intensity to the taste? Illustrate. 
21. \W what is the taste more or less influenced V Illustrate. 



326 SENSATIONS. 

25. To what are morbid tastes sometimes due? 

26. Give an instance of the capacity of the taste for delicate training. 

27. How may the sense be blunted? 

28. What is the essential organ of smell ? Describe it. 

29. How is the lower half of the mucous membrane of the nose sup- 

plied with ordinary sensibility ? 

30. In what form must odors be presented to be appreciated? 

31. Illustrate the extreme sensitiveness of certain persons to odor. 

32. Can the sense of smell be trained ? Illustrate. 



CHAPTER XVIII. 
SIGHT. 

356. Organs of Sight. — By means of sight we receive 
impressions of light, movement, form, size, shades of color, 
and the manifold beauties of nature and art. The organ 
of sight is the eye, and the parts belonging to the eye, or 
auxiliary to its use, are the eyeball, eyebrow, eyelids, eye- 
lashes, lachrymal and Meibomian glands, tear passages, 
muscles, and optic nerve. 

357. Eyebrows. — Each eyeball rests in an orbital cavity, 
partially surrounded by cushions of fat. The orbits are 
deep and conical, and are formed by the junction of 
various bones. Their upper front edges project and 
overhang their openings, thus forming the broivs, which 
are covered with thick skin and short, strong hairs. The 
brows, with the other projecting walls of the orbits, and 
the nose, serve to protect the eyes from injury. The 
hairs of the eyebrows prevent the perspiration from flow- 
ing into the eyes. 

358. Eyelids. — In front of each orbit are two movable 
curtains, known as the upper and lower eyelids^ the upper 
being more movable than the lower. When closed, they 
cover the orbital openings. Both have upon their edges 
hairs Qey clashes') which project outward, the bulbs o( 
which are supplied with nerves. The eyelashes are sensi- 
tive and give warning of the approach of insects, dust, etc., 



328 SIGHT. 

even in the dark ; and, when the eyelids are partially 
closed, form an admirable screen. In some persons the 
eyelashes are long and silky, while in others they are 
short and stiff. 1 

A thin, loose skin covers the eyelids on the outside. 
Their inner lining is a thin mucous membrane, the con- 
junctiva, which also covers the front of the eyeballs. 
This membrane is extremely sensitive, and aids the eye- 
lashes in protecting the eye from dust and other foreign 
particles. 2 Between the skin and conjunctiva of the lids 
are cartilages, which serve to preserve the convexity and 
firmness of the walls of the lids. 

Embedded in the cartilages are the Meibomian glands, 
with their tubes. These glands secrete an oily material, 
which lubricates the edges of the lids, thereby preventing 
them from adhering and the tears from overflowing upon 
the cheeks. 3 The lids distribute the tear secretion over the 
surfaces of the eyes, assist in regulating the admission of 

1 Sometimes, "when the lids are diseased, the lashes turn inward and 
irritate the eye. 

2 Conjunctivitis, or inflammation of this membrane, is one of the com- 
monest affections of the eyes, especially among those whose general 
health is deteriorated, or who are exposed to dusty or other irritating 
air. In Egypt, owing to the intense heat, to the high winds, and clouds 
of sand, this and other inflammations of the eye become very severe, even 
destroying the organ. It is said that many of the Crusaders in the Holy 
Land were made blind from these causes. Vitiated or devitalized air has 
a direct irritating effect on the conjunctiva, as on all mucous membranes. 
"This is shown by the fact that repeated attacks of inflammation of 
the mucous membrane of the eye, which have occurred in a vitiated 
atmosphere, and which have resisted all curative means, are often cured 
at once, and prevented from recurring, when a wholesome supply of air is 
obtained, all other conditions remaining the same." 

3 The last effect will be understood if the edges of a cup are greased 
and the cup is filled with water. The surface of the water may then be 
made higher than the edge of the cup, without the water's overflowing. 



SIGHT. 



329 



light, and protect the eyes from heat, cold, and the contact 
of foreign particles. The eye is closed by the action of a 
broad, thin, elliptical muscle which surrounds the orbit 
and spreads out upon the lids. By it the skin and soft 
parts about the eye are wrinkled and drawn together 
inward, and the lids held firmly together. 



359. The Lachrymal Apparatus. — At the external and 
upper portion of the orbits are located the lachrymal 
glands, which secrete the tears. 
is constant, like the insensible 
it is carried into the 



This watery secretion 
perspiration. Part of 



H A.G 




nose 
through openings, one on the 
edge of each licl 5 near its in- 
ner extremity. These open- 
ings may be readily seen in 
a mirror by everting the lids. 
Each connects with two little 
canals (lachrymal canals, or 
tear ducts), which communi- 
cate also with an enlarge- 
ment called the lachrymal 
or tear sac, and this latter 
with the fiasal duct, which discharges into the nose 
(Fig. 103). The tear sac, together with the nasal duct, 
constitutes the lachrymal canal. The lachrymal secretion 
keeps the front of the eyeballs in that moist and trans- 
parent condition which is necessary for comfort and clear 
vision. If the eye becomes dry, as it does sometimes 
from disease or long exposure to dry, hot winds, it be- 
comes clouded, and light docs not easily penetrate it. 1 

1 Lustreless eyes are seen in fish which have been removed for a time 
from the water. In some forms of serofulous or blood disease in the 



Fig. 103. 

LG, lachrymal gland. 
TD, openings of tear ducts. 
LS, lachrymal sac. 
ND, nasal duct. 

Skin and parts external to these organs 
removed. 



330 SIGHT. 

Usually the lachrymal secretion passes into the nasal 
ducts after performing its functions ; but, if largely 
increased in quantity by emotion or irritation, it over- 
flows in tears upon the cheeks. Emotional persons may 
readily weep without adequate cause. 1 

360. Eyeballs. — Each eyeball is spheroidal in form, and 
has the segment of a smaller and more prominent sphere 
fitted upon its anterior portion, somewhat as a watch 
glass is set into its case (Fig. 105). The diameter of 
the eye from the front backward is about an inch ; the 
transverse diameter a little less. The segment of the 
larger sphere, forming about five-sixths of the globe, is 
opaque, while that of the smaller and anterior sphere, 
the cornea, which is without blood- vessels,. is transparent, 
light passing through it as through a clear window-glass. 2 
The posterior five-sixths of each eyeball is composed of 
three coats, or tunics : the sclerotic, 3 choroid, and retina. 

361. The Sclerotic Coat is a white, firm, fibrous en- 
velope, not very sensitive, and having but few blood- 
human being, the Meibomian and lachrymal secretions are decreased in 
amount, and the eyes become bloodshot and cloudy, giving rise to the 
peculiar appearance known as "blear-eyed," the defect being enhanced 
by the roughening and falling out of the eyelashes. 

1 Sometimes, also, where the tissues of the lower lids are relaxed, as in 
old persons, and the lids are turned out, the tears overflow. 

2 The cornea is a modification of the sclerotic coat, its fibres being 
united by a cement-like substance into transparent sheets or membranes. 
It can be best seen by looking at it in the human being from the side, or 
by observing the reflection of objects upon it. In looking at an eye in 
front, we look through the cornea and aqueous humor. 

3 In childhood the sclerotic coat (Greek cr/cA^pos, "hard") being thin, 
appears bluish, on account of the pigment behind. In old age it is 
yellowish, on account of deposit of fat. 



SIGHT. 



331 



vessels. It assists in maintaining the globular form of 
the eyeball, and protects the delicate structures within. 
To its outer surface 
are attached the six 
muscles, four straight 
and two oblique, 
which move the eye- 
ball. Upon the front 
of the eye the scle- 
rotic coat forms what 
is called the " white 
of the eye," and is 
covered by the con- 
junctiva. In its inner 
surface are lodged the 
ciliary nerves. Be- 
hind, and a little to 
the inner side, it is 
pierced by the optic 
nerve, or nerve of 
sight, whose fibrous 
sheath is continuous 
with the dura mater of the brain. Along with and in the 
centre of its filaments there passes into the eye a large 
central artery, which is distributed to the lining coat. 




Fig. 104. 
Muscles of the Eye. 

1, the muscle which lifts the upper lid. 

2, the superior oblique muscle. 

3, the pulley through which its tendon plays. 

4, 5, 6, superior, inferior, and external straight 
muscles. 

10, inferior oblique muscle. 11, optic nerve. 

12, cut surface of cheek bone. 18, nasal orifice. 



362. The Choroid, sometimes called the vascular coat, is 
the middle coat of the eye, and is closely adherent to the 
inner surface of the sclerotic. It is soft, containing a net- 
work of blood-vessels, and is of a dark color, like the 
inside of the skin of a dark grape. It is lined with a 
layer of flat, dark-brown, or nearly black, pigment cells. 
This dark surface absorbs such of the rays of light enter- 



332 SIGHT. 

ing the eye as would otherwise be reflected and diffused 
and prevent accurate vision. 1 In albinos, the pigment 
cells are deficient, and accordingly vision is imperfect 
when the eyes are exposed to strong light. 

363. The Iris and Pupil. — A prolongation of the choroid 
coat in the front of the eye forms the iris, which is a 
curtain across the interior of the eye, behind the cornea, 
to the margin of which it is attached. In its centre is the 
pupil, a round opening, through which must pass all the 
light that enters the eye. 2 The iris is a muscular organ 
having two sets of fibres, one circular and one radiating. 
Through the involuntary action of these fibres the pupil 
contracts or dilates, when exposed to greater or less light, 
thus performing its function of regulating the amount of 
light admitted to the retina. But the pupil does not act 
instantaneously; hence, on coming into a bright light 
from a dark room, or going into a dark room from the 



1 Optical instruments, microscopes, opera glasses, and telescopes are 
black on their inner surface, for the same reason. The inside of the photo- 
graphic camera is also black, that the light admitted may be concentrated 
and the picture properly produced on its sensitive plate, which might be 
called the retina. 

2 The shape of the pupil differs in different animals. In the cat it is a 
narrow, horizontal slit when contracted, and is round when dilated. 
Capable of great dilatation, it enables the cat to see even in the dark. 
In the human -eye the pupil seems black, except in the case of the albino. 
The black appearance is due to the fact that, in looking at the pupil, we 
look into a dark chamber at the back. In the albino, the pigment cells 
being deficient, we see the pinkish color afforded by the blood-vessels. 
In certain nocturnal animals, such as wolves and cats, in obscure light the 
pupil presents a sparkling or glaring appearance, which at one time was 
supposed to be due to a kind of phosphorescence, but is now recognized 
as a reflection from a patch of metallic lustre found upon the choroid coat 
of the eyes of these animals. 



SIGHT. 



333 



bright sunlight, vision is confused until the proper 
amount of light has been excluded or admitted by the 
contraction or expansion of the pupil, and until the 
retina also has accommodated itself to the change. Cer- 




Fig. 105. 
Vertical Section of the Eyeball, and Part of the Optic Nerve. 



2, sclerotic coat. 

4 and 5, external and internal covering's of 

the optic nerve, continuous with those 

of the sclerotic coat. 

8, superior and inferior straight muscles. 

9, the cornea. 

15, the choroid coat. 



17, ciliary muscle. 

18, ciliary body. 

23, branches of central artery of the retina. 
2S, the crystalline lens. 

29, the iris. 

30, the pupil. 

32, anterior chamber. 



tain medicinal substances have the property of dilating, 
and others of contracting, the pupil. For example, bella- 
donna (or atropine, which is its active principle), taken 
internally or applied to or about the eye, dilates the 
pupil, while opium and the calabar-bean contract it. 1 



1 The acts of dilatation and contraction of the pupil may bo soon by 
alternately covcrini;' and uncovering the eye o( another, with the hand, 
for a moment. In many young persons considerable dilatation is normal. 
while the same is true of contraction in some old persons. Eoetremt 



334 SIGHT. 

The color of the iris varies, and is apt to be in accord 
with the general coloring of the individual. 1 By the 
terms, blue, brown, hazel, gray, or black eyes, the color of 
the iris is indicated. 2 Just behind the iris, toward its 
circumference, lie the ciliary muscle and the ciliary body. 
The latter is a dark pigmented mass, arranged in fluted 
folds known as the ciliary processes (Fig. 105). 

364. The Retina is the third coat, and lines nearly the 
whole of the posterior portion of the eyeball. 3 It is a 
delicate, transparent membrane, containing an expansion 
of the filaments of the optic nerve. It is the only part of 
the eye that is directly sensitive to light. But sometimes 
a jar of the retina or optic nerve by a blow upon the 
head, or an electric shock communicated to the eye- 
ball, or any irritation applied to the retina, produces 
flashes of light, — an effect which is familiarly termed 
" seeing stars." The function of the retina is to receive 
the rays of light which enter the pupil of the eye, and 
communicate the impressions thus produced through the 
optic nerve to a visual centre of the cerebrum . 

The retina is not equally sensitive to light through- 
out its whole extent. The point of entrance of the optic 

contraction or dilatation of the pupil is the result of poisoning or of 
disease. 

1 Sometimes brunettes are seen with light eyes, and blondes with dark 
ones, and occasionally a person is found with one eye light and the other 
dark. 

2 The eyes of young infants are almost always blue, the color not 
beginning to change until the sixth or eighth week of life. 

3 Its greatest thickness is said to be not more than T \^ of an inch, and 
microscopists describe eight or ten different layers in it. An outer one 
contains the "rods" and "cones," which are most intimately concerned 
in the perception of light, while next to the inner coat is the expansion of 
the optic nerve. 



SIGHT. 335 

nerve is insensible to light, and is therefore called the 
"blind spot." 1 About one-tenth of an inch outward 
from this point in each eye is an oval, called the " yellow 
spot," which is the most sensitive part of the retina. This 
spot is directly in the line of distinct vision. 2 

Each impression received by the retina lasts for a 
time before fading away. If impressions are received too 
rapidly one after another, vision is confused or dazzled, 
or the objects seem to be one ; the old impressions are 
retained while the new ones are being received. Thus, 
the spokes of a rapidly revolving wheel seem to form a 
continuous disk. A lighted torch rapidly swung around 
shows a circle of light. Two colors upon a card, if rotated 
rapidly, are confused into a blurred image, or, if the 
colors are primary, the complementary secondary color is 
perceived. 3 

The retina becomes tired and loses its sensibility by 
looking for a long time steadily at one object, and the 



1 The blind spot may be found by a simple experiment. Place the 
two thumbs side by side about twelve inches from the face. Shut the left 
eye, and look at the left thumb intently with the right eye, while you 
gradually move the right thumb away from it toward the right. At a 
certain point, generally about six or seven inches, the right thumb will 
seem to disappear. If carried still farther away, it will bo again soon. 
The explanation of this phenomenon is that, at the point of disappear- 
ance, the picture of the thumb falls upon the blind spot. 

2 The yellow spot, upon which the rays of light converge, i.e. are 
focussed, receives impressions through the motions of the eyeball from 
side to side as in reading, or in various directions, as we catch at a glanoe 
the beauties of a landscape. 

8 Toys for children, in which figures seem actually to bo in motion, are 
constructed on the principle stated above. The biograph camera takes 
pictures at the rate of forty per second. In exhibitions these are repro- 
duced on a screen, from tilms 150 to 800 feet long, which travel in front 
of the camera lens at the rate of about five feet per second. 



336 SIGHT. 

sight is relieved by closing the eyes for a moment, or by 
an occasional glance at other objects. 1 

365. Transparent Media of the Eyeball. — In addition to 
the cornea in front of each eyeball, within it there are 
three other transparent media, the aqueous humor, the 
vitreous humor, and the crystalline lens. The vitreous 
humor is a colorless, transparent, jelly-like substance, 
inclosed within the retina. It assists in preserving the 
form of the eyeball, and affords support to the delicate 
retina. On its front, in a cup-like hollow, rests the crys- 
talline lens. Between the lens and the cornea is the 
aqueous humor, consisting of a small quantity of watery 
fluid, which enables the iris to move freely. 

366. The Crystalline Lens is located just behind the iris 
and in front of the vitreous humor. It is about one- 
quarter of an inch in thickness, and is shaped like a double 
convex lens or magnifying glass. It is contained in a 
capsule, kept in place by a suspensory ligament, which is 
a continuation of the inclosing membrane of the vitreous 
humor. 2 The lens is of the consistency of jelly, but very 
elastic, especially in children; consequently, in them the 
shape is very readily changed, while in old persons the 
lens, being quite hard, is not easily changed. 

1 Looking steadily for a time at a bright light or spot will cause it to 
appear dark. After resting the eye, this dark color disappears. 

2 Cataract is an opacity of the crystalline lens, and not a ' ' white spot 
on the front of the eye," as some believe. It may affect the whole or 
a part of the lens. Usually light is transmitted through the lens when so 
affected, as through a ground glass window. To restore transparent 
media, or to remove the irritation which such opacity may set up, the 
lens may be removed by operation. Vision can then be restored in part 
by the use of spectacles or eyeglasses, i.e. artificial lenses. 



SIGHT. 337 

The function of the crystalline lens is to assist in bringing 
rays of light to a point or focus upon the retina. This 
is necessary to distinct vision ; for without the lens, the 
rays would not come to a focus, and sight would be 
blurred. At the focal point, an inverted image of the 
objects from which the rays proceed is pictured upon the 
retina. 1 Notwithstanding this inversion, in normal vision 
these images are seen in their proper positions and rela- 
tions, because we have learned, by comparison and ex- 
perience, to appreciate the size and form of objects reflected 
upon the retina. Since the brain is the ultimate organ of 
perception, a disordered brain will sometimes perceive 
distorted images of objects of which the retina receives 
correct impressions. So, too, apparent vision is possible 
without any retinal impression at all, the disordered brain 
seeing some phantom image of its own creation. In this 
way, in dreams objects appear to be so vividly seen that 
they may be readily described when the sleeper awakes. 

367. The Optic Nerve, which carries impressions from 
the retina to the cerebrum, is inserted into the posterior 
segment of the eyeball, a little to the inner side of its 
centre. Passing into the cavity of the skull, the nerves 
from the eyeballs approach each other till they consoli- 
date, forming what is known as the optic chiasm. At 

1 So, in a bright, direct light, by means of a convex lens, objects, such 
as trees and drawings, may be pictured upon a white or light-colored 
surface, but always inverted or upside down. A candle flame held before 
the cornea of an eyeball removed from a bullock (the sclerotic and choroid 
coats at the back of the eyeball being detached) will be seen reflected 
inverted upon the retina. When the lens has boon removed from the eye 
by operation, the focus of the rays of light falls about three-eighths of 
an inch behind the retina, and the object seems much larger than it really 
is, and much less distinct. 



338 SIGHT. 

this point there occurs a crossing of a portion of the 
optic nerve fibres, so that some of the filaments pass from 
the left optic nerve to the right, and from the left eyeball 
to the right eyeball, and vice versa. Filaments also pass 
from one optic tubercle, that is, from the origin of one 
optic nerve, to the other. 1 The eyes, as Dalton remarks, 
"are not so much two distinct organs, as one double one." 
Besides the direct impressions (color, size, etc.) carried 
to the brain by the optic nerves, impressions which result 
in reflex action are brought back to the eye from the optic 
tubercles. A stimulus of light, for example, is conveyed 
to the optic tubercles, and is reflected outward to the mus- 
cular fibres of the iris, causing contraction or dilation, as 
the case may be. 

368. Binocular Vision. — Objects are ordinarily perceived 
by the simultaneous use of both eyes, i.e. by binocular 
vision. Two images of each object are formed at the 
same time, one upon each retina, though so combined as 
to produce the impression of but one object upon the 
brain. 2 With binocular vision we appreciate, with greater 
accuracy, the solidity and distance of objects ; hence, with 
one eye closed, the difficulty of threading a needle, or 
touching any object quickly, will be much increased (a). 

369. Power of Accommodation, or Focussing. — All the 

various directions from which rays of light come into 

1 The optic tubercles are cerebral ganglia on the under surface of the 
brain, near its front portion, in which the optic nerves originate. 

2 The best binocular vision results when the images are both upon 
the yellow spots. If this be not the case, if, for example, one eye be 
pressed a little to one side by the finger, and an object is then looked at 
with both eyes, the object will seem double, the images falling upon 
different points in the two eyes. 



SIGHT. 



339 



tile pupil, taken together, form what is known as the 
field of vision. Objects can be most distinctly seen in 
the centre of this held. To enable one to have a long or 
short range of vision at will, to see remote objects, and 
then, within an incredibly short time, those close at hand, 
the crystalline lens, especially, has a power of accommoda- 
tion. This power also resides in the cornea, iris, and 
probably in the humors of the eye, but in a minor 
degree. 




Fig. 106 (Foster and Shore). 

The Changes in the Lens in Accommodation. — A, adjusted for distant objects. B, adjusted 
for near objects, con., conjunctiva, cm., ciliary muscle, s.l., suspensory ligament. 

Objects at different distances cannot be plainly per- 
ceived at the same time. The lens in each case must be 
accommodated to the distance. 1 Thus, while we o'aze at 



1 "There are two ways in which this adjustment might be effected. 
The length of the eye might be varied to meet the varying distance of the 
focal point, just as a photographer moves the sensitive plate o( his camera 
backward or forward to bring it into focus. But, as a matter of fact. 
another process takes place in the eye. The retina is net moved back- 
ward or forward, but the refractive power of the crystalline lens is 
changed by an alteration of its thickness. Now, when we leek at distant 
objects, and no effort of accommodation is required, the anterior surface 
of the lens is kept flattened by the pressure of its capsule, and by the 
elastic pull upon it. of the anterior suspensory ligament. — an elastic pull 



340 



SIGHT, 




a fly upon a window-pane or the threads of a veil, we do 
not see plainly the landscape beyond. If we see the land- 
scape plainly, the fly or the threads of the veil become 
indistinct. This accommodation is the result of changes 

in the shape of the 
lens, produced by 
the ciliary muscle, 
which encircles 
the lens and is con- 
nected with the 
delicate ligament 
that holds the lens 
in position. As 
the objects looked 
at are brought 
near the e}~e, the 
lens becomes more 
and more convex. 
When the eye is 
at rest, or when 
objects are distant, 
the lens is more 
flattened. The ciliary muscle bears the same relation to 
the e}^e as the adjusting screw does to the opera-glass, 
the photographer's camera, or the microscope. 

The range of accommodation is limited, and differs in 
different individuals. Ordinarily, accommodation fails 

which involves no muscular strain, and consequently no fatigue. But 
when we wish to look at a near object, the ciliary muscle, contracting, 
pulls forward the suspensory ligament and diminishes its circle of attach- 
ment, its tension is lessened, the pull on the capsule of the lens dimin- 
ishes, and the lens, by its own elasticity, assumes a more spherical shape, 
its anterior "surface moving forward and its power of converging rays 
being increased." — Physiology of the Senses. 



Fig. 107. 
Section of Eve. 



The line A-V is the axis of vision. The dotted lines show 
the position of the iris and the shape of the lens in 
accommodation for a certain distance. 

S, sclerotic coat. AH, aqueous humor. 

C, the cornea. CL. crystalline lens. 

CC, choroid coat. I, the iris. 

E, retina. CM, ciliary muscle. 

VII, vitreous humor. SL, suspensory ligament of lens. 



SIGHT. 341 

and vision is imperfect, when the object is less than six 
inches from the eye. Vision becomes imperfect and 
blurred, outside or inside of each one's normal limit. 
The average eye is able to recognize type one-thirty- 
second of an inch in height, held at least eighteen inches 
off, 1 and type three-eighths of an inch in height twenty 
feet away. But the ability to see plainly objects, either at 
a distance or near the eyes, can be developed by training. 2 
The pilot clearly defines objects at a long distance, even in 
an obscure light, which the average eye could not even 
distinguish. On the other hand, the watch-maker's eye- 
sight is very acute for objects near at hand. 3 

1 "The following paragraph from Dr. Snellen, of Utrecht, the author 
of the test-types in general use, gives a specimen of letters one-thirty- 
second of an inch in height : — 

" We have adopted as proper objects square letters, the limbs of which have a diameter equal to one- 
fifth of the letters' height. Such letters are clearly distinguished by a normal eye at an angle of five 
minutes. As the limbs and subdivisions of the letter just measure one-fifth of their height, they present 
themselves at an angle of one minute ; for instance, our letter C shows an opening, as compared with the 
O, of one minute visual angle. In testing accuracy of vision, we accept perfect recognition, and not un- 
certain perception, of the letters." 

2 This training is in reality more that of the brain than of the eye. 
Acute vision is therefore sometimes called "brain-sight." 

3 The eyesight may be brought to a high state of perfection by proper 
cultivation. It is related of Professor Agassiz that he once selected as an 
assistant the candidate who could best see and describe what was to be 
seen from an open window. One person saw merely a board fence and a 
brick pavement, another added a stream of soapy water, while a third 
detected the color of the paint on the fence, noted a green mold or 
fungus on the bricks, evidence of bluing in the water, and other details. 
Houdin, the celebrated prestidigitateur, in his autobiography, attributes 
his success mainly to the quickness of perception which he acquired by 
walking repeatedly and rapidly by a shop window full of miscellaneous 
articles, endeavoring to recognize as many objects as ho could at a glance. 
In many respects the human eye resembles the photographic camera, with 
its darkened chamber, reflecting surfaces, adjusting screws, sensitive 
plates, etc. When used by an experienced and painstaking owner, much 
more accurate pictures are produced than if the owners are reckless or 
uneducated. 



342 SIGHT. 

370. Physiology of Vision. — Rays of light traverse the 
transparent and refracting media of the eye and fall upon 
the retina, picturing upon it images looked at. The im- 
pressions brought to the retina stimulate the activity of 
the fibres of the optic nerve, and are transmitted by them 
to the cerebrum. The visual nerve centres, in which the 
optic nerve fibres originate, thus stimulated, produce the 
sensation of light and objects, and we see. 

371. Defects in Vision. — Owing to the extreme sensi- 
tiveness of the eyes, defects in vision are quite common. 
In cases of injury to or disease of one eye, the peculiar 
crossing of the fibres of the optic nerves may give rise to 
sympathetic inflammation, or disease of the other eye. 1 

The ophthalmoscope, an optical instrument which, used 
in a dark room, by means of reflected light, illuminates the 
bottom of the eye, was invented by Helmholtz in 1851. 
It enables the physician to detect optical defects which 
the patient may not have been aware of. Before the use 
of the ophthalmoscope, many diseased or disordered condi- 
tions of the eye were not accurately recognized. For 
example, it was not known that defective circulation in 
the retinal blood-vessels may disturb the vision ; nor that 
changes in the form, consistency, or relation of the various 
parts of the eye may induce grave optical defects. 

372. Color Blindness is the inability to distinguish cer- 
tain colors. Helmholtz and others consider red, green, 
and violet as base colors, i.e. colors by the mingling of 
which, in proper proportions, white and the various colors 
of the solar spectrum may be produced. It is believed 

1 As to the removal of foreign bodies, and the treatment of injuries of 
the eye, see Emergencies, page 400. 



SIGHT. 343 

that there are special retinal elements for the perception 
of each of these base colors, and that the color-blind are 
deficient in one set of these elements, most commonly the 
red. 1 It is especially important that railroad employees 
and seamen should not be color-blind. Vessels carry at 
night upon their right hand or starboard side a green 
light, and upon the left hand or port side a red light. A 
red light is also the danger signal upon railroads. Color- 
blind engineers may not distinguish danger signals, nor 
color-blind pilots know how to pass an approaching ves- 
sel, thereby causing collision and loss of life. Especially 
are accidents to be expected, if the atmosphere is so humid 
that these men cannot distinguish the difference in the 
luminosity as well as in the color of signals (a). 

373. Short, or Near, Sight. — An eye perfectly formed, 
i.e. one in which rays of light are made to focus directly 
upon the retina, is called an emmetropic 2 eye. If the axis 

1 Color-blindness in general is called Daltonism, from Dalton, the Eng- 
lish chemist, who first carefully described it, and was himself subject to 
it. It is related that his friends were much concerned when he was to be 
presented at court, for fear that, being a Quaker, he would not wear the 
scarlet robe which his position required him to wear ; but to him it seemed 
of a gray color. "It is said that Dalton was twenty-six years old before 
he knew he was color-blind. lie matched samples of red, pink, orange, 
and brown silks with green of different shades ; blue both with pink and 
with violet; lilac with gray." "The common form of defective color 
vision is red-green blindness, of which there arc two varieties — the red- 
blind and the green-blind. In each variety there are many gradations of 
sensibility." 

2 From the Greek word e/i/xr/r/aos, i.e. "normal." Accuracy of vision 
may be ascertained by employing the ordinary cards used by ophthalmic 
surgeons, upon which are printed Roman letters of different sizes. 
Each line of letters has at the end a. number, which denotes the distance 
in feet at which a person should stand and see the letters clearly. It" he 
can do this, he possesses normal acuteness of vision. According to the 



344 



SIGHT. 



of the eyeball is too long or too short, the focus will not 
fall upon the retina, but in front of or behind it. There 
is then said to be an error of refraction. In myopia} or 
short sight, the axis of the eye is too long, and ra} r s of 
light entering the e}^e are focussed in front of the retina. 
Objects are not plainly seen until they are brought near 



A, parallel rays of light. 
H, long-sighted eye. 




Fig. 108. 

E, emmetropic or normal eye, rays focussing at proper point. 
M, short-sighted eye. 



enough for their images to be focussed upon the retina. 
This condition is often hereditary, but is also induced by 
strain, — for example, by reading very small print in a 
poor light, or by long, uninterrupted use of the e} r es in 
close work. For its relief, properly fitted concave glasses 
are needed (a). 

374. Long", or Far, Sight. — In hyjjermetrojiia, or long 
sight, the axis of the eyeball is too short, and the focus 
falls beyond the retina. The performance of accommoda- 



usual system employed in eye infirmaries, if a certain line is to be read at 
a distance of twenty feet, and the pupil can do so, he is marked |§ ; if he 
must go closer, and can first distinguish at eleven feet, he is marked ^. 
the denominator of the fraction representing the normal distance, and 
the numerator the actual distance. 

1 So called from Greek words which mean "to close the eyes," since 
short-sighted persons often partially close the lids in order to see distinctly, 
by shutting off the rays of light that do not come to a proper focus. 



SIGHT. 



345 



tion is painful, even when there is no attempt to use the 
eyes in near work. Print becomes blurred and misty if 
reading is continued too long. In children there is always 
danger of squint resulting from the effort to see things 
close at hand. This condition can be relieved by convex 
glasses, which will converge the rays of light upon the 
retina. 

375. Old Sight. — Presbyopia, or old sight, is a failure 
of accommodation, i.e. a loss of power to adjust the focus 
of the eye for near objects. It is especially due to the 
fact that with increasing age the lens becomes stiffer, and 
incapable of being bent into the convexity necessary for 
the adjustment of the focus for near objects. 1 To remedy 
this defect convex lenses are required. 

376. Astigmatism. — Another 
optical defect is astigmatism, 
or the inability of the eye to 
focus, at the same time,, lines 
perpendicular to each other 
(Fig. 109). This condition 
depends upon a difference in 
the curvature of the different 
meridians of the cornea or lens. 
Persons so affected may readily 
distinguish horizontal or per- 
pendicular lines of type, but not both sets equally well 
at the same time. 




Fig. 109. 



1 Sometimes old people are delighted at the return of what is called 
"second sight," by which they are enabled to read without the aid of 
their accustomed glasses. In fact, they have become short-sighted, owing 
to a change in the shape of the lens, and can see clearly objects near at 
hand, while objects far oil' are more indistinct than before. 



346 SIGHT. 

377. Effects of Alcohol and Tobacco upon Sight. — In 

some persons, alcohol in excess produces a troublesome 
conjunctivitis, and occasionally defective vision due to 
changes in the retina, optic nerves, or lens. Temporary 
color-blindness, and a form of defective sight known as 
"tobacco blindness," due to some changes in the optic 
nerves not fully understood, often result from the intem- 
perate use of tobacco. These conditions are likely to be 
chronic if the use of tobacco is continued. 

378. Hygiene of the Eyes. — Proper care of the eyes is of 
the greatest importance. Healthy and well-formed eyes, 
if properly used, do their work without the conscious- 
ness of their owners. Pain or discomfort in the eyes, or 
even slight defects in vision, are warnings of disorder, if 
not of disease. But persons whose general health is un- 
usually good are likely to be overconfident, and so fail to 
take notice of these warnings in time. Young children 
are too frequently encouraged in persistent near work, 
such as drawing, studying, reading, and sewing. Such 
children may become prodigies, but the soundness of their 
eyes is frequently sacrificed (a). Most of the eye trou- 
bles of infants are the result of the careless exposure of 
their sensitive eyes to glaring light or to impure air, or 
of the application of poultices and other materials to the 
eye. In adult life certain occupations tend to weaken the 
eyes, but even in such cases much can be done to save 
them. The following directions for this purpose are those 
deemed most important: — 

1. For all kinds of work have an abundance of clear 
and steady light, especially when engaged in writing, read- 
ing, embroidering, painting, or other work which tries the 
eyes. Fine work and that upon dark surfaces should be 



SIGHT. 347 

performed by daylight. Using the eyes closely during 
twilight is injurious. 

2. Avoid a glaring light, and see to it that the sun does 
not shine directly upon your work. Interpose shades of 
ground glass, or light blue or gray tinted glass or paper. 
The reflection into the eyes of sunlight from the surface 
of mirrors is not to be tolerated. 

3. Let the light reach your work preferably from the 
left side and from above, not from in front. 1 

4. When using artificial light (i.e. that from a lamp, 
gas, etc.), it is beneficial to shade the eyes from any heat 
and glare. If gas is used, the Argand burner, or the 
Welsbach, with its shade and chimney, is advisable. If 
a lamp, use only the best oil and a good lamp. " A slight 
tinge of blue or gray in the shade or chimney modifies the 
light pleasantly by absorbing the excess of yellow rays." 2 
The heat and glare of bright illuminating rays may be 
lessened by the interposition of globes filled with water. 

5. When reading, it is important that the type should 
be clear, of good size, and printed in dark, not pale, ink ; 
that the paper printed upon should have a yellowish tinge, 
or not be absolutely white. 3 For sensitive eyes, ink with 
a bluish tinge may be preferable (5). 

6. Do not read or write when walking, lying down, 
or riding, for under these conditions the accommodative 

1 If from the right or from behind, shadows are cast upon the work. 

2 Lamps, such as the Rochester, with a centre draught, give a stronger 
and steadier light than common lamps, and are therefore better. The in- 
candescent system of gas lighting (Welsbach) is superior to ordinary gas 
light. The incandescent electric light is also good, but bright gas and 
electric light should be tempered by light blue, gray, or green shades. 

3 Most oculists believe that the best paper is that, which is known to the 
track' as "natural," i.e. which has no dye in it, and which has boon bleached 
but little and is not glazed. 



348 SIGHT. 

apparatus of the eyes is strained. Especially is this true 
if we read in moving vehicles, for the irregular muscular 
strain resulting is exhausting to most eyes. Reading 
during convalescence from debilitating illness is attended 
by an improper strain of the weakened eye muscles. 

7. Do not bend over your work for any length of time ; 
such a constrained position tires the muscles of the eye, as 
well as those of the neck and trunk. 

8. Prolonged and uninterrupted tension of the eyes 
over any kind of work is injurious, but especially is this 
true of fine work. Look up and away from the work 
frequently, directing the sight toward varied and distant 
objects. 1 Rest the eyes, if they are fatigued or painful, or 
the images produced are blurred. 

9. In reading, a book should not be held nearer to the 
eyes than is necessary to see the print distinctly. Print 
like that in the text of this book should not be read con- 
tinuously nearer than about eighteen inches. If you are 
obliged to hold it nearer than fifteen inches, the probabil- 
ity is that you are near-sighted ; if two feet away, far- 
sighted. 

10. If the eyes ache or are weak, bathe them frequently 
in clear hot water, but do not use eye-washes, soap, poul- 
tices, or other application, unless prescribed by a physician. 
The eye is too precious an organ to be trifled with. 

11. "Have all diseases of the eye treated early and skil- 
fully, and remember that the well eye sympathizes with 
the diseased one, and you may lose both unless early atten- 

1 Writing tables and desks covered with blue or green cloth, paper, or 
leather, serve to rest the eyes. Rooms papered and painted in the same 
colors have the same effect. It is a disadvantage of city life that the eyes 
are occupied for the most part with close objects. Excursions into the 
country are valuable partly for the rest afforded the eyes. 



SIGHT. 349 

tion is given to the matter. Diseases of the eyes in which 
a large amount of matter forms are dangerous, and pa- 
tients so affected should be careful to get no matter from 
the diseased eye into the well one, and they should have a 
separate basin and towels for washing purposes." 

12. If you need to wear glasses or spectacles, do it ; the 
eyesight is more important than personal appearance. 1 

13. Beware of quack eye-doctors, and travelling or 
street venders of spectacles ; they lack medical education 
and experience. Even plain colored glasses or goggles, 
used without proper advice, are likely to be injurious. 



QUESTIONS. 

1. What are the parts belonging to the eye, or auxiliary to its use ? 

2. Describe how the eyes are protected from injury by situation ; 

by the eyebrows ; by the eyelids ; and by the eyelashes. 

3. What is the conjunctiva and its function? 

4. Of what use are the cartilages of the lids ? the Meibomian glands ? 

5. What are the functions of the eyelids? 

6. By what are tears secreted, and how are they disposed of? 

7. Of what use are the tears, and how is their secretion increased ? 

8. Describe the eyeballs. 

9. How does light enter them, and through what media? 

10. How many and what coats has the other, or opaque, part? 

11. Describe the sclerotic coat, and tell how the eyeball is moved. 

12. What gains admission to the eye through the sclerotic coat, and 

where ? 

13. Locate, describe, and give the use of the choroid coat. 

14. Of the iris and pupil. 

1 The eyes may be protected from glare o\' Light, such as the reflection 
from snow or sand, by smoked or light blue glasses; from groat boat, 
as in furnace rooms and smelting works, by the use of mica, instead 
of glass. People exploding fireworks find eye protectors of asbestos 
valuable. 



350 SIGHT. 

15. To what is the color of the eye due? 

16. Where is the ciliary muscle ? 

17. Locate, describe, and give the functions of the retina. 

18. Explain what is meant by the " blind spot " ; by the " yellow spot." 

19. Why do the spokes of a rapidly revolving wheel seem to run 

together ? 

20. How may the retina of the eye become tired and cease to act ? 

and how may its action be restored? 

21. Locate, describe, and give the use of the vitreous humor ; of the 

crystalline lens. 

22. In what position are the images of objects thrown upon the retina ? 

Why do we see them in their proper position ? 

23. What is the ultimate organ of perception, and to what are unusual 

visions due ? 

24. Where and what is the aqueous humor ? 

25. What is meant by the " field of vision " ? 

26. What by the "power of accommodation," and to what is it due? 

27. Give illustrations of the effect of training the power of accom- 

modation. 

28. What is the object of the optic nerves ? 

29. At what point does a decussation of the optic nerves take place ? 

30. How is the iris stimulated to contract and dilate ? 

31. What is meant by binocular vision, and what is its use? 

32. What is meant by an emmetropic eye ? 

33. What is myopia, and to what is it due? 

34. What bad habits produce it, and how can it be relieved? 

35. What is hypermetropia,, and to what is it due ? 

36. What is presbyopia, and to what is it due ? 

37. How are hypermetropia and presbyopia remedied ? 

38. What is astigmatism, and to what is it due? 

39. What is color-blindness and what are its dangers ? 

40. What cautions must be observed in the care of the eyes ? 



CHAPTER XIX. 
HEARING. 

379. Sound. — Hearing is effected by means of impres- 
sions made by the vibration of elastic bodies (ordinarily 
the atmosphere) upon the organs of hearing. 1 A shock 
from a sounding body, communicated to the surrounding 
atmosphere, passes in waves toward the ear, moving like 
the ripples upon water after a pebble has been thrown 
into it. 

When the vibrations follow each other regularly, musi- 
cal sounds are produced ; when they are irregular, noises 
result. The pitch of sounds depends upon the rapidity 
of the vibrations. Their intensity, or loudness, depends 
upon the amplitude of the vibrations. " Thus a tuning- 
fork bowed gently will give out a faint sound, while the 
same fork bowed strongly will give a note of the same 
pitch as the former, but sounding much louder." There 
is also a property of sound called quality? which enables 
us to distinguish, for example, the piano from the violin, 
or a musical instrument from the human voice. Most 
vibrating bodies give out complex sounds, made np oi' a 
vibration as a whole, known as the w * fundamental torn 1 /' 

1 The earth, wood, and many other solid substances transmit sound 
readily. Even so slight a sound as the scratching of a pin on one end 
of a long log may he heard at the other end. An approaching train may 
he discovered by the sound transmitted through the iron rails. 

2 In musical sounds this is known as •• color," " timbre, M or •• klang." 

851 



352 HEARING. 

and of partial vibrations, i.e. "partial tones," or "over 
tones." 1 We distinguish, one instrument from another, 
and one voice from another, by the number and com- 
parative strength of these partial tones. The notes 
on the piano and organ are said to vary from 33 to 4224 
vibrations in a second. The piccolo emits a shrill note 
of 4752 vibrations in a second. These are the ordinary 
notes used in music, but the human ear can distinguish 
a note with as few vibrations as 20, or as many as 
38,000, in a second. The higher tones, however, are more 
or less painful to the ear, so powerful are the vibrations 
in the air of the auditory canal. 

380. The Organ of Hearing is the ear. It has a very 
complex and delicate structure, which is for the most part 
located in the petrous, or stony, portion of the temporal 
bone, and is thus well protected from injury. It is 
divided into three parts, — viz., the external, middle, and 
internal ear. The first two are for the collection and 
transmission of sounds ; the last, for their reception and 
conveyance to the brain, through the auditory nerves, 
which connect with it. 

381. The External Ear includes the auricle, commonly 
called the ear, and the auditory canal, which leads to 
the membrana tympani, or drum-head. The auricle is a 
shell of cartilage covered with skin which closely fits its 
every groove, ridge, and depression. It flares out some- 
thing like a funnel, the better to catch vibrations of sound. 



1 Every sound is composed of a number of partial tones, just as light 
is composed of a number of colors. Partial tones are also called "har- 
monics." 



HEARING. 



353 



In man it is rarely movable, the muscles for that purpose 
not being large or well developed. 1 It is well supplied 




Fig. 110. 
The Organs of Hearing. 



1, auricle. 

2, opening of ear, showing orifices of seba- 

ceous glands. 

3, external auditory canal. 

4, semi-circular canals. 

5, auditory nerve, with facial nerve. 



6, membrana tympani, with the elastic fibrous 
membrane which forms its border. 

7, tympanic cavity. 

8, tensor muscle of the tympanum, the tendon 
being attached to the upper portion of the 
handle of the malleus. 

9, upper portion of Eustachian tube. 



with blood-vessels, nerves, and lymphatics, and has at its 
lowest part a cushion of hit and fibrous tissue. 2 



1 In animals the auricle is generally very movable, enabling them to 
perceive faint sounds by turning the ear toward (hem. Even some human 
beings possess considerable 1 power in (his respect. 

2 Sometimes the cartilage dips down into the lobule, and is liable to 
injury when the ear is pierced for ear-rings. Serious inflammation may 
thus be produced. 



354 HEAKING. 

The auricle gradually blends with the walls of the audi- 
tory canal. This canal is about one and one-fourth inches 
long, averages one-fourth inch in diameter, and has first 
an upward, then a downward, inward, and somewhat for- 
ward direction. The outer one-third is cartilage ; the 
inner two-thirds, bone. Through this canal the drum- 
head, which closes its lower end, may be seen by means 
of a reflecting mirror and an instrument called the ear 
speculum. The walls of this canal are lined with skin, 
which is continuous with that of the auricle, and also with 
that over the drum-head, where the skin is very tine. In 
the auditory canal are an abundance of both sweat and 
sebaceous glands, and many coarse, stiff hairs. It has 
also numerous wax-producing glands, 1 which secrete the 
wax of the ear, a sticky and bitter substance that tends to 
prevent the inroads of insects and the growth of fungi. 

382. The Drum -head, or membrana tympani (wrongly 
called the drum}, at the bottom of the auditory canal, is 
the partition between the external ear and the middle ear, 
or drum cavity. It is circular in form, about one-fourth 
of an inch in diameter and ^Jq- °^ an incn thick, and con- 
sists of three layers : an outer one of skin, a middle one of 
fibrous tissue (to which the other layers are attached), 
and an inner one of mucous membrane, continuous with 
the lining membrane of the drum cavity. The external 
surface of the drum-head is smooth and of a pearly lustre. 
Near its central line is an opaque, white ridge, due to the 
attachment of the so-called handle of the hammer, one of 
the small bones of the ear, to the middle layer of the 
drum-head. 

1 They are classified as modified sweat glands. 



HEARING. 355 

383. The Middle Ear, tympanum, or drum proper, is an 
air cavity, 1 about one-half inch in height and width, and 
about one-fourth of an inch deep. It is lined with mucous 
membrane, a continuation from that of the throat, through 
the Eustachian tube, which tube connects the drum cavity 
with the pharynx. Connected with this cavity from be- 
hind, and lined with mucous membrane, are the mastoid 
cells, or little air cavities in the mastoid portion of the 
temporal bone 2 (the prominence immediately behind 
the auricle). Through these cells, or through the roof 
of the drum cavity, which is very thin, an inflammation of 
the middle ear may extend to the brain. 

384. The most important contents of the drum cavity 
are the three ossicles, or little bones of the ear; viz., the 
malleus or hammer, the incus or anvil, and the stapes or 
stirrup, so named from a resemblance to these objects. 
Though weighing but a few grains, these little bones have 
muscles, cartilages, and blood-vessels, and are so joined 
together that they form a bridge, or chain of bones, reach- 
ing across the drum cavity from the drum-head to the in- 
ternal ear. By vibratory motions they convey sounds to 
the fluid of the internal ear, in which float filaments of the 
auditory nerve. The bone nearest the drum-head, and 
the largest of the three, is the hammer, which is held in 
position by ligaments attached to the roof and outer wall 
of the drum cavity. Its handle is, as we have seen. 



1 This cavity, or drum, in its construction, somewhat resembles an 
ordinary snare, or military, drum, which is a reservoir of air. with two 
drum-heads capable of vibration. In an ordinary drum, air is admitted 
to the inside (drum cavity) by holes in the sides of the drum. Into the 
drum of the ear, the air is admitted through the Eustachian tube. 

2 Supposed to be concerned in the resonance o( the voice. 



356 HEARING. 

fastened securely to the middle layer of the drum-head, 
while its head is articulated with the next bone, the anvil. 
The anvil is held in position by two ligaments, one 
attached to the upper and posterior wall of the drum 
cavity, and the other to the drum-head. If the handle of 
the hammer is pulled outward, this joint between the 
hammer and anvil unlocks, releasing the anvil, but if it is 
pushed inward, the anvil is carried with it. The anvil is 
joined to the stirrup, its long process, or leg, fitting into a 
depression in the head of the latter. The foot-rest of the 
stirrup is oval, and accurately fits into the oval window of 
the labyrinth, as the cavity of the internal ear is called. 

385. The Eustachian Tube is a little more than an inch 
and a half long, and its direction from the mouth to 
the ear is upward, outward, and backward. In the act 
of swallowing, the anterior wall is pulled away from the 
posterior by muscle fibres, offshoots from the muscles 
of the palate, and air enters the Eustachian tube. 1 At- 
tached to the drum-head is a delicate prolongation of 
one of these offshoots, known as the tensor tympani, or 
stretcher of the drum. This tube supplies air to the drum 
cavity, forms an escape tube for its secretions, and is a 
passage for equalizing a counter current of air, when the 
drum-head is driven suddenly in by the concussion of a 
blow or explosion. Gunners, when a heavy cannon is 
about to be fired, open their mouths so that the force of 

1 Eepeated acts of swallowing are said to prevent much of the discom- 
fort and pain in the ears consequent upon going down in diving-bells and 
ascending mountains. 

"The advantage of having tbe tube closed at all times, except when 
we swallow, lies in this, that were it always open there would be too much 
reverberation caused in our ears by the sound of our voice." 



HEARING. 357 

the concussion may be less felt. 1 Closure of the Eusta- 
chian tube is apt to cause deafness, by preventing free 
entrance and exit of air and by the consequent increased 
pressure upon the drum-head. 

386. The Internal Ear comprises the labyrinth and por- 
tions of the auditory nerve connected with it. The laby- 
rinth is a hollow bony cavity. Its central portion, called 
the vestibule, is a sort of anteroom, the entrance to which 
from the middle ear (i.e. the oval opening or window) 
is closed by the foot-rest of the stirrup. Its upper and 
forward portion, the cochlea, or snail shell, is a tube coiled 
in a pyramidal form. Its lower and posterior portion is 
composed of the semicircular canals, three in number. 
The inside of the cochlea is divided into two passages, 
one above the other, connecting at the upper portion of 
the cochlea. The lower part of the upper one opens into 
the vestibule, near the oval window, while the correspond- 
ing part of the lower passage is near the round Avindow, 
which is closed by a membrane. 

A fluid called the endolymph fills the labyrinth. It 
is a part of the natural water of the brain and skull 
cavity. 2 When this fluid in the labyrinth is compressed 
by the pressure inward of the stirrup, it finds relief at 
the round window, by a slight yielding of the membrane. 
Lining the osseous labyrinth is the membranous labyrinth. 
Distributed in and upon it are the delicate filaments of 

1 If, while a bather's head is immersed, two stones or shells bo clashed 
together under the water, the sounds perceived by him will be almost 
deafening, and may permanently impair his hearing. Children should be 
extremely careful not to play this dangerous trick upon one another. 

2 A fluid between the membrane of the labyrinth and its bony encase- 
ment is called the perilymph. 



358 



HEARING. 



the auditory nerve. Of this nerve there are two main 
branches, — the cochlear branch, supplying the cochlea, 
and the vestibular branch, supplying the remaining por- 
tion of the membranous labyrinth. The filaments of the 
cochlear nerve are distributed in a very complex manner 




Fig. 111. 
(From photograph by Etdingek.) 

A. Eight temporal bone, auricle and external canal removed. — MT, membrana tympani, or 

drum-head ; M, handle of malleus showing through. 

B. Eight temporal bone, inner side, petrous portion removed. — MT, the drum-head ; OS, 

chain of bones in position. 

C. The bones of the ear. — 1, the malleus : 2, the incus ; 3, the stapes. 

D. The relation of the bones of the ear to the bony portion of the internal ear. — 1, the ossi- 

cles, foot-rest of stapes, attached to oval window ; 2, the cochlea ; 3, the semicircular 
canals ; -i, the upper end of Eustachian tube. The round window is not seen in the 
cut. 

to the shelves of the cochlea, and end upon thousands of 
little hair-like cells, harp strings as it were, which are 
held in place upon the so-called a?'ches of Corti. 1 The 
vibration of these hair-like cells is communicated to their 



1 There are said to be about three thousand arches of Corti in the 
human ear, each one tuned to respond to the various musical sounds. 



HEARING. 359 

connecting nerve filaments, and thus to the auditory 
nerve and the brain. It is stated by physiologists that 
we hear noises with the vestibule nerves, and music with 
the cochlear ones. 

387. It is supposed that, besides their connection with 
hearing, the semicircular canals have something to do with 
the coordination of muscular movements. Experiments 
on birds and other animals show that when these canals 
are injured, uncontrollable motions of the head ensue, 
followed by reelings and falls, and the inability to control 
the muscles involved in walking or flying ; but neither 
consciousness nor the sense of hearing is impaired. Some- 
times in persons with ear disease, similar manifestations 
occur on an attempt to walk, although consciousness is 
unimpaired. From the above circumstances, some speak 
of a sense of equilibrium, and locate it in the semi- 
circular canals. 

388. The Physiology of Hearing is briefly as follows : 
Sound waves are collected and strengthened by the auri- 
cle. 1 Passing down the external auditory canal, they 
strike the drum-head, and cause it to vibrate and set in 
motion the ossicles, which in turn, through the foot-plate 
of the stirrup bone, impart motion to the water of the 
labyrinth. 2 Through this fluid the impressions of the 
soundwaves are conveyed to the membranous labyrinth. 

1 In the lower animals, the auricles are true collectors oi sound. In 
man they ha,ve to do with the quality of sound more especially, as any 
one can ascertain by gently pressing the auricle backward or forward 
when near a number of sounds, as of steam whistles, etc. 

-The vibrations of the membrane of the oval window arc probably 
transmitted through the perilymph and membranous labyrinth to (he 
endolymph. 



360 HEARING. 

and thence to the brain, by the filaments of the auditory 
nerve which lie upon the membrane. To be able to hear 
distinctly, it is necessary that there should be an ac- 
curate arrangement of the various portions of the audi- 
tory apparatus, free movements of muscles, membranes, 
and bones, of the fluid of the labyrinth, and of the air 
outside and inside the drum cavity. 

389. Defective Hearing may exist without the knowl- 
edge of the sufferer or of his friends. Of 570 school 
children examined in New York City, 1 76 were found to be 
deficient in hearing, either in one ear or in both, while only 
one had been known by the teachers to be deaf, and only 
19 out of the 76 were aware of aural defects. 2 Neglected 
inflammations of the throat, especially in those living in 
an impure atmosphere, and eruptive diseases (such as scar- 
let fever and measles, where inflammation extends into 
the Eustachian tubes) may cause deafness. Decayed teeth 
or inflamed gums, by reflex irritation through a ganglion 
near the ear, sometimes produce earache and temporary 
deafness. 

Blows upon the ear are always dangerous, and may 
cause temporary or permanent deafness. Accumula- 
tion of ear wax is a very common cause of deafness. 3 

1 See circular of information of the Bureau of Education, No. 5, 1881. 

2 In conducting such tests, the voice is considered better than the tick- 
ing of a watch. The patient, having one ear stopped, should stand with 
closed eyes at various distances from the examiner, while the other ear is 
being tested. The sentences repeated should be intelligible and frequently 
changed, and should contain words with hissing and guttural sounds, these 
not being easily understood when hearing is impaired. Though this mode 
of testing is the best, it is not as accurate as the test for defective vision. 

3 A very large number of persons apply at the eye and ear infirmaries 
for relief from deafness, and obtain it after accumulated ear wax has been 
removed. 



HEARING. 361 

Cleaning the ear too frequently with swabs, or clearing 
out the wax with pin-heads, hair-pins, and other metal- 
lic implements, will be apt to excite inflammation, 1 and 
may facilitate the growth of fungi. Neglected diseases 
of the middle ear may result in brain disease, by inflam- 
mation through the mastoid cells. Ear diseases sometimes 
produce ringing and hissing sounds in the ear, which are 
very annoying. In certain forms of disease, the patient's 
own voice sounds loud and disagreeable to him. 

390. Hygiene of the Ears. — To prevent catching cold 
in the ears, they should be washed frequently but gently, 
and in very cold weather may be protected by covering 
with a loosely fitting cap, tippet, or ear-tabs. Pressure 
or overheat will increase the perspiration and soften the 
skin. Draughts of air from open windows should be 
avoided. The habit of breathing through the mouth 
is injurious, as it dries the mucous passages of the ear, 
and thus interferes with hearing. Improper clothing, 
overheated rooms, or wet feet may cause inflammation 
of the ear. Prolonged bathing in cold water and div- 
ing from a height should be avoided. When about to 
dive, or swim under water, a pledget of cotton in each ear 
is advisable; but the prolonged wearing of cotton in the 
ears makes them sensitive. 



1 The habit of probing and scraping the external ear is injurious ; it 
excites the ceruminous glands to pour out a superabundance of wax, 
which impairs hearing, and is an annoyance to those who desire to appear 
cleanly. A graver harm also may be done, such as wounding the delicate 
lining of the ear, or puncturing the drum membrane, or displacing lite 
little bones. The best way to cleanse the external ear is carefully to 
inject warm water, or warm water with a little good soap dissolved in it, 
with no scraping, and little or no swabbing. Any substance not easily 
removed by syringing had better bo left to the care of a physician. 



362 HEARING. 

391. Effects of Alcohol and Tobacco upon Hearing. — Al- 
cohol and tobacco sometimes produce such irritation or 
dryness of the Eustachian tubes as to cause a more or 
less troublesome deafness, ringing in the ears, or other 
uncomfortable sounds. 



QUESTIONS. 

1. How is hearing effected ? 

2. What is meant by the intensity of sound? the pitch? the quality? 

3. What is the capacity of the ear to distinguish different sounds ? 

4. What is the organ of hearing, and its divisions ? 

5. What does the external ear comprise ? 

6. Describe the auricle and its use. 

7. Describe the auditory canal. 

8. What glands are located in the external ear? 

9. Describe the membrana tympani, or drum-head. 

10. What is the middle ear, and what does it comprise ? 

11. Where are the mastoid cells ? 

12. Describe the contents of the drum cavity. 

13. How do the small bones of the cavity and the fluid of the laby- 

rinth act, to enable us to hear ? 

14. Describe the Eustachian tube and its uses. 

15. What is the effect of its stoppage? 

16. What does the internal ear comprise ? 

17. Describe the labyrinth, and its several divisions and contents. 

1 S. What is distributed throughout the labyrinth to convey the audi- 
tory impressions to the cerebrum ? 

19. 1 That is the belief of physiologists as to the function of the semi- 

circular canals, and on what is this belief founded ? 

20. What is the physiology of hearing ? 

21. What may be said as to the prevalence of defective hearing, and 

to what causes in general is it due ? 

22. What are some of the consequences of ear diseases? 

23. What care should be taken of the ears, and what precautions used V 



CHAPTER XX. 

THE VOICE. 

392. Voice : Speech. — All animals, except the very lowest 
types, possess some audible method of communicating with 
their fellows, 1 — i.e. the voice. Some are incapable of 
producing more than one kind of sound, — a monotonous 
cry, — while the sounds emitted by others admit of con- 
siderable variation. The dog's notes of welcome to his 
master are very different from the harsher tones with 
which he greets intrusive strangers. But to man alone 
is it given to express thoughts in articulate sounds or 
speech. Between the higher and lower races of mankind 
there is a great difference as to the use of the voice, in 
both language and song, and its development is usually in 
direct relation to the intelligence of the races. Idiots, not- 
withstanding their possession of a normal vocal apparatus, 
cannot always converse intelligibly, but resemble some of 
the lower animals in the character of their vocal sounds. 
Parrots and other birds can be taught, by constant repeti- 

1 Among insects this is sometimes accomplished by the rapid vibr ions 
of wings, the tapping of antennae or limbs upon some resonant object, or 
the rubbing of hard portions of the body against each other, the leg against 
the wing, for instance, as in the locust family. Sir John Lubbock claims 
that bees can vary their hum so as to express their feelings. The com- 
mon domestic fowl emits one kind of sound when quietly employed in 
scratching for food, and another when a hawk approaches. 'The crane 
has a marvellously constructed trumpet, for use especially at night and 
when taking long flights. 



364 THE VOICE. 

tion, to repeat difficult words and sentences, and to imitate 
cries, laughter, and sobbing ; but, so far as we know, they 
do not originate words or sentences. 

The development of speech is intimately connected with 
the acuteness of the special senses, for it is through them 
that we gather impressions which develop into ideas, and 
thence into language. This is especially true of the hear- 
ing. By persistent and painstaking efforts, some who 
have been born deaf have been taught to articulate, and 
even to converse, but without that delicate modulation of 
tone and accentuation and emphasis of words which can 
be given only by a regulating ear ; and the limited power 
thus laboriously acquired is, after all, exceedingly precari- 
ous and easily lost (#). 

393. The Organs of Voice are the larynx (Fig. 80) and 
its accessories, the windpipe, lungs, respiratory muscles, 
pharynx, mouth, and the nasal cavities. All of these 
parts are necessary for the proper modulation of the voice. 
The mechanism required for its production may be com- 
pared to that of a reed organ, the lungs corresponding to 
the bellows which supply air, the bronchial tubes and 
trachea to the wind chest which conducts the air, the 
larynx, with its vibrating cords, to the vibrating reed 
of the organ, and the pharynx, mouth, and the parts in 
connection with them, to the body tube or resonant pipe, 
which modifies the sounds produced. 

394. The Larynx. — Its framework is composed of nine 
cartilages, connected by ligaments and operated by nu- 
merous muscles. It is lined by mucous membrane, and is 
well supplied with blood-vessels and nerves. The largest 
of the four principal cartilages is the thyroid, or shield 



THE VOICE. 365 

cartilage, a broad, thin plate, shaped something like the 
cover of a half -open book, and joined to the hyoid bone 
above by a membrane. The back of the book represents 
the ridge of the thyroid cartilage, as seen or felt in the 
front of the neck, and familiarly known as Adam's apple. 
Below the thyroid cartilage, and attached to it by an en- 
circling membrane, is the second of the four cartilages, the 
cricoid, which is shaped like a seal ring, with the narrow 
portion in front. Lastly, upon the posterior and upper 
surface of the cricoid are two slight eminences for articu- 
lation, with two pyramidal and very movable cartilages, 
called the arytenoids. 1 

Surmounting the arytenoid cartilages are two very 
small ones, known as the supra-arytenoicl, or buffer, carti- 
lages, which deaden and distribute pressure, and serve to 
prevent injury to the larynx, especially in swallowing. 
Attached by its lower and narrow end to the inner and 
upper part of the thyroid cartilage is the epiglottis, or 
cover cartilage, shaped something like a lilac leaf. Its 
principal function is to assist in preventing the entrance 
of food or other articles into the larynx during the act of 
swallowing. At such times the larynx is raised, its walls 
are approximated, and the epiglottis, as a lid, covers the 
opening of the glottis. On looking into the throat during 
a full inspiration, the rounded, free, upper edge of the 
epiglottis is sometimes visible behind the base of the 
tongue. Within the folds of the mucous membrane, 
stretching from the epiglottis to the arytenoids, are two 
other cartilages, long and sickle-shaped, termed prop 
cartilages, which assist in keeping the larynx open. 

1 I.e. like a pitcher, so called because when joined together tiny re- 
semble the beak, or mouth, of a pitcher. 



366 THE VOICE. 

395. The Vocal Bands. — Intimately concerned in the 
production of voice are the vocal bands (or cords) and 
the muscles of the larynx. The former are two horizontal 
elastic bands of ligament, stretched across the larynx 
from front to back. They are attached in front to the 
angle in the thyroid cartilage, just below the attachment 
of the epiglottis (one on each side of the interior of the 
larynx), and are there comparatively immovable, while at 
the back they are attached to the very movable arytenoid 
cartilages. 1 By the contraction and relaxation of these 
bands the opening between them, known as the glottis, is 
enlarged or diminished in size during respiration, and for 
the production of A^oice. 2 

396. Muscles of the Larynx. — The tension and degree of 
approximation of the cords is variously modified through 
muscles, and thus in part is produced the various differ- 

1 Their arrangement allows the edges or margins to be sharply defined, 
and to vibrate as the air passes over them. These bands are sometimes 
called true vocal cords, to distinguish them from two membranous folds 
lying above them, known as false vocal cords, because they are not con- 
cerned in the production of the voice. 

2 "You know musical chords or strings, as those of the guitar, violin, 
etc., are attached only at their two ends, so that they can freely vibrate 
between ; the tongues or reeds of organs, accordeons, clarinets, and all 
other artificial reed instruments, are usually attached at one end only, so 
that they have three free edges ; but the human reeds or vocal bands are 
attached on three sides, and have only one free edge. Those of you who 
know what a large number of reed or organ pipes are needed in the organ 
made by man, to produce the notes of varying pitch and timbre, cannot 
fail to be struck with astonishment at the fact that in the organ in man's 
body a single reed-pipe, the larynx — by a wonderful power of varia- 
tion inherent in itself — suffices for the production of the most various 
sounds. No musical instrument has ever been constructed by man that 
approaches in perfection or effectiveness that of the human voice." — 
Dr. Louis Elsbeeg. The TTiroat and its Functions. 



THE VOICE. 



367 



AC 



ences of sound which make up the human voice. Some of 
the muscles of the larynx move and rotate the arytenoids 
outwardly, thus separating the vocal cords and widening 
the chink of the glottis. 
Others move and rotate 
the arytenoids inwardly, 
thus approximating the 
vocal cords, and, in a 
varying degree, closing 
the glottis. The remain- 
ing muscles of the larynx 
serve to regulate the ten- 
sion of the cords, or are 
concerned in respiration, 
or act upon the epiglottis 
during the act of swallow- 
ing. The nerves which 
supply the mucous mem- 
brane of the larynx with 
sensibility and the mus- 
cles with motor power 
are four in number. 

397. Mechanism of the 
Production of Voice. — Be- 
fore the introduction and 
use of the laryngoscope, 1 
there was much uncer- 
tainty as to the mechan- 
ism for the product ion 




Fig. 1 12. 
Posterior View of Larynx. 

T, base of tongue. 

Til, upper part of thyroid cartilage (the epiglot- 
tis is seen between the upper portions of this 
cartilage and behind the tongue). 

CO, the cricoid cartilage. 

AC, arytenoid cartilages, hid in part by muscles. 
Til, trachea. 

1 and 2, nerves of larynx, branches distributed 
to the tongue, to the epiglottis and the folds 
of membrane between the epiglottis and ary- 
tenoids, and to muscles controlling the action 
of the cricoid ami arytenoid cartilages. 



1 An oval or round mirror attached to ;i long handle, which, placed in 
the back and upper pari of the throat, reflects the interior oi the Larynx, 

and, under favorable conditions, a part of the trachea. This instrument 



368 



THE VOICE. 



of voice. An examination of the interior of the larynx 
with this instrument during ordinary respiration shows 
the chink of the glottis to be quite wide during in- 
spiration, but much narrower 
during expiration ; for in the 
latter case the muscles of the 
larynx are passive, air being 
gently forced out. During vo- 
calization the vocal cords are 
particularly well defined. Speech 
is shown to be effected during 
expiration only, though harsh 
sounds may be formed during in- 
spiration. As soon as an attempt 
is made to produce a sound, the 
cords are thrown into action. In the production of high 
musical notes or shrill sounds, they are made tense and 
are closely approximated, and are relaxed and moved fur- 
ther apart during the emission of sounds opposite to these. 




Fig. 113. 

View of the interior of the l'arynx 
during respiration. Kings of 
the trachea seen through the 
laryngeal opening, the vocal 
cords (represented in white) 
being apart. 



398. For the production of clear 
vocal sound, the cords must be 
brought into close approximation 
and must be capable of easy vibra- 
tion. If they cannot so approach 
each other, whispering results. 
If they are not sufficiently smooth 
or straight, or if their action is 
irregular, or if they have on their 




Fig. 114. 

The Position of the Vocal Bands 
during Phonation. 



originated from the observations of the celebrated singing teacher, Garcia, 
upon himself, and the investigations of two Austrian physicians, Turck 
and Czermak. The first successful demonstration of the action of the 
vocal cords is said to have been made by Garcia in 185-i. 



THE VOICE. 369 

edges flakes of mucus, the tones become rough and hoarse 
in character. 1 

Stammering is caused by a spasmodic contraction of the 
diaphragm, interrupting expiratory efforts. " The stam- 
merer has control of the mechanism of articulation, but 
not of the expiratory blast. He must control his respira- 
tory muscles, to steady their action during speech. A 
stutterer has control of these muscles and of the dia- 
phragm, but his lips and tongue are insubordinate." 

399. Variations in Vocal Sounds depend mainly upon 
their intensity, pitch, and quality. Intensity, or loud- 
ness, depends upon the elasticity of the vocal bands and 
the force of the escaping air. The more relaxed the 
bands and the stronger the current of air over them, the 
larger are the sound-waves and the louder the sounds 
produced. 

Differences in pitch depend upon the rapidity with 
which the bands vibrate. The more rapid the vibrations, 
the higher the pitch. The slower they are, and the less 
closely the cords approximate, the lower the sound. 

Quality, or timbre, is that characteristic by which we 
can distinguish different voices, and recognize the voices 
of our friends, even though their features may be con- 
cealed. Quality is of a composite nature, and is duo to 
the more or less harmonious relations between intensity, 
pitch, and other characteristics of sound. It depends 
largely upon the condition of the resonant cavities of 

1 The varying tones produced by two elastic bands more or loss paral- 
lel with each other, and with edges o( varying rigidity, may bo illustrated 
by blowing through glass tubes of different length ami caliber, to the 
opposite ends of which two pieces o\' thin rubber cloth arc firmly fastened, 
the free edges being parallel, or nearly so. 



370 THE VOICE. 

the throat, mouth, and nose. Enlarged tonsils, loss of 
teeth, dryness of the mucous membrane, cleft palate, 
hare-lip, and other defects change the quality of vocal 
sounds. Our vowel sounds are clearly enunciated only 
when the sounding breath is not obstructed above the 
larynx in its outward passage. With the mouth wide 
open, only a harsh sound can be made by the vocal bands. 
Consonant sounds result when there is an obstruction by 
the lips, tongue, teeth, etc., to the outward motion of the 
air. The position of the tongue and of the soft palate 
favors the emission of certain sounds. A nasal twang 
is the result of talking with the nose or the passages 
thereto from the lungs more or less obstructed. It is 
not so much because we talk through the nose, as because 
we do not use the nasal vent with sufficient freedom. It 
is called a nasal twang, because the closed or contracted 
nasal apertures have caused unpleasant modification of 
the sound. 

The different qualities of voice depend not only upon 
natural variations in the larynx and the accessory organs 
of speech, but' also upon the degree of culture to which the 
voice and its organs have been subjected. 1 In some per- 
sons the voice is so perfectly modulated that it never 
seems too high, too low, too harsh, or too flat. 2 

1 Among the Greeks, for the training of the voice there were three sets 
of teachers, the first to develop power and range of voice, the second to 
improve the quality, the third to teach modulation and inflection. 

2 The capabilities of some voices are almost incredible. It is related by- 
Mrs. Seiler, in her manual on "The Voice in Singing," that the singer, 
Farinelli, once competed with a trumpeter who accompanied him in an 
aria: "After both had several times dwelt on notes, in which each 
sought to excel the other in power and duration, they prolonged a note 
with a double trill in thirds, which they continued until both seemed to 
be exhausted. At last the trumpeter gave up, entirely out of breath, 



THE VOICE. 371 

There is also a property of voice known as reach, 
i.e. "the penetrant power of a sound over distances and 
obstacles, such as other sounds, and is due to the purity of 
the tone, which in its turn is dependent on the accuracy 
with which it is produced." At the Peace Jubilee in 
Boston, in 1869, Madame Parepa Rosa's voice was dis- 
tinguishable above those of an accompanying chorus of 
nearly 12,000 singers and an orchestra of 1000 instru- 
ments, in a hall where the audience consisted of 40,000 
people. 

The ordinary range or compass of the voice is about two 
octaves, seldom less than one or more than two and a half. 
In some great singers the range is three and a half. 1 

400. Ventriloquism. — The peculiar mode of speaking 
known as ventriloquism is a curious modification of the 
voice, and is not, as the word literally means, "talking 
from the stomach." The power of the ventriloquist is 
sufficiently marvellous without our attributing it to a 
still more marvellous source. Without apparently mov- 
ing his lips, by some occult management of the vocal 
organs, by great skill in mimicry and considerable ad- 
dress in appealing to the imagination, the ventriloquist 
causes different human voices, animal cries, and other 
noises to seem to issue from persons or objects outside of 
himself. This remarkable power may account for many 



while Farinelli, without taking breath, prolonged the note with renewed 
volume of sound, trilling, and ending finally with the most difficult of 

roulades." 

1 The entire range of the human voice exceeds live octaves, for 
there have been bassos who sang with east 1 and power the lower V of 
40 vibrations, and sopranos who readily reached the high F of 1400 
vibrations, or even the higher C of 2000 vibrations. 



372 THE VOICE. 

of the wonderful responses which are said to have been 
made by the ancient oracles. 1 

401. The Chief Varieties of Voice are four in number ; 
viz., the bass and tenor in the male sex, and the contralto, 
or alto, and the soprano, in the female. There is a variety 
of voice between the bass and tenor, known as the bari- 
tone ; and one between the alto and soprano, called the 
mezzo-soprano. Ordinarily the strength and beauty of 
bass and contralto voices are in the lower notes, and 
of soprano and tenor in the higher. Bass singers may 
reach as high notes as tenors, and alto singers as sopranos, 
or vice versa, but they do not attain the proper clearness 
and richness of tone. A falsetto voice is one pitched 
above its natural compass. In early childhood, the char- 
acter of the voice is about the same in both sexes. The 
quality of the soprano voice in boys is often especially 
prized in the rendering of church music. At about the 
age of fourteen years, the boy's voice begins to change. 
The larynx increases in size, the power of regulating its 
muscular control is diminished, and the falsetto voice is 
likely to break in upon the ordinary voice, especially in 

1 "From the observations of Miiller and Colonibat, it seems that the 
essential mechanical parts of the process of ventriloquism consist in taking 
a full inspiration, then keeping the muscles of the chest and neck fixed, 
and speaking with the mouth almost closed, and the lips and lower jaw as 
motionless as possible, while air is very slowly expired through a very 
narrow glottis, care being taken, also, that none of the expired air passes 
through the nose. But, as observed by Miiller, much of the ventriloquist's 
skill, in imitating the voices coming from particular directions, consists in 
deceiving other senses than hearing. We never very readily distinguish 
the direction in which sounds reach our ear ; and when our attention 
is directed to a particular point, our imagination is very apt to refer 
to that point whatever sounds we may hear." — Kirke, Handbook of 
Physiology. 



THE VOICE. 373 

declaiming and singing. 1 The voices of girls change 
somewhat at about the same age ; they develop strength 
and compass, the quality remaining about the same. But 
with both sexes at this period there should be no systematic 
cultivation of the voice. 

402. Hygiene of the Voice. — Weak and improperly modu- 
lated voices can be improved by proper care and culture. To 
this end all diseased conditions, such as enlarged tonsils, 
adenoid growths, 2 a very relaxed soft palate, nasal or 
pharyngeal catarrh, 3 defective teeth, etc., should be reme- 
died, and muscular exercises, adapted to the wants of 
each individual, should be systematically practised. The 
muscles of the diaphragm and those of the chest may be 
exercised by occasional full respirations, and by the hands 
being placed against a wall, and the chest moved forcibly 
toward and away from the wall. 

" The muscles of the larynx are best exercised by sys- 
tematic singing exercises on the tones at or near the middle 
of the ordinary compass of the individual." Repetitions 
of the act of swallowing, and various movements of the 
lips, cheeks, and tongue, are valuable. Wind instruments, 
adapted to the strength of the performer, are also of 

1 The high-pitched voice of children is due to the small size of the 
larynx and the short vocal cords. 

2 Adenoid growths, spoken of in Chapter XIII., occur in about ten 
children in every hundred, causing catarrhal inflammation of the throat, 
and sometimes deafness. They force the child to breathe through the 
mouth, and diminish the air supply to the lungs. "There is no such 
thing as a healthy throat in an individual who breathes through the mouth 
as a habit." 

3 "One of the commonest causes of nasal ami throat catarrh in child- 
hood is indigestion, and the commonest cause of Indigestion is the habit of 
eating rapidly and washing food down with fluids during a meal." 



374 THE VOICE. 

service in some cases ; but if they are too powerful or are 
used excessively, injury to the lungs is likely to result. In 
particular, the voice should be frequently used in a natural 
and proper manner. Spasmodic and prolonged use, espe- 
cially if the voice is pitched too high, strains the vocal 
apparatus, and produces inflammation of the mucous mem- 
brane of the throat. The forced and unnecessary chest 
respirations sometimes indulged in by public speakers and 
singers place the thorax and larynx in tiresome and con- 
strained positions, and interfere with the natural use of 
the voice. 

The training of the voice should begin in childhood, 
when the vocal organs are most pliable. It should be 
entrusted to competent teachers, and, like other forms of 
muscular exercise, should be pursued systematically and 
daily, but never to the point of fatigue. It is related 
of a celebrated musician that, in answer to an inquiry 
why he practised so systematically, he replied, " If I neg- 
lect to practise one day, I notice it ; if for two days, my 
friends notice it ; and if for three, the public notice it." 

Even in adult life, the strength and quality of the voice 
may be improved, and clergymen, actors, and other public 
speakers have had their usefulness increased by lessons in 
elocution and the care of the voice (a). 

403. Effects of Alcohol and Tobacco upon the Voice. — 

Alcohol sometimes produces huskiness of the voice, by 
thickening the lining membrane of the larynx and weak- 
ening the laryngeal muscles. Tobacco, especially if the 
smoke from it is inhaled, sometimes sets up a troublesome 
and persistent hacking cough, due to a dryness of the 
mucous membrane and irritation of its sensitive nerve 
filaments. 



THE VOICE. 375 

QUESTIONS. 

1. What is to be said of the audible means of communication of men 

and animals, and on what does its development depend? 

2. With what is the development of speech intimately connected ? 

3. What parts of the body are concerned in the production of voice ? 

4. Which is the special, or essential, organ of voice ? 

5. Describe the larynx, its cartilages, vocal cords, and muscles. 

6. How are the differences of sound of the voice produced ? 

7. How has the mechanism for this purpose been ascertained? 

8. What does an examination of the interior of the larynx with the 

laryngoscope reveal? 

9. How are sounds produced, and why are some sounds musical and 

others not ? 

10. What causes the differences in their intensity ? pitch ? 

11. What is the quality of a voice, and on what does it depend? 

12. What is ventriloquism? 

13. What is reach? 

14. What is said of the range or compass of the human voice? 

15. What are the chief varieties of voice? 

16. How and when do the voices of boys and girls change ? 

17. How is the voice modulated to produce the various articulate 

sounds ? 

18. What is to be said of nasal sounds? of clearness of voice? 

19. Give general directions for the care and culture of the voice. 



EMERGENCIES. 



404. The following directions as to the care of the 
injured will often save life, if carefully * followed. "In 
many cases of injury the crisis is reached before the 
patient arrives at the hospital gate, and the lack of in- 
structed aid at first often turns the tables against him." 
Officiousness on the part of bystanders is likely to do 
harm. 1 Whenever practicable, a physician should be sent 
for and the injured person given into his charge. When 
called, the doctor should be informed of the nature of the 
accident, that he may bring with him the proper appli- 
ances and restoratives. 

General Directions. 

405. First. Do not join the crowd about an injured per- 
son unless you can be of service. As the throng increases 
in numbers and presses more closely about the sufferer, 
his chances for recovery are lessened ; his air supply is 
diminished, and the efforts of those assisting him are 
interfered with. At least ten feet of space on all sides 
of the injured person should be kept clear, except for 
those actually concerned in caring for him. 

1 To replace officiousness with efficiency is the aim of the Red Cross 
Societies in this and other countries. 

376 



EMERGENCIES. 377 

Second. If you withdraw, take as many idlers as you can 
with you. If no one has assumed charge of the case, take 
it in hand, going quickly but calmly to work ; but, if there 
is already a leader, offer to go for a doctor, blankets, or 
stimulants, or to do whatever is desired. Do not argue 
with others who are assisting, as to methods of work, for 
delay imperils the life of the one you desire to save. On 
the other hand, do not proceed too rapidly. For ex- 
ample, do not attempt to administer stimulants before 
the injured person can swallow. 

Third. The injured person should be examined ivith the 
greatest care. Rough handling may open a wound in 
which bleeding has ceased and start a dangerous hemor- 
rhage, or cause the jagged end of a broken bone to wound 
seriously an important blood-vessel or nerve. Thoroughly 
examine the entire body, in search of broken or dislocated 
bones, wounds, unusual swellings or depressions. Note 
whether the face is flushed or pale, whether the pupils re- 
spond to light, whether the breathing is quiet and regular, 
or noisy, or difficult ; also note the condition of the pulse. 
A pale face indicates faintness ; flushing, too much blood 
in the head. If the pupils do not respond to light, or if 
the breathing is noisy, there is danger of apoplexy. 

Fourth. If the pulse is easily compressed by your 
finger, the patient's heart is beating feebly, and there is 
danger of life's ebbing away ; therefore stimulants are 
needed. If the face is flushed or the pulse strong (i.e. 
not easily compressed), stimulants arc dangerous. 

When the skin is cold, restore warmth by gentle friction 
with the hands, and by applications of heated flannels and 
bottles filled with hot water, especially to the feet, about 
the body, and in the armpits. If the head is very hot. 
cold water or pieces of ice may be applied to it. The 



378 EMERGENCIES. 

injured person generally needs abundance of air, and it 
may be necessary to create a current by the use of a fan ; 
but, at the first evidence of chilliness, the patient should 
be covered with blankets, shawls, coats, etc., though not 
so heavily as to induce perspiration. If the person needs 
stimulants and is able to swallow, give fifteen drops of 
aromatic spirits of ammonia in one-third of a glass of 
water; or brandy or whiskey, one part to four or five 
of water. Repeat every fifteen minutes, if prostration 
continues. 

Fifth. To remove an injured person, use as a stretcher 
a strong shawl or sheet doubled and suspended between 
two poles, a board, a door, a window shutter, a ladder, or 
something similar. If the distance is short, the patient 
may be carried by two persons, with hands so locked as 
to form a chair. If the distance is great, an ambulance 
may be devised by placing one or more mattresses in a 
covered vehicle of sufficient size. In lifting an injured 
person, three attendants are generally required : two to 
support the body, while one attends to the injured part. 
When about to convey by a stretcher, depute some one 
to keep back the crowd, while another goes before to 
secure a comfortable shelter. Cover the face of the 
injured one with a handkerchief or other light article, to 
prevent the uncomfortable feeling of being stared at. 
He should be instructed not to answer the questions of 
mere idlers. 

Unconsciousness. 

406. Unconsciousness may be partial or complete, and 
may be caused by concussion of the brain, by shock from 
physical injuries or mental emotion, by apoplexy, epilepsy, 
narcotic poisons, loss of blood, or by blood poisoning, as 



EMERGENCIES. 379 

in some forms of kidney disease. If there is entire insen- 
sibility, an arm, when lifted and let fall gently, offers no 
muscular resistance, but is a dead weight ; the pupil of 
the eye does not contract on exposure to light ; and no 
effort to close the lids is made when the operator's finger 
is brought quickly toward the eye. If unconsciousness is 
partial, or if it is feigned, as in some cases of hysteria, 
the conditions are the reverse. 

407. Fainting. — The danger here is from a feeble heart. 
The pulse is weak, the face pale. 

Treatment. A few minutes of rest may bring about 
recovery, the person being laid flat upon his back, with 
all impediments to free breathing removed. If there is 
vomiting, place him on his side. A dash of cold water 
upon the face, tickling of the nostrils, the inhalation of 
the vapor of smelling salts or ammonia, and the use of 
strong coffee or of stimulants internally may be necessary. 

408. Intoxication. — Symptoms. Breath has the odor of 
liquor ; 2 unconsciousness, more or less complete ; usually 
can be roused ; breathing quiet ; pulse frequent ; pupils 
slowly respond to light. 

Treatment. Generally, more vigorous measures should 
be employed than for fainting; viz., slapping of the face, 
tickling or slapping of the soles of the feet, and twisting 
of the hair. If there are symptoms of collapse (i.e. cold 
skin and feeble pulse), apply warmth and give coffee or 

1 Sometimes a temperate person, rendered unconscious from a severe 
accident, is treated as if intoxicated, when the breath smells of liquor, 
which has been taken by him because of faintness or exhaustion. Such 
a mistake not only causes an utter neglect of measures necessary for 
recovery, but leads to great injustice and mortification. 



380 EMERGENCIES. 

aromatic spirits of ammonia. It must be remembered 
that intoxication may be associated with more alarming 
forms of unconsciousness, such as apoplexy, in which 
case too vigorous restorative measures may imperil life. 

409. Apoplexy. — Symptoms. Patient generally uncon- 
scious ; face flushed or very pale ; pulse full ; pupils do 
not respond to the light ; breathing more or less noisy ; 
paralysis of one side of face or of one or more of the 
limbs ; sometimes convulsions. 

Treatment. Place in recumbent position, head raised a 
little ; loosen the clothing about the head, neck, and chest. 
If head is hot, apply ice or cold water. Keep patient 
quiet. Leave other means to the doctor. 

In concussion of the brain, as from a blow upon the 
head, the symptoms resemble those of apoplexy. Frac- 
ture of the base of the skull is generally indicated by 
bleeding from the ear. 

410. Convulsions or Fits. — Do not attempt to hold the 
patient still. Merely prevent him from injuring himself. 
If there is danger of the tongue being bitten, place a 
piece of wood between the teeth. In the ordinary con- 
vulsions of children, from undigested food, etc., and in 
convulsions from blood poison, place the patient for a few 
minutes in a warm bath. If the head is hot, keep cold 
water applied to it during and after the bath. If con- 
vulsions continue, produce vomiting by administering one 
teaspoonful of syrup of ipecac, and a movement of the 
bowels by an enema of soap and warm water. 

In the convulsions of epilepsy, these measures are not 
necessary. Simply keep patient from hurting himself. 
Do not struggle with him. 



EMERGENCIES. 381 

411. Sunstroke and Heat Exhaustion are two conditions 
entirely different, but both are caused by fatigue and pro- 
longed exposure to great heat. They are most likely to 
occur among feeble and intemperate persons, among those 
who work under the direct rays of the sun or in badly 
ventilated and overheated rooms, or among those who 
wear too much clothing (especially heavy head-coverings) 
in hot weather and use iced drinks to excess. 

Symptoms. In sunstroke, the skin is usually hot, pulse 
full, and breathing labored, and the patient may be un- 
conscious. There is danger from congestion, which occurs 
in the internal organs. In heat exhaustion, there is cold- 
ness, pallor, and weak pulse. 

Treatment. Recumbent posture in a cool place, ice to 
the head, and cold douches upon the face, neck, chest, and 
spine, attended with friction until consciousness returns. 
Stimulants are required if the pulse is very weak ; and if 
reaction does not soon set in, mustard (but not to blister) 
may be applied to the feet, the back of the neck, and the 
chest. When there is apparently no active congestion, but 
evidences of heat exhaustion, stimulants are to be used 
from the first, and cold applications sparingly, if at all. It- 
may be necessary to induce warmth of the body, but this 
should be done in a cool room. Rest in bed is important. 

412. Suffocation. — Drowning, Smothering, Hanging, and 
Gas-poisoning constitute a group of accidents in which 
death results mainly from a deprivation of air. 1 Carbon 
dioxide, accumulating in the blood, poisons the nerve 
centres in the medulla, checks breathing, and may stop 

1 In accidents of this kind, the face is generally swollen and of a bluish 
color; sometimes the eyes and tongue protrude; about the mouth is 
more or less mucus, occasionally streaked with blood. 



382 EMERGENCIES. 

the action of the heart. Animal heat is also lost, some- 
times entirely, so far as we can perceive. 

In all cases of suffocation, oxygen is to be supplied, cir- 
culation of the blood reestablished, and animal heat restored. 

Treatment. 1. Cut or tear clothing from face, neck, and 
chest, and expose patient to the open air, except in very 
severe weather. Valuable time is lost by endeavoring to 
untie or unbutton clothing. 

2. If the jaws are clenched, separate them, and keep 
the mouth open by placing a cork or a bit of wood be- 
tween the teeth. 

3. With the index finger covered with a handkerchief 
or piece of cloth, remove from the mouth mucus or any 
other substance which may prevent the ingress of air. 

4. In nearly all cases of suffocation the tongue is 
relaxed and sometimes swollen, and may fall back into the 
throat, blocking the entrance for air. If you are obliged, 
without assistance, to resuscitate any one, practise arti- 
ficial respiration, as hereafter described in § 413, First 
Method. The head of the patient being kept lower than 
the body, and face downward, the tongue will fall forward 
by its own weight. If you have an assistant, he should 
pull the tongue forward with a cloth, and hold its tip 
firmly out of the mouth, the patient being on his back. 1 

5. Heat is to be restored by warm, dry blankets, and 
friction under them ; by the application of hot flannels, 
bottles of hot water, or heated bricks, to the pit of the 
stomach, the armpits, the sides, the feet, and between the 
thighs. 

1 In the resuscitation of very heavy persons, whom yon cannot lift from 
the ground, if you have no assistance, put a strip of cloth over the tongue 
pulled forward, and hold it in place by tying the cloth at the back of the 
neck, or fasten it by an elastiG band passing over it and under the chin. 



EMERGENCIES. 



383 



6. In cases of partial suffocation, it is often sufficient 
to loosen the clothing about the neck, slap the chest 
with a cold wet towel, expose the patient to the open air, 
and allow him to inhale the fumes of ammonia; admin- 
ister stimulants, if necessary, and keep him free from ex- 
citement while recovering. When the patient does not 
breathe, perform artificial respiration, as directed under 
head of " Drowning." 

413. Drowning. — Treatment. 1 1. To remove water from 
the air passages. After loosening clothing which interferes 




Fig. 115. 
Removing Water — Patient on Ground. 



with breathing, clearing the mouth, and seeing that the 
tongue does not fall back into it, remove water from the 



1 The following instructions for rescuing drowning people should bo 
remembered: "Approach the drowning from behind, seizing them by 
the collar, or a woman by the back hair, and towing (hem at arm's length 
to boat or shore. Do not let tluan cling around your neck or arms to 
endanger you. Duck them tinder until unconscious, if necessary to break 
a dangerous hold upon you ; but do not strike to stun them.'* 



384 



EMERGENCIES. 



air passages as follows : place the person face down- 
ward over your knee, or upon the ground with a large 
roll of clothing beneath the stomach, and press on the 
back over the stomach for a half minute ; or, the patient 




Fig. 116. 
Removing Water — Clasping under Chest. 

being face downward, stand astride his hips with your 
face toward his head, and raise him two or three times 
with a slight jerk, your hands being clasped under the 
lower part of his chest. 1 

2. Artificial Respiration. Now, ivithout delay (unless 
the person is breathing) commence artificial respira- 
tion. Continue this for two hours or more, if neces- 



1 To hold a body up by the heels, so that the water may run out, is 
unnecessary. Rolling a body upon a barrel is a barbarous custom, at- 
tended with the danger of injury to internal organs, and is not to be 
tolerated. It is seldom that any large quantity of water enters the lungs 
or stomach. Some water is usually drawn into the air passages, unless 
the person faints when immersed. 



EMERGENCIES. 



385 



sary, 1 while assistants are constantly trying to arouse 
animal heat, by rubbing the extremities and in other 




Fig. 1 1 7. 
Artificial Respiration — Michigan Method. 



ways before described, without hindering artificial breath- 
ing, which is the one remedy not to be lost sight of. 



1 After how long a period of immersion in water a person may be 
resuscitated is not definitely known, and depends on various circum- 
stances. If water has passed into the throat, air is excluded, and suffo- 
cation is prompt. So also if the drowned person has been tossed about 
in the surf. On the other hand, if the drowning person is able to 
control respiration, and lift his head occasionally above the surface, life 
will be prolonged, and the chances for resuscitation are increased. Such 
also is the case if fainting occurs, as respiration and the heart's action 
cease through the action of the nervous system, and there are conse- 
quently no respiratory or circulatory efforts demanding air for the puri- 
fication of the blood. It may be noted here that many persons, even 
good swimmers, are drowned by reason of being seized with cramps or 
spasmodic contractions of muscles which cannot he controlled. Persons 
who are subject to cramps or twitching of the muscles, or who are 
debilitated, should not venture into water beyond their depth. 



386 EMERGENCIES. 

First Method. Keep the patient face downward, main- 
taining all the while your position astride the body, grasp 
the clothing over the points of the shoulders, — or, if the 
body is naked, thrust your fingers into the armpits, clasp- 
ing your thumbs over the points of the shoulders, — and 
raise the chest as high as you can (Fig. 117) Avithout 
lifting the head quite off the ground, holding it long 
enough to count slowly "one, two, three." Replace him 




Fig. 118. 
Artificial Eespiration — Michigan Method. 



on the ground, with his forehead on his flexed arm, the 
neck straightened out, and the mouth and nose free. 
Place your elbows against your knees and your hands 
upon the sides of his chest (Fig. 118), over the lower ribs, 
and press downward and inward, with increasing force, long 
enough to count slowly "one, two." Then suddenly let 
go, grasp the shoulders as before, and raise the chest 
(Fig. 117); then press upon the ribs, etc. (Fig. 118). 
These alternate movements should be repeated ten to 



EMERGENCIES. 387 

fifteen times a minute. Use the same regularity as in 
natural breathing. 1 

Second Method. After getting rid of the water, turn 
the patient quickly on his back, placing a roll of cloth- 
ing under the back, so that the short ribs bulge promi- 
nently forward and are raised a little higher than the 
level of the mouth. Have the tip of the tongue held 
out of a corner of the mouth by a handkerchief in the 
hand of a bystander, and the arms stretched forcibly back 
above the head. Then kneel astride or beside the patient's 




Fig. 119. 
Artificial Respiration — Government Method. 

hips, with your hands resting on the abdomen ; spread out 
your fingers so that you can grasp the waist about the short 
ribs. Throw all your weight steadily forward upon your 
hands, squeezing the ribs at the same time as if you wished 
to force everything in the chest upward out of the mouth. 
Continue this movement while you count slowly "one, two, 
three " ; then suddenly let go with a. final push, which 
springs you back to your first kneeling position. Remain 

1 This is the method advised by the Michigan State Board of Health, 

and has the merit that it can be carried out by one person, if the patient 
is of light enough weight to be lifted readily. 



388 



EMERGENCIES. 



erect upon your knees while you count " one, two," then 
throw your weight forward as before. Repeat all these 
motions with regularity : at first, four or five times a 




Fig. 120. 

Artificial Respiration — Government Method. 

minute, gradually increasing the rate to about fifteen 
times a minute. 1 If natural breathing be not restored, 
after three or four minutes, turn the patient over on his 




Fig. 121. 
Artificial Respiration — Government Method. 

face, with a roll of clothing under the stomach, and press 
firmly for a half minute on his back ; then turn him over 
on his back and renew artificial respiration. 



1 Method of Dr. Howard, advised by the United States Life Saving 
Service. It requires two operators. Both in this method and in that 
advised by the Michigan State Board of Health, assistants are necessary 
to restore heat. etc. 



EMERGENCIES. 389 

3. After Treatment. After the person breathes, carry 
him promptly to a house, or under cover, and if possible 
put him in bed. See that he is thoroughly dry and warm, 
using friction, blankets, and hot applications, as already 
indicated. If warmth is not readily established by these 
means, a warm bath may be given, the body being im- 
mersed to the neck for not more than four or five minutes. 

When the patient is able to swallow, slowly admin- 
ister sips of hot coffee, hot water and brand}^, or aro- 
matic spirits of ammonia and water. Keep him quiet and 
warm in bed, in a well-ventilated room, for forty-eight 
hours or more, if necessary, and encourage sleep. Some- 
times, even after he seems on the road to recovery, dis- 
tressed breathing will occur, from a secondary congestion 
of the weakened lungs, brought on by excitement or by 
moving about too much. Large mustard plasters ap- 
plied to the chest will help to relieve this condition. If 
this fails, the desired end may be gained by carefully 
repeating the artificial breathing, or by slapping the chest 
with a towel wet in cold water, or by holding ammonia 
to the nostrils. 

Various Injuries. 

414. Burns and Scalds. — Burns are caused by contact of 
the body witli fire, heated substances, or chemical agents ; 
scalds, by contact with steam or boiling liquids. The 
danger in either case is from shock, and from inflamma- 
tion of internal organs. It increases, generally, in pro- 
portion to the nearness to the vital organs, the amount 
of surface injured, and the destruction of the underlying 
tissues. 

If you see a person on fire, act promptly. Pick up 
the nearest rug, shawl, table-cover, overcoat, or slip of 



390 EMERGENCIES. 

carpet. Hold it before you to protect yourself, as you 
wrap it around the burning part, keeping the names as 
much as possible from the face of the sufferer, so as to 
prevent the entrance of overheated air into the lungs. If 
necessary, throw the burning person to the ground and roll 
him over and over in blankets, carpets, or other woollen 
materials, and extinguish burning material with water. 1 

Treatment. 1. Remove the clothing about the injured 
parts, as far as possible, by cutting, being careful not to 
tear blisters open. Soften by water all adherent pieces of 
clothing. Cover the burned or scalded places with strips 
of soft linen or cotton cloth (not with cotton batting, for 
it adheres too closely, and is too heating), saturated in a 
mixture of carbolic acid, glycerine, and olive oil, one tea- 
spoonful of the first mixed with the same amount of gly- 
cerine, and then well shaken together with one pint of oil, 2 
or saturated in carbolized vaseline, or in a strong solution 
of bicarbonate of soda. Lacking these, the spots may be 
covered with cream, dampened starch, or any substance 
that will exclude the air. When blisters form, their 
contents may be removed by slight punctures of a 
sharp needle. 

2. In severe cases there is more or less shock, and it 
may be necessary to suspend local measures, and revive 

1 Kindling fires with kerosene oil, filling lamps when they are lighted, 
running or moving quickly while one's clothes are on fire, and working 
about open fires in loose cotton dresses, are all sources of danger. 

2 This mixture is much cleaner than many of the burn mixtures, and 
quiets pain. It should be kept on hand in houses and factories. In case 
olive oil cannot be obtained, similar oils will answer. Strips of cloth 
are to be preferred to large pieces, as they can be more readily removed. 
In burns from an acid, apply first lime-water or a solution of baking 
soda; if from an alkali, — as lye, — apply vinegar and water, one part 
vinegar to four parts water. 



EMERGENCIES. 391 

the patient by stimulants, as before directed in cases of 
shock. 

3. Do not remove the dressings unless cleanliness de- 
mands it. When you do, use great gentleness, that you 
may not injure newly formed skin. Oily dressings should, 
from time to time, have fresh oil applied over them, and 
it is well to spray liquid dressings with a mixture of car- 
bolic acid, one teaspoonful to one-half pint of water. 

4. Troublesome, contracting scars, producing deformi- 
ties, sometimes follow burns. Especially is this the 
case at the bend of a joint, or where the skin is loose, 
as about the eyes, mouth, and neck. In short, there is 
great responsibility involved in the care of burns and 
scalds, and no person should attempt their continued 
treatment, when a physician can be obtained. 

415. Frost Bite. — This results from exposure to severe 
cold. The affected part, through reduced vitality, becomes 
bluish or white. Sometimes exposure to cold winds or a 
severe snowstorm will gradually produce a congestion of 
internal organs and a tendency to sleep, which, if indulged, 
especially in the open air, may result in death. 

Treatment. To bring about reaction, place the person 
in a room without fire, and gradually rub the chilled or 
frozen parts with ice, snow, or cold water. Stimulants 
may be necessary. When the parts begin to redden and 
sting, or become painful, stop active treatment, for reac- 
tion has commenced, and care is necessary (by rest, 
sleep, and gradually increasing warmth) lest the returning 
circulation in the skin become too active, and so cause 
inflammation. 

416. Fractures and Dislocations. — The signs o( a fractured 

or broken bone are, generally, more or less change in the 



392 EMERGENCIES, 

shape and natural appearance of the injured part, pain 
and inability to move the part readily, tenderness and 
unnatural mobility at the point of injury, and a grating 
sound when the broken ends of the bone are gently rubbed 
against each other. The symptoms of dislocation, or bones 
out of joint, are, in general, a more marked deformity and 
more impaired motion than in the case of a fracture. 

Treatment. There is generally but little urgency in the 
treatment of a broken limb. The common impression 
that a broken bone must be set immediately is erroneous, 
and tends to induce much handling of the injured parts. 
This is always dangerous, as jagged ends of bones may 
be made to injure the soft tissues. Put the patient in as 
comfortable a position as possible, pending the arrival of the 
surgeon. Support the affected part by pillows, blankets, 
shawls, or coats, so as to prevent the painful twitchings 
of the injured muscles, and to preserve, as nearly as pos- 
sible, its natural shape. In case of fracture of the collar 
bone, place the forearm in a sling, improvised from a 
long towel or any piece of cloth, putting a soft pad in 
the armpit of the affected side ; let the patient lie on 
his back, with a small pillow between his shoulders. 
If the patient is to be moved, steady the affected arm by 
a bandage over it and around the body. A broken arm 
is made most comfortable by placing it in a semi-flexed 
position upon a pillow; a broken leg, by gently extend- 
ing it to its full length and supporting it by pads on 
both sides. With a broken knee cap, the leg should be 
elevated on an inclined plane, with a ngure-of-8 bandage 
about the knee. If one or more of the ribs are broken, 
apply a bandage firmly around the chest, to prevent mo- 
tion, so far as possible. When a jaw-bone is broken, hold 
the parts in proper place by a bandage about the head. 



EMERGENCIES. 393 

When the patient is to be removed, the necessary addi- 
tional support to the broken bones may be obtained by 
binding on softly padded " splints/' that is, shingles, pieces 
of leather, sticks, or anything that can serve to hold the 
bones quiet and, as nearly as possible, in normal position. 
The setting of a bone should be done by a surgeon. 
When once the injured parts are adjusted, they should 
not be disturbed. 1 

In a case of dislocation, the bystanders should merely 
make the sufferer as comfortable as possible. The reduc- 
tion of a dislocation should never be' attempted by a 
layman, if a surgeon can be obtained. 

417. Sprains 2 are bruised or torn ligaments, cartilages, 
muscles, and nerves about the joints, and are serious in- 
juries. 

Treatment. After such an injury, though apparently 
slight, rest is necessary, and this may be temporarily 
obtained by firmly, but gently, wrapping the part in 
cloths or bandages dipped in hot or cold water, as the 
feelings of the person may indicate and the surround- 



1 The process of repair in broken bones is similar to that witnessed in 
the healing of wounds of the soft parts. New, delicate material is abun- 
dantly deposited between and about the ends of the broken pieces. This 
gradually hardens to the consistency of bone, in the meantime decreasing 
in size, so that very little deformity results if the broken bones have boon 
kept well in place. The best surgeons are at times unable to prevent 
deformities, owing to the impossibility, in certain instances, of securing the 
proper apposition and retention of the broken parts. An unprofessional 
person should not attempt to set a broken bone, if a surgeon can possibly 
be procured. 

2 The terms sprain and strain essentially apply to the same conditions, 
though strain is sometimes used as meaning merely the result of stretch- 
ing of muscles. 



394 EMERGENCIES, 

ings admit. The surgeon may ultimately apply a proper 
splint. 

418. Contusions or Bruises result from falls, blows, or 
pressure, and, if severe, are attended by shock, broken 
blood-vessels, and crushed muscles and other tissues. 
Black and blue spots, which result from the oozing of 
blood from injured blood-vessels, are largest where the 
tissues are lax and contain little fat, such as the connec- 
tive tissue under the skin of the scalp and eyelids. They 
usually disappear after a few hours or days. 

Treatment. Rest, relief from shock, the elevation of 
the bruised part so as to retard the flow of blood into it, 
and the application of cloths wet with hot or cold water. 1 

419. Wounds are generally classified as follows: — 
Incised wounds (i.e. cuts or incisions of various depths, 

made generally by sharp instruments), punctured wounds 
(such as stabs, and pricks made by splinters, thorns, or 
needles), and poisoned wounds (such as the bites of snakes, 
spiders, or rabid dogs). If the wounded part is very 
much bruised, the wound is called a contused wound. If 
the skin and tissues beneath are much torn, it is a lacerated 
wound. 

Wounds may be attended by more or less hemorrhage, 
by pain, and b}^ the presence of dead or foreign matter, 
viz., fibres of cloth, dirt, or coagulated blood. 



1 Hot water hastens most quickly the disappearance of black and blue 
spots, but cold water is also of value. Cloths may be wet in alcohol and 
water, equal parts, or in equal parts of alcohol, vinegar, and water, or in 
water to which has been added one-sixth part of tincture of arnica or 
extract of witch hazel. Water dressings, if continued too long, lower the 
vitality of the part, and should be replaced by a firm flannel bandage. 



EMERGENCIES. 395 

Treatment. Ascertain the source and amount of the 
bleeding, and do not be alarmed by the amount of the 
clothing stained, for a small amount of blood will often 
make a large stain, and yet the source of the bleeding may 
frequently be controlled with ease. 1 When the wound is 
located, the kind of hemorrhage will be apparent. If a 
large artery has been cut across, the blood spirts. If, 
from spontaneous coagulation, the blood has ceased to 
flow, it may be well not to disturb the condition of things, 
until removal of the patient to a better location ; but 
remember that in the removal, if the person is jarred much, 
bleeding may recur, and will need to be checked. To stop 
external bleeding, pressure is of the first importance, then 
applications of ice, hot water, tannin, or alum. If the bleed- 
ing is comparatively slight, or occurs in places where 
the bones are near the surface, as in the scalp and face, 
pressure may be applied to the wound by the fingers, or by 
a pad held firmly in place by a bandage. If severe, and 
especially if from an artery, pressure must be applied 
between the wound and heart, by means of a pad bound 
over the main artery. In the case of a limb, it should be 
elevated, and the artery should be pressed upon above 
the wound, by a knot in a suspender or piece of cloth, 
which is first tied about the limb and then twisted by 

1 A surgeon relates the following: "Was called one night to see a 
woman, reported to be bleeding to death. Found her in a close room, 
sitting in a chair, with blood-stained carpet about her, ami. wrapped 
around one of her legs, a sheet soaked in blood. Tearing this oft', 1 
found a little stream of blood trickling from a small opening in a blood- 
vessel, between the knee and the ankle. Pressure with the finger 
readily controlled the bleeding tor the time, and a properly applied 
bandage accomplished the end afterward. Much anxiety, loss o\ blood, 
and injury to carpet might have been saved by a little coolness and 
knowledge." 



396 EMERGENCIES. 

means of a stick until the bleeding ceases. 1 This is 
called a tourniquet. 

When the bleeding is controlled, carefully remove dirt 
or other foreign matter, and replace any organ which may 
protrude. Wash the wound and the parts about it with 
carbolic acid and water (one teaspoonful to a pint), con- 
taining a little glycerine, or with hot water, or with com- 
mon salt and water, one tablespoonful of salt to a pint of 
water. The operator's hands should be cleansed previously 
with hot water and soap. These antiseptic precautions 
insure cleanliness and ward off dangers from bacteria. 

After cleansing, dry the wound gently, and, if it is an 
incised one, bring its edges together by strips of surgeons' 
adhesive plaster, parallel to each other, and from one- 
half to one-fourth of an inch apart. Never cover the 
entire wound with plaster, as some exit must be allowed 
for any oozing that may occur. The tourniquet may 
now be removed, if the proceeding be not attended with 
renewed bleeding, and a pad and bandage of clean, dry cloth 
or of antiseptic gauze applied, to assist in keeping the strips 
of plaster in position and to prevent secondary bleeding. 

If the wound is jagged and torn, so that the edges 
cannot be brought together, replace the parts as nearly as 
possible in their normal position. If there is a tendency 
to bleeding, apply firmly clean cloths wet with carbolized 
hot or cold water; if there is no such tendency, cleanse 
the wound, and apply dry dressing 2 with pressure. 



1 The main artery of the arm runs along the inner edge of the promi- 
nent muscle which stands out when the arm is strongly bent ; of the thigh, 
along its inner middle line. These arteries and other principal ones are 
outlined in Fig. 62. 

2 Dressings do not need to he removed for several days, unless they 
become foul. 



EMERGENCIES. 397 

420. Punctured Wounds are usually considered most 
dangerous, on account of the bruising which generally 
accompanies them, the injury to the deeper tissues, and 
the character of the sources of injury, — rusty nails, 
pieces of shell, needles, splinters of wood, etc. If in the 
sole of the foot or the palm of the hand, they may cause 
lockjaw, and are sometimes followed by erysipelas and 
other forms of inflammation ; whereas, the principal 
danger from an incised wound is hemorrhage. 

Treatment. If the sources of the injury are still in the 
wound, remove them. Thorns, needles, splinters, etc., 
should not be left in the body, with the idea that they 
will work their way out. Poking at them, however, as 
in the case of splinters, adds to the irritation already set 
up. If a splinter is under the finger or toe nail, and can- 
not be pulled out, scrape the nail thin over the splinter, 
until it can be easily cut and the splinter seized ; or make 
an incision on each side of the foreign body, and remove 
the tongue of nail between. The skin and tissues of the 
palm and the sole are so firm and dense that imprisoned 
matters cannot easily find exit, and lockjaw may result. 
It is important, therefore, that an incision should be made 
over the foreign substances, so as to reach them easily 
and to allow a free exit for blood, etc. The removal of 
needles, unless they are near the surface, had better not be 
attempted by others than surgeons, as on being touched 
they readily slip between the fibres of muscles and connec- 
tive tissues. If there is a tendency to such slipping, or 
if the needle seems deeply buried, hold the part still till 
the surgeon comes. 

When a fish-hook enters a part, and does not go through, 
push the point through it' possible, and then cut the barb 
off and withdraw the remnant. It' the barb cannot bo 



398 EMERGENCIES. 

pushed through, cut down upon the hook and remove it. 
In these wounds, carbolized water dressings (one tea- 
spoonful to a pint of water) are best. Pain mar be re- 
lieved by the addition of laudanum (one tablespoonful to 
a pint of water). 

Poisoned Wounds will be considered under the head of 
poisons, p. 411. 

421. Special Hemorrhages. — Of these, the most common 

and the least dangerous is bleeding from the nose. This 
results from falls, blows, or disease, or may be an effort 
of nature to relieve internal congestion. Often it is pre- 
ceded by a feeling of weight, pain, and fulness about the 
forehead. 

Treatment. Ascertain if the blood escapes from one or 
both nostrils, then raise the arm on the affected side above 
the head, compress the nostrils, and apply cold to the 
forehead or back of the neck. Frequently it is sufficient 
if the patient remains quietly in a sitting posture. If the 
bleeding continues and the perjon is faint, inject into the 
affected nostril a syringeful of ice- water or solution of 
common salt, or a weak solution of alum, or blow in some 
tannin. The nostrils may be plugged by cotton dipped 
in one of the above solutions. If blood still forces itself 
into the throat, and so out of the mouth, the case should 
be put in charge of a physician. In all forms of hemor- 
rhage, the patient must be kept quiet in a cool room, and, 
when faint from severe bleeding, in a recumbent posture, 
with the head lower than the body. Bleeding in the mouth 
may be relieved by pressure, or by one of the above styp- 
tics. Blood coming from the stomach is usually dark in 
color, and mingled with food. From the lungs, the blood, 
is bright red and frothy, mixed with bubbles of air, and 



EMERGENCIES. 399 

is generally accompanied by a cough. For relief, try 
quiet, a recumbent posture, ice and styptics internally, in 
small quantities, so as not to induce vomiting ; cold may 
be applied over the region of the stomach. Bleeding 
from the gum, after the extraction of a tooth, is sometimes 
alarming ; but continued pressure in the socket with the 
tip of the finger, or a piece of sponge, or a plug of wood 
held firmly in place by the jaws, is ordinarily sufficient. 
When pressure, cold, and ordinary styptics will not con- 
trol hemorrhage, touching the bleeding spot with a red-hot 
knitting-needle is of service. 

422. Foreign Bodies. — Pieces of bone, meat or other 
food, pins, false teeth, etc., sometimes lodge in the 
larynx, causing great difficulty in swallowing and breath- 
ing, and give rise to the feeling and danger of suffocation. 

Treatment. A sharp blow upon the back, if given im- 
mediately after the accident has occurred, will sometimes 
assist the patient to eject the foreign body. If it fails, 
invert the patient, and move him from side to side, while 
some one strikes him between the shoulders with the open 
hand; or lay him ou chairs, bed, or table, with the head 
and upper part of the chest hanging over, and make sud- 
den pressure on the back when he breathes out. If this 
fails, and the foreign body cannot be dislodged by the 
finger introduced into the mouth, the surgeon is needed. 

Little children sometimes put peas, beans, shoe-buttons, 
pins, etc., into the nose or ears. Insects also enter 
these places. Small bodies may be removed from the ear 
by syringing with tepid water, the nozzle of the syringe 
being placed against the Tipper wall o( the ear canal, 
and the auricle pulled upward and backward. Larger 
bodies may be gently scooped out by a bent probe or 



400 EMERGENCIES. 

the rounded end of a hair-pin, care being taken not to 
injure the drum membrane. Insects may be washed out, 
after being smothered with salt water or oil. If the for- 
eign body is in the nose, close both nostrils, take a full 
breath through the mouth, and then breathe out suddenly 
and forcibly through the affected nostril. Sometimes 
sneezing, induced by snuff, will dislodge it. 

Foreign bodies in the eye, if not removed promptly, 
cause serious inflammation. Never rub the eye to dislodge 
them ; gently use a moist camel's-hair brush, or a piece of 
wet cotton wrapped around a very small, smooth piece of 
wood. Particles of steel or iron may be removed by a 
magnet. Sometimes it is difficult to see a minute particle, 
unless a bright light falls directly upon the eye. The best 
position for the operator is to stand behind the chair of 
the patient, or a little to one side, steady the affected eye, 
and keep the lids open with the fingers of the left hand ; 
or, sitting in front of the patient, turn the upper lid 
gently backward, over a lead-pencil, penholder, or firm 
toothpick. The lower lid is readily everted. A magni- 
fying glass is of service, in detecting whether a supposed 
particle is one in reality, or merely a stain from a piece 
of metal, or a natural discoloration. Eyestones are some- 
times used to dislodge particles from under the eyelids ; 
but it is much better for the patient to take hold of the 
lashes of the upper lid, raise it from the eyeball, and then 
move it firmly but gently over the loAver lid toward the 
inner corner of the eye. The inflamed condition of the eye, 
after a foreign body has been in it, is generally relieved by 
a drop of olive oil or castor oil upon the eye, or by a gentle 
bathing with hot water. Poultices or patented eye-washes 
should not be used. If the foreign matter is lime, bathe 
the eye with a weak solution of vinegar and water. 



EMERGENCIES. 401 



Poisons. 



423. Poisons may be classified as irritant, narcotic, and 
acro-narcotic. The first act locally, upon the skin, air 
passages, lungs, and alimentary canal. They cause pain 
and inflammation, and may produce vomiting, or difficulty 
in breathing or in swallowing. Substances whose local 
action is very destructive are called corrosive poisons. 
Irritant poisons include metallic poisons, such as copper 
and mercury ; irritating gases ; and vegetable and animal 
substances, such as cantharides, decayed meat, and poison- 
ous fish. The corrosive group comprises the strong acids, 
such as sulphuric, nitric, muriatic, and oxalic ; and alka- 
lies, such as potash and ammonia, acid and alkaline salts, 
and corrosive sublimate. 

Narcotic poisons act remotely, i.e. through the blood and 
nervous system, and produce delirium, convulsions, stupor, 
or marked prostration. They include such substances as 
opium, chloral, alcohol, belladonna, and aconite. Acro- 
narcotic poisons act both locally and remotely. They 
include pinkroot, ergot, lobelia, etc., and the poisons in 
venomous bites and stings and virulent wounds. 1 

Symptoms. Usually we suspect poisoning if a person is 
taken suddenly and violently ill, especially if there is great 



1 A popular idea is that a poison is a substance which, taken in small 
amount, will destroy life. The fact is, there are varying degrees of sus- 
ceptibility to the action of a poisonous substance, and by the habitual use 
of a substance large doses may often be taken with impunity. Some 
persons are so susceptible that they cannot take even the most minute 
dose of calomel without a resulting sore mouth, or of belladonna, without 
its producing a dry throat and dilated pupils. Of the lower animals, 
hogs, it is said, can eat henbane with impunity ; pheasants, stramonium ; 
goats, tobacco and water hemlock. 



402 EMERGENCIES. 

pain and repeated or severe retching or vomiting, and if it is 
known that the person has recently taken food or drink. 1 It 
sometimes happens that severe colic from undigested food, 
an attack of cholera morbus, the pain and distress refer- 
able to heart disease, or the stupor due to apoplexy are 
mistaken by the ignorant for symptoms of poisoning, and 
the patient is roughly and wrongly dealt with. To ascer- 
tain whether a person has been poisoned, carefully examine 
the mouth, lips, and breath ; search the clothing and the 
room in which the poison is supposed to be. A person 
who has taken poison with intent to kill is likely to 
prevaricate and destroy the evidence of the poison used. 
Spasms, with more or less unconsciousness, indicate 
strychnine ; quiet, deep sleep, from which a person is not 
easily aroused, and strongly contracted pupils indicate 
opium ; stupor, with salivation, indicates mercury; inflam- 
mation of the mouth, severe pain, retching, and vomit- 
ing indicate arsenic or other corrosive poison ; delirium 
indicates belladonna, stramonium, or hyoscyamus; unusual 
excitement, with occasional stupor, indicates alcohol or 
Indian hemp ; loss of muscular power, feeble pulse, great 
prostration, paleness, and coldness of the skin indicate 
tobacco, aconite, or digitalis ; bloated and livid face, 

1 Poison may do its work slowly, if taken in small amount and 
repeatedly, and the patient may be thought to have a chronic dis- 
ease. Such poisons are called cumulative. Lead and arsenic are ex- 
amples. 

Drugs and medicines containing poisonous ingredients, as chloroform, 
opium, belladonna, fusel oil, etc., should not be left within the rea,ch of 
little children or others likely to use them recklessly or without cause. 
Such things should be in bottles of a peculiar shape, and with peculiar 
colored labels. There is a great danger (which is constantly increasing) 
in the indiscriminate use of powerful medicines without the advice of a 
physician. 



EMERGENCIES. 403 

limbs contracted, and head thrown back indicate the 
suffocative gases. 1 

Treatment. In most cases of poisoning, we are to en- 
deavor : 1. To get the poison out of the body, by 
encouraging vomiting. 2. To neutralize, or render inert, 
by means of antidotes, what cannot be removed. These 
act mechanically, chemically, and by reason of their 
physiological properties. 3. To combat any dangerous 
symptoms that have arisen, and to obviate their effects 
by means of stimulants, artificial respiration, and by 
exciting the action of the skin, kidneys, and bowels. 

First, to remove the poison as quickly as possible from 
the body, emetics should be given. Give at least every fif- 
teen minutes, until vomiting is produced, copious draughts 
of warm water or other drinks, or one pint of warm water 
with a teaspoonful of mustard, 2 well stirred in. Tickling 
the throat with a feather assists the act of vomiting. If 
the person will not swallow readily, close the nostrils with 
the thumb and finger, while the emetic is given. If neces- 
sary, pry the mouth open, depressing the tongue with the 
handle of a strong spoon, a clothespin, or a stick. By press- 
ing on the jaws at their joints, the mouth will be forced 
open. 

Second, to neutralize or render inert what cannot be 
removed, antidotes should be given. Examples of chemical 
neutralizing substances are weak acids (lemon juice or 
diluted vinegar), to be used when the poisons are such 

1 Alcoholics may hide the common symptoms of poisoning. The 
profound sleep of some intoxicated persons resembles closely the sloop 
produced by opium. 

2 The mustard should be thoroughly mixed with the water, lost some 
of it may cling to the lining ol the stomach and excite Inflammation. 
The stomach pump should be used by physicians only. 



404 EMERGENCIES. 

alkalies as lime, potash, etc. ; and, on the other hand, 
alkalies, such as lime-water, weak soda-water, and soap- 
suds, to neutralize acid poisoning. Common salt, with 
milk and the white of an egg, should be opposed to nitrate 
of silver, verdigris, and corrosive sublimate. A fresh 
preparation of iron, formed by precipitating tincture of 
chloride of iron with a larger amount of ammonia, is an 
antidote for arsenic and metallic poisons generally. Bel- 
ladonna is an example of a physiological antidote. It 
dilates the pupil of the eye, in opposition to opium, which 
contracts it. Coffee is a valuable physiological antidote 
to opium, its tendency being to excite, and to overcome 
stupefaction. Mechanical antidotes, i.e. such as allay 
irritation, are olive oil, milk, flour and water (in a thin 
paste), chalk mixtures, castor oil, mucilage, flaxseed tea, 
the white of egg and water, and, in case of strychnine 
poisoning, charcoal mingled with water. They serve to 
coat over the irritated mucous membrane, and thus pro- 
tect it. 

Specific Poisons, 
irritant and corrosive poisons. 

424. If the poison taken is knoivn to be a corrosive one. 
omit emetics, and give antidotes immediately. 

1. Acids. —Sulphuric (oil of vitriol), nitric (aqua fortis), 
hydrochloric or muriatic, oxalic, carbolic, 1 acetic, etc. The 
first three of the above are much used in certain factories, 
photographing establishments, etc., and are sometimes left 
carelessly about. Oxalic acid (frequently used to polish 

1 Carbolic acid, so called, is not properly an acid. 



EMERGENCIES. 405 

kitchen boilers) is sometimes taken by mistake for Epsom 
salts, which it resembles in appearance. 

Antidotes. Baking soda, borax, chalk, magnesia, wall 
plaster, or saleratus, mixed with water; lime-water; soap- 
suds; oil in large amount; followed by mucilaginous drinks, 
and stimulants, if necessary. When sulphuric acid has 
been taken, it should be quickly diluted by a free use of 
ice water. 

2. Alkalies and their Salts. — Soda; ammonia (water of 
ammonia, muriate of ammonia, or sal ammoniac); potassa 
(caustic potash in sticks and lumps) has been mistaken 
by children for candy; lye; liquor potassae, a clear, liquid 
medicine; pearlash, or carbonate of potash; nitrate of potash, 
or saltpetre, used in corning beef, has been mistaken for 
purgative salts ; chlorate of potash, a common remedy for 
sore throat, has been used unwittingly in large and poi- 
sonous doses ; binoxalate of potash has been taken by 
mistake for cream of tartar. 

Antidotes. Vegetable acids, such as vinegar, lemon 
juice, citric and tartaric acid in solution ; fixed oils, — 
castor, linseed, olive, cod-liver, machine, — which form soaps 
and so prevent caustic effects; mucilaginous drinks, es- 
pecially when saltpetre has been taken. 

3. Metallic Substances. — Antimony. In tartar emetic 
and wine of antimony ; an ingredient of pewter, Britan- 
nia, and type metal; oxide of antimony. 

Antidotes. Assist the distressing vomiting by draughts 
of tepid water, flaxseed tea, or sugar water; give a cup of 
strong, green tea. 

Arsenic. An ingredient of paris green (used to destroy 
insects among plants); of orpiment, a yellow paint: of real- 



406 EMERGENCIES. 

gar, a red paint; of arsenite of copper, or Scheele's green; 
used in some brightly colored artificial flowers, wall papers, 
candy boxes, and kindergarten papers; in fly powders, rat 
pastes; in the stuffing of birds; by enamellers; and in 
a number of medicinal preparations. Arsenic, as ordina- 
rily obtained in the shops, is a fine, white powder, and 
may be mistaken for sugar or some equally harmless sub- 
stance. 

Antidotes. Freshly prepared oxide of iron (to be ob- 
tained at a drug store); give one teaspoonful every few 
minutes. Dialyzed iron, moistened charcoal, plaster, and 
calcined magnesia are other antidotes. Encourage vomit- 
ing. Allay irritation. 

Copper. Found in some cooking utensils; in the alloys, 
bronze, brass, bell metal, german silver, etc. ; in sulphate 
of copper, or blue vitriol; in acetate of copper, or verdi- 
gris. Poisoning has occurred from pickles made green by 
copper ; from the use of colored confectionery ; from the 
wrappers of farinaceous foods; from inferior filling for 
the teeth ; and, in the workshops of some trades, from 
copper dust. 

Antidotes. Milk; white of eggs; a quarter-teaspoonful 
of baking soda in water, every five minutes for half an 
hour. Allay irritation. 

Iodine. Ordinary tincture of iodine; in some liniments. 
Antidotes. Boiled starch and water ; boiled or baked 
potatoes. 

Iron. Copperas, green vitriol, or sulphate of iron, used 
in lotions and as a disinfectant. 

Antidotes. Baking soda and mucilaginous drinks. 



EMERGENCIES. 407 

Lead. In the acetate or sugar of lead, often used as an 
application to sores or as an eye-wash 1 ; in white lead 
and red oxide used by painters ; in some hair-dyes ; in 
water kept in leaden vessels or pipes ; in wines sweetened 
by lead ; in tin foil covering of tobacco and farinaceous 
foods ; in pickle jars with metal tops ; in newly painted 
rooms. It sometimes poisons the makers and users of 
glazed cards, japan ware, cosmetics, lead type, or tin spoons. 

Antidotes. Strong solution of Epsom or Glauber's salts, 
or emetics. 

Mercury. Bichloride of mercury, or corrosive sublimate, 
used in solution as a medicine, as an ingredient of lotions, 
and for the destruction of vermin ; in red oxide, or red 
precipitate, and the white precipitate upon looking- 
glasses ; in the preservation of stuffed birds and animals. 
It is corrosive. 

Antidotes. White of eggs ; flour beaten up with milk 
and water. 

Phosphorus. An ingredient of many rat poisons. Chil- 
dren have been poisoned by eating these, and by sucking 
matches. The vapor in match factories is a source of 
poison. 

Antidotes. Large quantities of magnesia or chalk in 
water; plaster; milk of magnesia; white of eggs. Avoid 
fatty substances. 

Silver. Lunar caustic or nitrate of silver, an ingredient 
of hair-dyes ; used in solution as a lotion : some forms used 
in photography and the trades. 

1 Eye-washes containing lead are apt to cause opacity of the eye, 



408 EMERGENCIES. 

Antidotes. One to two teaspoonfuls of salt in a tumbler 
of water decomposes the poison and arrests its activity. 
Allay irritation. 

Tin. In some dyeing substances ; in poor cans for the 
preservation of food. 

Antidotes. See "Copper,'' p. 406. 

Zinc. Sulphate of zinc or white vitriol, used in lotions; 
chloride of zinc in disinfectants. 

Antidotes. Bicarbonate of soda in water ; milk and 
white of eggs. Vomiting relieved by copious draughts of 
warm water. 

4. Gases. — Chlorine, a suffocative gas, used in trades 
and chemical experiments ; carbonic oxide (stove gas), 
from incomplete combustion in stoves and furnaces ; car- 
bon dioxide (choke damp), in deep wells, cisterns, vats, 
closed cellars, mines, sewers, etc. ; sulphuretted hydrogen 
(odor of decaying eggs), a subtle poison, found wherever 
there is putrefaction, in cesspools, sewers, and outhouses ; 
illuminating gas, etc. 

Antidotes. Fresh, pure air ; dashes of cold water upon 
the face ; inhalation of vapor of ammonia ; artificial 
respiration. 

5. Animal and Vegetable Poisons. — Poisonous fish: conger- 
eel, bladder fish, gray snapper, etc. ; some shell-fish. 

Antidotes. Emetics; emollients; strong purgatives; stim- 
ulants. 

Croton oil, a violent purgative, also used in liniments, 
may be mistaken for a harmless oil ; poke berries ; oil of 
tansy; beans of castor -oil plant ; wild parsnip ; oleander; 



EMERGENCIES. 409 

marsh marigold ; cantharides, or Spanish Fly ; colchicum, 
used frequently in rheumatic medicines, etc. 

Antidotes. After vomiting, give strong coffee, or vinegar 
and water ; mucilaginous drinks ; stimulants. 



NARCOTIC POISONS. 

425. Opium, in laudanum, paregoric, cordials, powders, 
many liniments, soothing syrups, cholera mixtures, etc., is 
a particularly active poison in the very young and the old. 

Antidotes. Strong coffee ; aromatic spirits of ammonia 
(fifteen drops every fifteen minutes till the patient re- 
covers) ; electricity ; cold douches ; slapping of the surface 
by hands or wet towels. Keep the patient -moving if in- 
clined to sleep, and, if possible, in the open air. 

Belladonna (deadly nightshade) in ointments, liniments, 
and lotions. Its active principle, atropia, is used in 
solution by oculists as an application to the eye. The 
leaves and berries of the plant are sometimes eaten by 
children. 

Antidotes. Cold douches ; brandy ; paregoric, fifteen 
drops, or laudanum, five drops, with care, every quarter 
of an hour, with large doses of lime-water; electricity. 

Hemlock. — Five varieties are said to be poisonous, and 
all parts of the plant. The roots of the water hemlock are 
sometimes mistaken for parsnips. One variety (fool's 
parsley) is sometimes mistaken for ordinary parsley. The 
hemlock is common, and grows in hedges and wild places. 

Antidotes. Aromatic spirits of ammonia. If much pain 
and vomiting, ten grains of bromide o( potassium every 
half -hour, or hour, as the case demands. 



410 EMERGENCIES. 

Stramonium (thorn-apple, Jimson or Jamestown weed). 
— Found along roadsides, and near fences in out-of-the- 
way places. Blossoms, capsules, and seeds are poisonous, 
if eaten. 

Antidotes. Same as for Belladonna, p. 409. 

Strychnine, as sold in the shops, is a white powder ; bought 
frequently to poison animals ; is an ingredient of tincture 
of mix vomica. 

Antidotes. Chloroform, or ether, inhaled to relieve spasm ; 
cold douches ; aromatic ammonia ; camphor spirits ; bro- 
mide of sodium, five grains every half hour ; rectal injec- 
tion of an infusion of tobacco ; artificial respiration. 

Prussic Acid. — Hydrocyanic acid, used in a dilute form, 
medicinally; cyanide of potassium, used to kill moths, 
butterflies, etc. ; in laurel water ; the meat of peach, cherry, 
plum, and almond pits, if freely eaten. 

Antidotes. See " Gases," page 408. 

Chloroform and Chloral, both too often used indiscrimi- 
nately and recklessly by people at large. 

Antidotes. Slapping of body, cold douches, stimulants, 
electricity, artificial respiration. 

Digitalis (foxglove), a garden plant. Its extract used 
medicinally. 

Antidotes. Same as for Belladonna, p. 409. 

Hyoscyamus (henbane), used medicinally. 
Antidotes. Same as for Belladonna, p. 409. 

Alcohol, used repeatedly, even in the so-called moderate 
amount, is sometimes a slow poison. In larger amount, 
especially in the young or feeble, it has caused acute 



EMERGENCIES. 411 

poisoning, and even death. Wood spirits, i.e. wood alco- 
hol, used as a solvent of gum, and sometimes in liniments, 
is more poisonous, if taken internally, than ordinary 
alcohol. 

Antidotes. In acute poisoning, emetics, cold douches, 
coffee, aromatic spirits of ammonia, and slapping the soles 
of the feet. 

ACRO-NARCOTIC POISONS. 

426. Venomous Bites and Stings. — Treatment. In case 
of snake bite, or that of an animal supposed to be mad, 
tie a string or handkerchief tightly about the limb just 
above the bite ; then suck the wound, or encourage the 
blood to flow by means of a cupping-glass. Wash out the 
wound with warm water and rub thoroughly into it a 
piece of nitrate of silver, or paint it with undiluted car- 
bolic acid, or press into it, for a moment, the end of a red- 
hot knitting-needle. When poisoned by a snake, use alco- 
holic stimulants freely. Sometimes the bite of a human 
being is very dangerous. 

When stung by bees, wasps, scorpions, etc., extract the 
" stinger " by fingers, small forceps, or pressing about it 
with the barrel end of a watch key ; then apply spirits of 
ammonia, saleratus water, or mud. 

Poisoned Wounds ; Infectious Diseases. — The contact of 
the skin (especially if it is broken) with decomposing 
substances, poisonous cards, utensils, etc., or o( the 
mucous membrane with matter secreted from diseased 
surfaces, has produced diseases from which persons have 
died. 

Treatment : Stimulants internally, and mild applications 
externally, till the doctor comes. 



412 EMERGENCIES. 

POISONOUS PLANTS, i 

427. Fatal cases of poisoning are usually among children, 
in the spring of the year, when they search for green things, 
and too frequently " dare " each other to eat of plants they 
find. Conium is mistaken for sweet cicely, poke roots for 
artichokes, blue flag for sweet flag, kalmia leaves for 
wintergreen, and hellebore for marsh marigold. Children 
should be taught the difference between poisonous and 
non-poisonous plants. 

Water Hemlock. 2 — Every part is poisonous, if eaten, 
especially the root ; grows in lowlands, and resembles 
parsley. 

Poison Hemlock (Conium). — Seeds mistaken for anise ; 
root poisonous if eaten, especially in late spring. 

Black Nightshade. — Clusters of white flowers, followed 
by black, round berries ; should not be eaten ; neither 
should the red berries of the bitter-siveet. 

Coke, or Scoke. — The root is poisonous, if eaten. 

The Lobelias are poisonous; viz., the cardinal flower with 
tall spike of red flowers, the large lobelia with blue blos- 
soms, and Indian tobacco. 



1 Most of these act both as irritants and narcotics, but the narcotic 
effect depends largely on the amount absorbed by the skin or mucous 
membrane. 

For stramonium, hemlock, and belladonna, see narcotic poisons. 

2 Cowbane, spotted parsley, muskrat weed, beaver poison, and wild 
parsnip are common names for water hemlock. 



EMERGENCIES. 413 

Toadstools. — Three varieties are particularly poisonous. 
Sometimes mistaken for edible mushrooms. 

Mushrooms. — Poisonous mushrooms, according to Chris- 
tison, are recognized by their dark color ; acrid, bitter 
taste ; pungent odor ; and by the fact that they generally 
grow in dark, damp places. 1 The edible have gills at first 
delicate pink, afterward purple and tawny black ; stem 
white, full, firm, varying in shape, with a white, persistent 
ring. They must be sought for in the open fields. The 
best kinds have a peculiar, easily recognized odor. 

Aconite (monkshood, wolfsbane). — Preparations of 
leaves and roots are used medicinally, internally, and in 
liniments. Preparations of the root are several times 
stronger than those of the leaves. The plant has been 
mistaken for the horse-radish. This poison produces pecul- 
iar numbness, or tingling sensations in the mouth, throat, 
and skin. 

Mezereon. — A garden shrub having bright red berries, 
sometimes eaten by mistake for currants. 

1 " On the subject of distinguishing poisonous species, Mr. Cooke says 
that there is no golden rule which will enable us to tell at a glance the 
good species from the bad. The only safe guide lies in mastering, one by 
one, the specific distinctions, and increasing the knowledge through ex- 
perience, as a child learns to distinguish a filbert from an acorn, or a loaf 
of sorrel from one of white clover. The characters of half a dozen good, 
esculent species, he says, may be learned as easily as the ploughboy 
learns to discriminate as many species of birds, lie tolls us. moreover, 
that it is not enough to avoid poisonous species, but that discretion should 
be used in preparing and eating good ones. They change so rapidly that 
even the cultivated mushroom, if long kept, is unfit for use. Nor is it 
enough that they be of good species and fresh ; but plenty of salt must be 
used in their preparation, to neutralize any deleterious property, and 
pepper and vinegar are also recommended as advantageous.' 1 — Popular 
Science Monthly. 



414 EMERGENCIES. 

Spurred Rye, or Ergot. — In medicines; sometimes care- 
lessly ground with rye into flour. 

Poison Sumac ("poison dogwood," "poison elder") is 
between a shrub and a tree, found in moist places ; all of 
its parts are poisonous. 1 

Fruits. — Do not eat berries of the bitter-sweet, black 
nightshade, buckthorn, poke, baneberry, leather wood, 
yews, juniper, red elderberry, privet, English ivy, wahoo, 
or daphne. 

Seeds. — Do not eat the seeds of stramonium, corn-cockle, 
castor-oil plant, black cherry, foxglove, saffron, or mul- 
lein, or the common horse-chestnut, or red buckeye. 

Flowers. — Do not eat those of stramonium, laurel, 
stagger-bush, elder, locust, or lily of the valley. 

Treatment for above Acro-narcotic Poisons. — Allay ir- 
ritation by drinking milk, olive oil, mucilage, etc. 
Overcome narcotic effects by fresh air, stimulants, cold 
douches, electricity, artificial respiration. 

428. Certain plants are poisonous to the touch, some per- 
sons being more susceptible than others. 

The Poison Ivy is very common, grows along the ground, 
or clings to stones, stumps, fences, or trees. It is dis- 
tinguished from the harmless woodbine or Virginia 



x For further information as to poisonous plants, see Report of New 
Jersey Agricultural Experiment Stations, Bulletin No. 135, and "Principal 
Poisonous Plants of the United States," Bulletin No. 20, Department of 
Agriculture, Division of Botany. 



EMERGENCIES. 415 

creeper, which often grows with it, by having three 
leaflets together, instead of five, as has the latter vine. 
All parts of the plant are poisonous, especially its juice. 
Thick gloves should be worn when working where it is. 
Treatment. Wash poisoned spot with alcohol and water, 
then keep applied cloths saturated with lime water, butter- 
milk, a strong solution of sulphite of soda, or iodide of 
potassium. 

Poison Dogwood is more poisonous to many persons than 
poison ivy. Treatment same as for ivy poison. 

The Stramonium Plant, when touched, sometimes inflames 
the skin. Treatment same as for ivy poison. 



APPENDIX. 



References are to page and section of text. In the text, reference to these 
notes is made by letters. 



Page 11, § 11 (a). Divine and Wholesome Discontent. — "I 

would make men and women discontented, with the divine and whole- 
some discontent, at their own physical frame and at that of their children. 
I would accustom their eyes to those precious heirlooms of the human 
race, the statues of the old Greeks ; to their tender grandeur, their chaste 
healthfulness, their unconscious, because perfect, might ; and say, — 
There ; these are tokens to you, and to all generations yet unborn, of 
what man could be once ; of what he can be again if he will obey those 
laws of nature which are the voice of God. I would make them discon- 
tented with the ugliness and closeness of their dwellings ; I would make 
the men discontented with the fashion of their garments, and still more 
just now the women, of all ranks, with the fashion of theirs ; and with 
everything around them which they have the power of improving, if it 
be at all ungraceful, superfluous, tawdry, ridiculous, unwholesome." — 
Canon Charles Kingsley, Health and Education. 

Page 11, § 11 (b). Deaths in Armies, in War Times, from Sick- 
ness and Wounds. — "The losses through sickness in war times are 
great, even in temperate climates. During the Crimean War, when the 
Anglo-Franco-Sardinian forces reached the total of 428,000 men. there 
were 302,000 sick, 09,200 of whom died. Only 0200 soldiers died from 
wounds. In the Franco-German War of 1870-71. out of 200,000 Germans 
surrounding Metz, 130,000 were in hospitals ; and out of a total number 
of 295,000 sick men taken care of in German hospitals, only 88,000 wore 
there on account of wounds received on the battle-field. The total number 
of German soldiers sick or wounded amounted to 812,000 men. Accord- 
ing to the statistics of the American Civil War, the number who were 
killed in battle and died from wounds was 93,969. Those who died from 
disease numbered 180, 210." The deaths reported in the Spanish- American 

417 



418 APPENDIX. 

War, among United States soldiers, from May 1, 1898, to April 30, 1899, 
was 6406. Of these, 5438 were from disease ; 968 soldiers were killed in 
battle, or died of wounds, injuries, and accidents. 

Page 43, § 37 («). Habits of Posture modify the Shape. — " Every 
occupation presents temptations to the body to acquire a habit of posture 
which, in time, modifies the shape of the individual. . . . The woman who 
sews by hand acquires a low right shoulder ; while the one who habitu- 
ally uses a machine, upon which both arms rest, tends to become high- 
shouldered with symmetrical body lines. The man who stands at a desk 
with arms supported, in time assumes the same shape. The sailor who 
climbs the masts, acquires a similar shape, although in a different way. 
The man of letters, with head forward and chin depressed, elongates his 
cervico-occipital muscles, so that at middle life we recognize him without 
difficulty. The drug and dry goods clerk, if right-handed, works with 
left foot thrown to the side and body to the right ; both arms in front of 
the hip line. The resultant shape we are all familiar with, if at all 
observant. The horse-car driver, as he stands with his right hand on the 
brake and left on the dash-board, acquires a "left foot twist" in accord- 
ance with this posture. The truck-driver, who sits with arms forward 
holding his reins, is a characteristic figure. The man who digs the street, 
the bricklayer, and the hod-carrier all assume, in time, their own trade- 
mark." — Prof. Eliza M. Mosher, The Influence of Habitual Posture 
on the Symmetry and Health of the Body. 

Page 54, § 48 (a). The Human Hand. — " We ought to define the 
hand as belonging exclusively to man, corresponding in sensibility and 
motion with that ingenuity which converts the being who is the weakest 
in natural defence to the ruler over animate and inanimate nature. . . .. 
As Galen long since observed . ; Did man possess the natural armor of the 
brutes, he would no longer work as an artificer, nor protect himself with 
a breastplate, nor fashion a sword or spear, nor invent a bridle to mount 
the horse and hunt the lion ; neither could he follow the arts of peace, 
construct the pipe and lyre, erect houses, place altars, inscribe laws, and, 
through letters, hold communication with the wisdom of antiquity.' But 
the hand is not a distinct instrument ; nor is it properly a superadded 
part. The whole frame must conform to the hand, and act with reference 
to it." — Dr. Bell, The Hand. 

Page 57, § 51 (a). Importance of Conjoint Action of Muscles.— 

" The state of equilibration between the muscles performing opposite 
kinds of movements . . . may be readily illustrated by the part played 



APPENDIX. 419 

by the muscles placed before and behind the spine, in maintaining the 
erect posture of the body. The position is kept up without effort, with- 
out even consciousness, by the healthy man whose muscles are well bal- 
anced and in good ' tone. ' It may be, however, that the same man, after 
a long day's work over a desk in an ill-ventilated city office, no longer 
presents that supreme unconsciousness of his muscles and their action, 
and the stoop of his shoulders and bent head demonstrate to others that 
the balance is no longer kept, that the tonicity of the morning has passed 
off, and the wearied muscles are no longer on the watch. And so it is 
when, in sleep, the muscles are relaxed and gravity asserts its force, so 
that the head falls forward by its own weight, no longer restrained by 
the passive counteraction of its ' extensor ' muscles. ... So little is the 
effort required to keep the body erect, that it is a sign rather of weakness 
than strength in any one who exercises an effort to do this. This may 
seem paradoxical, but it is nevertheless the case ; and he who walks ' bolt 
upright,' with his chin in the air and his back as rigid as a plank, is often 
not a strong, but a weak man." — Dr. Sidney Coupland, Personal 
Appearances {Health Primer). 

Page 63, § 58 (a). Time to be allotted to Sleep. — " Where 

attempts have been made by literary characters to assign a proper 
period for sleep, they have either been guided by their known capabili- 
ties, or by what they have esteemed themselves capable of effecting ; or 
they have been led, in their ignorance of physiology, into Utopian con- 
siderations regarding the time wasted, as they conceive, in rest. How 
else can we account for the idea of Jeremy Taylor, that three hours only 
in the twenty-four should be devoted to sleep ? In an equally arbitrary 
manner, Baxter fixes on four hours, Wesley on six, and Lord Coke on 
seven. So much depends on the constitution and habits of individuals, 
that if some were restricted to the period allotted to Baxter, or Taylor 
especially, their lives could not fail to pay the forfeit. Men of active 
minds, whose attention is engaged in a series of interesting employ- 
ments, sleep much less than the lazy and listless. It is probable that, in 
these cases, sleep is more intense." — Dr. Robley Dunglison, Human 
Health. 

Page 69, § 02 (a). The Value of Physical Education to Students. 
— Professor Edward Hitchcock says of the work accomplished at Amherst 
College: "Prom the beginning oi the existence of the department of 
physical education in Amherst College it has never been the desire to 
develop the muscular system at the expense of any other part of the body. 



420 APPENDIX. 

as is too often understood to be the meaning of physical education or train- 
ing. This department was not created, nor has it been developed, for the 
purpose of extraordinary attention to the muscular system. Its sole object 
has been to keep the bodily health up to the normal standard, so that the 
mind may accomplish the most work, and to preserve the bodily powers 
in full activity for both the daily duties of college and the promised labor 
of a long life. Indeed, in that particular, the precept of Cicero has been 
literally followed, namely, that bodily exercise should have for its chief 
object the development of a capacity for rational work. At the same time, 
it has been equally desired that the so-called exercises of this department 
should be mentally as well as physically enjoyed by the students, and not 
be made a tedious, mechanical, or heavy drill. . . . The results accom- 
plished by this department in Amherst College lead its government to 
continue its existence, and sustain it on a par with the others." 

Dr. D. A. Sargent, Professor of Physical Training at Harvard, in 
a paper read before the American Public Health Association, says: 
" Students enter college trained in mind but not in body ; and where one 
fails for want of mental ability, ten break down for want of physical 
stamina. Many are short in stature for their age, or tall and slender, 
with a deficiency of muscular strength. Under an appropriate system of 
physical training, however, they make most rapid advancement, showing 
that their bodies had been kept in arrears, while their brains were devel- 
oped. Many are ignorant of the first principles of physiology and 
hygiene, and leave school with acquired defects which are past remedying, 
but which a little appropriate knowledge and training could have obviated. 
Not infrequently the students who stood the highest in the preparatory 
schools are taken with a sort of mental dyspepsia after entering college, 
and devote most of their energies to physical exercises. This is invariably 
the case where the preparatory training has been forced and unnatural." 

Page 69, § 63 (a). Cramp and Palsy from Overuse of One Set of 
Muscles. — A form of palsy, sometimes known as hammer palsy, occurs 
from the continuous use of the hammer in scissors-making and forging of 
knife-blades, 100 blows, it is said, being necessary to forge one blade. In 
one day a good operator will'make 24 dozen blades. "Tailor's palsy," 
"milker's cramp," and "writer's cramp" are instances of the overuse 
of certain muscles. In regard to " writer's cramp," Dr. George M. Beard 
states, after an examination of 125 cases, that "it is far less likely to 
occur in those who do original work, as authors, journalists, composers, 
than in those who do routine work, as clerks, book-keepers, copyists, 
agents, etc." 



APPENDIX. 421 

Page 70, § 64 (a). Some of the Results of Improper Muscular 
Exercise. — "Every year a number of middle-aged men, who for years or 
months have been engaged in the sedentary occupation of a profession, of 
literature, or of business, at the commencement of the autumn holidays 
start for the Continent or the Highlands, and suddenly undertake immense 
fatigue in the ascent of Alpine heights, or the no less laborious work of a 
day on the moors, without the least preparation. So also we see, every 
bank holiday, crowds of young men starting off for some tremendous 
walk, or ' bucket ' up the river, utterly unprepared for the task they 
undertake. Is it to be wondered at that men return complaining that 
their holiday has done them no good ; that, instead of vigor, they complain 
of exhaustion ; that their appetite fails them, their nights are sleepless, 
their limbs ache, and they are jaded and spiritless ? It is the evils pro- 
duced from this erratic athleticism that give rise to the formidable indict- 
ments that from time to time have been urged against vigorous exercise 
and the pursuit of manly sports, which, if properly managed and under- 
taken systematically, are really the foundation of really healthy life." — 
Dr. C. H. Ralfe, Exercise and Training (Health Primer). 

Page 72, § 67 {a). Why Young Women should have Muscular 
Exercise. — "It has been my privilege, for more than twenty-five years, 
to be intimately associated with young women, either as teacher in the 
schoolroom in the earlier years, or as medical practitioner, or teacher of 
hygiene, during the latter ones, and every day's added experience only 
confirms me in the position I have occupied from the first relative to the 
various forms of nervousness which characterize our sex. That position 
affirms that the best possible balance for a weak nervous system is a well- 
developed muscular system. Weak, shaky, hysterical nerves always ac- 
company soft, flabby muscles ; and it is a mournful fact that the majority 
of the young women whom I meet in schools are notably deficient in 
muscular development. 1 ' — Dr. Mary J. Studley. 

Page 72, §67 (6). Housework as Exercise. — Too many house- 
keepers believe that their indoor work affords sufficient exercise for 
them. Undoubtedly housework, if conscientiously performed, does 
exercise nearly all the muscles of the body. But it should not take 
the place of brisk, daily out-door walking, with its consequent inhalation 
of fresh air and thorough expansion of the lungs. It has boon estimated 
that proper exercise for women should be equal to a walk o( six miles per 
day. Average housework exerts as much muscular force as would be 
expended in walking two and a halt* miles, thus leaving a margin of three 



422 APPEXDIX. 

and a half miles for the daily walk. English women frequently walk 
eight to nine miles. Unfortunately, some housekeepers endeavor to do 
more daily work than a walk of eight to nine miles per day would repre- 
sent. They seldom go into the open air or take any other recreation, and 
sooner or later break down. 

Page 73, § 69 (a). Kinds of Exercise. 

Good Effects of Certain Forms of Exercise. — "Dancing is a 
cheerful and useful exercise, but has the disadvantage of being used 
within doors, in confined air, and often in dusty rooms and at most un- 
seasonable hours. Practised in the open air, and in the daytime, as is com- 
mon in France, dancing is certainly an invigorating pastime ; but in heated 
rooms, and at late hours, it is the reverse, as these do more harm than can 
be compensated by the healthful exercise of the dance." — Dr. Combe. 

" Five minutes of pretty brisk exercise on the bars, or with dumb-bells, 
or in any other moderate way, repeated several times during the morning, 
will have a wonderfully good effect in promoting full respiration, purify- 
ing the blood, and in nourishing the muscular system. The writer often 
picks up a chair, or any other moderate weight at hand, and after five 
minutes' play therewith, over the head or otherwise, can feel that the 
muscles of the arm have in that short time secured an extra supply of 
blood, which tends at once to nourish them, and to diffuse and equalize 
the circulation." — Dr. Richard McSherry, Popular Science Monthly. 

"It is surprising how short a period of vigorous exercise, daily, will 
develop an approach to the maximum of muscular power. ... I 
believe that one hour a day of vigorous exercise, with proper attention to 
diet, will efficiently train a well-formed and healthy man for any reason- 
able feat of strength or endurance." — Dr. Austin Flint, Jr., The Source 
of Muscular Power. 

Bicycle Riding. — "The bicycle as a means of training the body in 
habits of correct poise, and of strengthening the holding power of muscles, 
is a force the value of which can scarcely be overestimated. Like all 
good things, however, it must be used with discretion, if it is to do the 
good work for mankind which it so richly promises. The upright posture 
on the bicycle offers to the body exhilarating exercise with every organ 
and most of the muscles in normal position, and with an expenditure of 
force within the limits of ordinarily healthy individuals ; the stooping 
posture, fast riding, and long hill climbing should of course be avoided." 
— Prof. Eliza M. Mosher. 

Bicycle Riding vs. Horseback Riding. — "Bicycle riding has certain 
advantages over the present style of horseback riding. . . . When women 



APPENDIX. 423 

get into the habit of riding part of the time with the stirrup on the right 
side and part with the stirrup on the left, one objection to the spinal ro- 
tation and the un symmetrical development will be overcome, and it is to 
be presumed that eventually they will all ride astride as their great-grand- 
mothers did before the days of Elizabeth. The expense (of horseback 
riding) precludes this form of exercise for most women. Cheapness, 
safety, accessibility, and the small amount of preparation required are 
all on the side of the wheel." — Dr. R. L. Dickinson. 

Page 77, § 75 (a). Strength and Elasticity of Skin. —The strength 
of the connective tissue of the skin is best illustrated by the tension it 
will bear without breaking, as seen in one of the rites followed among 
Indians in testing the bravery and endurance of candidates who aspire to 
be chiefs. One end of a rope is attached to a pole fastened in the ground, 
the other to a sharp stick run through the skin of the chest of the candidate. 
His aim is to then circle about the pole until the stick is torn out. An ob- 
server writes that he has seen the skin pulled out to a distance of eight or 
ten inches before tearing. The elasticity of the connective tissue of the skin 
of a healthy person is evidenced by the ease with which the skin returns 
to its proper position after having been lifted and the hold relaxed. The 
" Elastic Skin Man," on exhibition a few years ago, had an abnormally 
elastic skin. The skin of the chin, for example, could be raised to the 
mouth, and when released promptly returned to its place. 

Page 79, § 76 (a). The Production of Corns and Callous Spots. 

— It is a law that interrupted pressure produces hypertrophy, i.e. an 
increase of nourishment or supply, resulting in an increase of size, and 
constant pressure produces atrophy, or a want of nourishment or supply, 
resulting in a decrease of size. "Callous" spots upon the knees of shoe- 
makers and the chests of other workmen are to be ascribed to the inter- 
rupted pressure upon the respective parts, by lapstone and hammer, 
''brace and bit," "burnishers," "breast-drills," etc. Corns, in like 
manner, are the result of the irritation of certain portions of the epidermis 
lying near to the bones, by the interrupted pressure from shoes which are 
either too tight or too loose. On (lie other hand, the constant pressure of 
shoes, bandages, etc. {i.e. by night ami by day), will cause atrophy, as 
may be seen in the deformities of the feet of certain Chinese girls. 

Page 80, § 78 (a). The Vast Number of Pores and Drainage 
Tubes of the Skin. — "Taken separately, t ho little perspiratory tube. 
with its appended gland, is calculated to awaken in the mind very little 



424 APPENDIX. 

idea of the importance of the system to which it belongs ; but when the 
vast number of similar organs composing this system is considered, — 
for it includes the sebiparous glands, which are also agents in perspira- 
tion, — we are led to form some notion, however imperfect, of their prob- 
able influence on the health and comfort of the individual. I use the 
words 'imperfect notion ' advisedly, for the reality surpasses imagination, 
and almost belief. ... I counted the perspiratory pores on the palm of 
the hand, and found 3528 to a square inch. Now, each of these pores 
being the aperture of a little tube of about a quarter of an inch long, it 
follows that in a square inch of skin on the palm of the hand there exists 
a length of tube equal to 882 inches, or 73| feet. ... I think that 2800 
might be taken as a fair average of the number of pores in the square 
inch of surface, and 700, consequently, of the number of inches in length 
of the tubes. Now, the number of square inches of surface in a man of 
ordinary height and bulk is 2500 ; the number of pores, therefore, 
7,000,000 ; and the number of inches of perspiratory tube, 1,750,000 ; 
that is, 145,833 feet, or 48,600 yards, or nearly twenty-eight miles.' 1 '' — 
Wilson, Diseases of the Skin. 

Page 83, § 82 (a). Causes of Baldness. How to maintain the 
Health of the Hair. — Baldness, which is very common among middle- 
aged men, as well as among the old, results from local or general causes, 
or both combined. It may come from the pressure of tight hats and caps 
cutting off the supply of blood, from an insufficiency of air, caused by too 
constant wearing of head coverings, from diseases of the scalp, such as 
animal and vegetable parasitic growths, from severe inflammation, as 
erysipelas, or any exhausting disease, or from worry, age, or hereditary 
weakness in the parts. So-called "hair-restorers" are only valuable in 
so far as they stimulate the activity of the scalp. Some of them, however, 
including various hair-dyes, destroy the health of the hair, injure the 
scalp, and impair the general health. The frequent use of overheated 
curling irons is believed to be one of the causes of "falling of the hair " 
among women. A too frequent use of a fine comb increases the activity 
of the skin, and causes the epidermis to throw off numerous cells, which, 
combined with the oil of the hair, dirt , etc. , create ' ' dandruff. ' 5 Frequent 
brushing with a good stiff brush strengthens and improves the hair by 
invigorating the scalp, and increases the amount of sebaceous material, or 
"natural hair-oil." Most people have, therefore, within their reach, a 
natural ointment which is far superior to pomades and artificial hair-oils. 
An occasional cleansing of the scalp by a thorough brushing, and washing 
in water containing a few drops of ammonia, followed by the application 



APPENDIX. 425 

of a small amount of vaseline, is far better than the use of oils and grease, 
which may be of doubtful utility or positively harmful. 

Page 85, § 84 (a). The Relief of Thirst through the Skin. — " It 

has been frequently remarked that the sensation of thirst is always least 
pressing in a moist atmosphere, and that it may be appeased to a certain 
extent by baths. . . . We could hardly account for an actual alleviation 
of thirst by immersion of the body in water, unless we assumed that a 
certain quantity of water had been absorbed. A striking example of relief 
of thirst in this way is given by Captain Kennedy, in the narrative of his 
sufferings after shipwreck, when he and his man were exposed for a long 
time without water, in an open boat. With regard to his sufferings from 
thirst, he says : ' I cannot conclude without making mention of the great 
advantage I derived from soaking my clothes twice a day in salt water, 
and putting them on without wringing. ... So very great advantage 
did we derive from this practice, that the violent drought went off, the 
parched tongue was cured in a few minutes after bathing and washing 
our clothes ; at the same time we found ourselves as much refreshed 
as if we had received some actual nourishment.'" — Flint, Text-book 
of Physiology. 

Page 95, § 96 (a). Sun Baths among the Ancients. — "According 
to Plutarch, when the youthful Alexander visited Diogenes at Corinth, 
he found the famous cynic tranquilly lying in the sun. The warrior affa- 
bly saluted the philosopher, and asked if he could do him any"* service. 
1 Only stand a little out of my sunshine, ' replied Diogenes. This incident 
occurred when this renowned Athenian had reached the age of ' three- 
score and ten ' — long past the eccentric days of his life in a tub and his 
daylight lantern-searches for an honest man ; and there is good reason 
to suppose that he really valued the invigorating solar rays more than 
any boon Alexander could give. Nor was he alone in his devotion to 
sunshine, for, as we learn from Pliny, it was a common practice in 
Greece for old men to recruit their energies, both mental and physical, 
by exposing themselves naked in the sun — a fact which Hippocrates 
might have had in mind when he wrote, 'Old men are double their 
age in winter, and younger in summer.'" — Dr. C. E. Angell, in the 
Sanitarian. 

Page 101, § 102 (a). Constriction of the Waist. — " Recent experi- 
mental research, by a variety of observers, coincides in establishing cer- 
tain facts concerning waist constriction. . . . 



426 APPEXDIX. 

" 1. The normal breathing of woman is like that of man — abdominal. 
Waist constriction changes the type of breathing to costal. 1 

"2. The pelvic organs, normally, make a considerable excursion with 
each respiration. Waist constriction in the upright position checks this 
motion almost entirely. 

' ' 3. Sitting or bending forward lessens the pressure within the abdomen. 
Waist constriction in these positions greatly increases intra-abdominal 
pressure. 

' ' 4. The abdominal organs are displaced downward by waist constric- 
tion, and at times to an extreme degree. 

" 5. The pelvic floor is bulged downward. 

"6. The circulation in the pelvis is obstructed. 

"7. The abdominal wall suffers by thinning of muscle and accumulation 
of fat, and the trunk muscles waste. 

' ' 8. The chest expansion is crippled by compression of the lower ribs 
and the check on the play of the diaphragm. 

1 ' 9. The capacity for outdoor exercise is hampered." — Dr. R. L. Dick- 
inson, Simple and Practical Methods in Dress Beform. 

Page 107, § 108 (a). Some of the Risks attending the Use of 
Unclean Clothing. — "Unclean clothing is sometimes a direct means 
of conveyance of disease. The unclean fabric becomes saturated with 
poisonous substances, with the fumes of tobacco, for instance, and holds 
its wearer in a persistent atmosphere charged with unwholesome vapor. 
Still more seriously it becomes the medium of the poisons of the spreading 
diseases. I could cull from my note-books many examples of the last- 
named danger, but must be satisfied to mention one or two striking and 
brief illustrative facts. I have known scarlet fever carried by the cloth- 
ing of a nurse into a healthy family, and communicate the disease to 
every member of the family. I have known cholera to be communicated 

1 "Abdominal respiration is essential to icoman's health ; clothing must be 
worn that does not restrict it. All women who wear corsets and tight waist- 
bands breathe with a distinct movement of the upper chest. This costal or 
thoracic respiration is as unnatural to the woman as it is to the man. Mays has 
shown by tracings that Indian girls breathe like men, Kellogg has elaborately 
confirmed the observation among various Indian tribes, among Chinese women, 
agricultural women, and English pit-brow lassies, and Wilberforce Smith has 
added his evidence. All agree that civilized women who have been in the 
habit of wearing clothing truly loose about the waist show the same type. 
Women asleep breathe like men, and male and female animals breathe alike." 
— Dr, R. L. Dickinson. 



APPENDIX. 427 

by the clothes of the affected person to the women engaged in washing 
the clothes. I have known small-pox conveyed by clothes that had been 
made in a room where the tailor had by his side sufferers from the terri- 
ble malady. I have seen the new cloth, out of which was to come the 
riding-habit for some innocent child to rejoice in as she first wore it, 
undergo the preliminary duty of forming part of the bedclothing of 
another child stricken down with fever. Lastly, I have known scarlet fever, 
small-pox, typhus, and cholera communicated by clothing contaminated 
in the laundry." — Dr. B. W. Richardson, Diseases of Modern Life. 

Page 122, § 121 (a). Relief of Constipation. — Constipation, or a 
sluggish condition of the bowels, is very common, and has much to do 
with ill health. The following suggestions for relief will neither answer 
for all persons, nor always take the place of medicinal measures, which 
should come from the attending physician : 1st. Daily muscular exercise, 
especially walking, if not carried beyond the strength of the individual. 
Too much exercise may aggravate the trouble. 2d. A cold bath before 
breakfast for those who can stand it. 3d. Moist compresses {i.e. several 
thicknesses of cloth) applied for two or three hours daily over the abdo- 
men. 4th. Daily kneading of the bowels, especially in the course of the 
large intestine. 5th. A glass of hot or cold water before breakfast, or 
water in which a few cloves have remained over night, or in which there 
is just enough salt to give a slight saline taste. 6th. Fruit ; oranges, ap- 
ples, bananas, or grapes, before or at breakfast ; figs, dates, and other 
similar fruits throughout the day, in small quantity, or stewed fruit 
for supper, or a baked apple before retiring. 7th. Oatmeal, Indian meal, 
Graham bread, Graham crackers, sardines, coffee (for some persons, tea), 
molasses, molasses cake, zwieback, etc. 

While the above measures, used with discrimination, are of value, it is 
but right to state that many persons, especially those who take but little 
exercise, are liable to carry the hygienic treatment to extremes, and to 
injure their digestive organs by much indigestible food. 

Page 127, § 124 (a). The Importance of Thorough Chewing of 

Food. — The value of insalivation in connection with mastication becomes 
apparent when we consider how difficult it is to chew dry substances 
like crackers until they are moistened. It is also almost impossible to 
swallow substances which are very dry. The value of a thorough com- 
minution of food, in making it more soluble, is shown by a comparison 
of the length of time it takes for a lump of sugar to dissolve in water, 
with that consumed by a similar lump broken into line particles, in the 



i 



428 



APPENDIX. 



same amount of water. Imperfect chewing and the absence of sound 
teeth produce many a dyspeptic. On the other hand, the rilling of 
teeth, or the substitution of a good artificial set for teeth which are worn 
out or decayed, has often furnished the dyspeptic the only means of 
cure. It is well known to veterinary surgeons that horses sometimes 
lose their appetite and strength on account of broken or irregularly worn 
teeth, which prevent them from chewing their food. 

Old people and young children are very apt to bolt their food. As 
they do not chew well, their food should be thoroughly minced for 
them. 



Page 135, § 134 (a). Time occupied in the Digestion of Various 
Articles of Food. — In 1822, Alexis St. Martin, eighteen years of 
age, a voyageu?' in the employ of the American Fur Company, was 
wounded in the left side, the ball perforating the stomach. Through an 
opening which did not heal entirely for a number of years, Dr. Beaumont 
of the United States Army was enabled to watch the digestion of foods in 
the stomach. The following extract from a table prepared by Dr. Beau- 
mont shows the digestibility of various foods. The estimates may be con- 
sidered as approximative only, being founded upon an isolated case ; still, 
experiments have been made upon animals which tend to confirm those 
made upon St. Martin. 



Pigs' feet, soused (boiled) . 1 00 

Tripe, soused (boiled) ... 1 00 

Soup, barley (boiled) ... 1 30 

Trout, salmon, fresh (fried) 1 30 

Venison steak (broiled) . . 1 35 

Milk (boiled) 2 00 

Cabbage, with vinegar (raw) 2 00 

Eggs, fresh (raw) 2 00 

Apples, sour, mellow (raw) . 2 00 

Milk (raw) 2 15 

Turkey (roasted) 2 30 

Eggs, fresh (soft boiled) . . 3 00 

Beefsteak (broiled) .... 3 00 

Mutton, fresh (boiled) ... 3 00 

Soup, chicken (boiled) ... 3 00 

Bread, corn (baked) ... 3 15 

Oysters, fresh (roasted) . . 3 15 



Mutton (roasted) 3 15 

Eggs (hard boiled) .... 3 30 

Eggs (fried) 3 30 

Potatoes, Irish (boiled) . . 3 30 

Oysters (stewed) 3 30 

Beets (boiled) 3 45 

Green corn and beans (boiled) 3 45 

Salmon (boiled) 4 00 

Soup, beef, vegetables, and 

bread (boiled) 4 00 

Duck, barn-yard (roasted) . 4 00 

Heart, animal (fried) ... 4 00 

Pork, salt (fried) 4 15 

Veal (fried) 4 30 

Cabbage (boiled) 4 30 

Duck, wild (roasted) ... 4 30 

Pork, fresh (roasted) ... 5 15 



Page 174, § 177 (a). Oddities of Diet. — Certain tribes of Indians 
in South America eat at times a peculiar kind of clay. Beetles were 



APPENDIX. 429 

eaten by Roman epicures, and are said also to be eaten by Turkish women 
for the purpose of fattening themselves. Bees, moths, ants, mice, and 
many small animals form staple articles of diet in some parts of the world. 
Humboldt tells us that centipedes are eaten with avidity by some of the 
natives of South America. Birds' nests, rats, and snails are eaten in 
China. The Tartars ate horses, camels, and dogs, and drank mare's milk. 
The Egyptians thought wheat, beans, and barley poor food, and did not 
eat the head of any animal. In Africa certain tribes will not eat sugar or 
drink milk. 

Page 181, § 187 (a). Food Value of Sugar. — " Certain rowing 
clubs in Holland report very beneficial results from the use of large 
amounts of sugar in training. It seemed to counteract the bad effects of 
a meat diet, so that the dreaded symptoms of overtraining did not appear. 
The rowers who used sugar always won because of superior endurance. 
. . . Professor Pfluger says that, without doubt, the sugar in the blood is 
heavily drawn on during violent exercise ; hence the longing for it in a 
form that can be rapidly assimilated. ... Its use by mountain climbers 
is well known. The Swiss guide considers lump sugar and highly sweet- 
ened chocolate an indispensable part of his outfit. ... In India it is said 
that workmen must have daily large amounts of food well seasoned with 
sugar. The employer must furnish it or lose his workmen. In all 
tropical lands the consumption of dates, figs, and other sweet fruits is very 
large. ... In small quantities and in not too concentrated form, sugar 
will take the place, practically speaking, weight for weight, of starch as 
a food for muscular work, barring the difference in energy and in time 
required to digest them, sugar having here the advantage. In times of 
great exertion or exhausting labor, the rapidity with which it is assimi- 
lated gives it certain advantages over starch." — Mary Hinman Aisi:i„ 
Sugar as Food, United States Department of Agriculture. 

Page 182, § 180 («)• Use of Fat in Hot Climates. — " Consider 

how olive-oil is used in the warm parts of Europe, and how ghee is used 
in India, in order to satisfy yourself that oily matter may be taken with 
facility in hot countries as well as in cold. You hear nothing about 
indigestion ; you find that a bad olive harvest or a scant supply of ghee is 
a great national calamity. A Hindoo servant o( a Eriend, who kept up his 
Indian habits of eating in London, has often told uio that nothing would 
make up for a deficiency of ghee or butter, ami that this was the common 
experience of his countrymen at home or away from home, lie looked 
upon a sip of ghee in very much the same light as that in which his fellow- 



430 APPENDIX. 

servants looked upon a draught of beer. ' Wine is good, but oil is better,' 
said a peasant to the courier who was with me in Andalusia ; and after 
gulping down a large mouthful of olive-oil, and smacking his lips more 
than once, the expression of his countenance was an apt illustration of the 
meaning of the Scriptural text which speaks of oil as making ' the face to 
shine.' Indeed, it may be taken for granted that oil may be used in large 
quantities throughout the year in the hot olive-growing countries of the 
south of Europe, not only without making people bilious, but with unmis- 
takable benefit." — Dr. C. R. Radcliff, London Practitioner, "A Few 
Words About Eatables.'''' 

Page 183, § 191 (a). Use of Fat in Cold Climates. — The accounts 
given by travellers of the amount of food, and especially of fat, eaten 
by the inhabitants of the frigid zone are almost incredible. The Russian 
admiral, Saritcheff, tells of a man who ate, in his presence, at a single 
meal, twenty-eight pounds of boiled rice and butter. 

" Sir John Franklin tried how much fat an Esquimaux boy could con- 
sume : fourteen pounds of tallow candles quickly disappeared ; and Sir 
John closed the experiment with a piece of fat pork, as he began to feel 
apprehensive for his stores. Oil is a luxury greedily devoured by the 
Northern races, as was amusingly proven in a seaport town some years 
ago. The town was lighted by oil lamps, and the inhabitants remarked 
that they went out for several successive nights ; at last it was discovered 
that some Russian sailors in the harbor climbed the lamp-posts and drank 
the oil." — Mapother, Lectures on Public Health. 

Page 184, § 192 («). Fasting. Importance of "Water. — " With- 
out something to eat or drink, man will not live beyond a few days, or at 
most a week. Access to water, however, makes a great difference. There 
is a well-known case of an Ayrshire miner who lived twenty-three days, 
buried in a coal mine, without swallowing anything but small quantities 
of chalybeate water sucked through a straw. He had the advantage of 
being shut up in a contaminated atmosphere, which, by diminishing ner- 
vous sensibility, lessened the cravings of hunger. Berard quotes the ex- 
ample of a convict who died of starvation after sixty-three days, but in 
this case water was taken. Cases of alleged fasting longer than this are 
certainly due to imposture. The insane appear to bear fasting better than 
those in their sober senses ; and, in some morbid conditions of the body, 
nourishment may certainly be done without for a surprising length of 
time. Animals have an advantage over man, so far as living without food 
is concerned." — CasselVs Magazine. 



APPENDIX. 431 

Page 185, § 194 (a). Salt ; its Importance. — " Animals will travel 
long distances to obtain salt ; men will barter gold for it ; indeed, among 
the Gallas and on the coast of Sierra Leone, brothers will sell their sis- 
ters, husbands their wives, and parents their children, for salt. In the 
district of Accra, on the Gold Coast of Africa, a handful of salt is the 
most valuable thing upon earth after gold, and will purchase a slave or 
two. Mungo Park tells us that with the Mandingoes and Bambaras the 
use of salt is such a luxury that to say of a man, ' He flavors his food 
with salt,' is to imply that he is rich, and children will suck a piece of 
rock-salt as if it were sugar. No stronger mark of respect or affection 
can be shown in Muscovy, than the sending of salt from the tables of the 
rich to their poorer friends. In the Book of Leviticus it is expressly com- 
manded as one of the ordinances of Moses, that every oblation of meat 
upon the altar shall be seasoned with salt, without lacking ; and hence it 
is called the Salt of the Covenant of God. The Greeks and Romans also 
used salt in their sacrificial cakes ; and it is still used in the services of 
the Latin church — the ^parva mica,'' or pinch of salt, being, in the cere- 
mony of baptism, put into the child's mouth, while the priest says, ' Re- 
ceive the salt of wisdom, and may it be a propitiation to thee for eternal 
life.' Everywhere, and almost always, indeed, it has been regarded as 
emblematical of wisdom, wit, and immortality. To taste a man's salt, 
was to be bound by the rites of hospitality ; and no oath was more solemn 
than that which was sworn upon bread and salt. To sprinkle the meat 
with salt was to drive away the devil ; and to this day nothing is more un- 
lucky than to spill the salt." — Letheby, On Food. 

Page 193, § 202 (a). United States Army Ration. — " There is in 
the army of the United States a considerable difference between the 
ration of the soldier and the diet of the soldier. The critics of the army 
ration do not understand this. The ration is the allowance for subsist- 
ence of one person for one day. The diet is what is actually prepared 
in the kitchen for consumption by the soldier day by day. The ration is 
prescribed by law, and consists of the meat, the bread, the vegetables, the 
fruit, the coffee and sugar, the seasoning and the soap and candle com- 
ponents. . . . The slightest knowledge of practical cookery will enable 
any one ... to form an idea of what may bo called the flexibility o\ 
the army ration. ... If the proximate principles be calculated it will 
be found that many variations may bo made in the relative proportions of 
proteids, hydrocarbons, and carbo-hydrates. . . . The ration is so elastic 
that the soldier may verily oat his candles if he does not require them for 
other purposes, lie may Leave the candles in the hands of the subsisteiuv 



432 



APPENDIX. 



department, and if their money value will pay for a can of peaches, or a 
pound of rice, or so much of any other of a long list of articles kept for 
sale by the subsistence officers, he can eat his candle component in the 
form of peaches and rice, or any other of the purchasable things. . . . 
So, indeed, with all the other components of the ration, excepting only 
the fresh vegetables, fresh bread, baking powder, and dried fruit. . . . 
There is even a greater elasticity than this to the ration, for the money 
credit for components not drawn and used may be applied to the purchase 
of articles from outside sources, articles not kept for sale by the subsistence 
department. ... A soldier's ration is fixed by law, and it is a most 
liberal one, but his dietary depends upon the intelligent supervision of 
company officers and the ability of the company cooks." — Dr. Charles 
Smart, Deputy Surgeon General, U. S. Army. 



The 



Meat Components. 




Fresh beef or fresh mutton 




(when the cost does not 




exceed that of Beef) . . 


20 oz 


or Pork or Bacon .... 


12 oz 


or Salt Beef 


22 oz 


or Dried Fish 


14 oz 


or Pickled Fish or Fresh Fish 18 oz 


or Canned Salmon .... 


16 oz 


Vegetable Components. 




Beans or Peas 


21 oz 


or Rice or Hominy . . . 


If oz 


Potatoes 


16 oz 



or Potatoes (121 oz.) and 
Onions (3| oz.) 

or Potatoes (Hi oz.) and 
canned Tomatoes (41 oz.) 
or 4| oz. of other fresh 
vegetables (not canned) 
when they can he obtained. 

Fruit Components. 
Dried Fruits — Apples, Peaches, 

Prunes, etc 2 oz. 



Ration. 

Bread Components. 
Flour or Soft Bread . . . . 18 oz. 

or Hard Bread 16 oz. 

or Corn Meal 20 oz. 

Baking Powder, when necessary 
for soldiers to bake their 
own bread if oz. 

Coffee and Sugar Components. 
Coffee, green If oz. 

or Roasted Coffee .... Us oz. 

or Tea, green or black . . ^ oz. 
Sugar 2f oz. 

or Molasses or Cane Syrup if gills. 

Seasoning Components. 

Vinegar A gills. 

Salt if oz. 

Pepper, hlack 5 g oz. 

Soap and Candle Components. 

Soap M oz. 

Candles, when illuminating oil 

is not furnished . . . . # s oz. 



— U. S. Subsistence Department. 

The ' ' Travel Ration ' ' for soldiers on forced marches consists of bread, 
beef, beans, coffee, and sugar. 



APPENDIX. 



433 



Page 193, § 202 (6). Pood. 

Estimated Daily Needs. 



Children, 1 to 6 years 

Children, 6 to 15 years 

Women (Germany) , moderate work 
Man (Germany) , moderate work 
Man (United States) , moderate work 
Active laborer (England) .... 

Writer, hard work 

Subsistence diet 



Protein. 


Fat. 


Grams. 


Grams. 


28 to 70 


35 to 48 


75 


37 to 50 


92 


44 


118 


56 


127 


113 


156 


71 


150 


150 


57 






Carbo- 
hydrates. 
Grams. 



60 to 250 
250 to 400 
400 
500 
494 
568 
500 



CALORIE8. 



765 to 1400 
2040 
2125 
3050 
3500 
3630 
4060 
1760 



Food Actually Consumed. 



food purchased 
food used . . 



U. S. Army ration 

U. S. Navy ration 

U. S. college students (boarding club) 
U. S. college foot-ball team . . . . 

U. S. well-to-do family . . . . . . 

U. S. teamsters {hard work) . . . . 

Italy, underfed laborers 

Average of ten farm- " 

ers' families in Ver- 
mont, Connecticut, 

and New York 
Average of fourteen 1 

mechanics' families food purchased 

in Connecticut, New \ 

York, Tennessee, food used . . 

and Indiana J 

Average of fourteen ) 

professional men's | food purchased 

families in Connect- \ 

icut, Pennsylvania, I food used . . 

Indiana, and Illinois J 
Average of twelve la- j food purchased 

borers' families in > 

New York City ) food used . . 
Average of eleven ) food purchased 

poor families in > 

New York City ) food used . . 



120 


161 


143 


184 


138 


184 


181 


292 


128 


177 


254 


363 


82 


40 


101 


136 


97 


130 


110 


161 


103 


150 


108 


132 


104 


125 


103 


119 


101 


116 


93 


98 


93 


95 



3851 
4998 
4827 
5742 
4082 
7804 
2192 

3655 
3515 



3690 
3465 

3438 

3325 

2950 

2906 
3005 

2916 



Professor Aim \ n k. 



Page 195, § 205 (a) . Fresh Meat as a Preventive of Scurvy. — Dr. 
T. J. Turner, Medical Director, United States Navy, in an article in the 

Sanitaria)), April, 1884, shows that an ample supply o( Eresh moat, i.e. 
from animals killed on the spot, such as the walrus and narwhal, is 
superior to any form of preserved meat in the prevention o\' scurvy, in 
that it furnishes the necessary salts and acid (probably lactic acid). In 



434 APPENDIX. 

fact, he speaks of fresh raw animal food as the best anti-scorbutic. 
Where it cannot be obtained in sufficient quantity, he suggests that a 
mixture of sodium, potassium, and calcium phosphates be added to pre- 
served and cooked meats or other foods, and that lactic acid be added to 
the vinegar used as a condiment. 

The experience of armies shows that fresh meat is more wholesome 
than canned meat. It is now carried by many vessels in refrigerators. 

Page 198, § 207 (a). Economy in Food. 

The Cheapest Food. — " The cheapest food is that which furnishes the 
most nutriment at the least cost. The most economical food is that which 
is both healthful and cheapest. . . . When the mother goes to market to 
make her purchases, she is thinking of meat, and flour, and potatoes, what 
they cost, and how the folks at home will relish them. . . . Her real prob- 
lem, though she does not understand it, is to get the most and the best nutri- 
ment for her money. . . . She is to obtain, at the least cost, protein, fats, 
and carbo-hydrates needed to meet the wants of her family. Flavor and 
appearance are things to look out for, of course. She may buy them in the 
food if she has the money and is willing to spend it, but they are costly. She 
may supply them by good cooking and tasteful serving, but this will take 
skill and care, and too many women in her circumstances lack the one 
and are averse to the other. Or she may ignore both flavor and appear- 
ance, and if her husband does not like the food she sets before him, and 
other things about the home are not attractive, he will very likely go to 
the ' poor man's club,' otherwise known as the saloon. ... If she spends 
a dime for beefsteak at 20 cents a pound, she gets half a pound, which 
supplies 0.08 pound of protein and 550 calories of energy ; but if she 
invests the same money in flour at 2| cents per pound she has 4 pounds, 
with 0.44 pound of protein and 5.680 calories of energy." — Prof. W. O. 
Atwater, Food and Diet. 

Economical and Nutritious Food. — "There is an unfortunate 
prejudice among us against learning of foreign countries. The Ameri- 
can, workman says indignantly that he does not want to learn how to live 
on 'starvation wages.' But the facts, viewed coolly, are just these : The 
inhabitants of older countries have learned some lessons that we too must 
soon learn, whether we will or no, and to profit by these lessons before 
we are really obliged to will in no way lower wages ; it will simply help 
us to get more comfort and pleasure out of our money. Students of 
economy, political and domestic, find no better school than the experience 
of older countries, and consequently draw lessons from their greater thrift 
and economy in living. Mrs. Helen Campbell found, among the poor 



APPENDIX. 435 

sewing women of New York, that none were skilful in cooking their 
scanty food, excepting only the German and Swiss women. All observ- 
ing travellers unanimously give this testimony : ' If our American work- 
man knew how to make as much of his large wage as the foreigner does 
of his small one, he could live in luxury.' But, you ask, what are the 
special lessons to be learned of the foreign housewife ? We answer, 
chiefly self-denial and saving. Do not give up in despair because you 
have a small income, and resign yourself to living meanly, in a hand- 
to-mouth fashion. Diligent study of the question and resolute abstention 
from luxuries will solve the problem, if it can be solved. We indulge 
ourselves and our children too much in what tastes good, while all the 
time we have not money enough to buy necessaries. . . . We seem, in 
general, to spend too much money in our country on food compared with 
what we use in other directions ; our great trouble is that we do not know 
how to save every scrap of food and use it again in some form. For one 
thing, we have yet to learn the great art of soup making, — and, it seems, 
also of soup eating. The American housekeeper would say to me : ' This 
is nothing new ; for years we've been hearing about soups. We don't like 
soups. ' I only ask, ' Have you tried them for a considerable length of 
time, so that you have become skilled in making them, and your family 
used to their taste ? ' One fact alone ought to insure for them a good trial : 
that at least three nations, the German, French, and Italian, make daily 
use of them, and have for generations. To take part of our food in this 
form is an absolute necessity, if we are to do the best possible with a 
certain amount of money." — Mrs. Mary Hinman Abel, Practical 
Sanitary and Economic Cooking. 

Page 200, § 209 (a). The Importance of Good Cooking. 

How Good Cooking pays. — "Foul air and overcrowding would. 
however, be less fatal in its results were food understood. The well-filled 
stomach gives strange powers of resistance to the body. . . . Happily, to 
know an evil is to have taken the first step in its eradication. . . . To 
have made cooking and industrial training the fashion is to have cleared 
away the thorny underbrush on that debatable ground, the best education 
of the poor. . . . That cooking schools and the knowledge of cheap and 
savory preparation of food must soon have their effect on the percentage 
of drunkards no one can question. Philanthropists may urge what 
reforms they will — less crowding, purer air, better sanitary regulations — 
but this question of food underlies all. The knowledge that is broad 
enough to insure good food is broad enough to mean better living in all 
ways. . . . One woman, who has learned in any degree to order her own 



436 APPENDIX. 

home and life aright, will be more a power with those among whom that 
life passes than a dozen average preachers." — Mrs. James T. Field, 
How to Help the Poor. 

The High Calling of a Cook. — " Bad cooking is the rule, good cook- 
ing the exception. The truly artistic cook — the veritable cordon bleu — 
is a rare bird with us. The calling of a man cook ranks a little above that 
of the waiter-man ; it is, perhaps, nearly up to that of a first-rate barber 
or hair-dresser. Almost invariably the professional male cook is an exotic 
production, — generally imported from France, — the calling being beneath 
the dignity of a native American not of African descent. A hired woman 
cook holds her head somewhat higher than the waitress and laundress, not 
so much on account of her superior rank, as from certain advantages of 
her position. The responsibility of cooking, however, in small households 
either rests with a maid of all work, or it is assumed by the mistress, 
whose qualifications are derived from perhaps a little experience, the 
possession of some family receipts, and, possibly, a cook-book. I shall 
not linger on this topic, but leave it with a few assertions. If alimentation 
have the importance and dignity which I have claimed for it ; if appetite 
and taste are to be estimated by their physiological relations, the functions 
of a cook are of a higher grade than that denoted by the facts just stated. 
A skilful cook, male or female, is entitled to as much distinction, at least, 
as a clever mechanic. The calling should be reckoned an honorable one. 
The science and the art of cooking should be taught by competent pro- 
fessors, and should be embraced in the curriculum of female schools. 
More than this, here is a field for discoveries, inventions, and continued 
progress. To devise new combinations and culinary processes is a worthy 
object of study and experiment. He who may originate a new article of 
diet, palatable, digestible, and nutritious, by utilizing materials which are 
readily available, deserves something of the credit belonging to one who 
makes two blades of grass grow where but one grew before." — Dr. 
Austin Flint, Food in Its Relations to Personal and Public Health, a 
paper read at the annual meeting of the American Public Health Associ- 
ation, 1876. 

Page 201, § 210 (a). The Preservation of Food. 

Methods of Preserving Food for Transportation. — The value of 
proper canning and of other methods of preserving food are well illustrated 
in the detailed instructions as to provisions, given by the Navy Depart- 
ment to the commander of the Greely Relief Expedition in the spring of 
the year 1884. Macaroni and vermicelli, bacon, preserved cranberries, 
etc. , are to be packed in air-tight wooden kegs ; marrow beans, dried 



APPENDIX. 437 

green peas, dried Lima beans, sweet corn, pork, salt beef, etc., in well- 
seasoned, tight half-barrels ; baking-powder, compressed vegetables, 
mince-meat, evaporated fruit, fried potatoes, roast chicken and turkey, 
head cheese, sausages, apple and peach butter, candied lemon-peel, figs, 
tamarinds, cooked corn, beef, preserved beef and mutton, raw and fried 
oysters, sardines, butter, etc. , in hermetically sealed tins ; smoked and dried 
meats, well covered with canvas. Fried oysters and eggs (boiled twenty 
minutes) are to be put into cans and covered with hot lard. " The special 
mackerel and special salmon shall be of the best quality, and warranted 
to keep two years." 

Improper Canning of Food. — " The intelligent purchaser will not buy 
a can of goods in which the brown streak of resin is not visible at the 
soldering point. To deceive him, it is alleged, the canners have adopted 
the habit of ' bronzing' the tops of cans to conceal the absence of the resin 
stain. It is fair to infer that bronzed cans are soldered with muriate of 
zinc amalgam. . . . Every cap should be examined, and, if two holes are 
found in it, send it at once to the Health Board, with the contents and the 
name of the grocer who sold it. Reject every article of canned food that 
does not show the line of resin around the edge of the solder on the cap, 
the same as is seen on the seam at the side of the can. ' Standard,' or 
first-class goods, have not only the name of the factory, but also that of 
the wholesale house which sells them, on the label. ' Seconds,' or doubt- 
ful or ' reprocessed' goods, have a ' stock label ' of some mythical canning- 
house, but do not have the name of any wholesale grocer on them. Reject 
all goods that do not have the name of the factory, and also the name of 
some wholesale firm, on the label. A 'swell,' or decomposing can of 
goods, can always be detected by pressing in the bottom of the can. A 
sound can pressed will give a solid feel. When gas from the decomposition 
of the food is inside the can, the tin will rattle by pressing up the bottom 
as you displace the gas in the can. Reject every can that shows any rust 
around the cap on the inside of the head of the can. If housewives are 
educated to these points, then muriate of zinc amalgam will become a 
thing of the past, and dealers in k .swells 1 have to seek some other occu- 
pation." — Dr. J. G. Johnson, Medico-Legal Society^ Feb. 9, L884. 

Page 207, § 214, Notk 1 (a). How to utilize Remnants of Food. 

— "Nothing so well symboli/.cs tin- economical habits of continental 
Europe, and especially France, as the pot aufeu. This is an iron pot kept 
constantly simmering upon the fire, into which is put from day to day all 
the wholesome remnants of food, which in this country arc thrown away. 
Our people, in their magnificent way of doing things, never stop to con 



438 APPENDIX. 

sider how much nutriment adheres even to well-picked bones of porter- 
house steak, mutton chops, ribs of beef, legs of mutton, etc. All these, 
and many things besides, are put into the pot au feu ; water, seasoning, 
and fragrant herbs are added as required, and the constant simmering — 
a solvent for even the toughest of Texan beef — extracts every particle of 
marrow, even, and the bones come out as clean and white as if they had 
been bleached in the sun. Among the common people, more than half of 
the nutriment of the day comes from the pot au feu, and if any member 
of the family comes home at an unusual hour hungry, it affords at all times 
a meal at once warm and wholesome. This explains how, as Hugh McCul- 
loch tells us, the forty millions of France could live on what the forty 
millions of America throw away ; and when we consider the wretched 
cookery that prevails in this country, it is not too much to affirm that they 
live twice as well as do our farmers and day laborers. ' ' — Lancaster 
Farmer. 

Page 208, § 214 (a). The too Frequent Use of Meat. —Undoubt- 
edly, meat is too frequently used to the exclusion of other foods. For 
children, meat once a day is sufficient. The report of Dr. D. M. Camman, 
physician to the Orphans' Home and Asylum of the Protestant Episcopal 
Church, New York City, in the N. Y. Medical Journal, March 29, 1884, 
shows that for the last twenty-Jive years the children in that institution 
under eight years of age have received no meat, but in place of it an abun- 
dance of milk ; yet the health of the children has been unusually good. 
The eating of meat three times a day, except by persons who do very hard 
physical work, taxes the eliminating organs. The effects of too much 
meat combined with too little exercise are frequently manifested in the 
biliousness, headache, gout, etc., which befall persons who "live high." 
Few people need meat, ordinarily, more than twice a day ; in summer, not 
more than once a day. The sick are often inclined to consider meat, or 
meat teas, soups, and broths, as the most nutritious foods they can take, 
and hence sometimes delay their recovery by overtaxing the liver and 
kidneys. 

Page 208, § 214 (6). The Adaptation of Food to the Digestive 
Powers. — "Nature has provided for the young of the mammalia, in milk, 
food containing all the elements of nutrition in a semi-prepared state, 
which only requires a very short time for its thorough transformation into 
chyle. The same may be said of all oviparous animals, for they live on 
the contents of the egg in the early stage of their existence. Nature has 
evidently wished to spare the delicate organs of the young, in the earliest 



APPENDIX. 439 

period of life, the labor which they are destined later in life to undergo, 
in the elaboration of their food. 

"The stomach of the strong man, of the navvy, of the drayman, may be 
compared to a quartz-crushing machine. It wants quartz — that is, 
strong, coarse foods, bread, bacon, pork, beef, to work upon — to crush. 
To give it eggs and milk would be like putting trifle or blanc-mange 
into the quartz-crushing machine ; it would merely put it out of gear. 
On the other hand, the child, the delicate woman, the dyspeptic, the 
invalid, have stomachs that may be compared to a light chocolate- 
crushing machine. Quartz they cannot crush, and the attempt would 
ruin the machine, although it may be perfectly equal to crushing light 
things, such as chocolate, eggs, etc. In sickness and in deranged health 
the digestive organs lose their tone and powers, and should be treated as 
Nature treats the young ; that is, the kind of nitrogenous food should be 
given which entails the least work on the part of the stomach. It is 
weakened, its muscular and secreting powers are diminished, and it no 
longer requires for its health many hours of rude exercise daily." — 
Nutrition in Health and Disease. 

Page 208, § 215 (a). The Relative Value of Various Meats. —An 

inquiry among various charitable institutions shows that beef is relished 
best, and in the form of stews ; next, mutton and pork ; then fish, espe- 
cially in the form of chowder. Of late years, a great deal has been said 
against the use of pork, and undoubtedly much of the pork sold to and 
used by the poor is unfit to eat. But if pigs are fed largely upon corn, 
and are kept well cleaned and housed, they yield healthy pork. The flesh 
of all animals is affected by transportation in badly ventilated cars, and 
even the method of killing influences the quality of the meat. 

Page 210, § 210 (a). Raw Oysters. — " 'Our practice in regard to 
the oyster is exceptional, and furnishes a striking example of the general 
correctness of the popular judgment on dietetic questions. The oyster is 
almost the only animal substance which we eat habitually and by pref- 
erence in the raw or uncooked state ; and it is interesting to know that 
there is a sound physiological reason at the bottom of this preference. The 
fawn-colored mass which constitutes the dainty of the oyster is its liver, 
and this is little less than a mass of glycogen ; associated with the glycogen, 
but withheld from actual contact with it during life, is its appropriate 
digestive ferment, — the hepatic diastase. The mere crushing of the dainty 
between the teeth brings these two bodies together, and the glycogen is at 
once digested, without other help, by its own diastase. The oyster, in the 



440 APPENDIX. 

uncooked state, or merely warmed, is, in fact, self-digestive. But the 
advantage of this provision is wholly lost by cooking, for the heat employed 
immediately destroys the associated ferment, and a cooked oyster has to 
be digested, like any other food, by the eater's own digestive power.' 
This graphic description by Dr. Roberts tells us how it is that oysters au 
naturel are so much in vogue for invalids, as they deservedly are. Also, 
why oysters should not be cooked in oyster sauce, but put into the pre- 
pared sauce just as it comes to table ; why, as King Chambers insists, in 
a beefsteak pudding, the oysters should not be cooked, but a flap of the 
paste raised, and the oysters popped in, just as the pudding is served. In 
making oyster pates, the paste is cooked in bread-crumbs, which is then 
taken out and the oysters put in ; after which, the pate's are just warmed, 
and no more, and then brought up to the dinner table. The idea that 
long cooking increases the digestibility of food is not always correct." — 
Fothergill, Indigestion and Biliousness. 

Page 210, § 217 («). Decomposing Food to be guarded against. 

— "Under ordinary circumstances, many cases are recorded in works 
upon poisons, such as Dr. Christison's, where decayed animal food has 
produced severe and even fatal diarrhoea, in spite of cookery having con- 
cealed some of its repulsiveness. High game has fortunately gone out of 
fashion, and the most frequent form in which we now meet with decom- 
posing albuminoid matter is that of a fusty egg. Some housekeepers seem 
to consider this quite good enough for made dishes, and thus spoil material 
worth ten times what they save by their nasty economy. No egg should 
be allowed to enter the kitchen that has the slightest smell of rotten 
straw." — Dr. T. K. Chambers, Manual of Diet. 

Page 210, § 217 (6). Selection of Meats. — '"Good meat has the 
following characters : 1. It is neither of a pale pink color nor of a deep 
purple pink, for the former is a sign of disease, and the latter indicates 
that the animal has not been slaughtered, but has died with the blood in 
it, or has suffered from acute fever. 2. It has a marbled appearance from 
the ramifications of little veins of fat among the muscles. 3. It should be 
firm and elastic to the touch, and should scarcely moisten the fingers — 
bad meat being wet and sodden and flabby, with the fat looking like jelly 
or wet parchment. 4. It should have little or no odor, and the odor 
should not be disagreeable, for diseased meat has a sickly, cadaverous 
smell, and sometimes a smell .of physic. This is very discoverable when 
the meat is chopped up and drenched with warm water. 5. It should not 
shrink much in cooking. 6, It should not run to water or become very 



APPENDIX. 441 

wet on standing for a day or so, bnt should, on the contrary, dry upon 
the surface." — Letheby, On Food. 

Page 212, § 218 (a). Milk. Difficulties in obtaining Pure 
Milk. — " The first thing to be borne in mind is that milk is naturally a 
pure product. If any milk is found unclean, unwholesome, or dispropor- 
tioned in its proper parts, the chances are that it is not the fault of the 
cow. In all such cases the presumption is that some person is to blame, 
either the one who cares for the cow or the one who handles the milk. . . . 
There is a great desire to get milk cheap, and it is not an unknown thing 
for customers, including hotels and private institutions, as well as private 
families, to demand such large measure for their money that the dealers 
feel compelled to ' extend ' the milk in order to meet these requirements 
and prevent loss of trade. Some are satisfied with the adulterated stuff, 
not knowing that the same amount of actual food, but no more and per- 
haps less, is being delivered in the large measure than was formerly 
delivered in the small one. This explains how it sometimes happens that 
milk is retailed in cities at less than the regular wholesale price. People 
too easily forget quality and think only of quantity. The only sensible 
thing for the housekeeper or other buyer of milk to do, is to willingly pay 
a fair price, and insist upon good milk in return. Buyers should remem- 
ber that, at the highest prices usual anywhere, good milk is about as cheap 
an article of food as can be purchased. It should also be borne in mind 
that milk can be contaminated as easily after delivery to the family or con- 
sumer as before, and too often a milkman is blamed for bad milk or cream 
when it was made so by conditions over which he had no control. If left 
where dust can settle in it or flies have access to it, or if set in an ill-ven- 
tilated cellar or in a warm place, it is pretty certain to be in bad condition 
after a few hours, no matter how good it was when delivered. Numerous 
well-authenticated cases are known where customers have complained of 
milk received, and upon investigation it has been proved that servants in 
the house tampered with the milk, removing cream for their own use or 
adding old milk or vinegar to make it sour prematurely. The object o( 
the latter act was, in connivance with an outsider who supplied the 
motive, to cause the buyer to change to some other dealer whom the 
servant was ready to recommend." — R. A. Pearson, Facts about Jlilk, 
U. S. Department of Agriculture. 

Changes of Milk. — "Thunderstorms, impurities, warm temperature. 
and other conditions known to exist when milk is most liable to give 
trouble have been blamed for its changes. Hut it is now known that these 
are only indirect causes, and that the changes in milk which bother the 



442 APPENDIX. 

housekeeper are due to, and cannot take place without, the presence of 
minute organisms called bacteria. . . . Any milk having a large amount 
of sediment is suspicious. Particles of dirt are a sign that germs are 
abundant. Thus dirty milk may be dangerous as well as disgusting. 
The dirt in milk consists mostly of particles of dead skin and ma- 
nure, which fall into the pail from the body of the cow during milking ; 
but dust in the stable, and dirt and dust in the vessels used for handling 
milk, and unclean attendants, are also common sources of dirty sediment 
in milk. Milk from unhealthy or unthrifty cows, or that which has been 
handled by sick persons is dangerous, as it may contain infectious germs 
or foreign substances which might affect the health of the consumer. 
The germs of typhoid fever, scarlet fever, diphtheria, and consumption 
(or tuberculosis) have been found in milk, and thus transmitted to man, 
and spread from family to family. Feverish cows, . . . and sometimes 
cows that have been milked a long time, produce milk which should not 
be used. Any milk having an unnatural appearance should be discarded. 
Odors and peculiar flavors are due to bacterial action or to the volatile 
oils of some foods ; onions, turnips, cabbage, and certain weeds, as garlic 
and wormwood, give characteristic odors and tastes to milk." — Ibid. 

Care or Milk. — "The proper care of milk after it has been delivered 
to the consumer is a matter of great importance. ... If milk is kept in 
an open vessel in a refrigerator with meats and various kinds of vegeta- 
bles, it will absorb odors from them. It is also sensitive to flavors, and if 
allowed to stand in an old tin dish the ' tin taste ' can easily be recog- 
nized. Milk should therefore be kept in a cool place, free from odors, 
and in a perfectly clean vessel of suitable material. A well-glazed earthen 
or porcelain dish, or a glass jar or bottle, is the best container ; tin is 
good so long as bright and the iron is well-covered. Wooden dishes are 
objectionable. 

" As already stated, the change to which milk is most liable is simple 
souring, and the best agents to prevent this change are cold and heat. 
Too much care cannot be used in seeing that the milk is cold when deliv- 
ered, and that it is then immediately put into a cool place. If allowed to 
stand in the warm air, even for a few minutes, the time it will keep 
sweet is shortened. Of course it will keep longer at a temperature between 
35° and 50° F. than above 50° F. Sometimes milk does not keep sweet 
when no cause can be discovered for its souring. This is frequently the 
case in summer. Often the trouble is the refrigerator, which may seem 
cold on account of the great difference between its temperature and that 
outside, while it is, in fact, not cold, and a thermometer may show its 
temperature to be even above 60° F. " — Ibid. 



APPENDIX. 443 

Page 216, § 224 (a). The Importance of Vegetable Food. — 

"The commonest fault committed by housekeepers in respect of vegeta- 
bles is, that they do not supply a sufficient variety, seeming to consider 
that the meat is the only part of the meal that requires care, and that all 
the rest is mere garnish, beneath the notice of a Briton, and unfit to 
sustain his vigorous life. Yet that is not the experience of the observers 
of mankind. The attention of Herodotus was called to the fact that the 
Persians, the manliest and most sporting nation in the world, had at 
meals not only several dishes, but several courses of vegetable food, pre- 
ceding a very moderate allowance of solid meat. And Sir Henry Kawlin- 
son describes the diet of this tough race as practically the same now ; 
so that the assumptions of some anthropologists that hunting races are 
necessarily riotous eaters of flesh, and that carnivoracity strengthens a 
nation, are not accurate. The Persian gentleman is the spiritual father 
of the British squire ; yet, at many a hospitable board, if a guest does 
not fancy meat that day, or has eaten enough of it at a previous meal, he 
will have to fall back upon potatoes, or to solace himself by picking a 
few bits out of the sauces of made dishes, where the vegetable flavor has 
been saturated with that of meat, and spoilt. Usually, he goes on eating 
too much nitrogenous food out of sheer idleness." — Chambers, Manual 
of Diet. 

Page 216, §224 (6). '"Potatoes as Food for Man' is the sub- 
ject of a farmers' bulletin issued by the United States Department of 
Agriculture. This shows that the potato, being essentially a starchy 
food, to be wholesome should be eaten with meat, eggs or fish, which are 
essentially nitrogenous foods. Eaten alone the potato furnishes a one- 
sided, badly-balanced diet. The report shows that the reason why pota- 
toes have been a staple article of diet for years is in accordance with the 
scientific principle that one food must supply the deficiency of another. 
The most important groups of constituents in foods are protein (nitroge- 
nous matter), fats, and carbohydrates (starches, sugars, etc.). Hence, 
when potatoes are eaten with foods largely nitrogenous, they supply a 
well-balanced diet, conducive to health and vigor. There is a tendency 
to decry the potato, and it certainly need not be sewed three times a 
day, as it is in many households, simply because the housewife has not 
the culinary knowledge to find substitutes. There are many pleasing 
ways of preparing them all winter, but these are the days when they are 
least desirable, and when the careful housewife will replace them as often 
as possible with substitutes. In the spring, when old potatoes are at 
their worst and new ones little better, they should be entirely replaced 



444 APPENDIX. 

by such articles of food as hominy, served hot with a bit of crisp bacon 
for breakfast ; with rice, boiled, fried, or in croquettes ; with macaroni, 
spaghetti, or even beans. Such substitutes will be found more palatable 
and far more healthy, even in households which have deemed nothing 
could take the place of the everlasting potato, served three times a day 
and seven times a week. 1 ' 

Page 217, § 224 (c). Salads. — " Vegetables intended to be used for 
salad should all be fresh and crisp, and sweet and clean. Their colors 
should be positive and even ; the reds very red, the whites very white, 
and the greens pure as those in an autumn sunset sky, except in the full- 
grown leaves, such as watercress. . . . With a little trouble, not, how- 
ever, necessarily attended by expense, a succession may be provided 
of materials for salad all the year round, so as to have one at table 
every day. And a great preservation of health I believe it to be for 
hearty persons. The most difficult season to provide for is the latter end 
of winter, and it may be of use to mention that the dandelion is then 
a friend in need. If a pot be placed over the plant as it grows, or the 
leaves tied up like lettuce, or it be transplanted into a frame, it can be 
bleached, and thus loses its bitterness. Daisy leaves are also eatable ; 
and thus, with a sprig of tarragon, a few cold potatoes, and some ever- 
constant mustard and cress, giant cress, Australian or curled cress, an 
olive or two pared thin, or some beet root and a slice of Madeira onion, 
a great variety of combinations may be made." — Chambers, Manual of 
Diet 

Page 217, §224 (d). The Food Value of Peas, Beans, etc. — 

" Then there are the vegetable albuminoids, especially the pulse tribe, or 
legumes, which are capitally disintegrated by cooking, and best by boil- 
ing or baking. Thus beans, haricots and broad, peas, lentils, dahl, etc., 
are all well broken up by heat. The disintegrated flour can easily be 
passed through a sieve, and then the disintegration factor of the digestive 
act is disposed . of. There can be no question about the fact that with 
some persons vegetable albuminoids are much more easily digested than 
animal albuminoids ; and I quite agree with Sir Henry Thompson in his 
remarks upon this subject. Besides, too, fat spreads easily over the dis- 
integrated particles of cooked vegetable albuminoids, as is well seen in 
the baked beans and fat pork of New England. Indeed, by such means 
fat can often be taken without offence to a stomach that cannot other- 
wise tolerate it ; and much of the digestibility of fat depends upon the 
fineness of the particles into which it is subdivided. Haricot beans well 



APPENDIX. 445 

boiled, passed through a sieve, and then the floury part mixed with milk, 
make an excellent soup ; quite equal in food value to any made with 
meat stock. The ordinary lentil soup is at once a most economical and 
a most valuable soup, though scarcely, perhaps, quite adapted for persons 
with indigestion. But ' the proof of the pudding is in the eating thereof,' 
— if it does not disagree, there is certainly no objection to its use." — 

FOTHERGILL. 

Page 218, § 225 (a). The Quenching of Thirst by Fruit rather 
than by Liquor. — " Some dyspeptics find that they must take no fluids 
with their food, and have to live on a very dry dietary, an Arab dietary. 
Others require more fluids than they allow themselves. Others require a 
biscuit, or some light article of food '• betwixt meals.' When this is made 
an excuse for a glass of sherry, it is to be closely criticised as a question- 
able habit, ' more honored in the breach than the observance.' To take 
some fruit would be better in every way. Some succulent fruit would 
satisfy the craving 'for something,' and would not require the beverage 
' to get it down.' Such use of fruit ought to be more general than it is at 
present. In all households where the expense does not forbid it, a large 
dish of picked fruit of various kinds, when the season permits of it, 
should be placed on the sideboard every morning, with a label ' Help 
yourself ' on it (as is found in the waiting rooms of several London con- 
sultants). Children would soon cease to overeat themselves, just as do 
the assistants in confectioners' shops, when they realize that it is to he a 
constant affair, not an occasional treat to be made the most of. Such an 
idea is well worthy of adoption. If the 'temperance' section of society 
would set the example, it would soon be followed by others, to the benefit 
of the digestive organs of many while it would be agreeable to all. Fresh 
gathered fruit out of the garden and orchard ought to be placed on the 
breakfast table every morning. For those who experience a bitter or hot 
taste in the morning on awakening, such addition to the breakfast table 
would be most acceptable."' — Fothergill, Indigestion and Biliousness. 

Page 219, § 22G («). The Use of Savory Herbs. — Miss Corson, 
superintendent of the New York Cooking School, in her Cooking 
Manual, says: "Sweet and savory herbs arc absolutely indispen- 
sable to good cooking ; they give variety and savory flavors to any 
dish into which they outer, and are nearly all o( some decided sanitary 
use ; the different kinds called for in the various receipts further on in 
this work can be bought at almost any grocery store, or in the market ; 
but we advise our readers to obtain seeds from some good florist and 



446 APPENDIX. 

make little kitchen gardens of their own, even if the space planted be 
only a box of mould in the kitchen window. Sage, thyme, summer 
savory, sweet marjoram, tarragon, sweet basil, rosemary, mint, burnet, 
chervil, dill, and parsley will grow abundantly with very little care ; and 
when dried and added judiciously to food, greatly improve its flavor. 
Parsley, tarragon, and fennel should be dried in May, June, and July, 
ju^t before flowering; mint in June and July; thyme, marjoram, and 
savory in July and August ; basil and sage in August and September ; 
all herbs should be gathered in the sunshine, and dried by artificial heat ; 
their flavor is best preserved by keeping them in air-tight tin cans." 

Page 219, § 227 (a). Ice and Ice Water. — " About three pints of 
fluids are the normal allowance of water to human beings in a temperate 
clime under ordinary circumstances ; but when there is much perspiration, 
induced by exertion or other cause, a much larger quantity is nec- 
essary. In iron works, the men, exposed to high temperature and bathed 
in perspiration, when at work drink from two to four gallons of fluids 
per diem. There is a popular prejudice against drinking freely of cold 
fluids when heated, and no doubt death is sometimes so induced ; but 
the consumption of cold and even chilled drinks is now much on the 
increase. Ice is no longer regarded as a mere luxury ; it has become 
a necessary of life in hot weather, and its addition to a beverage adds 
much to its agreeableness. The chilled fluid directly lowers the heat of 
the body, and abstracts from it as much heat as is requisite to raise the 
temperature of the chilled fluid to that of the body, that is, from about 
32° to 99° ; this exercises a distinct influence over the body temperature 
for some time. It is obvious from this that the quantity of the chilled 
fluid has much to do with the effect, and a pint will take twice as much 
heat to raise its temperature as will half a pint. Consequently it is not 
unimportant to the imbiber what the amount of his fluid is, as well as its 
temperature ; and to those who produce heat but slowly a sip of iced fluid 
is as cooling as a draught of it to another whose heat-forming power is 
great. The draught of the latter would be as dangerous to the first as 
the sip of the first would be useless and ineffective to the latter. At 
all entertainments, dancing and other, where the heat becomes great, 
ice, both as a beverage and in the more solid form of ice cream, forms now 
the essential matter of the refreshment table, and is very acceptable. It 
must be remembered, however, that free indulgence in iced fluids is very 
apt to induce a sharp diarrhoea in many persons. Also the free consump- 
tion of ice has not unfrequently the effect of creating even a stronger 
craving than ever for fluids, from the same action upon the throat that 



APPENDIX. 447 

snowballs have on boys' hands, — the persistent cold causes a free flow of 
arterial blood to the part. In such cases a drink of warm fluid often gives 
relief." — Fothergill, Maintenance of Health. 

Page 220, § 228 (a). When Scum and Water Weeds are Harm- 
ful. — According to Prof. W. G. Farlow, M.D., 1 "The flowering plants 
known as water weeds, both those that grow from the bottom of ponds 
and watercourses, and have distinct stems and leaves, and also those that 
float on the surface as scum, are, under ordinary circumstances, harmless. 
They may prove (1) troublesome or injurious by growing so luxuriantly 
as to choke up small streams and shallow ponds ; (2) by serving as points 
of attachment or shelter for injurious small plants ; and (3) by decaying 
in hot weather." 

Page 220, § 228 (6). A Simple Test for the Purity of Water. 
— " Fill a bottle made of colorless glass with the water ; look through the 
water at some black object ; the water should then appear perfectly color- 
less and free from suspended matter. A muddy or turbid appearance 
would indicate the presence of soluble organic matter, or of soluble 
matter in suspension. It should be ' clear as crystal.' 

" Empty out some of the water, leaving the bottle half full ; cork up the 
bottle and place it for a few hours in a warm place ; shake up the water, 
remove the cork, and critically smell the air contained in the bottle. If it 
has any smell, and especially if the odor is in the least repulsive, the 
water should be rejected for domestic use. By heating the water to boil- 
ing, an odor is sometimes evolved that otherwise would not appear. 

" Pure water should be tasteless and remain so after being warmed. It 
should also be odorless ; but, since the delicacy of smell and taste varies 
greatly, sanitarians attach special importance to Heisch's test for sow- 
age contamination or the presence of putrescible organic matter. A 
clean pint bottle is filled three fourths full of the water to be tested, and in 
the water is dissolved a teaspoonful of the purest sugar — loaf or granu- 
lated sugar will answer ; the bottle is then corked and kept in a warm 
place for two days. If in from twenty-four to forty-eight hours the 
water becomes cloudy or muddy, it is unfit for domestic use. If it 
remains perfectly clear it is probably safe to use." — 1L alth. 

Page 220, § 220 (a). Spring Water. — " A country house is for- 
tunate if it possesses at a convenient distance a good, cool, copious 
spring. Nothing is more attractive or more serviceable about a IVun- 



1 First report of Louisiana Board o( Health 



448 APPENDIX. 

sylvania farm than the spring house ; often jutting out from a bank or 
hillside, built low, but firmly, of gray stone, and shaded over by a few 
old trees. Within you see the clear, transparent pool of water, in its 
reservoir of stone, pure as the air or sky overhead ; and around it, or 
carefully placed in it, the pans of milk or cream, or butter, waiting for 
family use. A draught from that supply, flowing out to make a limpid 
stream through the meadow below, gives more refreshment on a midsum- 
mer day than the most tempting beverage of man's contrivance. It has 
in it no horrors, no mockery, only health.' 1 '' — Dr. Henry Hartshorne, 
Our Homes. 

Page 224, § 233 (a). Purification of Water by Filtering. — The 

following home-made filter is advised by Dr. Parkes, the eminent sani- 
tarian : " Take a large, common flower-pot, and put into it a bit of zinc 
gauze or a clean bit of flannel ; then coarse gravel to the depth of about 
three inches ; over that the same amount of white sand washed very clean ; 
and next, four inches of charcoal in small fragments, — animal charcoal, 
when it can be had. On the top of all, a piece of well-cleaned sponge 
may be placed, making sure that this is changed or thoroughly cleansed 
once in a week or two — more or less often, according to the impurity of 
the water." 

Page 229, § 240 (a). Importance of Breathing through the Nose. 

— "Air inspired through the nose passes through a refining process, which 
prepares it for the lungs very much as mastication prepares food for the 
stomach. If food is improperly masticated, the stomach suffers. If air is 
improperly refined, the air passages suffer. The nose and not the mouth 
was designed as the gateway to the lungs. . . . The mouth may be closed 
on going to sleep, opened while sleeping, and, when consciousness arrives^ 
closed again, and thus many are ignorant of the fact that they ever breathe 
through the mouth. If these people are questioned closely, the fact will 
be elicited that the mouth and throat are always dry in the mornings, and 
that it may be several hours before this condition wears away. . . . When 
dryness of the throat is caused by sleeping with the mouth open, if the 
nasal passages are found to be sufficiently large to supply the lungs with 
air, the mouth should be kept closed by wearing a skullcap with strings 
or straps fastened to its sides, which, being tied or buckled under the chin, 
hold the jaws together." — Dr. Thomas R. French. 

Page 241, § 253 (a). The Results of Re-breathing Expired Air. 

— "If you want to see how different the breath breathed out is from the 
breath taken in. you have only to try a somewhat cruel experiment, but 



APPENDIX. 449 

one which people too often try upon themselves, their children, and their 
work-people. If you take any small animal with lungs like your own, — 
mouse, for instance, — and force it to breath no air but what you have 
breathed already ; if you put it in a close box, and, while you take in 
breath from the outer air, send out your breath through a tube into that 
box, the animal will soon faint ; if you go on long with this process, it 
will die. 

" Take a second instance, which I beg to press most seriously on the 
notice of mothers, governesses, and nurses. If you allow a child to get 
into the habit of sleeping with its head under the bedclothes, and thereby 
breathing its own breath over and over again, that child will, assuredly, 
grow pale, weak, and ill. Medical men have cases on record of scrofula 
appearing in children previously healthy, which could only be accounted 
for from this habit, and which ceased when the habit stopped." — Rev. 
Chas. Kingsley, Health and Education. 

Page 244, § 258 (a). The Adoption of Prevalent Customs. — The 

emigrant "should always adopt any custom which, however new and 
strange, he finds in use among the settlers of a new country. Those who 
have preceded him have had the like Saxon unwillingness to adopt a new 
habit, and have only done so from necessity, the reasons for which may 
not always be apparent. It is better to fall into it at once, and then seek 
for its explanation. Especially is this caution necessary in the matter of 
food. Thus the newly-arrived emigrant in India goes on with his English 
food, his bottled beer, wine, etc., and is ere long a broken-down, jaundiced 
creature, whose liver has been ruined, firstly, by the work thrown upon it 
in accumulation of bile in it in excess, the climate only requiring sparing- 
quantities of food, and, secondly, by the medicine taken to relieve his 
condition. ... In travelling, the same thing is seen, though to a less 
extent than in emigration, and the superior power of adaptation to the 
wants and requirements of the country explains the health of one person. 
and the want of it, much of the ill-health of another." — Fothergill, 
Maintenance of Health. 

Page 253, § 209 (a). How to Prevent the Spread of Infectious 
Diseases. — " The first thought of the parents of a child sick with a com- 
municable disease is one of desire for the child's recovery, and results in 
the calling in of the family physician. This is eminently the desirable 
step to take, for the physician is needed to give counsel out o( his previous 
experience with similar cases, and as far as possible to assist nature in the 
restorative process. But parents and physician must In 1 even more zealous 



450 APPENDIX. 

in considering the welfare of those members of the family who are, up to 
this time, perfectly well. Properly managed this may be the only case of 
this disease occurring in this house or in the neighborhood ; improperly 
managed, an epidemic, widespread and dreadful in its ravages, will be the 
result. Prevention of further extension of the disease should be the 
watchword now, and the steps taken to bring this about must be prompt 
and vigorous. Our first suggested practical lesson in sanitary practice is 
this : Place the sick under the care of the physician and nurse, but be 
sure that the health officer is allowed to establish conditions such that the 
disease may be confined to the first case. . . . 

" Whenever any case occurs which is suspected to be a dangerous, com- 
municable disease, patient and nurse should at once be isolated from all 
other persons, those who may themselves be susceptible to the disease, or 
those who may be the means of communication between the sick and the 
well. After this, nothing must be allowed to pass from the sick-room to 
that part of the house occupied by others, until it has been disinfected by 
proper means. This applies to air, water, food, dishes, clothing, books, 
papers, — everything that has been within the limits of the sick-room. 
Isolation must be faithfully applied to all articles of clothing, food, dis- 
charges from the body, or other things which become infected. The 
most extreme care must be taken that all such things shall be thoroughly 
isolated until they are disinfected. 

" Ordinarily it will be the attending physician who will decide whether 
or not it really is a case of a communicable disease, but immediate steps 
should be taken even though it is only suspected to be such a case, and the 
active work of preventing any further spread of the disease should not 
cease until it is ascertained that it is not such a disease, or until the patient 
has recovered and the final disinfection is accomplished." — Teachers'* 
Sanitary Bulletins, Michigan State Board of Health. 

Page 254, § 270 (a). Some Pacts about Malaria. — "Malaria 
tends to be carried by gentle winds along valleys and level tracts in warm 
or mild weather. It is much less to be apprehended during the sunshine 
hours of the day than toward night, although it is reported to rise at times 
hundreds, or even thousands, of feet up into the air after leaving its place 
of origin ; the rule is that the subtle influence of malaria remains usually 
within a few feet of the soil, so the nearer one is to the soil the greater the 
liability to the disease. Accordingly it is safer to have the sleeping room 
situated more than twelve feet above the surface of the ground, especially 
if the earth is being dug up. It is best in ague districts not to breath the 
air near the ground either very early or late in the day. Fires at night 



APPENDIX. 451 

and moderately warm clothing are of service against the infection. Forests 
tend to intercept this strange poison." — Currier, Practical Hygiene. 

Dr. A. N. Bell, the eminent sanitarian, says that " this poison is a poor 
sailor, seldom crossing large bodies of water, and is most potent at night. 
So well do the natives of hot and malarious countries understand this, 
that at Lake Maracaibo, for example, they sleep at night in their boats on 
the lake, after their labor through the day on shore, not allowing them- 
selves to stay on the deadly poisonous shore after sunset, or to return to 
it until after sunrise." 

The Value of the Eucalyptus Tree in draining Wet Soils. — 
"That the E. globulus has earned by fair experiment its name of fever 
tree, as a preventive, seems now to be settled. Its rapid growth must 
make it a great drainer of wet soils, while its marked terebinthine odor 
may have its influence, and it is highly probable that the liberation of this 
essence into the air stands connected with its generation of ozone. But 
whatever the sanatory activities of the eucalypt may be, the fact is 
squarely settled that spots in Italy, uninhabitable because of malarial 
fever, have been rendered tolerable by the planting of E. globulus, and it 
is believed that a more plentiful planting would nearly, if not quite, 
remove the difficulty. A military post is mentioned in Algeria in which 
the garrison had to be changed every rive days, such was the virulence of 
the malaria. A plantation of eucalypts cleared the miasma nearly away, 
and rendered unnecessary the frequent changes of the garrison. In this 
case, sixty thousand trees were planted." — Prof. Samuel Lockwood, 
Popular Science Monthly, April, 1876. 

Page 255, § 271 (a). The "Black Hole of Calcutta. " — In 1750, 
one hundred and forty-six English prisoners in Calcutta were confined 
over night in an apartment about eighteen feet square and fourteen feet 
high, having but one small window. In the morning, there were alive 
tioenty-three only of the strongest, who had been able to get near the win- 
dow in the struggle that had occurred for fresh air. And of these, nearly 
all died subsequently of a very low type of typhus fever, known as •• putrid 
fever." The place of their imprisonment has ever since been known as 
the "Black Hole of Calcutta." 

Of the one hundred and fifty passengers shut tip in the steamer London- 
derry, with hatches battened down, during a stormy night in ISIS. 
seventy-two died before morning. 

Page 255, § 271 (6). The Air of Bedrooms. Hospital Wards, etc. 
— The air escaping from the ventilator of a crowded room is said to he 



452 APPENDIX. 

very offensive, and, if drawn through pure water, will taint it. The air 
of bedrooms sometimes becomes so contaminated at night that sleep is 
restless or broken. The admission of a little fresh air will at such times 
often enable one to sleep soundly. Little children or feeble persons, 
having passed the night in a close room, are liable in the morning to 
headache, want of appetite, and a general feeling of debility. 

Sometimes hospital wards become absolutely unsafe for patients, through 
the permeation of the walls, floors, and bedding, with poisonous organic 
matter. Such wards should be thoroughly cleansed and disinfected. In 
some instances it has been necessary to replaster the rooms. 

Page 256, § 273 (a). Carbon Dioxide in Caves, Wells, etc. — 

"Upon the borders of Lake Laacher, near the Rhine, and in Aigueperse, 
in Auvergne, there are two sources of carbonic acid so abundant that they 
give rise to accidents in the open country. The gas rises out of small 
hollows in the ground, where the vegetation is very rich ; the insects and 
small animals, attracted by the richness of the verdure, seek shelter there, 
and are at once asphyxiated. Their bodies attract the birds, which also 
perish. In former times the accidents caused by this gas in caves, mines, 
and even in wells, gave rise to the most extravagant stories. Such locali- 
ties were said to be haunted by demons, gnomes, or genii, the guardians 
of subterranean treasures, whose glance alone caused death, as no trace of 
lesion or bruise was to be found on the unfortunate persons so suddenly 
struck down." — Cammile Flammarion, The Atmosphere. 

Page 257, §274 (a). Carbon Dioxide. 

Carbon Dioxide in Dwellings, Schools, etc. — "The air in a 

London schoolroom contained 29 parts of carbonic acid in 10,000 of air, 
Munich " " 72 " " " " " 

Hospital at Madrid " 43 " " " " " 

Bedroom" " " 48 " " " " " 

Lecture room at Paris " 67 " " " " " 

— Dr. Henry Hartshorne, Our Homes (Health Prime)'). 

A similar excess often exists in our schools, lecture rooms, etc., causing 
the inmates to be listless and drowsy, and to suffer from headache and 
faintness. According to Pettenkofer, a man exhales every hour from six 
tenths to seven tenths of a cubic foot of carbonic acid gas. Angus Smith 
asserts that a good oil " moderator " lamp produces a little more than half 
a cubic foot. A common gas burner, consuming three cubic feet of gas 
per hour, gives off about as much carbonic acid gas as three men in the 



APPENDIX. 453 

same time would do. The light from a good and properly cared for 
students' lamp, or other reliable lamp, is much better for health, as well 
as eyesight, than illuminating gas ; but if the oil is poor or the wick is 
turned so low that combustion is imperfect, a poisonous vapor, mixed 
with floating specks of carbon, diffuses itself through the air, and instances 
are on record of severe prostration resulting from such impurities. 

A Simple Test for Carbon Dioxide. — " Dr. Angus Smith's Household 
Test for Carbonic Acid Gas is as follows : Procure a bottle holding ten 
and a half fluid ounces, fill it with the air of the room you wish to examine, 
by blowing it in with a bellows or sucking it in through a glass tube pushed 
down to the bottom of the vial ; pour in half an ounce of lime-water, and 
after corking tightly, shake well for two or three minutes. If, after a 
short time there is no milky appearance of the lime-water, you may know 
to a certainty that the ten ounces of air in the bottle do not contain enough 
carbonic acid to form a visible precipitate of carbonate of lime (chalk) in 
the lime-water, and this has been proved by careful experiment on a large 
scale to be equal to less than six hundredths of one per cent of carbonic 
acid in the sample of air tested ; a quantity which has been agreed upon 
by some high sanitary authorities as the limit beyond which the accumu- 
lation of this impurity (and others, perhaps much more noxious, which 
seem always to accompany it when it arises from human or animal respi- 
ration) is injurious to health, and should not be permitted to occur." — 
Dr. J. G. Richardson, Long Life and How to Beach It. 

Page 260, § 279 (a). Devitalization of Air. 

Poisonous Wall-Papers. — Within the last few years it has been 
demonstrated by physicians and chemists, both in this country and 
Europe, that wall-papers (especially those that are roughened, or " flocked," 
and of a bright green color) are at times poisonous, owing to arsenic 
substances in the coloring. The arsenic acts as a poison by being diffused 
in the dust of the rooms, or, as some believe, in a gaseous form as arsenu- 
retted hydrogen, when it may be recognized by a "garlic-like or musty 
odor." The phenomena of arsenical disease ordinarily produced are 
similar to those attending a severe cold, viz., an irritation of the eyes 
and of the lining membrane of the nose and throat. The irritation may 
extend to the bronchial tubes, lungs, and lower portions of the alimentary 
canal, or the poison may produce skin eruptions, or may be absorbed in 
such quantity as to produce convulsions ami various disturbances of the 
nervous system. For further information in regard to poisonous wall- 
papers, the reader is referred to the investigations made by Dr. Ked.ie, 
as detailed in the Reports of the Michigan Suite Board of Health. 



454 APPENDIX. 

Devitalized Air in Dwellings. — "In many private houses, houses 
even of the well-to-do and wealthy, streams of devitalized air are nursed 
with the utmost care. There is the lumber room of the house, in which 
all kinds of incongruous things are huddled away and excluded from light 
and fresh air. There are dark under-stair closets in which cast-off 
clothes, charged with organic debris of the body, are let rest for days or 
even weeks together. There are bedrooms overstocked with furniture, 
the floors covered with heavy carpets in which are collected pounds upon 
pounds of organic dust. There are dressing rooms in which are stowed 
away old shoes and well-packed drawers of well-worn clothing. There 
are dining rooms in which the odor of the latest meal is never absent, and 
from the sideboard and cupboards of which the smell of decomposing 
fruit or cheese is always emanating, etc. . . . Under such conditions 
thousands of families live, children grow up, and old people die. They 
may all go for years and suffer no acute disease, and those of the family 
whose duty calls them daily into the open air may even be healthy ; but 
those who have to remain nearly all day in the devitalized atmosphere of 
the home, show the fact in paleness of face, languor of limb, persistent 
sense of weariness, and dulness of spirit. Under such conditions acute 
disease, epidemic fever, or other actively dangerous malady need not occur 
unless it be introduced from without ; but the home is ready for it if it be 
introduced." — Dr. Benjamin W. Richardson, Diseases of Modern Life. 

Page 260, § 279 (&). Cleanliness versus Dirt. — " True cleanliness 
is a matter of minutiae, and admits of no subterfuge. If dirt can find a 
crack, a ledge, or an absorbent surface which cannot be reached by the 
ordinary method of cleansing, there dirt will accumulate ; and where dirt 
is, there will disease be also. If we are to look to our neighbors for 
painstaking cleanliness, we must go to Holland for example, where it is 
popularly believed that no gastronomic injury would ensue from dining 
directly off the flooring boards or tiles. Beyond the delightful duty of 
scrubbing everything which is not painted, the Dutchman and his wife 
find no such esoteric and sanitary delight as in painting everything 
which cannot be scrubbed or rubbed bright. And the Dutchman is 
right. No layer upon layer of paper-hangings, with brown, gray, or 
green arsenical dust to slowly poison the more susceptible of the family. 
No sham plaster walls, porous to sewer-gas and corrupted with putrefied 
paste, can be allowed. If we have lath and plaster, let it be painted ; and 
if we cannot have wainscot or mahogany, kept brilliant by continual 
cleanly friction and polish, let us have a clean, painted, wooden surface, 
as artistic in tint and in the disposal of the colors and decoration as taste 



APPENDIX. 455 

and means will afford it ; but, to carry out a determined war against dirt 
and disease, let us have paint. These are no longer notions peculiar to 
the Dutch. They are sanitary axioms, which we cannot afford to ignore." 

— Dr. H. C. Bartlett, Paper on Chemistry of Dirt. 

Page 260, § 280 (a). Dr. Richardson on Damp Air in Houses. 

— " It is not invariably the new house that is rendered dangerous by being 
damp. There are in this country many old houses, picturesquely situated, 
which are not less dangerous. The stranger passing one of these residences 
is struck by its beauty. There is the ancient moat around it, or the lake 
in front with the sailing boat and swans, the summer-house, and splendid 
trees down to the water's edge. The stranger may well enough be fasci- 
nated by the view, but let him inquire and he will too often find a truly 
ghostly history of the place. He will be told, probably with some exag- 
geration of the truth, that the house is unlucky, that no one who has 
lived in it has reared a healthy child, and that a traditional malediction 
taints the place. If he enter the house he finds the basement steaming 
with water vapor ; walls constantly bedewed with moisture ; cellars 
coated with fungus and mould ; drawing-rooms and dining rooms always, 
except in the very heat of summer, oppressive from moisture ; bedrooms, 
the windows of which are, in winter, often so frosted on the inner 
surface from condensation of the water in the air of the room, that all 
day they are coated with ice. The malediction on the young nurtured in 
that mansion may not be so deep as is rumored, and it is much less 
obscure than is imagined ; but it is there, and its name is 'damp.' " — 
Dr. Benjamin W. Richardson, Diseases of Modern Life. 

Page 262, § 281 («). Condition of Ordinary Tenement Houses. — 

" This is the place : these narrow ways diverging to the right and left, 
and reeking everywhere with dirt and filth. Such lives as are led here 
bear the same fruit here as elsewhere. The coarse and bloated faces at 
the doors have counterparts at home and all the wide world over. De- 
bauchery has made the very houses prematurely old. See how the rotten 
beams are tumbling down, and how the patched and broken windows 
seem to scowl dimly, like eyes that have been hurt in drunken frays. . . . 
What lies beyond this tottering flight of steps that creak beneath our 
tread? A miserable room lighted by one dim candle, and destitute of 
all comfort, save that which may be hidden in a wretched bed. Beside 
it sits a man ; his elbows on his knees ; his forehead hidden in his hands. 
'What ails that man?' asks the foremost officer; 'Fever,' he sullenly 
replies, without looking up. Conceive the fancies of a fevered brain in 
such a place as this 1" — Charles Dickens, American Notts, 



450 APPENDIX. 

l - When the great riot occurred in 1863, every hiding-place and nursery 
of crime discovered itself by immediate and active participation in the 
operations of the mob. Those very places and domiciles, and all that are 
like them, are to-day nurseries of crime. ... By far the largest part 
— eighty per cent at least — of the crimes against property and against 
the person are perpetrated by individuals who have either lost connection 
with home life or never had any, or whose homes had ceased to be suffi- 
ciently separate, decent, and desirable to afford what are regarded as 
ordinary wholesome influences of home and family. Pure air, pure light, 
and sufficient room for domestic privacy and purity, are the simple reme- 
dies for these evil conditions.'' — B&port of Tenement House Committee, 
New York. 

'■A fire in the night in one of these human beehives, with its terror 
and woe, is one of the things that live in the recollection ever after as 
a terrible nightmare. ... A more unlovely existence than that in one 
of these tenements it would be hard to imagine. Everywhere is the 
stench of the kerosene stove that is forever burning, serving for cooking, 
heating, and ironing alike, until the last atom of oxygen is burned out of 
the close air. Oil is cheaper than coal. The air shaft is too busy carry- 
ing up smells from below to bring any air down, even if it is not hung full 
of washing in every story, as it ordinarily is. Enterprising tenants turn 
it to use as a refrigerator as well. There is at least a draught of air, 
such as it is. . . . The stuffy rooms seem as if they were made for 
dwarfs. Most decidedly, there is not room to swing the proverbial cat 
in any one of them. . . . The original demand was for 600 cubic feet 
of air space for each adult sleeper. . . . But of 28,000 and odd tenants 
canvassed in New York, in the slumming investigation prosecuted by the 
general government in 1894, 17,047 were found to have less than 400 feet, 
and of these 5526 slept in unventilated rooms with no windows. . . . 
Uptown or downtown, as the tenements grow taller, the thing that is 
rarest to find is the home of the olden days, even as it was in the shanty 
on the rocks. 'No home, no family, no morality, no manhood, no patri- 
otism ! ' said the old Frenchman. Seventy-seven per cent of their young 
prisoners, say the managers of the state reformatory, have no moral 
sense, or next to none. ' Weakness, not wickedness, ails them,' adds the 
prison reformer." — Jacob A. Rns, The Tenement House Blight. 

Page 262, § 281 (6). The Need of Model Tenements. — "The 
persistence of sickness and mortality in the old, crowded, tenement 
dwellings of our city, and the rapid and very great falling off in the rates 
of sickness and death in the new and airy sanitary dwellings like Sir 



APPENDIX. 457 

Sydney Waterlow's in London, and Mr. White's in Brooklyn, or like the 
improved districts in Edinburgh and Glasgow, show that a great work 
for the physical and moral improvement of the common classes, and for 
the prevention of poverty and causes of pauperism, must be undertaken 
in plans for dwelling reform in our crowded city. The homes of the 
New York City poor must be provided with sunlight, fresh air, and the 
moral safeguards of real domesticity. The Improved Industrial Dwellings 
Company, of which Sir Sydney Waterlow is president, in London, report 
that in their nearly three thousand tenements there are no fevers and 
deaths by contagious diseases, and in Glasgow the health officer reports 
that in the reformed dwellings he has not beard of a case of infectious 
disease. Let the deadly contagion of vices and crimes be exterminated 
from the habitations of the poor, and let the natural agencies of health 
and purity surround and fill their dwellings, as means of saving from 
pauperizing, sickness, and from the evils that medical charities and penal 
institutions cannot cure." 

Good Results or Improved Dwellings. — Improved buildings in 
Brooklyn, built by Mr. A. T. White after the best London models, contain 
from one thousand to eleven hundred people. In the city of Brooklyn at 
large, the annual deaths of children under five appear to average between 
nine and ten in the hundred, while in these dwellings it is only between 
six and seven, according to the agent's figures. In old-style tenements 
of about the same size in New York, the Board of Health figures show 
a corresponding rate of 11.4. 

It appears from the death records in these Brooklyn buildings that 
"there is no instance in which a contagious disease has been communi- 
cated to apartments adjoining, or above or below. These diseases, of 
course, enter there, as into the best-guarded private houses, but the out- 
side staircase has so far provided all necessary isolation, while in ordi- 
nary houses used by several families the stairway hall is as natural a 
vehicle for the communication of disease as that of sound, smells, or 
flames." — Alfred T. White, Dwellings of the Laboring Classes. 

Page 262, § 282 (a). Living in the Open Air. — Dr. Benjamin 

Ward Richardson, of London, who has studied the condition of the home- 
less, divides them into three classes : first, vagrants ; second, itinerants, 
like the " cheap John " fraternity and showmen ; and third, nomads, like 
the gypsies. He says : — 

"The vagrant class, notwithstanding irregular meals, uncertain lodg- 
ings, and general lack of comfort, enjoy a degree of health equal, at least, 
to that of the hard-working classes in packed eoininiuiities. They do not 



458 APPENDIX. 

suffer from any special class of diseases, and zymotic diseases are not 
specially prevalent among them. Generally they do not live to a great 
age, but there are exceptions to this rule. 

"The itinerant class is much better fed and clothed than the vagrant 
class, and much better sheltered apparently, yet the close van, which 
serves at once for storehouse, kitchen, sitting-room, and sleeping apart- 
ment, does not conduce to the health and well-being of its inmates. 
They are not healthy looking, and their children have usually a pale and 
oppressed cast. They seem to be less subject to such diseases as measles, 
scarlet fever, smallpox, and typhoid fever, than residents of houses are. 

" The nomadic class, or tent-dwellers, are by far the most fortunate in 
regard to health. Rheumatism of the subacute or chronic variety, with- 
out fever, seems to be their only enemy in the way of disease. Of the 
zymotic diseases they know little. They do not suffer from consumption 
nor any of the chest diseases. . . . These statements apply only to gypsies 
in the nomadic state. When they settle down to the happier (?) influ- 
ences of civilization, such comforts as consumption, zymotic diseases, 
chest diseases, etc., come within their reach. . . . Poverty, of itself, is not 
necessarily a cause of the worst diseases. Open air is a powerful disin- 
fectant, protecting the gypsy from germs which we vainly fight with all 
the aid of science. 

' ' In many human habitations diseases are not only begotten, but 
entrapped. " 

Page 265, § 286 (a). The Passage of Air through Plaster, Bricks, 
etc. — "My illustrious preceptor, Prof. John W. Draper, demonstrated, 
many years since, by a series of ingenious experiments, the facility with 
which gases diffuse, even when opposed by a pressure equivalent to that of 
twenty atmospheres. The illustrations exhibited this evening warrant us 
in the deduction that the purity of air in our buildings, whether private 
or public, is due not only to ventilation and to the imperfect work of the 
carpenter, but also to the porosity of the plaster, and the brick or stone 
walls through which diffusion takes place, a part of the foul air within 
being exchanged for the fresh, oxygen- abounding air from without." — 
Dr. R. Ogden Doremus. 

Page 265, § 286 (6). Automatic Ventilation. — As an instance of 
automatic ventilation, may be mentioned the plan in use in the cabins 
of the ferry-boats plying between New York and Brooklyn. These 
boats carry thousands of persons every week. Before the introduction of 
the automatic ventilators, the air of the cabins, at times of day when 
the passengers were most numerous, was stifling and impure. Since their 



APPENDIX. 459 

use, a very perceptible change for the better has been noticed. The 
following are sometimes the results of non-automatic ventilation : In an 
institution for children the ventilators were open upon the doctor's visit, 
but a few moments after were found filled with old clothes. In a large 
school, where the air was impure and the cause of sickness, an investi- 
gation showed that the ventilating apparatus, though in itself good, was 
of no real value, for the janitor used the fresh-air flue of the furnace as 
a chicken coop, and the janitor's boy the ventilator in the roof as a 
pigeon house. 

Page 266, § 287 (a). The Amount of Air required in Ventila- 
tion. — " The only safe principle in dealing with the subject is to have a 
large margin for contingencies ; and the question really is not whether 
six hundred cubic feet per man is too much but whether six hundred 
cubic feet per man be enough for all the purposes of warming, ventilation, 
and comfort. It has been said that the question of cubic space is simply 
a question of ventilation, but it is rather a question as to the possibility of 
ventilation. The more beds or encumbrances you have in a room with a 
limited cubic space, the more obstruction you have to ventilation. The 
fewer the beds, the more easy it is to ventilate the rooms. There are 
fewer nooks and corners, fewer surfaces opposed to the movement of the 
air, and less stagnation." — Beport of Barracks Improvement Commission. 

Page 267, § 288 (a). "Instructions for Disinfection (prepared 
for the National Board of Health). — Disinfection is the destruction of 
the poisons of infectious and contagious diseases. Deodorizers, or sub- 
stances which destroy smells, are not necessarily disinfectants, and disin- 
fectants do not necessarily have an odor. Disinfection cannot compensate 
for want of cleanliness, nor of ventilation. 

"I. Disinfectants to be employed. — (1) Roll sulphur (brimstone) 
for fumigation. (2) Sulphate of iron (copperas) dissolved in water in the 
proportion of one and a half pounds to the gallon : for soil, sewers, etc, 
(3) Sulphate of zinc and common salt, dissolved together in water in the 
proportions of four ounces sulphate and two ounces salt to the gallon : 
for clothing, bed linen, etc. 1 

1 Carbolic acid is not included in the above list, for the following reasons ; 
It is very difficult to determine the quality o( the commercial article, and the 
purchaser can never be certain of securing it of proper strength ; it is expen- 
sive, when of good quality, and experience has shown that it must he em- 
ployed in comparatively large quantities to be of any use; it is liable by its 
strong odor to give a false sense of security. 



460 APPENDIX. 

" II. How to use Disinfectants. — (1) In the Sick-room. — The most 
available agents are fresh air and cleanliness. The clothing, towels, bed- 
linen, etc., should, on removal from the patient, and before they are 
taken from the room, be placed in a pail or tub of the zinc solution, boil- 
ing hot, if possible. All discharges should either be received in vessels 
containing copperas solution, or, when this is impracticable, should be 
immediately covered with copperas solution. All vessels used about the 
patient should be cleansed with the same solution. Unnecessary furni- 
ture, especially that which is stuffed, carpets and hangings, should, when 
possible, be removed from the room at the outset ; otherwise they should 
remain for subsequent fumigation and treatment. (2) Fumigation with 
sulphur is the only practicable method for disinfecting the house. For 
this purpose the rooms to be disinfected must be vacated. Heavy cloth- 
ing, blankets, bedding, and other articles which cannot be treated with 
zinc solution, should be opened and exposed during fumigation, as directed 
below. Close the rooms as tightly as possible, place the sulphur in iron 
pans supported upon bricks placed in wash-tubs containing a little water, 
set it on fire by hot coals or with the aid of a spoonful of alcohol, and 
allow the room to remain closed for twenty-four hours. For a room 
about ten feet square, at least two pounds of sulphur should be used ; for 
larger rooms, proportionally increased quantities. (3) Premises. — Cel- 
lars, yards, stables, gutters, privies, cesspools, water-closets, drains, 
sewers, etc., should be frequently and liberally treated with copperas 
solution. The copperas solution is easily prepared by hanging a basket 
containing about sixty pounds of copperas in a barrel of water. (4) Body 
and Bedclothing, etc. — It is best to burn all articles which have been in 
contact with persons sick with contagious or infectious diseases. Articles 
too valuable to be destroyed should be treated as follows : (a) cotton, 
linen, flannels, blankets, etc., should be treated with the boiling hot zinc 
solution ; introduce piece by piece, secure thorough wetting, and boil for 
at least half an hour. (&) Heavy woollen clothing, silks, furs, stuffed 
bed covers, beds, and other articles which cannot be treated with the zinc 
solution, should be hung in the room during fumigation, their surfaces 
thoroughly exposed, and pockets turned inside out. Afterward they 
should be hung in the open air, beaten and shaken. Pillows, beds, 
stuffed mattresses, upholstered furniture, etc., should be cut open, the 
contents spread out, and thoroughly fumigated. Carpets are best fumi- 
gated on the floor, but should afterward be removed to the open air and 
thoroughly beaten. (5) Corpses should be thoroughly washed with a 
zinc solution of double strength ; should then be wrapped in a sheet wet 
with the zinc solution, and buried at once. Metallic, metal-lined, or air- 



APPENDIX. 461 

tight coffins should be used when possible ; certainly when the body is to 
be transported for any considerable distance. 

"George F. Barker, M.D., University of Pennsylvania, Philadelphia; 
C. F. Chandler, M.D., Coll. Phys. and Surgs., Health Dept., New 
York ; Henry Draper, M.D., University of City of New York; Ed- 
ward G. Janeway, M.D., Bellevue Medical College, Health Dept., 
New York; Ira Remsen, M.D., Johns Hopkins University, Baltimore, 
Md. ; S. O. Vanderpoel, Health Dept., New York, Health Officer 
Port of New York" 

The Committee on Disinfectants of the American Public Health Asso- 
ciation give the following conclusions as to the value of various disinfec- 
tants in the order named : — 

Conclusions. 

Agents for the Destruction of Spore-containing Infectious Material. 

1. Fire, complete destruction by burning. 

2. Steam under pressure, 105° C. (221° F.) for ten minutes. 

3. Boiling water for half an hour. 

4. Chloride of lime, 1 a four per cent solution. 

5. Mercuric -chloride, a solution of one to five hundred. 

Agents for the Destruction of Infectious Material not containing Spores. 

1. Fire, complete destruction by burning. 

2. Boiling in water for ten minutes. 

3. Dry heat, 110° C. (230° F.) for two hours. 

4. Chloride of lime, a two per cent solution. 

5. Solution of chlorinated soda,' 2 a ten per cent solution. 

6. Mercuric chloride, a solution of one to two thousand. 

7. Carbolic acid, a five per cent solution. 

8. Sulphate of copper, a five per cent solution. 

9. Chloride of zinc, a ten per cent solution. 

10. Sulphur dioxide, 3 exposure for twelve hours to an atmosphere con- 
taining four volumes per cent of this gas in presence of moisture. 

Page 267, § 289 (a). Light as a Stimulus to Respiration. — " It 

has been an axiom from time immemorial that for health sleep should 
be taken during the still hours of night, and not during the day. The 

1 Containing at least twenty-five per cent of available chlorine. 

2 Containing at least three per cent of available chlorine. 

8 This will require the combustion of between three and four pounds of sul- 
phur for every one thousand cubic feet of air space. 



462 APPENDIX. 

example of the ruddy, healthy peasant, who retires to rest with his cattle, 
and is up with the lark, has been quoted a thousand times. It appears to 
me, however, that the undeniable fact of exposure to the light of day 
being an element of health which vivifies and reddens the blood was 
never satisfactorily explained until the publication of the experiments of 
the late Dr. Edward Smith, of the Brompton Hospital. Dr. Smith has 
proved that light is a powerful stimulus to respiration ; that under the 
influence of daylight one third more atmospheric air enters the lungs than 
under darkness, or even under exposure to artificial light. In other 
words, if in daylight during a given time six hundred cubic inches of 
atmospheric air were inspired, during the same time at night only four 
hundred would enter the lungs, — a powerful additional reason and argu- 
ment for pure air at night during sleep. As the oxygenation and subse- 
quent reddening of the blood depend on its contact with atmospheric air 
in the lungs during respiration, it is clear, if we accept the above state- 
ments, that the more the body is exposed to sunlight the more oxygen it 
will imbibe. As a necessary sequel, the more oxygen physiologically 
enters the economy, through the functions of respiration, the more per- 
fectly will all the vital processes which require oxygen be performed." — 
Bennett, Nutrition in Health and Disease. 

Page 268, § 289 (5). Light as a Destroyed of Disease Germs. — 

"Among the germicide agents which have been tested, I will first mention 
light. We have experiments by a number of different observers upon 
the germicide power of light, and it is a very interesting fact that expo- 
sure to the bright sunlight destroys pathogenic organisms, independent of 
the heat of the sun ; experiments have been made to show this. Taking 
two tubes, one of which is enveloped in tinfoil to exclude the light, but 
which receives the heat in the same way as the other ; in the one which 
is exposed to the bright sunlight the germs in certain cases are destroyed 
— in some instances in quite a short time. Duclaux found that certain 
micro-organisms are destroyed in twelve hours' time when exposed to the 
sun during June and July. He found that dry spores were destroyed in 
two months when exposed in a dry condition. These spores can be kept 
indefinitely when put in a dark place in a dry condition. Another ob- 
server, Arloing, found that the spores of anthrax in bouillon were killed 
in two hours ; whereas the anthrax bacillus required from twenty-seven 
to thirty hours. It was a strange fact that the anthrax bacilli which had 
grown out withstood the light longer than the spores. The explanation 
is supposed to be that the spore, just at the moment of sprouting, is more 
tender and more easily killed than the bacilli after they are in full devel- 



APPENDIX. 463 

opment and multiplying by binary division. He found by putting these 
same spores in water that they were not killed ; it was only in a suitable 
culture medium that the light had this effect on them. By the electric 
light spores in bouillon were killed in one hour. This shows us that in 
sunlight we have a sanitary agent of great importance ; a fact which has 
long been recognized by sanitarians, and now we have experimental data 
to support this well-recognized fact." — Dr. G. M. Sternberg. 

Page 274, § 295 (a). Nerve Cells. — " The cell of the nervous tissue, 
like that of all other tissues, is the essential, living part. In it go ori the 
mysterious molecular changes which are presented to us as nervous action. 
To it the surrounding structures are entirely subservient. It is the text- 
ural Rome to which all roads turn. It is upheld by the connective tissue ; 
it is nourished by the capillaries and lymphatics ; it is drained by the 
venules. Although it differs from other cells in many ways that are 
strongly marked, in none is it more distinctive than in the fact that it is 
placed in direct, or almost direct, communication with distant structures 
by fibres that conduct sensations to it and by others that convey actions 
from it. The type of a nervous organism, then, is a cell, to which are 
attached conducting fibres for sensation and motion respectively. The 
cells being clustered together in what is known as gray matter, and the 
conducting fibres being composed of so-called white matter, all nervous 
structures are made up of gray or cellular and white or conducting matter, 
be the relative proportions of each, and the form of the particular organ, 
what they may. Each group of cells — perhaps the science of the future 
will enable us to say each cell — has an intelligence of its own, which has 
long been beclouded by the name of 'function.' This intelligence, mis- 
named function, is adequate to the purpose of that particular group of 
cells. If they be the cells of a jellyfish, they enable the animal to float 
on the surface of the water, to nourish itself, and to seize its prey. If 
they be the cells of a bee, they enable it to organize all the wondrous 
economy of the hive, — to select its queen, to eliminate the drones, to build 
the mathematical cell. If they be the cells of the lion, they form the 
anatomical substratum of all the beast's kingly and ferocious habits. 
Finally, when they become the cells of the human gray matter, they are 
intelligent still, varying in the degree of that intelligence as it mounts 
from the lowly lower end of the spinal cord, increasing in complexity as 
it ascends, until it culminates in the most wonderful gray matter of all 
species, — the cortex of the cerebrum, the seat of the mind. 

" From the foregoing statements it follows that all nervous organisms 
are composed of numerous foci of cellular intelligence, intercommunicating 



464 APPENDIX. 

and bound together into one harmonious whole by the white or conducting 
fibres. 1 " — Dr. Landon Carter Gray, in the Annals of the Anatomical 
and Surgical Society. 

Page 280, § 303 (a). The "Weight of the Brain. — " The average 
male brain (in Europeans) is 49.5 oz. ; the female, 44 oz. The brain of 
Cuvier, the naturalist, weighed 64.5 oz., and that of Daniel Webster, 
53.5 oz. The brains of idiots have been found to vary in weight from 27 
oz. to as low as 8.5 oz. The brains of the insane are said to be 2\ per 
cent below the average of the sane. Tall men, as a rule, have larger 
brains than small men. . . . The maximum size of the brain is reached, 
not in human beings, but in the elephant tribe ; and after, the whales, 
whose ponderous bodies demand an enormous muscular expenditure. 
The elephant's brain weighs from 8 to 10 lbs. ; the whale's brain is said 
to weigh from 5 to 8 lbs. ... In addition to the propulsion of the muscles, 
a considerable amount of nerve force must be expended in supporting or 
aiding the processes of organic life, — digestion, respiration, circulation, 
and other operations. *' — Bain, Mind and Body. 

Page 283, § 307 (a). The Brain Working of Men and Women. 

— "We doubt whether woman is necessarily and essentially inferior 
mentally to man ; we are quite sure she is mentally dissimilar. The 
great maternal function alone could not operate without gradually induc- 
ing intellectual differences which are perpetuated by sexual transmission. 
All experience tends to show that woman shines in intuition, man in 
judgment; that woman is strongest when impelled by emotion, man 
when impelled by will ; that man is creative, woman administrative ; that 
woman is greatest in self-sacrifice, man in conquest and achievement. Be 
these differences inherent in sex, or the outcome of evolution, their experi- 
ence can hardly escape any observer who does not start with some pre- 
conceived theory. ' ' 

Page 283, § 308(a). The Development of the Brain in Chil- 
dren. — "Between the fifth and sixth years the base of the brain 
grows very rapidly ; the frontal bone protrudes anteriorly and grows 
upward. The anterior portion grows considerably, but still the white 
substance and middle portion of brain are prevalent, These are the 
organs for the receptive faculties and memory. About this time learning 
ought to commence in earnest. All the above figures point to the end of 
the seventh year as the period of beginning mental work. But the gray 
substance is also developing at that period. It ought to be influenced to 
a certain degree, like a young tree in the time of its growth, without, how- 



APPENDIX. 465 

ever, being strained. Many organs in the brain,— many functions. 
Neglect none ; exercise all gently. It is a mistake to exercise one faculty 
only. Our text-books, in the shape of catechisms, exercise the memory 
only, and thereby fatigue and exhaust. The compound exercise consisting 
in walking, with its changes and cooperative action, is less fatiguing than 
standing on a single leg. Learning by heart is not learning, and reciting 
is not thinking ; just as little as deglutition is digestion. " — Dr. A. Jacobi, 
Transactions N. Y. Academy of Medicine. 

Page 306, § 331 («). How the Nervous System is injured by- 
Overwork. — " You see, my dear working friends, I am great upon spar- 
ing your strength and taking things cannily. ' All very well, ' say you, 
'it is easy speaking, and saying "Take it easy "; but if the pot's on the 
fire, it maun bile.' It must ; but you needn't poke up the fire forever, and 
you may now and then set the kettle on the hob and let it sing, instead of 
leaving it to burn its bottom out. I had a friend who injured himself by 
overwork. One day I asked the servant if any person had called, and was 
told that some one had. ' Who was it ? ' 'Oh, it's the little gentleman 
that aye rins when he walks f So I wish this age would walk more, and 
' rin ' less. A man can walk farther and longer than he can run, and it is 
poor saving to get out of breath. ... I am constantly seeing men who 
suffer, and indeed die, from living too fast ; from true, though not con- 
sciously, immoral dissipation, or scattering of their lives. Many a man is 
bankrupt in constitution at forty -five, and either takes out a cessio of him- 
self to the grave, or goes on paying ten per cent for his stock in trade ; he 
spends his capital instead of merely spending what he makes, or, better 
still, laying up a purse for the days of darkness and old age. A queer 
man, forty years ago, Mr. Slate, or, as he was called, Schlate, — who was 
too clever and not clever enough, and had not wisdom to use his wit, always 
scheming, full of ' go ' but never getting on, — was stopped by his friend. 
Sir Walter Scott (that wonderful friend of us all, to whom we owe Jeanie 
Deans and Rob Roy, Meg Merrilies and Dandie Dinmont, Jinglin' Geordie, 
Cuddie Headrigg, and the immortal Bailie), one day, in Princess Street. 
'How are ye getting on, Schlate ? ' 'Oo, just the auld thing. Sir Walter. 
ma pennies a" 1 gang on tippenny eerands.' And so it is with our nervous 
power, with our vital capital, with the pence of life, — many oi them go 
on ' tippenny eerands. ' We are forever getting our bills renewed, till 
down comes the poor and damaged concern with dropsy or consumption, 
blazing fever, madness, or palsy." — Dr. John Brown, Spare Hours. 

Page 306, § 332 (a). Wear and Tear of the Body.—"! have 
called these hints Wear and Tear, because this title clearly and briefly 



466 APPENDIX. 

points out my meaning. Wear is a natural and legitimate result of 
lawful use, and is what we all have to put up with as the result of years 
of activity of brain and body. Tear is another matter ; it comes of hard 
or evil usage of body or engine, of putting things to wrong purposes, using 
a chisel for a screw-driver, a penknife for a gimlet. Long strain, or the 
sudden demand of strength from weakness, causes tear. Wear comes of 
use, tear of abuse. . . . Why is it that an excess of physical labor is better 
borne than a like excess of mental labor ? The simple answer is, that 
mental overwork is harder, because, as a rule, it is closet, or counting 
room, or, at least, indoor, work, — sedentary, in a word. The man who is 
intently using his brain is not collaterally employing any other organs, and 
the more intense his application, the less locomotive does he become." — 
Dr. S. Weir Mitchell, Wear and Tear. 

Page 306, § 332 (6). Hysteria and Nervousness. 

The Causes and Evils of Hysteria. — The term Hysteria is ordi- 
narily applied by the laity to alternating conditions of the emotions ; 
among medical writers, it refers to various phenomena of disturbed 
nervous force. It can simulate every known disease. The emotional 
variety, while it may be the result of incipient disease of the nervous 
system or some other part of the body, of overwork, or of worry, is too 
often due to the concentration of one's thoughts upon one's self, the 
desire for notoriety, etc. If hysteria is merely "a bad habit, " it should 
be broken up, not only for the welfare of the individual afflicted, but 
because impressible friends may acquire similar habits, by imitation. 
The cure consists in a change of surroundings (of habitation, companions, 
etc.) and in hygienic measures. If the hysteria is the result of disease, 
it needs the best medical aid, for it is then a serious affection. Dr. S. 
Weir Mitchell, in speaking of the fact that men as well as women are 
liable to hysteria says : "I have many a time seen soldiers who had 
ridden boldly with Sheridan or fought gallantly with Grant, become, 
under the influence of painful nerve wounds, as irritable and hysterical 
as the veriest girl. " In reference to the bad influences which hysterical 
persons exert, he writes truthfully: "A hysterical girl is, as Wendell 
Holmes has said in his decisive phrase, a vampire who sucks the blood 
of the healthy people about her, and I may add that pretty surely where 
there is one hysterical girl, there will be soon or late two sick women." 

What ails the Modern Girl? — "The modern girl hardly knows 
what she wants, whether it is the higher education, an aesthetic wardrobe, 
love, or fame. She plays tennis and progressive euchre, and flirts and does 
Kensington work and reads Herbert Spencer, and very often writes ; she 



APPENDIX. 467 

dabbles in music and talks theosophy, and if there are more things in 
heaven and earth than are dreamed of in her philosophy one questions 
what they can be. Withal, she is as restless as the wind. She does not 
love the quiet of home ; she lives on excitement ; she goes to Europe, to 
the springs, the mountains, the theatres, the receptions, if she can get 
there, or to the modiste ; she can always fall back upon clothes as a diver- 
sion, and, when everything else fails, she has nervous prostration and a 
trained nurse. In fact, the chief trouble with the modern girl, be she 
rich or poor, is that she either does too much, keeps her nerves on the 
strain, and by and by goes to the other extreme, and does literally nothing 
but consume drugs, talk of her ills, and consult the Christian Scientists ; or 
she has no real interests, fritters - away her time in shallow pursuits, 
becomes pessimistic and dyspeptic, dissatisfied with herself and all the 
world ; cries and questions if life is worth living, and feels especially blue 
on holidays. The remedy for all this is, perhaps, an object in life ; those 
who are well and unselfishly occupied do not question if life is worth liv- 
ing ; they know it is ; and whether they are busy in the shoe factory, 
behind a counter, at the fireside, in the kitchen or the dining room, so 
long as they are busy and not shirking or reaching forward for something 
more congenial, and neglecting present duty, their minds are at rest and 
uninvaded by despondency. One of the best remedies for depression of 
spirits is the effort to bestow happiness ; it has been known to prove 
effectual when all other methods have failed ; when novels and new gowns 
and cod-liver oil and bovinine and bromide, when admiration and flattery, 
are no more serviceable than an abracadabra or any heathen spell. 
Melancholy or other ills of this nature are the direct result of a too strong 
egotism ; and an absorbing interest in others is a safe and agreeable medi- 
cine and is usually the last thing a modern girl tries." — Boston Medical 
and Surgical Journal. 

Page 316, § 341 («). Keenness of the Senses. — "It seems to be a 
rule — one to which perhaps there are exceptions, and yet a rule — that 
when we suffer the loss or very serious impairment of one sense, nature 
compensates us by sharpening some other. Of this many interesting 
examples are seen. 

"Sanderson, the mathematician, lost his sight in 1683, when only one 
year old, after a severe attack of the smallpox. But in spite of his com- 
plete blindness, he gave himself up to the assiduous study of the sciences, 
and finally lectured at the University of Cambridge on mathematics and 
optics, with wonderful success. His sense of touch was exquisitely fine ; 
thus, in a collection of Roman medals, he could distinguish the genuine 



468 APPENDIX. 

from the false, although the latter were often so admirably counterfeited 
as to deceive those who examined them with their eyes. By the different 
feeling of the air on the face, he could tell when an object was placed 
before him, and his hearing was so accurate, in seizing and appreciating 
the slightest sounds, that he could determine the height of any chamber 
into which he was introduced, and his distance from the wall." 

Page 322, § 351 (a). What the Sense of Smell does for us.— 

"Of aU our senses, smell is the one that soonest gets out of practice, so 
much so that numbers of people really do not perceive disagreeable smells 
at all. If they always accustomed themselves to take notice, and to use 
their noses, they never would consent to live in the horrid air they do. 
That is a grand use of the sense of smell. It tells a person who attends to 
it, that there is some bad or injurious thing mixing itself in the air. A 
sensible person then sets to work to get rid of that thing, whatever it may 
be, and to make his air clean again. A stupid person takes no notice, and 
then his nose gets used to the disagreeable smell, and leaves off perceiving 
it." — J. Berners, Lessons on Health. 

Page 324, § 353 (a). Odors. — "It is well known that perfumes 
from very different sources may be classed under certain types. Thus 
the rose type includes geranium, eglantine, and violet ebony ; the jas- 
mine type, lily of the valley and ylang-ylang ; the orange type, acacia, 
syringa, and orange flower; the vanilla type, balsam of Peru, benzoin, 
storax, tonka bean, and heliotrope ; the lavender type, thyme and mar- 
joram ; the mint type, peppermint, balsam, and sage ; the musk type, 
musk and amber seed ; and the fruity type, pear, apple, pineapple, and 
quince. Attempts have been made to discover a relation between the 
colors of flowers and the intensity of their perfumes. White flowers 
manifest the greatest variety of odors, and then follow reds, yellows, 
greens, and blues. ... It is also noticeable that flowers which by their 
color emit most heat will volatilize the greatest amount of perfume, and 
that the more refrangible the rays reflected from the flower, the smaller is 
the amount of perfume. Colored substances have also different powers of 
absorbing odors. Whites, yellows, reds, greens, and blues absorb odors 
on a decreasing scale. The more intense the color the more likely is it to 
emit a strong odor, because no doubt the light acts on the essential oil on 
which the odor depends. Heat, more than light, favors the volatilization 
of perfumes. Hence the odors of a flower bed in a garden are often most 
apparent, not in bright sunshine, but in the shade. . . . An air of mod- 
erately high temperature and the presence of moisture favor the diffusion 



APPENDIX. 469 

of the odors of most, flowers." — Dr. John Cray McKendrick and Wm. 
Snodgrass, The Physiology of the Senses, Glasgow. 

Page 338, § 368 (a) . The Importance of the Convergence of the 
Eyes in Vision. — "To direct both eyes to the same point requires a 
delicately balanced associated action of several muscles of each eye. In 
any part of the body, where a certain set of muscles are accustomed to 
act together in a given direction, this particular combination of movements 
becomes natural and easy, and any other comparatively difficult. This 
may be appreciated, for instance, by any one who has undertaken to drive 
a nail into the ceiling, and has experienced the fatigue of the muscles of 
the arm and neck and back that follows almost immediately. We are 
accustomed always, in converging the eyes towards any small object, at 
the same time to direct them downwards, as the object is usually held in 
the hand, or lies on something before us, below the level of the eyes. This 
facility of turning both eyes inwards and downwards at the same time 
has not only been acquired by the individual, but has been inherited from 
his ancestors, and has become a part of his nature ; so that the association 
of convergence with any other than a downward movement demands an 
extraordinary effort. This is a cause of fatigue in looking at pictures hung 
high in a gallery. Considerable interest has been excited recently by an 
affection noticed in miners, and called 'miner's nystagmus,' in which 
the external muscles of the eyeball seem to lose their balance, and the 
eyes continually oscillate. It is thought to result from the unnatural 
position of the eyes, in working at the roof of the subterranean cavern in 
which these men pass their lives." — Eyesight and How to Care for It 
{American Health Primer). 

Page 343, § 372 («). Test for Color-blindness. — In several coun- 
tries, at the present day, all railroad engineers, pilots, switchmen, etc. , are 
tested as to color-blindness. From some examinations made by Dr. Jef- 
ries, of Boston, he concludes that about one person in every twenty-five 
is color-blind, and that color-blindness is much less frequent among women 
than among men. It can be readily tested in schools. 

"The most efficient test is the wool test of Holmgren, which consists 
of three skeins of wool dyed with standard test colors, viz., a light green, 
a pale purple or pink, and a bright red. Other skeins of rods, oranges, 
yellows, yellowish greens, pure greens, blue greens, violets, purples, pinks, 
browns, and grays, all called confusion colors, are provided, and the 
examiner is requested to select, one, and match it with one of the test 
colors. Suppose the light green skein is shown first. If the examiner 



470 APPENDIX. 

matches grays, brownish grays, yellows, orange, or faint pink with this 
he is color-blind. Then he is shown the purple skein. If he matches 
with this blue or violet he is red-blind, but if he selects only gray or 
green he is green-blind. Finally, he may be shown the red skein, having 
a bright red color, like the red flag used on railways. A red-blind per- 
son will then match, with this, green or shades of brown which to a 
normal eye seem darker than red, while if he be green-blind he will select 
shades of these colors which look lighter than red. Violet-blindness is 
recognized by the examiner confusing red and orange with purple." 
— Physiology of the Senses. 

Page 344, § 373 (a). The Disadvantages of Short Sight. —Short 
sight is said to be found seldom among farmers, seamen, and Indians, 
but it is very common in large cities among students, engravers, artists, 
etc., especially if they work by a flickering light, or one that shines 
brightly from in front directly upon the work. Prom an examination of 
the eyes of pupils between six and twenty-one years of age, in various 
schools throughout the country, by Drs. E. G. Loring, R. H. Derby, A. R. 
Mathewson, and J. S. Prout, it has been ascertained that among the 
lower classes 3.5 per cent were near-sighted, and among the higher 26 J 
per cent. In Germany the percentages are said to be even greater ; and 
it is rare to find army officers who do not wear spectacles. It may be 
that if as large a proportion of persons in this country with optical 
defects should wear glasses as is the case in Germany, we should be con- 
sidered as equally near-sighted. 

"A child may be thought a dullard, and to have no aptitude for 
observation or learning ; he may be counted cold-hearted and unrespon- 
sive when his face does not light up at the smile of his mother or the 
caress of his sister ; he may be esteemed sullen or stupid ; he may be 
counted a bad playfellow ; he may be thought eccentric or peculiar, 
because he does not behave like other children. All this and more may 
be the character ascribed to him, because his misfortune is to have bad 
sight. Besides, this, it is a truth in mental philosophy, that exactly such 
a character may be fastened upon him for life, because in his young 
days he was cut off from enjoyment of the visible world on terms of 
equality. with his fellows. Do we not know that dim-sighted persons are 
apt to be queer ? If their deficiencies had been noted and corrected 
at an early stage of life, who can say how much more symmetrical would 
have been their adult character, and how much happiness society and 
the family might have enjoyed from them?" — Pkof. H. D. Noyes, of 
New York, Eye Troubles in General Practice. 



APPENDIX. 471 

Page 346, § 378 (a). Injurious Effects of Certain Occupations 
upon the Eyesight. — "The knowledge of the injurious effects of certain 
kinds of schooling upon vision is not a new acquisition ; for Beer wrote, 
more than sixty years ago, ' He who has taken the fruitless pains as often 
as I have, to try and impress upon parents and friends, in the most 
friendly manner and upon the most convincing grounds, the mischievous 
effect upon the eyes of growing children of the forcing-house system of 
the present day, will still he disheartened to find his well-intended coun- 
sel, based upon long experience, and often repeated, either entirely 
neglected, or listened to only by a few.' . . . Because people hold the 
imperfectly understood principle that children should be constantly occu- 
pied, there is at all hours of the day a master at hand. There is read- 
ing, writing, language-learning, drawing, arithmetic, embroidery, singing, 
piano and guitar playing without end, until the persecuted victims are ren- 
dered pale, weak, and sickly, and to such an extent short-sighted or weak- 
sighted that finally counsel must be obtained. ... Of what avail is it 
to many charming girls, many estimable women, that as children they 
were regarded as prodigies, when the soundness of their eyes and the 
acuteness of their vision have been sacrificed ? " — R. B. Carter, Eyesight, 
Good and Bad. 

Page 347, § 378 (6). Printing Suitable for the Eyes.— Many of 
the cheap publications of the present day, and unfortunately some of the 
more costly, are poorly printed as to character of type, paper, space 
between the lines (i.e. "leading"), and "spacing," or distance between 
the words on the lines, and are therefore injurious to the eyes. 

" For all readers, pearl type, such as in these eleven words, 
" or of this size, agate, is altogether too small. 

" The same may be said of nonpareil, which unfortunately is used in periodical and other 
reading matter extensively circulated among' children and others. 

" Minion is larger, yet must be considered bad for the eyes, for it is much too 
small. 

"Even the next larger size, brevier, is not large enough, although very 
commonly employed. 

" Bourgeois type comes next in the scale, but for prolonged reading, as 
in encyclopaedias and numerous other much-used books, as well 
as periodicals and newspapers, 



472 APPENDIX. 

" it is inferior to long primer, which is a standard size for most 
well-printed books. 

" A still larger size, such as small pica, is better for young- 
children. 

" For the very young, pica, as seen in these two 
lines, is none too large. 

" Great primer type should be em- 
ployed in the first books that are 
put before the eyes of the young- 
est children." 

— Currier, Practical Hygiene. 

Page 364, § 392 (a). Sense Education. — Excellent work has 
been accomplished by "sense education "' in the Seguin Physiological 
School, New York. The following extract from a newspaper article, 
referring especially to the education of the voice in the feeble-minded at 
the above-named school, is so apropos that it is appended : ' ' There is that 
most depressing sight, the mouth of the child of feeble mind and body. 
Open it stands, gaping wide, with its pendulous lower lip. The facial 
muscles are ignorant of their duty. It is not will-power alone which will 
ever bring those lips together. Still this can be and is corrected. The 
child is taught to close it. Constantly the gentle teacher brings her finger 
to the child's lips, and an effort is made, after a while, by a self-sustained 
will, to close it. Sometimes a straw is held in the mouth, to show the 
child how to grasp it with the lips. After a while, when his attention is 
occupied with something else, he forgets to close it. The act of having 
his mouth open is noticed, and he shuts it at a word of command. He 
may have been perfectly unable a few months ago to arrest a flow of 
saliva from his mouth ; but now this secretion, which w T as over-abundant, 
has ceased. He might have been once a saddening sight to see ; but now 
much of that idiotic blankness has gone. But is it simply the child's 
appearance which has been improved ? No. A thousand things may 



APPENDIX. 473 

arise from this simple mouth instruction which are of advantage to the 
child in the sense of a brain-awakening. His speech has been thick and 
unintelligible. How could the poor lad pronounce a word properly, 
hampered as he was with rigid lips ? Now he is taught to pronounce 
letters properly. Every sound of every letter may have to be taught 
him. The lips become pliant, vibrate at last, and from what was a dumb, 
inanimate, resoundless block, distinct musical words now are flowing. 
The visitor is deeply impressed with what he has witnessed. He has 
seen the effect of constant, assiduous, philosophical training. He looks 
at a series of portraits of the children, and marks how rapid have been 
the changes. It is this sense-education which has taken from these drear 
faces their animal look, and made them human once more. Dr. Seguin 
it is who, though he be dead now, has given new life to many of God's 
creatures, and it is his wife who has carried out his work." 

Page 374, § 402 (a). Rules for the Care of the Voice. — "No 

man who is conscious of the ability to speak effectively can undervalue 
the power of a pleasant voice ; and no hearer of a melodious voice but 
will acknowledge its influence. We have, probably, all been charmed, 
and our attention riveted, by such a voice, even when the discourse was 
not above commonplace. The converse of this is, alas ! more often met 
with. It is a fact that many of the greatest thinkers, scholars, and 
writers use in public speaking and reading a heavy, low monotone, or 
they rasp the ear with a high and strident pitch. Their ' thoughts that 
breathe, and words that burn,' fall lifeless and cold, nay, even weary 
and repel their listeners, who experience a sense of relief when the inhar- 
monious voice ceases ; the speaker also being thankful that his painful 
struggle to be heard is over. How much the influence of the unfortunate 
possessor of such a voice is nullified ! If a statesman, how small must 
be his success in directing the fortunes of a nation ! If a clergyman, 
painfully will he feel that his earnest endeavors avail him nothing. If 
a barrister, he sees judge and jurymen sleeping, and to the detriment 
of his client he may lose his carefully prepared case. Yet. in almost 
every instance, a voice which has no inherent beauty may, by correct 
training, become attractive and pleasant, and obtain clearness, smooth- 
ness, and commanding resonance. 

'■'■Bides. 1. Never endeavor to produce a vocal tone without having 
plenty of breath, and that thoroughly under control. 2. Bold the breath 
when mspired, and commence to expire only on commencing to speak or 
sing, that is, at the moment it is required to set the ligaments in vibra- 
tion. 3. Do not think that loudness is essential to force or beauty : 



474 APPENDIX. 

shouting is always injurious. The telling quality of laryngeal tone 
depends solely on the amplitude of the vibrations, and this is controlled 
solely and entirely by the will, which directs the due proportion of -ur to 
set the vocal ligaments into more or less full vibration. For all purposes 
of practice it is especially advisable for the pupil to sing piano, which 
term does not imply diminished vigor, but simply reduced amplitude of 
the vibrations. 4. Never use the voice when functional failure gives 
warning that the organ, or the general health, is disordered. 5. Do not 
attempt to use the voice in unfavorable circumstances, as in the open air, 
especially if the weather be cold or raw, nor in a room impregnated with 
tobacco smoke, foul air, or dust. Above all, do not use the voice, even 
for conversation, in trains or vehicles, or in any circumstances of noise 
which will require undue functional exertion. In this connection it will 
be important to keep quiet, and avoid chattering and laughing, between 
songs or the acts of a drama or opera. 6. Do not use the voice for too 
long a period at a time, but always cease before fatigue is experienced. 
Especially avoid encores of songs which have required much exertion, or 
production of a telling high note in the final cadenza. It is but rarely 
that a song is sung as well on a redemand as at first. 7. After continued 
singing or speaking, be careful to prevent exposure of the throat, either 
externally or internally, to the impressions of cold air. The same remark 
applies as to the necessity of guarding against sudden changes from hot 
to cold air, even when the voice has not been used." — Browne, Voice, 
Song, and Speech. 



INDEX. 



References are to Pages. 



Abdomen, muscles of, 55. 
Abdominal, cavity, location, con- 
tents, 48. 

breathing, 235. 
Abductor muscles, 56. 
Absorbed food, fate of, 138. 
Absorption, by the skin, 85. 

of infectious diseases, by cloth, 107. 

of food, 112, 136. 
Accommodation or focussing, power 

of, 338. 
Achilles, tendon of, 55. 
Acids, as poisons, antidotes, 404. 
Aconite, as poison, 413. 
Acro-narcotic poisons, 411. 
Active tissues of the body, 10. 
Adam's apple, 365. 
Adductor muscles, 56. 
Adipose tissue, 64. 
Adulteration of food, 196. 
Afferent nerves, 275. 
Air, passages, the, 227. 

cells of the lungs, 231. 

quantity breathed, 237. 

tidal, 237. 

residual and reserve, 238. 

complemental, 238. 

changes in, during respiration, 240. 

composition of, 248. 

oxygen and nitrogen in, 249. 

ozone in, 250. 

harmful suspended matters, 250. 

disease germs, 251. 

malaria, 254. 

organic nitrogenous matter, 254. 

the "Black Hole of Calcutta," 451. 

of bed-rooms, hospital wards, etc., 
451 . 

harmful gaseous matters, 255. 

4 



carbon dioxide, 255, 452. 

carbon monoxide, 257. 

illuminating gas, 258. 

hydrogen sulphide, 258. 

sewer gas, 259. 

how devitalized, 260. 

devitalization of, 453. 

of country and city, 261. 

fresh, 262. 

purification of, 263. 

fresh, amount needed for each per- 
son in a room, 265. 

passage through plaster, etc., 458. 

sunlight, 267. 
Albino, skin of, 79. 

eyes of, 332. 
Albumin, of the body, 15. 

of food, 175. 
Albuminous, constituents of the 
body, 15. 

material of food, 133, 175. 

material of food, mode of preserving, 
201. 
Alcohol, nature, 19. 

general effects on the body, 20. 

and alcoholics, general facts as to, 24. 

effects upon bones, 48. 

effects upon muscles, 74. 

effects upon the skin. ST. 

effects upon the kidneys, 89. 

effects upon digestion and the diges- 
tive organs, 140. 

effects upon the organs of circulation 
and the blood, 170. 

as food, 202. 

effects upon respiration and the re- 
spiratory organs, 244. 

effects upon the nervous system. 308. 

effects upon touch, taste, and smell, 
325. 

effects upon sight, 346. 



476 



IXDEX. 



Alcohol, effects upon hearing, 362. 
effects upon the voice, 374. 
as a poison, 410. 

Alcoholic beverages, use and abuse, 
225. 

Alcoholics, classification of, 22. 

Alcoholism, acute and chronic, 21. 

Alimentary canal, location, struc- 
ture, function, 112. 

Alkalies and their salts, as poisons, 
405. 

Alveoli of the lungs, 232. 

Amids in food substances, 177. 

Amoeba, 4-8. 

Amoeboid, movements, 8. 

Amyloids, 180. 

Amylopsin, 135. 

Anatomy, human, definition of, 1. 

Animal, matter of bones, 35. 
foods, 189, 207. 
poisons, 408. 

Animal heat, or vital heat, descrip- 
tion of, 12. 
sources and loss of, 13. 
relation to circulation and respira- 
tion, 243. 

Antiseptics, definition and use of, 
266. 

Antitoxin treatment of disease, 19. 

Aorta, the, 147, 159. 

Apoplexy, 160, 282. 
treatment of, 380. 

Appendicitis, 122. 

Appendix vermiformis, 122. 
the (notes), 417. 

Appetite, healthy, 194. 
voracious, 195. 

Aqueous humor of the eye, 336. 

Arachnoid membrane, 279. 

Arbor vitae, 285. 

Arches of Corti, 358. 

Arms, bones of, 45. 

Arsenic, as poison, 405. 

Arteries, location, structure, proper- 
ties, 151. 

Arterioles, 152. 

Artesian wells, 221. 

Articular cartilages, 39. 

Articulations, see Joints. 

Artificial reflex actions, 303. 
respiration, methods, 384. 



Arytenoid cartilages, 365. 
Ascending- colon, 122. 
Assimilation, definition of, 8. 

of food, 112, 136. 
Astigmatism, 345. 
Atlas and Axis, 37. 
Atmospheric pressure, relation of 

body to, 247. 
Atropia, see Belladonna. 
Auditory, canal, 352. 

nerve, 358. 
Auricle of the ear, 352. 
Auricles of the heart, 147. 
Auriculo-ventricular openings of the 

heart, 147. 
Automatic movements of the body, 

how effected, 300. 
Axis cylinder of nerves, 274, 276. 



Bacilli, see Bacteria. 

Backbone, 41. 

Bacteria, description and action of, 

15. 
Balance of body, how maintained, 8. 
Baldness, 424. 
Ball and socket joints, 37. 
Barley as food, 214. 
Bathing, value of, 91. 

as a sanitary measure, 91. 

proper, 92. 

times for, 93. 
Baths, varieties of, 93-95. 

adaptation, 95-96. 

water, various effects of, 96-97. 
Beans, as food, 217. 
Belladonna, as poison, 409. 
Bicuspid teeth, 125. 
Bicycle riding, 422. 
Bile and its uses, 121, 130, 136. 

duct, common, 131. 
Biliousness, 136. 
Binocular vision, 338. 
Bioplasm, 4. 
Birth, 6. 

Bites and stings, venomous, 411. 
Black nightshade, as a poison, 412. 
Bladder, the, 48-89. 
Bleeding, how to stop, 395. 
Blind spot of the eye, 335. 



INDEX. 



477 



Blood, circulation of, 158. 

its value, composition, 161. 

transfusion of, 161. 

corpuscles, red, 161. 

corpuscles, white, 163. 

coagulation of, 161. 

quantity and quality, 165. 

poisoning through the skin, 167. 

changes in, during respiration, 240. 
Blood-vessels, 35, 143. 
Blushing-, cause of, 157. 
Body, human, general arrangement 
of, 2. 

fluids of, 2. 

tissues of, 10. 

chemical composition of, 14. 

wear and tear of, 465. 
Boiling- and broiling of food, 200. 
Bones, use and number, 29. 

shape, 29. 

classification, 29. 

of the skull and spinal column, 29. 

surfaces, 30. 

blood-vessels and nerves, 30. 

structure, 32. 

compact tissues of, 32. 

spongy or cancellous tissue of, 33. 

nutrition, 35. 

strength and elasticity, 35. 

of the hands and feet, 45. 

of the limbs, 45. 

of the ear, 355. 

broken, treatment of, 391. 

repair of, 393. 
Boots and shoes, 102. 
Bowels, see Intestines. 
Brain, the, and spinal cord, relation 
and membranes, 278. 

divisions of, 279. 

size and weight, 280, 464. 

localization, 283. 

working, of men and women, 4(54. 

development of, in children, 404. 
Bread, 215. 

stuffs, 214. 
Breastbone, 29, 44. 
Breathing, see Respiration. 

through the mouth. 228. 

through the nose, 448. 

expired air, results of, 148. 
Bronchi, the, 280. 



Bronchial tubes, large, 230. 

small (bronchioles) , 231. 
Bruise spot, 165. 

Bruises, treatment of, see Contusions. 
Burns and scalds, treatment of, 389. 
Butter and its substitutes, 212. 
Buttermilk, 212. 



Caffeine of coffee, 225. 

Caisson disease, to what due, 248. 

Calcium phosphate and carbonate, 

14, 185. 
Calories, 187. 
Canaliculi of bones, 35. 
Canals, Haversian, 35. 

semicircular, in the ears, 357. 
Cancellous tissue of bone, 33. 
Candy, the use of, 181. 
Cane sugar, 181. 
Canine teeth, 125. 
Cantharides as poison, 409. 
Capillaries, location, structure, func- 
tion, 154-157. 
Capillary circulation, 155. 
Carbohydrates, of the body, 15. 

of food, and their value, 178. 
Carbon dioxide in the air, 255. 

in caves, wells, etc., 452. 

in dwellings, schools, etc., 452. 

a simple test for, 453. 
Carbonic acid gas, see Carbon Diox- 
ide. 
Carbon monoxide in the air, 257. 
Cardiac opening of the stomach, 117. 
Cartilage, 32, 39. 
Cartilages, articular, 39. 

of the trachea, 230. 

of the eyelids, 828. 

of the larynx, 3(54. 
Casein in food, 175. 
Castor oil bean, as poison, 1(^8. 
Cataract, 336. 
Catching cold, how to avoid, 81, 91, 

109. 
Cauda equina, 291. 
Cavities of the skeleton, 46. 
Cell, life and death, 4-6. 

division of labor, 5. 

division, (>. 



478 



INDEX. 



Cellars, foul air, 256. 
Cells, description of, 2, 3. 

nerve, 274. 

mastoid, 355. 
Cement of the teeth, 123. 
Cereals or cereal grains, as food, 214. 
Cerebellum, location, 279. 

function, 285. 
Cerebral hemispheres, 281. 
Cerebration, unconscious, 304. 
Cerebro-spinal nervous system, lo- 
cation and functions, 272. 

fluid, 279. 
Cerebrum, 279-281. 

functions of, 282. 
Cesspools, dangers of, 256. 
Cheese, 213. 
Chemical processes of the body, 7. 

composition of the body, 14. 
Chest, or thorax, 44. 
Chink of the glottis, 368. 
Chloral hydrate as narcotic, see Nar- 
cotics. 
Chloride of sodium, see Common Salt. 
Chloroform and chloral, as poisons, 

410. 
Chocolate, 225. 
Choks damp, 256. 

Chordae tendineae of the heart, 148. 
Choroid coat of the eye, 331. 
Chyle, 135. 
Chyme, 134. 

Cigarette smoking, risks of, 26. 
Ciliae, description of, 3. 
Ciliary nerves of the eye, 331. 

muscle, body, and process, 334. 

motion, 9. 
Ciliated cells of the air passages, 228. 
Circle of life, 6. 

or field of vision, 339. 
Circulation, the, 112, 143. 

organs of, 142. 

pulmonary, respiratory, or lesser, 
143. 

systematic or greater, 143. 

collateral, 152. 

of the blood, movements, 158. 

force and rapidity, 160. 

relation of respiration to, 239. 
Circulation, respiration, and animal 
heat, relations of, 243. 



Cleanliness versus dirt, 454. 
Clothing-, uses of, 99. 

proper, 99. 

tight, bad effects of, 100-104. 

constriction of the waist, 425. 

quantity, 104-105. 

lightness, ventilation, and warmth, 
105-106. 

dryness and cleanliness, 106. 

bed, 106. 

unclean, risks attending the use of, 
426. 

color and dyes, 107. 

material, 108. 
Coagulation of blood, 164. 
Coats, or tunics of the eye, 330. 
Cocaine as a narcotic, 27. 
Coccyx, the, 42, 44. 
Cochlea of the ear, 357. 
Cocoa as food, 225. 
Coecum, the, 121. 
Coffee as food, 224. 
Coke, or scoke, as poison, 412. 
Colchiuum, as poison, 409. 
Cold baths, 97. 
Color, of the skin, 79. 

in dress, 107. 

of the blood, 162. 

of the eye, to what due, 334. 
Color blindness, 342. 

test for, 469. 
Columns of spinal cord, 292. 
Combustion, spontaneous, 243. 
Commissure, 281. 
Common salt, 185. 
Communicable or infectious dis- 
eases, 17. 
Compact tissue (of bone), 32. 
Complemental air, 238. 
Condiments, 219. 
Conjunctiva and Conjunctivitis, 

328. 
Connective tissue, 10. 
Consonant sounds, 370. 
Constipation, treatment of, 122,427. 
Consumption, or tuberculosis, 252. 
Contagious diseases, conveyance and 

danger, 17. 
Contractility of muscular tissue, 61. 
Contused wounds, treatment of, 
394-396. 



INDEX. 



479 



Contusions, or bruises, treatment of, 

394. 
Conversion of food into tissues, 110. 
Convolutions of the brain, 281. 
Convulsions, treatment of, 380. 
Cooking 1 , importance of good, 435. 
Cooperation, value of, in the body, 

272. 
Coordination of movements, 285, 

359. 
Copper, as poison, 406. 
Cordials, 23. 
Cords, vocal, 366. 
Corn, as food, 214. 
Cornea of the eye, 330. 
Corpora striata, 295. 
Corpuscles of the blood, 161. 
Corrosive poisons, 404. 
Cortex, 274, 281. 
Costal breathing, 235. 
Cotton, as clothing, 109. 
Cranial, cavity, 46. 

nerves, 285-287. 
Cranium, see Skull. 
Cricoid cartilage, 365. 
Croton oil, as poison, 408. 
Crowd poison, 255. 
Crystalline lens, the, 336. 
Customs, prevalent, adoption, 449. 
Cuticle, the, 77. 



Damp air in houses, 455. 
Death, local and general, 6. 
Deaths in armies, from sickness and 

wounds, 417. 
Decomposed meat, 210. 
Decomposition, 201. 
Decussate, 276. 

Defective hearing, causes of, 360. 
Defects in vision, 342. 
Deglutition, 112-132. 
Dental pulp, 123. 

floss silk, 128. 
Dentine of the teeth, 123. 
Deodorants or deodorizers, 266. 
Dermis, the, 77. 
Development and decline, 6. 

characteristic of man, 7. 
Devitalized air in dwellings, 260, 453- 



Dextrin, 180. 

Diapedesis, description of, 9, 163. 

Diaphragm, location, 47. 

importance in breathing, 235. 

importance in production of voice, 
373. 
Diastase, 180. 
Diastole of the heart, 149. 
Diet, oddities of, 428. 
Dietaries, 192. 
Dietary standards, 193. 
Differentiation, 5. 
Digestion, description of organs of, 
111, 122. 

steps of, 112, 131. 

accessory organs of, 122. 

stomach, 133. 

intestinal, 135. 

time occupied in, 428. 

normal requisites for, 139. 
Digestibility of food, 194. 
Digitalis, as poison, 410. 
Discontent, wholesome, 417. 
Disease, reasons for prevention of, 
11. 

antitoxin treatment of, 19. 
Disease germs, description of, 15- 
17. 

diseases they produce, and how, 
251-253. 
Diseases, infectious and contagious, 

17. 
Disinfection and disinfectants, 266. 

instructions for, 459. 
Dislocation, definition, 39. 

treatment of, see Fractures. 
Drinking water, 219. 
Drinks, natural and artificial, 219. 
Drowning, what to do in cases of, 

383. 
Drum, or drum-head, of the car, 
354. 

cavity, contents of, 355. 
Duct, thoracic, 121. 

salivary, 129. 

from gall bladder. 121. 131. 

pancreatic, L31. 

nasal, 329. 
Dura mater, 279. 
Dust in the air. 250. 
Dusting and sweeping, 252. 



480 



IXDEX, 



Dyes, poisonous, in clothing, 108. 
Dyspepsia, relief from, 140. 

B. 
Bar, location and structure, 352. 

external, 352. 

speculum, 354. 

middle, 355. 

internal, 357. 
Ears, hygiene of the, 361. 
Efferent nerves, 275. 
Eggs as food, 213. 
Elasticity, of muscles, 61. 

of arteries, 152. 
Emergencies, general directions, 376. 
Emmetropic, or normal eye, 343. 
Emulsion, 64. 
Enamel of the teeth, 123. 
Endocardium, 146. 
Endolymph, 357. 
Endosmosis and Exosmosis, 9. 
Endurance, powers of, 70. 
Energy, nervous, 305. 
Enzymes, 111. 
Epidermis, the, 78. 
Epiglottis, the, 365. 
Epithelial cells and tissues, 10. 
Epithelium, 113. 
Ergot, as poison, see Spurred Rye. 
Eucalyptus tree and sunflower, value 

of, 254. 
Eustachian tubes, location of, 115. 

relation to hearing, 356. 
Excretion, 7. 

Exercise, see Muscular Exercise. 
Expiration, movements of, 236. 
Extensor muscles, 56. 
External ear, 352. 
Extremities, see Limhs. 
Eye, the, use of, 327. 

coats of, 330. 

muscles and nerves of, 331. 

nupil and iris, 332. 

color of, 334. 

blind spot and yellow spot, 335. 
Eyeball, the media of, 336. 
Eyeballs, 330. 
Eyebrows, eyelashes, and eyelids, 

327. 
Eyes, hygiene of, 346. 

suitable printing for, 471. 



Facial nerves, or 7th pair, 290. 
Faculties of the cerebrum, 283. 
Fainting, how relieved, 379. 
Far sight, see Long Sight. 
Fasciculi of muscles, 58. 
Fasting, importance of water, 430. 
Fat, use of, 429, 430. 
Fat of the body, composition and 

uses, 15, 64. 
Fats, as food, 178, 181. 

value of, 182, 183. 
Ferments, mode of action of, 111. 
Fibres of muscles, 58. 
Fibrillae, 60. 
Fibrin, 15. 

and fibrinogen of blood, 165. 

ferment, 165. 

of food, 175. 
Fibrous tissue, 10. 
Field of vision, 339. 
Filth diseases, 17. 
Filtration and filters, 224. 
Fire damp, 258. 
Fireplaces, 265. 
Fish, as food, 209. 

poisonous, 408. 
Fits, see Convulsions. 
Flat foot, 46. 
Flesh, as food, 207. 
Flexor muscles, 56. 
Flour, 214. 

Flowers as poisons, 414. 
Fluids of the body, 2. 
Focussing, see Accommodation. 
Follicles, sebaceous, 82. 

of the hair, 83. 

of the stomach, 118. 

of the intestines, 121. 
Food, absorbed, fate of, 138. 

definition and uses of, 173. 

sources of, 174. 

elements of, 174. 

proteids of, 174. 

elements, nitrogenous, non-albumi- 
nous, 177. 

inorganic constituents of, 183. 

vegetable acids, 186. 

fuel value of, 186-187. 

substances, relative value of, 187. 



INDEX. 



481 



Food, mixed diet, importance of, 
189. 

quantity of, 190. 

dietaries, 192. 

estimated daily needs and food ac- 
tually consumed, 433. 

digestibility of, 194. 

variety of, 195. 

adulteration, freshness, maturity of, 
196. 

cost and waste of, 197. 

proper preparation and cooking, 198. 

economy and nutritiousness, 434. 

preservation of, 200, 436. 

alcohol as, 202. 

how to utilize remnants of, 437. 

adaptation to digestive powers, 438. 

decomposition to be guarded against, 
440. 
Foods, classification of, 207. 

animal, 207. 

harmful meats, 210. 

vegetable, 214, 443. 

vegetables, 216, 443. 

fruits, 218. 

nuts, 218. 

condiments, 219. 

water, 219. 
Foreign bodies, in nose, throat, ear, 

and eye, how to remove, 399. 
Fractures and dislocations, treat- 
ment of, 391. 
Freckles, cause of, 79. 
Frostbite, treatment of, 391. 
Fruit, as food, 218. 
Frying- food, proper method, 200. 
Fuel value of food, 18(5. 
Function, definition of, 1. 

specialization of, 5. 
Fundamental tone of voice, 351. 

G. 

Gall-bladder, 130. 
Game, as food, 209. 
Ganglia, 274. 

basal, 284. 
Garden produce, 197, 214. 
Gas poisoning-, resuscitation from. 

381 . 
Gases, in the atmosphere, 255, 

as poisons, 408. 



Gastric juice, 118, 133. 

Gelatin and gelatinoids, as food, 177. 

Glands, sweat, 79. 

sebaceous, 82. 

salivary, 128. 

Meibomian, 328. 
Glosso-pharyngeal nerve, 288. 
Glottis, 230. 

chinks of, 368. 
Glucose, or grape sugar, 15, 181. 
Gluten, as food, 175. 
Glycogen, 15, 130. 
Gray matter of nervous system, 274. 
Gullet, see Oesophagus. 
Gums, 122. 

Gustatory nerve, 319. 
Gymnasiums, 73. 

H. 

Habits, see Artificial Reflex Actions. 
Haemoglobin, 162. 
Hair follicles, 83. 

Hairs, location, structure, uses, 82. 
Hand, the adaptation for general use, 
45. 

the human, 418. 

the sense of touch, 317. 
Hanging, resuscitation from, 381. 
Hard palate, 114. 
Hard water, 221. 
Harmful meat, 210. 

air, 250. 
Haversian, canals, 35. 
Hay fever, production of, 324. 
Health, what the study of, includes, 1. 

value of, 11. 
Hearing, how effected, 351. 

organ of, 352. 

physiology of, 359. 

defective, 360. 

effects of alcohol and tobacco upon. 
362. 
Heart, the location ami relations, 1 13. 

component parts, 146. 

valves of. US. 

action or pulsations of. 149. 

sounds of. 1 19. 

beats. 150. 

nervous control of. 150. 

effects of alcohol ami narcotics upon. 

170. 



482 



INDEX. 



Heat, animal or vital, 12. 
sources and loss of, 13. 
exhaustion, see Sunstroke. 
Hemiplegia, 295. 

Hemispheres, the, of the hrain, 281. 
Hemlock, varieties of poisonous, 

409, 412. 
Hemorrhages, special (nose, lungs, 

mouth, stomach), treatment of, 

398. 
Hepatic veins, 129. 
Herbs, savory, use of, 445. 
Hiccoughing, 236. 
Hinge joints, 37. 
Hippophagy, 208. 
Histology, definition of, 1. 
Horns, anterior and posterior, of 

spinal cord, 291. 
Hot baths, 97. 

Human body, the, general facts, 1. 
Humors of the eye, 336. 
Hydrogen sulphide, 258. 
Hygiene, definition of, 1. 
Hyoscyamus, as poison, 410. 
Hypermetropia, see Long Sight. 
Hysteria and nervousness, 466. 

I. 
Ice, 220. 

and ice- water, 446. 
Ileo-coecal valve, 119. 
Illuminating gas, 258. 
Imbibition, definition of, 9. 
Immovable joints, 37. 
Immunity from infectious diseases, 

18. 
Impure blood, 147. 
Impurities, in water, effects of, 222. 

in the air, effects of, 262. 
Incised wounds, 394-396. 
Incisor teeth, 125. 
Incus, the, or anvil, 355. 
Infectious diseases, conveyance of 
and danger from, 17. 

immunity from, 18. 

how to prevent the spread of, 449. 
Inferior vena cava, 129, 147. 
Inoculation, 18. 

Inorganic constituents of the body, 
14. 

of food, 183. 



Insalivation, 112, 131. 

Insensibility, 379. 

Insensible perspiration, 81. 

Inspiration, 234. 

Intensity of sound, to what due, 351, 

369. 
Inter-costal muscles, 234. 
Internal ear, 357. 
Intestinal, digestion, 112-113. 

villi, 120. 

juice, 136. 
Intestines, or bowels, 118-121. 
Intoxication, relief of, 379. 
Inunction, 95. 
Involuntary muscles, 52. 
Iodine and iron as poisons, 406. 
Iris, the, 332. 
Iron, constituent of the food and 

the body, 186. 
Irritability of tissues, 271. 
Irritant poisons, 404. 



Joints, varieties, 36. 

structure of, 38. 

injuries to, 39. 
Judgment, 283. 
Juice, intestinal, 121, 136. 

pancreatic, 121, 129, 136. 

gastric, 133. 

K. 

Kidneys, location, structure, 88. 
functions, 89. 
effects of alcohol upon, 89. 

L. 

Labyrinth of the ear, bony and mem- 
branous, 357. 
Lacerated wounds, 394-396. 
Lachrymal apparatus, i.e. glands, 

canals, sacs, and secretion, 329. 
Lacteals, 120, see Lymphatics. 
Lactose, or sugar of milk, 15. 
Lacunae of bones, 35. 
Large intestine, the, 121. 
Laryngoscope, the, 367. 
Larynx, the, location of, 115. 

use in breathing, 230. 

cartilages of, 364. 



INDEX. 



483 



Larynx, use in voice, 364. 

muscles of, 366. 
Laughter, 236. 
Lead, palsy, 57. 

pipes, conveyance of water in, 
223. 

as poison, 407. 
Lens, crystalline, 336. 
Lentils as food, 217. 
Leucocytes, see White Corpuscles of 

the Blood. 
Life, phases of, 5. 

processes and work of, 7. 

tests of, 13. 
Ligaments, 38. 
Light, value of, to health, 267. 

as stimulus to respiration, 461. 

as destroyer of disease germs, 462. 
Limbs, the, 45. 
Lime, as constituent of food, 185. 

juice, value of, 195. 
Linea alba, the, 55. 
Linen, as clothing, 109. 
Liqueurs, 23. 
Liver, the, location and functions of, 

129. 
Living in the open air, 457. 
Living matter, properties of, 8. 
Lobelias, the, as poisons, 412. 
Lobules of the lungs, 231. 
Long, or far, sight, 344. 
Loudness of sound, see Intensity. 
Lungs, tbe, location, shape, struc- 
ture, 232. 

movements of, 233. 
Lymph, 166. 
Lymphatic glands, 169. 
Lymphatics, 167. 

M. 
Malaria, 254. 

some facts about, 450. 
Malleus, or hammer, 355. 
Malt liquors, 22. 
Maltose, 132. 
Marrow of bones, 33. 
Marsh gas, 258. 

Marsh marigold, as poison, 419. 
Mastication, 112, 131. 

importance of thorough, 4-J7, 
Mastoid cells, 355 



Meat, as food, 207-211. 

harmful, 210. 

fresh, as preventitive of scurvy, 433. 

the too frequent use of, 438. 
Meats, relative value of, 439. 

selection of, 440. 
Mechanical processes, 7. 
Media, transparent, of the eye, 336. 
Medulla oblongata, location, struc- 
ture, functions, 285. 
Medullary, canal of bones, 33. 

membrane, 34. 

sheath, 276. 
Medullated nerve fibres, 276. 
Meibomian glands, 328. 
Membrana tympani, 352-354. 
Membranes, description of, 9. 

of the brain, 278. 
Memory, 283. 
Mercury as a poison, 407. 
Mesentery, the, 119. 
Metabolism, definition of, 8. 
Metallic substances as poisons, 405. 
Mezereon, as a poison, 413. 
Microbes, see Bacteria. 
Micrococci, see Bacteria. 
Middle ear, the, 355. 
Migration of blood corpuscles, 163. 
Milk, sugar, 15, 181. 

as food, 189, 211. 

care of, 212, 441. 

changes in, etc., 441. 
Mineral baths, 94. 
Mineral matter of bones, 35. 
Mitral valve of the heart, 148. 
Mixed and movable joints, 37. 

muscles, 53. 
Model tenements, 262. 
Molar teeth, 125. 
Motor, or efferent nerves, 275. 

impulse, 294. 
Mouth, the, 114. 

breathing, dangers of, 2'28. 
Mucous membrane, 112. 
Mucus, 113. 
Mud baths ^. 
Multi-cellular organisms, 5. 
Muscle plasma. 61. 
Muscles, number ami use, 62. 

classification, 62. 

connections. 53. 



484 



INDEX. 



Muscles, arrangement, 55. 

action of groups, 55. 

antagonistic, or opposing, 56. 

importance of conjoint action, 418. 

of expression, 57. 

structure of, 58. 

chemical composition of, 60 

hygiene of, 62. 

overuse of one set, 420. 

effects of alcohol and narcotics upon, 
74-75. 

of the hair follicles, 83. 

constrictors of pharynx, 115. 

papillary, of the heart, 148. 

tensor tympani, 356. 

of the larynx, 366. 
Muscular tissue, properties of, 61. 

sensations or sense, 314. 
Muscular exercise, uses, 68. 

well-balanced, 69. 

proper adaptation, 70. 

power of endurance, 70. 

improper, some of the results of, 
421. 

best times for, 72. 

why young women should have, 
421. 

housework, 421. 

varieties of, 73, 422. 

in gymnasiums, 73. 

passive, 74. 
Mushrooms, poisonous and edible, 

413. 
Musical sounds, how produced, 351. 
Myopia, see Short Sight. 
Myosin, 15, 61, 175. 

N. 

Nails, structure, use, 84. 
Narcotic poisons, 409. 
Narcotics, definition, 27. 
effects upon muscles, 74. 
effects upon the skin, 87. 
effects upon the digestive organs 

and digestion, 140. 
effects upon the blood, 171. 
effects upon respiration and the 

respiratory organs, 245. 
effects upon the nervous system, 311. 
effects upon touch, taste, and smell, 
325. 



Nasal, cavities, or fossae, 322. 

ducts, 329. 

twang, 370. 
Near sight, see Short Sight. 
Nerve, fibres, 273-276. 

filaments, 274. 

cells, 274, 463. 

centre, 275. 

trunks, 276. 

fibres and cells, interdependence, 
277. 

force, see Nervous Impulse. 

force perverted, nervousness, 306. 
Nerves, structure, 275. 

sensory and motor, 275. 

cranial, 285-287. 

fifth pair of, 288. 

seventh pair of, or facial, 290. 

tenth pair of, or pneumogastric, 290. 

spinal, 292. 
Nervous, processes, predominance in 
man, 271. 

tissue, white, 273. 

tissue, gray, 274. 

impulse, or nerve force, 277. 

energy, 305. 
Nervous system, the, use, 271. 

general arrangement, 272. 

cerebro-spinal, 273. 

sympathetic, 295. 

reflex action, 300. 

hygiene of, 306. 

how injured by overwork, 465. 

effects of alcohol and narcotics upon r 
308. 
Neuralgia, 126. 
Neurilemma, the, 276. 
Nightshade black as poison, 412. 
Nitrogen of the air, 249. 
Noises, how produced, 351. 
Non-medullated nerve fibres, 276. 
Nostrils, as channels of respiration, 

227. 
Nucleus and nucleolus, 4. 
Nutrition, description of, 110. 
Nuts as food, 218. 



Oatmeal, as food, 214. 
Ochlesis, definition and dangers of, 
255. 



INDEX. 



485 



Odors, 468. 

Oesophagus, the, 116. 

Oil of Tansy, as poison, 408. 

Old sight, 345. 

Oleander, the, as poison, 408. 

Olein, 15, 64. 

Olfactory nerve and bulb, 323. 

Openings of the heart, 147. 

Ophthalmoscope, the, its use, 342. 

Opium, use and abuse, 27. 

as poison, 409. 
Optic nerve, the, 331, 337. 
Orbits, orbital cavities, 327. 
Organ, definition of, 2. 

of smell, 322. 

of sight, 327. 

of hearing, 352. 
Organic, constituents of the body, 14. 

matter in drinking water, how de- 
tected, 223. 

matter exhaled, 254. 
Organs, of absorption, 85. 

of digestion, 111. 

of circulation, 143. 

of respiration, 227. 

of taste, 319. 

of voice, 364. 
Osmosis, definition of, 9, 137. 
Ossicles, or bones of the ear, 355. 
Oval opening, or window of internal 

ear, 357. 
Oxidation, description of, 8. 
Oxygen of the air, 249. 
Oysters, 210. 

raw, value of, 439. 
Ozone of the air, 250. 



P. 



Pain, value of, 314. 

Palate, hard and soft, 114. 

Pallor, causes of, 157. 

Palmitin, 15, 64. 

Pancreas, the, location and function, 

129. 
Pancreatic juice, 129, 135. 
Pancreatine, L35. 
Papillae, of the skin, 78, 317. 

of the tongue, 319. 
Papillary muscles of the heart, 148. 



Paralysis, 282. 

Paraplegia, 295. 

Parasite poisoning, 210. 

Parotid glands, see Salivary Glands. 

Partial tones of the voice, 351. 

Patella, or knee pan, 29. 

Peas, etc., as food, 217, 444. 

Pelvic cavity, contents of, 48. 

Pelvis, the, 44. 

Pepsin and Peptones, 133. 

Pericardium, 146. 

Perilymph, 357. 

Perimysium, the, 58. 

Periosteum, 32. 

Peristalsis, 116. 

Peritoneum, 119. 

Permanent set of teeth, 124. 

Perspiration, 80. 

Perspiratory glands, see Sweat 

Glands. 
Phagocytes, 164. 
Pharynx, the, 115. 
Phases of life, 5. 
Phosphate and carbonate of lime in 

bones and teeth, 14. 
Phosphorus, constituent of the body 
and food, 186. 

as poison, 407. 
Physical culture, 68. 

education, value of, to students, 419. 
Physiology, human, definition of, 1. 

of vision, 342. 

of hearing, 359. 
Pia mater, 279. 
Pillars of the fauces, 115. 
Pitch, of sounds, to what due, 351, 
369. 

of voice, to what due, 369. 
Plasma, 161. 

Pleura, pleural sac and cavity, 233. 
Pleurisy, 234. 
Plexus, of nerves. 297. 
Pneuraogastric nerve, 290. 
Poison, definition of, 20. 

hemlock, 412. 

sumac and ivy. 414. 

dogwood, 415. 
Poisoned wounds, 411. 
Poisonous, fish, I0S. 

plants. 412 

fruits, seeds, and flowers, 414. 



486 



INDEX. 



Poisons, classification, 401. 

general directions for relief from, 
403. 

specific, 404. 

irritant and corrosive, 404. 

animal and vegetable, 408. 

narcotic, 409. 

acro-narcotic, 411. 
Poke berries, as poison, 408. 
Pores of the skin, 80. 
Pork, as food, 208. 
Portal vein, 121. 
Posterior nares, 115. 
Posture, habits of, modify the shape, 

418. 
Potatoes, 216, 443. 
Poultry, as food, 209. 
Presbyopia, see Old Sight. 
Preventive medicine, 11. 
Processes, chemical, mechanical, 

vital, 7. 
Proliferation of cells, 6. 
Prop cartilages, 365. 
Proteids, of the body, 14. 

of food, 133, 174. 

sources of, 175. 

value of, 176. 

excessive use of, 176. 
Protein, what it includes, 187. 
Protoplasm, definition and proper- 
ties of, 4. 
Prussic acid, as poison, 410. 
Ptomaines, 16. 
Ptyalin of the saliva, 132. 
Public hygiene, 1. 

Pulmonary, respiratory, or lesser 
circulation, 143. 

artery and veins, 147. 
Pulp of the tooth, and the pulp cavity. 

123. 
Pulsations, or throbbing of the heart, 

149. 
Pulse, the, 153. 
Punctured wounds, 394-397. 
Pupil, the, 332. 
Pure blood, 147. 
Purification, of water, 223. 

of air, 263. 
Putrefaction of food, 200. 
Pyloric opening of stomach, 117. 
Pylorus, the, 118. 



Q. 

Quality of sound, 351, 369. 
Quarantine, use of, 253. 

R. 

Rain, water, 220. 

value of, 249. 
Ration of U. S. Army, 431. 
Reach of the voice, 371. 
Reaction after bathing, 97. 
Reason, the, 283. 
Receptaculum chyli, 121. 
Rectum, the, 121. 
Red corpuscles of the blood, 161. 
Reflex action, what it is, 300. 

of the cerebro-spinal system, 301. 

of the sympathetic system, 302. 
Reflex actions, artificial, 303. 

the use of, 304. 
Refraction, error of, 344. 
Refrigerator, connection with sewer, 

259. 
Rennin, 134. 
Reproduction, 6, 8. 
Residual and reserve air of the lungs, 

238. 
Respiration, air passages, 227. 

object and organs of, 227. 

mouth breathing, 228. 

mechanism of, 234. 

inspiration, 234. 

types of, 235. 

expiration, 236. 

quantity of air breathed, 237. 

vital capacity, 238. 

relation to its circulation , 239. 

changes in the air and blood during, 
240. 

nervous control, 242. 

relation to circulation and animal 
heat, 243. 

effects of alcohol and narcotics on, 
244. 

artificial, 384. 
Respirations, number of, 237. 
Respirators, use of, 251. 
Retina, the, 334. 
Ribs, the, 44. 
Rice, as food, 214. 
Rickets, 35. 



INDEX. 



487 



Roasting of food, 200. 
Roman bath, 95. 
Rods and coues of the retina, 334. 
Rotator muscles, 56. 
Round window of the ear, 357. 
Russian baths, 94. 
Rye, as food, 214. 
spurred, as a poison, 414. 

S. 

Sacrum, the, 42. 

Salad vegetables, importance of, 217, 

444. 
Saliva, the, 132. 
Salivary glands, the, 128. 
Salt, common, 185. 

its importance, 431. 

as food element, 185. 
Salt-water bathing, 94. 
Sanitation, definition and effects of, 

1,11. 
Sarcolemma, 59. 
Savory herbs, as condiments, 219. 
Scalds, see Burns. 
Sciatic nerve and sciatica, 276. 
Sclerotic coat of the eye, 330. 
Scoke, poison, see Coke. 
Scope of study in this book, 1. 
Scurvy, condition of blood in, 165. 

causes of, 195. 

preventives of, 195, 217, 433. 
Sebaceous glands, 82. 
Secretion, 169. 
Seeds, as poisons, 414. 
Semicircular canals of the internal 

ear, 357. 
Semilunar valves of the heart, 148. 
Sensations, common and special, 

313. 
Sense, muscular, and of pain, 314. 

of touch, 317. 

of taste, 318. 

of smell, 322. 

of sight, 327. 

of hearing, 351. 

education, in Seguin School, 472. 
Senses, the, 313. 

the keenness of, 467. 
Sensible perspiration, or sweat, 81. 
Sensory, impressions. 292, 

or afferent nerves, 275. 



Septum of the nose, 323. 

Serous membrane, 119. 

Serum, 119, 146, 165. 

Serum albumin, 15. 

Sesamoid bones, 29. 

Sewer gas, composition and dangers 

of, 259. 
Shallow respiration, dangers of, 238. 
Shell fish, as food, 210. 
Shiver, the first and second, 96-97. 
Shoes, proper and improper, 102. 
Short, or near, sight, 343. 
Sight, organs and use of, 327. 

short, or near, 343, 470. 

long, or far, 344. 

old, 345. 

effects of alcohol and narcotics upon , 
346. 

injurious effects of certain occupa- 
tions upon, 471. 
Silk, as material of clothing, 109. 
Silver, as a poison, 407. 
Sinews, see Tendons. 
Skeletal muscles, 52. 
Skeleton, uses of, 41. 

principal closed cavities of, 46. 
Skim milk, 212. 
Skin, the, structure of, 77. 

strength and elasticity of, 423. 

corns and callous spots, 423. 

color of, 79. 

appendages of, 79. 

pores and drainage tubes, 423. 

functions, 84-86. 

relief of thirst through, 425. 

relation of, to the other parts of the 
body, 86. 

effects of alcohol and narcotics upon, 
87. 

care of, Chapters VII. and VIII. 
Skull, the, 37, 46. 
Sleep, amount and use of, 63, 419. 
Smell, organ of, 322. 

how odors are recognized, 323. 

development of sense of, 324. 468. 

effects of alcohol and narcotics upon. 

Soap, kinds and value of, 92. 
Sobbing-. 236, 
Soft, palate. 115. 
water, 221. 



488 



INDEX. 



Solar plexus, 297. 
Solaria, or sun rooms, 95. 
Sound, production of, 351. 

quality, loudness, pitch, etc., 369. 
Sounds, consonant and vowel, 370. 
Soup-making-, 200. 
Souring- of food, 200. 
Speech, 363. 
Sphincter muscles, 56. 
Spinal, column, use, form, number of 
bones in, 41. 

canal and cord, location, 42. 

column, curves of, 43. 

cord, 271, 291, 318. 

nerves, 292. 
Spirilli, see Bacteria. 
Spirits, composition and effects, 23. 
Spirometer, or lung tester, 238. 
Spleen, the, location, structure, func- 
tion, 170. 
Spongy tissue of bones, 33. 
Spontaneous combustion, 243. 
Sprains, treatment of, 393. 

definition, 39. 
Spring water, 220. 
Spurred rye, or ergot, as a poison, 414. 
Stammering and stuttering, 369. 
Stapes, or stirrup, 355. 
Starch, digestion of, 132. 

as food, 179. 
Steapsin, 135. 
Stearin, 15, 64. 
Sternum, the (Fig. 6), 31. 
Stimuli, definition and examples, 8. 
Stock for soup, 207. 
Stomach, digestion, 112, 133. 

location, structure, 116. 
Stoves and furnaces, stove gas, 257. 
Stramonium, as poison, 410, 415. 
Striae of muscles, 60. 
Strychnine, as poison, 410. 
Sublingual glands, see Salivary 

Glands. 
Submaxillary glands, see Salivary 

Glands. 
Suffocation, resuscitation from, 381. 
Sugar, as food, 180, 429. 
Sulphur, constituent of food and of 

the body, 186. 
Sulphuretted hydrogen, 258. 
Sun baths, 95, 425. 



Sunlight, 267. 
Sunstroke, 268. 

what to do in cases of, 381. 
Superior vena cava, 147. 
Supplemental air, see Reserve Air. 
Supporting tissues, 10. 
Supra-arytenoid cartilages, 365. 
Suspended matters in the air, 250. 
Suture or dovetail joints, 37. 
Swallowing, see Deglutition. 
Sweat, 81. 

glands, 79. 
Sweet bread, see Pancreas. 
Sympathetic nervous system, 272, 

295. 
Synovial membrane and synovial 

fluid, 39. 
Systole of the heart, 149. 



Tactile, corpuscles, 78. 

sensation, 313. 
Tactus eruditus, its value, 318. 
Taste, organs of, 318. 

how effected, 320. 

how influenced, 321. 
Tea, as food, 224. 
Tears, origin and use, 329. 
Teeth, the, uses and structure, 122. 

sets, 123. 

care of, 126. 
Temperate and tepid baths, 95. 
Temperature of the body, 12. 
Temporary, or first set of teeth, 123. 
Tendon of Achilles, 55. 
Tendons, structure, location, use, 53. 
Tenements, 261, 455, 456. 
Tensor tympani muscle, 356. 
Tenth pair of nerves, 290. 
Test type, 341. 
Tests of life, 13. 
Tetanus, 62. 
Thein of tea, 225. 
Theobromine, 225. 
Thermometer, medical, or clinical, 

12. 
Thirst, relief of through the skin, 425. 

quenching by fruit, 445. 
Thoracic, cavity, contents of, 47. 

duct, 121, 167. 

type of respiration, 235. 



INDEX. 



489 



Thorax, the, 44. 

Throat, the, see Pharynx. 

Thymus gland, 169. 

Thyroid cartilage of the larnyx, 364. 

Tidal air, 237. 

breathing, 238. 
Tight, boots and shoes, 102. 

clothing, effects of, 100. 
Timbre of voice, see Quality. 
Tin, as poison, 408. 
Tissue, definition of, 2. 

connective, 10. 

spongy, or cancellous, 33. 

compact, 32. 
Tissues, classification of, 10. 
Toadstools, as poisons, 413. 
Tobacco, general effects of, 25. 

effects on muscle, 75. 

effects on the skin, 88. 

effects on the digestive organs and 
digestion, 141. 

effects on the blood and organs of 
circulation, 171. 

effects on respiration and the respi- 
ratory organs, 245. 

effects on the nervous system, 311. 

effects on touch, taste, and smell, 
325. 

effects on sight, 346. 

effects on hearing, 362. 

effects on the voice, 374. 
Tone, of muscles, 61. 

fundamental, 351. 
Tones, partial, 352. 
Tongue, the, its use, 114, 319. 
Tonsils, the, 115. 
Tooth-bone, or ivory, 123. 
Touch, organs of, 317. 

delicacy of, 318. 
Toxins, 16. 
Trachea, the, 230. 
Transfusion of blood, 161. 
Transudation, 169. 
Transverse colon, 122. 
Trichinae, 197. 

Tricuspid valves of the heart, 148. 
Tripe, as food, 207. 
Trunk, the, 2. 
Trypsin, 135. 

Tuberculosis, see Consumption, 
Tunics of the eye, 330. 



Turbinated bones of the nose, 228. 
Turkish baths, 94. 
Tympanum, the, see Middle Ear. 
Types of breathing, 235. 

U. 

Ulna bone, the, 45. 
Unconscious cerebration, 304. 
Unconsciousness, causes of, 378. 
Urea, 89. 
Ureter, 89. 

V. 

Vaccination, description, value, 18. 
Valve, ileo-coecal, 119. 
Valves of the heart, 148. 
Valvulae conniventes, 119. 
Vasomotor nerves, 297. 
Vascular, 32. 
Vegetable, acids, 186. 

foods, 189, 214. 

poisons, 408. 
Vegetables, 216. 
Veins, pulmonary, 147. 

location, structure, function, 157. 
Venomous bites and stings, 411. 
Venous, or impure blood, 147. 

system, capacity of, 158. 
Ventilation, 263. 

automatic, 458. 

amount of air required, 459. 
Ventilators, 264. 
Ventricles of heart, 147. 
Ventriloquism, how produced. 371. 
Vermicular motion, see Peristalsis. 
Vermiform appendix, 122. 
Vertebrae, location, number. 41. 42. 
Vertebral column, see Spinal Col- 
umn. 
Vestibule of the ear, 357. 
Villi of the intestines, the, 120. 
Viscera, 48. 
Vision, binocular, 338. 

power of accommodation, 338. 

field of. 339. 

physiology of. 342. 

defects in. 3-12. 

normal sight, 313. 

color blindness, 342. 

importance of convergence of eyes, 
469. 



490 



INDEX. 



Vital heat, 12. 

processes in the body, 7. 

capacity, 238. 

knots, or points, 286. 
Vitreous humor of the eye, 336. 
Vocal, cords or bands, 366. 

sounds, variations in, 369. 
Voice, the, 363. 

organs of, 364. 

muscles of larynx, 366. 

mechanism of the, 367. 

chief varieties of, 372. 

hygiene of, 373. 

rules for the care of, 473. 

effects of alcohol and tobacco upon, 
374. 
Voice-box, see Larynx. 
Voluntary muscles, 52. 
Voracious appetite, 195. 
Vowel sounds, production of, 370. 

W. 

"Warmth of the body, see Animal 

Heat. 
Waste- water pipes, 259. 
Water, its value in the body, 183. 

as food, 219. 

drinking, 219. 

drinking, sources of, 220. 



weeds and scum, 447. 

simple test for purity, 447. 

spring, 447. 

hard and soft, 221. 

drinking, impure, 222. 

purification of, 223, 448. 

hemlock, as poison, 412. 
Watery vapor in breath, 241. 
Well water, 220. 
Wheat, as food, 214. 
Whey, 212. 
White, blood corpuscles, 163. 

matter of the nervous system, 273. 
Windpipe, the, see Trachea. 
Wines, composition and effects, 23. 
Wisdom teeth, 124. 
Woollen clothing, value of, 108. 
Wormian bones, 29. 
Wounds, treatment of, 394. 

contused and lacerated, 396. 

punctured, 397. 

poisoned, 398, 411. 



Yellow spot of the eye, 335. 



Z. 

Zinc, as poison, 408. 



JUN 25J900