Chapter IV: ABSORPTION is performed in two ways, by the veins, and the (4)

In using the zinc solution, place the articles in it as soon as they are removed from the patient, and before they are taken from the room; if practicable, have the solution boiling hot at the time. In fumigating apartments, all the openings should be made as nearly air-tight as possible. The articles to be included in the fumigation should be so exposed and spread out that the sulphurous vapor may penetrate every portion of them. For a room about ten feet square, at least two pounds of sulphur should be used; for larger rooms, proportionally increased quantities. Put the sulphur in iron pans supported upon bricks placed in washtubs containing a little water, set it on fire by hot coals or with the aid of a spoonful of alcohol, or by a long fuse set on train as the last opening to the room is closed. Allow the apartment to remain sealed for twenty-four hours. Great care should be taken not to inhale the poisonous fumes in firing the sulphur. After the fumigation, allow free currents of air to pass through the apartment; expose all movable articles for as long time as may be to the sun and the wind out of doors; beat and shake the carpets, hangings, pillows, etc.

The disinfectants and the instructions for using them, as given above, are mainly those recommended by the National Board of Health.] Vaults, drains, vessels used in the sick room, etc., should be disinfected by a solution of the second kind; chloride of lime may also be used for the same purpose. Rooms, furniture, and articles that can not be treated with the solution of the first kind, should be thoroughly fumigated with burning sulphur. Where walls are unpapered, re-whitewash with pure, freshly slacked quicklime, adding one pint of the best fluid carbolic acid to every gallon of the fluid whitewash. Powdered stone lime sprinkled on foul, wet places, or placed in pans in damp rooms, will absorb the moisture; and dry, fresh charcoal powder may be combined with it to absorb noxious gases.

WHAT TO DO TILL THE DOCTOR COMES.

The following instructions are intended simply to aid in an emergency. When accidents or a sudden severe illness occur, there is necessarily, in most cases, a longer or shorter interval before a physician can arrive. These moments are often very precious, and life may depend upon a little knowledge and much self-possession. The instructions are therefore given as briefly as possible, that they may be easily carried in the memory. A few suggestions in regard to common ailments are included.

BURNS.--When a person's clothes catch fire, quickly lay him on the ground, wrap him in a coat, mat, shawl, carpet, or in his own garments, as best you can to extinguish the flame. Pour on plenty of water till the half- burned clothing is cooled. Then carry the sufferer to a warm room, lay him on a table or a carpeted floor, and with a sharp knife or scissors remove his clothing.

The treatment of a burn consists in protecting from the air. [Footnote: It is a great mistake to suppose that salves will "draw out the fire" of a burn, or heal a bruise or cut. The vital force must unite the divided tissue by the deposit of material and the formation of new cells.] An excellent remedy is to apply soft cloths kept wet with sweet oil, or with tepid water _which contains all the "cooking soda" that it will dissolve_. Afterward dress the wound with carbolic acid salve. Wrap a dry bandage upon the outside. Then remove the patient to a bed and cover warmly. [Footnote: In case of a large burn, lose no delay in bringing a physician. If a burn be near a joint or on the face, even if small, let a doctor see it, and do not be in any hurry about having it healed. Remember that with all the care and skill which can be used, contractions will sometimes take place. The danger to life from a burn or scald is not in proportion to its severity, but to its extent--that is, a small part, such as a hand or a foot, may be burned so deeply as to cripple it for life, and yet not much endanger the general health; but a slight amount of burning, a mere scorching, over two thirds of the body, may prove fatal.-- HOPE.] Apply cool water to a small burn till the smart ceases, and then cover with ointment. Do not remove the dressings until they become stiff and irritating; then take them from a part at a time; dress and cover again quickly.

CUTS, WOUNDS, ETC.--The method of stopping the bleeding has been described on page 128. If an artery is severed, a physician should be called at once. If the bleeding is not profuse, apply cold water until it ceases, dry the skin, draw the edges of the wound together, and secure them by strips of adhesive plaster. Protect with an outer bandage. This dressing should remain for several days. In the meantime wet it frequently with cool water to subdue inflammation. When suppuration begins, wash occasionally with tepid water and Castile soap.

Dr. Woodbridge, of New York, in a recent address, gave the following directions as to "What to do in case of a sudden wound when the surgeon is not at hand." "An experienced person would naturally close the lips of the wound as quickly as possible, and apply a bandage. If the wound is bleeding freely, but no artery is spouting blood, the first thing to be done is to wash it with water at an ordinary temperature. To every pint of water add either five grains of corrosive sublimate, or two and a half teaspoonfuls of carbolic acid. If the acid is used, add two tablespoonfuls of glycerine, to prevent its irritating the wound. If there is neither of these articles in the house, add four tablespoonfuls of borax to the water. Wash the wound, close it, and apply a compress of a folded square of cotton or linen. Wet it in the solution used for washing the wound and bandage quickly and firmly. If the bleeding is profuse, a sponge dipped in very hot water and wrung out in a dry cloth should be applied as quickly as possible. If this is not available, use ice, or cloths wrung out in ice water. If a large vein or artery is spouting, it must be stopped at once by compression. This may be done by a rubber tube wound around the arm tightly above the elbow or above the knee, where the pulse is felt to beat; or an improvised 'tourniquet' may be used. A hard apple or a stone is placed in a folded handkerchief, and rolled firmly in place. This bandage is applied so that the hard object rests on the point where the artery beats, and is then tied loosely around the arm. A stick is thrust through the loose bandage and turned till the flow of blood ceases."

BLEEDING FROM THE NOSE is rarely dangerous, and often beneficial. When it becomes necessary to stop it, sit upright and compress the nostrils between the thumb and forefinger, or with the thumb press upward upon the upper lip. A piece of ice, a snowball, or a compress wet with cold water may be applied to the back of the neck.

A SPRAIN [Footnote: "A sprain," says Dr. Hope, in that admirable little book entitled _Till the Doctor comes and How to help Him_, "is a very painful and very serious thing. When you consider that from the tips of the fingers to the wrist, or from the ends of the toes to the leg, there are not less than thirty separate bones, all tied together with straps, cords, and elastic bands, and about twenty hinges, all to be kept in good working order, you will not wonder at sprains being frequent and sometimes serious."] is often more painful and dangerous than a dislocation. Wrap the injured part in flannels wrung out of hot water, and cover with a dry bandage, or, better, with oiled silk. Liniments and stimulating applications are injurious in the first stages, but useful when the inflammation is subdued. _Do not let the limb hang down, keep the joint still_. Without attention to these points, no remedies are likely to be of much service. A sprained limb must be kept quiet, even after all pain has ceased. If used too soon, dangerous consequences may ensue. Many instances have been known in which, from premature use of an injured limb, the inflammation has been renewed and made chronic, the bones at the joint have become permanently diseased, and amputation has been necessitated.

DIARRHEA, CHOLERA MORBUS, ETC., are often caused by eating indigestible or tainted food, such as unripe or decaying fruit, or stale vegetables; or by drinking impure water or poisoned milk (see p. 321). Sometimes the disturbance may be traced to a checking of the perspiration; but more frequently to peculiar conditions of the atmosphere, especially in large cities. Such diseases are most prevalent in humid weather, when the days are hot and the nights cold and moist. Especial attention should at such times be paid to the diet. If an attack comes on, ascertain, if possible, its cause. You can thereby aid your physician, and, if the cause be removable, can protect the rest of the household. If the limbs are cold, take a hot bath, followed by a thorough rubbing. Then go to bed and lie quietly on the back. In ordinary cases, rest is better than medicine. If there be pain, have flannels wrung out of hot water applied to the abdomen. [Footnote: If it be difficult to manage the foments, lay a hot plate over the flannels and cover with some protection. By having a change of hot plates, the foments can be kept at a uniform high temperature. This plan will be found useful in all cases where foments are needed.] A mustard poultice will serve the same purpose if more convenient. Eat no fruit, vegetables, pastry, or pork. Use water sparingly. If much thirst exist, give small pieces of ice, or limited quantities of cold tea or toast water. Take particular pains with the diet for some days after the bowel irritation has ceased.

CROUP.--There are two kinds of croup--true and false. True croup comes on gradually, and is less likely to excite alarm than false croup, which comes on suddenly. True croup is attended with fever and false membrane in the throat; false croup is not attended with fever or false membrane. True croup is almost always fatal in four or five days; false croup recovers, but is liable to come on again. The great majority of cases of the so- called croup are simply cases of spasm of the glottis. "Croupy children" are those who are liable to these attacks of false croup, which are most frequent during the period of teething.--DR. GEO. M. BEARD. Croup occurs commonly in children between the ages of two and seven years. At this period, if a child has a hollow cough, with more or less fever, flushed face, red watery eyes, and especially _if it have a hoarse voice, and show signs of uneasiness about the throat_, send at once for a doctor. Induce mild vomiting by doses of syrup of ipecac. Put the feet in a hot mustard-and-water bath. Apply hot fomentations, rapidly renewed, to the chest and throat. A "croupy" child should be carefully shielded from all physical excitation, sudden waking from sleep, and any punishment that tends to awaken intense fear or terror. Irritation of the air passages through faulty swallowing in drinking hastily, should be guarded against. Good pure air, warm clothing, and a nourishing diet are indispensable.

COMMON SORE THROAT.--Wrap the neck in a wet bandage, and cover with flannel or a clean woolen stocking. Gargle the throat frequently with a solution of a teaspoonful of salt in a pint of water, or thirty grains of chlorate of potash in a wineglass of water.

FITS, APOPLEXY, EPILEPSY, ETC.--These call for immediate action and prompt medical attendance. Children who are teething, or troubled with intestinal worms, or from various causes, are sometimes suddenly seized with convulsions. Apply cloths wet in cold water--or, better still, ice wrapped in oiled silk--to the head, and _especially to the back of the neck_, taking care, however, that the ice or wet cloths do not remain too long. Apply mustard plasters to the stomach and legs. A full hot bath is excellent if the cold applications fail. Endeavor to induce vomiting. Seek to determine the cause, and consult with your physician for further guidance.

Apoplexy may be distinguished from a fainting fit by the red face, hot skin, and labored breathing; whereas, in a faint, the face and lips lose color, and the skin becomes cold. In many cases, death follows so quickly upon an apoplectic seizure, that little effectual service can be given. Call the nearest physician, loosen the clothing, and raise the head and shoulders, taking care not to bend the head forward on the neck. Keep the head cool. Do not move the patient unnecessarily.

In a common fainting fit, give the patient as much air as possible. Lay him flat upon the floor or ground, and keep the crowd away.

All that can be done in a fit of epilepsy is to prevent the patient from injuring himself; especially put something in his mouth to keep him from biting his tongue. A cork, a piece of India rubber, or even a tightly- rolled handkerchief, placed between the teeth will answer this purpose. Give the sufferer fresh air; loosen his clothing, and place him in a comfortable position. Epilepsy may be due to various causes,--improper diet, overexcitement, etc. Consult with a physician, and study to avoid the occasion.

CONCUSSION OF THE BRAIN generally arises from some contusion of the head, from violent blows, or from a shock received by the whole body in consequence of falling from a height. In any case of injury to the head where insensibility ensues, a doctor should be called at once. Remove the patient to a quiet room; loosen his clothing; strive to restore circulation by gentle friction, using the hand or a cloth for this purpose; apply cold water to the head, and, if the patient's body be cold and his skin clammy, put hot bottles at his feet. Ammonia may be cautiously held to the nose. Beyond this, it is not safe for a non- professional to go, in case of a severe injury to the head. Concussion is more or less serious, according to the injury which the brain has sustained; but even in slight cases, when a temporary dizziness appears to be the only result, careful treatment should be observed both at the time of the injury and afterward. Cases of head injury are often more grave in their consequences than in their immediate symptoms. Sometimes the patient appears to be getting better when really he is worse. Rest and quiet should be observed for several weeks after an accident which has in any way affected the brain.

TOOTHACHE AND EARACHE.--Insert in the hollow tooth cotton wet with laudanum, spirits of camphor, or chloroform. When the nerve is exposed, wet it with creosote or carbolic acid. Hot cloths or a hot brick wrapped in cloth and held to the face will often relieve the toothache. In a similar manner treat the ear, wetting the cloth in hot water, and letting the vapor pass into the ear.

CHOKING.--Ordinarily a smart blow between the shoulders, causing a compression of the chest and a sudden expulsion of the air from the lungs, will throw out the offending substance. If the person can swallow, and the object be small, give plenty of bread or potato, and water to wash it down. Press upon the tongue with a spoon, when, perhaps, you may see the object, and draw it out with your thumb and finger, or a blunt pair of scissors. If neither of these remedies avail, give an emetic of syrup of ipecac or mustard and warm water.

FROSTBITES are frequently so sudden that one is not aware when they occur. In Canada it is not uncommon for persons meeting in the street to say, "Mind, sir, your nose looks whitish." The blood cools and runs slowly, and the blood vessels become choked and swollen. _Keep from the heat_. Rub the part quickly with snow, if necessary for hours, till the natural color is restored. If one is benumbed with cold, take him into a cold room, remove the wet clothes, rub the body dry, cover with blankets, and give a little warm tea or other suitable drink. On recovering, let him be brought to a fire gradually. [Footnote: If you are caught in a snowstorm, look for a snow bank in the lee of a hill, or a wood out of the wind, or a hollow in the plain filled with snow. Scrape out a hole big enough to creep into, and the drifting snow will keep you warm. Men and animals have been preserved after days of such imprisonment. Remember that if you give way to sleep in the open field, you will never awake.]

FEVERS, and many acute diseases, are often preceded by a loss of appetite, headache, shivering, "pains in the bones," indisposition to work, etc. In such cases, sponge with tepid water, and rub the body till all aglow. Go to bed, place hot bricks to the feet, take nothing but a little gruel or beef tea, and drink moderately of warm, cream-of-tartar water. If you do not feel better the next morning, call a physician. If that be impossible, take a dose of castor oil or Epsom salts.

SUNSTROKE is a sudden prostration caused by intense heat. The same effect is produced by the burning rays of the sun and the fierce fire of a furnace. When a person falls under such circumstance, place your hand on his chest. If the skin be cool and moist, it is not a sunstroke; but if it be dry and "biting hot," there can be no mistake. Time is now precious. At once carry the sufferer to the nearest pump or hydrant, and dash cold water on the head and chest until consciousness is restored.--DR. H. C. WOOD.

To prevent sunstroke, wear a porous hat, and in the top of it place a wet handkerchief; also drink freely of water, not ice cold, to induce abundant perspiration.

ASPHYXIA, or apparent death, whether produced by drowning, suffocation, bad air, or coal gas, requires very similar treatment. Send immediately for blankets, dry clothing, and a physician. Treat upon the spot, if the weather be not too unfavorable.

1. Loosen the clothing about the neck and chest, separate the jaws, and place between them a cork or bit of wood.

2. Turn the patient on his face, place his arm under his forehead to raise the head, and press heavily with both hands upon the ribs to squeeze out the water.

3. Place the patient on his back, wipe out the mouth and nostrils, and secure the tongue from falling backward over the throat. Kneel at his head, grasp his arms firmly above the elbows, and pull them gently upward until they meet over the head, in order to draw air into the lungs; reverse this movement to expel the air. Repeat the process about fifteen times per minute. Alternate pressure upon the chest, and blowing air into the mouth through a quill or with a pair of bellows, may aid your efforts. Use snuff or smelling salts, or pass hartshorn under the nose. Do not lose hope quickly. Life has been restored after five hours of suspended animation. [Footnote: Another simple method of artificial respiration is described in the _British Medical Journal_. The body of the patient is laid on the back, with clothes loosened, and the mouth and nose wiped; two bystanders pass their right hands under the body at the level of the waist, and grasp each other's hand, then raise the body until the tips of the fingers and the toes of the subject alone touch the ground; count fifteen rapidly; then lower the body flat to the ground, and press the elbows to the side hard; count fifteen again; then raise the body again for the same length of time; and so on, alternately raising and lowering. The head, arms, and legs are to be allowed to dangle down freely when the body is raised.]

4. When respiration is established, wrap the patient in dry, warm clothes, and rub the limbs under the blankets or over the dry clothing energetically _toward the heart_. Apply heated flannels, bottles of hot water, etc., to the limbs, and mustard plasters [Footnote: The best mustard poultice is the paper plaster now sold by every druggist. It is always ready, and can be carried by a traveler. It has only to be dipped in water, and applied at once.] to the chest.

FOREIGN BODIES IN THE EAR.--Insects may be killed by dropping a little sweet oil into the ear. Beans peas, etc., may generally be removed by so holding the head that the affected ear will be toward the ground, and then _cautiously_ syringing tepid water into it from below. Do not use much force lest the tympanum be injured. If this fail, dry the ear, stick the end of a little linen swab into thick glue, let the patient lie on one side, put this into the ear until it touches the substance, keep it there three quarters of an hour while it hardens, and then draw them all out together. Be careful that the glue does not touch the skin at any point, and that you are at work upon the right ear. Children often deceive one as to the ear which is affected.

FOREIGN BODIES IN THE NOSE, such as beans, cherry pits, etc., may frequently be removed by closing the opposite nostril, and then blowing into the child's mouth forcibly. The air, unable to escape except through the affected nostril, will sweep the obstruction before it.

ANTIDOTES TO POISONS.

ACIDS: _Nitric_ (aqua fortis), _hydrochloric_ (muriatic), _sulphuric_ (oil of vitriol), _oxalic_, etc.--Drink a little water to weaken the acid, or, still better, take strong soapsuds. Stir some magnesia in water, and drink freely. If the magnesia be not at hand, use chalk, soda, lime, whiting, soap, or even knock a piece of plaster from the wall, and scraping off the white outside coat pound it fine, mix with milk or water, and drink at once. Follow with warm water, or flaxseed tea.

ALKALIES: _Potash, soda, lye, ammonia_ (hartshorn).--Drink weak vinegar or lemon juice. Follow with castor or linseed oil, or thick cream.

ANTIMONY: _Antimonial wine, tartar emetic_, etc.--Drink strong, green tea, and in the meantime chew the dry leaves. The direct antidote is a solution of nutgall or oak bark.

ARSENIC: _Cobalt, Scheele's green, fly powder, ratsbane_, etc.--Give _plenty of milk, whites of eggs_, or induce vomiting by mustard and warm water; [Footnote: See that the mustard is well mixed with the water, in the proportion of about half an ounce of the former to a pint of the latter.] or even soapsuds.

BITE OF A SNAKE OR A MAD DOG.--Tie a bandage above the wound, if on a limb. Wash the bite thoroughly, and, if possible, let the person suck it strongly. Rub some lunar caustic or potash in the wound, or heat the point of a small poker or a steel sharpener white hot, and press it into the bite for a moment. It will scarcely cause pain, and will be effectual in arresting the absorption of the poison, unless a vein has been struck.

COPPER: _Sulphate of copper_ (blue vitriol), _acetate of copper_ (verdigris).--Take whites of eggs or soda. Use milk freely.

LAUDANUM: _Opium, paregoric, soothing cordial, soothing syrup_, etc. --Give an emetic at once of syrup of ipecac, or mustard and warm water, etc. After vomiting, use strong coffee freely. _Keep the patient awake_ by pinching, pulling the hair, walking about, dashing water in the face, and any expedient possible.

LEAD: _White lead, acetate of lead_ (sugar of lead), _red lead_.--Give an emetic of syrup of ipecac, or mustard and warm water, or salt and water. Follow with a dose of Epsom salts.

MATCHES: _Phosphorus_.--Give magnesia, chalk, whiting, or even flour in water, and follow with mucilaginous drinks.

MERCURY: _Calomel, chloride of mercury_ (corrosive sublimate, bug poison), _red precipitate_.--Drink milk copiously. Take the whites of eggs, or stir flour in water, and use freely.

NITRATE OF SILVER (lunar caustic).--Give salt and water, and follow with castor oil.

NITRATE OF POTASH (saltpeter, niter).--Give mustard and warm water, or syrup of ipecac. Follow with flour and water, and cream or sweet oil.

PRUSSIC ACID (oil of bitter almonds), _cyanide of potassium_.--Take a teaspoonful of hartshorn in a pint of water. Apply smelling salts to the nose, and dash cold water in the face.

STING OF AN INSECT.--Apply a little hartshorn or spirits of camphor, or soda moistened with water, or a paste of clean earth and saliva.

SULPHATE OF IRON (green vitriol).--Give syrup of ipecac, or mustard and warm water, or any convenient emetic; then magnesia and water.

X.

SELECTED READINGS

TO ILLUSTRATE AND SUPPLEMENT THE TEXT.

_Arranged in order of the subjects to which they refer_.

"Read not to contradict and confute, nor to believe and take for granted, nor to find talk and discourse, but to weigh, and consider."

LORD BACON.

"He who learns the rules of wisdom without conforming to them in his life, is like a man who labored in his fields but did not sow."

SAADI.

SELECTED READINGS.

_The figures indicate the pages in the text upon which the corresponding subjects will be found_.

THE SKELETON.

MAN, AS COMPARED WITH OTHER VERTEBRATE ANIMALS (p. 3).--Man, the lord of the animal kingdom, is constructed after the same type as the cat that purrs at his feet, the ox that he eats, the horse that bears his burden, the bird that sings in his cage, the snake that crawls across his pathway, the toad that hides in his garden, and the fish that swims in his aquarium. All these are but modifications of one creative thought, showing how the Almighty Worker delights in repeating the same chord, with infinite variations. There are marked physical peculiarities, however, which distinguish man from the other mammals. Thus, the position of the spinal opening in the middle third of the base of the skull, thereby balancing the head and admitting an upright posture; the sigmoid S-curve of the vertebral column; the ability of opposing the well-developed thumb to the fingers; the shortened foot, the sole resting flat on the ground; the size and position of the great toe; the length of the arms, reaching halfway from the hip to the knees; the relatively great development of the brain; the freedom of the anterior extremities from use in locomotion, and the consequent erect and biped position. In addition, man is the only mammal that truly walks; that is endowed with the power of speech; and that is cosmopolitan, readily adapting himself to extremes of heat and cold, and making his home in all parts of the globe.--STEELE'S _Popular Zoology_.

FIG. 68.

UNION OF FRACTURES (p. 8).--In the course of a week after a fracture, there is a soft yet firm substance, something between ligament and cartilage in consistence, which surrounds the broken extremities of the bone, and adheres to it above and below. The neighboring muscles and tendons are closely attached to its surface, and the fractured extremities of the bone lie, as it were, loose in a cavity in the center, with a small quantity of vascular albumen, resembling a semitransparent jelly.

Here, then, is a kind of splint which nature contrives, and which is nearly completed within a week from the date of the accident. We call this new formation the _callus_. This process goes on, the surrounding substance becoming thicker and of still firmer consistence. In the course of a few days more, the thin jelly which lay in contact with the broken ends of the bone has disappeared, and its place is supplied by a callus continuous with that which formed the original capsule. This is the termination of the first stage of curative progress. The broken ends of the bones are now completely imbedded in a mass of vascular organized substance or callus, something between gristle and cartilage in consistence; and as yet there are no traces of bony matter in it. At this time, if you remove the adventitious substance, you will find the broken ends of bone retaining exactly their original figure and presenting the same appearance as immediately after the fracture took place.

At the end of about three weeks, if you make a section of the callus, minute specks of earthy matter are visible, deposited in it here and there, and at the same time some of the callus, appears to disappear on the outside, so that the neighboring muscles and tendons no longer adhere to it. The specks of bone become larger and more numerous until they extend into each other; and thus by degrees the whole of the callus is converted into bone. Even at this period, however, there is not absolute bony union, for although the whole of the callus has become bone, it is not yet identified with the old bone, and you might still pick it off with a penknife, leaving the broken extremities not materially altered from what they were immediately after the injury. This may be regarded as the end of the second stage of the process by which a fracture is repaired. Now a third series of changes begins to take place. The broken extremities of the bones become intimately united by bony matter passing from one to the other. The mass of new bone on the outside, formed by the ossification of the callus, being no longer wanted, is absorbed; by degrees the whole of it disappears, and the bone is left having the same dimensions which it had before the occurrence of the accident.

The process of union is completed in young persons sooner than in those advanced in life; in the upper extremities sooner than in the lower; and in smaller animals more speedily than in man. In human subjects a broken arm or forearm will be healed in from six to eight weeks, while a leg or thigh will occupy nine or ten weeks.--SIR B. C. BRODIE.

FIG. 69.

THE HAND AND THE FOOT (p. 2l).--_Man Compared with the_ _Ape_.-- The peculiar prehensible power possessed by the hand of man is chiefly dependent upon the size and power of the thumb, which is more developed in him than it is in the highest apes. The thumb of the human hand can be brought into exact opposition to the extremities of all the fingers, whether singly or in combination; while in those quadrumana which most nearly approach man, the thumb is so short, and the fingers so much elongated, that their tips can scarcely be brought into opposition; and the thumb and the fingers are so weak that they can never be opposed to each other with any degree of force. Hence, though well suited to cling round bodies of a certain size, such as the small branches of trees, the anterior extremities of the quadrumana can neither seize very minute objects with such precision nor support large ones with such firmness as are essential to the dexterous performance of a variety of operations for which the hand of man is admirably adapted.

The human foot is, in proportion to the size of the whole body, larger, broader, and stronger than that of any other mammal, save the kangaroo. The surface of the astragalus (ankle bone) which articulates with the tibia, looks almost vertically upward, and hardly at all inward, when the sole is flat upon the ground; and the lateral facets are more nearly at right angles to this surface than in any ape. The plane of the foot is directed at right angles to that of the leg; and its sole is concave, so that the weight of the body falls on the summit of an arch, of which the os calcis (heel bone) and the metatarsal bones form the two points of support. This arched form of the foot, and the contact of the whole plantar surface with the ground, are particularly noticeable in man, most of the apes having the os calcis small, straight, and more or less raised from the ground, while they touch, when standing erect, with the outer side only of the foot. The function of the _hallux_, or great toe, moreover, is strikingly contrasted in man and the ape; for, while in the latter it is nearly as opposable as the thumb, and can be used to almost the same extent as an instrument of prehension, it chiefly serves in the former to extend the basis of support, and to advance the body in progression.--DR. W. B. CARPENTER.

FIG. 70.

_The Natural Flexibility of the Toes, and How it is Destroyed_.--We often admire the suppleness of the fingers by means of which we can perform such a variety of acts with swiftness and delicacy. Did it ever occur to you that the toes, which in most feet seem incapable of a free and graceful motion, even when they are not stiffened and absolutely deformed by the compression of the modern shoe, are also provided by Nature with a considerable degree of flexibility? The phalanges of the toes, though more feebly developed, have really the same movements among themselves as those of the fingers, and, in case of necessity, their powers can be strengthened and educated to a surprising degree. There are well-known instances of persons who, born without hands, or having lost them by accident, have successfully supplied the deficiency by a cultivated use of their feet. Some of these have distinguished themselves in the world of art. Who that has been so fortunate as to visit the Picture Gallery in Antwerp on some fine morning when the armless artist, M. Felu, was working at his easel, can forget the wonderful dexterity with which he wielded his brushes, mixed the oils on his palette, and shaded the colors on his canvas, all with his agile feet? The writer well remembers the ease and grace with which, at the close of a pleasant interview, this cultured man put the tip of his foot into his coat pocket, drew out a visiting card, wrote his name and address upon it, and presented it to her between his toes!

Contrast this intelligent adaptation of a delicate physical mechanism with the barbarous treatment it too commonly receives. The Chinese are at least consistent. They cripple and distort the feet of their highborn daughters until they crush out all the power and gracefulness of nature in the artificial formation of what they term a "golden lily"; but they never expect these golden-lilied women to make their withered feet useful. With us, on the contrary, every girl would like to walk well, to display in her general movements something of the "poetry of motion"; yet the absurd and arbitrary fashion of our foot gear not only makes an elastic step one of the rarest of accomplishments, but renders oftentimes the simple act of walking a painful burden. The calluses, corns, bunions, ingrowing nails, and repulsive deformities that are caused by and hidden under the narrow- toed, high-heeled instruments of torture we often wear for fashion's sake are uncomfortable suggestions that our practices are not greatly in advance of those of our Celestial sisters. Dowie, a sensible Scotch shoemaker, satirizes the shape of a fashionable boot as suited only to "the foot of a goose with the great toe in the middle." The error which may have led to the adoption of this conventional shape appears to lie in a misconception of the natural formation of the foot, and of the relation of the two feet to each other. It is true, that when the toes are covered with their soft parts, the second toe appears a little longer than the first, and this appearance, emphasized and exaggerated, is perhaps responsible for a practical assumption that Nature intended an even-sided, tapering foot. On the contrary, the natural foot gradually expands in breadth from the instep to the toes and, in the skeleton itself, the great toe is the longest.

"There is no law of beauty," says Dr. Ellis, "which makes it necessary to reduce the foot to even-sided symmetry. An architect required to provide more space on one than on the other side of a building would not seek to conceal or even to minimize the difference; he would seek rather to accentuate it, and give the two sides of the structure distinctive features....Moreover, the sense of symmetry is, or ought to be, satisfied by the exact correspondence of the two feet, which, taken jointly, may be described as the two halves of an unequally expanded dome."--E. B. S.

THE MUSCLES.

ATTACHMENT OF THE MUSCLES TO THE BONES (p. 30).--One of the two bones to which a muscle is attached is usually less mobile than the other, so that when the muscle shortens, the latter is drawn down against the former. In such a case, the point of attachment of the muscle to the less mobile bone is called its origin, while the point to which it is fixed on the more mobile bone is called its attachment....A muscle is not always extended between two contiguous bones. Occasionally, passing over one bone it attaches itself to the next. This is the case with several muscles which, originating from the pelvic bone, pass across the upper thigh bone, and attach themselves to the lower thigh bone. In such cases the muscle is capable of two different movements: it can either stretch the knee, previously bent, so that the upper and the lower thigh bones are in a straight line; or it can raise the whole extended leg yet higher, and bring it nearer to the pelvis. But the points of origin and of attachment of muscles may exchange offices. When both legs stand firmly on the ground, the above-mentioned muscles are unable to raise the thigh; instead, on shortening, they draw down the pelvis, which now presents the more mobile point, and thus bend forward the whole upper part of the body.

One important consequence of the attachment of the muscles to the bones is the extension thus effected. If the limb of a dead body is placed in the position which it ordinarily occupied during life, and if one end of a muscle is then separated from its point of attachment, it draws itself back, and becomes shorter. The same thing happens during life, as is observable in the operation of cutting the tendons, as practiced by surgeons to cure curvatures. The result being the same during life and after death this phenomenon is evidently due to the action of elasticity. It thus appears that the muscles are stretched by reason of their attachment to the skeleton, and that, on account of their elasticity, they are continually striving to shorten. Now, when several muscles are attached to one bone in such a way that they pull in opposite directions, the bone must assume a position in which the tension of all the muscles is balanced, and all these tensions must combine to press together the socketed parts with a certain force, thus evidently contributing to the strength of the socket connection....This balanced position of all the limbs, which thus depends on the elasticity of the muscles, may be observed during sleep, for then all active muscular action ceases. It will be observed that the limbs are then generally slightly bent, so that they form very obtuse angles to each other.

Not all muscles are, however, extended between bones. The tendons of some pass into soft structures, such as the muscles of the face. In this case, also, the different muscles exercise a mutual power of extension, though it is but slight, and they thus effect a definite balanced position of the soft parts, as may be observed in the position of the mouth opening in the face.--ROSENTHAL, _Muscles and Nerves_.

MUSCULAR FIBERS (p. 3l).--The anatomical composition of flesh is very similar in every kind of creature, whether it be the muscle of the ox or of the fly; that is to say, there are certain tubes which are filled with minute parts or elements, and the adhesion of the tubes together makes up the substance of the flesh. These tubes may be represented grossly by imagining the finger of a glove, to be called the sarcolemma, or muscle- fiber pouch, and this to be so small as not to be apparent to the naked eye, but filled with nuclei and the juices peculiar to each animal. Hundreds of such fingers attached together would represent a bundle of muscular fibers. The tubes are of fine tissue, but are tolerably permanent; whilst the contents are in direct communication with the circulating blood and pursue an incessant course of chemical change and physical renewal.--EDWARD SMITH, _Foods_.

FIG. 71.

THE SMOOTH MUSCLE FIBERS consist of long, spindle-shaped cells, the ends of which are frequently spirally twisted, and in the center of which exists a long, rod-shaped kernel or nucleus. Unlike striated muscle, they do not form separate muscular masses, but occur scattered, or arranged in more or less dense layers or strata, in almost all organs. [Footnote: An instance of a considerable accumulation of smooth, muscle fibers is afforded by the muscle pouch of birds, which, with the exception of the outer and inner skin coverings, consists solely of these fibers collected in extensive layers.] Arranged in regular order, they very frequently form widely extending membranes, especially in such tube-shaped structures as the blood vessels, the intestine, etc., the walls of which are composed of these smooth muscle fibers. In such cases they are usually arranged in two layers, one of which consists of ring-shaped fibers surrounding the tube, while the other consists of fibers arranged parallel to the tube. When, therefore, these muscle fibers contract, they are able both to reduce the circumference and to shorten the length of the walls of the tube in which they occur. This is of great importance in the case of the smaller arteries, in which the smooth muscle fibers, arranged in the form of a ring, are able greatly to contract, or even entirely to close the vessels, thus regulating the current of blood through the capillaries. In other cases, as in the intestine, they serve to set the contents of the tubes in motion. In the latter cases the contraction does not take place simultaneously throughout the length of the tube; but, commencing at one point, it continually propagates itself along fresh lengths of the tube, so that the contents are slowly driven forward.

As a rule, such parts as are provided only with smooth muscle fibers are not voluntarily movable, while striated muscle fibers are subject to the will. The latter have, therefore, been also distinguished as voluntary, the former as involuntary muscles. The heart, however, exhibits an exception, for, though it is provided with striated muscle fibers, the will has no direct influence upon it, its motions being exerted and regulated independently of the will. Moreover, the muscle fibers of the heart are peculiar in that they are destitute of sarcolemma, the naked muscle fibers directly touching each other. This is so far interesting that direct irritations, if applied to some point of the heart, are transferred to all the other muscle fibers. In addition to this, the muscle fibers of the heart are branched, but such branched fibers occur also in other places; for example, in the tongue of the frog, where they are branched like a tree. Smooth muscle fibers being, therefore, not subject to the will, are caused to contract, either by local irritation, such as the pressure of the matter contained within the tubes, or by the nervous system. The contractions of striated muscle fibers are effected, in the natural course of organic life, only by the influence of the nerves.--ROSENTHAL.

OVEREXERTION AND PERSONAL IMPRUDENCE (p. 40).--Among children there is little danger of overexertion. When a little child reaches the point of healthy fatigue, he usually collapses into rest and sleep. But with youth comes the spirit of ambition and emulation. A lad, for instance, is determined to win a race, to throw his opponent in a football scramble, to lift a heavier weight than his strength will warrant; or a girl is stimulated by the passion she may possess for piano playing, painting, dancing, or tennis. The moment of exhaustion comes, but the end is not accomplished, and the will goads on the weary muscles, perhaps to one supreme effort which terminates in a sharp and sudden illness, perhaps to days and weeks of continued and incessant application, during which the whole system is undermined. Thus is laid the foundation for a feeble and suffering maturity.

To elderly people, overexertion has peculiar dangers, dependent largely upon the changes which gradually take place in the tissues of the body. The walls of the blood vessels become less and less elastic, and more and more brittle, as life advances, until at last they are ready to give way from any severe or unusual pressure. We constantly see old people hastening their death by personal imprudence. An old gentleman running to catch the morning train; an old farmer hastening to turn the strayed sheep out of a cornfield; the old sportsman having a last run with the hounds; the last pull at the oars; the last attempt of old age to play at vigorous manhood.

A prominent American physician has said that between the ages of forty and fifty every wise man will have ceased to run to "catch" trains or street cars; and that between fifty and sixty he will have permanently discarded haste of all kinds. Equal precautions should be observed by both young and old, but especially by those advanced in life, in regard to extremes of heat, cold, or storm. William Cullen Bryant, by exposing himself to a scorching sun and refusing to permit a friend to protect him with an umbrella while delivering an address in Central Park, received injuries to his system that carried him to his grave. Ralph Waldo Emerson, by standing in a chilling wind, contracted a cold and died. George Dawson, by going thoughtlessly into a freezing atmosphere from the sweltering rooms of a crowded reception, took cold which resulted in pneumonia and death. Matthew Arnold, for years a sufferer from heart difficulty, in a single instance neglected the advice of his physician not to indulge in any violent exercise, made repeated attempts and finally succeeded in jumping a fence, and in a few hours was a dead man. Roscoe Conkling braved the most terrible blizzard ever known in the east and sacrificed his life. And yet, these were all men of exceptional prudence. Probably no other five persons in the world of like surroundings and vocations were more careful of their health. In an unguarded moment their prudence left them, and they paid the terrible penalty.--_Compiled_.

EFFECTS OF INSUFFICIENT OUTDOOR EXERCISE UPON THE YOUNG (p. 41).--Children deprived of adequate outdoor exercise are always delicate, pale, and tender; or, in a figurative sense, they are like the sprig of vegetation in a dark, dank hole,--bleached and spindling....An inactive indoor life is one of the most effectual ways of weakening the young body. It renders the growth unnaturally soft and tender, and thus susceptible to harm from the slightest causes. It hinders the garnering of strength necessary for a long life, and gives to the germs of disease a resistless power over an organization so weak and deficient....Measles, scarlet fever, and diphtheria find among such a congenial soil, and run riot among the elements of the body held together by so frail a thread....Such children are always at the mercy of the weather. Colds and coughs are standard disorders in winter, headaches and habitual languor in summer....The scapegoat for this result is the climate: if that was only better, mothers are sure their children's health would also be better. No, it would not be better: no earthly climate is good enough to preserve health and strength under such unnatural training....Children of the laboring classes, often dirty and imperfectly clad, seldom have colds, simply for the reason that, for the greater part of the day, they have the freedom of the streets. It is not the dirt, it is not the rags, _but the life-giving force of an active outdoor life_ that renders such children so strong and healthy. --BLACK, _Ten Laws of Health_.

POPULAR MODES OF OUTDOOR EXERCISE (p. 42).--_Walking_.--Every person has his own particular step, caused by the conformity, shape, and length of his bones, and the height of his body. Such a thing, then, as a regulation step is unnatural, and any attempt at equalizing the step of individuals of different heights must result in a loss of power.

The moment, also, that walking comes to be _uphill_, fatigue is sensibly increased. The center of gravity of the body is changed, and the muscular force necessary to provide for the change causes the fixing of the diaphragm, and a rigid condition of many muscles. Respiration is interfered with, owing to the fixing of the diaphragm, and the heart becomes affected thereby. A person with a sensitive or diseased heart can, during a walk, tell when the slightest rise in the ground occurs. We make climbing more exhausting from the habit we have of suspending the breath. Let the reader _hold his breath_ and run up twenty-four steps of a stair, and then perform the same act _breathing freely_ and deeply. It will be found that by the first act marked breathlessness will be induced, whereas by the latter the effect is much less. This management of the breath constitutes the difference between the beginner and the experienced athlete. The enormous increase of the quantity of air consumed during exercise will at once bring home a number of lessons. One is, that exercise is best taken in the open air, and not in gymnasia; another, that free play to act for the regions of the chest and abdomen must be given. On no account must a tight belt be worn around the soft-walled abdomen. If a belt is preferred to braces, let it be applied below the top of the haunch bone, where the bones can resist the pressure.

Whatever may be the pastimes indulged in by young men, walking should never be neglected. The oarsman will become "stale" unless the method of exercise is varied; the gymnast will develop the upper part of his body, while his lower extremities will remain spindleshanks. So with all other forms of exercise; success, in any form of game, sport, or gymnastic training, can not be attained unless walking be freely taken.

_Skating_ is simply an exaggerated swinging walk, with this difference, that the foot on which one rests is not stationary, but moves along at a rapid rate. The benefit to the circulation, respiration, and digestion is even greater in skating than in walking. The dangers from skating are:

1. The giving way of the ice. Great caution should be used in regard to the safety of a frozen pond or river.

2. Taking cold from becoming overheated, and from subsequent inactive exposure. Physiological knowledge will teach people that, when they begin to skate, outer wraps should be laid aside, and again put on when skating is finished.

3. Sprains, especially of the ankle, and other minor accidents arising from falls. Ankle boots with strong uppers should be worn during skating. Those who have weak ankles ought to wear skates with ankle straps and buckles, acme skates being relegated to those who are not afraid of going "over their foot."