JNBA > CSStp ': 184$ ';-»>. t" ;;'^:; C"*Vifc3 *.*- •"■-,''rfE& >••;?'^^'.-v- ■**'J3'1*:' -:V vr ■ V Ifi? U ^.. ^:<** * * .... <• ,v'-%.A yur'gr K '^ :;." > ■\*i /.._•/: -.-••.^."'•y1jz■*);>' . ■«:J'.,<.»*--'Sr<-*T*lKL '• • "j ■ ••/^■■•■iK:.«ft • -r- .-"'/'■.:/':i''/'v*'.«;V."■.»,:, •■,''■*:*'''<::,"yf." ■ > . '.'■ •'•v',i^a^L:;.?-:::-•' ?*-■ 9-?^'5 Library of Medicine FOUNDED 1836 Bethesda, Md. II. S. Department of Health, Education, and Welfare PUBLIC HEALTH SERVICE 73 ^PEASE—MOUSE.—Thursday mOTn,^;-. Jan, 19th. at the residence of the bride's V 1,le external bone ; 6. c. The internal tabic, the in- y1fr^jjggjf,fe,*!j tervening rellu!;ir texture, being spongy and carrying If C vessels and nervi-s from one part to another. The bones of the face are fourteen in number: the two nasal bones, two lachrymal bones, and upper jaw, two malar bones, the two palatine bones, the two turbinated bones, the vomer, and the lower jaw. The last named bone is the only one susceptible of movement. These bones afford protection to the organs of smell and sight, in connection with the skull bones. They also give form to the face, and support to its soft parts. 46 PHYSIOLOGICAL FAMILY PHYSICIAN. A FRONT VIEW OF THE SKELETON. Fig. 16. HEAD AND NECK. a, The frontal bone. 6, The parietal bone. C, The temporal bone. d, A portion of the sphenoid bone. e, The nasal bone. /', The malar, or cheek bone. g, The superior maxillary, or the upper jaw. h, The lower jaw. i, The bones of the neck. TliUNK. a, The twelve bones of the back. 6, The five bones of the loin*. C, d, The breast bone. e,f, The seven true ribs. g, g, The five false ribs. h, The rump bone, or sacrum. i, The hip bones. UPPER EXTREMITIES. a, The collar bone. 6, The shoulder blade. c, The upper arm bone. d, The radius. e, The ulna. i f, The carpus, or wrist. g, The bones of the hand. 5 h, First row of finger bones. „A t, Second row of finger bone?. 'pi k, Third row of finger bone?. fir /, The bones of the thumb. LOWER EXTREMITIES The th'gh bone. The knee pan. The tibia, or large bone of the leg The fibula, or small bone of the leg. The heel bone. The bones of the instep. The bones of the fo >t. The first row of toe bones. The second row of toe bones. The third row of toe bonfea. THE BONES. 47 A BACK VIEW OF THE SKELETON. Fie. 17. THE MEAD. v, The parietal bone. 6, The occipital bone. c, The temporal bone. d, The cheek bone. e, The lower jaw bone. NECK AWD TRUNK. a, The bones of the neck. b, The bones of the back. C, The bones of the loins. d. The hip bone. e, Tie sacrum. UPPER EXTREMITIES. a, The collar bone.^ b, The blade hone. c, The upper bone of the arm. d, The radius. ■ e, The ulna. jr /, The bgnesof the wrist. g, The bones of the hand. h, First row of finger bones. I, Second row of finger bones. ft, Third row of finger bones. /, The bones of the thumb. LOWER EXTREMITIES. a, The ihigh bone. 6, The large bone of the leg. c, The small bone of the leg. d, The heel bone e. The bones of the instep. f, The bones of the toes. 48 PHYSIOLOGICAL FAMILY PHYSICIAN. Fig. 18. The trunk contains fifty-seven bones. Of these the^,vertebrae (as the bones of the spinal column are called) number twenty- four. (The word vertebrae signifies to turn.) The upper seven are named the cervical, because they belong to the neck. The next twelve are named the dorsal. The las! five are called the lumbar, because they are situated in the loins. On examin- ing one of these bones, we find seven pro- jections, named processes. Four of these, that are employed in binding the bones to- gether, are called articulating. Two of the remaining are called the transverse,—the other the spinous. The last give attach- ment to the muscles of the back. This col- umn rests upon the sacral bone, which is closely compressed between the bones of the pelvis. The bone at the extremity of the sacrum is called the coccyx, making twenty-six in the spine, or back. The large part of the vertebra?, called the body, is round, and spongy in its texture, like the extremity of the round bones. The processes are of a more dense character,— consequently less easily injured. These joints, or vertebra?, have between them a peculiar substance, of a highly elastic nature. This not only fa- cilitates the bending movements of the back, but this flexible and yielding cushion of cartilage and ligament, serves the important purpose of diffusing and diminishing the shock in walking, or leaping, and tends to the pro- tection of the delicate texture of the brain. The projections are so arranged, that a tube, or canal, is formed immediately behind the bodies of the vertebrae, in which is placed the medulla spinalis, or spinal marrow,- sometimes called the pith of the back bone. THE BONES. 49 *" This is an accurate drawing of one of the bones of the spine at the neck; a, is the body of the bone; b, the spinous pro- *cess, or handle, which gives the > ^ name of spine to lb.3 whole ff column; c, c, the transverse pro- cesses to which the muscles ad- here, producing motion; d, d, .rojund holes through the arms of the bones for safely lodging an artery which car- ries blood to the brain; e, e, the upper, /, /, the under surfaces which make a joint above and below it; g, the hole through which the spinal marrow, or pith of ?ne back, passes in safety from the head, through the whole chain of twenty-four vertebrae." The costa or ribs, are twenty-four in number. For the curious, I would say, that they number alike in both sexes. These are irregularly curved,—the upper ones being much shorter than the middle ones. Their posi- tion is inclined, being neither vertical or horizontal, giving dilitation, or expansion, to the chest1, when their anterior and moving extremity is elevated. The upper ribs being the shortest, it is an indication, that the lower jiart of the chest should be the largest. Between the sternum or breast bone, and the anterior extremity of the ribs, we find a yielding substance, named cartilage. This con- duces to the elasticity of the chest, and free movement of the ribs. The following engraving, will give you a good idea of the bones of the chest, which is composed of a portion of the spinal column, of the ribs, and sternam or breast bone. NATIONAL LIBRARY OF MEDipnit 50 PHYSIOLOGICAL FAMILY THYSIC1AN. b. b. the spine; a. Sternum or breast bone, c. c. c. C. C. C. desig- nate the ribs, the upper ones being more curved and much shoiter than the lower ones. The parts between the division of the ribs and the ster- num represent the cartilages that join the ribs with the breast bone. The upper extremities consist of the clavicle or collar bone, the scapula or shoulder bone, the humerus or first bone of the arm, the two bones of the fore-arm, eight bones in the wrist, five in the hand, fourteen in the fingers and thumb, making sixty-four in both arms and hands. The collar bone is attached at one extremity to the ster- num, and the oilier is united to the shoulder bone. If the clavicle is broken, the shoulder will be inclined for- ward, and in a manner become useless. A fracture of this bone is somewhat troublesome to manage. The scapula is a hard, irregular bone, cushioned upon a con- siderable mass of muscle, or lean meat. At one comer there is a slight depression, upon which is placed the large round head of the humerus or first bone of the arm. This shallowness favors freedom of motion in every di- rection, but leaves the bone in a condition to be easily displaced. This is the reason that there are more dis- placements of this bone, than any other in the system. THE BONES. 51 Fig. 21. " In this cut is seen the union of the shoulder blade, or 9 scapula, the collar bone, or clavicle, l0lhe sternum or the breast bone, and the shoulder joints. n These are detach- ed from the body; hence the view is a front one. A portion of the collar bone of the right side is also seen,—all the others being on the left side. The figures from 1 to 11, indicate the ligaments that keep them united when the muscles are dissected away." The humerus or first bone of the arm, is long, cylin- drical, hollow and enlarged at each extremity. The cells of this hollow are filled with an oily substance, termed marrow. The enlarged extremities, though they present a greater surface, contain no more matter than the central points, but they are more porus or spongy. To these enlarged extremities are attached the tendons of the muscles, and the satin ribbon-like bands, named ligaments, which bind' the bones together. Fig. 22. The above engraving represents a section of the thigh bone, a. a. the ex- tremities bavins a shell or thin plate of compact teilure covering small cells diminishing in size but increasing in number as ihey approach the articulation, C. the cavity that contains the marrow, 6. 6. the walls of the shaft which are verv firm and solid. The structure of the bones of the arm is similar to the lower extremities. The lever, or lower end of this bone, unites with the bones of the fore-arm, to form the hinge-like joint called 52 PHYSIOLOGICAL FAMILY PHYSICIAN. the elbow. In the upper ends of the ulna and radius of the fore-arm, and the lower extremity of the humerus, the ligaments that bind the bones together to form the joint, and the terminal tendinous extremity of the mus- cles, are attached. By a very simple arrangement of the radius and ulna, the palm of the hand is turned upward and downward. This is effected by a button-like enlargement of the extremity of one bone, playing in a little groove in the side of the extremity of the other. The one bone has the enlarged head, or extremity, the other has a groove adapted to it.# At the other extremity, the button-like head and groove are reversed. The bones thus arranged are bound to- gether by bands, named the coronary ligaments. These bones are acted upon by two sets of muscles, turning the hand different ways ; at the lower extremity the two bones are united with eight small bones, called the car- pus or wrist. These are firmly bound together, and permit of only a small amount of motion and are diffi- cult of displacement. They are not so frequently " put out" as is often imagined. The diseases that are palmed off for displacement of these bones, are mainly injuries of the connecting ligaments and soft parts, with which the bones are surrounded. In the palm of the hand five bones are found, called the me- tacarpal. They are small, hollow, round and enlarged at each extremity; one end is united to the carpal bones, while the other extremity gives bases to the pha- langes or bones of the fingers. Four of them are bound together at the phalangiel extremity ; the other diverges. The fingers are composed of three ranges of bones, the thumb of but two^ upon the palm side they are flattened, but rounded upon the opposite. Upon the last joint the nails are placed, which are appendages of the skin. The lower or. pedal extremities are connected with the spinal column, by the ossa innominata or nameless bones, which in the child consists of three pieces, but in youth become united. Within this bone there is a deep depression named the acetabulum, from its supposed. resemblance to the cup used by the Romans to measure their vinegar. Into (his cup or depression,, the bead. THE BONES. 53 of the femur or thigh bone is inserted. The two inno- minata, with the sacrum and coccyx, from the pelvis which supports the bowels. The sacrum is a wedge- shaped bone, concave in frontT and convex behind. It is called the sacrum, from the fact that it was offered by the ancients in sacrifice. The coccyx in infants, consists of several pieces, but in youth it becomes consolidated into one bone. This forms the terminal extremity of the spinal column. The femur or thigh bone, is the largest and heaviest in the system. It is hollow and cylindrical; having many large projections, to which are attached the massive mus- cles of the thigh. The ball-like head of the lower ex- tremities is firmly bound, into the acetabulum cup-like cav- ity by ligaments. Fig. 23. ■""^'.iii/ " This is a drawing of the lower part of the hip bone, c or innominatum, in which is b- seen the head of the thigh ' ■ \~\^HlSllli boneT tied into its socket by ^ \__j IDffBlJt"............/a short round'cord to keep it always in place. Wese it not for this wise pnovis* w JJjW ion, a thousand unguarded, \:l!wW movements would throw the hip out of joint :. a is the g membrane that covers the joint;. b the cord that keeps the bones in the socket ; c the socket in the hip bone-; d a rim of the socket to deepen' kr aad/ head of the thigh bone; 6 the point of boneoo which we sit." The move- ment of this-joint is^ not so free and various as that ofi ube shoulder, but it is stronger and less liable to. be thrown out of its socket. The lower end is very large, forming two large tuberosities that are felt very prom- inent at the knee. £* 54 PHYSIOLOGICAL FAMILY PHYSlCl.vN , Fig. 24. Fig. 24 represents a section of the kneo joint, d, d, the extremity of the (high and leg bone, c, the patella or knee pan. The knee joint is formed mainly by the extremity of the femur,, and the large bone of ihe leg, named the tibia. The joint is hinge-like, having flexion, and extension, and but little lateral motion. This is one of the most impor- tant and complex joirits of the whole system, it having many connecting bands or ligaments. The patella or knee pan, is a small cone and, like a pulley, plays over the head of the thigh bone. It is connected with the ti- bia by a strong band or ligament at its lower edge ; at its upper edge it gives attachment to the strong terminal attachment of the muscles upon the anterior part of the thigh. The three bones of a peculiar form and situation, together with the many and complicated connectingligaments, make this one of the most complicated joints in the system. The importance as well as complication of this joint, render its injuries a matter of imporiance. They should never be tampered with by the unskillful and ignorant ; neither should they be neglected by the patient. Early surgical advice should be sought, even if the injury be seemingly slight. Below the knee we find two bones, but unlike those of the fore-arm. In the leg, the tibia is much lar- THE BONES. 55 ger than the fibula. In form they are triangular, and at each extremity firmly bound together by ligaments. In addition to this, there is a thin membranous ligament run- ning from one bone to the other, the entire length of the bones. The large bone forms the main part of the an- kle joint, it being placed upon the connecting bone of the foot. The extremity of the fibula is merely placed upon the side of the astragalus, or connecting bone of the foot. The tarsus is composed of seven irregular bones, lar- ger and more firmly bound together than the carpus. These bones are placed in a double row, forming an arch of much elasticity. Upon these bones are placed' the metatasial bones of the foot. They are curved upward in the centre, increasing the arch of the foot. Upon these are placed the phalanges, or the fourteen bones of the toes. In some respects they resemble the bones of the fingers, with the exception that they are shorter and smaller, nor do they move with so much freedom. This is the reauk of two causes, viz : the arrangement of the muscles is not so complete, and they are not used so much or as freely, as the fingers. Persons deprived of the use of the hand and fingers, by practice, can ac- custom the parts to action, so that they will act with great facility. But their employment is always limited. COMPOSITION OK BONES. The bones are composed of two principles. The one is called the animal, the other the earthy matter. The animal is composed chiefly of gelatine, or, in other words, jelly. The earthy is principally composed ©f two salts, viz. : the phosphate and the carbonate of lime. This can be proved by a simple series of experi- ments. Take the bone of any animal and put it into the fire a short time; on removing it, we shall see the form of the bone preserved. It is much whiter, and can be reduced to a fine powder by a little rubbing. This is owing to the loss or destruction of the gelatine by the ac- tion of fire, the carbonate and phosphate of lime remain- ing. Subject a bone to the action of diluted muriatic 66 PHYSIOLOGICAL FAMILY PHYSICIAN. acid' for a few days. On removing the bone from the acid, the form will be noticed to be unaltered* But now it may be cut with a knife with ease. It may be bent in any way, with little effort. The acid has United with the carbonate and phosphate of lime, and the muriate of lime has been formed, which is a salt soluble in Water* the carbonic and phosphoric acids being set at liberty. There is now left the gelatine that preserves the form of the bone ; this is soft and yielding. In cases of rickets, there is a deficiency of the salts of lime, and this is the cause of the deformities that attend these diseases of children. It is well known that the bones and limbs of infants are more easily bent, than in advanced age. This is in consequence of the gelatine predominating, and the gelatine alone remains, which preserves the form of the bone. This soft and immature state of the bones, in the young child, unfits it to sustain long continued standing in an upright position. The attempt to induce a child to stand or walk, while very young, is unwise, and often pro- ductive of injury to the system of the child. The lower limbs being imperfectly developed, there being-but a small amount of the earthy salts, they bend when the weight of the body is thrown upon them for any length of time. The efforts to induce the child to walk, by the use of standing-stools, leading-strings, and other means, create the bow-legs or bandy-legs, as they are called, that we see in the community. The bones that compose the spinal column, and the ribs in the child, are very soft and yielding. Such being the case, the clothing should be' loosely applied, to the child. A very small amount of pressure upon the gelatinous ribs, will push them in upon the lungs, heart, liver, stomach, and other important internal organs. The bandage or swathe, made use of by some mothers to support the parts about the navel of the child should be abandoned. In ordinary cases, they need no support, aitf such attempted assistance is sure to be attended with injury. Let all' the clothing of the child be loose. The hip bones of the child, like the other bones, are soft and yielding. If the child be car- ried much upon one arm around the parlor, deformity may be produced. As the'child advances in life, the gelatine COMPOSITION OF BONES. 57 gives place to the earthy matter, which renders the bones firm to resist the action of the more mature muscles, and the forces operating upon them. As the child ad- vances in years, the bones bend less easily, and are fractured more readily. In middle age, the proportion of gelatine, and the carbonate and phosphate of lime, are more nearly balanced. They fracture more readily than in the child. They are at this period of life, firm, elas- tic, and not so readily injured as in younger years, or more advanced life. In old age they are found to be friable or brittle, and if they are fractured, it will require a greater length of time to unite them, than in middle age ; for the reason tlrat the gelatine is diminished, while the salts of lime have been very much increased. The health of the bones depends upon a supply of nutrient bloody and proper exercise. As a general thing, we see that, among the active and industrious m-en, when digestion is good, the lungs healthy and well developed, with an abundant supply of pure air, they have also, well developed and well formed limbs. On the contra- ry, persons who toil in damp rooms, who sleep in badly ventilated chambers, whose food is poor in quality, and deficient in quantity ; that pursue a laborious and ex- hausting occupation for many hours continuously, and in unnatural positions, will have their bones more or less diseased. When the system of the child or young animal is developing, attention should be given to their cloth- ing, food, sleeping rooms, and employment. The amount and kind of labor should be adapted to the age, health, and development of the bones. The bending bones of the child, and the brittle bones ofjhe aged man, are not adapted, by their organization, to long continued and hard labor. Neither are the yielding bones of the child fitted for long continued sitting, or standing in one position. If deformities exist, these practices increase them. Every chikl and every de/ormed person should have employment, and opportunity to exercise,—but the employment and exercise should always be adapted to the conditions of the patient, and varied frequently. Exercise invites a flow of fluids to the bones of the 58 PHYSIOLOGICAL FAMILY PHYSICIAN. body; the bones of those who have the proper amount of exercise are firmer, stronger, more healthy, and less fiable to disease, than in the person that is indolent, and has but little exercise. We find the most symmetry of form, and exemption from disease, among the laborious and toiling classes in the community. Thus we see, there is truth in the Latin maxim : " CJbi irritatis, ibi fluxus." When there is irritation, or exercise, there is a o w offluids. FRACTURED BONES. Fig. 25. In this engraving, B. represents the thigh, A. the thigh bone fractured obliquely, the ends of the bone sliding by each other, by the shortening or contraction of the muscles. This always occurs in oblique fractures. C. represents the bone broken transversely. In this species of fracture, there is no shorten- ing of the limb. When the ends of the broken bone are brought together and retain by splints and bandages, it is called the set- ting of a bone. The method of applying bandages will be explained in another sec- tion. In fractures, the union of the divided bones is effected by a glutinous, gelatinous material, which is separated from the blood by the vessels of the fractured bone. Several days must elapse, before there is sufficient action excited in the blood vessels of the fractured bone, to secrete this agglutinating material. In youth, the union is effected from ten to twenty days ; in the aged, a much longer period is demanded. I would here say, that many think that the attention of the surgeon is need' ed during the first few days after the injury, but when the inflammatory pain and swelling has soroew&at abated, FELONS OR WHITLOW. 59 his attendance is deemed unnecessary. " The limb is doing we//," is the word, and " I will send for you when I need, or want you." In fact, the watchful eye of the surgeon is most called for, while the bones are uniting. This, in the young, is effected from the eighth to the fifteenth day ; in the middle age, from the tenth to the twenty-fifth day ; in aged persons, from the fifteenth to the fortieth day. The varying health and condition of the system, render the time of union very different in persons. At the period of the bone's unit- ing, if it be not in place, and straight, the limb will be shortened and crooked. The dressing at this period, should be very nicely applied, if a strong, healthy limb is expected. The material that first unites a fracture, is first gelatinous and soft, it then becomes harder, firmer, and cartilaginous. After this, the parts assume a firm, bony character. The fractured bones after their union, may be bent, until the callus is hardened by the deposi- tion of the salts of lime. FELONS OR WHITLOW. In the disease called felon, or whitlow, the matter fre- quently forms beneath the firm, investing membrane, called the periostium, which surrounds, and is in close contact with the bones of the fingers. In all cases where matter is secreted under this membrane, some days will elapse before it will appear upon the surface of the skin. This membrane being firm and unyielding, the matter causes most agonizing pain, and frequently destroys the bone of the finger. Poultices do but little, tf any good, in such cases The many things used and advised for this mal- ady, are of little avail. Many have suffered days and weeks, trying first one thing, then another, with no ben- efit The failure of these things results from the situa- tion, and nature of the disease. If you would alleviate and prevent suffering, save the bone from destruction, and retain the finger, go to the surgeon and have the fincer opened freely to the bone. This is the only safe and efficacious treatment. Many wish to wait until the 60 PHYSIOLOGICAL FAMILY PHYSICIAN. sore is " ripe," or "fit to open." Let me say it -is " ripe" and fit to open, within twenty-four hours after its commencement. Give free exit to the first drop of matter that forms, then apply a poultice. RICKETS. In the disease of the bones in children, known by the name of rickets, a softening of the bones, to a greater or less extent exists, from a diminution of the phosphate of lime. In the care of children thus diseased, free exer- cise in the open air, nutritious food, cleanliness of skin, a proper amount of clothing, good sized, and well ven- tilated sleeping rooms, would be very sure of effecting a cure. Rickety children being generally confined to that class, among whom due attention to the food, clothing, exercise and air, is not had, medicine to regulate the dis- ordered bowels may be needed. THE LIGAMENTS. The ligaments next demand our attention. There is attached to the enlarged extremity of the bones, satin- like bands termed ligaments. These are inelastic, firm, unyielding, and possessing no sensibility, when in health. These parts, like the bones, when not diseased, may be cut, rasped, or burned, and there will be no pain; but when diseased, the pain is severe. In health, the com- fort and movement of the person would be restricted if the bones and connecting ligamentous bands were sensi- ble. When these parts become diseased they require a period of repose for reparation, like the bones when fractured. The pain that attends the movement and use of diseased joints, admonish the sufferer to desist from labor that time and favorable conditions, may re- store the parts to health. Hence pain and tenderness of the diseased tissues may be considered a blessing. Un- der these bands, running from the projecting and promi- nent point of one bone, to that of another, is found a sack-like ligament, called the capsular. This surrounds all the joints. THE LIGAMENTS. 61 «The heads of all the bones are-covered by a substance termed a cartilage. It is, in point of hardness, firmness, and elasticity, midway between the bone and muscle.' Beneath this is seen the rough extremity of the bone to which it is united. It can be cut easily with a fine edged knife. This cartilage, has drawn over it a very thin, smooth membrane. This membrane is reflected from the cartilage to the capsular ligament, and covers it. Thus we see that the part last described, and called the synovial membrane, is a closed sack. From this there oozes out, or is secreted, a very soft smooth fluid, that lubricates, or oils the joint. It is to the joint what oil is to the axle of the wheel. In some forms of inflammation of the joint, at the commencement this syno- vial fluid is diminished in quantity—causing a feeling of roughness about the joint. When the quantity of fluid is • increased, as in some stages of inflammation, it is called dropsy of the joints. Take the joint of a calf, or ox, and examine it. The satin-like bands called ligaments, will be seen running from one bone to the other: under these will be seen the mem- branous bag called the capsular ligament. This is seen to be very smooth, as it is lined with the soft synovial membrane ; beneath this membrane is seen the cartilage, that may be cut with a knife, under the rough extremity of the bone. The joints of these animals, very general- ly, resemble the joints of man. Hence the examination of these joints may be of profit to the child in the study of human anatomy and physiology. The bones of the * upper and lower extremities are so constructed as to per- mit of free movements, and there is a provision made against the displacement of the bones by the arrangement of strong and firm ligaments. In the dislocation of a joint, some of the ligaments must be torn. 6 62 PHYSIOLOGICAL FAMILY PHYSICIAN. Fig. 26. In this figure we have a view of the short, strong lig- aments about the elbow joint. The short ligaments of the elbow are here demonstrated. We see that they are not on- ly short, but they are strong and numerous. The won- der is, that the elbow can be dislocated without entirely destroying the entire ligamentory arrangement. The figures from 1 to 4 not only give the locality, but even the figure. Fig. 27. " This diagram shows the con- nection of the little bones of the wrist or carpus, with the long bones of the fore-arm. 1 the ul- * na. 2 radius, 3 scaphoides, 4 lu- a nare, 5 cuneiforme, 6 pisiforme, e 7 trapezium, 8 trapeziones, 9 e magnum. The letters mark the b ligaments that tie them togeth- io ei. The following figure give? a fine view of the strong ligaments that bind the bones together about the wrist and hand upon the anterior side. THE LIGAMENTS. 63 Fig. 29. " Complex as the ligaments appear in this plan, there is cer- tainly an admirable simplicity conducing exactly to the perfec- tion of the frame of the hand. Each letter shows the place of each ligament as found on dis- section, joined to the bones which are thus drawn together like so many wedges. It would be impossible for the most in- genious mechanic to take the dry bones and secure them to- gether by wires, clasps, rivets, or straps, so strongly as nature has done, by means of these lit- tle shining ligaments." " By this drawing, which is true to nature, it will be seen distinctly how the bones of the instep and ankle are articulated, how the instep and phalanges, or toe bones, meet; and lastly, the small letters direct the eye to the locality of each liga- ment which assists in binding this congeries of large and small blocks firmly together like a pavement. g In cases of club-foot, the ligaments are very much deranged, in conse- quence of the distortion and dis- placement of the bones. But how- ever formidable the case may appear, if seasonable exertion is made, the very worst club-foot may be rem d- n elled by an iron shoe provided with metallic rods running up by the side of the ankle so that both apparatus and the bones may be kept in place. With the advice of the surgeon, any 64 PHYSIOLOGICAL FAMILY PHYSICIAN. ingenious mechanic can remedy a malformation of the foot, if the trial is commenced while the bones are imper- fectly ossified." DISLOCATIONS. In all instances of displacement of bones, the liga- ments and membranes are severed, as it is not possible to dislocate a joint without injuring the connecting liga- ments. Such being the case, if the bone is restored to its natural bed, it requires time for the repair of the sev- ered ligaments. In these cases, as in instances of se- vere sprains, there will be swetting,# pain and tenderness, and other symptoms indicating inflammation. This in- flammation must be removed by appropriate treatment; at first the part must be permitted So rest. This is ab- solutely required. At this time, a soothing application, with very mild friction, may be used. To relieve the tension of the vessels, leeches, cupping, cathartics with a low diet, would be beneficial ; after the pain, swelling, and tenderness, have somewhat subsided, smart finction ••••'k, w,ln stimulants, as the different kinds of linament and v* brandy would be of much benefit. At this stage of the disease, exercise the limb, in order to stimulate the weakened vessels. By this the tone and strengih of the limb would be increased. All remedies should be ap- plied at the proper time. The proper time for rest, low diet, gentle aperients, and bathing, is at the commence- ment of the inflammation attending severe injuries of the joints. The proper time for stimulating washes, lina- ment, friction, and using the limb, is after the heat, swelling}" and tenderness, has somewhat subsided. The treatment that would be beneficial at the latter part of the cure of an injured joint, might destroy the limb if used at an earlier stage. SPRAINS. In sprains, the connecting bands, or ligaments of the joints are injured. At the time of the injury, and imme- diately after, if little pain and inconvenience are expe- rienced, it is regarded as slight, as it is but a sprain. SPRAINS. 65 The person continues to use the parts. The injury of the vessel-, with the continued use, soon increase the activity of the circulation. The part becomes ten- der and painful, and accompanied with inflammation of these dense tissues. As before remarked, the bones, cartilages, and ligaments, have no sensibility, and pres- sure upon these parts would cause no pain in health. But when injured, pain and suffering follow, admonish- ing us to cease using the parts. Treatment.—The management of sprains is a matter of much importance to the community. In all cases the injured part, should be immediately freed from exposure. Bathe the limb with, warm water, warm vinegar and water, or warm camphorated spirits, and moderate fric- tion may be applied—but rest is the sheet-anchor. These are the means to be adopted to prevent the troub- lesome stiff joints, and white swellings, so often seen in the community. When a bone is fractured, there is no complaint of sprained limbs. The simple reason of this is, the joints are rested while the fractured bones unite. While the bones are repairing, the injury done them is likewise removed. We learn from this that rest, low diet, lo- tions of camphorated spirits, vinegar and water, are effective means of medication in common cases of slight sprains. The band or rolled bandage, is of much im- portance in the treatment of sprains, after the heat, swelling and inflammation have subsided, and the joints are in a state which is termed weak. In all cases of severe sprains, application to a com- petent surgeon should be early made. The joints be- ing so complex, if severely injured, there is much dan- ger to be apprehended. By taking the advice of com- petent men, expense and valuable limbs would be saved, and much suffering avoided. Better do thus, than seek the advice of all irresponsible, disinterested advisers, who in reality know nothing of the nature and treatment of such injuries. Natural surgeons are no better than natural watch repairers. Better trust a three dollar 6* 66 PHYSIOLOGICAL FAMILY PHYSICIAN. pinchbeck watch with the latter (which no person would do) than the management of a limb with the former. 0 BANDAGES. In all families, bandages are applied, when the limbs or joints are injured. When well applied they are of much benefit. When not properly used, they are of no utility, but sometimes do great injury. Every person should know how to prepare and apply a bandage. A bandage is .made of cotton or linen cloth divided into strips, Irom half an inch to three inches or more in width; old cloth is better for bandages than new, as it is smoother and will not give so much. Fig. 30. It should be wound into a small roll, as seen in the upper engraving 30, or into two rolls, by commencing at each end as seen in the lower figure. (The upper one is the most convenient for common use. It is called the single headed roller, while the lower one is called the double headed roller. " To roll a bandage with ease, fold the terminal end of the roller five or six times on itself, so as to form a sort of axis or mass; roll this a few times on the thigh to give it size. Then place its two extremities between the thumb and forefinger of the right hand, while the body is allowed to run over the forefinger of the left, where it should be firmly pressed by the thumb of the same hand, so as to make a considerable degree of traction, and tighten the cylinder. Having arranged this, give a rota- tory motion to the band, by causing the cylinder to re- volve upon its axis by means of the fingers and thumb of the right hand, whilst, at the same time, the left revolves partially around the cylinder itself, which, by this com- pound movement, is soon formed as required, and as may be well seen in the cut. BANDAGES. 67 The spiral, is the bandage most frequently employed in the treatment of diseases of the extremities, as well as those of the hunk. As most of the parts to which it is applied are conical, it follows that, in the ascent from the lower to the upper part of them, especially in the extremities, we must pass from the apex of the cone to its base, and that conse- quently one edge of the body of the roller will press on the part, while the other will project beyond it, and form what are known under the name of Gaps, as a, b, c. To Fig. 32. obviate this and cause the bandage to apply itself per- pendicularly to the whole surface of the part, the roller must be half folded on itself, or a doubling made, which is called a Reverse. As the bandage by this action ac- 19 6S PHYSIOLOGICAL FAMILY PHYSICIAN. quires an increased thickness, a greater degree of pressure will be made on these points than at any other, and it is therefore desirable, in order to obviate the bad effects which might result from it, that the reverse should be as short and as smooth as possible. To do this, hold the roller in the position in which it is generally applied, that is, either by its body or its two extremities, the hand be- ing in a state of supination; the fingers of the other hand are then applied to that part of the body of the bandage which is already in contact with the limb, not to assist in forming the reverse, or to fold it down, but simply to pre- vent its slipping while the reverse is being made. Thus fixed, we should see that no more of the band is unrolled than will enable us to separate the hand a short distance from the limb, say three or four inches; and then feeeping all slack between the fingers which fix the body of the roller and the part which is in the cylinder, turn the hand holding the cylinder from supination into decided prona- Fig. 33. tion (Fig. 33)—taking care to make no traction, nor to sink the cylinder below the level of the limb till the fold or reverse is made, when we may again proceed up the limb. These reverses are indispensable wherever there is an increase in the size of the part, from the extra de- velopment of certain muscles; and it is therefore of the greatest importance that the proper way of making them should be acquired, as no spiral bandage can proceed four inches on an extremity without requiring a reverse. BANDAGES. 69 Although generally regarded as the most difficult point in the application of the roller, iris not so in reality, and a little attention to the rules, recollecting always that no traction is to be made, nor the cylinder sunk below the limb, or widely separated from it, while the reverse is forming, will enable any one after a little practice to make them with great ease and neatness. To add to the latter, they should, as far as possible, be kept in a perpendicular line, as seen in the cut of the spiral of the lower ex- tremity. The special applications of the Spiral Bandage are as follows:— SPIRAL OF THE CHEST. This is composed of a single-headed roller, ten or twelve yards long, and three or four inches wide. Position of the Patient.— Always sitting up, so that the hand of the surgeon may pass readily behind the back. application.—The initial end is applied to the anterior part of one axilla, say the left; and the roller is then conducted upwards across the front of the chest, passes over the right clavicle, and over the back to the point of departure; another and simi- lar turn being effected, it is then carried across the front of the chest to the right axilla, to form an oblique from this to the left clavicle, after which it is carried firmly around the chest in spiral turns from above, downwards. Use,—In fractures of the ribs, care being taken to ap- ply compresses to their anterior and posterior extrem- * ities, if the fragments project inwards; but if out' wards, upon the parts themselves. 70 PHYSIOLOGICAL FAMILY PHYSICIAN. SPIRAL OF THE ABDOMEN. Composed of the same parts as the above. Application.—Commencing at the lower part of the chest, carry the roller spirally round the abdomen from above, downwards. Use.—To compress the abdomen, in certain cases, as after the operation for tapping in ascites. SPIRAL OF ALL THE FINGERS, OR GAUNTLET. Composed of a band, eight yards long and one inch Fig. 35. wide, rolled in a cylinder. Application.—Commence the bandage by one or two circulars around the wrist; pass obliquely over the back of the hand, and by oblique turns descend to the nail of the forefinger; then by spiral reversed turns, asiend to its base; pass to the middle fin- ger; descend by oblique turns to its nail; ascend by spirals to its base, and so on, till all the fingers are covered in, terminating at the base of the little finger, then pass in front or on the back of the hand to finish by circulars around the wrist. Use.—We may resort to this bandage when more than one finger is injured, and there is reason to fear their uniting if they are permitted to come in contact, as in cases of burns. SPIRAL OF THE UPPER EXTREMITIES, Composed of a roller, eight yards long, two or two BANDAGES. 71 and a half inches wide and compresses if it is required as a compressing bandage. Application.—Having covered in the fingers if neces- sary by the gauntlet, commence with one or two circular turns around the wrist, in order to fix the end of the bandage, then pass obliquely over the back of the hand and palm, to reach the extremities of the fingers, ascend by three spiral turns without reversing, which brings us to the phalangeo-metacarpal joint of the thumb; cover this and the wrist-joint by a figure of 8, as will be de- scribed hereafter, and ascend the limb by spiral and re- versed turns, till we reach the elbow; cover this also by a figure of 8, if the arm is to be flexed, if not, by simple spiral turns without reverses, and continue the spiral and reverses to the shoulder, placing compresses, &c, where they may be required. Fig. 36. Use.—To cover in, support, and compress the whole limb, as in varicose veins, aneurismal tumors, treatment of fractures, &c. Position of the Patient.—Sitting or lying down, with arm and forearm extended, and the palm of the hand looking forwards, the thumb being widely separated from the hand. The effects of this bandage, when well applied, are excellent; but it may become very fatiguing and painful if drawn tight, and if too tight, may produce gangrenous ulcers of the skin. In 1837 it was found necessary in the Pennsylvania Hospital to-amputate the forearm of a 72 PHYSIOLOGICAL FAMILY PHYSICIAN. man who had had only a simple fracture of the lower ex- tremity of the radius, but whose arm was grangrenous from the mal-ap plication of this bandage by a country surgeon. The spiral of the thigh, of the leg, of the foot, and of the toes, are similar to the above, and may therefore, be included in the SPIRAL OF THE LOWER EXTREMITY. Composed of two simple rollers, each eight yards long and two and a half inches wide. Position of the Patient.—If possible, seated with the extremity of his heel on the very point of the surgeon's knee, or else lying down, arid the leg supported by as- sistants. The surgeon may be either at the foot, or on the outside of the limb, and either sitting or standing. Fig. 37. Uses.—This bandage, if well applied, fulfils every indication either in the treat- ment of fractures, ulcers, varicose veins, or oedema, and will usually keep its place, if the patient remains in bed, for two or three days. The main difficulty in its ap- plication consists in the covering in of the heel. This is not absolutely necessary, as the close adhesion of the integu- ments to the parts below, prevents any great amount of swelling ; but where a considerable degree of compression is made on the leg, it is a better plan to co- ver in the heel entirely. To do this, proceed from the inside of the instep of the right foot under the heel to its outside, then around its point to the inside, form- ing a cap for the heel, round under the sole of the heel up across the instep, to go round the point to the opposite side and come up over the out-side of the an- kle, then over the instep, under the sole, up over the ankle in front, over the inter- BANDAGES 73 nal malleolus, round to the external, and then up the limb. Application.—Commence by making one or two cir- cular turns, immediately above the malleoli, to fix the end of the roller, then descend, if in the right foot, from the external malleolus obliquely across the instep and under the sole to the extremity of the little toe; from this make two or three oblique turns which will cover in the foot as far as the instep, and then cover in the heel by turns of the figure of 8, one extremity of the eight embracing the heel and ankle, the other the instep; after which, ascend the limb by spiral reversed turns, which may be made with either hand, until you roach the knee. Cover in this joint by a figure of 8, and proceed with the second roller to make spiral reversed turns on the thigh, till the whole is covered in. BANDAGE OF THE INSTEP. Composed of a single-headed roller, seven yards long and two inches wide. Application.—Lay the initial extremity of the roller on the tarsal end of the metacarpal bone of the little toe, if in the right foot, on that of the big toe, if in the left. Hence pass obliquely over the front of the foot to the Fig. 38. first joint of the big toe in the right foot, or to that of the little toe if in the other. Then go under the sole of the foot horizontally in a line with the metacarpo-phalangial 7 74 PHYSIOLOGICAL FAMILY PHYSICIAN. artic ulation, to the outer or inner side of the foot, accord- ing as it is the right or left. From this point make two obliques over the front of the foot, which will bring us to the instep on its inner or outer side, and then pass di- rectly to the point of the heel in a line parallel with the sole of the foot, the edge of the roller projecting a little beneath the sole, thence around the heel to come to the instep again, keeping still parallel with the sole of the foot, cross the instep and make another turn similar to the first, which shall embrace the heel and instep cover in one- third of the preceding turn, and form a spica on the in- step. Continue these turns, gradually ascending, till the foot will hold no more, when we may terminate the band- age by circulars above the ankle, or else form a spiral up the limb. Use.—This forms a most excellent bandage for cases requiring firm compression of the instep or ankle, as in wounds of the anterior or posterior tibial arteries at these points, and is at the same time exceedingly neat in its ap- pearance : the figure also shows the proper position of the limb of the patient and of the surgeon. Fig. MANY TAILED BANDAGE. In some instances it is convenient to ap- ply the many tailed bandage. It is compos- ed of several strips from one to two inches wide. These are arranged so that the edge of one strip overlaps another. Then they are slightly tacked together. Application.--The end of one strip is brought obliquely over the limb, then the other ex- tremity is drawn obliquely over this as seen in the upper strip in Fig. 39. All the strips are applied in a similar manner as seen in the engraving. The ends of the last one are pinned or tacke8 together. Use.—This is a good bandage when one is demanded and the limbs cannot be moved in removing the dressing. BANDAGES. 75 LACED OR BUCRLED BANDAGES, Are so named from the manner in which they are con- fined to the part: as they are usually obtained from the glovers and others, I shall only refer to them in passing. LACED BANDAGE FOR THE KNEE. Fig. 40. This is made of an elastic tissue, as buckskin or kid, which is lined with India- rubber, and laces at the side, as seen in the drawing. It is sometimes employed where constant compression is required, as after dislocations of the patella. A laced bandage may be made for the ankle joint, or the whole of the lower limb. In case of weakness of the limb or joints of injuries, they are invaluable. They will make more equal compression and retain their place better than a bandage, and are therefore superior, when it is necessary to use a bandage for a long time. SLING FOR THE ARM. Application.—Place one handkerchief in a cravat around the neck, and knot its ends over the sternum. Place the other in a trian- gle under the forearm, so that its base may be next the wrist, then tie its an- gles to the cravat, and car- ry the summit around the elbow to fasten to the body of the triangle in front. 76 PHYSIOLOGICAL FAMILY PHYSICIAN. Use.—To support the forearm. This method of form- ing the sling is better than the common way, as the knots do not cut the back of the neck, owing to the position of the cravat, whilst the summit, being fixed at the elbow, keeps the arm. more closely to the side of the body. DIGESTIVE ORGANS. The mammalia, which constitutes the highest order of organic development in the animal Mngdom embraces, as the term signifies, all such animals as rear their young, —as the human species, the monkey tribe, the whale, and various species of domestic animals. Here men and animals are provided with a complication of organs, all of which are more or less subservient to the process of digestion. Without this process, the functions, or offices of the other organs, could not long be sustained. As it is from the chyle the blood is formed, if the digestive powers should be suspended, this milk-like fluid would cease to be elaborated, and no blood would be formed. The functions of the heart and arteries being suppressed, the brain would cease to act, and life become extinct. The same is true of the digestive organs, if the heart dis- continued its action. Thus it would appear, that the functions of all the organs are performed in a circle, the one being dependant on the other ; and, like a circular chain, break one link, and it remains useless until re- paired. To understand the structure and office of these organs, it is necessary to explain each one individually, and then collectively. The organs to be examined first, are those by the action of which the food is converted in- to a fluid, which is taken up by the absorbent vessels of the intestines and introduced into the circulation. In these organs the knowledge and wisdom of the Great De- signer are manifested. They are divided by descriptive anatomists into sever- al parts. I will first call your attention to the mouth. Here we find in the upper part and roof of the mouth the palate ; in the upper and lower jaw the teeth are in- DIGESTIVE ORGANS. 77 serted for masticating or chewing food; within this cavity, is placed the tongue. Under it, and within the lower jaw, are large glandular bodies, in which is secreted, or separated from the blood, a peculiar fluid, named the saliva, or spittle. Behind the angle of the lower jaw, and below the ear, is a body, similar in character and structure. The one behind the jaw, is the body that enlarges in mumps—the one below the jaw forms what is called the kernel, when enlarged from colds,—the one under the tongue, when it enlarges, forms the disease termed a "frog." All these glands open into the mouth, and their peculiar secretion is conveyed there. The following engraving gives a fine representation of these salivary glands. Fig. 42. I, indicates the parotic gland. 3. the duct leading from it, an opening into the mouth at 5. 4 represents the buccinator muscle. 6 the submaxilary gland under an 1 within the jaw. 10. the sublingual gland placed under the tongue, which is marked 11. At the back part of the mouth we find what is called by anatomists the pharynx. This is the mouth- like commencement of the opening, called the oesopha- gus or gullet, which opens at the root of the tongue. The oesophagus is a muscular tube that lies behind the trachea or wind pipe, being in contact with the bones of the spine in the neck and chest. This tube passes through the diaphragm, or midriff, and communicates • 7* 78 PHYSIOLOGICAL FAMILY PHYSICIAN. with the stomach at its upper and left extremity. This- opening is named the cardia, or the cardiac orifice of the stomach. Through this tube, the food, after being mas- ticated or chewed, is passed into the stomach- The stomach and liver, are placed immediately below the diaphragm and in contact with it. This muscular mem- brane separates these organs from the lungs and heart, that are placed in the chest. The liver is found on the right side of the system, the stomach upon the left. These organs, respectively, extend but a trifle beyond a line dividing the system into two halves, which dividing line, is called the median. The form of the stomach is curved, somewhat resembling a Scotch bag-pipe, to which it has been compared. At the left extremity of the stomach and attached to it, is an organ, called the milt or spleen. The use of this orgaiTis not well under- stood. At the right, and smallest extremity of the sto- mach, is found an opening, named the pylorus, or pylo- ric orifice of the stomach. This communicates with the upper part of the intestines.. The following engraving will give a good idea of the situation of the liver, stomach, spleen, pancreas, and upper part of the small intestines. Fig. 43. t represents the gall cyst placed upon the under surface of the liver ; h the cardial orifice of the stomach, c the duodenum or upper portion of the in- testines, d. the pancreas, /, the spleen. DIGESTIVE ORGANS. 79 In this engraving, the under surface of the liver and stomach are represented. The oesophagus is composed of two coats or membranes, the internal, or mucous coat, with which the food comes in contact, and the muscular coat, which is composed of two coats of mus- cular fibres, the one longitudinal, the other circular. It is by the action of this coat, that food and drink are swallowed. The stomach is composed of three coats, or layers. The external coat is called the serous mem- brane, the middle coat the muscular membrane, the in- ner coat the mucous membrane. In order, to have it better understood, I will compare it to an article of food with which most are acquainted. Take the por- tion of the ox, called • the tripe. One side appears smooth and glistening. From this side there can be stripped off a thin semi-transparent membrane. This,. like the external coat of the eye in man, contains no. blood vessels that can be seen, while in a state of health. Under this serous, or peritoneal coat, if the tripe be boiled, there will be found a thick membrane, that com- poses the main body of the article. This will be seen to be composed of fibres, or strings, like lean meat, or muscles. These fibres run in two directions, some around and some lengthwise, and it is called the muscu- lar coat. In the human stomach, the fibres of the mid- dle or muscular coat, are of a similar character but not as large. The thread-like fibres, are also, seen running in different directions. It is by the action of this coat, that the stomach contracts upon the food, in the process of digestion. By this contractile energy, the food, after it has undergone its appropriate change, passes out of the stomach through the pylorus. The internal surface of the tripe presents a variable appearance. In some parts it appears in folds, or plaits ; in others it has the appearance of cells, not unlike the honey-comb. This is called the mucous coat, or mucous membrane, which comes in contact with the food. An innumerable number of blood vessels and nerves are found scattered over the surface of this membrane. There are also many little glands, and 80 PHYSIOLOGICAL FAMILY PHYSICIAN. follicles, in which is separated from the blood the pe- culiar mucous that sheaths, or covers the parts, when in health. The following engraving is a representation of the small glands of the intestines, that lie under the mucous or internal coat. They are represented highly magnified. The villi are also displayed. Fig. 44. The internal, or mucous coat of the human stomach presents nearly the same rugose or fold-like appearance as the intestines, it also abounds with myriads of small bodies, called glands, in which is secreted from the blood the gastric juice, a solvent so powerful in some animals as to dissolve stones and metals. The above engraving represents glands upon the DIGESTIVE ORGANS. 81 coats of the stomach, from which the gastric juice is se- creted. They are magnified 45 diameter. Fig. 46. The above cut represents a portion of the mucous membrane of the stomach, showing the entrances of the secreting tubes or cells upon its surface. The omentum, or caul, consists of two membranes, loaded with more or less of fat, lying between the mem- branous lamina. This membrane is attached to the largest and anterior curvature of the stomach, and falls in front of the intestines, in a curtain-like manner. The liver, the largest gland in the system,' is placed in con- tact with the diaphragm, extending a little to the left of a line dividing the system into two equal parts. It is convex upon its upper surface, and concave upon the lower. This gland has a cyst upon the under surface, called the gall bladder; the appearance of this organ cor- responds to that of the domestic animals. In this organ the bile is secreted. Passing transversely across the abdominal cavity, under and below the stomach, lies the pancreas, which is called the sweetbread. In this organ a milk-like fluid, in ap- pearance, is secreted from the blood; this, with the bile secrete'd in the liver, enters the upper portion of the in- testines, called the duodenum, about five inches below the stomach. The intestines, or bowels, are divided into two grand divisions, viz. the large and small. The large intestines are divided into three parts, viz. the caecum, or blind por- tion, the colon, and rectum. The caecum, is a small worm- Jike process, attached to the head of the colon. The 82 PHYSIOLOGICAL FAMILY PHYSICIAN. ,! In this view of the abdomen, d, is the gall-bladder, lying on the under side of the liver, the dark mass to which it is attached ; h, is the coronary artery, which supplies the stomach, a, b, C, with blood. The curve of the stomach is well shown, e, e, the arteries which supply the caul marked t, i, which falls down from the front of the stomach, over the intestinesjhke an apron; g, a ves- sel of the liver. The pancreas is behind the stomach." head of the colon, called the caput, commences upon the inside of the right haunch bone, ascends on the right side DIGESTIVE ORGANS. S3 as far as the liver. Under this organ it turns and cross- es the system under the liver and stomach, and reaches the spleen, where it again turns and descends, and finally dips into the pelvic cavity or basin, situated in the lower part of the abdomen. The portion upon the right side, is called the ascending colon. The portion below the stomach and liver, the transverse colon. The portion upon the left side, the descending colon. The part in the pelvic basin, is called the rectum. In man, as in the domestic animal, the hog, the colon is thrown into sacks, or pouches. Fig. 48. In the above engraving the ascending colon commencing on the right side, with the transverre colon,/, is represented with the pouches g, g, represents a portion of the small intestine, a, b, c, e, d, h, represents the superior mesenteric artery and branches 84 PHYSIOLOGICAL FAMILY PHYSICIAN. The small intestines are divided into the duodenum, jejunum, and ilium. The duodenum constitutes the first twelve inches. It commences at the pyloric orifice of the stomach, passes down to the right about five inches under the liver, and in contact with it. It then crosses to the left side, behind a mass of the small intestines, the transverse part of the colon and omentum. The re- maining portion of the small intestines, the jejunum and ilium, are loosely attached to the parts about the spine. The whole tract of the intestines, is about thirty feet in length. The coats of the intestines are three in number, as in the stomach, and similarly ar- ranged. The internal surface has many folds, called the valvulae conniventes. This makes this coat more exten- sive than either the other two. In addition to the great number of blood vessels and nerves supplied to these parts, there is another set oT vessels called the lacteals, or lymphatics of the intestines. These vessels open into the intestines upon the mucous membrane. They are exceedingly small and very numerous, and pass through a set of glands named the mesenteric, and are collected into one vessel, named the thoracic duct. This vessel is of the size of a common goose quill, and passes up the chest, behind the heart, and opens into the large vein at the lower part of the neck. Fig. 49. <»7 17 4 w 1, The oesophagus, or swallow perforating. 2, The left opening of the dia- phragm. 3, The cardiac orifice of the stomach. 4, The small curvature of the stomach. 5, The great curvature of the stomach. 6, The fundus of the stomach. 7, The pyloric orifice. 8 ,The duodenum, divided into three portions. 9, The. ascending, 10, The transverse, and 11, The descending, portion. 12, The jejunum, forming three fifths of the small intestines, distin- guished from the ilium in being thick- er, more vascular, larger, and having more valves. DIGESTIVE ORGANS. 85 13, The Hum, forming less than two fifths of the small intestines, and ter- minal ing in the caecum, having two valves at the entrance. 14, The caecum, the first of the large intestines, situated in the right, having attached to it 15, The appendix venniformis. The caecum terminating in 16, The ascending portion of the colon, which directs its course from the cae- cum towards the stomach, connected to the right kidney by a fold ot the peri- tonaeum. 17, The arch of the colon, traversing the abdomen beneath the stomach. 18, The descending portion of the colon, directing its course towards the left region, connected to the left kidney by a fold of the peritonaeum. 19, The sigmoid flexure of the colon, situated in thelelt iliac region, and ter- minating in 20, The rectum." * The nutriment that passes into the system, is subject- ed to the action of the stomach and intestines. All sol- id food taken into the mouth, is, or should be reduced to a fine state by the action of the teeth upon it, and, by being well masticated, it has mixed and incorporated with a great amount of fluid from the glands about the mouth. This fluid is named saliva or spittle, which moistens the food, that it may pass with ease through the oesophagus into the stomach. When there is a proper amount of saliva mixed with the food, it stimulates the glands of the stomach, causing them to throw out a pow- erful solvent, called the gastric juice. By the action of this fluid, and the contractile muscular energy of the stomach, the food of different materials of the animal and vegetable kind, is changed into a homogeneous mass, named chyme. The chyme is passed through the pylo- rus into the duodenum, or the upper part of the bowels. Here the chyme excites an action in the coats of the du- odenum, in the liver and pancreas. These organs are called into action, and they secrete bile and pancreatic juice in considerable quantities. These fluids unite with the chyme and change it into a fluid, of a milk-like ap- pearance, named chyle, The fluid of the food of a nu- trient character, with the residual matter is moved along the intestinal tract over the mucous membrane by the ac- tion of the muscular coat. This movement, is called peristaltic or vermicular, from its resemblance to the movements of a worm in crawling. As the chyle passes along the intestines, the open mouths of the lacteals, suck it up and transfer it to the thoracic duct, through which it passes to be mixed with the blood. The residual mat- ter by the peristaltic movement of the bowels is carried 8 96 PHYSIOLOGICAL FAMILY PHYSICIAN. out of the system as an excretive in the daily alvine evacuations. In the change that the food undergoes in the stomach, the bile has no agency. In a healthy state of this organ no bile is found there, and the common belief that the stomach has a redundancy of bile in it, is erroneous. Tbe expression so common, that a person is bilious, is not ordinarily correct; if bile is brought np in vomiting, it merely shows that not only is the action of the stom- ach inverted, but also that of the upper part of the bow- els. In some very severe cases of Hernia and obstruc- tion of the bowels, the alvine feculent matter is ejected by the long continued and severe vomiting. It is a law of the system that each organ is excited to the most healthy and efficient action, when called into action by its own appropriate stimulus. This being the case, we find the glands about the mouth responding to the stimulus of the nutrient food that is adapted to the wants of the system, The wants of the system do not require tobacco, and its stimulation to the glands of the mouth causes disease, not only in them, but in other or- gans of the system. Spirits, wine, tea and coffee, are not natural excitants of* the stomach, the wants of the system do not demand their stimulation, and the tenden- cy of their use is to induce disease in the stomach. The chyme formed in the stomach is adapted to the healthy stimulation of the duodenum, liver, and pancreas. The chyle is the natural stimulating excitant of the lacteal ves- sels. Each stage of the digestive process must be prop- erly effected, in order to have the digestive organs in a healthy efficient state, Again, every organ of the system will act for a time with healthy energy, and then rest is needed, to recruit its exhausted powers. The arm can be used for a few hours without pain, then the fibres of the muscles be- come exhausted, from loss of nervous stimulus. A little time for rest will restore the exhausted fibres. The eye will become wearied, and there may be dimness of vis- ion, induced by looking steadily at an object for a time, but calling to assistance " nature's kind restorer," the un- pleasant sensations are dispelled. DIGESTIVE ORGANS. 87 The glands of the mouth will act with vigor, and se- crete saliva in abundant quantity, and then they require time to repair their energies. So with the stomach; it will act upon an adequate amount of food, but like the other organs of the system when called into action, rest is demanded at proper intervals. In order that the health of the digestive organs be maintained, certain conditions must be observed. To these we now invite attention. The first condition is, that the food should be taken at regular and stated peri'- ods. The frequency of taking food will be modified by the age, the health, the-exercise, and the habits of the in- dividuals. Whatever may be the time adopted, the stat- ed period should be duly regarded. The digestive pro- cess is always more rapid in the young and active, than in the aged and indolent; therefore food should be more frequently taken; still regularity should be observed. In some young and vigorous persons the food may be di- gested in one hour, in other persons it may require four hours or more ; and in most instances, from three to four hours will be required to digest ordinary meals. In all instances the stomach will require from one to three hours to recruit its exhausted powers, after the labor of digesting a meal, before it will again enter upon the vigorous and healthful performance of its func- tions. U food be taken before the stomach has re- gained its tone by repose, the secretion of gastric juice and the contraction of the muscular fibres will be alike imperfect. And again, if food be taken, before the digestion of the preceding meal is completed,^the re- sult will be still worse, because the already ertgaged solvent is acting upon the first meal, and the one subse- quently taken will remain until supplied with the gastric fluid. The interval between each meal should be long enough to have the whole quantity digested, and sufficient repose given to the laboring organs. If this principle be true, the adage taught the person convalescing from fever, and the dyspeptic , '•' eat a little at a time, and eat often," is unsound in principle, and injurious in practice, as the stomach would have no pe- 88 PHYSIOLOGICAL FAMILY PHYSICIAN. riod of repose. Persons following this adage and thosO addicted to irregular habits of eating, and taking a "bite" at any time when convenient, between the regular meal times, complain of a " faint, sickening" feeling at the stomach. The sensation is somewhat like that experi- enced when by undue labor the muscles have been over- tasked. These " morsels" of food are frequently taken to relieve this disagreeable sensation; for the moment it is seemingly efficacious, but like the narcotic alcohol, the relief is only for the moment, and the remedy still farther weakens and prostrates the organs. By this practice a redness of the tongue is produced, and a dryness of the mouth and throat, and a tenderness in the region of the stomach. This is illustrated in the instance of weak eyes that are subjected to a strong light. The vessels soon become filled with blood, or ex- tremely red ; this is the result of using the weakened eyes too long; the same is true of the stomach. Persons whose digestive organs are thus relaxed should at first take a small quantity of food that is easily digested; such as milk, fish, ripe fruit, the unbolted wheat bread, that has been baked twenty-four hours. Then let there be ample time for the food to digest, and for repose of the organs, before another supply is given. The feebler the person and the stomach, the more important to observe this rule. In the feeding and nursing of infants, as well as older children, it should always be regarded. The person who has been confined by an exhausting sick- ness, should* most scrupulously regard this rule if he would recruit his strength and flesh with rapidity. What amount of food should be taken ? This de- pends upon two circumstances : 1st. The amount of growth, if there be any. 2d. The amount of the waste of the system. To these two circumstances it should be graduated. The lad that is growing fast, not only needs food to repair the waste of the system, but material to promote the growth of the muscles and bones. Hence we notice in the healthy lad, the frequent call for food, the keen appetite, and the vigorous digestion. In every department of nature, waste, or a loss of substance, is DIGESTIVE ORGANS. 89 attendant on action. The great toe of the bronze statue of St. Peter, at Rome, has been reduced in size one half by the kissing of the Romanist devotees. Thus, even kissing is attended with waste. The lad who is active requires more nourishment than one of indo- lent habits. And when the system is matured, there is less demand for food, as only a quantity sufficient for the renewal of the system is required. The individual who has accustomed himself to active avocations, and on leaving them to pursue those of an opposite character, as the learning of a sedentary trade, or attending school, requires less nutriment, as the waste of the system is diminished, in the same proportion as the exercise. If the same quantity of food is taken after the exercise is diminished as before, there will be induced a reple- tion of the system. Students should guard themselves against this evil, the first few weeks of commencing school. So should girls who leave the active household labor, for the sedentary labor of sewing in the shop of the dress-maker. Should the food be taken dry, and well masticated, or should it have the assistance of tea or coffee to pre- pare it for the stomach ? If the use of tea and other beverages be proper, then the glands about the mouth that secrete saliva, are unnecessary. The saliva is a natural and healthful stimulus to the stomach, when unit- ed with the nutrient food. If other fluids are substituted, the stomach will want this stimulus: and the glands themselves being left in an inactivg state, lose their tone as well as the stomach. The one suffers from inaction, the other from the irritating effects of an uncalled for fluid, and deficiency of the natural stimulus. If reason would guide man, as instinct guides animals, in relati6n to the manner of taking fluids with the food, and the quantity likewise, one great cause of dyspepsia would be removed. The horse is never known to leave his prov- ender to obtain water to wash it down, or the ox, to wash down his blade of herbage. But many persons from habit, rather than thirst, drink largely during meals. This causes distension and enfeebles the contraction of 8* 90 PHYSIOLOGICAL FAMILY PHYSICIAN. the stomach; it not only induces a diseased state of the ^stomach, but causes an unpleasant sense of feeling. While the washing down of food is productive of evil, a moderate amount of drink after eating is useful in the digestion of the food. The kind of food. Should it contain only nutrient matter, or should it have mixed with it innutritious matter ? Experience has shown that the unbolted wheat bread, or " Graham bread," as it is called, is better adapted to the stomach than the flour bread; for this organ, like some others in the system, besides the stimulus of the blood, nervous fluid, and food, needs the stimulus of distension to a certain extent. Aliment that has a certain amount of innutritious matter united with it, answers this indication. The simple articles of diet, seem peculiarly adapted to distend this distensible organ. These articles are the nutrient fruits, vegetables, milk, bread, and the different kinds of animal food, in moder- ate quantities, during the cool season of the year. Dur- ing the warm season, abstinence from animai food would be productive of comfort and health. If milk and flesh be taken as articles of diet, they should be of a healthy character. No fluid secreted in a disordered animal is healthy and fit for an article of diet. The same is true of the flesh of animals; if they are diseased, the flesh is unfit for food. Animals, as well as men, have the nat- ural functions of their organs deranged when the exer- cise, food, and air is unnatural, and not adapted to the constitution of the cre^ure. Confine sheep in a close, bad air, without exercise, and they die of the rot. Cows kept in stables are tuberculous. On the same principle, stall-fed cattle and sheep, deprived of customary exer- cise and air, become diseased. The forcing feeding process of domestic animals is unnatural, and tends to cause disease, as a similar process would in man. If an animal not accustomed to exercise for some weeks, be driven several miles to market, the driving will cause a deranged state of the animal's system, rendering it unfit for food. The milk of cows deprived of exercise, air, and natural food, is of an impure character, and unfit DIGESTIVE ORGANS. 91 for diet. For reasons named above, all stall-fed meat is unfit for food. Highly seasoned food is not adapted to the condition of the digestive organs. It usually contains too much nutriment in too small bulk ; it excites the mucous membrane too much, and stimulates the stomach by distension too little. Hence persons feed- ing upon such articles, become more or less diseased. The proper state of the organ of the system, when the food is taken, is of much practical value. It appears to be a law of the system, that two important set of organs cannot be called into intense action at the same time, without injury to the system, for the reason that all the organs of the system when in action demand the stim- ulus of an increased amount of blood and nervous fluid. To supply this increased quantity, there is a demand made upon the other organs of the system. The diges- tive organs are then excited to action, by inviting the fluids from other parts of the system, thus leaving the unused organ deficient in the natural amount of fluids, during the performance of such labor. Some length of time must elapse, before the action of the system is equalized, and until this equilibrium is restored, they are unfitted for an extra amount of action. If the limbs of a person have been violently exercised, it incapa-citates him for vigorous mental application, because the vessels of the used active muscles, are in a state of increased action. The brain consequently, will not have a supply of blood. If the brain and stomach are called into action at the same lime, as in the digestion of food and severe mental study, both organs will suffer, as they cannot be duly stimulated by blood. So of the muscular system and stomach, or the muscular system and brain. Individuals repeatedly calling into action two sets of organs at the same time, to a greater or less extent, become diseased. Feed two dogs, upon similar articles of food, let one lie down quiet, the other be sent in pursuit of game. At the expiration of one hour, have them killed. The stomach of the one that had remained quiet, will be nearly or quite empty, while the food in the other will be 92 PHYSIOLOGICAL FAMILY PHYSICIAN. found nearly unaltered. In the one dog, the energies of the system have been concentrated upon the stomach, in the other they have been exhausted on the organs of motion. So it is with man, if his mind or muscles act intensely after eating, the stomach will not be stimulated sufficiently to change the food in a suitable period. If retained in the stomach an unusual length of time, it be- comes irritated. And this is one fruitful cause of dys- pepsia, among persons of all classes. A per.od of in- action is called for immediately after eating, and again when a person-has been intensely engaged in any mental or muscular effort, the stomach should not be called im- mediately into intense action, to digest a full meal, for the reason it is in a state of comparative feebleness and inactivity. It is no uncommon occurrence, that laboring men, after eating a hearty meal at night, awake with colic pain. In such instances, the brain becomes dormant and does not impart the requisite amount of nervous fluid. From this we may learn the deleterious effects of eating, immediately before retiring for the night. The nervous stimulus being defective, the food remains an irritating substance, causing disturbed sleep and unpleas- ant dreams. The practical rule would be, not to eat any thing for two or three hours before retiring. Here 1 will ins'ert a Latin maxim in regard to health i " Ex magna caena, Stomacho fit m.ixirm paena Ut sis jiocte levis, Fit tibi cajna brevis." English, ** To be easy* all night, Let your supper be light, Or else you'll complain Of a stomach in pain." The health and vigor of the stomach, and associat- ed organs, require well developed and heallby lungs. The frequent stomach complaints, among those that have narrow chests, sustain this position. The blood of the system demands that the lungs be adequate to pu- DIGESTIVE ORGANS. 93 rify it. If they are not, indigestion will be the result. Pure air is essential to a keen appetite, and vigorous di- gestion. If it be impure, the waste of the system, viz : carbonic acid gas, is not separated from the blood— under such circumstances the system will not receive pure blood, as its wants demand. The.blood thus vitiat- ed is not fitted to sustain the tone of the organs employed in the digestion of food. During the sitting of the committee appointed by the British Parliament, to inquire into the effects of the manufacturing employment upon the physical system, among other persons examined, one stated that some years before, he had ventilated his mill on a well devised plan, which he had removed at a subsequent period. On being asked the reason for removing the ventilating ap- paratus, he replied, he noticed after the mill was ven- tilated, that his men consumed a greater quantity of food ; and rather than incur an extra expense for beef, he caused the ventilating apparatus to be taken out. From this testimony, we learn the reason why those per- sons wko sleep in small ill ventilated rooms, who breathe an impure air, have little or no appetite in the morning when they first rise, and why the mouth and throat are so dry and filthy. The blood, under such circumstances, is sent to the organs impure, and they are not stimulated as their nature demands. Inspiration, independent of its effects in purifying the blood, exerts an important influence upon the abdominal organs. At each full act of inspiration, the central por- tion of the diaphragm is depressed from one to two inches. This depression is accompanied by a relaxation of the anterior abdominal muscles. At each act of expiration the same set of muscles contract, the ribs are depressed, the diaphragm relaxes, and its central partsascend. This movement of the midriff causes the elevation and depres- sion of the stomach, liver, &c, at each act of respira- tion. This gives to the abdominal viscera, the stimulus of exercise. It is noted of individuals, who restrain the free movements of the abdominal muscles by tight dresses, that the tone and vigor of the digestive organs 94 PHYSIOLOGICAL FAMILY PHYSICIAN. are impaired. The restricted waist will not admit of a full, and deep inspiration ; and so essential is this to health, that the abuse of it soon destroys, or enfeebles the functions of the system. Fig. 51. Fig. 50. Fig. §0, represents the antero posterior section of the thorax or chest, when the lungs are contracted. . Fig. 51, represents the antero posterior section of the chest when the lungs are inflated. 1,1. The diaphram in Fig. 50. 2, 2. the muscular walls of ab- domen. Fig. 51. 1, the diaphragm. 2. the muscular walls of the abdomen. In these two figures the diaphragm is seen to be more convex into the cavity of the chest, and the walls of the abJomen flatten when the lungs are contract- ed than when they artf inflated. The position of a persop, standing or sitting, exerts an influence upon these organs. If a person lean or stoop, the distance between the pelvic bones and sto- mach is diminished. The depression of the diaphragm is prevented, and the stomach, liver, pancreas, and oth- er abdominal organs are pressed upon. The deficiency of the movements of these organs, joined with unnatural pressure, induces many severe diseases of the parts. When we see that healthy and well developed muscles keep the spinal column in an erect position, and that DIGESTIVE ORGANS. 95 this position subserves to the health of the digestive or- gans, should not the child be taught to avoid all positions but the erect, while studying, or walking ? This posi- tion, combined with unrestricted waists, will do much to remove the now prevalent disease, dyspepsia. The health of the digestive organs require the muscu- lar system to be duly exercised. If this condition is want- ing, the appetite will fail, and digestion will become im- paired. As action produces waste, material to repair this loss of substance is demanded. When muscular ac- tion is increased, the appetite is more acute, the motion of the stomach is more energetic, and the amount of chyle being increased, a fuller, deeper, and more com- plete respiration to purify it, is necessary. Thus we see, that exercise and pure air are a sovereign specific for impure blood, want of appetite, feebleness of the system and the digestive organs. The goad to the famished ox, will induce the animal to make a few convulsive efforts, that still farther depress the wearied and prostrated sys- tem. But nourishment and moderate exercise will add to the real energies of the animal. Let persons thus en- feebled, attempt to relieve their sinking powers by drudg- ing alone, with stimulants and highly seasoned food, the excitement and hope like the convulsive struggle of the animal, will be fleeting. The excitement will be follow- ed by a corresponding depression. There is no royal road to health, unless the organic Jaws are understood, and practiced. GENERAL SUGGESTION TO FAMILIES AND MOTHERS, All individuals, when sick, are naturally inclined to resort to something that will give relief; hence, domes- tic medication is, and always will be, practised by par- ents, to a greater or less extent. It is desirable then, that safe and suitable remedies should be known by those that direct the home treatment. When an individual employs a physician, four things he desires of him : 1st. That he will cure him speedily. 2d. That the treat- ment employed be not only effective, but safe. 3d. 96 PHYSIOLOGICAL FAMILY PHYSICIAN. That he will direct as little medicine as possible to effect the desired object, 4th. That no experiments be tried. To effect these four things, the following conditions are necessary : 1st. That the medical adviser seek out the causes of the disease, and, if possible, remove, or destroy their influence. 2d. He should know how much the system will do to effect its restoration, what assistance, and how much it needs ; or, in the words of Thomas Jefferson, the medical adviser " should learn the limits of his art." To carry out this, a knowledge of the causes of disease is demanded ; the effects and operation of medicine ; and also when* the disease can be safely trusted to the united efforts of nature, and when these efforts should be assisted. Except a physician has such knowledge, he must, and does experiment. An un- derstanding physician has a knowledge of the healthy structure and functions of the system, as well as the dis- eased action. To decide whether there is a displacement of a bone, a knowledge of its natural position is requisite ; without which no comparison could be made. For a lady to treat the little ills of her family with propriety, some information is necessary. She should learn the cause of the disease. To illustrate-this, suppose a boy should have diarrhea. This may be produced by eating apples, or cherries, or it may be produced by a chill upon the skin. If the former be the cause of the complaint, an emetic and cathartic to remove the indigestible matter would be demanded. In the latter, the warm or vapor bath is demanded. Here we see that effective and safe medication demands an inquiry into the cause of the com- plaint. After the mother has made the inquiry, and learned the cause of the disease, she should know the effects of the means used to relieve the system, as the bath, or the emetic ; and this knowledge should be defi- nite. If a physician should give an emetic, or other medicines, and be asked what operation the medicine was expected to produce, should he answer, I do not know, I have not thought of that matter, but I expect and hope it wijl cure you. Such a physician would be call- DIGESTIVE ORGANS. 97 cd an experimenter, and would be dismissed as a danger- ous man. So it is with the mother. She should know the effects of her teas upon the system. After the cause is removed, the physician should de- cide the question, if the powers of the system demand any aid, by way of medication. So it should be with the mother. In no case should the parent give the " in- nocent" and " harmless" teas, if the system will relieve itself without such assistance. The different effects of the same medicine, in different quantities, upon the sys- tem, should be understood by the physician. For in- stance, Laudanum, if given in small quantities, is a stim- ulant, like brandy ; if given in a large quantity, it is a sedative and will produce rest and sleep. So it is with the mother's thoroughwort, and other herb teas. Dif- ferent effects result from different quantities being given. Thoroughwort tea given in very small quantity, would be a stimulant and tonic. If given in a large quantity, it will act as an emetic and cathartic. The different effect being the result of the different quantity. So of all the domestic herb teas, as well .as the medicine from the hand of the physician. The state of the system and diseased organs, will mod- ify the effects of medicine. At one time a small amount jf camomile tea would be retained upon the stomach ; ■:t another, the same amount would induce vomiting. This is the result of the varying condition of the stomach. Medicine given, or recommended by any lady, be it call- ed a " a harmless" tea, or any thing else, without know- .ng the cause of the disease, is an " experiment." Med- icine directed without knowing the diseased condition of the system, is an "experiment." If it is given or directed, not knowing theeftects of the article, it is also an "experi- nent." The simple and valuable article bread, would, at me time, and in one condition of the system, nourish and give strength; at another, the same would cause pain and suffering. So with brandy ; a given quantity can be taken at one time without intoxication ; the same quan- tity taken at another, would produce drunkenness. In some painful diseases of the system when the suffering 98 PHYSIOLOGICAL FAMILY PHYSICIAN. is very severe, a large dose of opium might be given with safety ; the same quantity given when free from pain, and life would be destroyed. This is also true of all do- mestic teas, and medicines. The saying of many a kind and benevolent mother, that "if it does no good it will do no harm," " it is perfectly safe," " it is quite inno- cent," " I advise you to try it," u without trying it you don't know how much good it will do," " it is far better to take it than to have the doctor trying experi- ments," for "they kill more than they cure," exhibit a false principle of action, It is the process of experi- menting. The ladies are all against the physician's ex- perimenting, and it is just that they should be. On the other hand should not they avoid the same steps ? This spirit of monopolizing experiments, is not kind on the part of the ladies. It is anti-republican. Medicine given by the physician, or lady of any kind, and in any quantity, not knowing the proper conditions, as before named, is an uncalled-for experiment. Very much in- jury is often done by the "lady guest from the best of motives. The mother should never give one iota of medicine, without knowing the cause of the disease, the state of the system, and the definite effects of such u:edi* cine. The medication of the lady and mother should be based upon two things : 1st. It should always be safe. 2d. It should be not only safe, but effective. These two things should be kept in mind. The directions of the mother, as well as the physician, should be adapted to relieve manifest symptoms, and not imaginary names. Labelling a disease with a certain name, and then giving medicine for a disease'so named, is " dangerous quack- ery." FOOD IN ACUTE DISEASES. The most important matter in the management of acute diseases, is the food. In all diseases of the lungs, bowels, and general fever of the system, refrain from giving food. Under such circumstances, it is not di- gested. It will not promote the growth, nor repair the waste of the system, except it pass through the changes ACUTE DIARRHLA. 99 described in the section on the digestion of food. In sickness, no food should be given to the adult, or child, however young, unless it be digested. If not digested in the stomach, it will pass into the intestines as an irritating and foreign body. Thus food taken in diarrhea, is al- ways injurious. Bonaparte, when indisposed in the least degree, would frequently abstain from food, for several days. Many a kind mother gives food to her offspring when ill, fearing if she does not, its feeble system will suffer from an inadequate supply of that which should give it life. But her fears are ill grounded. The lacteal vessels of the intestines are inactive when food is withdrawn, and the absorbents scattered over the system are called into activity. They remove the fat, and other parts, an atom at a time, and convey it into the veins. It is then carried into the lungs, and changed into blood. It is in this way, the system is sustained in fever, diarrhea, &c. The removal of the fat for this end, is the cause of the sunken eye, the hollow cheek, and the emaciated limbs. In a word, it may be said an individual feeds upon himself. In this, is manifest the wisdom of Him who, when he created man, placed in his system these vessels which would sustain him, when no food could be taken. ACUTE DIARRHEA. This disease is an affection of the small intestines. It is attended with discharges from the bowels of a wa- tery character, and with increased frequency, accompan- ied with pain, weakness, and thirst. It may be caused by indigestible food, as green apples, or a chill upon the skin. The cause is the first inquiry. Treatment. If there is indigestible food in the stom- ach, an emetic or cathartic is called for. If there is a chill upon the skin, with dryness, the sweat, the warm bath, or the vapor bath, will be demanded. Ipecacuanha makes a good emetic, and castor oil a good cathartic. The baths, or sweats, will induce a flow of fluids to the skin. Warm stimulating linaments to the bowels, would 100 PHYSIOLOGICAL FAMILY PHYSICIAN. be good. A large ginger, or mustard poultice, to the? bowels, would be beneficial. In addition, follow the direction given in the section on food in acute diseases. This is an important item. CHRONIC DIARRHEA. This like the acute form-, is a disease of the small in- testines. Treatment.—In this attention to the skin by means of bathing, friction,' linaments and mustard, plaster would be invaluable. The food should be nutritious, unstitnu- Fating, easy to be digested, and taken at regular periods. The following medicine would be found of service. ft Gum Opium pufv. grs. v. Acetate of Lead. grs. xxx. Rad Ipecac. grs. vi. Mix. " Divide into twenty pills. Take one ounce in eight hours. The following would be good. ft Tinct. Kino. Tinct. Opii. Tinct. Cinnamon. Mix. Take thirty drops at a time, once in five hours. In all cases of Diarrhea, take but little drink. If the above simple treatment does not remove the affection, employ the family physician, instead of an irresponsible neighbor. In the above simple description, I include the diarrheas, termed mucus, bilious, lienlerich. These divisions, are of no practical use. They are distinctions that are " over nice." DYSENTERT. Dysentery is a disease of the large intestines. It is attended with bloody, slimy discbarges, voided with. COLIC, 101 great pain; there is tenderness of the bowels, a dry, hot skin, and thirst, want of appetite and strength. Treatment. Abstain from taking food, excite an ac- tion upon the skin, as in the disease of the small intes- tines. The drinks should be given in small quantities. Apply a mustard, or ginger poultice, to the bowels,— have the room well ventilated and quiet. Give a small port:on of rhubarb and soda, or castor oil and sweet oil, in equal parts. After the bathing of the skin, and the oil or rhubarb, has acted upon the bowels, a few drops of laudanum or paregoric, in peppermint herb tea, may be given. Injections of starch are of service. There may be added to them, a few drops of laudanum. The bath- ing and friction to the skin, the oil to the bowels, the poultice, and the abstaining from food, are usually ad- equate to control the disease. Should they not do it, send for the understanding physician immediately, as this is a most formidable complaint in some instances. When diarrhea and dysentery are epidemic and severe, flannel worn next to the skin, even in warm weather, is excel- lent to prevent the disease. In the hot climate of India, those who wear flannel are less prone to contract dysen- tery than those who dress in linen. If the disease continues a long time, and becomes chronic, the treatment is similar to that of chronic Diar- rhea. COLIC Colic is another affection of the bowels, of a painful character. This disease is not attended with increased discharges, as the two last named diseases, but the re- verse obtains. There is an obstinate constipation, or costiveness. At the first, there are griping pains, with no tenderness of the bowels. If the disease continues a little time, the bowels will become tender and swollen, and indicate a state of inflammation. This disease may be produced by indigestible food, cold drinks, taken when the system is warm, or by chills upon the skin, as the bowels aud skin have a very intimate, sympatheti« connection. 9* 102 PHYSIOLOGICAL FAMILY PHYSICIAN".. Treatment. This should be adapted to the cause of the disease, and the existing symptoms. If there is indigestible food ii> the stomach, give an emetic of ip- ecac. If the skin is dry, cold, and contracted, apply friction, a thorough sweat, or the warm and vapor bath. In all cases where sweating or bathing is used, always wipe the skin dry. For internal medicine, give castor oil, united with it from, ten to fifty drops of laudanum, in some warm peppermint tea. Give stimulating injections, and apply large poultices, made of ginger, over the bow- els. Give drink in very small quantities, and no food. Apply these means, and the disease will usually yield. In place of the oil, senna and manna may be given, or a* decoction of thoroughwort, and epsom salts- „ VOMITING.- Vomiting is another affection treated, in its primary stage, by the mother and nurse. In this disease, the cause should be ascertained with certainty. Vomiting may be caused by disease of the brain, by chills, or by indi- gestible food. Treatment. If food is tlie irritating substance, remove it by an emetic of a mild unirritating character. The action of the skin should be increased by warm friction, the warm or vapor bath. After the bath, use a good supply of clothing to the limbs and body. An active mustard poultice should be applied over the region of the stomach, and this should be kept on until the vessels of the skin are filled with blood, evinced by a redness of the skin. All food, and irritating drinks and medicine, should be withheld'. A solution of gum arabic in water, from a tea to a table spoonful at a time, will be an appro- priate drink. Cool pure air, and a quiet room, are of special importance. The practice of giving large quantities of stimulating teas and drinks, is hurtful and injurious, because it in- creases the irritation of the stomach. The vessels of the stomach, in cases of vomiting, are excited, and dis- tended with blood, as the blood vessels of the eye are, CHOLERA MORBUS. 103 when it is inflamed,—and as the stimulant makes the eye worse, so it does the same to the stomach. It is true some ladies assert, that hot teas are cooling, as did a worthy matron of Massachusetts, who when asked by the attending physician what she had given her husband, replied, only a bowl of some good cooling tea, made of " hops, summer savory and saffron." %The medication of vomiting, by our matrons, is too stimulating, too irri- tating, too much of an experiment. Usually making a a bad matter worse. An understanding physician will act upon the skin, and will let the stomach rest^ he will give mild drinks in very small' quantity, as barley water, or gum water. If he gives medicine, it will be only an- odynes in small quantities. Should the treatment above detailed not arrest the vomiting in a few hours, send for a physician, as there may be inflammation of the stom- ach, or brain. A ease of this kind cannot be decided by an ignoramus, or quack, as it is an affection demand- ing the decision of the intelligent and well educated man. CHOLERA MORBUS. Cholera Morbus is a disease in which there is both vomiting and purging. This deranged condition of the bowels, occurs in the warm months of the year. The attack is usually sudden, the patient is awaked from sleep, or suddenly alarmed during the day by extreme nausia. Sometimes pain and a sense of lassitude, ush- ers in the attack. The matter ejected may be the re- mains of food, bilious matter mixed with mucus, or a peculiar half watery discharge, compared to the washings of fresh meat. Spasms of the abdomen and extremi- ties frequently attend this disease. The combination of these symptoms, rapidly exhausts the strength, and vital powers. ___ Treatment.—It should be treated by abstinence from food ; take drinks in very small quantities, apply warm fomentations to the bowels, warm blankets and warm dry friction to the extremities. Anodynes, as laudanum, or paregoric, given in peppermint tea, would be good. Have 104 PHYSIOLOGICAL FAMILY PHYSICIAN. the room kept quiet, and the air pure. After any dis- ease of the bowels has been checked, and the person seems quite well, care should he taken that no food be eaten that, will not digest easily. It should be given in small quantities, and at regular periods. The mucous membrane of the stomach, or bowels that have been diseased, is weakened, and easily irritated. The skin should be kept warm by porous clothing, and bathed each morning, rubbing dry with a crash towel, until it produces a glow of heat and redness upon the skin. A chill upon the skin may drive the blood to the weakened bowels, and a relapse will consequently follow such ex- posure. LIVER COMPLAINT AND DYSPEPSIA. In the affection called liver complaint, dyspepsia, &c, persons usually have some coat upon the tongue ; it may be red at the edges, and sometimes smooth. They have also sourness, and flatulence, or wind in the stomach, tenderness at the pit of the stomach, or epigastric region, rigidity of the muscles of the abdomen. Sometimes the muscles are relaxed ; there is costiveness sometimes, al- ternating with diarrhea ; there may be shortness of breath, and cough, fulness about the head, and headache, pain and weakness of the back. This state of the inter- nal organs, and these symptoms, are attended with a sal- low, pale, dry skin, often covered with branny scales, cold feet and limbs. The question may arise, can this disease be prevented, and if it exists, can it be removed? It can be prevented, by attending to the directions given in the sections upon the skin, muscles, digestive organs, lungs, and brain. Read the sections upon bathing, clothing, exercise of the muscles, breathing pure air, and excessive use of the brain. Treatment.—To remove the complaint, it is necessa- ry to attend to the same conditions assiduously, as to prevent it, not omitting the observance of them a single day; adapting the amount of clothing, food, and exercise, LIVER COMPLAINT AND DYSPEPSIA. 105 to the strength and powers of the weakened organs of the system. As there is costiveness, and a confined, inac- tive state of the bowels, a judicious combination of tonics, stimulants, and aperient medicines, would assist the pow- ers of the weakened organs of the system in removing the disease. Take quassia, 1 ounce, peppermint herb, 1-2 an ounce, epsom salts 1-2 an ounce. Steep in one pint of water. Of this, take a dessert spoonful before eating. In some instances, the mild preparation of iron would be good, united with mild aperients, and anodynes. This can be used with propiiety, under the advice of the understanding physician. All can prevent disease without medical advice, but all cannot rid themselves of the same, without the advice of the educated medical man. CONSTIPATION OR COSTIVENESS. Constipation, or costiveness, is a disease exceedingly prevalent among the American people, particularly the ladies. It is a disease that induces other complaints, as the last described disease of the liver, stomach, headache, &c. Haemorrhoids, or piles, is another serious com- plaint, caused by the inactive and costive state of the bowels. This disease often alternates with diarrhea. Sometimes a costive and diarrheal state of the bowels co-exist. In such affections, the alvine matter accumu- lates in the large intestines, and oftentimes this accumi*- lation is very great. When voided, it is dry and hard, like small balls, hence it has received the name of scy- bala, which is a source of much irritation to the intesti- nal canal. The prevention of this disease is a great and important desideratum in the community. It is of equal importance, if not paramount with a knowledge of the method of cure. The rules for the prevention of this dis- ease, are-given in the sections upon bathing, clothing, exercise of the muscles, the structure and uses of the stomach, intestines and lungs. Treatment.—To effect a cure of this complaint, it is first necessary to remove the causes, whatever they may 106 PHYSIOLOGICAL FAMILY PHYSICIAN. be. If there is an insufficiency of exercise, obviate it by taking a greater amount. If it is the diet, a change should be made in the article of food taken. If the habits of attending to the evacuation of the bowels, the ablution and clothing of the skin, the ventilation of the workshop, or sleeping room, have not been proper, correct them, as described in the section on the skin, muscles, and lungs. In addition, the enfeebled organs may require assistance. To do this understandingly, the condition of the diseased parts should be inquired into. The retain- ed matter being dry, indicates that the fluids separated from the blood, are not thrown out in quantities sufficient to render it soft and soluble, to be voided with ease. Again, the retention of the alvine matter, indicates that the tone of the muscular fibres of the intestines has been diminished and that they are wanting in contractile ener- gy, which has been destroyed by over-distention. Thus it is seen that medicines and means are necessary to re- store the secretion, and impart tonic contractile power to the weakened and released parts. Kneading and shampooning the bowels, as advised and practiced by Halsted, will be found highly beneficial as they excite an action in them. Laxative food is an- other means. Efforts to have the evacuation at regular periods, is of great importance, and the chiTd should be learned from the earliest infancy, to note this rule, as we are beings of habit. If medicine is resorted to, it should be of such a character that it will excite a flow of fluids to soften the retained fecal matter, and at the same time, increase the peristaltic motion of the bowels, so as to render them capable of unloading themselves. Tonics alone, would be inefficient, as they would only act upon the muscular fibres, inducing contraction, by giving tone to the parts. They do but little, and this little indirect- ly, to excite an action of the secreting glands. The same is true of stimulants. If cathartics are resorted to, the glands of the intestines are momentarily excited to an unnatural action, and the relief obtained is not lasting. The parts have been excited only, and not strengthened, rum will excite the system of the drunkard to action, but CONSTIPATION. 107 it does not give permanent strength. The system is always made weaker by alcohol, so are the parts involv- ed in costiveness left weakened by the cathartic, and the disease is only increased. The parts need steady and mild stimulation, that the tone and strength may be per- manently increased. In the treatment of this affection, clothing, ablution, feed, and exercise, should be similar as that of other chronic affection of the intestines. Whatever medicines are used, they should be given in small quantities, that nature may perform her work, with as little assistance as possible. Most of the pills recom- mended by the papers, leave the bowels weakened and more confined than before. A judicious combination of medicine, would be the following : Thoroughwort, (or eupatorium perfolialum,) 1 ounce ; peppermint herb, 1-2 ounce ; epsom salts, 1-2 ounce. Steep in one pint of water. Take of this, two tea spoons-full at a time, once in six hours. Continue it for several weeks, using the ether means suggested. Atjiight a pill may be tak- en of the following: Prussiat of iron, 1 drachm ; extract ofconium malculatum, 20 grains ; rhubarb root, pulver- ised, 1-2 drachm; Ipecac root, pulverised, six grains, oil of peppermint, 8 drops ; mix it together, and divide it into 30 pills, The simple medicine named above, aided by due observance of the air, exercise, food, &c, with -* the addition of injections of cold water, if pursued from three to six months, will cure, or greatly benefit all cases of costiveness. In costiveness, liver complaints, and in haemorrhoids or piles, the use of a spino abdominal supporter would be of more service than medicine. Most cases can be cured by their use. Read the section on the mechani- cal treatment of chronic disease. HEMORRHOIDS OR PILES. This disease is painful and debilitating, and after it has once been produced, it is very easily reproduced, if there has been a cure of it. It consists of a swelling of some of the small veins, that surround the lower part of 108 PHYSIOLOGICAL FAMILY PHYSICIAN. the intestines, or rectum. These swelled veins form tumors, that sometimes present themselves externally; the affection is then called the open piles. In other in- stances they are just within the verge of the rectum, the disease is then called the internal, or blind piles. If the tumors bleed, then they are called the bleeding piles. Many things may ca,use this disease. It is very rare that a case of piles is found, that has not been, or is not attended with costiveness, or this, alternating with di- arrheal discharges. And so universal does this cause operate to induce the piles, that it may be said with pro- prieiy, to be the cause of the haemorrhoids, and that cos- tiveness is the disease to be prevented, to prevent the piles; as costive, or loaded bowels, make a pressure upon the veins of the rectum. These veins being press- ed upon, enlarge, as the veins of the arm do when a tape is drawn around them in bleeding. Being kept full, their coats yield, and small tumors protrude. The veins of the arm will not diminish in size, until the pres- sure of the ligature is removed. So with the veins in piles, they will not decrease, until the costiveness is re- moved. The method of relief, or cure, is partially de- scribed in the section upon the liver complaint and cos- tiveness. In addition to the means of preventing this affection, the avoidance of cathartics, as the patent pills and bitters, should be sedulously observed. All articles which would irritate and inflame these vessels, should not be taken. Besides the means recommended in the section on constipation, the chewing of small bits of rhubarb, of the size of a pea, several times each day, swallowing the spittle, and dissolving a piece of alum in the mouth, of about the same size, and taken in the same manner, would be beneficial. For an outward application, an ointment, of an anodyne and astringent character, would be beneficial. The following would be good : fresh lard, 1 ounce; pulverised nut galls, 2 drachms; opuim, pulver- ised, I drachm. Mix them well together; appiythis to the tumors, three or four times each day. By these means relief is always obtained, and in many cases a radi- HERNIA OR RUPTURE. 109 cal cure. In no case will the medicine be of much avail, if the condition named in the section on costiveness, be not observed. The medicine advised should be put up, and taken under the direction of a well-informed, com- mon sense physician. This will be prudent, as one per- son will require one quantity, and others a different amount, to produce the same result. The other observ- ances can be reduced to practice by all, HERNIA OR RUPTURE. The disease termed hernia, rupture, and sometimes breach, is exceedingly common, and confined mostly to males. Probably one-fifth, or one-eighth of the labor- ing men suffer from this infirmity. Many females and children are afflicted with this complaint. It is often concealed ; a feeling existing in the community that it is a disgrace. This concealment often leads to much suf- fering, and not utifrequently death. This disease is often called colic, stoppage, or inflammation of the bowels, &c. Ignorance of the nature of the disease, and its concealment, prevent the proper means from being duly applied, as it is at the commencement that applications are the most efficacious. The situation and size of her-, nia, vary in different persons, and in the two sexes. The tumor is from the size of a filbert to that of an orange, and the opening through which the tumor passes, may be of the size of a crow quill, or it may be an inch in diam- eter. The small openings, and the small hernia, are the most dangerous, because they become confined, or stran- gulated, the most frequently and readily. Hernia may occur in a child of two days old, and it may be produc- ed in a man or woman of sixty. The tumor, in some instances, is composed of the omentum, or caul, in other cases, of a portion of the small intestines, and again it may be composed of the small intestines and omentum united. The dis- ease is the same, whether composed of the one or the other, or both. In some instances, the hernia 10 110 PHYSIOLOGICAL FAMILY PHYSICIAN. is painful and troublesome, in others, but little incon- venience is experienced. When the tumor protrudes and becomes confined, it often produces death. In ev- ery instance, where there are colic pains, let it be ascer- tained by careful examination, whether hernia exists. I knew the case of a lady of sixteen summers, who had at- tended church during the day ; and while putting the tea- kettle over the fire, she was attacked with violent colic pains, as it was supposed. The family physician was immediately called, but could not succeed in relieving her. An experienced physician, with whom I was study- ing at the time, was called as counsel in the case. He immediately inquired if hernia existed. To this the at- Fig. 50. " a, b, represents the inguinal canal left for the passage of the spermatic rord, which is marked by the two dotted lines, a marks a little doited circle, which is called the internal abdominal ring. It is the internal orifice of the in- guinal canal, b, is the external abdominal ring, and is situated at the bony edge of the pelvis g. These parts are the most common location for hernia in men. Tins hernia is called inguinal. Just below this, C marks Vhe spot where the tumor generally appears in femoral hernia. This is the most common va- riety in women, d designates the umbilicus where the vessels going to and coming from the afler-birlh, enter and pass out of the foetus before birth. This is the seat of umbilical hernia. This is more common in women than men. HERNIA OR RUPTURE. Ill tending physician and patient, replied that they were not aware of any* Here he let it rest. The girl died with- in forty hours after the attack. A post mortem examin- ation disclosed a strangulated hernia, of the size of a small chestnut, as the cause of the pain and death. The tu- mor was at the .upper part of the thigh at the spot marked c, in fig. 50. This is the common place for hernia in females. Here a close and proper exam- ination, would have detected the disease, and probably saved her life. Many of our citizens are cut down in the vigor of health, by colic, or inflammation of the bowels, when in reality, hernia alone was the true cause. I speak of this, that more attention may be given to this com- plaint by the people and physicians. Mothers and nurses should carefully examine the low- er part of the bowels, and upper anterior part of the thigh, in children, to see that no hernia exists, if they have tenderness and pain in the bowels. In the primary stage there will be pain and tenderness at the point of the rupture. The intestines may protrude in considerable size, or they may not. If there is this sensation at the lower and anterior part of the bowels, or upper part of the thigh, upon its anterior part near the groin, attended by a tumor, immediately call upon a sur- geon, and have an examination. Let this be observed,* by both man and woman. In most instances they can be cured, if properly treated at the commencement of the disease. In all cases of hernia, it jeopardizes life, as soon as it becomes strangulated; hence the importance of having it seen by a surgeon at the onset, and a well adapted truss applied immediately. In making efforts to return the protruding tumor, the parts at first should be relaxed as much as possible, which is effected by moderately bending the body upon the hips. The next object will be, the reduction of the parts form- ing the tumor. This is done by an operation called tax- is. This requires tact and peculiar care, as the tumor may be of the size of a goose egg, and the aperture through which it has to pass, may not be half an inch in diameter. It would be as impossible to crowd the tu- 112 PHYSIOLOGICAL FAMILY PHYSICIAN- mor through the aperture at once, as it would be to pot a handkerchief through a half-inch gimlet bole at one ef- fort; but commencing at one corper, it may be easily drawn through. So can the hernia be reduced in a sim- ilar manner. A small portion must be passed up at a time, commencing with that part near the opening, close to the body. If pressure be made upon the whole tu- mor, the effort will be an ineffectual one. This pressure should be made with the end of the thumb and fingers, grasping, the neck of the tumor, mnking moderately firm pressure upward and outward, in the direction of the ca- nal through which the parts have passed. If a small portion can be returned, the whole can be. The effort should not be persisted in but for a short time, for active inflammation of the bowels may be produced by the pressure. Under such circumstances, send for a good surgeon, as the life of the individual is endangered. If he does not succeed in reducing the tumor, after relaxing the system by bleeding, the warm bath, &c, a surgical operation gives the only hope of saving* the patient. In selecting trusses, obtain one that fits the person, or get none; as the design is to give no pain, and support the parts. Let the pressure be as light as it can be, and re- tain the intestines in their place. In all cases of hernia at the umbilicus in girls, a truss should be early worn. • OF THE KIDNEYS. The kidneys, are the organs in which the urine is se- creted, or separated from the blood. These large or- gans are situated above the haunch bone, at the back part of the abdominal cavity, and below the diaphragm. There fs always a considerable amount of fat., or adipose mat- ter, that surrounds them. In their structure, appearance, situation, and functions, they resemble, in a striking man- ner, the kidneys of animals. There are running from the kidneys, small hollow tubes, named ureters. These open into the lower and back part of the bladder. Through them the urine secreted in the kidneys, is pas- OF THE KIDNEYS. 113 sed into the bladder, which is a membranous organ, placed in the pelvic cavity. The bladder is composed of three coats, or membranes, like the intestines. The external or serous, the middle or muscular, the internal, or lining coat, named the mucous membrane. This is lined, or shielded, by a coating of mucus, which protects the membrane from the irritation of the urine. ie thin membrane surrounding the kidney. Immediately beneath this covering is a peculiar substance called the cortical, or bark, that sends inward * prolongations ; between which, is placed the medullary portion 2,2,2,2. The pelvis is seen at 4, while 3 marks the ureter. GRAVEL AND STRANGURY. The kidneys, bladder, and their appendages, are of- ten diseased, and most frequently the disease is termed " gravel." Although the disease does exist, it is not as common as most people imagine. Many influences com- bine to render these organs the seat of disease. They receive a vast amount of blood, from which the urine is secreted, and if this blood is impure, the urine will also be loaded with impurities. It is well known if a person take a quantity of the oil of turpentine into his stomach, 114 PHYSIOLOGICAL FAMILY PHYSICIAN, " In this, a and 6 show the tendinous'part of the diaphragm or partition be* tween the chest and abdomen: d, the kidney, with its fellow opposite ; /, the descending aorta ; h, an artery given off for the intestinal tube ; i, where the great artery divides, to send a branch to each leg; g, the ascend- ing great vein, conveying blood to the right side of the heart; c, the capsule, ■o called, belonging to the kidney, the use of which is unknown ; n, the ureter, a tube which conveys the urine from the kidney to the under side of the bladder, where it terminates. The right ureter is seen on that side, also ter- minating in the bladder, k. m, I, are arteries; o is a small artery, which runs down, on the bone, into the pelvis." RESPIRATION. 115 the urine will be tinged by it in a few minutes; so of other articles, as garlic, or rhubarb. The kidneys are organs of waste, like the skin; there exists between the two, a close and intimate sympathy. This may be seen when the surface of the body is chilled, or when there is great heat. If the action of the waste vessels of the skin be much increased, the kidneys will secrete but little urine. If the vessels of the surface be contracted and inactive, the kidneys become more ac- tive, and secrete more urine. This is illustrated in going from the hot, to the cold air. Inadequate and improper clothing, with impure air, are fruitful sources of urinary complaints. A prevention of these complaints would be to observe the conditions, mentioned in the sections on the skin, stomach, and lungs. In all diseases of these organs, give special attention to the skin and bow- els, in seeking a cure of them. Medicines, if any are ta- ken, should be of an anodyne andaperiertt character. Treatment. Mucilages, as the flaxseed tea, solution of gum arabic, to which is added a little carbonate of soda, and five or ten drops of laudanum would be good. Fomentation, to the back and bowels would be benefi- cial. The warm bath with friction to the skin, sitting over the vapor of hot water and vinegar is efficacious. Aperient medicine, as equal parts of castor oil and- sweet oil are valuable. RESPIRATION. The food, after it has been changed into chyle m the intestines, is transferred into the transverse vein, situated at the lower and anterior part of the neck. Here, it is mingled with the venous, or dark blood, returning from the head and arms, to the heart. This returning fluid and chyle, are not adapted to promote the growth of the system. It is not blood, but the basis of this circulating fluid, and it requires to be oxygenated, or brought in conlact with the air, to suit the wants of man. The ap- paratus to oxydate the blood in the worm, is the skin; in fish, the gills ; in animals and man, the lungs. This is not only apparent in man and animals, but the tiny 116 PHYSIOLOGICAL FAMILY PHYSICIAN. shrub, and the hardy tree, have their fluids acted upon by their lungs, viz : the leaves. The apparatus to effect the change of the two fluids, in man, may be divided into three parts : 1st. The frame-work of the chest, viz : the bones. 2d. The muscles attached to the bones to move and change their relative position. 3d. The wind bag, called the lungs, placed within the cavity of the chest. The bones are the twelve vertebra? of the spine, commencing with the eighth from the base of the skull. To each of these bones are attached two ribs, one on each side. These ribs are of unequal length, and have button-like heads, by which an attachment is made to the spine, and the slightest movement of the spinal column affects these ribs. They increase in length, from the first to the tenth, from the tenth downward, they decrease in length. The curve of the ribs is irregular,—so much so, that if a rib be thrown upon a table, its irregularity will prevent its immediately being in a state of rest. The upper ribs, nearest the neck, are the most curved. There is attached to the anterior extremity of the ribs, a cartilage that connects them with the sternum or breast bone. The upper cartilages are shorter, and more resisting than the lower ones, which are found to be longer, smaller, and consequently more flexible. These cartilages some- times become ossified, or changed into bone, but it rarely happens except in persons who have passed the meridian of life. When this change is effected, respi- ration is impeded. The two lower ribs have no con- nection with the sternum, but unite themselves to the abdominal muscles. The sternum, or breast bone of the child, is composed of seven pieces, in the adult they are united into three. In youlh, and in middle aged persons, the lower third of the sternum is cartilaginous, and projects forward, in the natural form, to give room to the stomach and liver, that lie immediately under it. Among the fashionable, this projection is regarded as a deformity. From the increased length of both the ribs and cartilages, we might reasonably suppose the lower part of the chest should be broader, and fuller than the upper. RESPIRATION. 117 The small, contracted ches or should be, elevated. This arrangement accounts for the equal elevation of all the fibs. But an observer would see, that the lower ribs are raised mu'jh more than the upper ones. This is effected by the action of another set of muscles, situated between the ribs; these are named the intercostal. Each one is attached^ at its upper extremity, to the lower edge of the first rib, and at its opposite extremity, it makes an attach* ment to the upper edge of another rib. The upper or first rib is the fixed point, the lower one, being moveable, is elevated. The second rib is acted upon by one set of intercostal muscles; the lower rib by eleven. The eleva- tion of the lower rib from the action of this set of mus- cles, will be eleven times as much as the second rib. Thus the chest is not only more capacious at its lower part, but here it is enlarged by the increased elevation of the ribs. To the margin of the ribs is attached a thin, muscular membrane. This membrane separates the chest from the abdomen. When in a state of rest, it is elevated in the centre, presenting a convex surface superiorly or on the upper surface, and concave inferiorly or on the lower sur- face. ^When the muscles attached to the ribs contract, they are all elevated,—the lower, much more than the upper ones. By this elevation, the cavity of the chest is increased laterally, and outwardly, and, at the same time, the muscular membrane, the diaphragm, contracts. The protruded ribs being the fixed point of this muscle, the central part that projects into the chest, is depressed; making a plane of its surface. By this arrangement, the cavity of the chest is enlarged inferiorly. In looking at the movements of the chest, we see an adaptation of the bones and muscles to each other, and the lungs, also, are found to dilate mo si at'the lower part of the chest. This is needful, that there be a perfect harmony of the struc- ture and uses of this respiratory apparatus. Within the cavity formed by the diaphragm, the spine, the ribs, and muscles, are found thelungs, (sometimes called the lights,) the heart, and large blood vessels. RESPIRATION. 119 This cavity is divided into two parts, the right and left, by a partition called the mediastinum. In the right com- partment, is found the right lung, which is divided into three lobes; in the left, is found the left lung, divided into two lobes, and the heart. Fig. 55. |n the above plate, the position of the heart and lungs as they lie in the chest is seen : T, marks the windpipe or Trachea; C, C, the collar bones ; from 1 to 10 the ribs, the two lower of which are not seen. The lines crossing the ribs at the right ol the figures designate the manner by which the ribs are con- nected with tne breast bone ; a, the right ventricle ; b, the left ventricle ; c, division between the two ; x, d, the rignt auricle; e, the left auricle ; A, the aorta; g, pulmonary artery; ft, the descending vena cava the vessel which returns the collected venous blood of the head and upper extremities ; S, the cartilaginous extremity of the breast bone. The external membrane of the lung, is called the pleura. It is very thin, covering both lungs, and lining the cavity of the chest. The next tissue is the parenchyma, or sub- stance of the lungs. It is made up of a congeries of air tubes, aaeries, veins, nerves, and absorbents. These vessels are connected together by cellular tissue, which is the medium of union throughout the system. The mucous coat of the lungs, or mucous membrane, is that which lines the air tubes, commonly called the bronchi, together with the air vesicles. 130 PHYSIOLOGICAL FAMILY PHYSICIAN. Fig. 56. The above view exhibits the heart and lungs removed from the chest, and the lungs freed from all other attachments. They are arranged so as to show the parts with «reater accuracy. 1, The right auricle of the heart. 2, The superior vena cava. 3, The inferior vena cava. 4. The right ventricle. 5, The pulmonary artery issuing from it. a, a, The pulmonary artery (right and left) entering the lungs. 6, 6, Bronchi or air tubes entering the lungs, v, v, pulmooe.ry veins issuw" from the lungs. 6, The left auricle. 7, The left ven- tricle. 8, The aorta. 9, The upper lobe of the left lung 10, Its lower lobes. 11, The upper lobe of the right lung. 12, The middle lobe. 13, The lower lobe. The trachea, or windpipe, is an appendage of the lungs. The upper part is called the larynx, situated at the upper and anterior part of the n~ck, forming a pro- jecting prominence. (This is known by the name of Adam's apple.) The part feetween this and the sternum, is called the trachea. This divides into two branches, the one passing to the right lung, the other to the left. They are again divided and subdivided, until the tubes are exceedingly small. At the extremity of these minute tubes, there are sit- uated minute ovoid vesicles, about the one hundreth of an inch in diameter. These are the air cells of the lungs. A homely comparison may be made between these parts, and a grape vine, loaded with grapes, by supposing the vine and grapes hollow, having nothing but their external RESPIRATION. 121 coats. The trunk being the large tube under them, re- presents the windpipe; the sterns being the subdivision of the great tube, the bronchi; and the thickly clustered grapes, the air vesicles. The inspired air passes through the trachea, bronchi, and enters the air vesicles which it distends. In the engraving 57, a, represents the trachea or windpipe, d, the left lung, c, e, small tubes termed bronchi opening into the air vesicles, 6. bifurcation. Fig. 58. Fig. 5S, bronchial tube and air cells of tire lungs much magnified, 1, minute bronchial tube, S, 2, 2, group of air cells, 3, the same parts laid open. The venous blood, and the chyle, are brought from the right side of the heart in the 'pulmonary artery. This divides into two large branches, going to each lung; each of these two vessels is divided into thousands of hair-like arteries, which pass over the very minute ovoid vesicles. 11 122 PHYSIOLOGICAL FAMILY PHYSICIAN. The venous blood and chyle, are carried through these capillary vessels, and as they pass over the vesicles, the blood and air come in contact. At this point the blood and chyle is changed into a bright red, or vermillion hue, and it is then returned through another set of vessels to the left side of the heart. As it is the inhaled air which is the effective agent in converting the chyle produced from our food into blood, its composition will here be in- serted. By chemical analysis, it is found to consist of two gases, oxygen and nitrogen, or azote. They exist in the proportion of one-fifth of the former, to four-fifths of the latter. These gases have also combined with them, a small quantity of carbonic acid gas, also the efflu- via of flowers. When the muscles of the chest and diaphragm are contracted, causing an expansion of the chest, the air rushes in through the trachea and bronchial tubes, and in- flates, or distends the ait vesicles, at the extremity of the bronchial tubes. The blood, in passing over these in- flated vesicles, is acted upon by the oxygen, and purified. It is not known, whether the azote acts upon the blood or not, though some theoretical speculations have existed in regard to it. Respiration, or breathing, consists in inhaling the air into the lungs, and expelling it from them. At each act of respiration, the muscles of the chest elevate the ribs, and the diaphragm is depressed at the same time. The abdominal muscles are relaxed by this action producing a cavity or vacuum in the lungs. This vacuum is much increased by the previous act of expiration, but it is soon filled by the air which passes into the tubes by its own weight. From this we see, that the lungs are mere pas- sive agents, dilating and contracting as the chest is ex- panded, or contracted. At each respiration, all the air in the lungs is not expelled, but a considerable portion remains, called the residual air, or air of the lungs. This sometimes becomes an important affair in certain criminal trials, as in infanticide, or the murder of new-born infants. Lungs that have been inflated, always contain some air, which is not expelled in the death-struggle. If the lungs RESPIRATION. 123 of tie infant float upon the water, it is regarded as suffi- cient proof that the child was living at birth. In a slate of rest the number of respirations in a heal- thy man are from 14 to 18 in a minute; usually about four pulsations, or beats of the heart, to one respiration. In disease the respiration is increased in frequency, more than the action of the heart, particularly in diseases of the lungs. The quantity of air inhaled, depends upon the size of the lungs, and the freedom of expanding the chest. A medium computation is found to be about 20 cubic inches of air at each act of respiration. This, in twenty-four hours, would amount to 460,800 cubic inches, or 266 1-3 cubic feet. The blood in the capillary ves- sels of the lungs, is separated from the air in the bronchi and vesicles, by the interposition of the very thin coat of the hair-like vessels, and the almost infinitely thin mem- brane, that forms the wall of the air cells. It may be a query how the air which enters the lungs, acts upon the blood,—and how the blood can be retained in its own proper set of vessels, and yet be exposed to the influ- ence of the air. Some experiments may elucidate some* what this point. "Take a glass tube and tie over one end of it a. piece of bladder, or some other membrane, then, having partly filled the tube with a solution of gum, or sugar, immerse it with the end covered with the mem- brane, downwards in a vessel nearly filled with water. The fluid from the vessel will pass into that in the tube, and the latter will be seen to rise at once. Reverse the experiment, by putting the sugared water into the vessel, and the other into the tube. The fluid in the tube will sink, because the same passage of fluids takes place, but in the opposite direction. Thus we see, that there is an attraction between one fluid and another, or an affinity of one fluid for another." The pure water has an affinity for the sugared; the one passes through the bladder more easily and readily, than the other. Put a mixture of water and alcohol into a phial, and leave it uncorked. The alcohol will have an affinity for the air, and will be diffused through it more readily than water, when there is no intervening obstacle. But tie a 124 PHYSIOLOGICAL FAMILY THYMilAN. piece of bladder over the mouth of the phial, and let it stand a few days. The diluted alcohol will become stronger, the water having passed through the bladder, leaving the alcohol. Here it will be seen that alcohol has a greater affinity for the air than water; but that the water will more readily penetrate, or pass through a mem- brane, than the alcohol. By the aid of these experiments we will endeavor to explain the action of the blood and air upon each other, in the lungs. The dark, venous blood passes in the lungs through the pulmonary artery; this blood contains a large amount of carbonic acid gas, which is distributed over the bronchial tubes and vesicles, by the many and minute hair-like, or capillary vessels. The air, which is composed of oxygen and nitrogen, is passed into the air vessels, which become inflated. There is interposed between the air and blood in the lungs, an exceedingly thin coat of the capillary vessels, and also of the air vesicles. This separating membrane is similar, in its mechanical arrangement, to the mem- branous bladder in the experiments described in preced- ing sections. The oxygen of the air has a greater affin- ity for the dark venous blood, than it has for the nitrogen, with which it is united in the lungs; the membrane inter- posed between the blood and the air, permits the oxygen to pass through it, the membrane being permeable to the oxygen, but not to the nitrogen. The oxygen of the air having a greater affinity for the venous blood, than it has for the nitrogen, permeates the membrane to unite with the blood, as the water leaves the alcohol and passes through the membrane to unite with the air. The car- bonic acid gas that the blood contains, passes through this thin membrane, leaving the blood and uniting with the air upon the same principle, and in a similar way to the passage of oxygen from the air to the blood. The blood having received a supply of oxygen, and parted with a portion of carbonic gas, undergoes a change in its color from the dark modena hue, to the bright scar- let. In this state it is returned to the left side of the heart. From this side of the heart it is distribiUed to the different parts of the system. In the miimte- vessels of. RESPIRATION. 125 the system there is a union of the carbon and oxygen, forming carbonic acid gas; by this the blood is rendered impure and dark, and is returned through the veins to the right side of the heart. The air in the lungs having less oxygen and containing carbonic acid gas, is expelled from the lungs in the act of expiration, which is repeated from 14 to 20 times each minute. During the interval of respiration, the change of the blood is progressing in the lungs, as there is re- sidual air remaining. The quantity of carbonic acid gas thrown out of the system, will depend upon the quantity of oxygen supplied by the atmosphere, and the amount of food and exercise taken, and the size of the lungs. The quantity of carbon will be proportioned to the food and exercise taken. The quantity of oxygen, and the volume of lungs, should be proportioned to the amount of carbon to be eliminated from the system. VOLUME OF LUNGS. Let us first examine the necessity of ample volume of lungs. If a gill of alcohol, mixed with a gill of water, be poured into a vessel having a square foot of surface, then tie over the vessel a membrane, as a bladder, and suppose the water will evaporate in twenty-four hours. If the surface was only six inches square, only one-fourth of the water would evaporate through the membrane,— leaving the water mixed with the alcohol. If the surface be extended to two square feet, the water would evapo- rate in twelve hours. Apply this principle to the lungs: Suppose there is two hundred cubic feet of carbonic acid gas to be carried out of the system, each twenty-four hours. This gas in twenty-four hours would pass through. a membrane of vesicular surface of two thousand square feet; and if the lungs were diminished in size, so there were only one thousand square feet of vesicular mem- brane, this amount of gas could not, and would not, be duly carried from the system. Under such circumstances, the blood would not be purified, and this unpurified blood would be sent to every part of the system. Again, sup- 11* 126 FHYSIOLOGICAL FAMILY PHYSICIAN. pose, the two thousand square feet of membrane- woultf transmit two hundred cubic feet of oxygen into the sys- tem each twenty-four hours; (the quantity demanded by the wants of the system.) If it is diminished one-half, the necessary amount of oxygen will not pass into the blood. From the above illustrations, we may learn the importance of having well developed chests, and volum- inous lungSi By increasing the size of the lungs, the ox- ygen is supplied to the blood more abundantly, and it is more perfectly deprived of its carbonic acid gas. The close dressing to the chest of the child, will prevent its perfect development, as truly as does the tight dressing of the Chinese lady's foot prevent its growth. It is more easily done in infancy, as the ribs and soft parts are yielding, but it may be done at any period of life. As the greatest expansion of the lungs is in the lower part of the chest, and as in the lower half of the lungs,- the great- est amount of air passes, so here the greatest amount of carbon is carried from the blood; should the chest be contrated here, the purifying principle of the air cannot do its office. The means for expanding and developing the chest, are exercise in the open air, reading aloud, singing, sitting erect, and fully inflating the lung-. This should be commenced in childhood, and steadily perse- vered in, to old age. By so doing, the contracted con- sumptive chest, in many cases, can-be corrected, and the tendency to consumption removed. FREE MOVEMENT OF THE RIBS AND DIAPHRAGM. The movement of the diaphragm must be unrestrain- ed, to preserve the health of the system. To carry off the former supposed quantity of water from the alcohol, let the surface of the membrane be exposed to twenty cubic inches of air, and that this be changed twenty times each minute, and as the air becomes loaded with vapor, let it be removed and a fresh quantity supplied. If only one-half the amount of air requisite, is supplied each minute, one-half as much water will be removed from the alcohol through the membrane, in twenty-four MOVEMENT OF THE RIBS AND DIAPHRAGM. 127 hours ; consequently, the alcohol1 would be impure, the water not being entirely removed. We will now turn our attention to the lungs. Suppose they are of am- ple size, and, to purify the blood, twenty cubic inches of air is inhaled at each inspiration, and will expand them" properly. This is the quantity necessary to supply the blood with oxygen an?T also to combine with the car~ bon of the system, that an adequate amount of carbonic acid be eliminated through the lungs. Restrain the elevation of the ribs, and depression- of the diaphragm, and reduce the quantity of air pass- ed into the lungs to ten cubic inches, and notice the result. The venous blood will be returned to the sys- tem loaded with an undue amount of the poisonous gas, and only half the called for amount of oxygen is intro- duced into the system. It is in this way that tight cloth- ing influences the system. The movement of the lower ribs and diaphragm being restrained, the quantity of air necessary to be inhaled into the lungs is diminshed, and the whole system must suffer from an infringement of the organic laws. The contrast between the free and expansive chest, and the compressed waist, is well ex- hibited in Figures 5o and 54. The effect of the contraction of the lower ribs and its influence upon the lungs, is too. visibly seen in the pale and ghastly hue, of the faces of city misses. By reason of this compression, the blood does not duly re- ceive the stimulus of oxygen; and consequently the ra- pidity of its circulation is impeded. The blood passing thus sluggishly through the system is conveyed to the different organs, enfeebling their action, and inevitably causing disease. The prolific cause of the contracted chests, is the present style of dress that is almost universal. These baneful fashions are copied from the periodicals so wide- ly circulated, containing a "fashion plate"' of the " lat- est fashions" from Paris. In every instance, the con- tracted, deformed, and as it is called, " neat, lady-like waist," is portrayed in all its " fascinating loveliness." These periodicals are found on every centre table, and 12S PHYSIOLOGICAL FAMILY PHYSICIAN. they exercise an influence, almost omnipotent. If the plates which corrupt the morals, are excluded by civil legislation, with the same propriety, ought not those to be suppressed that have a tendency to induce a course of conduct so adverse to health, by rendering the blood im- pure. PURE AIR AND VENTILATION OF ROOMS. Of the air taken into the lungs, at each respiration, only the oxygen passes through the membrane of the air vessels, to become mixed with the blood. The ni- trogen, which constitutes four-fifths of the inhaled air, is thrown out by the lungs in the act of expiration. The air for respiration should contain one-fifth part of oxy- gen. At each time of inhalation, a portion of the oxy- gen permiates the vesicular membrane and unites with the blood. And it receives from the blood about the same amount of carbonic acid gas. This loss of oxygen and gain of carbonic acid, unfits the air to be used in respiration a second time. In addition to the vitiation of the air, there is passing from the skin and lungs, a large amount of the decayed and waste matter of the system. This amounts to two or more pounds each twenty-four hours, and is diffused throughout the room. If there be not fresh air continu- ally coming into the room, the individual there sitting, will breathe this noxious air, which is another cause of impure blood. The same principle is demonstrated in the mixture of alcohol and water. If the air be dry, the water will pass readily through the membrane, if it be saturated with moisture, but little water will pass through. If the air be*free from carbonic acid gas, it will readily and with seeming avidity take from the blood, through the vesicular membrane the carbonic acid that may be mixed with the venous blood. If, like the air saturated with water, it contains as much carbonic acid, as the air will hold in solution, it will not attract any gas from the ve- nous blood, and the fluid will be returned through the PURE AIR AND VENTILATION OF ROOMS. 129 various vessels, unfit to repair the waste of the system. From this, we learn that impure air breathed into the lungs has the same effect, as when the contracted chest prevents the pure air from purifying the blood. For this- reason, workshops, churches, and dwelling houses, should be so constructed as to admit pure air freely and constantly, and to permit the escape of the impure and vitiated air. This is of more importance, than the warming of houses. We can compensate for the defi- ciency of a stove, by an extra garment, or an increased quantity of food ; but neither garment, exercise, food, or any thing else will compensate for fresh air. The same may be said of school-houses. The brain of the scholar must be stimulated by pure blood,, or its proper functions will not be performed. The pupil will complain of headache,, from irritation of the brain, caused by a diminution of pure oxygenated blood, and an excess of carbonic acid gas. Above all, sleeping rooms should be well ventilated, that the air in the morning be as pure as when- retiring- at night. A room thus ventilated', would prevent the morning headaches and the want of appetite, so common among the feeble. Every room should be so con- structed, that pure air can be admitted freely, as all de- viations tend to weaken and destroy the system. The impure air of sleeping rooms is probably destroying. more than intemperance. Look around the country, and those men and families that are the most exposed, that live in huts, but little superior to the sheds that shel- ter the farmer's flocks, are found to be the most healthy and robust. Headaches, liver complaints, and coughs, are almost unknown to them; not so with those who spend their days and nights in rooms, where the sashes of the windows are caulked, or perchance- dbubtedr to* prevent the keen, but healthy air of winter from enter- their apartments. Disease and suffering are their con- stant companions. The one breathes the pure air, the other does not. Influence of the Brain upon the Lungsi The condi- tion of the brain, exercises an influence upon respiration. 130 PHYSIOLOGICAL FAMILY PHYSICIAN. If it be enfeebled by the depressing passions of the mind, or by disease, the action of the respiratory muscles and the diaphragm will be inefficient. This is exemplified in those individuals, who have met with reverses of fortune, where character and pro- perty were lost. Thousands are brought to a premature grave, by the effect of depressed spirits. A striking in- stance is related by Laennec. In a female religious es- tablishment in France, were practiced great austerities; the mind was kept fixed in contemplating the terrible truths of religion, and in mortifying the flesh. The whole establishment in the space of ten years was sever- al times depopulated, with the exception of the persons employed at the gate, in the kitchen, and garden, with that falal disease, consumption. This institution did not long exist, being exterminated by order of the French go- vernment. Effects of impure blood upon the system* The blood may be rendered impure by either of the influences be- fore described, or by any two, or all of them combined. We will note the effect it has upon the bones. As one condition of health and strength, they demand pure blood. If this is not supplied to them, they become soft and brittle, their vitality is impaired, diseases of various kinds is the ultimate result. Another portion of the blood goes to the 400 muscles. These organs are at- tached to and act upon the bones. Upon the health and contractile energy of the muscles, depends the abil- ity to move and work. Give these organs of motion impure blood,—this being to them an unhealthy stimulus, —they feel soft, they are weak, the step is feeble, and the movement of the arm inefficient and the muscles of the back also refuse to perforin their usual amount of la- bor. This impure blood goes to the stomach, liver, and oth- er organs subservient to the digestion of food. This blood having an inadequate amount of oxygen, and a su- perabundance of carbonic acid gas, impairs the digestive process, causing a faintness of the stomach, loss of ap- petite, and a deranged state of the large and small intes- COLDS. 131 tines. The person has the reputation of being troubled with the dyspepsia, or liver complaint. Another por- tion goes to the lungs in the nutrient arteries. The delicate structure of these organs in which the-blood is, or should be purified, needs the requisite amount of pure blood to give them vigor and health. The blood not be- ing of that character, the lungs themselves lose their tone and ability to purify the blood ceases in a little time, even if they were permitted to expand freely. This dark, sluggish blood also passes to the skin; the health and beauty of-this tissue require well oxygenated blood. This not existing, the surface becomes covered with pimples and blotches, and the individual suffers from " humors," as they are called. Drinks made of various kinds of herbs, pills and powders, are taken for this dis- ease. They will do but little if any good while the caise of impurity of the blood is continued. This impure blood is sent to the brain. If this important organ is stimu- lated by impure blood, the nervous headache, bilious headache, and all kinds of aches and confusion of ideas, loss of memory, impaired intellect, dimness of vision, and dullness of hearing, are attendants from this impure stimulus. Often, in the process of time, it becomes dis- organized, and the brittle thread of life is broken. COLDS. The diseases of the lungs are of such a character, that much interest is attached to them. The simple cold, or cough, its nature and treatment, is not well understood by the matrons of the community; although each may have their " cure all" for it, or some grand specific, usually it is treated in a manner, that coincides with the popular adage, " stuff a cold and starve a fever." This stuffing is generally accomplished by taking large quantities of food and hot stimulating teas. Many times the latter is used alone. Many have suffered and re- covered, and the treatment from this has been deemed a good one. Indeed, many have recovered from fever and small pox, seventy years since, when no cold or 132 PHYSIOLOGICAL FAMILY PHYSICIAN. • fresh air was allowed these patients ; they lived, not- withstanding the treatment was pernicious. The reputa- tion of any physician would be destroyed at the present time, did. they now practice ia this way for these diseases. Success is not proof of the correctness of the practice, in this, no more than it was in the fever, and small pox, many years since. A knowledge of the character of the disease, is essential to the proper treatment and speedy relief of the patient. Let the treatment be safe, effica- cious and simple, and the mass of the people will fully understand and practice therefrom. In most instances, a cold is induced by a chill, that induces a contraction of the blood vessels of the skin. The great waste carried off by the agency of the exha- lent vessels of this membra.ie, is retained in the system, and a great portion of it is turned to the mucous mem- brane of the lungs. It is a law of the system that or- gans similar in their functions have sympathy with each other. The accumulation of blood, loaded with the waste matter that should have been carried from the system, creates an unusual fulness in the minute vessels,that nour- ish the muco bronchial membrane. The waste matter causes an irritation of the minute vessels, and this irrita- tion increases the flow of blood to the nutrient small ar- teries of the lungs. There is a thickening of the lining membrane of the lungs, caused by the fulness of the small vessels before described ; and the swelling of this mem- brane is similar to the thickening of the external coat of the eye, that sometimes is thrown into a fold in inflamma- tion of this organ. The'membrane being thickened, the small air tubes are nearly, or quite closed, and the air is prevented from passing into the vesicles. As fluids do not pass as readily through a thick mem- brane, as a thin one, the air that passes into the cells, does not impart oxygen to the blood and receive carbonic acid as if it was thinner. The blood being partially pu- rified, does not pass with facility through the lungs. There is an accumulation of blood in two sets of vessels, the pulmonary and the nutrient, and this obstruction of COUGHS. 133 the circulation, is an additional obstacle to the passage of air into the lungs. When food is taken, it is changed into chyle, and passed into the veins ; the drinks are also passed into the same vessels. The chyle and the drink increases the amount of fluid in the vessels of the lungs, and by these the breathing is rendered more difficult ; and uni- formly no relief is obtained, until the vessels of the skin are called into action by free perspiration, or the secret- ed mucous from the lungs. Treatment:—One thing is called for to effect a speedy cure, viz.: to diminish the amount of fluid in the vessels of the lungs. This can be done in two ways. 1st. By diminishing the quantity of blood in the system. 2d. By diverting it from the lungs to the skin. The first condi- tion can be easily and safely effected, by abstaining from all food, and drinking no more than a gill in twenty-four hours. By this procedure, the quantity of blood will be speedily diminished, and the lungs relieved of the accu- mulated fluid. The second condition can be obtained by resorting to the warm or vapor bath. These, and the common sweat, will invite the blood to the skin from the lungs. Keep up the action of the skin for a few hours, and the lungs will be entirely relieved. In some instances, emetics and cathartics may be called for, and necessary. Mucilages, as gum Arabic, slippery-elm bark, would be good. After the system is relieved, the skin is more impres- sible lo cold, and consequently, needs careful protection by clothing. COUGHS. In cases of a cold leaving the lungs weak, attended by a cough, and the expectoration of matter, the following treatment will be proper: Each morning and evening, bathe the skin with cold water, saturated with salt, rub- bing every part of the skin dry with a crash towel. By constant rubbing for fifteen minutes, there will be createc" an active and red state of the skin. Put on clean flan- 12 134 PHYSIOLOGICAL FAMILY PHYSICIAN. nels, sleep in a room that is large and well ventilated; if the appetite is poor, and a confined state of the bowels exists, the following prescription Would be beneficial, af- ter attending to the skin as before directed: Quassia, 1 ounce; peppermint herb, 1-2 ounce; epsom salts, 1-2 ounce. Steep in one pint of water. Give a table spoon- ful three times each day. After the bowels and skin have received due attention, the following may be given to al- lay the cough: Thoroughwort, 1-4 ounce; black snake- root, 1-2 ounce; elecampane root, 1 ounce; rhubarb, 1-4 ounce; hops, 1-2 ounce. Steep in one pint of wa- ter. Add loaf sugar, I pound. Take a table spoonful morning and evening. Exercise in the open air; let the clothing be adapted to the weather. Follow the above, and most coughs will be benefitted. In all cases of long continued coughs, or colds, a moderate amount of nutrient food must be taken, three or four times each day. The withdrawing of food will only answer in colds recently taken, and that only for three or four days. CONSUMPTION. Treat consumptive coughs, asin the preceding section. Have the person clothe in flannels, and exercise freely in the open air. To this add a free expansion of the chest, by sitting erect, throwing the shoulders back, and filling the lungs as full as can be done without causing uneasiness. This done six or eight times each day, from twenty to thirty minutes each time, and persevered in for many weeks, will be found quite beneficial. In cases of scrofula, tendency to consumption, weakness of the voice, short- ness of breath, these means should be under the eye and advice of the understanding physician. PAIN IN THE SIDE. In all cases of pain about the chest, create an action upon the skin, and see that it is maintained; correct the ASTHMA.--SPITTING OF BLOOD. 135 condition of the stomach and bowels, take nutrient food, with little drink, and it will have a tendency to remove the pain. After attending to the state of the skin gener- ally, by bathing and friction, small doses of rhubarb and sulphur, may be given in equal parts. The chest may be well rubbed with a linament, composed of equal parts of camphorated spirit, oil of hemlock, olive oil, and spirits of ammonia, mixed well and applied once in eight hours, rubbing the chest until the skin looks red. Mustard seed poultices, plasters of hemlock gum, gal- banum, and sometimes blisters would be good applica- tions. ASTHMA. This disease is not well understood. The treatment is empirical. Some cases are relieved, by blisters be- tween the shoulders repeated and continued for some weeks. Smoking the leaves of the datura stramonium will sometimes give relief. Burning cloth dipped in a so- lution of salt petre is good to relieve paroxysms. The following is the treatment upon which 1 most rely. Apply blisters between the shoulders, and take a table spoonful of the following syrup once in five hours. j^ Actea Racemosa 1 ounce. Lobelia 1-4 ounce. Rhubarb 1-2 ounce. Steep in one pint of waterthen add hydriodate Potassa, 2 drachms. SPITTING OP BLOOD. The spitting of blood is usually regarded as a serious matter. It may, or it may not indicate serious disease of the lungs. Treatment. Have the person remain at rest, bathe the feet in warm water, apply smart friction to the skin with a coarse crash towel. Among the medicines used for this affection, common salt, and cayenne pepper are as good as any. An emetic of ipecac is sometimes ben- eficial.. 136 PHYSIOLOGICAL FAMILY PHYSICIAN. CROUP. In cases of croup, the disease is situated in the larynx, or upper part of the windpipe ; as this disease is active in its character, and runs its course in a few hours, the remedies must be prompt to be effective. Put the feet of the child into hot water, give the skin a sponging with water, in which a large amount of salt is dissolved ; fol- low this with smart continued friction, with a coarse, crash towel, till the skin looks quite red over the entire system. Apply cloths dipped in water as hot as can be possibly endured, in which a large amount of salt is dis- solved, to the throat of the child. Change these cloths very frequently, so as to keep them very hot. Give an emetic to induce vomiting immediately. In these cases, always send for a physician immediately. QUINSY. Many children have croupy breathing every time they take cold. These attacks usually occur at night, when the child is asleep, and the muscular system relaxed. This distressed breathing is frequently the result of en- larged tonsils in the throat, (or what is sometimes called the almonds of the ear, yet they have no connection with the ear.) These may be seen at the root of the tongue, and back part of the throat; and they appear like small prominences, nearly filling up the throat when awake, and quite doing it when asleep. The voice of such a child is seldom clear, and the mouth is open in breathing. Another reason why it is more apparent at night is the impure air of the sleeping room, which vitiatfft^he blood and thus enfeebles the muscles of respiration. The treatment of such cases is simple. In every case of en- larged tonsils have them removed by the surgeon. The operation causes but little pain and is attended with no danger. Keeping such enlarged tonsils causes deformi- ties of the chest, beside producing suffering and jeopard- izing life. Children predisposed to the croup should al- ways sleep in the pure air, and be bathed with cold water TREATMENT OF DROWNED PERSONS. 137 every morning. Pure air tends to render the blood more stimulating, and a healthy state of the digestive organs tends to the same end. These are the main things to be attended to, as medicines are only assistants to the pow- ers of the system. TREATMENT OF DROWNED PERSONS. When a person has been immersed in water and ap- parently dead from drowning, it is a matter of much im- portance, that the proper means be assiduously used to resuscitate such persons. The following directions are from one of the ablest men in the country, connected with the surgical profession. " Immediately as soon as the body is removed from the water, press the chest sud- denly and forcibly downward and backward, and instant- ly discontinue the pressure. Repeat this without inter- ruption, until a pair of common bellows can be procured, when obtained, introduce the nozzle well upon the base of the tongue. Surround the mouth with a towel or hand- kerchief and close it. Direct a bystander to press firmly upon the projecting part of the neck, (called Adam's ap- ple) and use the bellows actively. Then press upon the chest to. ex pel the air from the lungs, to imitate natural breathing. Continue this an hour at least, unless signs of natural breathing come on. Wrap the body in warm blankets and place it near the fire and do every thing to preserve the natural warmth, as well as to impart artificial heat if possible. Everv thing, however, is secondary, to inflating the lungs. Send for medical aid immediately. Avoid all frictions until respiration shall be in some de- gree established. VALENTINE MOTT) Surgeon General of American SJiif wrecks Society." May 1844. In cases of attempts to commit suicide by hanging, the phenomena of death are very similar to those of cessation of life in drowning. Treatment. Take the person down, 12* 133 PHYSIOLOGICAL FAMILY PHYSICIAN. remove the cord from the neck, then adopt the treatment advised in the section upon drowned persons. CIRCULATION. The circulation of blood in the system, is effected by the agency of the heart, arteries, and veins. This function was not well understood by the ancients. They found, after death, that the heart wa3 composed of two parts : the vessels of one part being filled with coagulated blood, while those of the other part were en- tirely empty. The arteries, or those vessels which opened into the side of the heart, which contained no blood, were found empty,—while the veins, or those vessels which opened into the other side, were found to be filled with clotted blood. Hence they inferred, that the side of the heart and vessels leading to it, which contained blood after death, were the vessels that car- ried the blood to the different parts of the system ; and the empty side of the heart, and set of vessels, were sub- servient to the circulation of a very subtile fluid, called by them animal spirits. This theory was generally received and adopted, until the days of Harvey. He taught that one set of ves- sels, called veins, carried the blood from the different parts of the system to the right side of the heart; that another set of vessels, called pulmonary arteries, car- ried the blood from the right side of the heart to the lungs ; another set of vessels, called pulmonary veins, carried the blood from the lungs to the left side of the heart ; and that another set, named the systemic arteries, carried the blood to the different and many BflLfs of the system, from the left side of the heart. This view of the circulation, makes the heart a double organ, the one side receiving and transmitting one kind of blood, while the other side receives and transmits another kind. The heart is found to be of this character in man, aad in all warm blooded animals. Notwithstanding the two hearts are united within a single envelope, the right and left CIRCULATION. 139 cavities are perfectly distinct from each other, as repre sented in fig. 59. Fig. 59. " Bv this engraving, the reader will readily understand what we mean by the two hearts of man, and other warm blooded animals, as they are here exhibited, and as they appear when dissected apart. Each one of them is a perfect organ by itself, and the one is perfectly independent of the other. That having the letter 6 upon it is the right heart, and that with a g, the left. This is a front view, or like looking into the chest oi another person. The right heart is the engine of the lungs, lor it supplies those organs ex- clusively. The left heart throws the blood, as already remarked in the text, round the curve above g, in the direction indicated by the arrows, over the en- tire body. '• a, a, are the cavas, or great veins, returning blood from the head and arms, and lower extremities. The uppermost is the superior vena cava, and the one below the inferior vena cava. The arrows show the direction of the returning currents of venous bloed, to b, the auricle, which forces it into C, the ventricle, which again forces it up into a, d, the pulmonary artery, where it divides to go to each lung; e, is one of the four pulmonary veins, which convey the blood, just forced into the lungs, into the auricle f, of the left heart. When that contracts, it drives its blood into g, the ventricle, which, in its turn, forces it onward again into the arch, or the aorta, the main pipe, where it glides along in the direction of .the arrow, dividing into smaller streams on its way, and finally goes down the descending aorta h, to supply the body below. " There are many animals which have only the right heart, bjt none that possess the left one alone." Some^few animals have only one heart, which performs the office of the double heart in man. Others have two hearts lying beside each other, and perform the office of the double heart. Some of the reptiles have no heart, but they have a central artery and vein, through which the blood circulates. The heart of man is placed in the left side of the chest, resting upon the diaphragm, the base of which is beneath the second and third ribs, where they join the sternum. The apex of the heart strikes against the sixth rib. 140 PHYSIOLOGICAL FAMILY PHYSICIAN. The following is a good diaphragm of the double circu- lation of man and animals. Fig. 60. T. the trachea ; S, S, S, the bronchial tubes X, X, air vesicles in which the bronchi terminates ;,a, a, a, a, systemic veins through which the impure blood is returned to the right auricle ; b, C, represents the right ventricle, d, d, d, right and left pulmonary arteries, e, e, e, pulmonary veins through which the pure blood is returned from the lungs to/, the left auricle, and g, the left ven- tricle, A. the aorta through which the blood is carried from the left ventricle : h, h, and i, i, branches of (he aorta through which the arterial blood is carried to the system. The pulmonary arteries empty themselves into thepulmonary veins, and the aorta and its branches empty themselves into the systemic veins. The heart of man weighs about nine ounces, but va- ries in size in different persons. This organ is surround- CIRCULATION. 141 " a, the heart, in its natural position, the sternum being taken away, and the pericardium laid open in front, to give a full and perfect view of the organ ; C is the arch of the aorla, or primative artery of the body, from which all others arise ; e, is the diaphragmatic nerve, having its origin high up, on the side of the neck, and traveling down into the chest, on the outside of the pericardi- um, or heart-case, to reach the diaphragm, the partition that divides the chest from the abitom«n. If this nerve is iliviiied, all motion in the diaphragm will cease. It should be recollected that it is a muscle of respiration, rising and falling witrttlic inflation and collapse of the lungs. The base, or rather under side of the heart, as it is suspended from above, rests on the diaphragm at the lower 6 ; 6, 6, »*, the heart-case ; d, tho descending cava, or great vein that returns the blood from the head and arms, into the right auiicle of the heart." ed by a membranous sack, called the pericardium, or heart case. This is attached to the base of the heart. Upon opening it, there is usually found about a tea spoonful of watery fluid. 142 PHYSIOLOGICAL FAMILY PHYSICIAN. The heart of man, like that of the beef, is a muscu- lar organ, composed of fibres running in different direc- tions. The one side of the heart of the beef is found thicker than the other, it is so in man. The right, or thin side, receives the dark, or venous blood and chyle, and transmits them to the lungs only. The other, or left side of the heart, takes it from the lungs and impels it through the system. The distance from the heart to the lungs is small, compared with the distance from the heart to the extremes of the system. The thickness of the two sides is proportioned to the distance the blood has to traverse from the two compartments. Each side of the heart is separated into two divisions, the auricle and ventricle. The former is called, by butchers and far- mers, the deaf ear; the latter, the heart. The auricle is much thinner than the ventricle, as the blood is only passed from it into the ventricle. " The double heart of man: q, descending vena cava; o, ascending vena cava; n, right auricle ; 6, right ventricle; k, pulmonary artery ; 1,1, right and left branches of this artery, going to the lungs on either side of the ch?st; CIRCULATION. 143 m,m, veins of the lungs, which return what the artery sent in, to r, the left auricle ; a, the left ventricle ; c, e,f, aorta, or great artery of the body, rising out of the left heart; g-, arteria innominata ; h, the subclavian artery, going to the left arm; i, the carotid artery, which goes up the side of the neck to the head. " Note. The arrows show the course the blood moves in each of the ves- sels demonstrated with the heart; n, the right auricle; m,m, veins of the lungs ; », left coronary artery, p, veins returning T>lood from the liver and bowols. " There is no essential difference in the external appearance* or internal or- ganization of the heart of man and breaihing animals generally ; hence, in a cabinet, it would be exceedingly difficult for a practical anatomist to designate the human from the heart of a brute, provided they were of equal dimensions. "Nothing is easier than to fill a heart with wax, or even plaster paris, in or- der to exhibit, distinctly, all its vessels, and its exact shape in a slate of disten- sion. The heart of any of the domestic animals, procured at the market, may be thus filled and kept for many years." The inside of the heart of man, as well as of animals, presents an irregular appearance like pillars or columns, named the columna carnea, or the fleshy columns. To these pillars are attached small tendinous cords, or threads, that run from them to some membranous folds, called valves. Those in the right side of the heart are called tricuspid, and those in the left side are named mi- tral valves. They are situated between the auricles and ventricles, and open and permit the blood to flow from the auricles to the ventricles. The contraction of the former is simultaneous with the dilation of the latter. Fig. 63. Right side of the He art. b, superior vena cava ; a, d, orifice of the inferi- or vena cava; c, fossa ov- alis; /, the thin walls of the ventricle ; g-jg-jColuir.- na cornea, or fleshy pillar; k, k, the cuspid valve; h, f, Eustachian valve. The auricle and ventri- cle are here represented as laid open. 144 PHYSIOLOGICAL FAMILY PHYSICIAN. Fig. 64. This figure represents the pul- monary artery and right ventricle luid open, bunging to view the semilunar valves of the artery. a, pulmonary artery ; b, walls of ventricle ; c, c, C, similunar valves at the commencement of the artery. Fig. 65. , Left side oi- the Heart. This figure represents the left auricle laid open, a, f, d, represent the veins through which the blood is returned from the lung3 ; i, walls of left ventricle ; e, h, mitral valves be- tween the left auricle and ventricle; g, fleshy pil- lars, called calumna car- nea. From the right ventricle of the heart, passes the pul-> monary artery through which the blood flows to the lungs e from the left ventricle passes off the large artery of th CIRCULATION. 145 Fig. 66. a This figure represents the po- sition of the semilunar valves afr the commencement of the aorta ;*o., the aorta ; 6, walls of left ventricle laid open ; c, c, c, the similunar valves of the aor- ta. system, named the aorta; through this, all the red, or pu- rified blood of the system passes. By the contraction of each ventricle, the blood is forced into the appropri- ate vessels, viz.: aorta and pulmonary artery; when the ventricles have forced the blood out of them, they dilate to receive a fresh supply from the auricles. To prevent the blood from passing back into its ventricle, by the con- traction of the coats of the arteries, there are placed three valves at the commencement of each artery, that open and permit the blood to flow from the ventricle in- to the artery: but when a retrograde action of the blood commences, they close, and prevent its return to the heart. Thus we find four sets of valves in this organ, acting like the valves of a pump, permitting the blood to flow in one direction, but preventing its reflow. In the earli- est months of existence, there is an opening between the two auricles, and between the artery that passes to the lungs and the one going to the system. They are usually closed at birth, but sometimes they remain open, causing the disease named cyanosis, or blue disease. This is an incurable disease. The child usually dies young. 13 146 PHYSIOLOGICAL FAMILY PHYSICIAN. GENERAL VENOUS SYSTEM. Fig. 67. The dark or venous blood, by the action of a thou- sand small veins,is collect- ed into two large veins, called vena cava ascending and vena cava descending, which open into the auricle of the right side of the heart. . The blood flows more sluggish through the veins than in the arteries. They are more capacious, but no more blood passes through them. The coats also are not so thick as those of the arteries. l/pon the inside of ihe veins are seen valves or folds; these present uo obstacle to the flow of blood towards the heart, but when any foreign influence shall cause a retrcgradc motion of the blood, they become tense and are thrown across the canal of the vein, presenting a barrier to the reflux of the blood. - The large arterial trunks, as well as the veins, lie under the muscles and between them. GENKKAL ARTERIAL SYSTEM. 147 In this figure is se^n represein- ed a vein laid open to shew the valves ; a, the trunk of the vein ; b, b, valves ; C, branch of vein en- tering it. GENERAL ARTERIAL SYSTEM. The arteries are hollow tubes, having dense elastic coats, through which the blood is conveyed to every part of the system. From the main trunk there are given oft* numerous small branches, by means of which the different organs are supplied with blood. The small branches terminate in a separate system of minute vessels named capillaries. This set of small vessels is inter- spersed between the extremities of the arteries and the commencement of the veins at the minute extremities. The blood passes through these, from the arteries to the veins. In its passage from one set of vessels to the other, it loses its red color, and becomes dark. The blood is carried from the heart, through the arte- ries, by the contractile power of the heart, the contrac- tion of the arterial coats, and by the influence of the muscles upon the arteries. 148 PHYSIOLOGICAL FAMILY PHYSICIAN. Fig. 69. The contractile pow- er of the human heart has bceu estimated by different physiologists from 8, to 180,000 lbs. Its power varies in dif- ferent individuals. It is the contraction of the heart, that causes the pulse at the wrist, and also the jets or ir- regular flow of blood from large arteries when divided. The tonic contractile power of the arteries, depend upon the thickness and health of their coats. The action of the mus- cles upon the circula- tion, is by the pressure of the hardened, con- tracted central part of the muscles upon the arterial tubes. The amount of the influ- ence willdepend upon the energy of the mus- cular contraction. The more energetic the con- traction, the more ra- pid and vigorous the circulation. The power that moves the blood through the veins, is similar to that of the ar- teries, with the exception of the expulsive power of the heart. The dilitation of the veins is of an active char- acter, causing a vacuum ;* there is a suction power that attracts the blood to them. The time it takes the blood to circulate to the extrem- ities of the system and return, is dependent on many cir- cumstances. 1. Its quantity. 2. The frequency of the GENERAL ARTERIAL SYSTEM. 149 Fig. 70. Ily referring to the plan of the purfcct double heart, »', shows the origin ..f the carotid artery, a branch from the arch of the aorta. In this, very accu- rate plan of the superficial arteries of the head, a. is the continued trunk of the carotid artery: it is this vessel which is usually divided in suicides; it is ihis vessel also, with its mate on the other side of the neck, whii h, when compres- sed, causes apoplexy and death. /, tho occipital artery, going to the muscles on the back of I he head ; 6, is the larynx, or vocal box; c, indicates the place where the carotid divides into the n, the external carotid, branching outward ; 6, also, is the superior thyroid artery ; p, the thyroid gland, and inferior thyroid artery ; k, the temporal artery, fell beating in the temple, and sometimes select- ed to bleed from, in desperate cases ; o, the left subclavian artery ; I, the masseter muscle; h, depressor anguli oris, having running under it the exter- nal maxillary artery; », the zyuomaticus major, directing the eye also to the coronary artery of the lips; vc the jaw in chewing ; », buccal artery, going to the buccinator, or trumpeter's mus. le ; /, anUrior deep temporal branch : e, infra oribitar artery. The bone in this figure is supposed to have been taken away, in order to ex- hibit the arteries o, which branch, kke the limits of a tree,over the surface of the dtlra mater. 'BRONCHITIS. 151 the body, and the feebler the system and circulation, the more injurious the practice. Persons in ill health usually have cold extremities, and a pale, dry skin. Health can never be considered regained, until this state of the skin and extremities is removed; which can be done by suita- ble clothing, by exercising the muscles of the system, by judicious labor, bathing, and other conditions referred to in preceding sections. Bands and ligatures, when they compress the arteries and veins, are extremely pernicious. In no case should cords or belts, be worn so tight as to impede the circulation of the blood. A ligament put around the arm by the surgeon, when he wishes to bleed from the arm, Cijuses the veins to become fuller and swol- len. The same in true, applied to any part of the sys- tem. This fulness of the veins is followed by knotty- like swellings, which are called varicose veins of the limbs. These veins are not unfrequently the cause of ulcers. If the veins of the limb become full and permanently swol- len, a surgeon should be consulted, that the cause be re- moved and suffering averted. BRONCHITIS. Tight dressing about the neck makes pressure upon the veins, the blood being prevented from freely returning to the heart. The effects resulting from such practices and habits, are a full and swollen face, its livid hue presenting an unnatural appearance. The veins of the brain are congested, and filled with a redundancy of blood, which leads to a disease of this important organ. This tight dressing about the neck is one of the fruitful causes of the loss of voice, or bronchitis, among public speakers. This is a disease of the larynx, or upper part of the windpipe; the vessels at this point are weakened. To prevent this trouble, dress the neck loosely, permit the veins to return their blood freely to the heart. This dis- ease is rarely seen in females, and never among teamsters, and others who dress their necks loosely. When the vessels become congested, induce a contractile power in them by friction, cold bathing, moderate and judicious use of the organs of the throat. 152 PHYSIOLOGICAL FAMILY PHYSICIAN. "This figure has been introduced to show the manner of supplying the brain with arterial blood by the vertebral arte- ries. It will doubtless be recollected by the critical student, that in the lateral arms of the vertebrae of the nock, there were round holes, from one bone to the other. Through those | holes an artery creeps securely into the skull, unexposed to the thou- sand accidents to which the carotid arteries aie liable. If, for example, an^ operation requires lha't the caiotidesshould be tied, so that no blood can pass in them, a sup- ply for the brain is se- cured by these verte- brals. When they have arrived within the skull, —»-—•*&&' -**,**^- at the under side of the Liaiu, fie tw i nrirked b, b, unite into one, which is C, and then branches oft' amjn-* the c nvolutinns of the brain, in licated by the various letters ; g. is ihe little brairfb-r cerebellum; f the middle lobe of the brain, or cerebrum; e, the anterior loba of the cerebrum; an I o, the optic nerves, or nerves of vision. This is no fanciful distribution of the arteries of this organ, but a perfectly true representation." DISEASES OF THE HEART. These are various; and attending them the action of the heart is usually irregular. The walls of either cavil) of the heart may be thickened. This is called hyper- trophy. They may become thinner. This is called di- litation. The valves .may be destroyed. This is called valval disease. The heart may sympathize with the brain, lungs, or stomach, which may induce an irregular action of this organ. Such being the uncertainty of the causes of disease of this organ and its condition, we advise all persons having symptoms of disease of the heart to con- sult a good physician. STOPPING OF BLOOD. 153 Fig. 73. •' What is seen in this drawing exists in every living arm. Over ihe bend of the elbow, a mere web lies between the great artery and the vein. The vein is Liken away, but it will show how dangerous it is to bleed the vein at this " point, on account of the nearness of the artery, which is liable to be wound- ed by the point of the lancet. A knowledge of this fact should deter C every one from employing surgeons in whom they have not the niO'st implicit confidence, that ihev understand anato- my, a, b, c, d, e.f. g. It, k, mark the branches of the biachial arteiy a, as they are, in relation to the muscles ; i, is \hc fascia or the membrane, between the arteiy and vein, and wnich is a jf tendinous snip sent off" from the biceps flexor cubiti,. or bending muscle of the fore-arm, as though it was expressly designed to confine ihe throbbing aite- ry in its place, and protect It from the injuries to which it seems liable by carrying burdens in the arms. This strip of tendon is like the arch of a bridge, for if the arm is bent it is still ten?e, and therefore alwaysja defence. This brachial artery, near the elbow, divides into branches; one of them sinks into the muscles, to supply them, by the side of the ulna, on a line with the little finger, and hence called ihe ulnar artery The main trunk of the brachial, however, travels downward, quite superficially, near the edge of the radius, and therefore has the name of radial artery. In the wrist, being just under the skin, it is pressed against the bone, where its pulsations are fell: feeling the pulse, in the language of physicians, simply means the sensation conveyed by the throbbings of this ar- tery, when thus compressed. Further on in the palm of the hand, it forms h..lfa circle, termed the palmar arch, and from its outward curve digital branches convey the blood to the fin- gers and thumb. STOPPING OP BLOOfi. If the brachial artery is severed, the blood is thrown 154 PHYSIOLOGICAL FAMILY PHYSICIAN. out in a large jet, or stream. The same results will fol- low if any large artery of the system is divided. If small vessels are severed, the blood will flow out regularly and no jet will be seen. In all instances of a division of a large vessel, the person wounded or some by-stander must arrest the bleeding, or dangerous effects may follow. This must be done before a surgeon is called, by mak- ing pressure upon the vessel between the heart and its division at the wound, or the pressure may be made with the finger upon the mouth of the divided vessel as seen in engraving (74,) where the finger is represented pressed into a gaping wound. This compression should be continu- ed for some time, or until a sur- geon is called. After holding the finger upon the vessel.a short time, it may be removed and there may be no hemor- rhage. If the jet of blood is large, indicating the division of a large vessel, a surgeon should be called to put a ligature around the artery, a a bleeding will soon return. The divided arteries of the lower limbs, head, neck, and body, should be treated by compression as represented in the arm. If no large vessels but many small ones are divided, there is no danger from excessive bleeding. In this case press the lips of the wound together and hold them a few minutes, then wash out the wound with cold water. The bleeding is stayed by the divided vessels retracting into the flesh, and their divided mouths contracting. The many things used to stop blood are of no utility. The bleeding is arrested by the contraction or retraction of the vessels as above described. TREATMENT OF "FRESH CUTS." 155 Fig. 75. In a division of an artery of the lower extremity the hemor- rhage may be arrested by pres- sing with the thumb or finger, the large artery at the groin, where it comes out of the abdomen. In fig. 75, a wound is seen in which the large blood ves- sel is divided, and^the method of compressing the artery at the groin is represented. The above described methods, are the only proper means to use in arresting bleeding when large arteries are •divided. Filling the wound with different articles should* not be resorted to. TREATMENT OF " FRESH CUTs". The small " fresh cuts," are treated by the'friend that is near, as the mother, sister, father, or brother. The treatment of these, is as various as the taste and know- ledge of individuals, yet all profess to believe their meth- od to.be u the best." Most pretend that their favorite application, has healing properties. Says a good old lady, " 1 know my salve is healing. I have put it on thousands of times, and the parts always healed." It is probably true, the parts healed, still it does not sustain the position. Many cuts have been dressed with cold water, and have healed, and many cases have healed with- out any application. The manner the wound is healed, I will point out. The vessels of the divided part are excited to action by the stimulus of the division of the parts, or, as called 156 PHYSIOLOGICAL FAMILY PHYSICIAN. by Dr. John Hunter, "the stimulus of imperfection." The vessels thus excited, immediately throw out a color- less substance of a semi-fluid character, called lymph. It is of a fibrinous character, and coats over both lips of the wound their entire depth. This lymph which is se- parated from the blood, may be seen on the surface of the wound the second day; and it is the material that fills the wound and unites the divided parts. Hence we say, that the many things applied, have not in themselves any healing quality. Treatment.—Always examine a wound, and if the blood is not thrown out by jerks, no large artery is divid- ed. The wound may be pressed together with the fin- gers, and held so for a few minutes; then remove the fin- gers and wash the gap with cold water, and continue to wash it, by letting the water drop from a sponge or cloth, until the bleeding shall entirely cease, and all the blood has been removed. Then bring the parts together, and retain them by narrow strips of adhesive or resinous plas- ter. These should be put on smoothly. Cover the plaster with a fold of cloth, and put a bandage loosely around the part. The following engraving represents the manner these strips of plaster are held and applied to the wound. Fig. 76. In most instances in domestic practice, the strips of adhesive plaster used to dress wounds are much too wide. In all instances, let the cloth be smoothly covered with TREATMENT OF " FRESH CUTS." 157 the plaster. Cut it into narrow strips, not more than one fourth of an inch wide; apply a sufficient number of these strips to cover the wound. The following engrav- ing represents the manner of cutting these strips. In a simple wound dressed in this way, the dress- ing need not be moved for five or six days ; when they are moved, the parts may be cleansed by washing with weak soap suds, or warm water, and if needed, fresh strips of adhesive plaster may be applied. In removingjt\ the dressing from a wound, remember to raise each end of the strip of plaster and draw it toward the wounaS^ This is important, as the liability of the woun^/e-open- ing is diminished. The following engraving represents the manner of removing the strips of adhesive plaster. 14 158 PHYSIOLOGICAL FAMILY PHYSICIAN. The adhesive strips bring the parts together, and di- minish the gap. Again, these strips keep the air and other foreign substances from the wound. Every family should have the adhesive or resinous plaster ready to spread and apply to the ordinary " cuts," as the expense for two ounces would not exceed 12 cents. Upon the matter of dressing wounds, there is a great want of correct information. Many things are advised and applied. One will apply black pepper, others cam- phorated spirits. Those who chew tobacco, think that a sovereign balm, and consequently a tobacco cud is crowd- ed into the wound. Major W-----, the able and distin- guished engineer, was present when a laborer engaged in one of the coffer dams used in erecting the bridge over the Connecticut river, received a wound. The Major forthwith filled his mouth with an extra supply of the weed, and filled the wound with the saliva, bound it up, and sent the man to a surgeon. This gentleman, an un- derstanding and intelligent man, made this application with the best of intentions ; he had probably seen it used, and applied it without thought. Surgeons find this rem- Vedy used in every section of the country. In wounds of Iwnimals, as well as in the human race, salt, rum, vinegar, «Bnd other "healing" and "cooling," applications, as "Tfiey are called, are applied, and in all cases they are high- ly irritating and injurious, LACERATED WOUNDS. In torn or ragged wounds, there is not so much bleed- ing, as in cuts with sharp instruments. The vitality or life of the part is diminished, and they do not unite so speedily. The treatment of such wounds is somewhat different from that of cuts. Wash the wound with wa- ter, bring the parts together and retain them by adhesive plaster. In some instances, the application of the emol- lient poultice will be called for, to allay nervous irrita- tion, and to induce the formation of matter. In some in- stances the blood-vessels may be injured, and do not bleed immediately, but will give trouble in a few hours POSITION OF LIMBS IN DRESSING WOUNDS. 159 or days. Prudence and economy require, that these cases be examined by the eye of the understanding sur- geon. PUNCTURED WOUNDS. When injuries are made by sharp pointed instruments, the wound is usually deep, penetrating deeply into the limb, cutting first the skin, then the muscles, and severing the arteries, veins, and nerves. The several vessels bleed, and the blood does not escape, but is kept press- ing and irritating the parts. Such wounds are moat dan- gerous. An emollient poultice, made of ground slippery elm bark, linseed meal, or crackers and milk, boiled to- gether, would alleviate the pain. In all cases of severe wounds, the food should be moderate in quantity, and unstimulating ; and if the person has been accustomed to active exercise, the food should be diminished in amount. POSITION OF LIMBS IN DRESSING WOUNDS. The position of the limb will favor the closing of the. wound. If the wound be upon the anterior and inner part of the arm between the shoulder and elbow, bend- ing the elbow will favor the closing of the wound, see Fig. 76. If the wound be upon the back of the arm, between the shoulder and elbow, by keeping the arm ex- tended the wound will be closed, see Fig. 76 a. If the wound be upon the anterior part of the arm be- tween the elbow and wrist, bend both elbow and wrist. See 76 b. If a wound be upon the anterior part of the thigh, by bending the thigh upon the body and extending the knee, the wound will be closed. If the wound be up- on the back part of the thigh, by extending the thigh upon the body, and flexing the knee, it will favor its closing. If the wound be upon the anterior part of the leg, be- tween the knee and ankle, by extending the knee and flexing the ankhj, it will aid its closing. In wounds upon the back part of the leg between the ankle and knee by extending the foot and bending the knee the gaping of the 160 PHYSIOLOGICAL FAMILY PHYSICIAN. wound will be diminished. In wounds upon the anterior part of the trunk of the body, by keeping the body flexed. In wounds upon the back part of the trunk by keeping the body straight, the union of such wound will be aided. ENLARGEMENT OF THE VEINS. These are by no means uncommon. They are called varicose veins, and are frequently attended by ulcers termed varicose. Fig. 79. Treatment.—Firm and equal com- pression is the only effective medica- tion. This is easily accomplished by using a laced gaiter made of flannel or buckskin. The engraving Fig. 79, gives a good idea of this useful method of supporting the weakened veins. This method of bandaging may be used in any case demanding such support. THE NERVOUS SYSTEM. The nervous system is divided into three parts, for anatomical description). The brain, the medulla spinalis or spinal marrow, sometimes named the pith of the back bone, and the nerves. The brain is the central part of this system. It is surrounded by eight bones of the skull, named the cranial bones. These are arched, being convex externally and concave internally. They are covered upon the exterior with a thin, firm mem- brane, Darned the pericranium. Ovev this, we find a thin muscle, and the hairy scalp. Upon the inside are found three membranes. The first is- called the dura THE NERVOUS SYSTEM. 161 mater, which adheres strongly to the internal surface of the cranium. It has two considerable processes, one of which dips into a fissure of the brain, and divides it into two parts, called hemispheres. The arachnoid mem- brane is thin, semi-transparent, and in health has no ves- sels that are perceptible to the naked eye. The pia mater is a thin, soft membrane, abounding with vessels, and much of the blood going to the exterior of the brain passes through them. In one form of disease of the brain, these membranes are the parts diseased. Fig. 80. a, a, the scalp turned down ; b, b, b, the cut edge of the bones of the skull ; c, the external strong membrane of the bra n, the dura mater suspended by a hook ; d, the left hemisphere of the brain showing its convolutions ; e, the su- perior edge of the right hemisphere ; /, fissure between the two hemispheres. The brain is divided into three parts ; the cerebrum, or larger brain, the cerebellum, or smaller brain, and the medulla oblongata. The human brain is a soft pulpy mass, composed chiefly of albumen. This albumen is 14* 62 PHYSIOLOGICAL FAMILY PHYSICIAN. a substance similar to the white of eggs. If it be mar cerated in rum, it is hardened like a boiled egg. This is one of the changes wrought in the brain by rum-drink- ing, which destroys all the finer feelings of man, acting as a slow but sure poison. Th& rum is carried to the brain mixed with the blood in the blood-vessels. Upon the exterior surface are seen undulating windings, named convolutions. These are found upon the upper and lat- eral parts of the braim The external part of the brain is of an ash color, hence it is called the cinecitious, or cortical part of the organ. The central part is named medullary, and its- color is muchjighter. Fig. 81. The above engraving represents a horizontal section of the bones of jtlu) skull and brain; a, a, represents outer layer, of ash colored matter; b, 6,lh« white medullary central part of brain c, the corpus callosum. THE NERVOUS SYSTEM. 163 Fig. 82. This is an exhibition of a vertical section of the bones of the head, face and brain, showing precisely the appearance, were the head is divided in-the middle from the top dbwiv to. the neck. No letters of reference have been introduced, because the plate will be doubly valuable, when the general relation of the different portions have been learned from the text and the other diagrams. The reader will then trace with his eye the outline ofi the little brain mark- ed a. In this, the medullary matter is arranged in the form'of the trunk and branches of a tree, hence, it is called the arbor vitae, the cerebrum ; or large brain is the seat of thought ;. the ventricles and other interesting points, which, though intricate, are nevertheless worth the (rouble of understanding. The mechanical arrangement only, is contemplated in these illustrations. The cerebellum, or little brain, belongs to the animal system, and is totally different in its functions from the cerebrum, or brain proper, which is the immediate seat of intellect. The cerebellum is situated behind and below the cerebrum. It is smooth; the matter of which it is composed presents no convolutions, but is arranged in lamina, or plates. It is separated from the larger brain by a process of the dura mater, called tlie tentori- um. This membrane prevents the larger brain from compressing the lesser. The little brain like the larger, is composed of a cortical and medullary portion. 164 PHYSIOLOGICAL FAMILY PHYSICIAN. Fig. 83. In the above engraving the base of the brain is divided inlo three lobes, marked a, for the anterior, c, for the middle, while the convolutions of the pos- terior lobe may bs seen on each side of the cerebellum, this is marked /. 6, is the depression that divides the anterior from the middle Fobe, d. the convolu- tions forming an external covering for the whole of the cerebrum, e, depression between the convolutions, h, horizontal fissure or line of separation, t, spiral cord, k, pyramidal body and /, the olivary body, two prominences situated at ihe head of the anterior columns of the spinal cord, m, the bridge of varolius, this bridge or whitish substance maintains and unites one half of the cerebellum with the other, and beneath which as under a bridge popes prolongation from the cerebrum, o, n, prolongation from the cerebellum to form the bridge, p, two small rounded eminences named from their form the mammillary, q, an enlarge- ment called the luber cinerium, 1, the olfactory nerve, * its bulb and * * its three roots. This is the nerve of smell, the bulb Ties upon a bony plate just above the nose, which is pierced with many holes, through which il sends many small nerves, branches to supply the membrane lining the nose, 2, the optic nerve, * * * the meeting of the nerves from the opposite sides called the decussation or crossing of the o|itic nerve. This is the nerve of sight, and when divided vision is entirely destroyed, nor is there any evidence that after the nerve to all appearance has been completely restored, that the function haj ever been returned, 3, 4, an I 6, nerves that go to the muscles of the eye, con- sequently they are nerves of motion, 5, the trifacial nerve so called because about the time that it emerges from the cranium it divides into three branches, all of which are distributed to the parts about the face, one of the branches goes to the eye and is called the ophthalmic, one goes to the teeth of the upper jaw and the other goes to the teeth of the lower jaw. The two last are called the upper and lower maxillary nerves. The two first are for sensation and the last for sensation and n> >tion, 7, the facial nerves, 8, the auditorv nerve, 9, the glossa pharyngial nerve which supplies the tongue and pharvnx,' 10, ihe vagus THE NERVOUS SYSTEM. 165 or wandering nerve which is distributed to three separate systems, the respira- tory, circulatory, and the digestive, 11, the hypo glossal or nerve of motion of the tongue, 12, ihe spinal accessary. Fig. 84. a, the cerebrum, b, the cerebellum, g-, the medulla ablongata, c, d, the medulla spinalis, or pith of the back bone. The brain and spine are repre- sented divided into two halves. 166 PHYSIOLOGICAL FAMILY PHYSICIAN. The medulla spinalis, (or pith of the backbone,) is .placed in a tube, or canal, formed by a curious arrange- ment of the projections of the. vertebral bones. This part is surrounded by a strong membrane, called its sheath, that gives additional protection to the spinal marrow. The medulla spinalis does not fill the canal in which it is placed, btit it is surrounded by a fluid, called the cerebro spinal fluid. It is largest in the*, neck, and loins; the middle of the back being much the smallest. It is also divided into two halves, each half is divided into two parts, or columns, of matter^ From the anterior and posterior columns of matter on each side, there arises many threads, or filaments of nervous matter. A, spinal cord. B, spinal nerve. C, motive branch of the spinal nerve. D, ganglion of the posterior branch of spinal nerve. Some of the two series of filaments unite to form a cord that is named a nerve. The filament coming from the posterior root is one of sensation. The one coming from the anterior root is one of motion; the offices of the two are different. The anterior filament contributing to the contraction of the muscular fibres, while the posterior imparts sensation to the different parts of the system. There are twenty-nine pairs of nerves, of sensation and motion, passing from the spinal marrow to the differ- ent parts of the system. These pass out at the foramina, or brakes in the sides of the vertebrae. If the anterior root be divided, sensation alone will remain in the part THE NERVOUS SYSTEM. 167 Fig. 86. A, A, Cerebrum, or brain. B, B, Cerebellum, or little brain. C, C, Crura cerebri, or union of the fibres of the brain. D, D, Crura cerebelli, union of the two sides"bf the little brain E, E, E, Spinal Marrow. 1,1, Branchesof the 5th nerve, so often noticed in this work. 2, 2, Branches of the sub-occipital nerves. S, 3, Branches of the four inferor cervical nerves and the first dorsal, 16S PHYSIOLOGICAL FAMILY PHYSICIAN. forming the axillary plexus, from whence all the nerves of the arm and fingers have their origin. 4, 4 4, 4, Branches of the dorsal nerves. 5, 5, Lumbar perves. 6, 6, Sacral nerves. » supplied with filaments from this nerve, but no motion can be produced. In some instances the diseased part has no feeling, but it can be moved freely. In such in- stances the posterior root is affected, while the anterior remains in a state of integrity. By this we learn that \ each nerve has enclosed in its neurilema, or sheath, a sensitive and motive filament of nervous matter. At the upper part of the spinal marrow, between the anterior and posterior columns, there is a minute tract of nervous matter; from which a set of nerves pass to the muscles which elevate the ribs in respiration; and likewise they are distributed to the diaphragm. These are called respiratory nerves. By the arrangement and provision of this set of nerves, the function of respiration is placed beyond the control of the will. Thus we cannot com- mit suicide by willing that we will not breathe,, as we otherwise might if the respirating muscles received nerves only from the anterior and posterior tract of nervous matter before described. The nerves of the upper part of the spine, pass to the muscles of the face, lips, and neck. From the lower part of the neck and upper part of the spine, several large nerves are sent to the arms, hands, and skin. This part of the system is more abundantly supplied with ner- vous cords than any other. Twelve pairs issue from the twelve dorsal vertebra, which pass along the lower edge of each rib, and are distributed to the muscles that pass between and over these ribs. From the loins several large nerves pass down the anterior and posterior part of the lower extremities. Upon each side of the spine there is seen several nodules of pulpy nervous matter, termed ganglions. These ganglions are connected with each other by small nervous cords. They are likewise connected with the cerebro spinal system of nerves, described as issuing from the spine. This system of nerves is named the sympathetic or ganglionic. From the main centre of THE NERVOUS SYSTEM. 169 Fig. 87. Ml'SCLES. *• A, Pectoral muscle, B, Deltoid muscle. C, Laslissimus dorsi muscle. D, Serratus major artticus muscle. E, Biceps flexor brachii. F, Round ten- don of the biceps, crossing the elbow joint. G, The broad expansion of the biceps, shooting Into the fascia of the fore-arm. H, Triceps extensor muscle. I, Brachius internus muscle, an auxiliary to the biceps. K, Coraco brachialis muscle, an assistant to the deltoides. L, Supinator brevis muscle, turns the palm of the hand and fore-arm forward. M, Supinator longus, operates in unison with the brevis. N, Extensor radialis longior, extends the fore-arm. O, Many flexor muscles of the fingers, all arising from one point. P, Flexor digilorum profundus, bends the joint of the fingers. R, Annular ligament of 170 PHYSIOLOGICAL FAMILY THYSICIAN. the wrist, bending the tendons in a groove. S, Short muscles, forming the ball of the thumb. T, Flexor and abductor muscles of the little finger. 1, 1, Radial nerve. 2, 2, Ulnar nerve. S, External cutaneous nerve. 4, Muscular spiral nerve ; supplies the flesh on the back side of the arm and skin. 5, A communicating twig. 6, Articular neTve, round the joint. 7, Internal cu- taneous, supplies the skin under side of the arm. 8, External cutaneous, again; passing through a muscle, and then becoming a cutaneous nerve. 9, Branch of the external, going to the back of the thumb. 10, Muscular spiral nerve. 11, A branch of the external cuianeous. 12, The radial nerve. 13, The ul- nar nerve. (Different views.) 14, A branch of,lhe ulna, to the back of the hand. 15, Distribution of the radial nerve to the thumb, fore-finger, middle and one side of the ring finger, lfy Distribution of the ulna nerve to the oihcr side of the ring, and both sides of the little finger. N. B. We have exhibited in this plate a mass of muscles and nerves, that the reader may have some idea of the complex machinery necessary to the perfection of one single limb." 2, The optic nerve, the nerve of vision, se- cond in ihe order, 3', Mo- tor Oculi or third pair arising from the brain. _ 4, Trachlearis or fourth ' pair. 5, Trigemini or » trifacial with the three great branches spoken of before A, First divi- sion of the li'lli nerve called the ophthalmic branch which divides again into B, the fronial nerve. C, The lachry- mal nerve. D, The na- sal nerve. E, Second division of ihe tifih nerve. F, That branch of it co- in" to the teeth and skin of the upper jaw. G, a ganglion. " H, Branches going to ihe palate and ihrnat. I, Vidian nerve. 6, Sixth nerve of the brain. R, Organ of the great tympalhelic nerve. L, Its additional branch from the vidion nerve. M, Branch ot the fifth nerve go- ing to the tongue. This is the nerve of motion. this system, which is immediately behind the stomach, there passes off a multitude of small nervous filaments, that surround and accompany all the arteries that mean- der through the system. These minute nervous fibres exercise an important influence upon the vital organs, as the lungs, heart, and stomach. Every artery of the system, if no larger than the smallest hair, is supplied with nerves. By the arrangement of these nerves, and THE NERVOUS SYSTEM. Fig. 89. f4r 171 A, A, A, A, semilunar ganglion and solar plexus ; B, smalt Splanchnic nerve ; C, great splenchnic nerve; D, D, D, thoracic ganglia, 10 or It in 172 PHYSIOLOGICAL FAMILY PHYSICIAN. number ; E, internal branches ; F, external branches attached upon the bod- ies of the vertabra ; G, right coronary plexus ; H, left coronary plexus ; 1, superior cervical ganglion ; J, inferior twigs ; K, external threads very slen- der ; L, internal twigs very minute ; M, anterior thread ; N, Middle cervical ganglion ; O, interior twi^s ; P, external twigs ; Q, superior cervical ganglion ; R, superior branches; S, inferior branches; T, external branch; U, sub- maxillary ganglion ; V, vidian nerve ; W, naso palatine branch ; X, spheno palatine ganglion ; Z, auditory nerve and membrane of the tympanum, con- taining within its cavity, four small bones of the ear, 1, renal plexus, 2 2, lumbar ganglia, 3, internal branches, 4, external branches, 5, aortic plexus. those that come directly from the brain and spinal mar- row, a mutual dependence is preserved among all the various portions of the animal frame. The conditions to be observed, for the development, health, and the proper discharge of the functions of the brain and nerves, will now be the subject of brief prac- tical inquiry. In pursuing this"' inquiry, I shall regard the brain, as the organ through which the mind acts. If this be true, the energies of the mind will depend some- what upon the state of the material organ, the brain. I shall not enter here on the question, whether the brain is an aggregate of parts, performing separate and distinct acts. This important question has been ably discussed by writers of great talent. To them I refer the inquirer. There may be distinct organs in the brain, and yet we may be unable to locate these organs, map them out, and describe their boundaries. That the mind acts through the brain, and that its vigor of action depends upon certain conditions of the brain, is illustrated in the child. While the cerebral organ is undeveloped, the mental powers are feeble ; but, as the brain attains ma- turity, its mental- vigor advances. The same principle is illustrated in fever. The brain in this affection be- comes diseased, and the mind, to use a common phrase, wanders, or is lost. This is the state called delirium ; and in such instance, as soon as the fever abates, and the brain is freed from disease, the mind is restored. The same is true in insanity. Let the deranged condition of the brain be removed, and the mental malady is remedi- ed. In these instances we see that the mind is most distinctly influenced by the condition of the physical or- gan through which it acts. ON THE HEALTH OF THE BRAIN. 173 ON THE HEALTH OF THE BRAIN. Th* first condition upon which the vigor of the brain depends, is the perfect primary organization of the organ. If a limb is deficient in amy part, from birth, the strength and action of that limh will always be more or less defective. This is also seen' in the eye- If any part is wanting, or defective, there will be imperfect vis- ion. So with the brain; if the whole of its organization, or any part of it be deficient, the defect will be manifest- ed in the mind. A sound and perfect condition of this organ is the sine qua non to healthful mental vigor. The defects of the brain may be hereditary, or they may be induced by injudicious training, which renders this organ unduly weak and excitable. An example of this is seen in petted and pampered children; and not unfrequently we see the same defect for which the pa- rent is noted, transmitted to the child. If both parents have a similar organization and! imperfect in some one particular, the constitution of the child will be more deeply affected, than if only one parent had the defect. For example, if both parents have a taint of insanity in their organization, the cerebral organ of the child will be more likely to suffer than if only one parent had the im- perfection-. This is one reason why kindred1 should not intermarry. Persons related by the ties of consanguin- ity, usually are similar in their organization. The second condition upon which the health, and develope- f»ent of the brain depends, is exercise. If a child's brain is not called into action, it will not be so fully de- veloped. The same results are seen in the muscles of the arm when not used. The blood vessels not being called into action, the pact will be inadequately nourished. So of the brain ; if it be used, more bbod will be invited to the organ. This increase of blood, in moderate quan- tities will give nourishment to the organ, and likewise increase its bulk. The effects of this are seen when we compare the size of the cerebrum, or thinking part of the a brain of the German, with the head of tha Hindoo. 15* 174 PHYSIOLOGICAL FAMILY PHYSICIAN. Wherever intelligence shoots forth in its richest luxuri- ance, there are found the most capacious brains. The brain of Bonaparte, in youth, was not of an unusual size, but untiring application in after years, rendered it of gigantic proportions. The same is true of Cuvier, the celebrated French naturalist. From this we learn, that this organ is increased in size in the same manner as the muscles of the laboring man's arm, but care should be taken that the amount of exer- cise be in accordance with the law of the organ. An- other illustration is seen in the case of a man who retires from active business; if he has no subject of thought, nothing to excite the brain, like the arm suspended in a sling, the vessels will become comparatively inactive, and the size of the organ will be diminished; also the manifes- tations of the brain will be shorn of their power. Thus, we notice that the heads of elderly men diminish in size, when not engaged in some active pursuit of life. In this case, the brain first contracts, and the cranial bones fol- low, as they adapt themselves to the size of the mass within. If inadequate action of the brain be adverse to the health of this part of the system, care should be ta- ken that this exercise be not excessive in a child. This is followed by a permanent weakness, as is seen in the over exertion of the adult. Likewise if the feeble and immature brain of the child be not only called into intense action, but that action be long continued, the tendency will be to exhaust the vitality and powers of the organ. We not unfrequenlly see the precocious child sinking into an early grave, or the powers of the organ becoming ex- hausted by the long continued and inordinate action of an immature brain. When the efforts are disproportioned to the powers of the organ, they produce an irritability that disposes the organ to respond to any thing that shall induce a deranged action. If this assertion be true, the practice of keeping the brain of the young child in con- stant exercise in poring over its books, is injudicious; the constant action of its vessels induces a great determination ofjalood to this organ, and other parts of the system being • inadequately supplied with this nutrient fluid, lose their OF THE HEALTH OF THE BRAIN. 175 healthy tone. While the brain is thus excited,,the ac- tion of the other organs of the system is depressed. The brain itself is not only impaired by this increased action, but the whole physical frame is weakened; thus, the anx- ious and solicitous efforts of doating parents, in many in- stances, tend to destroy their fondest hopes, and highest anticipations. The child is roused to undue exertion, by the promised offers of rewards; the high hope of rivalry being planted in his breast, induces him to tax the brain, disproportioned to its power. In calling into action the brain, four rules should be observed. 1st. This organ should not be called into ac- tion when other organs of the system are in a state of ex- citement. The action of the brain will divert the blood and nervous fluid from the organs thus acting, and they will be found inadequate to the task imposed upon them; thus, when the stomach is called into action in digesting food, the brain should not be excited in study or profound thought, or if the brain is thrown into a state of inaction, as in sleep, the stomach will not be duly stimulated by nervous fluid. In«the first instance, the energies of the brain are centered in itself, and consequently it imparts nothing to the other organs of the system. In sleep, in the second instance, as it is in a state of inaction, it gen- erates no stimulus, and can impart none to other organs. From this, we may see the impropriety of the practice of eating large meals immediately before retiring to bed at night, or after any considerable mental or physical ex- ertion. Those that violate this organic law, are usually incorrigible dyspeptics, nor can they recover until they refrain from mental labor, that keeps the brain in a state "of excitement, sufficient to produce a state of debility in the stomach. This is one of the reasons that journies, and vacations are often found so beneficial. The advice of Dr. Twitchell, of N. H., to a gentleman of studious habits, to purchase a flock of sheep, and tend them upon the declivity of the Green Mountains, was sound and physiological. 2nd. The different organs of the system, seem to have hours when they can be used to best advantage. Thus, 176 PHYSIOLOGICAL FAMILY PHYSICIAN. at the close of day, when darkness veils the- earthy the brain seems inclined to a state of inaction- This is in consequence of the windows through wb'tch'it' looks upon this external world being closed. Thus, the night is de- signed not only for inaction of the brain, but for other parts of the system. Hence, study and thought should be pursued in the morning, and earlier part of the day; this is necessary that the excited action* of the'vessels may subside before the hours of steep. Mr on the other hand, a different course is pursued", most persons will pass a sleepless night. 3rd. A judicious repetition* of the impressions made upon the brain, is as necessary in the education of this organ, as in the training, of any other organ of the sys- tem. This is an indispensable requisite, so that all the faculties of the mind may act harmoniously in grasping the subject to which the attention of the person is called. The repeated and judicious excitement of the vessels of the brain, increases the size and power of the organ, and the strength and power of tire mind is elevated in the same ratio. 4tfo. The brain should be supplied with a properaiaount of blood of a healthy character; this condition! is- abso- lutely necessary, that the mental functions be properly sustained. If the system is drained of bloodlto a certain extent, the functions of the organs are suspended, as is seen in the unconsciousness that persons exhibit in faint- ing, after bleeding. If the blood be drawn from the sys- tem-beyond a certain limit, the vitality is immediately de- stroyed. The same is trueif the blood becomes impure, as when- a person inhales carbonic acid gas. BEABACBE AND NERVO-USNESS- It is not uncommon, to* frntf individuals wlio have a sal- low, cold skin, the desire for food irregular, and what is eaten productive of pain, a distressed! feeling and dizzi- ness of the head7 and the nervous system easily excited. Under such circumstances, frequently, the individual seeks relief in medicine to quiet the nerves; in general, it gives HEADACHE AND NERVOUSNESS. 177 little or no relief. In such a case, what is the cause of the nervousness? We have seen that the blood is form- ed from the chyle. The chyle is formed from the food. To change the-food into chyle, the health of the stomach must be good. The stomach, not duly acting upon the food, the chyle is defective in quality and quantity. The chyliferous basis of the blood being defective, the blood itself must be defective through all the changes which it may pass. If the brain is not stimulated by blood of a healthy quality, and proper quantity, the manifestations of it will become irregular and defective. The same effects will be produced, if a person has not a supply of food. Thus, insanity is prevalent among the ill-fed peasants of Mantua and Milan. Ship-wrecked mariners that die of starvation and exhaustion, are always found delirious as the hour of dissolution approaches. The same is seen to be true in chronic, diseases of the intestines and lungs. Treatment.—In order to remove the disease of the brain induced be inanition, food must be given to the starving mariner, and the insane Milan. This will recruit the impoverished blond. The same is true of the condi- tions of the nervous system, that follow and attend dis- eases of the stomach and bowels. The diseased condi- tion of the organ must be removed, that the food can be taken with safety, and then the impoverished condition of the blood can be removed by a liberal allowance of food. Sometimes, we see a person extremely nervous; the di- gestive organs are in a tolerable state of health, but the individual works and sleeps in a vitiated air. The blood is not duly oxygenated in the lungs; it goes to the brain deficient in oxygen, and loaded with carbonic acid gas. In this case, the cerebral organ is not stimulated by blood of a proper quality. The lungs are the organs whose functions are defective, Hot being supplied with a suffi- ciency of pure air; to remedy this condition of the brain, the room must be ventilated, and 'exercise should be ta- ken in the open air. The skin should be attended to, by bathing, friction, and proper clothing. Let there be moderate mental and physical exercise. 178 PHYSIOLOGICAL FAMILY PHYSICIAN. In this affection take the medicine directed under the sections, on Liver Complaint, Dyspepsia, and Costive- ness. INJURIES OF THE BRAIN. In injuries of the brain, the symptoms are usually alarming, and all individuals should have some informa- tion for such contingencies. In general, such accidents are attended by insensibility; the skin and extremities are pale and cold, the pulse is very weak and feeble, and the circulation is much reduced in power; the respiration also, is less deep, full and complete, and is reduced in fre- quency. The prevailing opinion among the people is, that the person must be bled immediately, hence, their importun- ity to the surgeon to open a vein, and abstract blood. What is the effect of bleeding, upon the system? It re- duces the action of the heart and arteries; it also induces a paleness of the skin and coldness of the extremities. From this, we may learn that blood-letting is demanded, and should be resorted to, only when the action of the circulating vessels is too great, the skin hot, and the countenance flushed. In concussion of the brain, from a fall or blow upon the head, the activity of the heart is diminished, the skin and extremities are pale and cold; no blood-letting should be used until the action of the vessels of the system is reinstated, the beat and color of the skin restored; then, it is sometimes called for. Treatment.—In the first instance, the individual should be placed in pure air, friction, and dry warmth should be applied to the palid and cold skin; this-should be assidu- ously persevered in, until heat and color are restored to the skin and limbs, and due action of the heart and arte- ries has been established. Mila stimulants may be used internally, with much advantage; as the air should be kept pure, the sympathising friends should not be permitted to stand about the patient, as they vitiate the air, as explain- ed in the sections upon the lungs, and this is of vital im- portance. In these cases, respiration is diminished in ire- MANAGEMENT OF SICK ROOMS. 179 quency, which prevents the blood from being duly purifi- ed; add to this, air which is deprived of a part of its oxygen, and loaded with carbonic acid and animal exha- lations, and the blood must be still more vitiated. The lives of many have been shortened, and the struggles of death rendered more severe, by having the room filled with anxious and sympathising friends; this will apply to other diseases beside injuries of the brain; in diseases and injuries of the brain, and in diseases generally, no visitor should be permitted to enter the room, unless he has some duty to perform. SYNCOPE OR FAINTING AND FITS. Syncope or fainting, should be conducted upon similar principles; in this, there is a loss of consciousness, the circulation is feeble, the skin pale and cold, and the re- spiration less frequent than usual. This is generally the result of impressions upon the mind, impeded movement of the ribs, or vitiated air. Too frequently, the two last exist together, as in the cases of fainting in public assem- blies; in all cases, let the patient have pure air: remove the impediments to the free movement of the ribs and diaphragm, apply friction and warmth to the skin, and ever let the individual be in a recumbent position. Keep the room free of bystanders, as they vitiate the air, in- creasing the illness of the sufferer. Stimulants, as am- monia, camphor and water, would be good. If the fainting or fit continues a long time send for a physician. MANAGEMENT OF SICK ROOMS. The management of the sick room demands some at- tention; ordinarily, in air acute diseases, the sick cannot take food, as the digestive organs are impaired in their functions; the air also, being more or less confined and vitiated, tends to render the blood impure. Should the disease be of the lungs, the effect upon the blood would be very much increased in consequence of the consolida- 180 PHYSIOLOGICAL FAMILY PHYSICIAN. lion of the luug; under such circumstances, much watch- ful care is required on the part of the physician and nurse, to manage the food so that the disease may not be in- creased by the nutriment introduced, or the system pros- trated by its being withheld. The food should be under the guidance of the physician in each individual case. When the person is recovering from illness, the food should be given with regularity, and in quantities not so great as to oppress the stomach, and not loo frequently. (See Sec. on Digestion.) The room should always be well ventilated; too much air is preferable to a diminish- ed quantity. If a person is very sick, company should not be ad- mitted, for the reason that the nervous system is highly impressible, and the slightest noise affects it. This should be the governing rule in the room of the sick child, as well as the adult. Observation shows the contrary of this to be the common practice. Should we judge by the chattering, and news-telling, that is often heard in sick-rooms, we might safely conclude that the sick child was destitute of ears, or that it had an insensible brain. The attendant physician should direct, when com- pany is to be admitted, and when not, into the sick- room. No other individual knows so well as the physi- cian, the condition of the sick person. The duty de- volves upon him, and not on the nurse, or friends, of ex- cluding company when injury would arise from the ad- mission. In the matter of visiting the sick as friends, there should be no privileged class known by the physi- cian. FEVER. By authors and the people, fever has been divided in- to several varieties, as the brain fever, the lung fever, the billious fever, the typhus fever, &c. In domestic, as in professional practice, three divisions are of doubtful utility. " Fever is fever," one organ may have its function more disturbed than another, yet the disease i - FEVER. 181 remains essentially the same. The symptoms of fever are some chills or rigors, soon followed by heat of skin, thirst, increased frequency of pulse, with restlessness and loss of physical and mental strength. Treatment.—At the commencement, a mild emetic, as the Ipecac, or a mild cathartic, as the Castor oil, Rhu- barb, and Carbonate of Soda, or Senna and Manna, would be proper. This may be followed by some balm or sage tea. Rub the skin once in six hours with weak lye, saleratus and water, or pure water, always wiping dry and rubbing with a coarse crash towel. The bathing should be continued from day to day during the illness. After the first day, give daily some mild aperient or in- jective to keep the bowels open, but avoid large doses of physic. During the first four days give no food or nourishment, but diluted drinks, as the digestive organs are so enfeebled, that food will not be changed. See that the room is kept free from company and well ventilated. This is of in- calculable importance. The above is all the treatment demanded in common cases of fever. In severe cases call in a physician early. EYE. The eye is composed of the lashes and lids, the mus- cles that move the organ, the membranes that form the coats of its body, and the humors or fluids that distend the eye ball. The body of the organ is placed in a bony cavity called the orbit. This shields the eye from acci- dents. MOTIVE MUSCLES. The small muscles that turn the eye upward and down- ward, are six in number. At their posterior extremity they are attached to the bones of the orbit behind the eye. At their anterior extremity they unite to ihe cen- tral part of the external coat of the eye. Four of them are denominated the straight muscle, and two, the ob- 16 182 PHYSIOLOGICAL FAMILY PHYSICIAN. lique muscles, in consequence of their oblique move- ment. The internal straight muscles turn the eye in- ward, the external turns it out, the superior straight mus- cles rolls the eye up, and the inferior rolls it downward. The following engraving will give a good idea of the dif- ferent muscles of the eye. Fig. 90. This plan exhibits the muscles, viewed obliquely from the upper and outer side of ihe right eye. o, Tne eyeball. 6, Part of the upper eyelid. C, Tunica conjunctiva, or continuation of the common skin of the forehead, which turns over the edges of the lids, and is finally carried over the front • f ihe globe, but perfectly transparent at this point. d, The integuments of the right side of the nose. e, e, The optic nerve. /, Tho four straight muscles, with tho levator or raising muscle of the up- per eyelid, together with the superior oblique muscles, embracing* the optic nerve where it enters the orbit. g, The levator of the lid drawn aside. k Levator occuli, or superior straight muscle, to roll the ball upward. *'. Abductor occuli, rolls the ball outward. k, Abductor occuli, rolls it towards the nose I, Depressor occuli, rolls the ball downward, towards the cheek. m, The superior oblique muscle passing through the loop at. n, Called the trochlea, or pulley, but, in fact, a simple loop. o, Insertion of the stipet ior oblique muscle, in the eyeball. p, Tho inferior oblique muscle, taking its rise from a bone. q, The insertion or the tendon . f the inferior oblique muscle in tbe fir«t con M the ball. COATS OF THE EYE. 183 STRABISMUS OR CROSS EYE. When the eye is permanently turned inward or out- ward, it is the squint or cross eye. If the eye is turned inward toward the nose, the internal straight muscle is shortened or contracted. If it is turned out, the external muscle is the one that is contracted. The causes of this are various ; hooping cough, convulsions or fits,~ may cause it, inflammation of the eye and muscle may produce it, also imitating cross eyed persons, may cause it. In all cases the vision of the oblique eye is impaired. This results from the inability to direct both eyes towards an object at the same time. Treatment. Divide the shortened muscle, by cutting down upon the eye. This is easily and safely perform- ed. When the eyes are brought parallel, the impaired vision of the eye that had been oblique will become good. COATS OF THE EYE. The body of the eye is covered with three coats 01 membranes. They are fitted the one within another like a nest of boxes. Fig. 91. This figure is the plan of the coats, or as they are sometimes termed, tunics. • Reference should be made to this after read- ing the text. The natural figure of the eye, in outline, is preserved. a, The sclerotic, or first hard tunic. b, The choroid, or fleecy tunic. c, The retina, or third and inmost tunic, which is an expansion of the optic nerve g, the certain seat of vision. d, The cornea, or prominent transparent cir- cle, over which the lids close in winking. e, The crystalline lens, or little magnifying glass of the eye, about a quarter of an inch in diameter. /, Is the space filled by one of the fluids of the eye, and called the anteriot chamber. g, The stump of the optic nerve, which is prolonged into the substance ot tho brain. 1st. The first coat is called the sclerotic. It is thick and firm, and posses sing but little sensibility. Its firmness and hardness give form to the eye. 2d. The second coat is named the choroid. It haB a dark red color, and i> but little connected with the first. This tunic is a complete web of arterier 184 PHYSIOLOGICAL FAMILY PHYSICIAN. and veins ; hence its reddish hue. There is upon the inside of this mem- brane, a fleecy nap similar to velvet, called the tapetum. 3d. The third coat is called the retina, so called from its resemblance tea net. Nothing can be more delicate, so much so, that it cannot bear its own weight. It is an expansion of the optic nerve, the immediate seat of vision. 4th. At the anterior parts of the eye, there is {a clear, shining wall, that ro- sembles a watch crystal. This is called the cornea. It is formed of thin, transparent plates held together by a spongy elastic substance. The spark- ling brilliancy of the eye is produced by an oily substance, that is continually oozing out of little glands that are lodged under the first plate. 5th. In viewing the eye, we see a vertical partition. This is called the ii-m. In color it may be black, blue or hazel. It has a central orifice, that is denominated the pupil. This contracts in a strong light, and dilates when the light is feeble. HUMOURS OF THE E1E. By humours, are meant the fluid that distends the body of the eye. They are three in number, the aqueous, the crysteline and the vitrious. Their situation can be learned frorft the following engraving. Fig. 92. This plan presents a longitudinal section of the left eye and orbit. a, The upper eyelid shut. b, The cornea". c, c, The cut edges of the iris. d, The pupil or round hole through the centre of the iris, which, in the living eve, resembles a black, highly polished dot. t, e, The cut edges of the sclerotic and choroid tunics, with the retina, before exhibited in the preceding drawings. /, The crystalline lens, as it is lodged with reference to other parts. g, g, Thr ciliary processes continued from the choroid coat. The plaits are here distinctly seen. IMPAIRED VISION IN OLD AGE. 186 A, The optic nerve, running from the brain, through the bones, to the globe of the eye, apparently closely embraced by the straight muscles. i, The levator muscle that raises the upper eyelid. k, The upper straight muscle of the eye. I, Inferior straight muscle, its antagonist, on the under side of the bal called depressor oculi. m, A section of the inferior oblique muscle, used in rolling the eye upward and inward, as in looking at a button laid above the root of the nose. The su- perior oblique, passing through a loop, carries the eye downward end outward, as in looking at the lop of the shoulder. These two 'muscles, by old writers, were termed rotatorcs and amatores, in allusion to their office of rolling the ball in expressing passions. n, n, A section of the blood-vessels and nerves, with a .large quantity of fat surrounding the optic nerve. 1st. The aqueous humor is the first in the order of demonstration. It lies directly back of the cornea, and most of it is anterior to the iris, a small part of it lies behind the iris ; thus, we learn that this curtain lies in a fluid, that keeps it moist, and prevents it, from becoming dry and shrivelling. This fluid is very clear and is frequently changed. If it is drawn away, it is reproduced in a very little time. This fluid keeps the cornea prominent, and always at a distance from the iris. In old age the amount of this humor diminishes, and tho eye flatten f. It is likewise less frequently changed, and becomes turbid and less transparent. This is one cause of impaired vision in old age, 2nd. The second humor is called the crystalline lens. It is a small body like a button, somewhat resembling pure flint glass. It is convex on both sides re- sembling the common sun glass. Its posterior convexity is greater, than its an- terior, thereby bringing its rays to a point a little way behind it. This lens is made of a series of plates, applied to each other like the coats of an onim. The centre is firmer than the edges. 3d. Behind the aqueous and crystalline humors, we find a third named the vitreous. This humor is kept in its place by being lodged in erlls. Like the preceding humors it is transparent, allowing the rs^ys of light to pass. NEAR SIGHTEDNESS. This is produced by the crystaline lens; being too convex. This may be congenital it may be produced by disease, or by improper use of the eye, as habitually holding a book or work very near the eye There are many more near sighted artisans and scholars, than near sighted farmers, sailors and hunters. The eye is very differently used in the two different classes. Treatment. The only remedy to be depended upon, is the use of concave glasses. IMPAIRED VISION IN OLD AGE. Among old persons we see that the ball of the eye becomes flattened, and the deficient humors become less convex. The remedy for this, is the use of convex glasses. These must be adapted to the eye of the per- son, and the condition of the eye. 16* 186 PHYSIOLOGICAL FAMILY PHYSICIAN. JUNICA CONJUNCTIVA OR SKIN OF THE EYE. The skin turns over the edge of the upper eye lid, passing about three fourths of an inch back, where it strikes the ball of the eye, to which it is made fast. It it folded back upon itself, adhering to the whole anterior surface of the cornea. It dips down and mounts over the lower eye lid, then looses itself in the skin of the face. This membrane is transparent. This is the por- tion of the eye diseased in common inflamed, sore and weak eyes. INFLAMMATION OF THE EYE. Every part of the eye may become inflamed,* but the conjunctiva is its common locality. The causes are various, as dust, blows, and long continued use, &c. Treatment. Take a small portion of some laxative medicine, as the Epsom salts, rhubarb and carb. soda. Let the food be unstimulating and moderate in quantity, remain in a room faintly lighted, using the eye but little, sponge around the eye with warm water, or vinegar and water, and washing the eye with warm water, or milk and water, or a decoction of poppy Jeaves. A wash of green tea is very good. The following \s a good eye wash. R Acetate of Lead, 20 grains. Sulphate of Zine, 20 grains. Laudanum, 1 drain. Water, 1 oz. Mix. This may be used once in six hours, after the acute inflammation has abated ; blistering the arm or back of the neck may be of much service. THE EAR. The ear, that organ by which we are made sensible of the impression of sound, is a very complicated instru- ment, and a beautiful piece of mechanism. The appa- THE EAR. 187 ratus of hearing, is placed in a bone, called the tempo- ral. The following is an engraving of the temporal bone. It is situated on each sidj^of the head. Fig. 93. I. The squamous or thin portion,2, 2, the petrous portion. 3, tne mastoid process behind the ear. 4, the sty- loid process. This apparatus consists of the external ear, the tube leading to the tympanum or drum of the ear, four bones, named the malleus", incus, orbiculare, and stapes. Fig. 94. This figure represents the four bones of the natural size. Tho smallest of these bones is matured at an early period of life. The smallest bone is represented magnified. The internal ear is called the labyrinth. This con- sists of several tubes, called the semicircular canals, and a spinal tube'resembling the shell of the snail, hence it is called the cochlea. These semicircular canals, and the cochlea contain a fluid, named the liquor cotunnjs, from Cotunnius, the anatomist that first described it. In this fluid the pulp of the auditory nerve is found floating. The following engraving represents the semicircular ca- nal, and the cochlea. 1S8 PHYSIOLOGICAL FAMILY PHYSICIAN. Fig. 95. In this engraving, the semicircular canal, and cochlea are represented as divided, exhibiting'the appearance of the cavity, in which the fluid of cotunnius, and auditory nerve are situated. Fig. 96. THE EAR. 189 There passes from the back part of the nostril, to the middle ear, where the four bones are situated, a tube or canal that is named the Eustachian, from an anatomist that first described it. Fig. 97. "a, ihe ex'crnal ear; b, the semicircular canals ; c, the meatus, or toba from the extreme concha to the tympanum ; d, spicula of bone, not essential to remember ; e, the incus ; f, the cochlea ; g, the drum of the ear ; h, the vestibule; i, the Eustachian tube; k, the tympanum, in which the little bones are placed. Tho Eustachian lube terminates, and the oval window opens into the vestibule.'' Impressions are first made upon the tympanum, which is put in motion. This trembling motion induced in the drum of the ear, is communicated to the bones of the ear, as one of these bones is placed in contact with the tympanum. The last of the bones in the middle ear, named the stapes, or styrrup bone, connects with the semicircular canals. The fluid contained within these canals is put in motion, and this movement is communi- cated to the extreme or pulp of the auditory nerve. This impression i& communicated to the brain. 190 PHYSIOLOGICAL FAMILY PHYSICIAN. Fig. 98. I. The outer passage, about an inch in length, the tower edge being rather longer than the upper, which terminates at 2, the membrane of the tympanum, « LMin word signifying drum ; 3, the mallet, with its handle restiujj against ihe tympanum, and iis head upon 4, the anvil, the lonL' narrow neck, of which terminates in a rounded knob by which it is connected with ihe head of the stirrup; 5 the window of the vestibule closed by the s'irrup ; 6 the win- dow at which terminates the ladder of the tympanum ; 7 the vestibule with the openings of the semicircular fanals ; 8 the supciior, 9 the horizontal, 10 the oblique semicircular canals ; an opening has been made to show the common termination of the superior and oblique semicircular canals in the cavity of the tympanum ; 11, II, 11, the ladder of the vestibule, with ns t,\o turns and a half; 12. 12, 12, the ladtfer of the lympai.tim. with its two turns and a half; both ladders terminating in the cupola; IS'the internal auditory passage ; 14, ihe Eustachian tube,, by which a communication is kept up between the cavity of the tympanum, and the back part of the nr«- irds and mouth ; 15, ihe'chord of the4gfcpa«um, a nerve passing through the tympanum ; t6, the styloid process^T7*a nerve called the kara^ portion ; 18, the mastoid process. ■** . IMPERFECT HEARING AND Di:AFNES9. Imperfect hearing is very common, and it results from many causes. Some of these causes can be re- moved, and the deafness consequent upon it relieved, and some cannot be. I will briefly name some of the IMPERFECT HEARING AND DEAFNESS. 191 most common causes of deafness. Deafness may be produced by a thickening of the tympanum. It is the result of inflammation, usually of a chronic character. This thickening destroys the vibratory character of the drum. In such instances, relief is obtained by seeking the aid of the surgeon, and getting relief for the inflam- mation. Blisters behind the ears would be good for deaf- ness produced in this way,'or a weak solution of the aceate of lead. In some instances, the cerumen or wax of the ear, becomes viscid or thick, and accumulates upon the drum of the ear, destroying or impairing the resonancejjf the drum. This can be remedied by put- ting a few drops of oil into the ear, and in a few hours after injecting some warm soap suds into the ear, with a small syringe. The oil softens the viscid wax, and the injection removes it. Any kind of animal oil may be used for this purpose, and will be found as subservient as the patent oils recommended for this purpose. The most common cause of deafness is, inflamma- tion and swelling about the throat : this is seen in ca- ses of scarlet fever, or canker rash, which is caused by the inflammation affecting the commencement of the Eustachian tube, behind the nostrils. Soreness of the throat, swelling or enlargement of the tonsils, is often- times attended with difficulty of hearing; in these cases, if the mouth and nose be closed, and a forcible effort is made to expel the air from the lungs, no air will be felt passing into the ear, as in a sound condition of the parts. The Eustachian duct in these cases, is closed. In such instances, the nostrums put into the ear, do no good ; they do not reach the disordered part. Means to re- move the inflammation from the throat will be of bene- fit; the application of such means, should be under the direction of the understanding physician. If the tonsils are enlarged, have them removed ; the operation causes but little pain, and is not dangerous. Deafness may be caused by disease of the internal ear, or the brain; such cases are difficult of cure. The deafness will not be re- moved until the affection of the brain is removed. DIRECTIONS FOR PREPARING SUITABLE DRINKS AND FOOD, FOR THE SICK. ______ v BARLEY WATER. ".Take of pearl barley, two ounces; water, two quarts. First wash the barley well with some cold water; then pour on about half a pint of water; boil it a little while; this water, which will be colored, must be thrown away. Bring the two quarts of waier to a boiling heat, and then add the barlfjv; continue the boiling till the whole is re- duced to one quart, then strain off the liquor. This may be sweetened or seasoned as directed by the medical at- tendant. perature of new milk. PURGATIVE INJECTION. Take of senna leaves, an ounce; coriander seed, (bruis- ed,) a drachm; boiling water, one pint. Put these to- gether in a covered vessel; let them stand an hour, then strain off, and add molasses, one table-spoonful; salt, one table-spoonful. Stir them till the salt is dissolved, and the temperature reduced to blood heat. STARCH INJECTION. Take of pure starch, two tea-spoonfuls; water, one pint. Mix the starch with the water, by gradually adding it in small quantities till there are no lumps; boil the whole together till a ropy fluid is formed; strain this through a cloth, and it is fit for use." POULTICES. 11 In the course of_,attendance upon patients, physi- cians not unfrequently have occasion to direct the appli- cation of poultices. These are almost always designed to exert a soothing and softening influence on the part to which they are applied, and are therefore always to be kept moist; and should be changed as often as they be- gin to be in the least degree dry. The edges of the poultices are too frequently spread much thinner than the centre. To prevent this,jt will be proper to take a piece of thick linen or muslin, an inch longer and wider than the size intended for the poultice, on this spread the pre- pared materials, as nearly as possible of one thickness, to within an inch of the edges, then turn up these edges into the margin of the poultice. By this means the poul- tice will be kept of uniform thickness, and eveiy part of it which is in contact with the skin can be kept equally warm and moist. A piece of thin mull-muslin, book- muslin, or something similar, may, very often, be spread over the surface of the poultice, to be applied next the skin. It is a good general rule, when poultices are to be removed, to have the new one prepared and close at hand before the other is taken off. The parts are thus kept moist, and at nearly the same temperature, a matter of much importance in all cases in which poultices are need- ed. When these remedies are ordered by the physician, the nurses should inquire whether he wishes them to be warm or cold, and prepare them accordingly. BREAD POULTICE (COMMON POULTICE.) Take of bread any quantity, put it into a vessel, and pour over it boiling water enough to cover it; continue the boiling till the bread is perfectly soft, stir it till it is 204 PHYSIOLOGICAL FAMILY PHYSICIAN. well mixed, withdraw it from the fire, and as it cools, stir into it oil or lard enough to keep it soft. Milk has mostly been used in making this poultice, but lit quickly sours in warm weather, and is more expensive, while it is less conveniently obtained than water. INDIAN-MEAL POULTICE. Take of Indian-meal, five parts; rye flour, one part. Mix them together, and let them fall in small quantities at a time from the hand into a little boiling water, stirring well all the time, till the mass becomes thick, then add oil or fresh lard, to keep the mass soft. A less expensive, and equally useful poultice, may be made of rye shorts, or wheat bran, by stirring either of these into a little boiling water till quite thick, then add- ing oil or lard as the poultice becomes cool. Poultices may be made of potatoes, turnips, or carrots, by removing the skin, then boiling them soft, and mash- ing them very well, and adding some oily substance to keep them moist, and prevent them from sticking to the skin. The carrot poultice is sometimes made by grating the fresh root into a soft pulp, and applying it without boil- ing. APPLE POULTICE. As rotten apples are not always at hand, and when they are to be procured, they are generally wormy, it will be better to prepare this poultice from the ripe fresh ap- ple; for this purpose, pare and core any convenient quan- tity of apples; stew them till soft; stir them while boil- ing, till well mixed; then spread the pulp upon the cloth, as already described, and place over it the thin muslin to be applied next the skin. HOP POULTICE. Take of hops, a large handful; boil them fifteen min- rouLTKKs. 205 utes in a pint of water in a covered vessel; strain off by forcible pressure; put the fluid again over the fire; keep it at nearly boiling heat, and thicken it with bread-crumb, Indian-meal, or wheat bran, as may be most convenient; mix a portion of lard or oil as directed in the composition of other poultices. HOP BAG, OR HOP FOMENTATION. Put into a muslin or thin flannel bag, size of the part to be covered, a quantity of hops, sufficient to fill it half full; sew up the mouth of this bag; put it into a basin, and pour over sufficient boiling water to cover it; let it stand fifteen minutes open to the air, that the water will admit the hand. Having the part prepared to which the fomentation is to he applied, take it out of the water, wring it half dry, and apply it to the place as warm as can be borne, or at the temperature ordered by the phy- sician. Place another bag of the same size and kind in the fluid, keeping it hot till ready for application. Con- tinue alternating these as often as one becomes cool and the other warm. THE HOP PILLOW Is prepared as above, except that the hops are merely moistened with spirits to keep them from rustling, instead of hot water. STARCH POULTICE. Take of starch any convenient quantity; mix it care- fully with a little boiling water till it makes a stiff mass; as it cools stir in a little lard or oil. SLIPPERY ELM POULTICE. Take of slippery elm (in powder), any convenient quantity. Stir this gradually into a little water till it is 18 206 PHYSIOLOGICAL FAMILY PHYSICIAN. thick; boil it five minutes, and spread it out on the poul- tice rag, as before directed. YEAST POULTICE. Take of wheat flour, one pound; yeast, half a pint. Mix them together over a gentle heat till the mixture be- gins to rise; then apply them as other poultices. MUSTARD POULTICE. Take of flour of mustard, flaxseed meal, each an equal quantity. Mix them into a paste with water; add oil or lard to keep the poultice from sticking to the skin. Indian-meal, wheat flour, or powdered bread will an- swer nearly as well as the ground flaxseed. The vinegar mostly directed, does not increase the value of the rem- edy. A fine rag should be interposed between the poultice and the skin; and great care should be taken to remove the whole from the surface as soon as the skin has ac- quired a scarlet redness. SPICE POULTICE, OR PLASTER. Take of powdered allspice, cloves, cinnamon and gin- ger, each equal quantities; rye meal, honey, or molasses, sufficient to make an adhesive mixture. Spread it on a linen or muslin cloth, and apply it as directed. SPICE BAG. Take of the powdered spices directed for the spice poultice. Mix them well together in a dry vessel; put them into a bag of thin flannel size ordered; spread them out; quilt the bag lightly to keep the spices from falling into a mass; spread the bag into a dish, and pour over it sufficient quantity of hot brandy, spirits of camphor, or whiskey, to soak through the bag and make it quite moist. Apply it warm to the part directed. This is better than POULTICES. 207 the spice poultice. It can be removed or changed as often as directed. ALUM POULTICE. Take the whites of two eggs; a piece of alum, size of a chestnut. Put them into a saucer and stir them briskly till the white has well curdled, take out the alum which is undissolved and spread the poultice out between two folds of cambric or fine linen." MECHANIC!, CUKE OF CHRONIC DISEASES. In the community many are found, who complain of weakness, difficulty of urination or passing the water; Costiveness, sometimes attended with Diarrhoea, Piles; faintness, flatulency or wind, and sourness of the stomach; pain in the bowels, back, and in the sides, especially be- tween the shoulders and at the lower part of the spinal column, palpitation of the heart, shortness of breath, with cough and weakness of the voice. With such conditions, we find the chest depressed or somewhat flattened, a sink- ing of the stomach, with a fullness or prominence of the lower part of the bowels. This condition of the system is attended with pain in the head, debility and pain in the limbs, dry, pale, sallow skin, attended with cold feet. When the muscles or walls of the abdomen are not relaxed, as seen in Fig. 99, they support and press up- ward and backward, the large and small intestines. In all cases of chronic disease, when the abdominal muscles (or flesh) are relaxed they cause a weakness and protrusion of the bowels, as seen in Fig. 100, and the intestines under such circumstances are not duly supported. Consequently they press downward upon the urinary bladder, as seen at H. Fig. 100, causing a difficul- ty of urination and symptoms of the gravel. The Ute- rus also being pressed upon, sinks or falls below its nat- ural position, causing the Prolapsus Uteri or falling of the womb. The following are the symptoms of this disease. Thera is a sensation of sinking or fainting at the stomach, weak- CURE OF CHRONIC DISEASES. 209 Fig. 99. I,represents the Rectum, or low-. er part of the intestinal tube. H, the uterus, or womb, rising to a level with the bladder at G. B, and D, represent a section of the spinal column or back bone. C, shows the convexity and situation of the diaphragm, as it exists in the cavity of the chest, in the act of expiring or breathing out the air from the lungs. The line L, shows the plane to which the central por- tion of the diaphragm descends, in ihe act of inspiring or breathing air into ihe lungs. ness and pain in the side and back, shortness of breathing, dragging pain in the lower part of the bowels, groins and back, weakness, numbness and swelling of the lower limbs, bearing down pains in the. region of the womb, at- tended with female weakness and difficulty of urination. All these symptoms do not exist in every case of the Prolapsus, but some are found in every case. One of 18* 210 PHYSIOLOGICAL FAMILY PHYSICIAN. I, represents the rectum. J. the uterus. H, the urinary bladder. D and E. the spinal column* A, tha d aphragm, and its convexity in ihe centre, while exhaling air from the lungs. L, the position while inhaling the air into the lungs. B represents the che3t flattened, and the stomach depressed and hollowed in. C rep- resents the walls of the bowels relax- ed ; consequently they sink down anil become tumid and prominent in this part. Compare this with Fig. 99. the most certain indications that this complaint exists, is the circumstance that the woman thus troubled, is always made worse after standing, walking, washing, fyc. Such patients are universally worse, the day after exer- cising, and frequently confined to the bed. Many wom- en thus diseased, cannot walk a long distance. This CURE OF CHRONIC DISEASES. 211 affection is usually preceded and attended by costiveness. The appetite is faulty, skin dry, and the person very nervous. The latter is a very common occurrence. This complaint is one that is but little understood by la- dies generally, yet very many are suffering from it. The intestines becoming depressed, support is not given to the liver, which is situated on the right side, or to the spleen, which is situated on the left side ; consequently, these organs are depressed, causing pain in the side ; the stomach also, not being, supported properly by the intestines, sinks, causing a sensation of faintness, some- times a sense of fullness and not unfrequently loss of ap- petite. The diaphragm, letter C. fig. 99, not being duly sup- ported by the liver and stomach, loses its convexity as seen at A, fig. 100, and due support not being given to this organ, it also loses its tone and contractile power, and sinks below the straight line seen at L. fig. 99, and becomes convex downwards, as seen at L. fig. 100. When the diaphragm assumes this position, there is a flattening of the chest, also an irregular action or palpita- tion of the heart, shortness of breath, cough, feeble- ness and inability to speak. The symptoms above alluded to, not unfrequently cause the individual thus affected to lean forward, to force the depressed organs upwards. The nerves of these deranged organs become irritated, and this irritation is transmitted to the spinal marrow or pith of the back bone, pahi and weakness of the limbs, particularly the lower extremities follow this condition of the nerves, which renders the person extremely nervous. The large and small intestines, need the stimulation of the active contraction of the abdominal muscles and di- aphragm, to keep them in a healthy state, and when the tonic contractibilily of both is diminished by this relaxed condition of the muscles, the bowels become inactive, producing constipation or costiveness, or this, alternating with a diarrhea] discharge. Contraction followed by relaxation is a law of the mus- cular system. But in fever, and chronic diseases of 212 PHYSIOLOGICAL FAMILY PHYSICIAN. the lungs, heart, stomach, liver, and intestines, the mus- cles or flesh become soft and flabby, attended with fee- bleness, and frequently relaxation, and these muscles having lost in a measure the power of contracting, become permanently relaxed. As the abdominal mus- cles assume the relaxed state with other muscles of the system, the intestines sink to the lower part of the cavity as before described, and while thus enfeebled, they can- not give due support to, or raise the already depressed organs. If a piece of India Rubber be extended, being attach- ed at each end to fixed points, and a weight be put in the centre, it will yield by still further elongation, and the centre will become depressed. While the loeight re- mains, the rubber will not contract, so as to elevate the central, depressed portion to a level with the points of attachment. So it is with the relaxed abdominal muscles. They are enfeebled and overstrained by the weight of the intestines, and as long as this condition ex- ists, the muscles cannot contract or shorten, so as to el- evate the internal organs, as seen in fig. 100, to their nat- ural position as seen in fig. 99. If the weight be taken from the India Rubber, it will contract, and the depressed centre will be elevated. But the weight of the liver, intestines, &c. cannot be re- moved from the abdominal muscles, while life continues ; consequently, relief by this means is not attainable. But the contraction of the rubber may be assisted, by sup- port bein"' given under the central depressed^ portion, and thus the centre will be elevated to a plane with the extremities. So a supporting cushion, or pad, may, and can be applied to the projecting abdomen, at C. fig. 100. The muscles thus supported and assisted, will be enabled to contract and bring the abdominal organs into a healthy and natural position. The following cut represents a Spino Abdominal Sup- porter, invented by Calvin Cutter for the relief of this relaxed condition of the muscles, which occurs in the male and female system. A side and front view of the CURE OF CHRONIC DISEASED. 213 instrument, and the manner in which it is applied, is giv- en in fig. 101 and 102. Support is given by this instrument, to the lower pro- truding part of the abdomen, seen at C, fig, 100. On examining this figure, it will be seen that it is necessary to make the pressure not only backward, but upward at the same time. By the oblique position of the front elliptic spring, and the upward direction of the lateral main spring, this compound pressure is effected. In instances where bandages are thrown around the weakened and depressed bowels, the pressure is only backward, and the bandages are usually applied too far above the protruding bowels to give the required sup- port. As the muscles of the system are elastic, so should all supporting articles possess the same quality. In the in- strument represented by fig. 101 and 102 the elasticity is obtained by means of elliptic and spiral springs; and so elastic is it, that it yields to every movement of the ribs and bowels; consequently it is worn with ease and com- fort by lady or gentleman. The lateral pads give sup- port to the large intestines, liver and stomach. The up- ward and backward pressure given at the same time by this instrument, is not to be found in any other mechani- cal support used for this kind of ailment. By the upward pressure of the front pad, the contrac- tion of the abdominal muscles in front is effected, causing an elevation of the intestines; and this elevation frees-the bladder, as seen in fig. 100 and brings the organs into their proper situation, as seen in fig. 99. By this me- chanical support, gravel, and urinary complaints are re- lieved and cured. Thus every individual afflicted with such complaints, would avoid much suffering, when stand- in?, walking, or lifting, by support of this kind. "The uterus, also, being relieved of the unnatural weight of the intestines, as seen in fig. 100, will rise to its nat- ural position, as seen in fig. 99. The bearing down pains experienced by females, the leucorrhea and its attendant symptoms will be remedied—the intestines being elevated and brought to their natural position—the liver, upon the 214 PHYSIOLOGICAL FXMILY PHYSICIAN. Fig. 101. Fig. 102. I), in fig. 101, an I A. 102, represent an elastic front pad ; upon this front pad is an elliptic *pi i ig. placed obliquely to ihe pad. This spring is attached to the band connecting the t«o lateral main springs by a clasp. The lateral or main >prinj ex ends upward over the haunch bone, on both sides, s?en at C. Above the 1'rmi pad, and within the haTiTuh bone, upon each side, there is attached to ihe main lateral spring, two lateial elastic pads, shown by B, in figs. 101, and 10-2. A, the p-iMerior extremity of each of the lateral springs, an elastic pad is attached, seen in fi,;. 10-; at fJ. right side,—the stomach and spleen on the left, will be duly sustained by their elevation; and from this cause the tension of their ligaments will be removed, and pain in the side relieved. The stomach being properly support- ed, the faintness, flatulency, and distress after taking food will be remedied. The liver and stomach be'ng sustain- ed in their natural position, due support will be given to the diaphragm, and thus favor its healthy contractile ac- tion.' The heart and lungs receiving due support from the internal organs at their base; shortness of breath, palpitation of the heart, cough, difficulty of speaking are removed upon Physiological principles. These organs, viz. Heart, Lungs, Stomach, Liver, and Intestines, assuming their natural position, the irritat- 76 CURE OF CHRONIC DISEASES. 215 ed nerves of the spine will become healthy, and thus re- lieve the pain of the limbs and back. The intestines be- ing supported by their appropriate muscles, the leaning and stooping posture is not called for, and through the erect posture, the weakness of the muscles of the back is at once relieved. The relaxed abdominal muscles, and dia- phragm, being sustained, the intestines are thereby stim- ulated to a healthy and efficient action, preventing and wr- ing that inactive state of the bowels, termed costiveness, as well as diarrhea, with colic pains, together with that painful disease, the piles. The pain at the lower part of the back is relieved by the support .given by the back pads. There are thousands in the community, now laboring under the symptoms before described, who have taken all -the popular remedies for diseases of the liver, lungs, stomach, bowels and spine, without benefit, which may be cured in a few weeks by the above described mechani- cal means. The understanding, clear-headed physicians, are now directing their attention to this method of medication. Objections are sometimes raised, that they may do in- jury. To this, I will invite your attention. The instru- ment is applied to the lower part of the bowels and back, as seen in fig. 101 & 102. The lateral springs are im- mediately above the haunch or hip bone. The large blood vessels, and nerves, the liver, heart and lungs re- ceive not the least compression, and in this it differs ma- terially, from the corset lacing process. The pressure of the front pad is upward, and it is made with no more uneasiness, than pressure not unfrequently made by the hand. Pressure upward is grateful, and attended with little or no pain, whereas, pressure backward, is attended with pain and uneasiness. The objections against com- pression of the chest and upper part of the bowels, can- not be brought against pressure being made at the lower part of the bowels on physiological principles. Another objection that may arise, is, that the instru- ment once used it must always be worn. This is not true. A muscle that is kept a long time in a state of un- 216 PHYSIOLOGICAL FAMILY PHYSICIAN. natural tension, becomes exhausted, and loses the power of contraction. A proof of this is shown in an over- strained muscle. The muscles of an arm when kept in a sling for a long time become contracted or shortened, and when taken out, it is with difficulty that the arm can be extended. The reason is, that the muscles acquire an increased con- tractile power, the same results will follow the mechan- ical support to the abdominal muscles. They are relax- ed, and need an increased degree of contractile power. This they cannot acquire, while compelled to support the bowels in their enfeebled, weakened state. Support them for a few weeks, and the fibres of the muscles, will acquire their contractile energy; and when this is obtain- ed, they will support the bowels without foreign aid. The truth of the above statements, I have seen veri-« fied in many cases. Many certificates of cure might be given, both from physicians and patients, of the following character. Case 1.—Dr. K. of H., Mass., was frequently call- ed to Mrs. B., who was afflicted with costiveness, female weakness or leucorrhea, pain in the sides and lower part of the back, a bearing down sensation when walking or standing, difficulty of urination, and faintness at the stom- ach; these symptoms were much increased by continued rapid exercise, which rendered her extremely nervous. She had taken much medicine, of both mineral and bo- tanical character, but had found only temporary relief— finally, Dr. K. recommended the trial of an abdominal supporter, which was procured, and gave permanent re- lief. Mr. B. called on the Physician, two years after, to thank him, for his last, and effectual prescription, say- ing, at the same time, that the instrument had saved him more than one hundred dollars. Case 2.—Dr. H., of Providence, R. I., was visit- ed by a lady from Mass. to obtain relief, in a case of similar symptoms, described in Case 1. She left home, thinking it would be necessary to remain there six or eight weeks. Dr. H. after an examination of her case, advised a small portion of common aperients, and obtain* CURE OF CHRONIC DISEASES. 217 ed for her a supporter. After using the supporter two weeks, she returned to her family cured—not by medi- cine, but by mechanical support to the abdominal mus- cles. Case 3.—Mrs. W., of H., Mass., consulted Dr. C, of W. for a weakness of the bowels, difficulty of urination, shortness of breath, cough, &c. Dr. C. di- rected that she should give attention to the skin by bath- ing, and flannel clothing, also, some mild opening medi- cine, and applied likewise, a Spino Abdominal Support- er. In a few days, the cough and other symptoms were relieved. Case 4.—Mr. H., a tailor, of S., Mass. had been afflicted with pain in the left side for many years. Cup- ping, leaching, blistering, liniments, and washes had been tried with no avail ; I applied a Spino Abdominal Sup- porter—in one week, the pain left the side, and has not since returned. Case £.—Mr. H. had been at the South, and return- ed with a severe liver affection, dyspepsia, with severe pain in the bowels. He obtained on trial, a Spino Ab- dominal Supporter, and in two days, his pains and aches disappeared. He laid it aside, and concluded not to purchase it, as he was poor—but the pain returned— he resumed the use of the instrument, and found relief. Having thus fairly tested the utility of the instrument, he forthwith purchased it. The Spino Abdominal Supporter before described, was patented by Calvin Cutter, M. D., of Massachu- setts, Dec^l5, 1844. It was presented at the Mechan- ics'Fair, in Boston, Sept. 16, 1844, and the following is the testimony of the examining Committee. " There are added some decided improvements to the Abdomi- nal Supporter by means of his spiral springs ; and the Committee, from their personal experience in these mat- ters, can safely recommend these instruments to the public." The above is the testimony of Dr. Lewis, and other leading physicians of Boston. The following is the testimony of the editor of the Bos- 19 218 'PHYSIOLOGICAL FAMILY PHYSICIAN. ton Medical and Surgical Journal of Feb. 5, 1845. He says,— " It is an abdominal supporter, unlike any contrivance, with which the profession are familiar. We shall not at- tempt to describe it further than to mention that spiral spring are introduced, in a way to keep the abdominal pad always pressing upward and slightly inward. Nothing could fit better,- or more completely fulfil the intentions of mechanical support in the lower part of the bowels." The general Agent of New England for the sale of Cutter's Patent Spino Abdominal Supporter, is N. Hunt, 128 Washington Street, Boston. Cutter's Supporters can also be obtained of in and in and by * m i .,'** ;4,4$& ?§£> -V. L