I I \ > THE PRINCIPLES OF PHYSIOLOGY APPLIED TO THE PRESERVATION OF HEALTH, AND TO THE IMPROVEMENT OF PHYSICAL AND MENTAL EDUCATION. BY ANDREW COMBE, M.D., PHYSICIAN EXTRAORDINARY TO THE QUEEN IN SCOTLAND, AND CONSULTING PHYSICIAN TO THE KINO AMD QUEEN Or THE BELGIANS, WITH SIX WOODCUTS. FROM THE SEVENTH EDINBURGH EDITION. NEW-YORK: PUBLISHED BY HARPER & BROTHERS, NO. 8 2 CLIFF-STREET. 184 0. "Nor is it left arbitrary, at the will and pleasure of every man, to do as he list; after the dictates of a depraved humour and ex- travagant phancy, to live at what rate he pleaseth ; but every one is bound to observe the Injunctions and Law of Nature, upon the penalty of forfeiting their health, strength, and liberty— the true and long enjoyment of themselves."—Mainwayringk. Entered, according to Act of Congress, in the year 1840, by Harper & Brothers, In the Clerk's Office of the Southern District of New-York. HIS MAJESTY LEOPOLD THE FIRST, KING OF THE BELGIANS. Sire, In consenting to ascend the throne, to which you were called by the fervent prayer of the Belgian peo- ple, your majesty was graciously pleased to declare, that, having from early life been placed in many dif- ficult and trying situations, you had long learned to value power only as a means of advancing the solid and lasting happiness of your fellow-creatures. How nobly your majesty has redeemed the pledge implied in this generous assurance, the tranquillity, security, and increasing prosperity of your majesty's adopted country proclaim in language which it requires not the aid of individual testimony to confirm; and I venture to refer to it only because your majesty's gracious permission to dedicate to you a work hav- ing for its aim the prevention and alleviation of hu- man suffering, is but another proof of the sincerity of the feeling by which it was dictated, and of the deep interest which your majesty takes in everything connected with the welfare and improvement of man- kind. As every amelioration of the physical condition of the people conduces not less to their advancement in IV DEDICATION. intelligence and good conduct than to their bodily comfort, I am inclined to hope that, even in a moral point of view, some good may be effected by the present exposition of the more important laws of the animal economy, and of the numerous practical ad- vantages to be expected from their regular and ade- quate fulfilment. While thus laying my little work before your ma- jesty as a sincere though humble tribute of respect and admiration, may I be farther permitted to ex- press my profound gratitude for the condescending goodness with which you have been pleased to re- ceive my imperfect services, as well as for the pro- fessional confidence with which your majesty contin- ues to honour me. That your majesty may long be spared, in health and happiness, to watch over the interests of the Belgian nation, is the sincere and earnest wish of, Sire, Your majesty's most grateful and devoted servant, ANDREW COMBE, Edinburgh, November 1, 1838. ADVERTISEMENT TO THE SEVENTH EDITION. It is now about four years and a half since the present work was first published, and already six editions, consisting together of eleven thousand cop- ies, have been exhausted in this country. In Amer- ica, a much larger number has been sold; and an edition, prepared with questions and answers at the end of the chapters to adapt it for a school-book, has been successfully introduced into several semi. naries of education. In Germany also, where an ex, cellent translation appeared about a year ago, it has been favourably received. These circumstances af. ford the most gratifying evidence that the importance of physiological knowledge as one of the most use- ful, if not indispensable, branches of general instruc, tion, is at last beginning to be appreciated among the intelligent classes of society, and that the present at- tempt to communicate it in a plain and unambitious style has not been unsuccessful. The approbation bestowed upon this volume by several of the medical journals, and by many of my brethren, is an indication that the want which it en, deavours to supply has been extensively felt by the profession as well as by the public; and encourages me to hope that, although designed chiefly for the general reader, it may nevertheless be found useful as a guide to the medical student, in facilitating his acquaintance with a branch of knowledge which, VI ADVERTISEMENT. considering its practical importance in the improve- ment of man and in the prevention and cure of dis- ease, is certainly too much neglected ; and on which he will not, however disposed, easily find elsewhere the means of obtaining adequate information. Various and extensive additions have been made to the work since it was first published; and to in- s crease its usefulness, a comprehensive index was an. nexed to the fourth edition. With these improve- ments it has since been stereotyped; and in fulfil- ment of an intention formerly announced, a treatise on Diet on the same general plan, and entitled " The Physiology of Digestion considered in relation to the Principle of Dietetics," was published some time ago, and is now in its second edition. Edinburgh, Nov., 1838. CONTENTS. Pekfacb........PaSe ll~20 CHAPTER I. INTRODUCTORY remarks. Physiology, Vegetable, Comparative, and Human.—Animate and Inanimate Bodies.—Objects of Physiology.— Usefulness of Phys- iological Knowledge.—Illustrations.—Evils of Ignorance.— Error in separating Anatomy and Physiology from their Prac- tical Applications.—What Health is —And how to be pre- served ......... • 21-40 CHAPTER II. STRUCTURE AND FUNCTIONS OF THE SKIN. The Skin—composed of three Layers.—The Cuticle—its Struc- ture and Uses.—The Mucous Coat—the Seat of Colour.—The True Skin—its Structure—the Seat of Perspiration—its Nature —'Consequences of Suppressed Perspiration.—Sympathy be- tween the Skin and other Organs. —The Skin a Regulator of Animal Heat.—The Seat of Absorption.—Touch and Sensation. —Connexion between the Skin and Nervous System . 41-72 CHAPTER III. HEALTH OF THE SKIN, AND ITS INFLUENCE ON THE GEN- ERAL SYSTEM. Mortality in Infancy from Cold.—Animal Heat lowest at that Age.—Too little and too much Clothing equally bad.—Rules for Dress.— Advantaires of Flannel in preventing Disease.—Venti- lation of Beds and Clothing.—Influence of Light —Importance of Ablution and Bathing.—Cold, Tepid, and Warm Bath.— Sponging with diluted Vinegar.—Friction of the Skin.—Vapour Bath and Warm Bath useful in preventing and curing Nervous Diseases and liability to Cold.—Sailing and Riding useful by acting on the Skin.......73-98 viii CONTENTS. CHAPTER IV. NATURE OF THE MUSCULAR SYSTEM. Muscles.—Their Structure, Attachment, and Conditions of Ac- tion.—Necessity of Arterial Blood and of Nervous Influence.— Muscles Act by alternate Contraction and Relaxation.— Fatigue consequent on continuing the same Attitude explained.—Inju- ries of Spine from neglect of this Law, and from Sedentary Oc- cupations in Schools.—The Mind ought to be engaged in Exer- cise as well as the Body.—Superiority of cheerful Play and amusing Games—A dull Walk the least useful Exercise.—In- fluence of mental Stimulus illustrated by Examples.—Exercise to be proportioned to Strength.—Laws of Strength Page 99-13q CHAPTER V. EFFECTS OF, AND RULES FOR, MUSCULAR EXERCISE. Effects of Muscular Exercise on the principal Functions of the Body explained.—Shampooing a Substitute for Exercise.—Evils of deficient Exercise.—Best Time for taking Exercise.—Al- ways to be taken in the open Air.—Different Kinds—Walking —Riding —Dancing — Gymnastics— Fencing— Shuttlecock — Reading aloud.—Case illustrative of the Principles of Exer- cise.—Involuntary Muscles ..... 131-154 CHAPTER VI. THE BONES, THEIR STRUCTURE, USES, AND CONDITIONS OF HEALTH. The Bones essential to Motion, and to the security of Ihe Vital Organs.—The Skeleton.—Bones are composed of Artwml and « of Earthy Matter.—The Animal Part the Seat of their Vitality. —The Proportions between these vary at different Periods of Life.—Vessels, Nerves, Life, Growth, and Decay of Bones.— Advantages of their Vitality and Insensibility.—Their adapta- tion to contained Parts.—Conditions of Health.—Necessity of Exercise.........165-177 CHAPTER VII. THE LUNGS—THEIR FUNCTIONS—AND HEALTH. Arterial and Venous Blood.—Circulation of the Blood.—Respi- ration.—Situation and Structure of the Lungs—their Air-cells and Bloodvessels.—Pulmonary Exhalation and Absorption.— CONTENTS. IX Conditions of healthy Action in the Lungs.—Influence of hered- itary Predisposition—of wholesome Food and good Digestion— of the free Expansion of the Lungs—of Exercise of the Muscles and Voice—ot Cheerfulness and of Depression of Mind—of pure Air and Ventilation.—Vitiation of the Air by Breathing—Ex- tentand Nature of the Vitiation.—Examples of Death produced by great Impurity—its Influence in destroying Health—Illustra- tions.— Want of Ventilation in Public Halls, Churches, Schools, and Houses—Necessity for the Scientific Regulation of Ventila- tion—Disease from ill-regulated Ventilation—Means of Venti- lation—Effects of vitiated Air on the Animal Economy.—Res- piration the Source of Animal Heat—Causes of deficient Gen- eration of Heat.—Means of Strengthening the Lungs and Chest. —Direct and Indirect Exercise of the Lungs—Beneficial Effects of, and Rules for, Pulmonary Exercise.—Precautions to be ob- served in Diseases of the Lungs, and in persons predisposed to Consumption, particularly at Puberty . . Page 178-231 CHAPTER VIII. NERVOUS SYSTEM AND MENTAL FACULTIES. Nervous System.—Structure of the Brain.—The Brain the Or- gan of Mind and Seat of Sensation.—Connexion between the Mind and Brain.—Conditions of Health in the Brain.—Influ- ence of hereditary Constitution—of the Blood.—Effects of im- perfectly oxygenated Blood.— Exercise of the Brain and Mind. —Effects of mental Inactivity—exemplified in the Deaf and Dumb.—Mental Inactivity a Cause of nervous Disease.—Ex- emplified in retired Officers, Merchants, and Others—in Fe- males of the middle and higher Ranks.—Effects of mental Activity on the Brain.—Effects of excessive mental Activity —Exemplified in precocious Children—in Youth—in hard Stu- dents—in early and middle Life, Case of Sir Humphrey Davy —in advanced Life, Case of Sir Walter Scott—a Cause of In- sanity.—Effects of over Activity of Mind on Health, Cases of Gretry, Weber, and others.....232-271 CHAPTER IX. RULES FOR MENTAL EXERCISE. Rules for the proper Exercise of the Mind and Brain.—Mind not to be tasked immediately after a Meal.—Best Time for Mental Exertion.—Importance of Regularity in Mental Employment. —Repetition of Mental Act indispensable to Improvement of Mind.—Effects of Repetition illustrated in Moral and Intellec- tual Training.— Kvery Faculty to be employed directly on its own Objects.—Illustrations.—Direct Exercise of the Moral Fac- ulties.—Best Means of exciting the Moral Sentiments.—Errors X CONTENTS. in ordinary Moral Education, and in Boarding-schools.—Use of Philosophy of Mind in conducting Education.—Influence of the Brain and Nervous System on the general Health.— Exemplified in ordinary Life, and in the Army.—The depress- ing Emotions destructive of Health.—Influence of the cheer- ful Emotions in preserving and restoring Health.—Sir H. Da- vy's Cure of Palsy by the application of a Thermometer ex- plained.—Examples at the Siege of Breda—in the Army and Navy, and on the Northern Expedition . . Page 272-308 CHAPTER X. APPLICATION OF THE PRECEDING PRINCIPLES. Causes of bad Health.—Not always the Result of Moral or Im- moral Conduct—nor of Accident—but of the Infringement of the Laws of Organization.—Proofs from past History.—Dimin- ished Mortality from increase of Knowledge, and better fulfil- ment of the Conditions of Health.—The Expeditions of Anson and Cook contrasted.—Gratifying Results of the Sanatory Ar- rangements of Ross, Parry, and Franklin.—Pulmonary Diseas- es in the Channel Fleet, from ignorance of Physiology.—Rates of Mortality indifferent Ages and Countries.—Causes of late Improvement.—Conditions of wealthier and poorer Classes compared—Good done by the apprehension of Cholera.—In- fluence of Habit.—Neglect of Organic Laws in Recruiting Ser- vice.—Examples ....... 309-337 CHAPTER XI. APPLICATION OF THE PRINCIPLES OF PHYSIOLOGY TO THE MORAL TREATMENT OF NERVOUS DISEASE AND INSANITY. Condition of the Nervous and Insane too little known.—Necessi- ty of improved Moral Treatment.—Use of Physiological Knowl- edge in effecting the required Improvements.—Principles on which the Nervous and Insane ought to be treated.—Necessity of providing the Means of Bodily and Mental Occupation, and humane and intelligent Attendants, in Asylums.—Admission of Visiters.—Middlesex and Edinburgh Pauper Asylums contrast- ed.—State of Private Asylums—M. Esquirol's Retreat at Ivry. —Conclusion........338-358 WOOD-CUTS. Bones of the Arm and Hand, 101. Muscles of the Human Body, 107. Bloodvessels of the Arm, 132. Human Skeleton, 158 Thoracic and Abdominal Viscera, 183. Human Brain, 234. PREFACE. The object of the present volume is to lay before the public a plain and intelligible description of the structure and uses of some of the more important or- gans of the human body, and to show how information of this kind may be usefully applied both to the pres- ervation of health and to the improvement of physical and mental education. In selecting the functions to be treated of, I have preferred to examine those which are most influential in their operation on the general 6ystem, and, at the same time, least familiarly known. Some, accordingly, whose sphere of action is com- paratively subordinate, I have not even named; and to others of essential consequence in the animal econ- omy, such as that of digestion, I have merely alluded. To have included the first would have added to the difficulties of the reader by the multiplicity of unim- portant details; and to have treated of the latter would have been, in a great measure, a work of su- pererogation, as treatises on the digestive organs are already in extensive circulation.* * Notwithstanding the above expression of opinion, so many suggestions have been made to me since the publication of the former editions to continue the work, and give a similar account of the functions of digestion, nutrition, circulation, &c, that I have nearly completed the preparation of another volume for that pur- pose, to be entitled " The Physiology of Digestion considered with reference to the principles of Dietetics." in this work I have in- sisted more on the general laws of digestion, and on the adapta- tion of diet to different ages, constitutions, and conditions of life, and less on the qualities of individual articles of food than is usu- ally done; and hope thus to have given it somewhat of the same plain and practical character which has contributed so much to the success of the present. 12 PREFACE. In offering practical rules for the guidance of the reader, it has been my constant endeavour to exhibit the relation subsisting between them and the partic- ular laws of the organization according to which their influence is exerted, that the recommendation given may rest, as far as possible, on the foundation of na- ture, and not on the doubtful authority of any indi- vidual. Many of the valuable treatises which have already appeared on the subject of health and of ed- ucation, seem to me to have failed in making an ad- equate impression on the public mind chiefly from this basis not having been brought sufficiently into view; and thus not only have the evils arising from defective education been unjustly and invidiously charged against education itself, but the most opposite methods have been advocated and practised with equal earnestness and plausibility, where a direct reference to the laws of organization would have at once re- vealed the source of the error, and afforded a protec- tion against its occurrence. It is not uninstructive to remark, that in the case of the lower animals, the necessity of modifying the method of cultivation according to the peculiarities of constitution which they present, has been long per- ceived and consistently acted on, and with such suc- cess as to afford us good reason for applying the same rule to our own species, and for considering every mode of education as erroneous and inefficient which is not in harmony with the higher nature of man. The extent, indeed, to which, by following this plan, we can carry our influence over the lower animals, and secure the development and efficiency of almost every organ, has often been the theme of admiration and surprise; and there can scarcely be a doubt, that were the same principle followed in the cultivation of the physical, moral, and intellectual powers of man, and were no rule received which is not in accordance with the laws of his constitution, a much higher de- gree of success would reward our exertions than has ever yet been experienced. The little regard which has hitherto been paid to PREFACE. 13 the laws of the human constitution, as the true basis on which our attempts to improve the condition of man ought to rest, will be obvious from the fact that, notwithstanding the direct uses to which a knowledge of the conditions which regulate the healthy action of the bodily organs may be applied in the prevention, detection, and treatment of disease, there is scarcely a medical school in this country in which any special provision is made for teaching it; the pupil being left to elaborate it for himself from amid information com- municated to him for other purposes. It is, there- fore, only too true, that "preventive medicine, the des- tined guardian of infancy, youth, manhood, and old age, adapted to the interior of families, has yet no existence."* Ill some of the foreign universities, in- deed, chairs have been instituted for diffusing instruc- tion of this description; and in France, a journal of Hygiene has existed for a short time. But in this country, with the exception of Sir John Sinclair's elaborate Code of Health, and one or two other publi- cations of a late date, the subject has never been treat- ed with anything like the regard which it assuredly deserves. In one point of view, indeed, the omission is not so extraordinary as it may at first sight appear. The prominent aim of medicine being to discriminate and to cure disease, both the teacher and the student naturally fix upon that as their chief object; and are consequently apt to overlook the indirect but substan- tial aid which an acquaintance with the laws of health is calculated to afford in restoring the sick, as well as in preserving the healthy from disease. It is true, that almost every medical man, sooner or later, works out this knowledge for himself; but, in general, he attains it later than he ought to, and seldom so completely as he would have done had it been made a part of his elementary education, to which he saw others attach importance. In my own instance, it was only when entering upon practice that * Lecture introductory to a course of popular instruction on the constitution and management of the human body, by Dr. Thomas Beddoes, 1797, p. 58. B 14 PREFACE. I had first occasion to feel and to observe the evile arising from the ignorance which prevails in society in re°ard to it. Impressed afterward more deeply than ever with the interest and utility of the study, I contributed two or three articles on the subject to one of our periodical journals, and resolved to make them the basis, at some future time, of a more de- tailed and connected exposition. This I have now attempted; not, I need scarcely add, with the view of superseding the physician by making " every man his own doctor," or of recommending the general pe- rusal of professional treatises—for both practices in- duce many more ailments than they cure—but simply with the hope that the method which 1 have followed, of connecting physiological details with practical ap- plications, may be found useful and interesting to both the student and the general reader. There is a tendency in the minds of many, when a new subject is presented to them, to run away with a part of a proposition or with an individual illustration, and to condemn as unsound the principle in elucida- tion of which it is adduced, because they happen to know facts which are at variance with the particular example brought forward. In this way, there is per- haps no one rule which I have advanced to which some individual case may not be plausibly opposed. But it does not necessarily follow that the principle or rule is thereby disproved. An example may be badly chosen, and yet the truth it is meant to convey may be as much a truth as before. Instead, therefore, of at once condemning a proposition on account of a sin- gle apparent exception, it will be better to extend the inquiry, and discover whether any peculiarity of situ- ation or constitution has interfered to modify the re- sult, and to condemn only when evidence of inaccu- racy is obtained. Thus, because some drunkards have enjoyed good health, and lived to an unusually old age, we are by no means entitled to infer that drinking was the cause of the good health, and that, if we would all drink as freely, we should all live as long. An example of this kind, far from disproving PREFACE. 15 the principle that ardent spirits are prejudicial to the human frame, only establishes the fact that individu- als exist who, from some idiosyncrasy, are better able than others to resist their bad effects; and, in like manner, when I state, as a general proposition, that severe muscular exertion is hurtful during rapid growth, I do not consider it as any argument against the fact to say that A. B. underwent great exertion when growing, without being injured by it. The gen- eral principle obviously remains unaffected by single instances of this kind, for the apparent exception can almost always be explained, and, even when it cannot, it occurs so rarely as to be entitled to no practical weight. It has been objected, that to teach any one how to take care of his own health, is sure to do harm by making him constantly think of this and the other pre- caution, to the utter sacrifice of every noble and gen- erous feeling, and to the certain production of hypo- chondriacal peevishness and discontent. The result, however, is exactly the reverse; and it would be a singular anomaly in the constitution of the moral world were it otherwise. He who is instructed in and familiar with grammar and orthography, writes and spells so easily and accurately as scarcely to be con- scious of attending to the rules by which he is guided; while he, on the contrary, who is not instructed in either, and knows not how to arrange his sentences, toils at the task, and sighs at every line. The same principle holds in regard to health. He who is ac- quainted with the general constitution of the human body, and with the laws which regulate its action, sees at once his true position when exposed to the causes of disease, decides what ought to be done, and thereafter feels himself at liberty to devote his undi- vided attention to the calls of higher duties. But it is far otherwise with the person who is destitute of this information. Uncertain of the nature and extent of the danger, he knows not to which hand to turn, and either lives in the fear of mortal disease, or, in his ignorance, resorts to irrational and hurtful precautions, 16 PREFACE. to the certain neglect of those which he ought to use. It is ignorance, therefore, and not knowledge, which renders an individual full of fancies and apprehensions, and robs him of his usefulness. It would be a stigma on the Creator's wisdom if true knowledge weakened the understanding and led to injurious results. And, accordingly, the genuine hypochondriac, whose blind credulity leads him to the implicit adoption of every monstrous specific, is not the person who has gained wholesome knowledge by patient study in the field of nature ; but he, and he alone, who has derived his notions of the human constitution and of the laws of nature from the dark recesses of his own crude ima- gination. Those who have had the most extensive opportu- nities of forming an opinion on this subject from ex^ perience, bear unequivocal testimony to the advanta- ges which knowledge confers in saving health and life, time and anxiety. Thus Dr. Beddoes, in alluding to the delicate constitutions of females of the higher ranks in this country, remarks, that he cannot " con- ceive how they can be rendered more hardy or less nervous, if that term is preferred, otherwise than by being seasonably taught the principles of self-manage- ment." And adds, that he specifies " the principles," because " little good can be expected unless we pro- ceed as in other instances where we exhibit to sense that connexion between cause and effect which con- stitutes the order of nature" (p. 26). In like manner, Dr. Davies, of the East India Company's Depot at Chatham, distinctly states, that the man of mature age, who has been some years at a trade before en- listing, and who has consequently gained some knowl- edge of his own constitution, always makes the most valuable soldier, because " he not only conforms with more ease to the system of diet and restraint neces- sary to subordination, but, having more experience, he is more observant of health, learns sooner how to take care of himself, to avoid or diminish causes of disease, and when ill, he gives more aid in bringing about a state of convalescence." Dr. Davies adds afterward, that this " knowinf how to manage is an invaluable qualification PREFACE. 17 to a soldier embarking for service in a tropical cli- mate ;" and if it is invaluable to the soldier, it is as- suredly not less safe and advantageous to the civilian. If, indeed, ignorance were itself a preventive of the danger, or could provide a remedy when it approached, then it might well be said that " ignorance is bliss;" but as it gives only the kind of security which shut- ting the eyes affords against the dangers of a preci- pice, and, consequently, leaves its victim doubly ex- posed, it is high time to renounce its friendship and protection, and to seek those of a more powerful and beneficent ally. If ignorance could divest us even of the sense of anxiety attending the apprehension of evil, the consequent tranquillity of mind, deceptive though it were, would be at least some compensation for submitting to its rule. But, unhappily, so far from ignorance of the nature and extent of the threatening danger saving us from gloomy anticipations, the fact is notoriously the reverse; for the darkest picture ever drawn is assuredly that devised by an unenlight- ened imagination. Every medical man can testify, that, natural character and other circumstances being alike, those whose knowledge is the most limited are the fullest of whims and fancies, the most alarmed at every trifling ailment, the most credulous respecting the efficacy of every senseless and preposterous rem- edy, the most impatient of restraint, and the most dis- contented at suffering. There are some, no doubt, whose constitutional sensibility prevents them ever controlling their feelings or being guided by the dic- tates of reason; but such persons are comparatively few in number, and even they become more tractable, as well as more comfortable in spirit, when their minds are enlightened and their true situation is dis- tinctly understood. If any of my readers be still doubtful of the propri- ety or safety of communicating physiological knowl- edge to the public at large, and think that ignorance is in all circumstances to be preferred, I would beg to ask him whether it was knowledge or ignorance which induced the poorer classes in every country of 18 PREFACE. Asia and of Europe, to attempt to protect themselves from cholera by committing ravages on the medical attendants of the sick, under the plea of their having poisoned the public fountains ? And whether it was ignorance or knowledge which prompted the more rational part of the community to seek safety in in- creased attention to proper food, warmth, cleanliness, and clothing 1 In both cases, the desire of safety and the sense of danger were the same, but the modes re- sorted to by each were as different in kind as in re- sult ; the efficiency of the one having formed a gla- ring contrast to the failure of the other. In thus strongly advocating the benefits to be ob- tained by the wide diffusion of a general knowledge of the laws of health, I must, however, express my belief, that the study of diseases and their modes of cure by unprofessional persons, is not only unprofita- ble, but often deeply injurious—just because such per- sons cannot possibly possess the collateral knowledge required to form a correct judgment of all the attend- ing circumstances, and are therefore extremely liable to fall into error, where every error is attended with risk. Let us suppose, for example, what I have seen and what has often happened, that a person of an ap- prehensive disposition, who has been occasionally subject to palpitation, takes up a medical treatise, and there finds that palpitation is a symptom commonly present where the heart is diseased. It is almost certain that such a person will, in his ignorance, make no farther distinction, but hurry at once to the con- clusion that his own heart is affected, and that he must speedily die. The notion being once implanted in his mind, he will become anxious and watchful of every sensation, deny himself necessary exercise from fear of over-exertion, and necessary food from fear of a bloodvessel giving way, and in no long time will fall into a state of weakness and disease which will confirm every one of his apprehensions. But had this individual, instead of acting on his own i»», perfect knowledge, consulted his medical adviser, whose business it is to make himself acquainted with the whole of the case, he would have discovered im- PREFACE. 19 mediately that the dreaded source of all this suffering was originally a simple fit of indigestion, which nature would have cured in three days, had not the machine been so perversely deranged by the very want of ex- ercise and food, in which the patient was ignorantly seeking for safety. Even here, be it observed, the danger arises from the incompleteness of the knowl- edge possessed ; and I would condemn the perusal of medical books only because the general reader can- not, except by going through a course of professional study, become qualified to make a proper use of their contents. And, accordingly, it is well known that few students escape fits of hypochondriacal apprehension when they first seriously enter on the study of dis- eases ; and that they become free from them almost in proportion as their knowledge advances.* Various repetitions occur in the course of the pres- ent work, which to some may seem unnecessary, and for which I ought to solicit the indulgence of the read- er. These have arisen chiefly from the intimate man- ner in-which the different functions are connected with each other, rendering it impossible to explain one without constantly referring to the rest. Occasion- ally, also, the novelty and importance of the subject have led me to risk repetition, in order to ensure at- tention ; but I trust that these faults, if felt as such, will be forgiven. Those who desire to obtain farther information of a general nature in regard to the structure and func- * The number of the Metropolitan Magazine for July, 1834, contained a very favourable review of the first edition of this work, which it recommended to the attention, especially of medical men. But it went on to caution ladies and unprofessional persons from dipping into its pages, not because they would find in them any- thing indelicate, unintelligible, or devoid of interest, for it expressly acquitted the book of all these faults; but because they would immediately afterward fancy themselves ill, and be afraid to move from fear of deranging some part of the bodily machinery ! To those whose curiosity should get the better of their discretion, the reviewer recommended, as an antidote, the perusal of Shakspeare, Don Quixote, or some entertaining novel, to raise their spirits. I mention this to show that the remarks in the text (which, by a curious coincidence, were first published in the second edition simultaneously with the review) are not uncalled for. 20 PREFACE. tions of Man, may refer to Mr. Lord's " Popular Phys- iology," Dr. Hodgkin's " Lectures on the Means of Promoting and Preserving Health," and also to an excellent treatise on Animal Physiology, in four of the earlier numbers of the Library of Useful Knowl- edge. The last is understood to be from the pen of Dr. Southwood Smith, the able author of a volume entitled " The Philosophy of Health," which was pub- lished in London simultaneously with the third edition of the present work, and with whose sentiments on the subject now before us, as expressed in the follow- ing extract from the concluding page of his earlier treatise, I need hardly say 1 entirely concur: " The obvious and peculiar advantages of this kind of knowledge are, that it would enable its possessor to take a more rational care of his health ; to perceive why certain circumstances are beneficial or injurious; to understand, in some degree, the nature of disease, and the operation as well of the agents which produce it as of those which counteract it; to observe the first beginnings of deranged function in his own person; to give to his physician a more intelligible account of his train of morbid sensations as they arise; and, above all, to co-operate with him in removing the morbid state on which they depend, instead of defeat- ing, as is now, through gross ignorance, constantly done, the best concerted plans for the renovation of health. It would likewise lay the foundation for the attainment of a more just, accurate, and practical knowledge of our intellectual and moral nature. There is a physiology of the mind as well as of the body; both are so intimately united, that neither can be well understood without the study of the other; and the physiology of man comprehends both. Were even what is already known of this science, and what might be easily communicated, made a part of general education, how many evils would be avoided, how much light would be let in upon the understanding, and how many aids would be afforded to the acquisi- tion of a sound body and a vigorous mind ; pre-requi- sites more important than are commonly supposed, to the attainment of wisdom and the practice of virtue." CHAPTER I. INTRODUCTORY REMARKS. Physiology, Vegetable, Comparative, and Human.—Animate and Inanimate Bodies.—Objects of Physiology.— Usefulness of Phys- iological Knowledge.— Illustrations.— Evils of Ignorance.— Error in separating Anatomy and Physiology from their Practi- cal Applications.—What Health is—And how to be preserved. Physiology, from Qvoic, nature, and hoyoc, discourse, signifies literally a discourse about natural powers, but, as now used, it applies exclusively to the doctrine of the uses or functions of the different constituent parts of beings endowed with the principle of life. As applied to the vegetable kingdom, it is called Vegeta- ble Physiology; to the lower animals, Comparative Physiology; and to, man, Human Physiology. In all of these instances,'however, the objects of physiology are the same, viz., the exposition of the mechanism and laws by which the various functions which char- acterize living bodies are carried on, so as to fit each individual for the particular sphere in which the Cre- ator intended it to exist. The grand mark of distinction between animate and inanimate bodies is to be found in the different rela- tions in which they stand to the ordinary laws of the material world. Inanimate or inorganized bodies have no internal power of action, and of themselves can effect no change. Possessed of certain fixed and invariable properties, they stand uniformly in the same relation to each other, and act invariably according to the same general laws, so that what is once ascer- tained of them can be predicted with certainty to hold true for ever after; and therefore, in conducting our investigations, we know that the same effects will always follow the same causes with mathematical precision. But when the same elementary material 22 ANIMATE AND INANIMATE BODIES. becomes part of a living body, this rule no longer holds; the laws of chymical and physical action are greatly modified, or for a time counteracted, and the now organized matter obeys the law of vegetable or animal life, and is not again subjected to those of purely chymical action, either till eliminated from the body, or till life is extinct; and, in point of fact, the putrefaction which instantly follows the extinction of the vital principle is neither more nor less than the ordinary laws of inanimate matter resuming their do- minion when no longer opposed by a higher power. An example or two will render the difference more apparent. All bodies gravitate towards the earth, according to a constant and well-known law. But ani- mals are able to resist this law, so far as to preserve an attitude at variance with its tendency, or even to rise, like the eagle, many thousand feet in the air in opposition to their natural weight; but on the extinc- tion of life they lose this power, and again become subject to the full influence of gravitation. In the same way many animals preserve an elevated and steady temperature, whether exposed to severe cold or to excessive heat; but, when life ceases, rapidly assume that of the objects by which they are sur- rounded. A human being may, for instance, be ex- posed to the intensest cold of the Polar Regions without having his own internal temperature reduced by a single degree so long as life endures; but from the moment when life ceases, his body begins to part with its heat, and ere long it becomes frozen and stiff like the inanimate masses by which it is sur- rounded. Here, then, is a grand boundary line dividing the organized from the inorganized, the animate from the inanimate body. Chymistry and natural philosophy investigate the laws and conditions which regulate the action and movements of inanimate or inorgan- ized objects; but, from what we have seen of the power of the vital principle in modifying these, it will be manifest that, however extensive and accu- rate our knowledge of the properties of the element- OBJECTS OF PHYSIOLOGY. 23 ary materials of living bodies, considered separately, may be, we can thence infer nothing in regard to the qualities of the animal compound when endowed with life, but must resort to observation and study for the discovery of the conditions by which life is charac- terized and under which it is carried on. Physiology, or the history of the functions which characterize living beings, is thus a subject of pecu- liar interest; and human physiology, or that which is about to engage our attention, is as important in its practical consequences as it is attractive to rational curiosity. In its widest sense it comprehends an exposition of the functions of the various organs of which the human frame is composed ; of the mecha- nism by which these are carried on ; of their relations to each other, or the means of improving their de- velopment and action; of the purposes to which they ought severally to be directed; and of the man- ner in which exercise ought to be conducted, so as to secure for the organ the best health, and for the function the highest efficiency. A true system of physiology comes thus to be the proper basis, not only of a sound physical, but of a sound moral and intellectual education, and of a rational hygiene; or, in other words, it is the basis of everything having for its object the physical and mental health and im- provement of man; for, so long as life lasts, the men- tal and moral powers with which he is endowed manifest themselves through the medium of organi- zation, and no plan which he can devise for their cul- tivation, that is not in harmony with the laws which regulate that organization, can possibly be successful. But besides the power of resisting the operation of the ordinary chymical and physical laws, living bodies are distinguished by other properties peculiar to themselves. Unlike inorganized matter, which exists in the same form from the beginning, bodies endowed with the principle of life derive their origin from pre- viously-existing living bodies of the same nature as themselves; and they in their turn give birth to others, and in this way the succession is kept up. 24 OBJECTS OF PHYSIOLOGY. Unlike the inert material which retains its properties unaltered throughout endless ages, the living body is constantly undergoing changes from the first to the last moment of its existence; and these are exempli- fied, on the large scale, in the great stages of youth, maturity, old age, and death. Unlike inorganized matter, which neither grows nor decays, living bodies require a constant supply of nourishment to admit of their growth in youth, and to replace the worn-out particles which are regularly thrown off at every period of life ; and unlike inanimate objects, the prop- erties of which never alter, living bodies cease at last to exist, and their component elements, deprived of the principles of life, again become subject to the ordinary laws of matter, and are speedily decomposed and scattered about, as if life had never been. The above properties, it may be observed, are common to vegetable and animal life ; but animals possess others peculiar to themselves. Among the most remarka- ble of these are sensation, thought, voluntary motion, and the faculty of communicating to each other their thoughts and feelings, through the medium of natural or artificial language. These are great marks of distinction, and, considered in a general point of view, amply suffice to divide the two great classes of animated beings; and while some animals exhibit individual powers in higher perfection, man stands far their superior, not only in combining in his own per- son all the senses and faculties which they possess, but in being endowed with moral and intellectual powers which are denied to them, and which at once place him at the head of the living creation, and con- stitute him a moral, religious, intelligent, and respon- sible being. So numerous and important are the various organs of which the human frame is composed, and so closely are they linked with each other in their ac- tion, that, in treating of them, it is difficult, or, rather, impossible to follow any arrangement which shall not involve considerable repetition, or which shall admit of every statement being at first fully under- UTILITY OF PHYSIOLOGICAL KNOWLEDGE. 25 stood. On the present occasion, however, a syste- matic mode of proceeding is not essential, my object being merely to communicate a general knowledge of a few of the more important functions, partly with a view to the direct practical purposes to which such information may be applied, and partly for the sake of rousing public attention to the necessity of inclu- ding this branch of science in every plan of what is called a liberal education. Let it not be said that knowledge of this descrip- tion is superfluous to the unprofessional reader; for society groans under the load of suffering inflicted by causes susceptible of removal, but left in operation in consequence of our unacquaintance with our own structure, and of the relations of the different parts of the system to each other and to external objects. Every medical man must have felt and lamented the ignorance so generally prevalent in regard to the sim- plest functions of the animal system, and the conse- quent absence of the judicious co-operation of friends in the care and cure of the sick. From unacquaint- ance with the commonest facts in physiology, or incapability of appreciating their importance, men, of much good sense in every other respect, not only subject themselves unwittingly to the active causes of disease, but give their sanction to laws and prac- tices destructive equally to life and to morality, and which, if they saw them in their true light, they would shrink from countenancing in the slightest degree. For proof of this I need only refer to the evidence on the Factories' Regulation Bill, which lately occu- pied so much of public attention. The law then, in operation authorized the working of children between the years of eight and sixteen, in the close-heated at- mosphere of a cotton-mill, for twelve hours a day; and as a great boon, no children are now employed under nine years of age, while between that and four- teen the period of daily labour is not to exceed eight hours. Had our legislators been instructed in anat- omy and physiology so far as to obtain even the most general notion of the constitution of the human body, 26 UTILITY OF PHYSIOLOGICAL KNOWLEDGE. and had they been aware of the intimate dependance of the mind on the condition of the bodily organiza- tion, they would at once have perceived the destruct- ive tendency of the former system of labour and con- finement, and the utter impossibility of combining with it that moral and intellectual cultivation which is so imperatively required. Instead of objecting to the limitation when it was proposed, they would have looked forward with dread to the physical and moral degradation which the system then in operation was fast effecting in the multitudes under its influence; and their only doubt would have been, whether even eight hours' labour in a close atmosphere was not too much for undeveloped children. The evidence in the printed report to the House of Commons is said to have been partially got up; but granting that it was so, it nevertheless contains a multitude of facts so en- tirely in accordance with the soundest and best un- derstood principles in physiology, and which no coun- ter-evidence can rebut, that one can only lament the ignorance which prevented many able and benevolent but prejudiced men from perceiving its true charac- ter, and yielding at once to the imperious dictates of nature and of duty. That there were great difficul- ties in the way of every alteration is quite true ; but surely no question of mere gain to any or to every class ought to be allowed to stand for ever in the way, when the lives and happiness of multitudes of our fel- low-creatures, and the tranquillity and real prosperity of the country, are at stake. Unless we begin some- where, how can any improvement ever be accom- plished ! Another instance of the dangers of ignorance lately presented itself. In the Edinburgh Advertiser of 1st March, 1833, we are informed that " a distressing oc- currence was discovered on Wednesday forenoon, on board the Magnus Troil, Shetland trader, Captain Ganson, lying at Leith. The master and mate, who are brothers, went as usual on Tuesday night to sleep in the cabin of the vessel; but, not appearing at the customary hour in the morning, the crew thought UTILITY OF PHYSIOLOGICAL KNOWLEDGE. 27 they had merely slept beyond their time. A little time having elapsed, they were repeatedly called ; but, no answer being returned, one of the men went into the cabin, where he found the two brothers almost dead through suffocation. It is thought that they had shut the companion and skylights so close, that they had , during the night exhausted the whole of the vital air ne- cessary for respiration contained in their confined situ- ation. Medical aid was procured, and hopes are en- tertained of their recovery. Both were much respect- ed." Captain Ganson, however, did not recover, but died convulsed on the following morning. Since the publication of the preceding statement, doubts have been entertained whether the catastro- phe resulted simply from confined air, or from the stove not having been extinguished, or from impure air proceeding from the bilge water. But as all agree that the accident could not have happened if there had been a proper supply of fresh air from without, it matters little from which of these sources the impure air was derived; for it is quite certain that, had Cap- tain Ganson and his brother possessed the slightest acquaintance with the nature of the atmosphere, and the relation of its elements to the function of respi- ration, they would have seen too clearly the danger of shutting themselves up in a confined space, ever to have risked their lives in the way they did. A con- stant supply of pure air is indispensable to the for- mation of proper blood in the lungs, and, consequently, to the preservation of life and the well-being of the whole body; but formerly, when this condition was as little known or regarded as it was by Captain Gan- son, many persons were shut up together in small ill- ventilated rooms in schools, jails, and hospitals, and the natural result was a degree of mortality from fe- vers and other diseases which, now that the laws of respiration are better known and more attended to, is never heard of. From the same hurtful absence of knowledge, a law exists, or lately existed, in France, by which in- fants must be taken within a very short time after be- 28 UTILITY OF PHYSIOLOGICAL KNOWLEDGE. ing born to Ihe office of the Maire, if it is wished to * have their births registered. But there is another and higher law, made by the Creator, with which this en- actment is at variance; and that law renders the in- fant incapable of bearing exposure to a low tempera- ture without injury. The result is, that in winter, especially in places where the Maire resides at a dis- tance, and where, consequently, the exposure is in- creased, a greater mortality takes place than is ob- served among infants placed under more favourable circumstances. Had the nature of the living func- tions been generally understood by the framers of such a law, it is obvious that it could never have been enacted ; for to have done so knowingly would have been in substance to legalize infanticide. One additional example may be given. It is well understood among professional men, that in speaking, singing, and playing on wind instruments, the lungs are called into play as powerfully as in running or any other species of severe muscular exercise. From not adverting to this fact, a strongly constituted indi- vidual, who brought on spitting of blood by bodily la- bour to which he had not been accustomed, conceiv- ed himself perfectly safe and even cautious when he gave up the spade, and confined himself to talking a great deal, which he did daily to numerous visiters, in explanation of favourite views then occupying all his thoughts. The consequence was, that the prescribed treatment was without effect, and a fatal illness was brought on. When the action of the lungs was sub- sequently explained to this individual, he saw at once the error into which he had fallen, and lamented the ignorance which had led to it, but too late to derive any advantage from his knowledge. We are constantly meeting with anomalies in prac- tical life, in the case of individuals little accustomed, when in health, to observe or to reflect on the influ- ence of external circumstances and modes of life in disturbing the action of the various animal functions, but at the same time easily and deeply impressed by all extraordinary occurrences affecting them. Thus, UTILITY OF PHYSIOLOGICAL KNOWLEDGE. 29 when any one is taken ill, his relatives or friends be- come extremely anxious to have his room properly ventilated; his body-clothes frequently changed and carefully aired; his food properly regulated in quan- tity and quality; his skin cleaned and refreshed ; his mind amused and tranquillized; his sleep sound and undisturbed, and his body duly exercised; and they state, as the reason for all this care, and most justly, that pure air, cleanliness, attention to diet, cheerful- ness, regular exercise, and sound sleep, are all highly conducive to health. And yet such is the inconsist- ency attendant on ignorance, that the patient is no sooner restored, than both he and his guardians are often found to become as careless and indifferent in regard to all the laws of health, as if these were en- tirely without influence, and their future breach or observance could in no way affect him ! Just as if it were not better by a rational exercise of judgment to preserve health when we have it, than first to lose it, and then pay the penalty in suffering and danger, as an indispensable preliminary to its subsequent res- toration ! One cause of such anomalous conduct is the dan- gerous and prevalent fallacy of supposing that, be- cause glaring mischief does not instantly follow every breach of an organic law, no harm has been done. Thus, what is more common than to hear a dyspeptic invalid, who seeks to gratify his palate, say, that ve- getables, for example, or pastry, or heavy puddings, do not disagree with him, as he ate them on such a day, and felt no inconvenience from them ] and the same in regard to late hours, heated rooms, insuffi- cient clothing, and all other sources of bad health, every one of which will, in like manner, be defended by some patient or other, on the ground that he ex- perienced no injury from them on a certain specified occasion; while all, when the rule is not directly ap- plied to themselves, will readily admit that such things are, and must be, very generally hurtful. Happy would it often be for suffering man could he see beforehand the modicum of punishment which his C2 30 UTILITY OF PHYSIOLOGICAL KNOWLEDGE. multiplied aberrations from the laws of physiology are sure to bring upon him. But as, in the great ma- jority of instances, the breach of the law is limited in extent, and becomes serious only by the frequency of its repetition; so is the punishment gradual in its in- fliction, and slow in manifesting its accumulated ef- fect ; and this very gradation, and the distance of time at which the full effect is produced, are the reasons why man in his ignorance so often fails to trace the connexion between his conduct in life and his broken health. But the connexion subsists, although he does not regard it, and the accumulated consequences come upon him when he least expects them. Thus, pure air is essential to the full enjoyment of health; and reason says, that every degree of vitia- tion must necessarily be proportionally hurtful, till we arrive at that degree at which, from its excess, the continuance of life becomes impossible. When we state this fact to a delicately constituted female, who is fond of frequenting heated rooms, or crowded par- ties, theatres, or churches, and call her attention to the hurtful consequences which she must inflict on herself by inhaling the vitiated air of such assemblies, her answer invariably is, that the closeness and heat are very disagreeable, but that they rarely injure her: by which she can only mean, that a single exposure to them does not always cause an illness serious enough to send her to bed or excite acute pain, al- though both results are admitted sometimes to have followed. An intelligent observer, however, has no difficulty in perceiving that they do hurt her, and that, although the effect of each exposure to their influence is so gradual as not to arrest attention, it is not the less progressive and influential in producing and main- taining that general delicacy of health by which she is characterized, and from which no medical treat- ment can relieve her so long as its causes are left in active operation The debility so generally complained of in spring by invalids and persons of a delicate constitution, and which renders that season of the year so formidable GRADUAL ORIGIN OF BAD HEALTH. 31 in prospect, and in reality so fatal, seems in numerous instances to result more from the accumulated effects of neglect during the preceding winter months, than from anything directly inherent in the season itself. At the commencement of winter, such persons feel comparatively strong from the beneficial exposure to the open air, light, and exercise, which they enjoyed during the summer and autumnal months. But in pro- portion as they are deprived of these advantages by the advance of winter, and are subjected to the evil consequences of confinement, deficient exercise, cold damp air, and deprivation of the stimulus of light, the stamina of the constitution become impaired, and de- bility and relaxation begin to be felt, and make prog- ress from day to day, till on the arrival of spring they have reached their maximum, and then either give rise to positive disease, or again gradually disap- pear at the return of the invigorating influence of long- er and warmer days. Where, however, pulmonary disease or any unusual susceptibility pre-exists, this principle will not apply; for in such cases, the east winds prevalent in spring are directly injurious. If the above view be correct, it is obvious that, in most cases, the hurtful cause is not, as is commonly supposed, so much any positive quality of the season, as the accumulated mass of the winter influences then reaching their maximum ; and this is not perceived, only because the effect from day to day, although per- fectly real, is too small to attract notice, while the ag- gregate result of the many days composing winter is striking enough. The fact that those who deny them- selves the delight of late parties and crowded rooms, and are sufficiently robust to undergo the necessary exposure in winter, suffer much less in spring, seems to corroborate the above explanation. We must not suppose, then, that because a single excess of any kind does not produce a direct attack of disease, it is therefore necessarily harmless; for it is only when the noxious agent is very powerful in- deed that its deleterious influence on the system be- comes instantly sensible. In the great majority of 32 GRADUAL ORIGIN OF BAD HEALTH. situations to which man is exposed in social life, it is the continued or the reiterated application of less pow- erful causes which gradually, and often imperceptibly, unless to the vigilant eye, effects the change and ru- ins the constitution before danger is dreamed of; and hence, the great mass of human ailments is of slow growth and slow progress, and admits only of a slow cure ; whereas those which are suddenly induce* by violent causes, are urgent in their nature and rapid in their course. And yet so little are we accustomed to trace diseased action to its true causes, and to distin- guish between the essential and the accidental in the list of consequences, that, as already observed, if no glaring mischief has followed any particular practice within, at most, twenty-four hours, nine out often in^ dividuals will be found to have come to the conclu- sion that it is perfectly harmless, even where it is ca- pable of demonstration that the reverse is the fact. The benevolence and wisdom of this arrangement are very conspicuous. There are many casual influ- ences from the agency of which man will never be able entirely to protect himself. If they are speedily withdrawn from him, the slight disorder which they {iroduce quickly ceases, and health remains essential- y undisturbed. But, if they be left in operation for a considerable length of time, the derangement which they excite gradually and slowly increases, till at last a state of disease becomes established, which requires an equally long or longer period, and a steady observ- ance of the laws of health, for its removal. Such is the history of the rise and progress of most of the ailments which afflict the human family, and the source of the grand distinction between acute and chronic diseases. We are apt to wonder that a se- vere disease like inflammation should run its course in a few days, while dyspeptic and nervous ailments require months for their cure. But our wonder is di^ minished when we attend to the fact, that the one generally dates its rise from a strong cause applied within perhaps a few hours or a few days; while the others are the slow and gradual results of months of CAUSES OF BAD HEALTH. 33 previous anxiety or neglect of dietetic rules and ex- ercise, during which the ailment was maturing unno- ticed and unsuspected. Had the real state of the matter been early perceived, and the causes been re- moved, the dyspeptic and the nervous invalids would have regained health and serenity in proportionally little time and with proportionally little suffering. In such cases, Nature kindly allows some latitude of ac- tion free of serious penalty, as if on purpose to pro- tect us from being hurt by such occasional exposure as we are necessarily subjected to by the ordinary vicissitudes of life ; but it is always on condition of re- turning to obedience the moment the necessity is over. If we presume on the indulgence being permanent, the evil accumulates and health is destroyed ; but if we return in time to the right path, little inconve- nience results. Where, however, the injurious influ- ences are of a more energetic kind, equal latitude of exposure is obviously incompatible with safety. Were they not to enforce immediate notice, our cor- poreal organs might be irrecoverably altered by dis- ease before we took the alarm, and it is therefore the purest benevolence to attach immediate suffering to them, in order to ensure that instant attention which alone can stay the rapidity of their progress. In chronic or slowly arising diseases, then, the sep- aration of the effect from its cause is only apparent and not real, and in practice it is essential to keep this in mind. A fit of insanity, for example, is often said to have come on without any cause, when, on mi- nuter examination, causes can be easily traced oper- ating through many previous months, only not of so violent a nature as to have at once upset reason, and the same will be found to hold in almost all those slow and insidious illnesses which so often baffle our best efforts; and although at present we cannot al- ways discover their true origin, it is clear that we shall ultimately succeed much better if we believe them to have causes which may be found out, than if we regard them as mysteries which no study or at- tention can ever explain. 34 CAUSES OF BAD HEALTH. It is this apparent but unreal separation of the ef- fect from its cause which has given rise to the vari- ety of opinions entertained in regard to the qualities of the same agents, and which has, perhaps, tended more than anything else to discourage rational re- gard to the means of preserving health ; and yet this very variety is a proof at once of the absence of sound views of our own nature, and of the urgent ne- cessity of possessing them. In society, accordingly, nothing is more common than to hear the most oppo- site opinions expressed in regard to the evils or ad- vantages of particular kinds of clothing, food, and ex- ercise. One person will affirm, with perfect sinceri- ty, that flannel is pernicious, because it irritates the skin, and uniformly causes an eruption over the whole body; and that linen or cotton is an excellent article of dress, because it produces no such consequences. Another will tell us, with equal truth, that flannel is a capital thing, because it is pleasant to the feeling, and affords protection from cold and rheumatism, which linen does not. One will affirm that a long walk or violent muscular exercise is an excellent ton- ic, because it gives a keen appetite, and a vivacity and alertness which are delightful. But another will declare that a long walk or severe exercise is exceed- ingly injurious and debilitating, because it destroys his appetite, and unfits him for exertion of mind or body, and always gives him headache. One will, in like manner, praise vegetable as the best diet, and an- other animal food as infinitely superior, and so on through the whole range of the physical objects which act upon the human frame; and the natural conse- quence of these apparent anomalies and contradic- tions is, that, when in health, we come practically to look upon the effects of air, food, exercise, and dress, as very much matters of chance, subject to no fixed rule, and therefore little worth attending to, except when carried to palpable extremes, or in the cure of disease. In this way, man, instead of being able to protect his children by the results of his own experience iq EVILS OF IGNORANCE OF PHYSIOLOGY. 35 his journey through life, goes on from generation to generation, groping a little, then seeing a little, then groping again, till he arrives, often prematurely, at the end of his existence, when he stumbles into his grave, leaving his posterity to pass unaided through the same series of experiments, and arrive at the same termination, as himself. This unnatural result must arise either from the laws which regulate the animal functions and the op- erations of external objects being variable and ever changing, or from the conditions of the living body on which they act being different in different per- sons, or in the same person at different ages or sea- sons ; and it is not difficult to determine to which of these it is to be ascribed. It cannot be the first, for the laws of nature are invariable and unbending. The food which to-day nourishes and sustains the body, and which to-morrow, when sickness is present, raises the pulse and excites the heart to febrile action, has not altered its qualities or changed its relation to the healthy body. It is the state of the body that has changed, and caused the apparent discrepance of ef- fect. In judging, therefore, of the propriety, advan- tages, or evils of exercise, food, and clothing, we must take into consideration not only the kind of exercise, the kind of food, and the kind of clothing, but also the age, health, and kind of constitution of the indi- vidual who uses them, and adapt each to the degree in which it is required ; and then we may rest assured that many of our difficulties will vanish, and certainty and consistency come proportionally into view. Were the intelligent classes of society better ac- quainted with the functions of the human body, and the laws by which they are regulated, many of these anomalies in practice would disappear, the sources of much suffering would be dried up, and the happiness of the community at large be essentially promoted. Medical men would no longer be consulted so exclu- sively for the cure of disease, but would also be called upon to advise regarding the best means of strength- ening the constitution, from an early period, against 36 EVILS OF IGNORANCE OF PHYSIOLOGY. any accidental or hereditary susceptibility which might be ascertained to exist. More attention would be paid to the preservation of health than is at present practi- cable, and the medical man would then be able to ad- vise with increased effect, because he would be pro- portionally well understood, and his counsel, in so far at least as it was based on accurate observation and a right application of principles, would be perceived to be, not a mere human opinion, but, in reality, an ex- position of the will and intentions of a beneficent Cre- ator, and would therefore be felt as carrying with it an authority to which, as the mere dictum of a fallible fellow-creature, it can never be considered as enti- tled. It is true that, as yet, medicine has been turned to little account in the way of directly promoting the physical and mental welfare of man. But the day is perhaps not far distant, when, in consequence of the improvements both in professional and in general ed- ucation now in progress, a degree of interest will be- come attached to this application of its doctrines far surpassing what those who have not reflected on the subject will be able to imagine as justly belonging to it, but by no means exceeding that which it truly de- serves. The practical importance of physiological knowl- edge in the training and education of the young, has been overlooked chiefly, I think, from the unnatural separation of the different branches of medical sci- ence from each other by its cultivators and teachers, and the exclusive devotion of each to his own favour- ite department. The Anatomist, for example, teaches structure, and structure only, and refers to the Phys- iologist for an account of the uses to which it is sub- servient ; and the Physiologist, on the other hand, ex- pounds functions, but scarcely touches upon the in- struments by which they are executed. The conse- quence is, that the student often becomes disgusted with what h* considers dry anatomical details, when perhaps nothing would interest him more deeply were the purposes which the structure fulfils in the animal EVILS OF IGNORANCE OF PHYSIOLOGY. 37 economy taught to him at the same time. Many, in like manner, fail to take any pleasure in the study of physiology, who would be truly delighted to hear the truths of which it treats expounded in connexion with peculiarities of organization, and with more frequent reference to their practical applications. The Anat- omist and Physiologist err, in short, in limiting them- selves too exclusively to their own particular pur- suits, and devoting too little attention to the relations which these bear to each other and to the great unit, the living being, of which they form a part. So far, indeed, has this separation been carried, and so injurious is the habit thence arising of contemplating objects under the narrowest point of view, that very lately an able teacher of physiology, in his public lec- tures, ridiculed the very notion of laying down gener- al'rules for the preservation of health, and imagined that he had set the matter entirely at rest by the sim- ple assertion that variety is advantageous, and affirm- ing that, therefore, uniformity of obedience to any rules must be prejudicial; as if it were not of the very es- sence of general laws to be modified in their opera- tion and results by the circumstances under which they act; and as if, because of such modifications, their influence might with safety be entirely neglected. The result of this erroneous system is, as already hinted, that the young practitioner is educated without having made himself sufficiently familiar with the con- ditions on which the healthy action of the animal econ- omy depends, or having even rightly appreciated the importance of such knowledge; and that, consequent- ly, in common with his patient, he sometimes unwit- tingly allows the operation of morbid causes to go on without interference, where, by a timely warning on his part, serious illness might have been averted; or unconsciously permits the gradual ripening of hered- itary tendencies into active disease, which rational precautions, early resorted to, might have kept in sub- jection throughout a long period of existence. Some practitioners, I am aware, object to unprofes- sional persons attempting to make themselves ac- D 38 EVILS OF IGNORANCE. quainted with the structure or functions of the human body, and, in practice, think it best never to give any explanation to the patient of the principles on which it is proposed to conduct the treatment. But, gener- ally speaking, it will be found that the cheerful co- operation of the patient is never so effectually secu- red as by addressing his understanding, and giving him an intelligible interest in what is proposed for his re- lief. In acute diseases, of course, explanation of any kind is often precluded. Here the professional man must act, and act with decision. But the great ma- jority of ailments are of a chronic character, in the cure of which the steady co-operation of the patient is almost indispensable. And even when the malady is acute, the patient will submit to severe measures much more readily when ordered by an adviser who has been in the habit of addressing his reason when opportunity occurred, than when prescribed by one who has always followed the system of dictation. So far from the rational care of health being justly chargeable with the imputation of selfishness, so often ignorantly thrown out against it, there is nothing which tends so much to relieve society from the bur- den of miseries not its own, as each individual taking such care of his constitution as shall enable him to cope successfully with the duties and difficulties of the situation in which he is placed. No man is so thoroughly selfish as he who, in the ardent pursuit of pleasure or of profit, heedlessly exposes his life to the hazard of a die, regardless of the suffering which he may entail upon those who depend on him for sup- port. In the abstract, we all admit that the enjoy- ment of health is the first of earthly blessings, and that without it all others may be lavished in vain; and yet it has been quaintly asked, " Who is he that values health at the rate it is worth ? Not he that hath it; he reckons it among the common ordinary enjoy- ments, and takes as little notice of it, or less regards it, than his long-worn clothes: perhaps more careful of his garments, remembering their price; but thinks his health costs him nothing, and, coming to him at so easy WHAT GOOD HEALTH IS. 39 a rale, values it accordingly, and hath little regard to keep it: is never truly sensible of what he enjoyed until he finds the want of it by sickness ; then health, above all things, is earnestly desired and wished for." In proportion, however, as we consider the matter with that attention which its importance really de- serves, we shall become anxious rather to take care of health when we have it, than first to lose it, and then exert ourselves to recover it. Such was evi- dently the feeling which elicited the following re- marks from the same clear-sighted author : " You that have health," says he, " and know not how to prize it, I'll tell you what it is, that you may love it better, put a higher value upon it, and endeavour to preserve it with a more serious, stricter observance and tuition. " Health is that which makes your meat and drink both savoury and pleasant, else Nature's injunction of eating and drinking were a hard task and slavish cus- tom. " Health is that which makes your bed easy and your sleep refreshing; that revives your strength with the rising sun, and makes you cheerful at the light of an- other day; 'tis that which fills up the hollow and un- even places of your carcass, and makes your body plump and comely ; 'tis that which dresseth you up in Nature's richest attire, and adorns your face with her choicest colours. " 'Tis that which makes exercise a sport, and walk- ing abroad the enjoyment of your liberty. " 'Tis that which makes fertile and increaseth the natural endowments of your mind, and preserves them long from decay, makes your wit acute, and your mem- ory retentive. " 'Tis that which supports the fragility of a corrup- tible body, and preserves the verdure, vigour, and beauty of youth. " 'Tis that which makes the soul take delight in her mansion, sporting herself at the casement of your eyes. " 'Tis that which makes pleasure to be pleasure, and delights delightful, without which you can sol- 40 WHAT BAD HEALTH IS. ace yourself in nothing of terrene felicities or enjoy- ments." But " now take a view of yourself when health has turned its back upon you, and deserts your company; see then how the scene is changed, how you are rob- bed and spoiled of all your comforts and enjoyments. " Sleep that was stretched out from evening to the fair bright day, is now broken into pieces, and subdi- vided, not worth the accounting; the night that before seemed short is now too long, and the downy bed presseth hard against the bones. "Exercise is now toyling, and walking abroad the carrying of a burthen. " The eye that flasht as lightning is now like the opacous body of a thick cloud; that rolled from east to west, swifter than a celestial orb, is now tired and weary with standing still; that penetrated the centre of another microcosm, hath lost its planetary influ- ence, and is become obtuse and dull," &c. If such, then, be a true picture of the opposite con- ditions of health and disease, what stronger induce- ments can any one require to give him an interest in the " study and observance of Nature's institutions," seeing that they are the only means by which "the beloved ends and wished-for enjoyments" can be at- tained, and that we " may as likely keep or acquire riches by prodigality, as preserve health and obtain long life by intemperance, inordinate passions, a noxious air, and such like injurious customs, ways, and man- ner of living ?"* * Maynwaringe on the Method and Means of Health, 1683. CHAPTER II. STRUCTURE AND FUNCTIONS OF THE SKIN. The Skin—composed of three Layers.—The Cuticle—its Struc- ture and Uses.—The Mucous Coat—the Seat of Colour.—The True Skin—its Structure—the Seat of Perspiration—its Nature —Consequences of Suppressed Perspiration.—Sympathy be- tween the Skin and other Organs.—The Skin a Regulator of Animal Heat.—The Seat of Absorption.—Touch and Sensa- tion.—Connexion between the Skin and Nervous System. In selecting the subjects of the following essays, I shall, as hinted in the preface, be guided partly by the intrinsic importance of the functions of which they treat to the well-being of the animal economy, and partly by the comparative ignorance which prevails in regard to them. Hitherto the digestive functions have formed the most prominent topic of disquisition, and a great mass of information has, from time to time, been laid before the public, with a view to in- duce greater attention to the regulation of diet and re- gimen ; and the action of digestive disorder, in deran- ging the general health and modifying the progress of disease, has also been sedulously pointed out. But there are other organs and functions, of nearly equal interest, which have been much less attended to than they deserve, and with which the general reader is very little familiar. Among these the Skin, the Mus- cles, the Bones, the Lungs, and the Nervous System, may be mentioned as most worthy of notice, and I shall accordingly endeavour to give such an account of them in succession, as will be both intelligible and of direct practical utility to every one. I shall com- mence with an explanation of the structure and func- tions of the Skin. The skin is that membranous covering which is spread over the whole surface of the body, and which D2 42 STRUCTURE OF THE SKIN. serves to bind together and to protect from injury the subjacent and more delicate textures. In different animals and at different parts of the body, it assumes different appearances. It is smooth, soft, and delicate in youth and in females; firmer and more resisting in middle age and in males; flabby and wrinkled in old age and after disease; puckered or disposed in folds in places that admit of extensive flexion, as over the finger-joints and in the palm of the hand; and thick and horny where it is subjected to the influence of pressure, as in the soles of the feet. The structure of the skin, like that of every other part of the animal frame, displays the most striking proofs of me transcendent wisdom and beneficence of its great Creator. Though simple in appearance and design, it is a compound of many elements, and the seat of as great a variety of functions. It is compo- sed of three layers of membrane, viz., the thin scarf- skin or cuticle, the mucous coat, and the thick true skin, as it is called, which immediately encompasses the body. These distinctions should be kept in view; for, as it is a general law of the animal economy that ev- ery part has a use or function peculiar to itself, the various uses of the compound can be understood only by attending to those of the simple elements. The epidermis, cuticle, or scarf skin, is the outermost of the three layers, and is that which is raised in blis- ters. It is a thin, continuous, and insensible membrane, and has no perceptible bloodvessels or nerves, and, consequently, neither bleeds nof feels pain when cut or abraded. Being homogeneous in structure, it is supposed by many to be merely an exudation of al- buminous mucus; and although depressions are obvi- ous on its surface, and exhalation and absorption are proved to be carried on through its substance, it is still in dispute whether it be actually porous or not. Probability is in favour of the affirmative, and the cir- cumstance of the pores not being visible is no proof of the contrary: for the cuticle is so elastic, that it may be perforated by a needle, and yet the hole not be discernible even under the microscope. The ques- STRUCTURE OF THE CUTICLE. 43 tion is, however, one of little moment, provided it be remembered that its texture, whether perforated or not, is such as to admit of exhalation and absorption taking place through its substance. The structure of the cuticle is in admirable harmo- ny with its uses. Placed as an insensible interme- dium between external objects and the delicate ner- vous expansion on the surface of the subjacent true skin, it serves as a physical defence against friction ; and while, by impeding evaporation, it preserves the true skin in that soft and moist state which is* essen- tial to its utility, it also, by impeding absorption, ena- bles man to expose himself without injury to the ac- tion of numerous agents, which, but for its protection, would immediately be absorbed, and cause the speedy destruction of health and life. This is remarkably exemplified in several trades, where the workman is unavoidably exposed to an atmosphere loaded with metallic and poisonous vapours, or obliged to handle poisonous substances; and where, without the ob- struction of the cuticle, the evils to which he is sub- jected would be aggravated a hundred fold. Being destitute of nerves, the cuticle is not hurt by the di- rect contact of external bodies ; and being very thin, it blunts without impairing the distinctness of the im- pression made on the nerves of sensation. The ne- cessity of this latter provision becomes very obvious, when the cuticle is abraded or removed by vesication. The surface below is then found to be too tender and irritable for the exercise of touch, and conveys to the mind scarcely any other sensation than that of pain. For the same reason, those parts of the skin which are most exposed to pressure and friction, such as the palms of the hands and soles of the feet, are pro- vided with a thicker cuticle to defend them from in- jury. The greater thickness of the cuticle in such situations is manifestly the intentional work of the Creator, for it is perceptible even at birth, before use can have exercised any influence. Indeed, were the tender skin not so protected, every violent contrac- tion of the hand upon a rough and hard surface, and 44 USES OF THE CUTICLE. every step made on uneven ground, would cause pain, and disable us for exertion. By another beneficent provision, calculated to af- ford increased protection according to the necessities of the individual, it happens that, when a part is much used, the cuticle covering it becomes thicker and thicker within certain limits, till in extreme cases it becomes as thick, hard, and resisting as horn. It is this thickening of the epidermis on the lady's finger that alone enables her to wield with impunity that im- portant instrument the needle. And it is the same thickening that fits the blacksmith and the mason, the stone-breaker and the boatman, to ply their trades, without that painful blistering which the young ap- prentice or unaccustomed labourer so regularly un- dergoes, and which must have continued to recur for ever had the cuticle been organized with bloodves- sels and nerves, or not subjected to this law of be- coming thicker wherever increased protection is re- quired. Another modification of the cuticle to suit a modi- fication of circumstances, is that observed in the nails. These belong to the cuticle, and separate with it; and, like it, they have neither bloodvessels nor nerves, and may be cut or bruised without pain. When the hand or foot is macerated in water, the nails and the cuticle show their identity of organization, by separ- ating together from the dermis or true skin below. The nails, like the cuticle, serve chiefly to protect the subjacent parts from injury; and accordingly, in those lower animals whose manner of life subjects their feet to continual pressure, and requires no nice exer- cise of touch, Nature has provided horny and resist- ing hoofs for their protection instead of merely a thickened epidermis. To produce thickening of the cuticle, exercise must be gradual, and not too severe. If, for example, a person takes a very long walk, rows a boat, or makes use of a heavy hammer for a few hours, without hav- ing been accustomed to such an effort, there is no time for the cuticle to thicken, and defend itself from STRUCTURE AND USES OF THE MUCOUS COAT. 45 the unusual friction. The parts below, being inade- quately protected, become irritated and inflamed, and throw out a quantity of watery fluid or serum on their surface, which raises up the cuticle in blisters, and, by making it painful to continue the pressure, obliges the person to desist from an exercise which, if continued, would evidently soon alter the structure of the sen- tient nervous filaments, and for ever unfit them for their proper uses : so that even in this result, benefi- cence and wisdom are prominently displayed. Immediately beneath the scarfskin, and between it and the true skin, is the mucous coat, rete mucosum, or mucous network, which is remarkable chiefly as being the seat of the colouring matter of the skin. It is seen with difficulty on dissection except in negroes, in whom it is thick. It is exceedingly attenuated in albinoes, and is, in fact, thick in proportion to the depth of colour. It is destitute of bloodvessels and nerves, but, like the epidermis, is permeable by other bodies. The colouring matter is said to be the same as that of the blood; Davy and Blumenbach, however, regard it as carbon. From all that is known regarding the mucous coat, it may be viewed generally as merely a thin soft cov- ering, placed between the outer and the inner skin, to protect the nerves and vessels of the latter, and give them their requisite softness and pliancy. Being of a dark colour in the negro, it has been supposed to di- minish the heating influence of the sun's rays in tropi- cal climates by the higher radiating power which is possessed by a black than by a light surface; but there is reason to doubt the soundness of the theory at least, for black is well known to excel in absorbing, as well as in radiating, heat; and late experiments on the coast of Africa seem to show, that the tempera- ture of the negro is actually about two degrees high- er than that of the European under the same circum- stances. The mucous coat is the seat of the beautiful and variegated colouring observed in the skins of many fishes and other animals, in which it has often a high and almost metallic splendour. 46 STRUCTURE OF THE TRUE SKIN. The third or inmost layer, called the true skin, cutis, dermis, or corion, constitutes the chief thickness of the skin, and is by far the most important of the three, both in structure and functions. • Unlike the cuticle and mucous coat, which are homogeneous in their whole extent, and apparently without organization, the true skin, or simply, as we shall sometimes call it for brevity's sake, the skin, is very delicately organ- ized, and endowed with the principle of life in a very high degree. Not only is it the beautiful and effica- cious protector of the subjacent structures, but it is the seat of sensation and of touch, and the instrument of a very important exhalation, viz., perspiration, the right condition or disturbance of which is a most pow- erful agent in the preservation or subversion of the general health. The dermis is a dense, firm, and resist- ant tissue, possessed of great extensibility and elas- ticity, and of a colour more or less red in proportion to the quantity of blood it receives and contains. Its looser internal surface, which is united to the cellular membrane in which the fat is deposited, presents a great number of cells or cavities, which penetrate ob- liquely into the substance, and towards the external surface of the skin, and also contain fatty matter. These areolae or cells are larger on some parts of the body than on others: they are very small on the back of the hand and foot, the forehead, and other places where fat is never deposited and the skin has much tenuity; while they are large in the palm of the hand and sole of the foot, where the skin is consequently thicker and fat abounds. These cells are traversed by innumerable bloodvessels and filaments of nerves; the latter passing through to be ramified on the outer surface of the skin, where they show themselves in the form of numerous small papillae Or points, which are very visible on the surface of the tongue, and on the fingers and palm of the hand. These papillae con- stitute the true organs of touch and sensation, and are therefore most thickly planted where these senses are most acute. The true skin is so abundantly supplied with blood USES OF THE TRUE SKIN. 47 and nervous power, that, for practical purposes, it may almost be regarded as composed of vessels and nerves alone; and it is important to notice this fact. The universal and equal redness of the skin in blush- ing is itself a proof of great vascularity; but a still stronger consists in our being unable to direct the point of the finest needle into any spot without punc- turing a vessel and drawing blood. The same test proves the equal abundance of nervous filaments in the skin; for not a point can be punctured without transfixing a nerve and causing pain; and it is well known that, in surgical operations and accidental wounds, the chief pain is always in the skin, because it is profusely supplied with nerves of sensation on purpose to serve as an instrument of feeling. From these examples, it is plain that the skin may be truly considered as a network of bloodvessels and nerves of the finest conceivable texture ; and, taking the vast extent of its whole surface (estimated to exceed in a man of average size 2500 square inches) into account, we can easily understand how these minute ramifica- tions may really constitute a larger mass of nervous matter than what is contained in the original trunks of the nerves from which they are incorrectly said to arise, and also how so large a proportion of the whole blood may be circulated through the skin at one time. To understand the important purposes of the true skin, we must distinguish between its constituent parts, and consider it in virtue of each of them, 1st, As an exhalant of waste matter from the system; 2dly, As a joint regulator of the heat of the body; 3dly, As an agent of absorption; and, 4thly, As the seat of sensation and touch. Besides performing the mechanical office of a shield to the parts beneath, the skin i? admirably fitted, by the great supply of blood which it receives, for its use as a secreting and excreting organ. The whole ani- mal system is in a state of constant decay and reno- vation ; and while the stomach and alimentary canal take in new materials, the skin forms one of the prin- 48 INSENSIBLE PERSPIRATION. cipal outlets or channels by which the old, altered, or useless particles are eliminated from the body; and hence, as all the secretions and excretions are de- rived directly from the circulating blood, jthe skin ob- viously requires a supply large in proportion to the ex- tent of its function. Every one knows that the skin perspires, and that checked perspiration is a powerful cause of disease and of death; but few have any just notion of the real extent and influence of this exhala- tion such as we shall attempt to exhibit it. When the body is overheated by exercise in warm weather, a copious sweat soon breaks out, which, by evapo- rating and so carrying off the superfluous heat, pro- duces an agreeable feeling of coolness and refresh- ment.* This is the higher and more obvious degree of the function of exhalation; but, in the ordinary state, the skin is constantly giving out a large quantity of waste materials by what is called insensible perspi- ration, a process which is of great importance to the preservation of health, and which is called insensible because the exhalation, being in the form of vapour, and carried off by the surrounding air, is invisible to the eye; but its presence may often be made mani- fest, even to the sight, by the near approach of a dry cool mirror, on the surface of which it will soon be condensed so as to become visible. Many attempts have been made to estimate accu- rately the amount of exhaled matter carried off through the skin; but so many difficulties stand in the way of obtaining precise results, and the difference in differ- ent constitutions, and even in the same person at dif- ferent times, is so great, that we must be satisfied with an approximation to the truth. Sanctorius, who carefully weighed himself, his food, and his excre- tions, in a balance every day for thirty years, came to the conclusion that^e out of every eight pounds of substances taken into the system passed out of it again by the skin, leaving only three to pass off by * The effect of evaporation in reducing temperature is explain- ed more fully on p. 59. v INSENSIBLE PERSPIRATION. 49 the bowels, the lungs, and the kidneys. The cele- brated Lavoisier and M. Seguin afterward entered on the same field of inquiry, and with greater success, as they were the first to distinguish between the cu- taneous and pulmonary exhalations. M. Seguin shut himself up in a bag of glazed taffetas, which was tied over his head and provided with a hole, the edges of which were glued to his lips with a mixture of tur- pentine and pitch, so that the pulmonary exhalation might be thrown outward, and the cutaneous alone be retained in the bag. He first weighed himself and the bag in a very nice balance, at the beginning of the experiment; then at the end of it, when he had be- come lighter in proportion to the quantity of exhala- tion thrown out by the breathing; and, lastly, he weighed himself out of the bag, to ascertain how much weight he had lost in all; and by subtracting the loss occasioned by the lungs, the remainder, of course, ex- hibited the amount carried off by the skin. He at- tended minutely also to the collateral circumstances of diet, temperature, &c.; and allowance being made for these, the results at which he arrived were the following: The largest quantity of insensible perspiration from the lungs and skin together amounted to thirty-two grains per minute, three ounces and a quarter per hour, or five pounds per day. Of this, the cutaneous constituted three fourths or sixty ounces in twenty- four hours. The smallest quantity observed amount- ed to eleven grains per" minute, or one pound eleven and a half ounces in twenty-four hours, of which the skin furnished about twenty ounces. The medium or average amount was eighteen grains a minute, of which eleven were from the skin, making the cutane- ous perspiration in twenty-four hours about thirty- three ounces. When the extent of surface which the skin presents is considered, these results do not seem extravagant. But even admitting that there may be some unperceived source of fallacy in the experi- ments, and that the quantity is not so great as is here stated, still, after making every allowance, enough re- 50 SENSIBLE PERSPIRATION. mains to demonstrate that exhalation is a very impor- tant function of the skin. And although the precise amount of perspiration may be disputed, the greater number of observers agree that the cutaneous exha- lation is more abundant than the united excretions of both bowels and kidneys; and that, according as the weather becomes warmer or colder, the skin and kid- neys alternate in the proportions of work which they severally perform; most passing off by the skin in warm weather, and by the kidneys in cold. The quan- tity exhaled increases after meals, during sleep, in dry warm weather, and by friction or whatever stimu- lates the skin; and diminishes when digestion is im- paired, and in a moist atmosphere. What we have considered relates only to the insen- sible perspiration. That which is caused by great heat or severe exercise, is evolved in much greater quantity; and by accumulating at the surface, it be- comes visible, and forms sweat. In this way, a ro- bust man may lose two or three pounds' weight in the course of one hour's severe exertion; and if this be suddenly checked, the consequences in certain states of the system are often of the most serious de- scription. When the surface of the body is chilled by cold, the bloodvessels of the skin become contract- ed in their diameter, and hinder the free entrance of the red particles of the blood, which are therefore of necessity collected and retained in greater quantity in the internal organs, where the heat varies very lit- tle. The skin, consequently, becomes pale, and its papillae contract, forming by their erection what is called the goose's skin. In this state it becomes less fit for its uses ; the sense of touch can no longer nice- ly discriminate the qualities of bodies, and a cut or bruise may be received with comparatively little pain. From the oppression of too much blood, the internal parts, on the other hand, work heavily: the mental organs are weakened, sleepiness is induced, respira- tion is oppressed, the circulation languishes, and di- gestion ceases; and if the cold be very intense, the vital functions are at last extinguished without pain NATURE OF PERSPIRATION. 51 and without a struggle. This is a picture of the ex- treme degree; but the same causes which, in an ag- gravated form, occasion death, produce, when applied in a minor degree, effects equally certain, although not equally marked or speedy in their appearance. According to Thenard, the cutaneous exhalation is composed of a large quantity of water and a small por- tion of acetic acid, of" muriates of soda and potass, of an earthy phosphate, a little oxyde of iron, and some animal matter; but Berzelius considers the acid as lactic, and not the acetic. Some carbonic acid and oily matter also are excreted. It is probable, how- ever, that the composition of the perspiration varies both at different ages and on different parts of the skin, as is presumable from the peculiarity of odour which it exhales in some situations. The armpits, the groins, the forehead, the hands, and the feet, per- spire most readily, and for this purpose receive a pro- portionally larger supply of blood. Everything tends to show that perspiration is a direct product of a vital process, and not a mere exudation of watery particles through the pores of the skin. Taking even the lowest estimate of Lavoisier, we find the skin endowed with the important charge of removing from the system about twenty ounces of waste matter every twenty-four hours; and when we consider that the quantity not only is great, but is sent forth in so divided a state as to be invisible to the eye, and that the whole of it is given out by the very mi- nute ramifications of the bloodvessels of the skin, we perceive at once why these are so extremely numer- ous that a pin's point cannot touch any spot without piercing them; and we see an ample reason why, independently of the impression made through the medium of the nervous system, checked perspira- tion should prove so detrimental to health—because for every twenty-four hours during which such a state continues, we must either have twenty ounces of use- less and hurtful matter accumulating in the body, or have some of the other organs of excretion grievous- ly overtasked, which obviously cannot happen with- 52 RECIPROCAL ACTION BETWEEN THE SKIN out disturbing their regularity and well-being. Peo- ple know the fact, and wonder that it should be so, that cold applied to the skin, or continued exposure in a cold day, often produces a bowel complaint, a severe cold in the chest, or inflammation of some in- ternal organ : but were they taught, as they ought to be, the structure and uses of their own bodies, they would rather wonder that it did not always produce one of these effects. In tracing the connexion between suppressed per- spiration and the production of individual diseases, we shall find that those organs which possess some simi- larity of function sympathize most closely with each other. Thus the skin, the bowels, the lungs, the liv- er, and the kidneys, sympathize readily, because they have all the common office of throwing waste matter out of the system, each in a way peculiar to its own structure; so that if the exhalation from the skin, for example, be stopped by long exposure to cold, the large quantity of waste matter which it was charged to excrete, and which in itself is hurtful to the sys- tem, will most probably be thrown upon one or other of the above-named organs, whose functions will, con- sequently, become excited ; and if any of them, from constitutional or accidental causes, be already weaker than the rest, as often happens, its health will natu- rally be the first to suffer. In this way, the bowels become irritated in one individual, and occasion bow- el complaints ; while in another, it is the lungs which become affected, giving rise to catarrh or common cold, or perhaps even to inflammation. When, on the other hand, all these organs are in a state of vigorous health, a temporary increase of function takes place in them, and relieves the system, without leading to any local disorder; and the skin itself speedily resumes its activity, and restores the balance among them. One of the most obvious illustrations of this reci- procity of action is afforded by any convivial compa- ny seated in a warm room in a cold evening.* The heat of the room, the food and wine, and the excite- ment of the moment, stimulate the skin, cause an af- AND OTHER ORGANS. 53 flux of blood to the surface, and increase in a high degree the flow of the insensible perspiration ; which thus, while the heat continues, carries off an undue share of the fluids of the body, and leaves the kidneys almost at rest. But the moment the company goes into the cold external air, a sudden reversal of opera- tions takes place; the cold chills the surface, stops the perspiration, and directs the current of the blood towards the internal organs, which presently become excited; and, under this excitation, the kidneys, for example, will in a few minutes secrete as much of their peculiar fluid as they did in as many of the pre- ceding hours. The reverse of this, again, is common in diseases obstructing the secretion from the kid- neys ; for the perspiration from the skin is then alter- ed in quantity and quality, and acquires much of the peculiar smell of the urinary fluid. When the lungs are weak, and their lining mem- brane is habitually relaxed, and secretes an unusual amount of mucus from its surface, the mass of blood thrown inward upon the lungs by cold applied to the skin, increases that secretion to a high degree. Were this secretion to accumulate, it would soon fill up the air-cells of the lungs and cause suffocation; but, to obviate this danger, the Creator has so constituted the lungs, that accumulated mucus, or any foreign body coming in contact with them, excites the convulsive effort called coughing, by which a violent and rapid expiration takes place, with a force sufficient to hurry the mucus or other foreign body along with it: just as pease are discharged by boys with much force through short tubes by a sudden effort of blowing. Thus, a check given to perspiration, by diminishing the quan- tity of blood previously circulating on the surface, naturally leads very often to increased expectoration and cough, or, in other words, to common cold. The lungs excrete, as already noticed, and as we shall afterward more fully see, a large proportion of waste materials from the system; and the kidneys, the liver, and the bowels have in so far a similar of- fice. In consequence of this alliance with the skin, E2 54 RECIPROCAL ACTION BETWEEN THE SKIN these parts are more intimately connected with each other in healthy and diseased action than with other organs. But it is a general law, that whenever an or- gan is unusually delicate, it will be more easily affect- ed by any cause of disease than those which are sound : so that, if the nervous system, for example, be weaker than other parts, a chill will be more likely to disturb its health than that of the lungs, which are supposed, in this instance, to be constitutionally stron- ger ; or, if the muscular and fibrous organizations be unusually susceptible of disturbance, either from pre- vious illness or from natural predisposition, they will be the first to suffer, and rheumatism will ensue; and so on. And hence the utility to the physician of an intimate acquaintance with the previous habits and constitutions of his patients, and the advantage of adapting the remedies to the nature of the cause, when it can be discovered, as well as to the disease itself. A bowel complaint, for instance, may arise from overeating as well as from a check to perspi- ration ; but although the thing to be cured is the same, the means of cure ought obviously to be different. In the one instance, an emetic or laxative to carry off the offending cause, and in the other a diaphoretic to open the skin, will be the most rational and efficacious remedies. Facts like these expose well the glaring ignorance and effrontery of the quack, who affirms that his one remedy will cure every form of disease. Were the public not equally ignorant with himself, their credulity would cease to afford to his presump- tion the rich field in which it now revels. The close sympathy between the skin and the stomach and bowels has often been noticed, and it is now well understood that most of the obstinate erup- tions which appear on the face and rest of the sur- face owe their origin to disorders of the digestive or- gans, and are most successfully cured by treatment directed to the internal disease. Even among the lower animals, the sympathy between the two is so marked as to have arrested attention. Thus, in speak- ing of the horse, Delabere Blaine says, " by a well- AND OTHER ORGAJNS. 55 known consent of parts between the skin and aliment- ary canal in general, but between the first passages and the stomach in particular, it follows, in almost every instance, that when one of these becomes af- fected, the other takes on a sympathetic derangement also, and the condition is then morbid throughout. From close observation and the accumulation of nu- merous facts, I am disposed to think, that so perfect is this sympathetic consent between these two dis- tant parts or organs, that they change the order of at- tack as circumstances occur. Thus, when the skin is primarily affected, the stomach becomes secondarily so, and vice versa," so that " a sudden check to the natural or acquired heat of the body, particularly if aggravated by the evaporation of a perspiring state," as often brings on disease of some internal organ, as if the cause were applied directly to the organ itself.* In noticing this connexion between the suppression of perspiration and the appearance of internal disease, I do not mean to affirm that the effect is produced by the physical transference of the suppressed exhala- tion to the internal organ. In many instances, the chief impression seems to be made on the nervous system; and the manner in which it gives rise to the resulting disease is often extremely obscure. Our knowledge of the animal functions is, indeed, still so imperfect, that we daily meet with many occurrences of which no explanation can be given. But it is nev- ertheless of high utility to make known the fact, that a connexion does exist between two orders of phe- nomena, as it calls attention to their more accurate observation, and leads to the adoptifti of useful prac- tical rules, even when their mode of operation is not understood. Nothing, indeed, can be more delusive than the rash application of merely physical laws to the explanation of the phenomena of living beings. Vitality is a principle superior to, and in continual warfare with, the laws which regulate the actions of inanimate bodies; and it is only after life has become * Blaine's Outlines of the Veterinary Art. Third edition, p. 6&, 56 RECIPROCAL ACTION BETWEEN THE SKIN extinct that these laws regain the mastery, and lead to the rapid decomposition of the animal machine. In studying the functions of the human body, there- fore, we must be careful not to hurry to conclusions, before taking time to examine the influence of the vi- tal principle in modifying the expected results.* It is in consequence of the sympathy and recipro- city of action existing between the skin and the inter- nal organs that burns and even scalds of no very great extent prove fatal, by inducing internal, generally in- testinal, inflammation. By disordering or disorgan- izing a large nervous and exhaling surface, an exten- sive burn causes not only a violent nervous commo- tion, but a continued partial suspension of an impor- tant excretion; and, when death ensues at some dis- tance of time, it is almost always in consequence of inflammation being excited in the boweis or sympa- thizing organ. So intimate, indeed, is this connex- ion, that some surgeons of great experience, such as the late Baron Dupuytren, of the Hotel Dieu, while they point to internal inflammation as in such cases the general cause of death, doubt if recovery ever takes place when more than one eighth of the sur- face of the body is severely burned. And whether this estimate be correct or not, the facts from which it is drawn clearly demonstrate the importance of the re- lation subsisting between the skin and the other ex- creting organs. In some constitutions, a singular enough sympathy exists between the skin and the bowels. Dr. A. T. Thomson, in his work on Materia Medica (p. 42), men- tions that he is acquainted with a clergyman who can- not bear the skin to be sponged with vinegar and wa- ter, or any diluted acid, without suffering spasm and * After the corresponding sheets of the first edition were print- ed, I met with some excellent practical remarks on the sympathy between the skin and the thoracic and abdominal viscera, in Dr. James Johnson's " Treatise on Derangements of the Liver, In- ternal Organs, and Nervous System," published some years ago They deserve every attention on the part of the profession, as showing how affections of different organs influence each other. AND OTHER ORGANS. 57 violent griping of the bowels. The reverse operation of this sympathy is exemplified in the frequent pro- duction of nettle-rash and other eruptions on the skin, by shellfish and other substances taken into the stom- ach. Dr. Thomson tells us, that the late Dr. Gregory could not eat the smallest portion of the white of an egg without experiencing an attack of an eruption like nettle-rash. According to the same author, even strawberries have been known to cause fainting, fol- lowed by a petechial efflorescence of the skin. We have seen that the insensible perspiration re- moves from the system, without trouble and without consciousness, a large quantity of useless materials, and at the same time keeps the skin soft and moist, and thereby fits it for the performance of its functions as the organ of an external sense. In addition to these purposes, the Creator has, in his omniscience and foresight, and with that regard to simplicity of means which betokens a profoundness of thought in- conceivable to us, superadded another, scarcely less important, and which is in some degree implied in the former; I mean the proper regulation of the bodily heat. It is well known that, in the polar regions and in the torrid zone, under every variety of circumstan- ces, the human body retains nearly the same tem- perature, however different may be that of the air by which it is surrounded. This is a property peculiar to life, and, in consequence of it, even vegetables have a power of modifying their own temperature, though in a much more limited degree. Without this power of adaptation, it is obvious that man must have been chained for life to the climate which gave him birth, and even then have suffered constantly from the change of seasons ; whereas, by possessing it, he can retain life in a temperature sufficiently cold to freeze mercury, and is able for a time to sustain, unharmed, a heat more than sufficient to boil water or even to bake meat. Witness the wintering of Captain Parry and his companions in the Polar Regions ; and the ex- periments of Blagden, Sir Joseph Banks, and others, who remained for many minutes in a room heated to 58 THE SKIN A REGULATOR OF ANIMAL HEAT. 260°, or about 50° above the temperature of boiling water. The chief agents in this wonderful adaptation of man to his external situation, are undoubtedly the skin and the lungs, in both of which the power is in- timately connected with the condition of their respect- ive exhalations. But it is of the skin alone, as an agent in reducing animal heat, that we are at present to speak. The sources of animal heat are not yet demonstra- bly ascertained; but that it is constantly generated and constantly expended has been long known; and if any considerable disproportion occurs between these processes, it is at the immediate risk of health. During repose or passive exercise, such as riding in a carriage or sailing, the surplus heat is readily car- ried off by the insensible perspiration from the lungs and skin, and by the contact of the colder air; but when the amount of heat generated is increased, as during active exercise, an increased expenditure becomes immediately necessary : this is effected by the skin and lungs being excited to higher action; by the lat- ter sending out the respired air loaded with vapour, and the former exhaling its fluid so rapidly as to form a sweat. Accordingly, we find that in cold countries and in frosty weather, the exhalation from the skin is reduced to a very moderate amount, the superabun- dant heat being rapidly carried off by contact with a cooler air; and that, in warm climates, where the heat is not carried off in this way, the surface is constantly bedewed with perspiration, and a corresponding appe- tite exists for liquids by which the perspiration may be kept up to a sufficient degree. Every one must have experienced the grateful effects of this provision, in passing from the dry, restless, and burning heat, like that of fever, to the soft and pleasant coolness which follows the breaking out of the sweat. Attention to the order of events affords the requi- site knowledge of the means employed for carrying off the increased heat which is produced when a per- son is exposed to a warm air and powerful sun or engaged in severe exercise. At first, the body is'ac- THE SKIN A REGULATOR OF ANIMAL HEAT. 59 tually felt to be warmer, the skin becomes dry and hot, and the unpleasant sensation of heat is soon at its maximum. By-and-by a slight moisture is per- ceived on the surface, followed by an immediate in- crease of comfort. In a short time afterward this moisture passes into free and copious perspiration; and if the heat or exertion be still kept up, the sweat becomes profuse, and drops from the body or wets the clothes which envelop it. A decrease of animal heat unavoidably accompanies this, because, independent- ly of any vital action cpntributing to this effect, as is most probable, the mere physical evaporation of so much fluid is itself sufficient to carry off" a large quan- tity of caloric. The curious experiments of Edwards tend to show that evaporation is really the only means required for reducing animal heat to its proper de- gree ; but the results obtained by him require to be confirmed, and the experiments varied and carried farther, before the inquiry can be considered as com- pleted. The sagacity of Franklin led him to the first discovery of the use of perspiration in reducing the heat of the body, and to point out the analogy subsist- ing between this process and that of the evaporation of water from a rough porous surface, so constantly resorted to in the East and West Indies, and other warm countries, as an efficacious means of reducing the temperature of the air in rooms, and of wine and other drinks, much below that of the surrounding at- mosphere. The quantity of fluid evaporated from the skin during profuse sweat so far exceeds that given out during the highest insensible perspiration, that two pounds in weight have been lost by this means in a couple of hours; an amount evidently sufficient to carry off the largest quantity of superfluous animal heat which can ever be present. In the performance of this function, the skin is, indeed, assisted by the exhalation from the lungs; but as both act on the same principle, the explanation is not affected by this circumstance. In very warm weather, the dog is always seen with the tongue lolling out of his mouth, and copiously 60 THE SKIN A REGULATOR OF ANIMAL HEAT. covered with frothy secretion. This is merely an- other modification of the means used for reducing ani- mal heat. The dog perspires very little from its skin, and the copious exhalation from the mouth is the ex- pedient resorted to by Nature for supplying its place. Bearing in mind the preceding explanation of the functions of the skin, the reader will peruse with in- terest the following remarks from Dr. Thomson's work* formerly quoted. " Dr. Davy, in his Travels in Ceylon, states, from his personal observation, that on first landing in a tropical climate, the standard heat of the body of a European is raised two or three de- grees, and febrile symptoms occur, which require temperance, the avoiding every cause of excitement of the vascular system, and the use of aperient medi- cines. All authors, and indeed every observing per- son, who has visited the torrid zone, agree that with the languor and exhaustion resulting from the high temperature of the atmosphere, there is a greatly in- creased mobility of the nervous system. The action of the cutaneous vessels amounts to disease, and produ- ces that eczematous or vesicular eruption of the skin known by the name of prickly heat, which occurs in Europeans who visit the West Indies on their first landing. On the other hand, this function of the skin is so much weakened, almost paralyzed, when the climate from which a person is passing is dry and bracing, and that into which he has passed is humid and relaxing, that congestions of blood take place in the larger vessels, the body becomes susceptible of the least impression of marshy exhalations, and agues and similar diseases are produced." We shall now be able to understand why in summer we suffer most from heat in what is called moist close weather, when no air is stirring; and why warm cli- mates, that are at the same time moist, are proverbi- ally the most unwholesome. The chief reason is the diminished evaporation from the skin which such a condition of the atmosphere produces, partially shut- * P. 66. CUTANEOUS ABSORPTION. 61 ting up the natural outlet of the superfluous heat of the body; and as it at the same time checks the exit of the waste matter which ought to be thrown out, and which is known to be as injurious to the system as an active poison taken into the body from without, the hurtful consequences of such weather and cli- mates, and the fevers, dysenteries, and colds to which they give rise, are partly accounted for. A moist state of the atmosphere is also favourable to absorp- tion ; and hence, if noxious effluvia are at the time floating in the air, they are more easily received into the system. It is on this account that night air is so unwholesome, particularly in malaria districts, which are loaded with moisture and miasma, or marsh poi- son ; for when the air is dry as well as hot, free evap- oration takes place, and absorption is almost null, so that little or no inconvenience is felt, and health of- ten remains uninjured. Delaroche has established this point conclusively by experiment. He exposed animals to a very high temperature in a dry air, and found them to sustain no mischief; but when he ex- posed them, in an atmosphere saturated with moisture, ',o a heat only a few degrees above that of their own bodies, and greatly lower than in the former instance, they very soon died. Here we see also the reason why, in ague and other fevers, the suffering, restless- ness, and excitement of the hot stage can never be abated till the sweat begins to flow, after which they rapidly subside; and why the remedies which, when given in the hot stage, added to the excitement and distress, may now be productive of the best effects. The function next to be noticed, viz., Absorption, is in some measure the opposite of the last. By its in- strumentality, substances placed in contact with the skin are taken up and carried into the general circu- lation, either to be appropriated to some new purpose or to be thrown out of the body. In the vaccination of children to protect them from smallpox, we have a familiar example of the process of absorption. A small quantity of cowpox matter is inserted under the cuticle on the surface of the true F 62 CUTANEOUS ABSORPTION. skin, and there left. In a short time it is acted upon, and taken into the system by the absorbent vessels. In like manner, mercurial preparations, rubbed on the skin for the cure of liver complaint, are absorbed, and affect the constitution precisely as when received into the stomach. Many even of the common laxatives, such as rhubarb and croton oil, have of late been suc- cessfully administered in the same way, and the rapid absorption of poisons from bites of rabid animals and wounds in dissection, through the same channel, is fa- miliar to every one. It is from the active principle of the Spanish flies used in blisters being taken up by the cutaneous absorbents, that irritation of the kid- neys and urinary organs so often attends the employ- ment of that remedy. The process of absorption is carried on by vessels fitted for the purpose, which are thence named absorb- ent vessels, or simply absorbents. In the skin they are so exceedingly small and numerous, that, when in- jected with mercury, the surface is said by Dr. Gor- don to resemble a sheet of silver. In health they are of too small a size to admit the red particles of the blood, and hence, from their contents being nearly transparent, they are sometimes named lymphatics. Some ascribe great importance, and others very lit- tle, to cutaneous absorption. In some diseases, such as diabetes, in which, occasionally for weeks in suc- cession, the urinary discharge exceeds, by many ounces daily, the whole quantity of food and drink, without the body losing proportionally in weight, we can account for the system being sustained only by supposing moisture to be extensively absorbed from the air by the skin and lungs. The ancients, indeed, believed that, when food could not be retained in the stomach, a person might be nourished by placing him in a bath of strong soup or milk ; but recent experi- ments serve to show that, in such circumstances, ab- sorption is too trifling in amount for any such result. Some indeed deny that any absorption would take place at all, because it is observed as a general fact that the body does not gain in weight by immersion CUTANEOUS ABSORPTION. 63 in a warm bath. But the inference is not well found- ed, for occasionally weight is gained ; and even when it is not, as much water must have been absorbed as would make up the loss sustained during immersion by perspiration, which is believed to go on more rap- idly in warm water than in the open air. That animals absorb copiously when immersed in water, has been amply proved by Dr. Edwards and other physiologists. Dr. Edwards selected lizards as the subjects of experiment, because he regarded their scaly skins as unfavourable for absorption. After re- ducing the bulk of a lizard by several days' expo- sure to a dry air, he immersed its tail and hind legs in water, and found that absorption took place to such an extent as to restore the original plumpness of all parts of the body. The same result attended a vari- ety of other trials, so that the fact does not admit of doubt. In man, absorption from the surface is great- ly retarded by the intervention of the cuticle ; and it is universally admitted that, when this obstacle is re- moved, the process goes on with great vigour. Thus arsenic applied to cancerous sores, and strong solu- tions of opium to extensive burns in children, have been absorbed in quantities sufficient to poison the patients. Colic in its severest forms has followed similar external applications of the salts of lead. Mercury, also, in the form of fumigation, has often been used where rapid action was required, because in the state of vapour it is very speedily taken up by the cutaneous absorbents. It is quite certain, then, that the skin does absorb. The only doubt is as to what extent the cuticle oper- ates in preventing or modifying that action. When friction accompanies the external application, the cu- ticle, as we see exemplified in the use of mercurial and other liniments, is not an efficient obstacle. But when friction is not resorted to, and the substance applied is of a mild, unirritating nature, such as oil, it may remain in contact with the skin for a long time without being taken into the system in appreciable quantities. If, however, it is irritating, like Spanish 64 CUTANEOUS ABSORPTION. flies, absorption speedily begins, and is carried on through the cuticle, as is proved by the effects produ- ced on the urinary organs. When the perspiration is brought to the surface of the skin, and confined there either by injudicious cloth- ing or by want of cleanliness, there is much reason to suppose that its residual parts are again absorbed, and act on the system as a poison of greater or less power, according to its quantity and degree of con- centration, thereby producing fever, inflammation, and even death itself; for it is established by observation, that concentrated animal effluvia form a very ener- getic poison. The fatal consequences which have repeatedly followed the use of a close water-proof dress by sportsmen and others, and the heat and un- easy restlessness which speedily ensue where proper ventilation is thus prevented, seem explicable on some such principle. It is believed by many, that marsh miasmata and other poisons are absorbed by the skin as well as by the lungs, and Bichat considered the fact as estab- lished in regard to the effluvia of dissecting-rooms. There are many reasons for concurring in this belief. The plague, for instance, is much more readily com- municated by contact than by any other means, and this can happen only through the medium of absorp- tion. Besides, it is observed that those who work with oil, and other greasy substances which obstruct the pores of the skin, often escape the contagion when all around them suffer. Flannel and warm clothing, in like manner, which have been proved to be ex- tremely useful in preserving those who are unavoida- bly exposed to the action of malaria and of epidemic influences, manifestly act chiefly by protecting the skin. A late writer on the Malaria of Rome strongly advocates this opinion, and expresses his conviction that the ancient Romans suffered less from it, chiefly because they were always enveloped in warm woollen dresses. This opinion, he says, is justified by the ob- servation, that since the period at which the use of woollen clothing came again into vogue, intermittent CUTANEOUS ABSORPTION. 65 fevers have very sensibly diminished in Rome. Even in the warmest weather the shepherds are now cloth- ed in sheepskins. Brocchi, who experimented ex- tensively on the subject, obtained a quantity of putrid matter from the unwholesome air, and came to the conclusion that it penetrated by the pores of the skin rather than by the lungs. Brocchi ascribes the im- munity of the sheep and cattle, which pasture night and day in the Campagna, to the protection afforded them by their wool.* These remarks deserve the serious attention of observers; particularly as, according to Patissier, similar means have been found effectual in preserving the health of labourers digging and exca- vating drains and canals in marshy grounds, where, previously to the employment of these precautions, the mortality from fever was very considerable. It is a general law, that every organ acts with in- creased energy when excited by its own stimulus; and the application of this law to the different func- tions of the skin may help to remove some of our difficulties. The skin exhales most in a warm dry at- mosphere, because the latter dissolves and carries off the secretion as fast as it is produced; and the same condition is unfavourable to absorption, because no- thing is present upon which the absorbents of the skin can act. In a moist atmosphere, on the other hand, the absorbents meet with their appropriate stimulus, and act powerfully; while exhalation is greatly di- minished, because the air can no longer carry off the perspiration so freely. Apparently from this exten- sive absorption, we find the inhabitants of marshy and humid districts remarkable for the predominance of the lymphatic system, as has long been remarked of the Dutch; and, as malaria prevails chiefly in situa- tions and seasons in which the air is loaded with moisture, and is most energetic at periods when ab- sorption is most active and moisture is at its maxi- mum, the probability of its being received into the system chiefly by cutaneous absorption is greatly in- * Edin. Phil. Journ., January, 1833. F2 66 TOUCH AND SENSATION. creased, and the propriety of endeavouring to protect ourselves from its influence by warm woollen clothing becomes more striking. In the army and navy, ac- cordingly, where practical experience is most follow- ed, the utmost attention is now paid to enforcing the use of flannel and sufficient clothing as a protection against fever, dysentery, and other diseases, particu- larly in unhealthy climates. In the prevention of cholera, flannel was decidedly useful. From the above exposition of the laws of absorp- tion, and from the facts referred to at page 61, may it not be feasibly inferred, that the efficacy of great heat in preventing contagion from the plague is partly ow- ing to the consequent dryness of the atmosphere no longer presenting the requisite stimulus to the ab- sorbents, but, on the contrary, powerfully exciting the action of the exhalants ? Damp directly stimulates the absorbents, and hence may arise its hurtfulness as a vehicle. The system, too, it is well known, is peculiarly susceptible of infection when the stomach has been for some time empty, as before breakfast. May not this be accounted for by the then greater ac- tivity of absorption ? From grouping all the constituent parts of the skin into one whole, and perceiving so many operations connected with that tegument, some may be apt to suppose it an exception to the principle laid down, that no single part can execute more than a single di- rect function. In reality, however, it is only by ta- king the guidance of this principle that we can extri- cate ourselves from the apparent confusion. We have already seen that exhalation and absorption are each connected with distinct textures in the skin. On far- ther examination, we shall find the office of Touch and Sensation intrusted exclusively to another con- stituent part, the nervous ; for, in serving as the instru- ment of feeling, the skin acts in no other way than by affording a suitable surface for the distribution and protection of the nerves which receive and transmit to the brain and mind the impressions made on them TOUCH AND SENSATION. 67 by external bodies. In this respect the skin resem- bles the other organs of sense, in all of which the nerve is the true instrument of the sense ; the eye, the ear, the nose, and the skin, being simply structures fitted to bring the nerve into relation with the quali- ties of colour, sound, smell, roughness, and smooth- ness, by which they are respectively affected; and they differ from each other, because sound differs from colour, colour from smell, and smell from rough- ness or smoothness ; and because sound or colour can be taken cognizance of by its own nerve, only when the latter is provided with an apparatus fit to be act- ed upon by the vibrations of the air or by the rays of light. In every instance, it is the external object act- ing upon a nerve which gives rise to the impression received from the organs of sense. Every part of the skin, however remote, is provided with filaments from the nerves of sensation, in order that we may become immediately sensible of the pres- ence and action of external bodies. If any part were destitute of this property, its texture and vitali- ty might be destroyed without our being conscious of the fact; whereas, in consequence of this provision of sensitive nerves, no object can touch the skin with- out our being instantly made aware of its presence and properties. A case described by Dr. Yelloly, in the third volume of the Medico-Chirurgical Transac- tions, illustrates in a striking manner the great utility of these nerves in warning us of danger. " The pa- tient's hands," says Dr. Yelloly, " up to the wrists, and the feet half way up the legs, are perfectly insen- sible to any species of injury, as cutting, pinching, scratching, or burning. . . He accidentally put one of his feet, some time ago, into boiling water, but luas no otherwise aware of the high temperature than by finding the whole surface a complete blister on removing it." While, however, sensation is common to the whole surface of the body, there are parts of the skin more immediately destined by Nature for the exercise of Touch, and for the better appreciation of all the quali- ties of which it is cognizant. Such are the hands and 68 TOUCH AND SENSATION. tongue in man, the proboscis in the elephant, the tail in some of the monkey tribes, and the tentacula in fishes. Now, in accordance with the explanation giv- en of the dependance of sensation upon nervous en- dowment, it is remarkable that all the parts destined for this special exercise of touch receive the most abundant supply of sensitive nerves. Thus the nerves going to the hand and arm, the most perfect instruments of touch and sensation in man, are at their dorsal roots five times larger than those which are destined for its motion; and, in like manner, the nerve supplying the tactile extremity of the proboscis of the elephant exceeds in size the united volume of all its muscular nerves. On the other hand, in ani- mals covered with hair or feathers, whose touch and sensation are comparatively defective, the muscular nerves far exceed in size those of sensation; and wherever Nature has endowed any particular part with high sensitive powers, she is invariably found to have distributed to that part, and to it alone, a propor- tionally higher nervous endowment. In man, the in- numerable nervous papillae destined for the exercise of touch maybe distinctly seen in parallel irregular rows on the fingers and palm of the hand, and every- body knows how acute the sense is in these parts. In fishes, on the other hand, no nervous papillae can be detected on the surface of the skin; but many of them have tentacula or projections generally about the mouth, for the special purpose of exercising touch, and these are always plentifully supplied with branch- es from the fifth pair of nerves. The nervous tissue of the skin is thus not only an important instrument for receiving and conveying to the mind accurate impressions in regard to the prop- erties of external objects, but it is even essential to our continued existence. The pain which is caused by injuries is no doubt very disagreeable, but in its uses it is a positive blessing, in warning us against the danger, and even certain destruction, which would speedily overtake us if we had no such monitor at hand. If we had no nerves on the surface to com- TOUCH AND SENSATION. 69 municate to us a lively impression of cold, we might inadvertently remain inactive in a temperature which would not only suspend perspiration, but benumb the powers of life; or we might, as we have already seen, approach so near the fire or boiling fluids, as to have the organization destroyed before we knew: where- as, by the kind interposition of the nerves, we can- not, when perspiring freely, be exposed to the cold air without an unpleasant sensation being experienced, impelling us to attend to our safety, and to keep up our heat either by additional clothing or by active ex- ercise. When both the nervous and the vascular parts of the skin are in healthy action, a pleasant soft warmth is felt over the body, which is in itself a de- light, and which gives to the mind a lightness and hilarity, or pleasant consciousness of active existence, the very opposite of the low and languid depression which so generally accompanies continued defective action in the skin, and which forms a marked feature in many nervous affections. For the due exercise of sensation, the nerves must be in a proper state of health. If, for example, the cuticle protecting the nervous papillae be abraded or removed by vesication, the naked nerves are too pow- erfully stimulated by the contact of external bodies, and, instead of receiving and transmitting the usual impressions of heat, cold, and configuration, they com- municate scarcely any feeling except that of pain; while, if the cuticle become thickened by hard labour, the impression made on the nerves is proportionally lessened, and little information is conveyed by them to the mind. A due supply of arterial blood is another requisite for the action of the nerves of sensation. If they be deprived of this, as by exposing the body to a degree of cold sufficient to drive the blood from the surface, the nerves become almost insensible, and severe wounds may be received in this state without the in- dividual being conscious of the accident, or feeling the slightest pain. For the same reason, severe cold, after a certain time, ceases to be painful, and death 70 TOUCH AND SENSATION. ensues like deep sleep and without suffering. But when a frozen limb is thawed, and the returning cir- culation begins to set the nerves in action, suttering forthwith commences, and the overaction is in dan- ger of leading to inflammation. The same phenom- ena, in an inferior degree, must be familiar to every one, in the prickling and tingling so commonly com- plained Of on heating cold hands or feet too rapidly at a good fire; symptoms which arise from the return of the blood stimulating the nerves to undue action. It is the nervous tissue of the skin which takes cog- nizance of the temperature of the bodies by which we are surrounded, and imparts to the mind the sensation of warmth and coldness. In the healthy state, the sensation is a correct index of the real temperature; but in disease, we often complain of cold and shiver- ing when the skin is positively warmer than natural. In this way, people whose digestion is weak and cir- culation feeble, complain habitually of cold and of cold feet, where others, differently constituted, expe- rience no such sensations. Exercise dissipates this feeling and increases heat, by exciting the circulation of the blood, throwing more of it to the surface, and thereby increasing the action of the cutaneous ves- sels and nerves. Some mental emotions operate upon the skin, and impair its functions much in the same way as cold. Grief, fear, and the depressing passions, by diminish- ing the afflux of arterial blood, render the skin pale, and, at the same time, diminish perspiration and ner- vous action ; while rage and other violent passions, by augmenting the afflux of blood, elevate the temper- ature of the surface, and give rise to the red flush, fulness, and tension so characteristic of excitement. Sometimes, indeed, the effect of mental emotions on the skin is so great as to induce disease. In speak- ing of impetigo, Dr. Bateman alludes to two gentle- men in whom the eruption arose from " great alarm and agitation of mind ;" and adds, that he " witnessed some time ago the extraordinary influence of mental alarm on the cutaneous circulation, in a poor woman TOUCH AND SENSATION. 71 who became a patient of the Public Dispensary. A sudden universal anasarca (dropsy under the skin) fol- lowed, in one night, the shock occasioned by the loss of a small sum of money, which was all she possess- ed."* Facts like these establish a connexion be- tween the brain and nervous system and the skin, which it is important not to overlook. The reverse influence, which the condition of the nervous matter distributed over the surface of the body exerts on the rest of the system, is also well known, and is exemplified in the effects of exposure to intense cold. The first sensation of chill excited in the nerves of the skin is quickly succeeded by that of numbness and insensibility; and if the exposure be continued, the impression is speedily communica- ted to the brain, and confusion of mind, followed ul- timately by the extinction of life, comes on. When, on the other hand, as in tropical climates, the surface is relaxed by excessive heat, the brain speedily par- ticipates in the relaxation, and the mind is unfitted for sustained or vigorous action. Invalids and literary men often suffer severely from excess of action in the brain, and deficiency of activi- ty in the nerves of the skin and remoter organs. The nervous stimulus, which is essential to digestion and to the health and warmth of the skin, cannot be pro- vided when the brain is too exclusively exercised in thinking or feeling; and for want of this stimulus, the tone of the digestive and cutaneous organs is greatly reduced; the surface of the body becomes cold, shrunk, and uncomfortable ; and the individual is sub- ject to annoyance and painful sensations from trifles which formerly gave pleasure. Bad digestion and deficient warmth of surface are thus proverbially complained of among literary and sedentary persons, and can be removed only by exciting the nervous and vascular functions of the skin, and diminishing those of the brain. Such are the direct and important uses of the skin. * Bateman on Cutaneous Diseases, p. 150. 72 FOLLICLES OF THE SKIN. But in addition to the parts already noticed, there are numerous small follicles or glands contained in its substance, more abundant where hairs are implanted, and in the vicinity of the orifices of natural canals, than in other regions, but existing in all parts except the palms of the hands and soles of the feet. They are about the size of a millet seed, and the skin which contains them is thin, reflected on itself, and very vas- cular. Their cavities are filled with an oily humour, and each opens by an orifice at the external surface of the skin. It is this oily matter which prevents water from penetrating easily and relaxing the cuti- cle, and the absence of which, when it has been re- moved by the soda used in washing clothes, allows the skin of the hands and fingers to assume that wrinkled and shrivelled appearance common among washerwomen. CHAPTER III. HEALTH OP THE SKIN, AND ITS INFLUENCE ON THE GEN- ERAL SYSTEM. Mortality in Infancy from Cold.—Animal Heat lowest at that Age.—Too little and too much Clothing equally bad.—Rules for Dress.—Advantages of Flannel in preventing Disease.—Venti- lation of Beds and Clothing.—Influence of Light.—Importance of Ablution and Bathing—Cold, Tepid, and Warm Bath.— Sponging with diluted Vinegar.—Friction of the Skin.—Vapour Bath and Warm Bath useful in preventing and curing Nervous Diseases and liability to Cold.—Sailing and Riding useful by acting on the Skin. As it is only in its useful applications to the im- provement and happiness of man that knowledge truly becomes power, I proceed, in accordance with this principle, to point out some of the advantages derivable from the information which I have attempt- ed to communicate. It appears from the London Bills of Mortality, that between a fourth and a fifth of all the infants baptized die within the first two years of their existence. This extraordinary result is not a part of the Creator's de- signs ; it does not occur in the lower animals, and must have causes capable of removal. One of these, to speak only of what relates to the present inquiry, is unquestionably the inadequate protection afforded, especially among the poorer classes, to the newborn infant, against the effects of the great and sudden transition which it makes in passing at once from a high and almost unvarying temperature in the moth- er's womb, to one greatly inferior and constantly lia- ble to change. At birth the skin is delicate, extreme- ly vascular, and highly susceptible of impressions, so much so that cases have occurred in which a leech bite has caused a fatal hemorrhage. The circulation 74 MORTALITY IN INFANCY FROM COLD. is, in fact, cutaneous; for the lungs, the stomach, the liver, and the kidneys, are as yet newly brought into activity, and feeble in their functions. If the infant, then, be rashly exposed to a cold atmosphere, the mass of blood previously circulating on the surface of the body is immediately driven inward by the contraction of the cutaneous vessels, and, by over stimulating the internal organs, gives rise to bowel complaints, in- flammation, croup, or convulsions, which sooner or later extinguish life. This shows the inexpressible folly of those who bathe infants daily in cold water, even in winter, and freely expose them to the open air, or to currents from open doors or windows, with a view to harden their constitutions; since it is quite certain that no more effectual means could be resort- ed to, in the earlier months of life, to undermine the general health, and entail future disease on the un- happy subjects of the experiment. This hurtful practice has perhaps arisen in some degree from the prevalent error of supposing that in- fants have naturally a great power of generating heat and resisting cold. That the very opposite is the fact, has been established by the experiments of Dr. Milne Edwards, which show that " the power of pro- ducing heat in warm-blooded animals is at its mini- mum at birth, and increases successively to adult age;" and that young animals, instead of being warmer than adults, are generally a degree or two colder, and part with their heat more readily. In ten healthy infants, from two hours to a few days old, the mean tempera- ture was observed by Dr. Edwards to be only 94.55° Fahr., that of adults being 97° or 98° ; and in a seven months' child, three hours after birth, he found the temperature so low as 89.6°, although the child was well clothed and near a good fire. That exposure to cold is really so injurious to infancy, is unhappily proved by a multitude of facts. In France, as already alluded to in the first chapter, it is the custom to carry every infant, within the first few days of its existence, to the office of the Maire, that its birth may be regis- tered. Suspecting that the exposure consequent upon BAD EFFECTS OF IMPROPER CLOTHING. 75 such a practice must be pernicious to health, espe- cially in winter, and where the distance is great, Dr. Edwards was induced to consult the returns made to the Minister of the Interior, from which he found that the proportion of deaths within a very limited period after birth was much greater in winter than in sum- mer, and in the northern than in the southern depart- ments ; and on farther inquiry, he discovered that the mortality was greater in parishes where the inhabi- tants were scattered at a distance from the Maire, than where they were congregated near him: so that the number of deaths in infancy seemed to be influenced by the degree and duration of the exposure to the cold air. What more striking proof than this can be re- quired of the evils arising from the ignorance of legis- lators in regard to the constitution of the human body ? No man who understood physiology could ever have sanctioned a law, the practical effect of which is to consign annually so many victims to an untimely grave. Many parents, from over-anxiety to avoid one form of evil, run blindfold into another scarcely less perni- cious, and not only envelop infants in innumerable folds of warm clothing, but keep them confined to very hot and close rooms. It would be well for them to recollect, however, that extremes are always hurt- ful, and that the constitution may be enfeebled, and disease induced, by too much heat and clothing, and too close an atmosphere, as effectually as by cold and currents of air. The skin, thus opened and relaxed, perspires too easily, and is readily affected by the slightest variations of temperature, whence arise colds and other ailments, which it is their chief inten- tion to guard against; and the internal organs, being at the same time deprived of their fair proportion of blood, become enfeebled, and afford inadequate nour- ishment and support to the rest of the body. The insensible perspiration being composed of a large quantity of water, which passes off in the form of invisible vapour, and of various salts and animal matter, a portion of which remains adherent to the 76 RULES FOR DRESS. skin, the removal of this residue by washing becomes an indispensable condition of health, the observance of which, particularly in early life, when waste and nutrition are both very active, prevents the appear- ance of cutaneous and other diseases common in in- fancy. Not only, therefore, is daily washing of the body required at that age, but a frequent change of clothing is essential, and everything in the shape of dress ought to be loose and easy, both to allow free circulation through the vessels, and to permit the in- sensible perspiration to have a free exit, instead of being confined to and absorbed by the clothes, and held in contact with the skin, as often happens, till it gives rise to irritation. In youth, the skin is still delicate in texture, and the seat of extensive exhalation and acute sensation; but it is, at the same time, more vigorous in constitution than it was during infancy; and the several animal fuctions being now more equally balanced, it is less susceptible of disorder from external causes, and can endure with impunity changes of temperature which, at either an earlier or a more advanced age, would have proved highly injurious. The activity and rest- less energy of youth keep up a free and equal circu- lation even in the remotest parts of the body, and this free circulation in its turn maintains an equality of temperature in them all. Cold bathing and lighter clothing may now be resorted to with a rational pros- pect of advantage ; but when, from a weak constitution or unusual susceptibility, the skin is not endowed with sufficient vitality to originate the necessary reaction, which alone renders these safe and proper—when they produce an abiding sense of chillness, however slight in degree—we may rest assured that mischief will inevita- bly follow at a greater or shorter distance of time. M any young persons of both sexes are in the'habit of going about in winter and in cold weather with a dress light and airy enough for a northern summer, and they think it manly and becoming to do so ; but those who are not very strongly constituted suffer a severe pen- alty for their folly. The necessary effect of deficient RULES FOR DRESS. 77 circulation and vitality in the skin is, as we formerly saw, to throw a disproportionate mass of blood in- ward ; and when this condition exists, insufficient clothing perpetuates the evil, until internal disease is generated, and health irrecoverably lost. Insufficient clothing not only exposes the wearer to all the risk of sudden changes of temperature, but it is still more dangerous (because in a degree less marked, and therefore less apt to excite attention till the evil be incurred) in that form which, while it is warm enough to guard the body against extreme cold, is inadequate to preserve the skin at its natural heat. Many youths, particularly females, and those whose occupations are sedentary, pass days, and weeks, and months without ever experiencing the pleasing glow and warmth of a healthy skin, and are habitually complain- ing of dullness of the surface, cold feet, and other symptoms of deficient cutaneous circulation. Their suffering, unfortunately, does not stop here, for the unequal distribution of the blood oppresses the inter- nal organs, and too often, by insensible degrees, lays the foundation of tubercles in the lungs, and other maladies which show themselves only when arrived at an incurable stage. Young persons of a consump- tive habit will generally be found to complain of this increased sensibility to cold, even before they become subject to those slight catarrhal attacks which are so often the immediate precursors, or, rather, the first stages of pulmonary consumption. All who value health, and have common sense and resolution, will therefore take warning from signs like these, and never rest till equilibrium of action be restored. For effecting this purpose, warm clothing, exercise in the open air, sponging with vinegar and water, the warm bath, regular friction with a flesh-brush or hair glove, and great cleanliness, are excellently adapted. But while sufficiency of clothing is attended to, ex- cessive wrapping up must be as carefully avoided. Great differences in the power of generating heat and resisting cold exists in different individuals, and it would be absurd to apply the same rules to those who G2 78 WHY WET AND COLD FEET ARE INJURIOUS. never feel cold, as to those who are peculiarly sensi- tive. The former may be benefited by cold bathing and degrees of exposure which would be fatal to the latter The rule is, therefore, not to dress in an in- variable way in all cases, but to put on clothing in kind and quantity sufficient in the individual case to pro- tect the body effectually from an abiding sensation of cold, however slight. Warmth, however, ought not to be sought for in clothing alone. The Creator has made exercise essential as a means; and if we neg- lect this, and seek it in clothing alone, we act at the risk, or, rather, with the certainty, of weakening the body, relaxing the surface, and rendering the system extremely susceptible of injury from the slightest ac- cidental exposures, or variations of temperature and moisture. Many good constitutions are thus ruined, and many nervous and pulmonary complaints brought on, to imbitter existence, and to reduce the sufferer to the level of a hothouse plant. Female dress errs in one important particular, even when unexceptionable in material and quantity. From the tightness with which it is made to fit on the upper part of the body, not only is the insensible per- spiration injudiciously and hurtfully confined, but that free play between the dress and the skin, which is so beneficial in gently stimulating the latter by friction at every movement of the body, is altogether prevent- ed, and the action of the cutaneous nerves and ves- sels, and, consequently, the heat generated, rendered less than that which would result from the same dress more loosely worn. Every part and every function are thus linked so closely with the rest, that we can neither act wrong as regards one organ without all suffering, nor act rightly without all sharing in the benefit. We can now appreciate the manner in which wet and cold feet are so prolific of internal disease, and the cruelty of fitting up schools and similar places without making adequate provision for the welfare of their young occupants. The circumstances in which wet and cold feet are most apt to cause disease, are ADVANTAGES UI ^Am— "■"*" rious. The extreme prevalence of dys- 274 BEST TIME FOR MENTAL APPLICATION. peptic complaints and of insanity among Americans is doubtless partly owing to the very practice which is supposed by some to be harmless to them. Dr. Caldwell, of Lexington, who has devoted much time and talent to the diffusion of sound knowledge and the improvement of the race, and whose opportunities of observation have been very extensive, expressly states, that "dyspepsy and madness prevail more extensively in the United States than among the peo- ple of any other nation. Of the amount of our dys- peptics," he says, " no estimate can be formed ; but it is immense. Whether we inquire in cities, towns, villages, or country places, among the rich, the poor, or those in moderate circumstances, we find dyspep- sy more or less prevalent throughout the land."* It is clear, from this testimony, that the people of the United States form no exception to the general law of Nature. The time best adapted for mental exertion falls next to be considered. Nature has allotted the darkness of night for repose, and for the restoration, by sleep, of the exhausted energies of mind and body. If study or composition be ardently engaged in towards that period of the day, the increased action in the brain which always accompanies activity of mind requires a long time to subside; and, if the individual be at all of an irritable habit of body, he will be sleepless for hours after going to bed, or perhaps be tormented by unpleasant dreams. If, notwithstanding, the practice be continued, the want of refreshing repose will ulti- mately induce a state of morbid irritability of the ner- vous system, not far distant from insanity. It is, therefore, of great advantage to engage in severer studies early in the day, and devote two or three of the hours which precede bedtime to lighter reading, music, or amusing conversation. The vascular ex- citement previously induced in the head by study has then time to subside, and sound refreshing sleep is much more certainly obtained. This rule is of great * Caldwell's Discourse on Physical Education, p. 87. INFLUENCE OF REGULARITY. 275 Consequence to those who are obliged to undergo much mental labour, and it will be found that many of our most prolific writers—of those especially who write much and yet preserve their health—are among those who have, either from knowledge or from incli- nation, devoted their mornings to study and their even- ings to relaxation. Such was Sir Walter Scott's dis- tribution of his time, and such I know to be that of one of our ablest living writers. There are, no doubt, individuals so happily consti- tuted, and whose natural sphere is so essentially that of activity, that they are able to think and work, early and late, for years in succession, with very little sleep, and with little regard to diet and regimen; but they are so obviously exceptions to the general rule, that we cannot for a moment hold them up as models for imitation; and even they would enjoy their astonish- ing gifts with greater security, were they to conform more completely to the laws of their organization. Periodicity, or the tendency to resume the same mode of action at stated times, is peculiarly the char- acteristic of the nervous system; and, on this account, regularity is of great consequence in exercising the moral and intellectual powers. All nervous diseases have a marked tendency to observe regular periods, and the natural inclination to sleep at the approach of night is but another instance of the same fact. It is this principle of our nature which promotes the formation of what are called habits. If we repeat any kind of mental effort every day at the same hour, we at last find ourselves entering upon it, without pre- meditation, when the time approaches; and in like manner, if we arrange our studies in accordance with this law, and take up each regularly in the same order, a natural aptitude is soon produced, which renders application more easy than by taking up the subjects as accident may direct. Nay, the tendency to peri- odical and associated activity occasionally becomes in the course of time so great, that the faculties seem to go through their operations almost without con- scious effort, while their facility of action becomes so 276 IN THE EMPLOYMENT OF THE MIND. prodigiously increased as to give unerring certainty where at first great difficulty was experienced.* In thus acquiring readiness .and forming habits, we merely turn to account that organic law which asso- ciates increased aptitude, animation, and vigour, with regular exercise. It is not the soul or abstract prin- ciple of mind which is thus changed, but simply the organic medium through which it is destined to act: and when we compare the rapid and easy eloquence of the practised orator with the slow and embarrassed utterance which distinguished him at the outset of his career, we have merely a counterpart in the organ of mind, of what is effected in the organs of motion, when the easy and graceful movements of the prac- tised dancer, writer, or piano-forte player take the place of his earliest and rudest attempts. The necessity of judicious repetition in mental and moral education is, in fact, too little adverted to, be- cause the principle on which it is effectual has not been understood. To induce facility of action in the organs of the mind, practice is as essential as it is in the organs of motion. The idea or feeling must not only be communicated, but it must be reproduced and represented in different forms, till all the faculties con- cerned in understanding it come to work efficiently together in the conception of it, and till a sufficient impression be made upon the organ of mind for the latter to retain it. We often blame servants for not doing a thing every day because they were once told to do so. The organic laws, however, teach us that we are presumptuous in expecting the formation of a habit from a single act, and that we must reproduce the associated activity of the requisite faculties many * These remarks are curiously confirmed by an anecdote of Silvio Pellico, which I read in the Foreign Quarterly Review (No. xxii., p. 478), when this sheet was passing through the press. When first imprisoned, Pellico was "allowed the use of a copy of Dante and the Bible. Of the former, he used to commit a canto to memory every day, till at last the exercise became so mechanical that it ceased to afford any interruption to the train of melancholy thought." I need scarcely point out the coincidence between this and the remarks in the text. EFFECTS OF REPETITION ILLUSTRATED. 277 times before the result will certainly follow, just as we must repeat the movement in dancing or skating many times before we become master of it. In like manner, we find, on turning to a new subject, that, however well we may understand it by one perusal, we do not fully master it except by dwelling upon it again and again. Repetition is thus necessary to make a durable im- pression on the brain; and, according to this princi- ple, it follows, that, in learning a language or science, six successive months of application will be more ef- fectual in fixing it in the mind, and making it a part of its furniture, than double or triple the time, if the lessons are interrupted by long intervals. Hence it is a great error to begin and study, and then break off to finish at a later period. The ennui is thus doubled and the success greatly diminished. The best way is to begin at the proper age, and to persevere till the end is attained. This accustoms the mind to sound exertion, and not to fits of attention. Hence the mis- chief of long vacations, and hence the evil of begin- ning studies before the age at which they can be un- derstood, as in teaching the abstract rules of grammar to children; to succeed in which implies in them a power of thinking and an amount of general knowl- edge which they cannot possess. In physical education, we are quite alive to the ad- vantages of repetition and practice. We know that if practice in dancing, fencing, skating, and riding be persevered in for a sufficient length of time to give the muscles the requisite promptitude and harmony of action, the power will be ever afterward retained, al- though little called into use; whereas, if we stop short of this point, we may reiterate practice by fits and starts, without any proportional advancement. The same principle- applies equally to the moral and intellectual powers because these operate by means of material organs. The necessity of being in private what we wish to appear in public, springs from the same rule. If we wish to be polite, just, kind, and sociable, we must Aa 278 EFFECTS OF REPETITION ILLUSTRATED. habitually act under the influence of the correspond- ing sentiments in the domestic circle and in every- day life, as well as in the company of strangers and on great occasions. It is the daily practice which gives ready activity to the sentiments and marks the character. If we indulge in vulgarities of speech and behaviour at home, and put on politeness merely for the reception of strangers, the former will shine through the mask which is intended to hide them; because the habitual association to which the organs and faculties have been accustomed cannot thus be controlled. As well may we hope to excel in elegant and graceful dancing by the daily practice of every awkward attitude. In the one case as in the other, the organs must not only be associated in action by the command of the will, but also be habituated to the association by the frequency of the practice; a fact which exposes the ignorant folly of those parents who habitually act with rudeness and caprice towards their children, and then chide the latter for unpolite be- haviour towards strangers. The same principle of repetition being necessary to make a durable impression on the brain and con- stitute a mental habit, also explains the manner in which natural endowments are modified by external situation. Taking the average of mankind, the limits to which this modification may be carried are not nar- row. Place a child, for example, of average propen- sities, sentiments, and intellect, among a class of peo- ple—thieves—in whom the selfish faculties are exclu- sively exercised ; by whom gain is worshipped as the end of life, and cunning and cheating as the means; and among whom is never heard one word of disap- probation or moral indignation against either crime or selfishness, and its lower faculties will be exclusively exercised and increased in strength, while the higher will be left unemployed and become weak. A child so situated will, consequently, not only act as those around him do, but insensibly grow up resembling them in disposition and character; because, by the law of repetition, the organs of the selfish qualities EFFECTS OF REPETITION ILLUSTRATED. 279 will have acquired proportionally greater aptitude and vigour, just as do the muscles of the fencer or dancer. But suppose the same individual placed from infancy in the society of a superiorly endowed moral and in- tellectual people; the moral faculties will then be habitually excited, and their organs invigorated by repetition, till a greater aptitude, or, in other words, a higher moral character, will be formed. There are, of course, limits set to this modification by the natu- ral endowments of the individual; but where the origi- nal dispositions are not strongly marked, the range is still a wide one. From this source arise many differences not only of individual but of national character, and such differ- ences as we observe take place from changes of for- tune and condition. The negro free in Africa differs widely from the negro subjected to the scourge of the colonist. The same principle is well illustrated by M. Arago in his account of Freycinet's Voyage round the World in 1818,19,20. In speaking of the different results of education in the Isle of France and in the mother country, he observes, that the professors, the methods, and the subjects taught, are quite on a par with those of Paris; but that, nevertheless, from the very early maturity of the human being in that climate, the pu- pils are removed from school so soon that the im- pression made on their minds is speedily obliterated; on which account, he adds, the only really educated and well-informed men to be met with are those who have been sent to France very young, and retained there till a later age and more thorough grounding have been attained, after which the risk of losing their acquirements is greatly diminished. The next rule to be observed in the cultivation of the brain and mental faculties, is founded on that law of our constitution which directs each organ to be ex- ercised directly upon its own objects, and not merely roused or addressed through the medium of another organ. We have said that when we wish, for exam- 280 DIRECT EXERCISE OF THE FACULTIES. pie, to teach the graceful and rapid evolutions of fencing, we do not content ourselves with merely giving directions, but our chief attention is employed in making the muscles themselves go through the evo- lutions, till, by frequent repetition and correction, they acquire the requisite quickness and precision of action : and when we wish to leach music, we do not merely address the understanding and explain the qualities of sounds, but we train the ear to their at- tentive discrimination, and the hand to the reproduc- tion of the motions which call them into existence. We follow this plan, because the laws of organization require direct practice, and we feel instinctively that we can succeed only by obeying them. Now, the purely mental faculties, being connected during life with material organs, are subjected to precisely the same law; and, therefore, if we wish to improve the reasoning powers, we must exercise them regularly in tracing the causes and relations of things. And, in like manner, if our aim is to develop the senti- ments of attachment, benevolence, justice, or respect, we must exercise each of them directly and for its own sake, otherwise neither it nor its organ will ever acquire promptitude or strength. It ought never to be forgotten, that in education it is the brain, or organ of the mind, and not the abstract immaterial principle, which requires cultivation, and that hence education operates invariably in subjection to the laws of organization. In improving the external senses, we admit this principle readily enough; but whenever we come to the internal faculties of thought and feeling, it is either denied or neglected. With gross inconsistency, we admit that the superior quick- ness of touch, sight, and hearing consequent upon judicious exercise, is always referable to increased facility of action in their appropriate organs; but when we explain, on the same principle, the superior development of the reasoning powers, or the greater warmth of feeling produced by similar exercise in these and other internal faculties, few are inclined to listen to our proposition, or allow to it half the weight EMPLOYMENT OF THE FACULTIES. 281 or attention which its importance requires, although every fact in philosophy and experience concurs in supporting it. We see the mental powers of feeling and of thought unfolding themselves in infancy and youth, in exact accordance with the progress of the organization ; we see them perverted or suspended by the sudden inroad of disease, and as suddenly re- stored ; nay, we sometimes observe every previous acquirement obliterated from the adult mind by fever or by accident, leaving education to be commenced anew, as if it had never been ; and yet, with all these evidences of the organic influence, it is still a novel- ty in education to propose that the established laws of physiology, as applied to the brain, should be con- sidered as our best and surest guide; and scarcely a volume can be pointed out in which it is even hinted that these laws have the slightest influence over mental or moral improvement. Were a general acquaintance with the laws of or- ganization to be held as an indispensable part of a liberal education, we would then be able to inculcate, with tenfold force and success, the necessity of ac- tively exercising every faculty, whether of thought, feeling, or motion, directly on its own objects, and at once to explode the mistake of supposing that any organ or function may be efficiently exercised through the medium of another, and that, to produce high moral feeling, it is sufficient to address ourselves to the intellect alone. The merest savage, following the footsteps of Nature, would pity the philosopher who should seriously assure him that, to cultivate acuteness of hearing or of vision, it was sufficient to be told how to listen or to look. The savage goes more directly and surely to work. If he wants physical strength, agility, and swiftness of foot, he sets him- self to develop the muscular system of his child by ample muscular exercise, by constant repetition of the movements and acts he wishes him to perform, and by causing him to run, to leap, or to swim ; and he rests in well-founded hope of accomplishing his pur- pose. Following the same rule when he seeks acute- A a 2 282 EXERCISE OF EVERY FACULTY ness of hearing, he does not merely tell his child how to listen, but he lays him with his ear to the ground, and teaches him, by practice, to distinguish the qualities of sounds. If he wishes him to excel in hunting, in fishing, in lying in ambush, or in scent- ing the approach of an enemy, he expects to be suc- cessful only in proportion as he finds occasion to em- ploy him in the practice of these pursuits. If he wishes to inculcate courage in battle, contempt of pain, endurance of fatigue, obedience to chiefs, or re- venge upon enemies, he chooses the sure way, and cultivates each of these qualities by calling it into direct action on its own objects; and we all know the success which the savage meets with in the edu- cation thus bestowed. With this experience before our eyes, then, let us, who pretend to superior wisdom and civilization, show ourselves also consistent, and ready to receive instruction from whatever quarter it may come. As God has given us bones and muscles, and bloodves- sels and nerves, for the purpose of being used, let us not despise the gift, but consent at once to turn them to account, and to reap health and vigour as the reward which he has associated with moderate labour. As he has given us lungs to breathe with and blood to circulate, let us abandon the folly of shutting our- selves up with so little intermission, engaged in mo- tionless study and sedentary occupations, and consent to inhale copiously and freely that wholesome at- mosphere which his benevolence has spread around us. As he has given us appetites and organs of di- gestion, let us profit by his bounty, and earn their enjoyment by healthful exercise. As he has given us a moral and a social nature, which is invigorated by activity, and impaired by solitude and restraint, let us cultivate good feeling, and act towards each other on principles of kindness, justice, forbearance, and mutual assistance ; and, as he has given us intellect, let us exercise it in seeking a knowledge of his works and of his laws, and in tracing out the relation in which we stand towards him, towards our fellow-men, TO BE DIRECT--ILLUSTRATIONS. 283 and towards the various objects of the external world : and, in perfect faith and sincerity, let us rely upon his promise that, in so doing, we shall have a rich reward ; a reward a thousand times more pure, more perma- nent, and more delightful, than we can ever hope to experience in following our own blind devices, regard- less of his will and intentions towards us.* Shortly after the third edition of this work was published, I had occasion, in the course of conver- sation with a very intelligent friend, to express the gratification which I felt on learning that in two ex- cellent educational establishments just opened in Ed- inburgh, by associations of the ablest teachers of the city, physiology was not only included as an impor- tant branch of study, but had proved attractive and interesting even to young ladies, who constituted a large proportion of the audience, although, by their previous education, they were as little prepared for the favourable reception of its doctrines as it was possible to conceive any one to be. On being asked why 1 attached so much importance to physiology as a practical science, I stated briefly some of the rea- sons mentioned in these pages. My friend was struck with their force, and wishing to be put in possession of them in a tangible form for a special purpose, re- quested me to write them out in the form of a letter. I complied with the request, and as an explanation arising out of an individual case often possesses more ♦ Those of my readers who wish to pursue the inquiry, and to trace the relations in which Man stands to his Creator, to his fellow-creatures, to himself, and to the external world, will find a clear and comprehensive guide in a small volume entitled " The Constitution of Man considered in relation to External Objects. By George Combe." In this work, of which upward of 15,000 copies have got into circulation within the last year, a general view is taken of the human constitution, and of the laws which regulate the organic, moral, and intellectual nature of man. The sources of most of the evils which afflict the human family are successfully traced to violations of those laws, and shown to be, to a great extent, within our own control; so that practical use- fulness, and not mere speculation, is the characteristic of the volume. 284 IMPORTANCE OF PHYSIOLOGY point and applicability than a more general argument, and the subject is one of immense importance, I shall subjoin the letter entire, although it necessarily in- volves some repetition of statements already given. Edinburgh, 9th April, 1835. " My dear----, " When we last met, I said that I was much grati- fied to see the recently-formed Association of Teach- ers ranking physiology first among the subjects which it was important for them, as professional men, to be acquainted with; and the reason 1 gave was the sim- ple fact, that all the moral and intellectual functions stand in the same relation to one part of our organized structure, viz., the brain, as the physical power of motion or exercise does to another, viz., the muscles ; that, consequently, to educate the moral or intellectual faculties successfully, we must have the same constant reference to the laws under which organization acts, as we have in educating the muscles and training them to any of the ordinary exercises of walking, dancing, fencing, or riding; and that hitherto this grand prin- ciple had been overlooked, and many modes of train- ing the intellect and feelings resorted to, which, being contrary to the laws of organization, could not succeed. " I gave the muscular system as an example, and stated it as a law of organization, that, to keep a part in health and vigour, it must be duly and regularly exercised. If it be too little, the blood flows lan- guidly through it, the nervous energy in it is enfeebled, and the part becomes weakened and indisposed to act without some strong stimulus. If it be too much exer- cised, its vessels and nerves become feeble and irri- table from exhaustion, and inability to act with vigour ensues. If it be exercised to a proper extent, the cir- culation through it becomes animated, it receives more blood, and, consequently, more nourishment; its nerves act with more tone, and it becomes stron- ger, readier for action, and after a time fitted for re- pose. If, however, the exercise be not resumed after sufficient repose, then weakness of necessity follows as above. WITH REFERENCE TO EDUCATION. 285 " To apply this principle to the exercise of a bodily power. Suppose that A B walks ten or fifteen miles every Monday morning, and during the other six days of the week not at all, and that, finding himself greatly fatigued by the exertion, he roundly asserts that ex- ercise is hurtful—what answer would be made ] He would be told that as he sowed so had he reaped; that, as he had infringed all the laws of exercise, so had he suffered the punishment due to the infringe- ment : 1st, By walking much farther than his consti- tution was fit for, he had induced debility from exhaus- tion ; 2dly, By remaining inactive the other six days, he had induced debility, with indisposition to action, de- pendant on a sluggish circulation and low tone of vi- tality. Had he wished to strengthen his muscular system, the laws of exercise required that he should employ his muscles to a sufficient degree to increase their tone, and regularly resume the exercise after » adequate repose. The very gradual and regular way in which horses are prepared for the race-course or hunting-field, is an excellent illustration of the impor- tance attached to the observance of the law of Nature in training animals. " In training the mental powers, precisely the same principle ought to guide our efforts, because God has made the mind as dependant on the brain for its action during life, as he has done the power of motion in the muscles; and, therefore, we are doubly bound to fol- low the law which he has given us for our guidance. According to this principle, then, every mental power may be weakened by too little, and also by too much exercise; because the brain, through which it acts, may be left sluggish or be exhausted by excess of ex- ertion, In the first case, the mental faculty becomes indisposed to act; and, in the second, it becomes in- capable of acting vigorously and steadily. It may be excited to action, but the action will be irritable, and unsteady, and unprofitable; not permanent, enduring, and available, such as attends the medium or right degree of exercise. " To apply this to moral education. It is evident 286 IMPORTANCE OF PHYSIOLOGY that, granting the truth of the principle (which can be demonstrated), every moral feeling which we wish to strengthen and cultivate must be duly, regularly, and systematically exercised before full success can be attained, just as we see done with the intellectual faculties of music, painting, language, and memory of facts. We have no choice in the matter. Either we must obey the law which God has imposed on our constitution, or we must fail in attaining the moral excellence of which he has made us capable. He has connected mind and feeling with organization to fit us for our residence in a material world, and we must either act under its laws or suffer. " Here, then, is the use of teachers being taught this fact. Love of approbation is a strong and active feeling of the human mind, and it is one to which food is easily administered, and the gratification of which is attended with much pleasure to those who are largely endowed with it. Being a very prominent feeling in society, it is, perhaps, the most regularly and sedulously educated which we have. Before an infant can walk, or speak, or understand, we begin by praising its beauty, its shoes, its rattle, or its dress: when it cries, we flatter it to silence; when it speaks, reads, sings, or dances, every one is in an ecstasy of admiration at its achievement. At school, its vanity is cultivated by places, and prizes, and public exhibitions. At college, emulation ill directed is often its bane. In the world, ' fame' is its grand prize. With fe- males, emulation, prizes, flattering, and compliment are still more effective. The result of this careful education and systematic exercise of an inferior feel- ing is manifest in every age and in every rank of life. It predominates everywhere. How much of charac- ter and conduct in public and in private circles springs from the single principle of love of approbation in its various modifications of emulation, vanity, desire of renown, love of praise, notoriety, or fame! There Is, in truth, scarcely an act of any note in which it does not come in as a primary element. " Is it equally so with the sense of justice or reli- WITH REFERENCE TO EDUCATION. 287 gion? Are they called systematically into play in every act which intervenes between the cradle and the grave! And do we find them constantly referred to as rules of conduct, as we do emulation, fame, glory, and honour 1 And do we find them exercising even a tithe of the influence over human conduct which the other does 1 Far from it: conscience, in- deed, is a "still small voice," for its cry is rarely heard, and its voice is easily drowned by less noble sounds. Why is it so 1 The reason is obvious : not being recognised as a primitive faculty connected with an organ of its own, no one thinks that it requires regular and systematic exercise to give it strength. Being viewed as an offshoot from intellect, it is said, ' Cultivate intellect, and the sense of justice will shift for itself.' From this error, parents and teachers not only neglect to educate conscience, or the sentiment of justice, but too often violate its dictates, in the be- lief that the child has not sense enough to see the violation. Instead of being made a ruling principle in every-day life, it is rarely heard of; and hence, from inactivity, it becomes indisposed to act* because such is the law of its organization. " It is the same with the religious feelings. If these be actively cherished and made to regulate ev- ery-day life, their organs acquire readiness and vigour of action, and the feelings become sources of happi- ness and right conduct. But if their exercise be re- served for the seventh day, and they be laid aside in the intervening six, the law of organization decreed by God is again broken, and from sluggishness indis- position to activity is induced! The separation of be- lief from practice, which some inculcate, has misled many and done infinite harm. "From the same principle which requires the regu- lar exercise of all the moral and intellectual faculties, it necessarily happens, that, if one or several be great- ly cultivated to the exclusion of the rest, all are apt to suffer. Those which are too constantly in action, are apt to pass into that irritable state of excitement which constitutes an almost morbid craving, and is 288 IMPORTANCE OF PHYSIOLOGY hurt by indulgence; while those which are not suffi- ciently exercised become sluggish and indisposed to act. This is, in truth, one of the reasons why persons remarkably gifted with partial talent, are rarely equal- ly remarkable for sound general sense or feeling, or for being proportionably happy. Continual activity in the one direction exalts their irritability, diminishes the healthy tone of the system, and leaves in abey- ance all the other faculties of the mind, whether mor- al or intellectual. Hence, in some degree, the pro- verbial irritability of poets, artists, musicians, and au- thors, whose minds are exercised on one set of ob- jects, and whose moral feelings are not brought suf- ficiently into play in the ordinary duties of life. And hence, I may add, the danger of deterioration of char- acter in young people from excessive addiction to one line of pursuit, and the neglect of their other and higher faculties. " In short, in attempting to produce moral excel- lence in the young, we have no royal road to stride over with seven-league boots. We must just submit to cultivate the sense of justice, and the sentiments of veneration and benevolence, on the same principle as we do musical talent or muscular power ; and we may be very thankful in having the guarantee of Om- nipotence to assure us of success when we do so. It is a fact which I can explain only by the prevailing neglect of moral education, that, as a general rule, the sense of conscientiousness is more active in childhood than in mature age. If the sentiment were properly cultivated, I think it would become propor- tionably stronger instead of weaker." So little, however, are even educated men familiar with the influence and laws of the organization, that, even in our best-directed establishments, as well as in private families, cultivation is still in a great meas- ure confined to intellect alone; and the direct exer- cise and training of the moral and religious senti- ments and affections are rarely thought of as essen- tial to their full and vigorous development. Moral WITH REFERENCE TO EDUCATION. 289 precepts are, no doubt, offered in abundance; but these address themselves chiefly to the intellect We must not be satisfied with merely exclaiming, " be kind, just, and affectionate," when perhaps, at the very moment, we are counteracting the effect of the advice by our own opposite conduct. " She told me not to lie," said Guy Rivers in speaking of his mother, " and she set me the example herself by frequently de- ceiving my father, and teaching me to disobey and de- ceive him." Conduct like this is more common in real life than is supposed, although generally less flagrant in degree. Parents and teachers, indeed, too often forget that the sentiments feel and do not reason, and that, consequently, even a stupid child may, by the instinctive operation of its moral nature, at once de- tect and revolt at the immorality of practices, the true character of which its reason is unable to penetrate or expose. It is one of the most effectual methods of cultivating and exciting the moral sentiments in chil- dren, to set before them the manifestations of these in our habitual conduct. What kind of moral educa- tion is that, for instance, which, while the instructress vilifies the physical appetites of hunger and thirst, and preaches disregard of their cravings and of the gratifications of taste, leads her to set down a meal to her boarders, from partaking in which she betrays the strongest desire to escape, on account of its in feriority to that which is provided for herself and the few at the head of the establishment ? What advan- ces in morality and religion can be expected under the charge of one who says, " Do unto others as you would be done by," and then leaves his dependants to suffer pain, chilblains, and disease, from want of a fire to warm the room in which they sit, he himself com- ing into it with features flushed by the heat of the blazing fire, which, for weeks, has been provided for his comfort in his own apartment \ What generosity of feeling can arise from the superintendence of a teacher, who, though liberally paid for the food of her pupils, and with moral precepts on her lips, satisfies the cravings of nature in the long interval between 290 NECESSITY OF THE DIRECT EXERCISE meals only at the expense of the pence constituting the pocket-money of the scholar 1 the food in this case being denied, not because it is considered im- proper—for, were that the case, it would be a derelic- tion of duty to give it on any terms—but from sheer meanness and cupidity. What kind of moral duties does the parent encourage, who, recommending kind- ness, openness, and justice, tricks the child into the confession of faults, and then basely punishes it, hav- ing previously promised forgiveness ? And how is openness best encouraged—by practising it in conduct, or by neglecting it in practice but praising it in words? Is it to be cultivated by thrusting suspicions in the face of honest intentions 1 And how is justice to be cultivated by a guardian who speaks about it, recom- mends it, and in practice charges each of four pupils the whole fare of a hackney-coach ? Or what kind of moral education is that which says, Do as I bid you, and I will give you sweetmeats or money, or I will tell your mamma how good you were; holding out the lowest and most selfish propensities as the motives to moral conduct! Did space permit, I might indeed pursue the whole round of moral and religious duties, and ask similar questions at each. But it is need- less. These examples will suffice; and I give them, not as applicable generally either to parents or teach- ers, but simply as individual instances from among both, which have come within the sphere of my own knowledge, and which bear directly upon the princi- ple under discussion. If I have here or elsewhere spoken too harshly of the errors of teachers and conducters of boarding- schools, it has been quite unconsciously, for my sole anxiety is to see them, as a class, elevated to that high moral and intellectual position in the scale of so- ciety, which those intrusted with so responsible a charge as the education of the young ought unques- tionably to occupy. But I have too deep a sense of the mischief done by incompetent persons assuming the duties and responsibilities of instructers, without possessing a single preparatory qualification, and with no higher motive than that of having been unfortunate OF THE MORAL FEELINGS. 291 in another calling, to hesitate about condemning prac- tices which 1 believe to be wrong. For those among them who have fitted themselves in earnest for the duties of their profession, and whose energies are de- voted to the welfare of their pupils—and there are many such—I entertain the highest respect, and to them none of the censure is meant to apply. Such were the remarks which, in the former edi- tions, I felt it necessary to make on the want of har- mony between precept and practice in the moral train- ing of the young in boarding-schools. Since then, my attention has been called to other practices, which are still more reprehensible than those already no- ticed. One of these is the custom which prevails in many seminaries of retaining, when the pupil leaves the school, the towels, sheets, and even the silver fork and spoon which each is required to bring along with her at entry. So far, indeed, was this paltry spir- it of appropriation carried in one instance, that even a pianoforte belonging to one of the young ladies was retained, without leave being either asked or given. In another instance the pupil brought along with her a new wardrobe, in which she and her friends intended that she should keep her own clothes and property. But, to her great mortification, it was taken from her the very first day, set up as an ornament in another room, and a single drawer in an old chest given in its place ! It also was left behind as the property of the family. Those who have been long familiar with the exist- ence of the above practice in boarding-schools, or who have themselves acted upon it from habit, with- out being conscious of any censurable meanness, may think I go too far in thus stigmatizing it. But I have never met with any one who, on hearing of it for the first time, hesitated a moment to denounce it as re- pugnant to all the higher feelings of our nature, and as peculiarly unbecoming in those whose conduct so directly influences the moral and religious training of the youth confided to their charge. The only excuse which I have ever heard alleged in its favour, even by those who defend it. is that such is the custom, and that 292 PROPER METHOD OF EDUCATING as parents are aware of the practice before they send their children to school, there is, therefore, no immo- rality involved in its continuance. This mode of rea- soning, however, is as false and oblique as the pro- ceeding which it is used to sanction; and does not touch the real merits of the question, Whether the retention of the property of the pupil be an open and honourable way of increasing their own gains or not 1 If it is, then it need not be concealed, but should be plainly and broadly stated in the list of terms. If it is not, but the thing is done merely from long custom, then the sooner it is given up the better: for although indulgence in that which is wrong may blunt the acute- ness of the moral perceptions, it can never so far alter the true relation of things as to render that right and virtuous which was at first wrong and unjust; and, to the essential merits of the question, it signifies little whether the property be detained by the express order of the conductors of the school, or by the attachment of ridicule to the pupil who would otherwise take it away. To every delicate mind, the one motive to the sacrifice is evidently as compulsory as the other. Another immoral and disgraceful practice in many seminaries is that of exacting from the private teach- ers employed in them a heavy per-centage (amounting in some instances within my knowledge to one half) on the fees which they receive from the pupils. If these fees be fair and reasonable, gross injustice is obviously done to the teacher by this underhand sys- tem of pillage. If, on the other hand, the teacher be compelled to increase his demand on the pupil beyond the point of a fair remuneration, on purpose to meet the per-centage required of him, then he is made the instrument of a dishonest exaction from others. On either supposition, the practice is immoral; and that it is felt to be so, even by the parties themselves, is proved by the very concealment with which it is at- tended. It has also the farther drawback of exposing the conductors to the temptation of employing, not the teachers who are best qualified, but those who will give up the largest allowances out of their own gains. It is no excuse whatever to allege, as is sometimes. THE MORAL SENTIMENTS. 293 done, in justification, that without these additions the rate of board received would afford an inadequate re- muneration to the conductors of the boarding-school. This would be an exceedingly good reason for increas- ing the amount payable by each pupil, but it is none whatever for the perpetration of a gross immorality. The education, and moral and religious training of the young, ought to be liberally and gratefully paid for. If, therefore, an erroneous calculation has been made at the outset, the board ought clearly to be increased; but the necessity for such increase ought to be openly and honestly stated, and not allowed to stand for ever after as an apology for the continued infliction of a miserable and degrading injustice; an injustice cal- culated to set at naught all the moral and religious instruction for which chiefly the remuneration is be- stowed. To the pocket of the pupil or parent it mat- ters little under what heads the amount is claimed; but to their feelings and character it is of great im- portance that no outrage to the common feelings of honesty should be mixed up with the conduct of edu- cation.* * As the observations in the text are strongly expressed, I think it right to subjoin a few specimens of the charges made in a most respectable school, of which the prospectus is now before me, and which, I think, will amply justify all that I have said. The sums received by the teachers are given on what I believe to be a trust- worthy authority. The pupil And, consequently, For it charged The teacher the annual sur- per quarter, receives, charge amounted to, Dancing, 1.2 2 0 I. 1 1 0 /. 4 4 0 Drawing, 3 3 0 2 2 0 4 4 0 Singing, 4 4 0 3 3 0 4 4 0 Harp, 4 4 0 3 3 0 4 4 0 Guitar, 4 4 0 3 3 0 4 4 0 German, 3 3 0 2 2 0 4 4 0 French, 2 2 0 1 11 6 2 2 0 Writing, &c.. 1 1 0 0 10 6 2 2 0 Geography, . 1 1 0 0 10 6 2 2 0 Elocution, 1 I 0 0 10 6 2 2 0 Annual total of surcharge I. 33 12 0 on the above branches, Bb2 294 PROPER METHOD OF EDUCATING There are persons who, when proved to be in the wrong, find great comfort to their wounded feelings in the fact of their neighbours or censors being as bad as themselves. To such of my readers as re- quire consolation of this description, I am ready to admit, that men of my own profession are also falli- ble, and that, not very many years ago, physicians participated largely in the profits of their apothecaries, on the very same principle as that on which conduc- tors of schools participate in the gains of the private teachers. But I am happy to say that this practice has been long discontinued, as not less degrading to the parties concerned in it than injurious to the public; and all that I wish, in the present instance, is to see their example followed for good as well as for evil. Not to be misunderstood, however, I must add that the parents and public are fully as much to blame for these delinquencies as those who more immediately commit them. If, in society, the teachers and guar- dians of youth were treated generally with the re* ppect and consideration to which those really qualifi- ed for the trust are so amply entitled, and a liberal remuneration were afforded them in the same spirit of confidence and equality, a higher class of minds would dedicate themselves to the profession, and qualify themselves by previous preparation for its duties. Whereas, under the existing system, there is no inducement whatever for any person of superior talent and character to enter upon a profession which places him in an inferior grade in society to that which the same talents and character, differently employed, would enable him to reach with ease; and hence, with a few honourable exceptions, those only embark in it who are compelled by the narrow- ness of their circumstances or the impossibility of finding any other career left open to them. Both parties are thus to blame, and both suffer the conse- quences of their own errors ; the one in being treat- ed with disrespect, and the other in disappointment at the miserable results of the expensive education which their children receive. THE MORAL SENTIMENTS. 295 Before leaving this subject, I am anxious to repeat, that I am far from including all boarding-schools in the above censure. There are some in which the practices commented upon are stigmatized and dis- countenanced ; and in alluding to such defects as / know to be still in existence in many of them, my sole object has been to increase their usefulness, by hastening the introduction of such improvements as are essential not less to their own moral respectabil- ity and ultimate prosperity than to the lasting advan* tage of their pupils. In the practical training of the young, it is of con- sequence to keep in mind that the moral sentiments, in common with the intellect, are dependant on or- ganization for their means of activity during life, and, consequently, are more successfully cultivated by be- ing habitually employed in regulating the every-day affairs of life, than by waiting for great occasions on which they may be exercised with unusual vigour. Benevolence, no doubt, is vividly excited by the as^ pect of great misery and unhappiness, and impels strongly to the relief of the suffering object; but this is not its most common or its most useful field. In ordinary life, it finds ample scope in charity to our neighbours, and in contributing to the happiness of our family circle, and of our associates and depend- ants. Benevolence is much better occupied in adding a gleam of enjoyment, in removing little sources of irritation, in promoting concord among relatives, and in other kind offices of a similar nature, than in giv- ing alms indiscriminately to all who demand them, or even in relieving occasional distress, where this is held, as it too often is, to dispense with all obligation to habitual forbearance and Christian good-will in the private relations of life. But how little is this most important faculty directly attended to or cultivated, in the way we see done with the faculties necessary for the practice of drawing or music, which, by in- cessant exercise, procured at a great sacrifice of time, money, and labour, are brought into such a state of 296 PROPER METHOD OF EDUCATING activity as ever after to enable their possessors to derive delight from their exercise, where the talents are possessed in any considerable degree ! And what might we not expect from the systematic training of the higher sentiments on a similar plan, in improving society and exalting the happiness of the race! But it is evident that the objects of benevolence are our fellow-creatures ; and, consequently, if we restrict our intercourse and our sympathies to the limits of our own drawing-rooms, and take no interest in the progress of the race or of the individuals composing it, we leave our best faculties in abeyance, and reap the reward of bodily debility, and weakness and mo- notony of mind. Conscientiousness is another moral principle that requires direct cultivation, and that rarely receives it. It holds the balance between man and man, and is excited by the presentment of any difference of right between individuals, of any injustice, or of any temp- tation offered by the other faculties, which may lead us to encroach on the rights of other men. It gives a strong sense of duty, with which it is agreeable to act in conformity, but which it is painful and injuri- ous to oppose. It gives weight and force to the im- pulses of the other sentiments, and, joined with in- tellect and the feeling of devotion, gives that faith in the beneficence and equity of the Deity, and in the immutability of all his laws, that forms the strongest encouragement to virtuous conduct and temporary self-denial. And here again, living in society, enga- ged in the active duties of life, and acting justly amid the conflicting interests of others—and not seclusion and privacy—are manifestly intended by the Creator as our proper sphere. I need not follow out this exposition in detail. The preceding illustrations will suffice to explain the prin- ciple; and to exceed this limit would withdraw at- tention too much from the matters more directly be- fore us. For the same reason that every faculty ought to be exercised directly upon its own objects, the exclusive THE INTELLECTUAL FACULTIES. 297 use of book-education as a means of conveying in- struction is manifestly unnatural as well as inefficient. If allowed to handle and examine a new object, a child will pursue the investigation with pleasure, and in five minutes will acquire more correct knowledge than by a whole hour's reading about its qualities without seeing it. In the one instance, its perceptive powers are stimulated by the direct presence of the qualities of which they are destined to take cogni- zance ; while, in the other, they are roused only through the imperfect medium of artificial language, and the child has to create the object in his own mind before he can take notice of its qualities. When we recollect the different ideas which the same written language suggests to different mature minds, we may form some conception of the impossibility of a child making progress in this way, and of the weariness and ennui which the thankless effort must always induce; and yet, at the present day, in nineteen out of twenty schools, all the knowledge that is offered is through the medium of books and language alone! It is well remarked by M. Duppa, in his excellent little work on the education of the peasantry in Eng- land, that " it is the habit of accurately observing the actual nature of objects, as perceivable by the senses, and distinctly marking their differences, which in af- ter life renders a man intelligent and judicious. There are few whose natural faculties are so dull as to be unable to perceive a distinction when pointed out to, them or when their notice is directed towards it; for instance, that one thing is long, another short; that one is round, another flat; one green, and another black. But how few are there who, when minutely questioned, can give a clear or circumstantial descrip- tion of any object they have been conversant with, or in what particular that object differs from another. And why is this ? Because they have not the habit of accurate observation of things; and they have not that habit, because, in modern education, a child's obser- vation, at the moment when all is new and observation most active, is wilfully drawn away from things to the 298 USE OF PHILOSOPHY IN EDUCATION. signs of things ; and the boy who might easily have been made to distinguish the nature and properties of the dif- ferent objects around him, has only learned to distinguish one letter from another." (P. 27.) It is but another proof of the harmony of design in all the works of the Creator, that this method of di- rectly cultivating the observing powers cannot be ad- • equately fulfilled without a certain amount of muscu- lar exertion and of daily exposure to the open air, in going about to collect and examine the varied objects of interest with which creation abounds. In other words, we cannot benefit the perceptive faculties, without at the same time benefiting the muscular sys- tem and the organs of respiration, circulation, and di- gestion; and this grand recommendation in the eye of reason, viz., pursuing study in the field of nature instead of in books alone, is actually, though not avowedly, the circumstance which retards its adop- tion in ordinary education. To take the scholar out of the schoolroom to look at the works of God, is thought to be encouraging idleness and a love of pleas- ure, and therefore it is denied! What, therefore, is wanted is a system of education in harmony with the constitution of the human mind, and a mode of life and of occupation which shall give not only full play to the intellectual powers, but also healthy excitement and activity, and a right direction to the moral, religious, and affective feelings. The details of such a system do not fall under the scope of a treatise like this; and I must, for the pres- ent, content myself with the exposition of the gen- eral principle.* A serious obstacle to entering upon * Mr. Simpson, in his recent work on " The Necessity of Pop- ular Education as a National Object," and in his admirable evi- dence before the Irish Education Committee of the House of Commons, in August, 1835, has filled up the above outline, and very ably shown how the different faculties of the mind may be best called into play. His clear, consistent, and eloquent exposi- tion of what is still wanted to render education effective and available for all classes of society, produced a strong impression on the Committee, and richly deserves the attentive consideration of *very one who takes an interest in the improvement of the race. INFLUENCE OF NERVOUS SYSTEM ON HEALTH. 299 the regular exertion here recommended requires to be noticed, as it arises from a feeling in the patient against which he cannot be too much on his guard. Where the nervous system is weak, and where it, of course, requires most to be strengthened, there is often a retiring sensitiveness of disposition, leading its possessor rather to avoid than to seek intercourse with society. Feeling the irksomeness of present exertion, the nervous invalid is apt to form the secret resolution to live in solitude till the mind shall become stronger, and then to seek society when it will no long- er be a burden. Unhappily, however, this feeling leads only to delusion, and the wished-for result be- comes every day more distant, the longer retirement and indolence are persevered in. It is by activity, and not by repose, that strength is to be acquired. We do not expect to increase bodily strength by ly- ing in bed, but by stirring about; and, in like manner, we shall never succeed in strengthening the nervous system by indulging in mental indolence. Many are led astray by the false expectation of acquiring strength without using the natural means from which alone strength can be procured. It may be remarked, that in the preceding pages I have made no allusion to the doctrines of Phrenology. My reasons are simply, that, for the object I had in view, a special reference to them was not necessary; and that, in a work written for the general reader and for practical purposes, I was naturally anxious to avoid every contested point. Accordingly, in limit- ing myself to the statement that different parts of the brain perform different functions, without specifying those connected with any particular part, farther than that they are all concerned in the mental operations, I am not venturing beyond what most eminent anato- mists and physiologists, in the past or present times, have taught before me. My own sentiments on the subject are already before the public ;* and I am * Vide Observations on Mental Derangement; being an appli- cation of the Principles of Phrenology to the elucidation of the Causes, Symptoms, Nature, and Treatment of Insanity. 1 vol. post 8vo., 1831. 300 INFLUENCE OF THE NERVOUS SYSTEM bound to say that every day's experience increases my conviction of the truth of Phrenology, and deep- ens my sense of its practical value. Those who de- sire to prosecute the inquiry will find ample assist- ance in the numerous works already published, both in this country and in France. The splendid work of Vimont would do honour to any age or country. I have already had frequent occasion to notice the direct influence exercised by the mind and brain over all the bodily functions and over the general health. As the subject is an important one, and has not received all the attention which it deserves, it may be proper, before concluding, to offer a few remarks on it. The nervous fluid or influence presents many phe- nomena allied to those of electricity, but its real na- ture is not yet known. All that can be said is, that it is an influence of a peculiar kind, originating in the brain and nervous system ; and that, like the blood, it is essential to the vital action of every animal or- gan. When I move the hand in writing, the muscles of the arm are called into play by an influence transmitted to them from the brain, by means of the soft white cords called nerves. This stimulus is so indispensable, that, if the communication between the brain and the muscles be cut off, by dividing or tying the nerve, no effort of the mind will longer suffice to excite them to action. In like manner, if the nerves of the lungs and stomach be cut through, so as to in- terrupt the flow of nervous influence, respiration and digestion will cease, although in every other respect their respective organs remain uninjured. Changes in the quality or amount of the nervous influence transmitted from the brain to any organ, have thus a direct power of modifying its function. If, from a peculiar state of the brain, the nervous in- fluence sent to the stomach be impaired, the tone of that organ will be also impaired, and digestion be- come imperfect; whereas if, in consequence of pleas- ing excitement, the nefVous stimulus be increased, a corresponding activity will be communicated to the ON HEALTH. 301 stomach, and digestion will be facilitated, as is expe- rienced after a dinner in pleasant society. But if, by a violent burst of passion or grief, the brain be inor- dinately and disagreeably excited, so as to send forth a stimulus vitiated in quality, the stomach which re- ceives it will partake in the disorder. Hence the sud- den loathing and sickness so often induced by unex- pected bad news, vexation, or alarm. Something analogous to this is still more visibly ex- hibited in the case of the muscles. If the mind be active and decided, the muscles, receiving a strong Btimulus, move with readiness and force; but if the cerebral activity be impaired by bilious depression, muscular action becomes slow, infirm, and indolent; whereas, if the brain be excited by strong passion, and the stimulus be impetuous, the movements instantly become energetic and decided; and, if the excitement be carried still farther, the regulated muscular con- traction passes the limits of health, and becomes in- voluntary and convulsive. As the quality of the nervous influence depends on the condition of the brain, that which springs from a brain of which all the parts are in sound and vigorous action is the best. Mental indolence and high mental excitement are alike inimical to bodily health; and, consequently, our great aim ought to be to secure for every mental power, moral as well as intellectual, that equal and regular exercise from which alone the proper nervous stimulus can spring. It is indeed interesting to observe the various ef- forts of the nervous influence, according to the facul- ties in predominant action at the time it is produced. If the higher feelings have the ascendency, and the more selfish propensities be merely active enough to give force to the character, without setting the mind at war with itself, the nervous influence is the most grateful and efficient which can be imagined for sus- taining the healthy co-operation of the whole body. This result follows, because the Creator evidently designed such a state of mind to be the best and hap- piest for man himself, and therefore took care to sur- 302 INFLUENCE OF THE NERVOUS SYSTEM round him with every motive to induce him to enter into it. If, however, the lower feelings be in great activity, and filled with designs and emotions repulsive to the moral sentiments, so that the faculties are ranked in opposition to each other; or, if the mind be oppress- ed with grief, anxiety, or remorse, the stimulus which it communicates is far from beneficial, being no long- er in accordance with the conditions designed by the Creator. It is in such circumstances, accordingly, that bad health is so often seen to arise from the state of the mind, and that suffering is produced which no art can relieve till the primary cause has ceased to exist. The same result follows over-exercise of intellect and inactivity of the feelings. From the concentra- tion of vital action in the brain, the stomach and oth- er organs are unprovided with the requisite nervous stimulus, and become impaired in their functions; and hence the dyspeptic and hypochondriacal symp- toms which so often render life a burden to literary men. Persons so situated, when advised to attend to diet, often answer that it is in vain, and that, while at some times nothing can be digested, at other times, perhaps within a few hours or days, nothing comes amiss—the power of digestion varying thus quickly, according to their mental condition. Whereas, when indigestion arises from a primary affection of the stomach, the least deviation in the way of indulgence proves injurious. In both instances, attention to diet is beneficial; but in the one it is less rigidly important than in the other. The influence of the brain on the digestive organs is so direct, that sickness and vomiting are among the earliest symptoms of many affections of the head, and of wounds and injuries of the brain; while violent emotions, intense grief, or sudden bad news, some- times arrest at once the process of digestion, and pro- duce squeamishness or loathing of food, although, an instant before, the appetite was keen. Narcotics, the ON THE GENERAL HEALTH. 303 direct action of which is on the brain, have a similar effect on the stomach. The influence of the mind and brain over the action of the heart and lungs is familiar to every one. The sighing, palpitation, and fainting, so often witnessed as consequences of emotions of the mind, are eviden- ces which nobody can resist. Death itself is not a rare result of such excitement indelicately-organized persons. This law of our constitution, whereby the regula- ted activity of both intellect and feeling is made es- sential to sound bodily health, seems to me one of the most beautiful arrangements of an all-wise and beneficent Creator. If we shun the society of our fellow-creatures, and shrink from taking a share in the active duties of life, mental indolence and physical debility beset our path. But if, by engaging in the business of life, and taking an active interest in the advancement of society, we duly exercise our various powers of per- ception, thought, and feeling, we promote the health of the whole corporeal system, invigorate the mind itself, and, at the same time, experience the highest mental gratification of which a human being is sus- ceptible—that of having fulfilled the end and object of our being, in the active discharge of our duties to God, to our fellow-men, and to ourselves. If we neglect our faculties or deprive them of their objects, we weaken the organization, give rise to distressing diseases, and, at the same time, experience the bitter- est feelings that can afflict human nature, ennui and melancholy. The harmony thus shown to exist be- tween the moral and physical world is but another example of the numerous inducements to that right conduct and activity in pursuing which the Crea- tor has evidently destined us to find terrestrial hap- piness. The reader will now understand why the state of the mind is so influential in the production and prog- ress of disease. In the army, this principle has of- ten been exemplified in a very striking manner, and 304 INFLUENCE OF DEPRESSION ON HEALTH. on so large a scale as to put its influence beyond a doubt. Sir George Ballingall mentions, in his lec- tures on Military Surgery, that the proportion of sick in garrison in a healthy country and under favoura- ble circumstances, is about five per cent. ; but that, during a campaign, the usual average is never ten per cent. So marked, however, are the preservative effects of cheerfulness and the excitement of success, that, according to Vaidy, the French army cantoned in Bavaria after the battle of Austerlitz, had only 100 sick in a division of 8000 men, being little more than one in the hundred. When, on the other hand, an army is subjected to privations, or " is discouraged by defeat or want of confidence in its chiefs," the pro- portion of sick is " often fearfully increased."* The same principle explains why it is so important for the physician to carry the feelings of the patient along with him in his curative measures. It is well known, for example, that those who live in constant apprehension of fever, cholera, or other ailment, are generally among its first victims when exposed to its causes. The reason is obvious. The depressing nervous influence resulting from the painful activity of the selfish feelings, affects all the organs of the body, and places them on the brink of disease, even before any external cause is in operation; and hence the easy inroad which the latter makes when it comes into play. The influence of the state of the mind on health is well exemplified in recruits for the army. According to Mr. Henry Marshall, regret for having enlisted and separation from friends make them brood over the inconveniences attending their new mode of life, and their health suffers in consequence. These causes, combined with the fatigue of drill and the re- straints of discipline, have so much influence, that " growing lads" frequently fall victims to them. The recruit, if not very robust, " loses that active forti- tude which is required to fit him to bear up against * Medico-Chirurgical Review, No. xxxvi., p. 430. INFLUENCE OF CHEERFULNESS ON HEALTH. 305 difficulties, and falls into a gloomy state of mind that is soon followed by deteriorated bodily health; he loses his appetite, becomes emaciated, a slight cough supervenes, and, after frequent admission into hospi- tals, he at last dies of diseased lungs. This is an out- line of the history of many a young lad who enlists in the army."* In France, where the conscription is compulsory, and many are, of course, serving against their will, the agency of depression of mind is still more marked and fatal. In the seven years extend- ing from 1820 to 1826, both inclusive, it appears from the returns that the French army lost ninety- seven men from pure nostalgia or home-sickness, an affection which is rarely fatal in this country. So efficacious, on the other hand, is a more cheer- ful state of mind, from the more healthful nervous influence which it diffuses through the frame, that surprising recoveries occasionally happen which can be ascribed to no other cause but this. A singular but instructive instance fell under the observation of Sir Humphrey Davy, when, early in life, he was as- sisting Dr. Beddoes in his experiments on the inhala- tion of nitrous oxyde. Dr. Beddoes having inferred that the oxyde must be a specific for palsy, a patient was selected for trial and placed under the care of Davy. Previously to administering the gas, Davy inserted a small thermometer under the tongue of the patient to ascertain the temperature. The para- lytic man, wholly ignorant of the process to which he was to submit, but deeply impressed by Dr. Bed- does with the certainty of its success, no sooner felt the thermometer between his teeth than he concluded the talisman was in operation, and, in a burst of en- thusiasm, declared that he already experienced the effects of its benign influence throughout his whole body. The opportunity was too tempting to be lost. Davy did nothing more, but desired his patient to re- turn on the following day. The same ceremony was repeated; the same result followed; and at the end * Marshall on Enlisting and Discharging Soldiers, p. 5. C c 2 306 EXAMPLES—SIEGE OF BREDA. of a fortnight he was dismissed cured, no remedy of any kind except the thermometer having ever been used.* Quacks profit largely by taking advantage of this principle of our nature : and regular practitioners would do well to bestow more pains than they do in assisting their treatment by well-directed moral influ- ence. Baglivi was deeply impressed with this senti- ment when he said, " I can scarcely express how much the conversation of the physician influences even the life of his patient, and modifies his com- plaints. For a physician powerful in speech and skilled in addressing the feelings of a patient, adds so much to the power of his remedies, and excites so much confidence in his treatment, as frequently to overcome dangerous diseases with very feeble reme- dies, which more learned doctors, languid and indif- ferent in speech, could not have cured with the best remedies that man could produce." Another remarkable instance occurred during the siege of Breda in 1625. When the garrison was on the point of surrendering from the ravages of scur- vy, a few vials of sham-medicine, introduced by the Prince of Orange's orders as the most valuable and infallible specific, and given in drops as such, produ- ced astonishing effects : " such as had not moved their limbs for months before were seen walking in the streets sound, straight, and whole; and many who declared they had been rendered worse by all former reme- dies, recovered in a few days, to their inexpressible Joy."t Every one, indeed, who has either attended inva- lids or been an invalid himself, must often have re, marked that the visit of a kind and intelligent friend is highly useful in dispelling uneasy sensations, and in promoting recovery by increased cheerfulness and hope. The true reason of this is simply that such Intercourse interests the feelings, and affords an * Paris's Life of Davy, p. 51. t F. V. Mye, De Morbis et Symptomatibus, &c, ouoted by Dr Johnston in his Treatise on Derangements of the Liver, &c. D. 206. v *• INFLUENCE OF THE MIND ON THE SICK. 307 agreeable stimulus to several of the largest organs in the brain, and thereby conduces to the diffusion of a healthier and more abundant nervous energy over the whole system. The extent of good which a man of kindly feelings and a ready command of his ideas and language may do in this way, is much beyond what is generally believed ; and if this holds in debility ari- sing from general causes, in which the nervous sys- tem is affected not exclusively, but only as part of the body, it must hold infinitely more in nervous de- bility and in nervous disease; for then the moral man- agement is truly the medical remedy, and differs from the latter only in this, that its administration de- pends on the physician, and not on the apothecary; on the friend, and not on the indifferent attendant. In his excellent little treatise on physical education, Dr. Caldwell justly remarks, that the influence of a regulated and well-balanced activity in the moral and intellectual faculties on the general health, compared with that of active and boisterous passions, is like the salutary effect of mild and wholesome nourish- ment contrasted with the fiery potency of alcohol. The former is eminently conducive to life, health, and enjoyment, while the latter is eminently opposed to them all. Of this truth Dr. Caldwell gives an in- teresting example from the history of his own country. Of the fifty-six delegates who .signed the Declaration of Independence, almost all were men of well-regu- lated and active minds, not marked by any excess of passion. Two of them died early from accidents. The aggregate years of the remaining fifty-four were 3609, giving to each an average of sixty-six years and nine months; thus affording a striking evidence of the salutary influence of the mind on health. From the same absence of active passion in mathe- maticians, the average duration of life in twenty of them, taken promiscuously by Dr. Caldwell, extended to seventy-five years, while, in an equal number of poets, whose vocation greatly depends on excitability of feeling, the average was so low as fifty-seven.* * Caldwell on Physical Education, p. 84-86. 308 INFLUENCE OF THE MIND ON THE SICK. The powerfully stimulating effect of healthy men- tal excitement on the bodily functions is familiar to every one, and is duly noticed in the works of the novelist and poet. In nine cases out of ten, a visit to a watering-place, or a journey through an interest- ing country, does more good by the beneficial excite- ment which it gives to the mind and brain, than by all the other circumstances put together. It is, indeed, greatly to the credit of the medical departments of both army and navy, that the influence of the mind in preserving and restoring health is more correctly appreciated and provided for than it is even in private practice. In the late expeditions of discovery to the Northern Regions, the utmost attention was bestow- ed by the enlightened commanders to keep up a health- ful vivacity of intellect and feeling among their men, by constant occupation, intellectual instruction, the representation of plays, masquerades, and other amu- sing and exciting exertions; and there cannot be a doubt that their remarkable immunity from disease was in no small degree owing to these admirable ar- rangements. From this is obvious the immense im- portance which attaches to the selection of a humane and considerate, as well as scientific commander. In the second volume of Captain Basil Hall's first series of Fragments of Voyages and Travels, some of the principles just explained are very amusingly illustra- ted. CHAPTER X. APPLICATION OF THE PRECEDING PRINCIPLES. Causes of bad Health.—Not always the Result of Moral or Im- moral Conduct—nor of Accident—but of the Infringement of the Laws of Organization.—Proofs from past History.—Dimin- ished Mortality from increase of Knowledge, and better fulfil- ment of the Conditions of Health.—The Expeditions of Anson and Cook contrasted.—Gratifying Results of the Sanatory Ar- rangements of Koss, Parry, and Franklin.—Pulmonary Diseas- es in the Channel Fleet, from ignorance of Physiology.—Rates of Mortality indifferent Ages and Countries.—Causes of late Improvement.—Conditions of wealthier and poorer Classes compared.—Good done by the apprehension of Cholera.—In- fluence of Habit.—Neglect of Organic Laws in Recruiting Ser- vice.—Examples. The reader will now be prepared to take a correct view of a question on which it especially interests us to have true and precise notions. I allude to the real origin of bad health. On this point very vague and contradictory opinions are prevalent; and, as our con- duct in life must necessarily be closely dependant on our views in regard to this subject, 1 cannot do better, before concluding, than devote a chapter to its con- sideration. Setting aside, for the present, hereditary tenden- cies to disease (which must have begun at first with some progenitor, from ordinary causes, and which, therefore, are not really unconnected with the inqui- ry), bad health may be regarded in one of three dif- ferent lights . First, As having no necessary connex- ion with our conduct, but as being the result of cir- cumstances entirely beyond our knowledge and con- trol, and sent by a superintending Providence, not to urge us to more rational care, but to soften our hearts and warn us from sin; Secondly, As the result of accident alone or of external influences which we 310 SOURCES OF BAD HEALTH. can appreciate, but from which it is impossible to withdraw ourselves; or, Thirdlv, As, in every in- stance, the result of the direct infringement of one or more of the laws or conditions decreed by the Creator to be essential to the well-being and activity of every bodily organ, and the knowledge and ob- servance of which are, to a great extent, within our power. According as one or other of these views shall be adopted, the most opposite practical results will fol- low. If the first be received as the truth, and health and sickness be viewed as dispensed without refer- ence to our bodily conduct, but solely as a means of reclaiming us from sin, attention to moral and reli- gious improvement alone will be our best protection, and any attempt to avert bad health, by studying and obeying the laws which regulate the bodily functions, will be entirely useless. If, again, the second princi- ple be correct, and disease arise from accident and from influences beyond our control, then neither our moral nor our bodily conduct will avail us as a pro- tection, and our only resource will be humble resig- nation to the will of God. But if the third be true, and the human frame be constructed by the Creator on principles calculated to carry on life for seventy years, and if, de facto, a large portion of the race perish be- fore attaining ten years of age, chiefly from infrin- ging the conditions on which the due performance of the various vital functions depends, it then becomes an object of great interest to us to study the structure of our organs, to discover the laws which regulate their functions, and to yield to those laws that impli- cit obedience from which alone health can spring. That the strictest observance of the moral laws, and the purest devotion of which human nature is capa- ble, are insufficient to secure health to the body with- out a simultaneous observance of the organic law3, is too clearly proved by the instances already addu- ced, and by the history of mankind, to require any demonstration here. The biographies of the pious and excellent furnish abundant examples to the con- SOURCES OF BAD HEALTH. 311 trary; while the annals of crime afford numerous in- stances of men of the most depraved characters en- joying unbroken health. If, indeed, the organic con- ditions be fulfilled, the upright man will enjoy a se- renity of health which the criminal can never know; but the moral observance alone will not avail him, if he at the same time neglect the organic laws.* In regard to the second proposition, a little reflec- tion will satisfy every intelligent mind that it is equal- ly untenable, and that disease is not always the result of accident or of circumstances which cannot be mod- ified. There are causes of bad health against which even the most stupid and prejudiced take some pre- cautions, and with success; and the whole art of medi- cine would be a grosser delusion than ever romancer believed it to be, if health were not influenced by cir- cumstances within our control. All our remedies, and all our attention to diet, clothing, and regimen, are indications of the contrary persuasion. There are, indeed, agencies from which we shall probably never be able entirely to protect ourselves. Such are va- riations in the state of the atmosphere, epidemic and contagious causes, and necessary exposure, in pursu- ance of higher duties, to known unhealthy influences; but, allowing for all these, ample scope remains with- in which man may, by an extension of his knowledge and industry, provide himself with safeguards far be- yond what he has ever yet made use of or has ever dreamed of discovering. The third view, or that which ascribes bad health to the infringement of some one or more of the or- ganic laws, thus presents itself as the only one in ac- cordance with observation and past experience; and, after the full exposition I have already given of the conditions of health of various important organs, I trust that little farther proof of this will be required. At the same time, as the principle is full of practical * I may again refer to " The Constitution of Man" for a con- sistent and intelligible view of the relation subsisting between the organic and the moral and intellectual laws. 312 SOURCES OF BAD HEALTH. value, I will take a short review of some facts which go far to establish its accuracy. Considering that the human frame is constructed to endure, in many cases, for sixty, seventy, or eighty years, it must seem extraordinary to a reflecting mind, that, in some situations, one half of all who are born should die before attaining maturity; and that, of 1000 infants born and reared in London, 650 die before the age of ten years. It is impossible to suppose that such a rate of mortality was designed by the Creator as the unavoidable fate of man ; for, by the gradual improvement of society and a closer observance of the organic laws, the proportion of deaths in early life has already been greatly reduced. A hundred years ago, when the pauper infants of London were receiv- ed and brought up in the workhouses, amid impure air, crowding, and want of proper food, not above one in twenty-four lived to be a year old ; so that out of 2800 annually received into them, 2690 died. But when the conditions of health came to be a little bet- ter understood, and an act of Parliament was obtain- ed obliging the parish officers to send the infants to nurse in the country, this frightful mortality was re- duced to 450 instead of upward of 2600! Can evi- dence stronger than this be required to prove that bad health frequently arises from causes which man may often be able to discover and remove, and which, therefore, it is his bounden duty to investigate and avoid by every means which Providence has placed within his reach? The different rates of mortality in crowded cities and country villages equally demonstrate the influ- ence of bad air, crowding, and imperfect food in abridging life. Even in the best managed communi- ties, the number not only of the sick of all ages, but of those who are cut off in early youth, is so prodi- gious as to show that we are far from having arrived at the maximum of health of which the race is sus- ceptible ; while the advances we have already made give us every reason to hope that, by perseverance KNOWLEDGE HAS DIMINISHED DISEASE. 313 and the extension of our knowledge, we may continue to improve for many centuries to come. The progress of knowledge and the increasing as- cendency of reason have already delivered us from many scourges which were regarded by our forefa- thers as unavoidable dispensations of an inscrutable Providence. In the days of the ancient Romans, their capital and territories were frequently almost depop- ulated by visitations of plague and pestilence, from which the present generation is, by a stricter observ- ance of the conditions of health, entirely exempted. In London, in like manner, the same contempt of cleanliness, ventilation, and comfort, which was so fatal to the Romans, produced similar results, and swept off its thousands and tens of thousands, till a fortunate disaster—the great fire—came in the place of knowledge, and, by destroying the crowded lanes and other sources of impurity, which man had shown himself so little solicitous to remove, procured for its inhabitants a perfect and permanent immunity from one of the deadliest forms of disease, and taught them the grand practical truth, that such awful visitations are not wanton inflictions of a vengeful Providence, but the direct consequences of neglect of those con- ditions by which the various vital functions are regu- lated, and by conforming to which alone health can be preserved. Accordingly, by greater attention to proper food, cleanliness, and pure air, London, with its gigantic population, now flourishes in comparative security, and scarcely feels the ravages of an epidemic which has inflicted a blow on some less fortunate cities, the effects of which will be long remembered. Smallpox is another scourge which annually carried off its thousands, and from which modern science bids fair to protect us; although, half a century ago, any one who might have ventured to express such an ex- pectation would have been ridiculed for his credulity. Even before Jenner's immortal discovery of vaccina- tion, the improvement of medical science consequent on increased knowledge of the structure and functions of the human body had greatly mitigated the fatality 314 KNOWLEDGE HAS DIMINISHED DISEASE. of smallpox. Formerly the patients were shut up, loaded with bedclothes, in heated rooms, from which every particle of fresh air was excluded ; and stimu- lants were administered, as if on purpose to hasten the fate of the sick. But sounder views of the wants of the animal economy at last prevailed; and, by the admission of fresh air, the removal of everything heat- ing or stimulating, and the administration of cooling drinks and other appropriate remedies, thousands were preserved whose lives would have been lost under the mistaken guidance of the older physicians. So lately as the middle of last century, ague was so prevalent "in many parts of Britain where it is now never seen, that our ancestors looked upon an attack of it as a kind of necessary evil, from which they could never hope to be delivered. In this instance also, farther experience has shown that Providence was not in fault. By draining the land, removing dunghills, building better houses in better situations, and obtaining better food and warmer clothing, it ap- pears that generations now succeed each other, living on the very same soil, without a single case of ague ever occurring where, a century ago, every man, woman, and child were almost sure to suffer from it at one time or other of their lives; thus again showing how much man may do for the preservation of his health and the improvement of his condition, when his con- duct is directed by knowledge and sound principles. If we wish for a still more admirable proof of the same practical truth, we have only to compare the condition of our seamen in maritime expeditions un- dertaken a century ago, with their lot in the present day; the expedition against Carthagena, or that of Anson, for instance, with those of Cook, Parry, and Ross, or the health enjoyed by the crew of the Val- orous with that of the seamen in the other vessels lying in the same harbour.* Anson set sail from England on 13th September, 1740, in the Centurion, of 60 guns and 400 men, ac- » Vide p. 80. CONTRAST BETWEEN MARITIME EXPEDITIONS. 315 companied by the Gloucester, of 50 guns and 300 men ; the Pearl, of 40 guns and 250 men ; the Wager, of 28 guns and 160 men; the Tryal sloop, of 8 guns and 100 men, and two victuallers, one of 400, and the other of 200 tuns. They had a long run to Madeira, and thence to the coast of Brazil, where they arrived on the 18th December; but by this time the crews were remarkably sickly, so that many died, and great numbers were confined to their hammocks. The commodore now ordered "six air-scuttles to be cut in each ship, to admit more air between the decks," and took other measures to correct the " noisome stench on board" and destroy the vermin, which nuisances had become " very loathsome ;" " and, besides being most intolerably offensive, they were doubtless, in some sort, productive of the sickness under which we had laboured." Such is the mild language used by the chaplain Mr. Walter, in communicating these frightful truths! On anchoring at St. Catharine's, 80 patients were sent on shore from the Centurion alone, of whom 28 soon died, and the number of sick increased to 96. Although this was nothing compared to what took place afterward, it is nevertheless worthy of remark; for as yet they had suffered no privations or unusual hardships, except from contrary winds. The causes of disease lay entirely within themselves. After a stormy and tedious navigation of three months round Cape Horn, scurvy carried off 43 more in the month of April, and double that number in May, 1741. Those who remained alive now became more dispirited and melancholy than ever; which "general dejection added to the virulence of the disease, and the mortality increased to a frightful degree." On 9th June, when in sight of Juan Fernandez, the debil- ity of the people was so great, that, 200 being already dead, the lieutenant could muster only two quarter- masters and six foremast-men able for duty in the middle watch ; so that, had it not been for the assist- ance of the officers, servants, &c, they would have been unable to reach the island; to such a condition was the crew of 400 men reduced in the course of a few months! 316 EXPEDITIONS OF ANSON AND COOK. I have noticed the cutting of holes for the admission of air between decks, and the dejection of the men. The narrative proceeds to say that the commodore's principal attention was now devoted to getting the sick on shore, as they were dying fast on board," the distemper being, doubtless, considerably augmented by the stench and filthiness in which they lay ; for few could be spared to look after them, which rendered the ship extremely loathsome between decks." The officers suffered least, as being the best fed and best lodged. Within a year, out of upward of 1200 men composing the crews of the squadron who had sailed from Eng- land, only 335 remained. The fate of the Spanish squadron, which sailed nearly at the same time, was still more horrible. The Esperanza, of 50 guns, lost 392 out of 450 men, and the other ships almost as large a proportion. It is true that, in doubling Cape Horn, they encountered the severest weather and the greatest privations, and that their deplorable fate was aggravated by these causes. But when we look to the conduct of later navigators in circumstances equally trying, it is im- possible to resist the gratifying conviction, that mor- tality like this forms no part of the designs of a be- neficient Providence; and that, for the best of pur- poses, our safety is placed, to a great extent, within the limits of our own power. The late memorable expeditions of Parry, of Franklin, and more especial- ly of Ross, who, with few resources, spent upward of four years in the desolate regions of the north with scarcely any loss of life, are examples pregnant with meaning \o all who are interested in the future prog- ress of man. It may be said that the climate and situation of the two parties were dissimilar. In some respects the objection is well founded: but Cook's second voyage round the world in 1772 affords a parallel presenting so many points of resemblance to that of Anson, that no one can reasonably object to their comparison On this occasion, the vessels selected were the Reso- lution, carrying 112 men, and the Adventure, with a EXCELLENT HEALTH IN COOK's VOYAGES. 317 crew of 81. Enlightened by former experience, Cook spared no pains to effect his equipment in the com- pletest manner, and to lay in such stores of clothing and provisions as he knew to be useful in preser- ving the health of those under his command. Among these were malt, sourkrout, portable broth, sugar, and wheat. Care was taken to expose the men to wet as little as possible, to make them shift themselves after being wet, and to keep their persons, hammocks, bedding, and clothes, perfectly clean and dry. Equal at- tention was paid to keeping the ship clean and dry between decks : once or twice a week it was aired with fires; and a fire was also frequently made at the bottom of the well, which was of great use in purify- ing the air in the lower parts of the ship. To the last precaution too great attention cannot be paid ; as the least neglect occasions a putrid and disagreeable smell below, which nothing but fires can remove. Fresh water, vegetables, and fresh provisions, were also eagerly sought for at every opportunity, and these it was Captain Cook's practice to oblige his people, by his own example and authority, to make use of. The results of these measures we shall now see. The two ships sailed on 13th July, 1772. Towards the end of August, when they were advancing to- wards the south, the rain " poured down, not in drops, but in streams ; and the wind at the same time being variable and rough, the people were obliged to attend so constantly upon the deck, that few of them esca- ped being completely soaked;" but although rain is a great promoter of sickness in warm climates, the air- ing by fires between decks, and the other precautions, were so effectual, that, on arriving at the Cape of Good Hope, only one man was on the sick list; where- as we have seen that, after a similar voyage, the Cen- turion arrived on the coast of Brazil with 80 sick, of whom 28 soon died. As we proceed, the contrast be- comes still more striking. On 22d November, Cook Bailed from the Cape in search of a southern continent. On the 29th, a violent storm, attended with hail and rain, came on, and caused the loss of most of the live Dd2 318 EXCELLENT HEALTH IN COOK'S VOYAGES. stock on board; and a sudden transition took place from warm and mild to extremely cold and wet weather, which was severely felt by the people. On 10th December they met with islands of ice; and, from that time till the middle of March, continued their search for land with unremitting diligence, amid cold, hardships, and dangers, such as landsmen can form a very imperfect idea of; and at last, on 26th March, after being 124 days at sea, during which they had sailed 3660 leagues, they came to anchor in Dusky Bay, New Zealand. "After so long a voyage," says Dr. Kippis, from whose Life of Cook these particu- lars are taken, " in a high southern latitude, it might certainly have been expected that many of Captain Cook's people would be ill of scurvy. This, howev- er, was not the case. So salutary were the effects of the sweetwort and several articles of provision, and especially of the frequent airings and sweetening of the ship, that there was only one man on board who could be said to be much afflicted with the disease; and even in that man it was chiefly occasioned by a bad habit of body, and a complication of other disorders." Can anything be conceived more demonstrative of the advantages to be derived from investigating and obeying the laws of health, than those splendid re- sults, when contrasted with those on board of the Centurion 1 In the Resolution, cheerful activity, clean- liness, dry pure air, adequate clothing, and a suitable regimen, were found to carry man unscathed through hardships, and exposure which, in the Centurion, were, from neglect of the same protective means, se- vere enough to sweep off a large proportion of her crew. And, as if on purpose to place the efficacy of these measures beyond a doubt, and to remove any objection which might be started on the ground of the inferior health of the Centurion's crew originally, it appears that, in the month of July, 1773, the Adven- ture had many sick, and twenty of her best men inca- pable of duty from scurvy and flux, when the Resolu- tion, with a larger crew, had but three men sick, and only one of them from scurvy. This difference in EXCELLENT HEALTH IN COOk's VOYAGES. 319 the state of health of the two ships was distinctly traced to the crew of the Adventure having eaten few or no vegetables when in Queen Charlotte's Sound, while, on board of the Resolution, Cook was most particular in enforcing attention to this part of their dietetic regimen. By this admirable care and unwearied watchfulness on the part of Cook and his officers, the Resolution performed a voyage of three years and eighteen days, through all climates, from 52° north to 71° south, with the loss of only one man by disease out of 1121 And in his last voyage, so efficaciously were the same means put in practice, that his ship was brought home after an absence of four years, without the loss of a single man by disease! Lord Nelson is said to have been equally successful, and to have spent three years on the West India station without one life hav- ing been lost by disease.* Similar results were obtained by the able command- ers of our more recent expeditions to the Northern Regions. The Fury and Hecla were, at one time, no less than twenty-seven months entirely dependant on their own resources, before scurvy began to make its appearance; and at the end of 28 1-2 months both ships returned home (in September, 1823,) with the loss of only five men; a result which, a century ago, could hardly have occurred, and which, even at the present day, is a remarkable indication of the talent and humanity of the officers by whom it was effected. Nothing, in fact, could have been better devised than the means practised in these expeditions to pre- serve the health of the people; and, did my limits permit it, I might illustrate almost every principle in this volume by a reference to its actual efficacy as displayed in these voyages. Not only were the con- ditions of health attended to as regarded the skin, the muscles, the bones, the lungs, and the digestive organs; but the health of the all-important nervous system was sedulously provided for by the constant * Sir George BallingalTs Lectures on Military Surgery, p. 73. 320 PREVALENCE OF DISEASE AT THE and cheerful occupation of the people in their various duties and amusements; and so judiciously were these planned, that a spirit of life and activity ex- tremely favourable to the preservation of health was constantly kept up, and had, no doubt, great influ- ence in producing that concord and unity of feeling among them, which were so conspicuous amid all their privations. If, from these bright examples, we turn to the ex- traordinary prevalence of disease at the penitentiary of Milbank in 1823-4, we shall find little reason to congratulate ourselves on the successful application of scientific principles to the preservation of health in our civil institutions. At the time spoken of, in- tractable affections of the bowels and other insidious forms of disease were so general in the penitentiary that few of the prisoners escaped, and parliamentary inquiry into their causes was ordered. Great discrep- ance of opinion prevailed, as usual, among the wit^ nesses, from each giving utterance rather to his own impressions than to opinions founded on any philo- sophical examination of the circumstances. But ev- idence enough was brought forward to show that several great errors had been committed. In the first place, the penitentiary itself was built, at an enormous expense, in a low, damp situation, rather under than above the level of the highest tides in the river, so that ventilation or the supply of dry pure air is always imperfect, and the atmosphere at night is often heavy and damp, as on all low grounds in the neighbourhood of rivers and half-covered mud. To this great and permanent source of debility were ad- ded, secondly, a very low and inadequate diet; and, thirdly, the influence of constant mental depression, arising partly from the local situation of the pris- oners, and partly from the monotonous confinement and labour under too scanty a supply of food. In such circumstances, it was certainly not wonderful that a low state of health, and, latterly, scurvy and bowel complaints, should make such general havoc. PENITENTIARY OF MILBANK. 321 That much of the sickness was justly attributable to these causes, is shown by the perfect immunity enjoyed for some years both by the officers of the penitentiary and by about thirty of the prisoners, who, from being employed in the kitchen and offi- ces of the establishment, were less subjected than the rest to the debilitating influence ; and also by the rapid convalescence of almost every one out of 635, on being removed to Woolwich and to the Regent's Park, and supplied with a more nourishing diet. On more minute inquiry, indeed, it appeared that, instead of the bad health having begun all at once in 1823, as at first supposed, bowel complaints had been extreme- ly prevalent from the first opening of the penitentia- ry in 1816, and had continued to be so, though in rather a less degree, down to that time; so that the causes, instead of being altogether of sudden origin, must have been inherent in it from the beginning, and only became aggravated by the farther reduction of diet, which took place some months previously, and by the inclemency of the weather. Dr. Latham gives striking evidence of the state of the mind exerting a powerful effect on the health of the prisoners. Speaking of the women who were sent on board of one of the hulks at Woolwich, he says that individuals were pardoned from time to time for good conduct, and that recently pardons had become very numerous, as a kind of atonement for the bad health to which they had been subjected. But, as all had nearly an equal claim, " every one pleased herself with believing that she would be the next, who would be set at liberty. Whenever, there- fore, an individual was pardoned, all the rest were thrown into an agony of the bitterest disappointment, and were, at the same time, overtaken by disease. It was not a mere nervous or hysterical ailment, but some actual form of real disease, such as they had before suffered, and requiring the strictest medical treatment for its relief."* Examples like these, let it be again * Account of the disease lately prevalent at the General Peni- tentiary, by Dr. Latham, p. 192. 322 NORTHERN EXPEDITIONS. and again repeated, show the extent to which health is in our power when we choose to fulfil the condi- tions on which alone it can be obtained. In looking forward to a still greater diminution of disease in the human family, it is cheering to fix at- tention on what has been already accomplished by the hand of authority. Had the same individuals who circumnavigated the globe with Cook, or braved the northern winters with Ross and Parry, been left for an equal number of years to undergo the ordina- ry vicissitudes of life at home, unrestrained in their inclinations and conduct by the constantly operating and beneficent influence of a superior mind, it is morally certain that disease and death would have made greater havoc among them than actually occur- red amid physical privations and suffering much greater than they were likely to have ever encoun- tered at home. This renders obvious the pressing necessity of diffusing widely among society that spe- cies of knowledge which has proved beneficial in the hands of those who were fortunate enough to possess it. If human health and happiness be thus effectual- ly promoted by increased attention to the conditions which regulate the vital and animal functions, nothing can be more useful than to communicate to every intelligent being such a measure of knowledge as will enable him to do for his own safety and improve- ment that which government now does for those whose services it requires. With these successful and cheering results of knowl- edge, it will be instructive to contrast another instance of the fatal effects of ignorance in a situation where knowledge might have been effectual in preserving life and sparing suffering. I shall take the example from an early publication of Dr. James Johnson,* who has devoted no small attention to the subject of health and the causes by which it is affected, and whose work contains much valuable matter connected with hygiene, as well as with the history and cure of dis- * On the influence of the Atmosphere on the Health and Func ♦ions of the Human Frame, &c, 8vo, 2d edition, p. 193. CAUSES OF DISEASE IN THE NAVY. 323 ease. In treating of exercise and the evils of its ex- cess, Dr. Johnson says, " I shall exemplify this rea- soning by an instructive lesson. During the late war, it was observed that, in its earlier periods, fever, fluxes, and scurvy made the greatest havoc; while, in its middle and ulterior periods, these diseases al- most disappeared, and pneumonia (inflammation of the lungs), with its too frequent consequence, phthi- sis, became infinitely more prevalent and fatal. The facts were apparent to all, but the causes few could divine. Some of our chymical wiseacres attributed the pneumonic diathesis to the lime-juice served out; but this hypothesis need not detain us, for I think a more rational explanation can be offered. As the pe- riod of warfare was lengthened out, discipline gradu- ally became more perfect, and at length attained its acme. Every evolution was now performed with a rapidity and precision that seemed the effect almost of magic. All machinery and apparatus were not only so arranged as to give human power its greatest force and facility of application, but human strength was put to its ultimatum of exertion, and every muscular fibre of the frame called into furious action during each manoeuvre of navigation or war. Thus, in exercising the great guns, the heaviest pieces of artillery were made to fly out and in, or wheel round, with almost the celerity of a musket in the hands of a fugleman. The most ponderous anchors were torn from their beds with astonishing velocity, while the men were often seen lying about the decks breathless and ex- hausted after such ultra-human exertions! " But reefing and furling sails were still worse. Here, as in all other operations, there was a constant struggle against time. The instant that the word • aloft' was given, the men flew up the shrouds with such agility, that, by the time they were on the yards, the respirations were then nearer fifty than fifteen in a minute! In this state of anhelation they bent across the yards, and exerted every atom of muscular energy in dragging up the sails and securing the reef- lines, while the thorax was strained and compressed 324 NEGLECT OF THE LAWS OF PHYSIOLOGY. up against the unyielding wood! What were the consequences? The air-cells were frequently torn; blood extravasated, and the origins of cough and he- moptoes continually laid. The lungs were now in a proper state for receiving the impression of aerial vi- cissitudes ; and constant exposure to night air, to rain, and every inclemency of the season, soon evolved the long black catalogue of pulmonic and phthisical maladies, which swept off our men in vast numbers, to the no small surprise of the officers, who could not divine the cause of this new and destructive enemy. " But it was not the lungs alone that suffered here. The central organ of circulation bore a part of the onus, and a host of anomalous and otherwise inex- plicable symptoms were produced, which completely puzzled the naval practitioners, who rarely suspected any lesion of the heart. These last affections both aggravated, and were in their turn aggravated by, the depressing passions engendered during the long con- finement on shipboard and separation from friends and native home." I need hardly stop to point out to what extent the fatal results above mentioned might have been pre- vented, had the officers been possessed even of super- ficial acquaintance with the laws of respiration and of muscular action. A perusal of the chapters on these subjects will enable the reader to judge for himself, and to determine whether the cause of the destruction was really difficult to be divined. Dr. Johnson, it may be mentioned, has the Channel and North Sea fleets chiefly in view in his remarks. Increased attention to the organic laws has greatly reduced the annual rate of mortality in Europe, even within the last forty years, and it cannot be supposed that farther improvement is impracticable. Dr. Haw- kins, in his Medical Statistics, states, that in 1780 the annual mortality in England and Wales was 1 in 40; in 1790 it was 1 in 45; in 1801 it was 1 in 47; in 1811 1 in 50; and in 1822 it had sunk so low as 1 in 58. In cities the diminution is still more remarkable. In London 80 years ago, the annual mortality was 1 in DIMINISHED MORTALITY. 325 20; it is now 1 in 40. In Manchester, Glasgow, and other places, a similar improvement has taken place; but, in some instances, the decrement in the rate of mortality has been so much exaggerated, that the deaths are stated at only 1 in 74; a proportion which is altogether incredible as occurring in any commu- nity. In France the average mortality is 1 in 40; in Aus- tria, 1 in 38; in Russia, 1 in 41; and in the United States, 1 in 40; while it is rated by Humboldt at 1 in 30 in South America. In Paris it is rated at 1 in 32. From the greater accuracy with which statistical returns are obtained and preserved in France and on the Continent, and the inadequate means which we have in this country of procuring correct tables, as well as the great disparity between the results obtain- ed here and abroad, there is every reason to suspect that, in England, sources of error have been over- looked, and that the rates are consequently too favour- able. It is difficult to believe, for example, that with us the rate of mortality can be so low as 1 in 58, when in France, Russia, and Austria, it is ascertained to be so high as 1 in 40, 1 in 41, and 1 in 38. Still, how- ever, the returns, such as they are, show a manifest improvement in the value of life within the last forty years, which can be ascribed only to a greater degree of comfort among the people, and a more skilful treat- ment of their diseases. The principle which I am advocating is established even by many of the continental returns, which are more trustworthy than our own. In France, the an- nual deaths in 1781 were 1 in 29; in 1802, 1 in 30; and in 1823, 1 in 40; and in Paris the mortality has diminished, in seventy years, from 1 in 25 to 1 in 32: so that, though we neglect altogether the more than doubtful statements as to Manchester and other places, with an annual mortality of only 1 in 60 or 70, evidence enough exists to prove the proposition that health is intimately connected with, and dependant on, man'a own conduct; and that, when the conditions of health 326 PROGRESS OF KNOWLEDGE. shall be better understood, we may reasonably look for still brighter results. It was very common at one time to eulogize the simple food and hardy habits of the poor and labour- ing classes as eminently conducive to health, when contrasted with the debilitating effects of the cares and luxuries of the rich. Experience unfortunately reverses the picture, and shows, by arithmetical ar- guments, that the excess of work and the privations to which the poor are habitually exposed, produce a much higher rate of mortality among them, especial- ly in seasons of scarcity or commercial depression, than among the richer classes of society; and the same thing is further proved by the fact that, in the army and navy, the officers almost invariably suffer less than the men from changes of climate, and from the fatigues and calamities of war. In France, the mortality among the infants of the poorer classes is said to be nearly double that occurring among those in more affluent circumstances; while, in the weal- thier departments, the average of life is twelve years greater than in those which are poor. In London according to Dr. Granville's tables, only 542 infants' out of every 1000 births among the poor survive their second year ; and in Paris, also, the mortality in the quarter inhabited by the working classes is nearly double that which occurs among the more wealthy The influence of impoverished diet, defective clothing and an unfavourable moral position, is strikingly ex- hibited among the children of soldiers, of whom ac- cording to Mr. Marshall, only a very small proportion reach the age of manhood; most of them being stint- ed m their growth, scrofulous in constitution, and bad in morals.* ' If, as seems to be the case, a corresponding dispro- portion occurs between the rates of mortality in the different classes of society in Great Britain, it sug- gests some most important considerations, the first of which is the simple question, Whether that condi- * Marshall on Enlisting, &c, p. 16. HEALTH IN DIFFERENT CLASSES OF SOCIETY. 327 tion of the lower orders can be regarded as eminent- ly prosperous or natural which subjects them to be cut off by death so many years before the term allot- ted to those by whom they are employed ? It also illustrates strikingly what 1 have said about bad health being more frequently the result of gradual causes long in unperceived operation, than of any sudden or accidental exposure; and proves that a mode of life or degree of labour is not to be rashly pronoun- ced harmless, merely because its injurious effects are not immediately seen, and because years may elapse before it breaks down the constitution. It is blindness to the existence of this principle which still misleads mankind, and renders them insensible to the agency of numerous hurtful influences, from which, by a little exertion, they might easily be re- lieved. Much angry discussion took place a few years ago as to the reality of the mischief inflicted by the pro- tracted and unremitted exertion required in our fac- tories and spinning-mills, where an unerring test might easily have been found. If those who contended that the times of labour were not too long for either the children or the adults, could have produced evidence to show that, among operatives, the average of life was equally high as among the apparently more favoured classes, there would have been at once and for ever an end of the argument; while, had the result pro- ved different, the system of labour might justly have been deemed oppressive, in the precise ratio in which the mortality among the operatives exceeded that among their wealthier countrymen. No criteri- on could be so infallible as the one now proposed; and if government possessed the means of obtain- ing accurate returns, it seems to me that the expense of procuring them would be well bestowed, as, what- ever might be the result, it could not fail to produce greater harmony of views and purpose than now unhappily prevails between the different classes of society. Everything which tends strongly to call attention 328 GOOD DONE BY APPREHENSION OF CHOLERA. to the conditions which influence public and individ- ual health, is calculated to do great good to the com- munity. In this point of view I am disposed to con- sider the visitation of cholera to the British Isles rather as one of those remarkable instances in which a beneficent Providence brings good out of evil, and converts an apparent calamity into a positive bless- ing, than as the public scourge which it has been generally proclaimed. True it is that many individu- als have perished, and others suffered by it in their affections and in their worldly circumstances ; but I question if anything short of the dread which chol- era produced could have combined all classes so effi- ciently and ardently in their efforts to discover and remove everything in the condition of the poor and labouring portions of the community which could prove detrimental to health. In the season of appa- rent danger, not only did the importance of cleanli- ness, ventilation, warmth, clothing, and nourishment, as preservatives of health, become manifest to minds on which nothing else could have made an impres- sion ; but their experienced efficacy became an impe- tus to the exertions of the lower orders in their own behalf, which will continue to be productive of good long after the cause from which it sprung shall be forgotten. The comparative exemption of the wealthier class- es from cholera is itself sufficient to show how much it is in the power of man, by the proper exer- cise of reason in the application of his knowledge, to obviate the dangers to which his health is expo- sed ; how closely his bodily welfare is dependant on his own conduct and external situation; and how very little, comparatively, it is the result of circum- stances which he cannot control or modify. In fact, every one who has investigated the subject with at- tention will readily testify that, but for the estab- lishment of soup-kitchens, the supplies of warm clothing, and the whitewashing, cleaning, and venti- lating of the houses of the poor before and during the epidemic, a much greater number would have INFLUENCE OF HABIT. 329 fallen victims to its ravages. And it is consoling to know, that even those who regard such visitations as direct inflictions of a vengeful Providence, and as nowise connected with mere neglect of the laws of health, were, nevertheless, not the least active in en- forcing and superintending the removal of every ex- ternal cause of disease, and promoting the comforts and supplying the wants of the needy and destitute; so that, whatever differences in mere belief there might be, all parties were content to act as if the Creator had intended the health of the race to depend, in a very high degree, on the care which was taken to fulfil the conditions which he has decreed to be essential to the due action and preservation of the various bodily organs. Many individuals exist who, from hereditary defi- ciencies, can scarcely attain tolerable health, even with the best care; and many more are to be met with who are exposed to bad health from the hurtful nature of the professions in which they are engaged. Many suffer, also, from vicissitudes of the weather, and other causes which we may never be able entire- ly to guard against. But all these united are few, when compared to the number of those whose health is ruined by causes capable of removal or of modifi- cation, and to which they are now exposed from igno- rance of their nature, from apathy, or from the want of the comforts and necessaries of life. If I have succeeded in calling attention to this important truth, one great object of these pages will be accomplish- ed ; and here I cannot help repeating the remark al- ready made more than once, that health is more fre- quently undermined by the gradual operation of constant though disregarded causes, than by any great and mark- ed exposures of an accidental kind, and is, consequently, more effectually to be preserved by a judicious and steady observance of the organic laws in daily life, than by exclusive attention to any particular func- tion, to the neglect of all the rest. It may be said that I allow nothing for the influence of habit in rendering situations and causes compara- Ek 2 330 INFLUENCE OF HABIT. tively innocuous which were dangerous at first. It is quite true that the human constitution possesses a power of adapting itself within certain limits to a change of circumstances; but it is not less true that sudden and extreme changes often destroy health and life before the system can adapt itself to the exigency; and that, after making the most ample allowance for this sort of safety, the protection which it affords against the active causes of disease is comparatively trifling. Where the change is sudden, as in passing from a temperate to a tropical climate, or even from very fine to very inconstant weather, the consequences to health are well known to be highly injurious. But where it is gradual and not extreme in degree, as in passing from winter to summer, health is not much endangered, because the system has time to accom- modate itself to its new circumstances. Different organs predominate in activity in different climates and seasons, and time is thus required to admit of the necessary changes taking place without disturbing the general balance of the circulation. In hot countries, for example, the skin predominates greatly in activity in comparison with the kidneys; whereas, in a cold country, the case is precisely reversed. If, therefore, a sudden transition be made from the one to the other without due preparation, the rapid change in the dis- tribution of the blood from the surface to the internal organs, or from these to the surface, consequent on such change, is likely to be attended with danger; al- though the same change, gradually effected, would be unattended with any injurious results. If, again, the change be from a healthy situation to one only a little less favourable, the consequences to the system will be also gradual and progressive. No immediate injury to health may be apparent, and the body may be said to adapt itself to the circumstances ; but, in reality, health will be lowered and life short- ened in exact proportion to the amount of the inju- rious exposure and the state of the system at the time. Individuals of a peculiar constitution may live INFLUENCE OF HABIT. 331 long, but the average of health and life will be posi- tively diminished; a fact which shows that the appa- rent exception is more a fallacy than a reality, and that, cmteris paribus, the highest health and greatest vigour will always be on the side of those who make the nearest approach to the fulfilment of the organic laws. It is, therefore, a glaring perversion of logic and reason to infer that we may safely rest satisfied with a limited portion of evil, on the plea that the consti- tution will adapt itself to its presence. The argu- ment ought to be turned in exactly the opposite di- rection. If the constitution possesses this power of adaptation to external circumstances, it becomes doubly incumbent on us to have it always surrounded with beneficial influences ; seeing that, when the laws of health shall be fulfilled, the same tendency to adap- tation will operate with equal force in permanently ameliorating the constitution. In every point of view, therefore, it is an object of much consequence to us to become acquainted with and to obey all the laws which regulate the functions of the human body. It would be easy, were it consistent with the limits and purpose of the present volume, to show that, al- though great advances have been made of late years both in physiological knowledge and in its applica- tions to the advancement of human happiness, many of the usages current in society, and many of the practices resorted to in education, are still far from being in harmony with the laws of the human consti- tution ; and that much good may be done by diffusing among the reflecting portion of mankind, and espe- cially among the young, more accurate notions of the structure and uses of the various bodily organs, and of the conditions required for their healthy action. Illustrations in proof this position, drawn from indi- vidual cases, may be cavilled at as incomplete, or re- garded as accidental coincidences ; but when the prin- ciple is exhibited in active operation on a large scale, minor qualifications fall into the shade, and leave the evidence absolutely unassailable. On this account I prefer selecting an example from the records of the 332 NEGLECT OF ORGANIC LAWS army, both as being striking in its features, and as being one in which the public interest is deeply in- volved. A few years ago, young growing lads were uniform- ly selected for the army in preference to men of a mature age, on the supposition that, because their habits were not formed, they could be more easily converted into good soldiers, than if taken a few years later. Many officers still entertain and act upon this opinion; and the period at which, by law, liability to military service commences in this country, remains fixed at eighteen years of age, although it has been raised to twenty by most of the Continental govern- ments. Examined physiologically, the practice of enlisting juvenile recruits seems peculiarly irrational. During growth, the conditions required for the healthy devel- opment of the body are, moderate and healthy exer- cise, plenty of nourishing food, abundance of sleep, and a cheerful state of mind. In making the transi- tion from boyhood to maturity, the equilibrium of ac- tion between the different parts of the system is so much disturbed, that, under the most favourable cir- cumstances, an unusual susceptibility of disease pre- vails, which renders that period of life particularly dangerous. By consulting the statistical tables pre- pared by Mr. Finlayson, and those of the popula- tion of Paris by Count Chabrol, already referred to, it will be seen, that, in all classes of society, the rate of mortality suddenly increases from the age of four- teen, when rapid growth may be said to commence, to that of twenty-three, when it is nearly completed. In Paris, for example, the tables for the year 1820 ex- hibit only 395 deaths as occurring between the ages of 10 and 15; whereas those between 15 and 20 amount to no less than 703, being nearly double; while, in the five years immediately subsequent, they rise to 1339, and afterward begin to decrease. Viewing these results in connexion with the laws of the animal economy, and bearing in mind that, even in peace, military service implies broken sleep, IN SELECTING RECRUITS. 333 separation from friends, and occasional exposure to fatigue and privation, we must consider it almost self- evident, that an army composed of young lads at this hazardous period of life must be sickly and inefficient, and that a large portion of the expense and trouble bestowed in enlisting and training them must be en- tirely thrown away. That such is actually the fact, has unfortunately been too often proved by fatal ex- perience. Mr. Marshall, in the valuable work already quoted, adduces an irresistible mass of evidence to show that, till the growth is completed, it is impossi- ble to form any correct estimate of the probable effi- ciency of a recruit; as numbers of apparently promis- ing young men are cut off by affections of the chest, and other acute diseases, before attaining maturity, and before being exposed to any unusual privations or fatigue. So literally accurate is this statement, that Coche, a high French authority referred to by Mr. Marshall, mentions distinctly, that even in time of peace, when no great hardships are to be encoun- tered, volunteers received into the army at the age of eighteen or twenty pass two, three, or four years of their period of service (eight years) in hospital, solely from inability to bear up against difficulties which scarcely affect those who are a few years older. If such be the result during peace, I need hardly say that, in time of war, the practice of enlisting very young men must be not less fatal to the recruits than costly to the country. It appears, accordingly, that in the army in Spain, sickness and inefficiency pre- vailed almost in proportion to the youth and the re- cent arrival of the soldiers. Sir James MacGrigor cites the 7th regiment as an illustration, and adds, that between 9th August, 1811, and 20th May, 1812, it lost 246 men; of whom 169 were recruits landed in the preceding June, while only 77 were old soldiers. The original number of this detachment of recruits was 353, so that more than one half died within the first eleven months. The total number of old soldiers, on the other hand, was 1143, and of them only 77 perish- ed in the same time! So convinced, indeed, is Sir 334 NEGLECT OF ORGANIC LAWS James of growing "lads being unequal to the harass- ing duties of the service," that in making calculations for measures in the field, he thinks that 300 men who had served five years would be more effective than 1000 newly arrived, not simply from their greater ex- perience, but chiefly from the additional stamina pro- ceeding from maturity.* In a note subjoined to the preceding opinion of Sir James MacGrigor, Mr. Marshall says, " Numerous examples might be quoted to show that young lads are much less able to endure the fatigue of marching than men a little more advanced in life. During the win- ter of 1805, a French army, which was stationed on the coast in the neighbourhood of Boulogne, marched about 400 leagues to join the Grand Army before the battle of Austerlitz, which it effected without leaving almost any sick in the hospitals on the route. The men of this army had served two years, and were not under twenty-two years of age. The result of the march of this army may be compared with that of another un- der different circumstances. In the campaign of the summer of 1809, the troops cantoned in the north of Germany marched to Vienna, but, by the time they arrived at the place of their destination, all the hospi- tals on the road were filled with sick. More than one half of the men composing this army were under twenty years of age, the usual levy of conscripts having been anticipated. After the battle of Leipsic, Napoleon made great exertions to recruit his army, and called upon the legislative senate to give him their assist- ance, to which they showed some reluctance. ' Shame on you!' cried the emperor; * * * ' I demand a levy of 300,000 men, but / must have grown men; boys SERVE ONLY TO ENCUMBER THE HOSPITALS AND ROAD- SIDES.' " In similar defiance of the laws of physiology, half- grown lads were at one time preferred for the East India service, on the false supposition that their un- consolidated constitutions would more easily adapt * Marshall on Enlisting, dec, p. 5. IN SELECTING RECRUITS. 335 themselves to the climate than those of men already arrived at maturity ; a proposition very nearly equiva- lent to saying, that because a person is already en- feebled, exposure to the causes of disease will there- fore have less effect on him than after his strength shall be restored! Palpably fallacious as this kind of logic now appears to be, it nevertheless reigned for years with undisputed sway, and still has a few stanch supporters. Sir George Ballingal is entitled to the credit of having early and earnestly raised his voice against it, in his work on Fever and Dysentery, published on his return from India in 1819. His evi- dence is very striking; but so slow is the march of reason, that it was only in December, 1829, that an or- der was issued from the Horse Guards that no recruits under twenty should be received for regiments serving in tropical climates ; and so late as the year 1826, near- ly 15 per cent, of the king's troops in Bengal were under that age. Mr. Marshall also, in touching upon this question, supports his positions by reference to facts of a very conclusive kind, and to authors whose opinions ought to have great weight. Among other evidence, he quotes the register of a regiment employed in the Burmese territory in 1824, 5, from which it appears that, in 1824, the ratio of mortality among the young men who went out with the corps was 38 per cent., or 1 in every 2 1-3; while among the volunteers, who were considerably older, the mortality was 17 per cent., or only 1 in 6. In 1825, it was 30.5 per cent., or 1 in 3 1-3 among the younger class, and only 6 per cent., or 1 in 16 among the older. P. 10.* * In availing myself of Mr. Marshall's labours, I may be allow- ed to express my opinion of the benefit he is conferring by his sta- tistical researches, not only on the service with which he has been so long and honourably connected, but also on the public at large. There are many practical questions deeply concerning public health, which can be fully elucidated only by such masses of facts being grouped together as shall destroy all minor inequalities, and place the operation of principles prominently in view. But to ef- fect this object with due regard to accuracy, requires an acquaint- ance with detaUs, an acuteness of observation, and a power of 336 NEGLECT OF ORGANIC LAWS Some other instances might be quoted in proof of the greatest mortality being always among the youn- gest men; and I might refer to a regiment mentioned by Dr. Davies, in which, when it was sent out to Bombay in 1808, there was not a single private above 22 years of age, and in which, out of 550 men, near- ly 300 required medical assistance within six weeks after he joined it; but it is unnecessary, as, although individual officers still prefer young men, government is at least awakened to their unfitness. A vague no- tion that growing lads do not bear fatigue, is indeed prevalent enough ; but I venture to say, that if those by whom the age of enlistment was first determined had been thoroughly acquainted with the laws of physiology, and had possessed a clear perception of the conditions of healthy growth, the practice of re- ceiving recruits at 17 or 18 years of age would never have been sanctioned, and the country would have been saved the pain and the expense of sending thou- sands of young men to " encumber the hospitals and roadsides" 'of the Peninsula, or to perish under the exhausting influence of a tropical climate. I have dwelt at some length on this subject, both because the practice which I condemn was lately in full operation, and is even yet not entirely exploded, and because, from the magnitude of its results, and the clearness with which they can be traced to the direct violation of a natural law of the constitution, it affords an instructive example of the evils arising from ignorance of the structure and functions of the human body, and of the aid which might be derived from a general acquaintance with physiology, in pre- serving health, and promoting the happiness of the race. It was my intention to analyze, in the same way, various other practices in which public or private health is concerned; but I have already so far exceed- successful generalization, which are rarely found in combination with adequate zeal and industry. It would be very useful if sim- ilar researches were instituted in regard to the occurrences in our public hospitals. IN SELECTING RECRUITS. 337 ed the limits originally proposed, that I must now draw to a conclusion, and judge, from the reception of the present volume, how far I am right in believ- ing that information of the kind now communicated will be acceptable or useful to the public. F F CHAPTER XI. APPLICATION OF THE PRINCIPLES OP PHYSIOLOGY TO THE MORAL TREATMENT OF NERVOUS DISEASE AND INSANITY. Condition of the Nervous.and Insane too little known.—Necessi- ty of improved Moral Treatment.—Use of Physiological Knowl- edge in effecting the required Improvements.—Principles on which the Nervous and Insane ought to be treated.—Necessity of providing the Means of Bodily and Mental Occupation, and humane and intelligent Attendants, in Asylums.—Admission of Visiters.—Middlesex and Edinburgh Pauper Asylums contrast- ed.—State of Private Asylums—M. Esquirol's Retreat at Ivry. —Conclusion. Having given the reader some notion of the extent to which human health and happiness depend on the fulfilment of the conditions which the Creator has attached to the exercise of the bodily and mental functions, and shown that the direct design of suf- fering and pain is to lead to a stricter obedience to the Divine institutions, and to more perfect enjoyment of life, I might now, perhaps, leave the farther appli- cation of the doctrines to the consideration of the reader. But the reception which the first three edi- tions of this volume have met with, gives me fresh confidence in the practical importance of the princi- ples which I have been unfolding, and encourages me to add in the present edition a few remarks on the condition of the nervous and insane—a class of suf- ferers who have the strongest claims on our sympathy, and in regard to whom, notwithstanding the numer- ous channels in which public benevolence has of late been so generously flowing, an apathy is still displayed which is not less hurtful than melancholy, and which can proceed only from their real state and wants be- ing too imperfectly known. If the wretchedness of the nervous invalid has CONDITION OF THE NERVOUS AND INSANE. 339 been more frequently made the subject of mirth and ridicule than of friendly regard and rational curative treatment, a still greater sacrifice of health, feeling, and happiness has been occasioned to the lunatic by the extreme ignorance which prevails in society in regard to the disorders of the nervous system. In the case of the insane, the secluded life which most of them are obliged to lead, separated from kindred and from society, and the disgraceful prejudices against them whicb have descended to us almost un- impaired from amid the superstitions of the darker ages in which they originated, have, in no small de- gree, contributed to this result. Insanity has thus remained one of the few evils' which mankind has never ventured to look fairly in the face, with a view to discover its nature, and the means of its prevention and cure. The consequences are, not only that it has been allowed to extend more and more widely, but that the waywardness of conduct, irritability of temper, and caprice of sentiment, which are the first indications of a disordered nervous system, are often resented by the friends as voluntary, and, therefore, culpable offences; and indignation or indifference is displayed where, perhaps, rational sympathy and an early perception of the true state of the patient might have led to the prevention of the disease. Similar maltreatment is far from uncommon in cases of what is called nervous—a term which some con- sider as equivalent to imaginary—disease, but in which, when used to denote a certain class of disorders hav- ing their seat in the nervous system, and not in the fancy, an amount of misery and wretchedness is of- ten imbodied, of which few who have not either felt themselves, or witnessed it in some valued friend, can form any adequate conception. In the correction of these evils, little can be effected while the igno- rance in which they arise remains undiminished; and, therefore, it becomes an imperative duty to allow no opportunity to escape of spreading abroad such in- formation as may help to dissipate the prevailing in- difference, and rouse attention to the magnitude of the existing evils. 340 SOCIETY AND EMPLOYMENT REQUISITE If the state and management of public and private asylums for the reception of the insane be examined with reference to the conditions of health already explained in treating of the respiratory, muscular, and nervous systems, it cannot fail to strike the re- flecting observer, that while in many institutions the most laudable zeal has been shown for the physical health and comfort of the patients, comparatively lit- tle has been accomplished, or even attempted, with the direct purpose of correcting the morbid action of the brain and restoring the mental functions. We have now, in most asylums, clean and well-ventilated apartments, baths of various descriptions, abundant supplies of nourishing food, and a better system of classification, the furious and the depressed being no longer subjected to each other's influence and so- ciety : and the result has been, that in so far as these important conditions are favourable to the general health, and to that of the nervous system in particu- lar, recovery has been promoted and personal com- fort secured. But in so far as regards the systematic employment of what is called active moral treatment and its adaptation to particular cases, a great deal more remains to be done than has hitherto been con- sidered necessary. This will be apparent on reflect- ing how extremely influential the regular action of the various feelings, affections, and intellectual pow- ers is on the health of the brain, and how few asy- lums possess any adequate provision for effecting this most desirable object. If want of occupation, and the absence of objects of interest, be, as we have seen, sufficient to destroy the health of a sound or- gan, the same causes must be not less influential in retarding the recovery of one already diseased. Hence it becomes an object of extreme importance in establishments for the insane, and in the social treatment of those suffering from nervous diseases, to provide the necessary means for encouraging the healthy and regular exercise of the various bodily and mental powers; and for drawing out, as it were, and directing to their proper objects, the various af- FOR THE NERVOUS AND INSANE. 341 fections, feelings, and intellectual faculties—this be- ing a condition essential, in a higher degree than any other, to the success of our curative measures. Those who have not attended to the subject may be disposed to think that the importance of mental and bodily occupation in cases of insanity and ner- vous disease is here exaggerated. But the physiol- ogist who looks to the established law of the animal economy, which decrees regular action of every or- ganic part to be essential to its health, no matter whether that part be bone, muscle, bloodvessel, nerve, or brain, will not fail to bear testimony to the truth of my remarks. The pathological observer, also, whose attention is daily called to the miseries and bad health resulting from the total absence of mental occupation in those whom fortune has condemned to a life of idle- ness, without having imparted to them that activity of constitution which seeks out objects of interest and makes occupation for itself, will at once acknowledge that a command of the means of healthy mental and bodily exercise would add more to his power over ner- vous and mental diseases than any other remedy which art has yet discovered. And yet, in the major- ity of our asylums, the patients are still merely pla- ced in security and humanely treated, without the least effort made to afford them occupation of mind or body, or any of the more cheering comforts of sympathy and social intercourse; and this being the case, can we be surprised that only one third or one half recover their reason, or shall we rest contented in imagining that human means can go no farther to alleviate their calamities'? It is in the treatment of this unhappy class of pa- tients, who are deprived of their dearest enjoyments and of the soothing intercourse and consolations of social and domestic life, that an acquaintance with the laws of health, and the structure and functions of the human body, becomes pre-eminently useful. When, for example, we contemplate the number of muscles, the importance of their functions, and their influence on the circulation and on the general sys- Ff2 342 USE OF PHYSIOLOGICAL KNOWLEDGE IN tern, and understand the laws or conditions of their healthy action, we cannot fail to perceive that any mode of treatment which does not provide for their exercise in the nervous and the insane, must be radi- cally defective, however kindly and judiciously it may be administered in other respects; and we have thus an unerring standard by which the efficacy of every contrivance used to rouse this class of patients from contemplative inaction to useful exertion may be at all times determined. Hence we have no hesi- tation in pronouncing as imperfect every asylum which does not provide for the regular active em- ployment of its inmates, either in their former trades or in some kind of bodily, and, if possible, useful and imperative exertion. When we know the structure,. uses, and relations of the skin, and are at the same time aware that, in disorders of the mind, its exhala- tions and nervous functions are almost always dis- ordered, so much so as often to be accompanied with a smell peculiar to mental invalids, it becomes impos- sible for us longer to overlook the necessity of devo- ting attention to its condition, and taking steps for its restoration to health as a means of promoting the recovery of the brain. When we become acquainted, in like manner, with the functions of the lungs and the nature of respiration, we can scarcely fail to use every exertion to secure free ventilation, and such ample accommodation as shall prevent several luna- tics from being placed together in a small apartment. And, lastly, when we become impressed with the fact that the human mind is endowed with affections, moral feelings, and intellectual powers, operating through the medium of bodily organs, and requiring for their health regular and free exercise on their respective objects—and that, without this gratified activity, they fall into debility and disease—we can no longer rest contented until every possible means of affording occupation to intellect, interest to the feelings, and employment to the body, shall have been resorted to. In fact, till adequate arrangements shall be made in every public and private asylum for effect- EFFECTING THE REQUIRED IMPROVEMENTS. 343 ing these purposes, and till the same principles shall be acted upon in private society in regard to nervous diseases, it will be only deceiving ourselves and shutting our eyes to the truth to suppose that we have accomplished all that can be done for the re- covery and relief of the nervous and insane; and too much pains cannot be taken to force attention to the defects which still impair the usefulness of many of our best institutions. In making these comments I have no wish either to blame any one or to overlook the difficulties which stand in the way of such improvements as science and humanity will one day consider indispensable. Adequately trained and qualified moral agents will not be easily obtained in such numbers as will be re- quired ; nor will money be easily procured to meet the necessary expense. Still, however slow our progress may be, it will begin the sooner and proceed the faster if attention be now called to the urgency of the case, and to the leading principles by which farther ameliorations are to be effected. It is a common but most deplorable mistake to sup- pose, that because a person is insane, he is insensible to the ordinary feelings and affections of humanity; that his reason is blind to the ordinary relations of life and of external nature; and that, consequently, it matters little in what language he is addressed or what demonstrations of feeling are offered to him; for, in the great majority of instances, the mind is only partially disordered, and is as much alive as ever to the perception of insult, kindness, common sense, and drivelling. And even in those rare instances in which all the faculties seem to be deranged, and in which much irritation and violence frequently exist, kindness, truth, and reason, although at the moment they seem without effect, rarely fail, when calmly persevered in, to produce a salutary impression and to sooth the patient. It therefore becomes of the utmost conceivable importance, in erecting asylums for the insane, to make also special provision for that systematic moral treatment, which is to the brain 344 PRINCIPLES ON WHICH and mind what medicine and dietetic regimen are to the stomach, the liver, and the bowels. It has been said, and I believe not without reason, that keepers of asylums who live, without any variety of inter- course and occupation, exclusively in the company of the insane, are themselves apt to become of unsound mind; and that of those who escape insanity there are comparatively few who do not ultimately acquire the peculiar expression of eye which is observable in lunatics. If, then, constant exposure to the society of lunatics be in any case sufficient to give rise to madness in a previously healthy mind, it is as clear as the light of day that the same influence must retard the recovery of those whose minds are already deranged; and that, on the same principle, it must be of importance to subject the lunatic continually to the restorative influence of the society of healthy and well-regulated minds. Every day brings fresh con- viction with it, that the more nearly we can approximate our treatment of the insane to that of reasonable beings, the more successful shall we be in effecting cures, and the more delightful will the duty become of ministering to the mind diseased. It is hardly necessary to remark, that in these ob- servations on the importance of regulating the moral treatment of the insane, I have in view chiefly that numerous class of patients in whom the acute stage has been subdued, either by medical aid or by the mere lapse of time. At the very commencement of the disease, a cure may frequently be accomplished by the removal of the exciting causes, active medical treatment, and careful superintendence at home. But after this period, much more will be accomplished by judiciously regulating the exercise of the mental and bodily functions, than by strictly medical remedies; and it is consequently chiefly to this stage that I now refer. To the nervous invalid the rule is still more extensively applicable. To secure regular and animating exercise of all thu mental and bodily functions, as conducive equally to the preservation and restoration of mental health, THE INSANE OUGHT TO BE TREATED. 345 ought then to be our grand aim in the construction and management of public and private asylums, and in the treatment of nervous patients. In planning the means of mental and bodily occu- pation for the insane, we should follow, as far as possible, the same rules and principles which are applicable to persons of sound mind. Thus, daily muscular exercise in the open air is essential equally to bodily health and to mental soundness, and is, therefore, indispensable to both sane and insane. It is more pleasant, more easily persevered in, and also more salubrious to the individual, when it is combined with an object calculated not only to occu- py the mind, but to impress the patient with the utility of his labours. This latter condition tends greatly to reconcile him to the world, and to sooth his feelings by the consciousness which it imparts to him of not being either a degraded or a forsaken being. Mere walking or riding, or employment resorted to merely as employment, generally becomes irksome, and is, consequently, either speedily given up, or pursued with a degree of languor which deprives it of its utility. On this account, mechanical and agricultural pursuits, which arrest attention and elicit activity, ought to be provided for in choosing a situation: for experience has demonstrated that, as remedies, such employments cannot be too highly estimated; and that, wherever the rank of the patient or the preju- dices of his friends do not preclude him from en- gaging in them, they produce the happiest results in promoting quiet and sleep, subduing irritation, dispo- sing to perfect subordination, and, above all, hast- ening the progress of recovery. Ample extent of ground for the purposes of agri- culture and gardening ought, therefore, never to be forgotten; and for those who either are fond of mechanics or have been trained to some manual em- ployment, workshops become equally necessary, and have the advantage of contributing to the general expenses of the house. In several establishments where field-labour, gardening, and workshops have 346 MENTAL AND BODILY OCCUPATION NECESSARY. been tried on an extensive scale, the results have been highly satisfactory, not only in the improved habits and comfort of the patients, and in their more speedy and numerous recoveries, but also in the important advantage of economy; as the labour of the patients has in some asylums gone far to defray tlveir current expenses, while scarcely a single accident is on record as having arisen from an improper use of the liberty allowed them, or of the edged tools put into their hands. Man is so much a social being, and depends so much on the sympathy, esteem, and co-operation of his fellows, that, as one of a body, he will submit cheerfully to tasks and duties against which, if pro- Kosed to him as an individual or as one of a few, e would unhesitatingly rebel. Disease may modify this tendency of the mind, but cannot destroy it; and the practical physician does not fail to avail him- self of its power in the management of the insane. Many will at first refuse to work in the fields, in the garden, or in the workshop, particularly if unaccus- tomed to manual labour, who, seeing others do so with cordiality and pleasure, will gradually allow their res- olution to give way, and, ere long, become as zealous as they were previously backward. One of the chief advantages of large establishments is the great facil- ity they afford of turning out numbers to every kind of employment, so as to subject an individual who refuses to exert himself to all the disadvantages of singularity, which the insane dislike even more than persons of sound mind. Where there is any difficulty in engaging patients of a higher class in the easier and more agreeable kinds of bodily labour, such as gardening, netting, and basket-making, much good may still be done by engaging them as much as possible in the employ- ments to which they were formerly accustomed. Billiards, bowls, walking, reading, writing, and music, are then valuable resources, and may be made to con- stitute the business of the day; care being always taken to turn the talents of the patient to a useful ADVANTAGE OF EDUCATED ATTENDANTS. 347 account whenever an opportunity occurs, so as to give him, as frequently as possible, the consciousness of filling his place as a member of society. In the smaller, and especially in private asylums, dedicated to the middle and higher classes of society, the presence of a numerous body of intelligent and educated attendants is a great desideratum. The i patients are too few in number to operate on each other by example, and their habits are not in har- mony with any manual employments. By placing numerous attendants among them, who would act systematically in endeavouring to engage them in useful labour, at first of a very light description, and to rouse them by example and cheerful encourage- ment, a good deal might be done; but as, in such retreats, the patients are generally persons of a more intelligent and refined description than in the larger asylums, the attendants, to be on a par with them, would require to possess proportionally higher moral and intellectual qualifications, so as to fit them for being companions and friends, as well as guardians, of the inmates. The expense of providing a suffi- cient number of qualified persons will long be an obstacle to their being obtained; but if the impor- tance of the provision were once fully appreciated, and its success demonstrated, it can scarcely be doubted that this difficulty would be surmounted. Every year we hear of large legacies being left to lunatic asylums by the benevolent; and if one of these were bequeathed to the first public institution that should introduce such a system, we should not have to wait long to see the example generally fol- lowed. The wealthier classes are, indeed, directly interested in the experiment, as their ranks afford proportionally the greater number of victims; and if the diseases were once treated on such principles, there would be much less reluctance to seek early advice, and, consequently, much more success in combating its attacks. Since the former editions of this work appeared, a friend has communicated to me, as confirmatory of the truth of these remarks, 348 ADVANTAGE OF EDUCATED ATTENDANTS. the cases of two patients who, after having been in- sane and violent for fourteen years, were placed some time ago in the society of a family circle, accustomed to the kind treatment of the insane. Even in these unpromising instances an improvement has taken place. " Every month," says my friend, " I perceive some strength gained by them in acquiring restrain- ing power in the presence of the family. So long as any perceptive power remains, such patients soon discover the difference of being again with intelligent and agreeable companions, instead of being subjected to the caprice and authority of an ordinary keeper." Pinel has said that thirty years' experience had taught him, that a striking analogy subsists between the art of educating and training the young and that of managing the insane, as the same principles are applicable to both. Natural activity, unwearied kind- ness, tact, and firmness, are eminently useful in both situations; but they are productive of their fullest advantages only when re-enforced by an accurate ac- quaintance with the laws which regulate the mutual influence of mind and body, with the nature and sphere of the primitive mental powers, and with the methods and objects by which each may be soothed into repose, or stimulated to activity; in other words, by an intimate knowledge of human nature and of the philosophy of mind. But it will be asked, What fortunate establishment possesses attendants endowed with such excellent qualifications, and where are such persons to be found by anyone who wishes to procure their assist- ance 1 The answer must be, Nowhere; but it may with equal truth be affirmed, that, as a necessary consequence, nowhere is the treatment of insanity so successful as it would be, were such assistants provided in sufficient numbers to mix with, and exert a constant and active influence on, the patients. In some retreats, an approximation to this desideratum is made in the frequent admission of visiters, who, actuated by kindness and intelligence, seek the society ADMISSION OF VISITERS TO LUNATIC ASYLUMS. 349 of the insane, devote themselves to their relief and comfort, and, by gaining their confidence and showing a sympathy with their situation, succeed in dispelling morbid associations, and restoring health and tone to the disordered mind. In these asylums, the propor- tion of cures is greater than in others apparently as well regulated, but in which no effort is bestowed in active moral treatment. In the Connecticut Retreat this system has been carried as far as the present state of knowledge will permit, and with the best effects; the proportion of cures in recent cases being nine out of ten of all admitted. At present, indeed, no amount of funds could command the services of a sufficient number of properly qualified assistants; but, nevertheless, it is important that the deficiency be made known, that we may make provision for supply- ing it, and not proceed contented with our present means, as if they were already adequate. The tend- ency of the human mind is to become accustomed to existing defects, and never to think of remedying them till some accidental occurrence displays their magni- tude, and turns attention to further improvements. As matters now stand, the higher class of lunatics are in one sense the most unfortunate of all. Ac- customed at home to the refinements of educated and intelligent society, to the enjoyments arising from change of scene, to horse and carriage exercise, and to the command of numerous sources of interest, they find themselves transported to an asylum where they may no doubt be treated with kindness, but where they are necessarily cut off from many of the comforts to which they have been accustomed, and must encounter prejudices, feelings, and modes of thinking and acting to which they are strangers, and with which they can have no sympathy. Being there restricted almost exclusively to the society of keep- ers, who, from their rank, education, and manners, cannot be considered qualified to gain their confidence or elicit friendly interchange of sentiment, the pa- tients are, in a great measure, deprived of that bene- ficial intercourse with sound minds which is indis- Gg 350 ADMISSION OF VISITERS TO LUNATIC ASYLUMS. pensable to health, and of the numerous opportunities which such intercourse presents for gradually stirring up new interests and leading to new trains of thought. The medical attendant, indeed, is often the only be- ing to whom patients of this class can freely unbur- den their minds, and from whom they can seek com- fort; but unfortunately, in most establishments, his visits are so few and short, that they can scarcely be reckoned as part of an efficient moral regimen. The poorer patients, on the other hand, although too much left to their own society, have still the ad- vantage of being, to a certain extent, in daily com- munication with minds in harmony with their own both in feeling and in intelligence; as the keepers are always men of the same rank, education, and man- ners as themselves. They consequently are less sen- sible of the change in their situation, and feel less acutely any accidental indignities to which they may be exposed. Experience has already shown that great benefit arises to the insane from the frequent association and sympathy of persons of tact, intelligence, and kindness, who feel a real interest in the happiness of the patients, and visit them from a wish to sooth and comfort them, and not from mere idle curiosity. Nothing tends so much as this to break down the formidable barrier which still separates the disorder- ed in mind from the sympathies of society, and to dis- pel those sinful prejudices which brand insanity with the stigma of crime, and impel us to shroud its vic- tims in obscurity and neglect. It may be said, " This is all true, and very proper for medical men to know; but why introduce it into a book intended for the general reader V My answer is, that I introduce it here purposely, because it is from among the public that the directors and mana- gers of institutions for the reception of the insane are chosen ; and so long as they remain unacquainted with the wants of the patients, little can be done to provide a remedy. Medical men may direct, but so- ciety must co-operate, and cheerfully and earnestly EDINBURGH PAUPER ASYLUM. 351 take a part in the good work. Besides, there are thousands of warm-hearted beings who would delight in this very duty, if they only knew how to set about it; and these can be reached only by writings ad- dressed to the general public. That I may not be considered as either too severe in pointing out existing defects, or too visionary in conceptions of the improvements required, I shall give a brief outline of the condition of one or two es- tablishments at present in full operation, and leave the reader to form his own conclusions. In Edinburgh, for example, we have two institutions for the reception of pauper lunatics; one belonging to the city, and the other attached to the West Church Charity Workhouse. That belonging to the city is situated in a part of the town almost surrounded by high buildings and the old town-wall, which is of great height, and goes far to obstruct the free circulation of air. The buildings themselves were erected many years ago for a projected trading company, and are confined in extent, low in the ceilings, entirely coop- ed up, and not in any way adapted for the purpose. The usual number of patients is about seventy. From the scanty accommodation, there is little or no room for proper classification; none for work- shops of any description, and very little for adequate ventilation or exercise. In the aspect of the place, there is nothing to cheer, to comfort, or to sooth; but, on the contrary, high walls, small windows, and iron bars appear on every hand. The same remarks apply essentially to the West Church Charity Asy- lum, with the single exception that it is more open to the air and the light of day. As a contrast to these we may take the Middlesex County Asylum at Hanwell, which I had occasion to visit in May, 1834, and to which I refer in preference to the excellent institutions at Perth, Dundee, and Glasgow, because it is appropriated exclusively to pauper patients, which the others are not, and is, therefore, a fairer object of comparison. The Han- well Asylum contains about 600 lunatics. The site 352 MIDDLESEX AND EDINBURGH PAUPER on which it is built is elevated, cheerful, dry, and airy, without being exposed, and commands an ex- tensive and enlivening view. The various apartments are well laid out, admirably warmed and ventilated, clean, and comfortably furnished. The window- frames being of iron instead of wood, there is per- fect safety without the appearance of restraint; and everywhere the apparatus of government is so little visible, that every one seems as if trusted entirely to his own discretion. Ample provision is also made for due classification, so that none are injured by be- ing placed in contact with those whose state is like- ly to have a hurtful influence on their feelings. In these respects, the superiority of Hanwell is in- contestable. It fulfils almost every condition requi- red for the purpose. Its moral advantages, however, are scarcely less remarkable. In its most humane, intelligent, and experienced resident superintendents, Sir William and Lady Ellis, Hanwell possesses a dis tinction which few other asylums, for either rich or poor, at present enjoy, but which is of immense import- ance as the mainspring of the whole moral machinery. Such, indeed, is the influence of their knowledge of human nature, undeviating kindness, and tact, in gain- ing the confidence and affection of the patients, that although the number of bad cases is unusually great (nearly five sixths being incurable before being sent to Hanwell), order, quiet, and comfort reign through- out ; and even among the worst, namely, the idiotic, the furious, and the epileptic, there is an aspect of comparative cheerfulness and confidence, which is the strongest proof of the general system of treat- ment being active, kind, discriminating, and judicious. Such is the general appearance of the establishment, that I can scarcely imagine a more gratifying spec- tacle to a humane and intelligent mind than that which a visit to Hanwell affords. In this opinion I am powerfully supported by Miss Martineau, who, after repeated visits to the asylum, has given an elo- quent testimony to the same effect in Tait's Edin- burgh Magazine (June, 1834), in an article which is ASYLUMS CONTRASTED. 353 full of interest, though it errs somewhat in assuming that asylums in general remain in the same deplo- rable condition which was so common about twenty years ago. In point of fact, a great advance has been made since then in both public and private establish- ments ; and few indeed are now so bad as Miss Marti- neau describes. Hanwell ranks, justly, among the foremost; but to place it in its true position, it is not by any means necessary to depreciate the condition of all the rest. I have visited one public establishment since the publication of her letter, to which almost the worst of her description was applicable at the time of my visit. Even in the two great institutions of Bethlem and St. Luke's, the old system is still so far in full force that the patients wander about their courts in hopeless indolence, without an effort being made, so far as I know, to provide them with syste- matic employment. The Edinburgh Pauper Asylum, also, is fortunate in having an excellent resident superintendent; but while I most willingly give him all the credit to which he is so justly entitled, I must be allowed to add, that an educated professional man, who is acquainted with the structure and functions of the human body, and has not only studied human nature as a physician and philosopher, but specially investigated the subject of insanity, possesses qualifications which experience alone can never impart; and it is therefore no dis- paragement to say, that, in regard to moral manage- ment, our asylum is less favourably circumstanced than that of Hanwell. The almost entire absence of the means of active employment and healthful exercise in the Edinburgh Asylum, is another point which contrasts singularly with the ample provision of them at Hanweil, and with the aspect of industry by which the latter is characterized. On passing the outer gate, some of the patients are generally to be met with busily em- ployed in keeping the grounds in order. Others are at work in their extensive garden, and others, again, in the adjoining fields. On entering the spacious 354 STATE OF PRIVATE ASYLUMS. offices attached to the asylum, some are found plying their trades of baker, brewer, and dairyman; while in the workshops, numbers are seen engaged in rope- making, shoemaking, tailoring, and basket-making. Nor are the women idle. Many of them are em- ployed in the kitchen, washing-house, and laundry; many in making and mending clothes; and many more in cleaning, knitting, sewing, and other house- hold duties. No one is forced to work ; whether he works or not, he is treated with kindness; but all are requested to work. If they obey, they are welcomed and encouraged. If they refuse, all their little extra comforts, such as tobacco, which are made to depend on their doing something as an equivalent, are with- held ; and they soon find it to be more agreeable, and more for their own interest, to be industrious than to be idle. In Edinburgh, on the other hand, there is neither sufficient ground for exercise, nor any means of use- ful bodily employment; and when it is considered that most of the patients are persons habituated to labour and to the open air, and unprovided with re- sources from which they can derive enjoyment within doors, the deprivations to which they are subjected by confinement assume increased importance. Du- ring the violence of the malady, when the patient requires to be confined, and is not composed enough for any quiet occupation, the want of room is less felt. But it is very different when the period of ex- citement is past, and both mind and body require to be roused to exertion on objects external to them- selves. So far from idleness being then either neces- sary or natural, the bodily energies are often in- creased and craving for an outlet; and, even in the worst cases, several, at least, of the mental faculties remain unimpaired, and ready to act when their ob- jects are presented to them. Idleness only aggra- vates the evil, by throwing the patient back upon his own morbid feelings; and the ennui to which it then gives rise renders the temper impatient and the con- finement intolerable. STATE OF PRIVATE ASYLUMS. 355 When a person in health is deprived of active ex- ercise, he generally passes a restless night; or, if he sleeps, he is visited by distressing dreams. The same thing occurs among the insane. If their energies do not get scope by day, they become noisy and impa- tient during the night. At Hanwell and other sim- ilarly managed institutions, employment and exercise in the open air are found by experience to be of great value, even as soporifics, and, therefore, highly useful in promoting recovery. In many private asylums, again, defects exist, which urgently demand improvement. The rooms are so small, low in the ceiling, and ill-ventilated, that, when the presence of an attendant is necessary during the night, the vitiation of the air becomes in- tolerable, does positive harm to the patient, and is often a source of complaint with the keeper. This is a very serious evil; for the exhalation from the skin and. lungs is often extremely offensive in the in- sane, and its accumulation, from confinement in a small apartment, becomes not only a source of an- noyance, but an obstacle to recovery. Cleanliness in person and in clothes, also, is too little enforced, and baths are too sparingly used. Little or no exertion is made to occupy or direct the mind, and no society or amusement of any kind is provided to cheer the te- dious hours. Not unfrequently, moreover, patients, still possessed of the greatest acuteness, and the nicest sense of propriety, are habitually addressed as if they were incapable of thinking, and required to be moved or influenced like babies and idiots. I have known instances in which threats, such as are vul- garly held out to children, have been used towards lunatics whose powers of intellect and delicacy of feeling were far above the average of sound minds; and the effect was to induce a flood of tears, from a deep sense of the indignity to which they were so rudely subjected. It is a fatal mistake, 1 must again repeat, to suppose that, because a person is insane, he is, therefore, insensible to ordinary motives, and may be safely treated as if he could not appreciate 356 m. esquirol's retreat at ivry. either reason or truth, kindness or severity. In gen- eral, the fact is the reverse, the sensitiveness to good or bad treatment being greatly increased. The celebrated and benevolent Esquirol has been loud and eloquent in enforcing regard to the feelings, and attention to the real welfare, of the insane; and in his private establishment at Ivry, near Paris, which I had the gratification of visiting along with him in September, 1831, he exemplifies almost every prin- ciple on which such an asylum ought to be conducted. The asylum is placed in a beautiful and airy situation, with a pleasant exposure, and its general aspect is that of an inhabited and well-kept villa. Four dis- tinct buildings, of ample size and elegant appearance, are conveniently distributed through a well laid out and ornamented park of twenty-five acres, part in garden, part in grass, and part in plantation, with neat walks bordered with flowers running in every direc- tion ; which, it will be observed, is a very handsome provision for thirty or thirty-five patients, to which number he restricts himself. For the troublesome or excited patients, there are two neat one-story buildings, one for males and the other for females, separate from each other, and far removed from those appropriated to the convalescent and tranquil. These one-story tenements open upon, and look into, spa- cious grassplots, surrounded on two sides by high walls, along which covered galleries are made for shelter from the rain and sun; so that the height of the walls seems as if intended to admit of galleries being made, rather than for the purpose of prevent- ing escape. The third side is occupied by a plain, neat, high railing, like that of the Tuilleries garden. To these plots and galleries the patients have access at pleasure; and most of them prefer coming out at the window, from which they can easily step, no re- straint being visible, and nothing of the prison being apparent. This degree of harmless freedom tran- quillizes them amazingly. Each room (neatly and plainly furnished) has beside it a room for a servant— each patient having one—so that ample surveillance m. esquirol's retreat at ivry. 357 is exercised. When a little confirmed in tranquillity, they are allowed to go out by a back door to a large ornamental walk, shrubbery, and garden, with a fine view over a lower wall, apparently opening upon the public fields, but, in reality, perfectly retired. The attendants are more refined and gentle in their man- ners, and better educated, as well as naturally more humane and intelligent, than the corresponding class of persons in this country. Their number, intelli- gence, and amiable disposition, are a great advantage both to themselves and to the patients. Being less exclusively confined to the society of the insane, they have not that peculiar expression of eye and general appearance which our keepers so often acquire, and which indicate a state in some degree allied to in- sanity. Esquirol says, that all his English visiters complain of the difficulty of getting any but coarse and ignorant men for keepers, and wonder how he succeeds ; but the French of all classes are naturally more observant of the kindnesses of ordinary inter- course, especially with their inferiors, than we are, and are habitually more tolerant of the caprices and weaknesses of others. The different classes of so- ciety thus stand at all times in a more favourable position than with us for acquiring an interest in each other, and for becoming friends, or, in other words, for effecting a cure. The importance of this confi- dence was well illustrated by an expression of Es- quirol's, in speaking of a patient: " At last," he said, " I succeeded in gaining his confidence; and after that," he added, with a significant look, " on va vite a) la guerison." This, of course, must be received as a general proposition only, but it shows the force of the principle. When tranquillity is secured, the patient is removed to another building, and from that to a third, each bringing him nearer and nearer to ordinary life, till, in the third, convalescents meet, in the character of ladies and gentlemen, at meals, music, billiards, read- ing, &c, along with the family of Dr. Metivier, a nephew of Esquirol, who resides there with his wife 358 CONCLUSION. and children. There the patients receive their friends, and with them make excursions to the envi- rons, or go to the theatre; or, if from the provinces, they go and see the wonders of the capital. They are thus gradually prepared to resume their station in society; and, from being treated throughout with most considerate kindness, they become attached to the family, and cease to repine at their temporary separation from friends and home. But, not to dwell too long on this most interesting subject, I shall con- clude at once by remarking, that it is necessary only to see the different appearance and conduct of the patients in a well-contrived and properly-regu- lated asylum, as contrasted with one of an opposite character, to perceive at once how influential active moral treatment is in promoting recovery, and how necessary it is to devote more attention than hitherto to this and the other conditions of health in our treat- ment of the insane. In commenting, as I have done, on the defects of the pauper asylum of Edinburgh, I must not be re- garded as accusing the managers of neglect or indif- ference. I am quite aware of their anxiety to better the condition of the patients, and that they have already done more in the way of cure than could have been conceived possible with their imperfect means. But it is on this very account—that the pub- lic may be stirred up to provide the necessary funds —that I am so anxious to direct attention to the miserable accommodation; for I cannot help con- sidering the asylum, in its present state, as a disgrace to the metropolis of the country. QUESTIONS ON thi PRINCIPLES OF PHYSIOLOGY. BY REV. ALFRED ADDIS, TRINITY COLLEGE, CAMBRIDGE. CHAPTER I. What is the literal signification of the word physiology ? How is the term now used? What are the branches of pnysiology called ? What is vegetable physiology ? Comparative ? Human ? In what respects are the objects of all these the same ? In what is the groundwork of distinction between animate and inanimate bodies to be found ? Mention the different relations in which they stand to the ordinary laws of the material world. Give some examples of these different relations. What is the object of chymistry and natural philosophy ? Can we infer anything of the qualities of living bodies from our knowl- edge of the elementary materials which compose them? How must we arrive at any just knowledge of the conditions by which life is characterized and under which it is carried on ? What branch of physiology is the subject of this treatise ? In what do its importance and attraction consist? What is human physiology in its widest sense ? In what respects is a true system of pnysiology eminently useful ? What do you mean by hygiene ? How are the mental and moral powers of man manifested ? What would be the most successful plan for their cultivation 7 Are living bodies possessed of any other distinctive properties besides the power of resisting the ordinary chymical and physi- cal laws? What are these peculiar properties? How do they differ from inorganized matter with regard to origin and produc- tion ? With regard to their preservation ? With regard to their growth and decay ? With regard to the term of their existence i To what classes are these properties common ? What are the most remarkable which are peculiar to animals ? What division of animated beings do these great marks of distinction warrant ? In what respects is man far superior to other animals ? What renders any systematic arrangement of a treatise on human physiology very difficult or impossible? Why is not a systematic arrangement necessary in the present instance ? 360 QUESTIONS. Why should this branch of science form an important part of a liberal education, and be familiar to the unprofessional reader T What evils result from popular ignorance on this subject ? What pernicious system was the Factories' Regulation Bill in England designed to amend? What prevented the legislative body from perceiving at once the evil tendency of the former sys- tem ? What amelioration would an acquaintance with anatomy and physiology have led them immediately to adopt ? What be- sides ignorance should not stand in the way of promoting the hap- piness of our fellow-creatures ? What was the case of Capt. Ganson's vessel, lying at Leith 7 To what was the accident attributed ? An acquaintance with what laws would have prevented this distressing occurrence? To what is a constant supply of pure air indispensable ? What have been the evil effects resulting from want of proper ventilation in small rooms, in schools, jails, and hospitals ? What pernicious law, with regard to infants, exists, or has exist- ed, in France? How is it at variance with the laws of the Crea- tor? What are its destructive consequences? How came it to be enacted ? And, if enacted knowingly, what would it legalize 7 In what cases are the lungs called into action as powerfully as in running, or any other species of severe muscular exercise ? Would an individual who nad brought on spitting of blood by bodily labour at the spade, be deemed perfectly safe and cautious by relinquishing that occupation and confining himself to harangu- ing and discoursing? What would be the consequence? From what circumstance ? What are the constant practical anomalies in life with regard to health? What treatment takes place in the time of sickness? What are the reasons assigned ? What inconsistency is observed upon the recovery of the patient? What inference are we to draw therefrom ? What is one cause of such anomalous conduct in regard to health ? Give an illustration. Another. What is the ground in- sisted upon for such inconsistencies? What would be beneficial to man in his so frequent breach of the laws of physiology ? Why does he so often fail to trace the connexion between his conduct in life and his broken health? In what manner do the consequences of his aberrations come upon him? To what is pure air essential, and how are its degrees of vitia- tion to be measured ? In the case of a delicately-constituted fe- male, who frequents heated rooms, crowded parties, theatres, &c, how is the plea, that the closeness and heat rarely injures her, to be understood ? What is the real state of the case, and the gen- uine eventual consequence! To what is the debility complained of in spring by invalids and persons of delicate constitution, more particularly owing 7 Detail the causes at length. In what cases does not the principle apply ( QUESTIONS. 361 Is the hurtful cause derived from any positive quality of the Bprmg season ? From what then ? Why is not this fact immedi- ately perceived? What may be said in corroboration of this view of the case ? How are we to judge of the harm produced by any single excess in the human system ? In what manner and by what kind of causes are the change and ruin of the human constitution gener- ally effected ? What, hence, is the character of the great mass of human ailments ? How do those suddenly and violently induced differ from them ? By what false inferences do we fail to trace diseased action to its true causes ? What is the rise and progress of the two kinds of casual influ- ences to which man is liable? What is the first called ? What is the other? Why ought we not to wonder at the speedy termination of severe cases of the former, when the latter, as dyspeptic and nervous ailments, require months for their cure ? What would have been the beneficial ef- fect of a just knowledge on this subject ? Detail at length in what the benevolence and wisdom of the arrangement are con- spicuous. How is the separation of the effect from the cause in chronic diseases to be estimated ? Give an illustration in the case of in- sanity. How does this apply to other cases ? And what may be the general deduction concerning them? To what has the apparent but unreal separation of the effect from its cause given rise ? What does this variety of opinions prove ? Mention some of these discordant sentiments. What is the natural result of these apparent anomalies and contradictions ? What influence does this want of unanimity exert upon suc- cessive generations. From what two causes must this discrep- ance arise? Why can it arise from only one of them? How, then, are the differences of opinion with regard to the advantages or evils of exercise, food, and clothing, to be settled so as to obvi- ate many difficulties ? Why should the intelligent classes of society become better ac- quainted with human physiology? What benefit would result to the physician and society in general therefrom ? What is the present state of medicine in its application to the physical and mental welfare of man ? What are its prospects in these respects ? How has the practical importance of physiological knowledge been overlooked in the training of youth ? What do the anatomist and physiologist respectively teach ? Why should anatomy and physiology not be taught separately ? In what do the anatomist and physiologist err? How far has the separation been carried ? In what is the absurdity of this plan evident ? What is the result of this erroneous system to the young prac- titioner ? How are practitioners to be answered who object to unprofes- sional persons making themselves acquainted with the structure Hh 362 QUESTIONS. or functions of the human body ? Why is physiological knowledge desirable in the patient in the case of chronic diseases? Why also in acute ? How is the charge of selfishness to be repelled by those who are solicitous in yielding rational care to the preservation of their health? Who are the truly selfish? In what respects has the blessing of health been too foolishly underrated ? What is the better object of consideration with regard to the enjoyment of health? How does Maynwaringe depict the advantages and blessings of health ? How also does he describe the evils attendant on its loss 7 What is the general inference to be deduced? CHAPTER II. On what principle are the following essays conducted 7 What have been hitherto the most prominent topics of disquisition in the animal economy ? What other subjects of discussion are most worthy of notice ? What is the skin ? Mention its different appearances in its dif- ferent conditions in the human frame. What is the structure and composition of the skin 7 How many layers of membrane has it? What are they? Are these distinc- tions of any importance ? Why ? What is the epidermis, cuticle, or scarfskin ? Describe it. From what is it supposed to originate ? Is it porous ? How is the ob- jection to the contrary answered ? What is the use of the cuticle, and how is it adapted to its use ? Give an illustration. Is the cuticle possessed of nerves ? What benefit is conferred by their absence 7 Show the wisdom of this arrangement. In what cases is a thicker cuticle provided 7 What reason have we to think this provision is intentional 7 When does the cuticle become thicker than its original consist- ence, and for what purposes i Give some illustrations. What organization of the cuticle would have been less beneficial 7 To which layer of the skin do the nails belong 7 Why ? What are their use ? What are their substitute in the lower animals ? How must the thickening of the cuticle be produced >. Why 7 Give an illustration. What is between the scarfskin and the true skin 7 Describe it accurately, and give its peculiarities in negroes and albinoes. What is the colouring matter ? What is known of the mucous network? What is its use? What in negroes ? Is this theory correct ? Why ? What place does the mucous coat occupy in fishes ? What is the third or inmost layer called ? In what does it differ from the cuticle and mucous coat? Of what is it the seat and the instrument ? Describe it. What appearance does its internal surface preseut ? Describe the areola or cells. By what are they QUESTIONS. 363 traversed ? What is the course and appearance of the nerves of the skin ? What are they called? Where are they chiefly visi- ble ? What do they constitute ? Where are they most thickly planted ? Of what, for practical purposes, may the true skin be said to be composed 7 What are proofs of the cellular nature of the skin 7 What proves the equal abundance of nervous filaments in the skin? What may be a general description of its character ? Of the ex- tent of its surface ? Of its amount of nervous matter? What may be considered as the four constituent functions of the true skin? Kxplain how the skin is a secreting and excreting organ, and give the meanings of those words. What are extraordinary and ordi- nary exhalations of the skin ? Prove the reality of the latter. Does the amount of excreted matter admit of calculation ? What was the estimate made by Sanotorios? What distinctions did Lavoisier and M. Sequin introduce? What do you mean by cutaneous and pulmonary ? How did Seguin calculate the cuta- neous and pulmonary exhalations? What was the largest quantity of pulmonary and cutaneous per- spiration per minute, hour, and day, according to Seguin? The smallest ? The average ? What is the value of his estimate ? What proportion does the cutaneous exhalation bear to the excre- tions of bowels and kidneys ? What modification does the weath- er effect on the exhalations ? What are other causes which af- fect them, and in what measure ? How does the sensible perspiration compare with the insensible? What consequence results from the former's being suddenly check- ed? Describe the condition of the skin when this takes place. The effects produced on its use. The results to other functions of the body. Are its ultimate consequences always sudden? What is Thenard's analysis of the cutaneous exhalation? Whatis Berzelius's? How does the composition vary ? Where does the blood enter most into the composition ? What inference is to be deduced 7 What is the lowest estimate of the cutaneous excretion made by Lavoisier 7 What reasons have we, from considering the ner- vous system of the skin and its daily insensible exudations, to con- clude that checked perspiration must prove so detrimental to health ? What is the practical application of this fact? Why do organs sympathize with each other? What organs sympathize with the skin? Why? What effect has checked perspiration on these organs? What is the result if any of them are in a diseased state ? What if in a healthy condition ? Give an illustration of the reciprocity of action in the sympa- thetic organs allied to the skin. What increases the secretion of the lungs when in a weak state ? What great danger is obviated by the convulsive effort of cough- ing ? How ? What has the state of the skin to do with producing expectoration, and a cough ? 364 QUESTIONS. What is one office of the lungs in conjunction with the skin? What is the consequence of this union? By what law does dis- ease operate upon sympathizing organs? Illustrate. What ought a physician to make himself acquainted with ? Is the same dis- ease always produced by the same cause? Ought it to be treated always by the same remedy 7 Illustrate. To what class of per- sons does popular ignorance give currency 7 What extraordinary sympathy exists between the skin and the stomach and bowels? Among the lower animals? How does the sympathetic concert between these two organs reciprocate? How may the connexion between suppressed perspiration and internal disease be accounted for? Can an explanation of the mode of operation be always given ? Why not 7 What connexion have scalds and burns with the internal organs? How may this fatal connexion be accounted for? What is Baron Dupuytren's opinion? What is the unquestionable inference? Mention two or three remarkable instances of the sympathy be- tween the skin and the bowels? What is to be considered next to the exhalation of waste matter from the system? What is the temperature of the human body in various climates? What great principle in man subdues the external influences of his locality? In what does the benefit of this arrangement consist? What are the chief agents employed in adapting man to his external situation 7 What may be observed of Capt. Parry, Blagden, and Sir Joseph Banks ? What is known of animal heat ? What is the law of its gener- ation and expenditure ? Illustrate. What connexion has thirst with the temperature of the body? What is the process by which extraordinary heat is carried off from the system? What did the experiments of Edwards and Franklin tend to show upon the subject? How may superfluous animal heat be easily carried off on the evaporating principle ? Is the skin the only agent ? How does the case of the dog bear upon the question ? What is Dr. Davy's observation on the standard heat produced in a European's body on his first landing in a tropical climate ? How does it affect the nervous system ? The skin ? How is the skin affected on his passing from a dry to a humid region ? Why is hot, when connected with moist, weather unwholesome ? What different effects are produced by a hot and dry, and by a hot and moist atmosphere 7 How has Delaroche established this point? How, then, may the benefits of perspiration in some dis- eases be accounted for ? What is the next function of the skin to be noticed ? What is the mode of its operation? Give a familiar example of the pro- cess of absorption. Another. Another. Another. How is the process of absorption carried on ? Describe the prop- erties of the absorbents. Why are they called lymphatics ? How does the disease called diabetes incontrovertibly prove the doctrine of absorption ? What was the ancients' belief on the sub, QUESTIONS. 365 ject ? With what reason ? What weight of evidence for and against this function do the phenomena attending immersion in a warm bath bring ? Relate some experiments made by Dr. Edwards on animals in proof of the absorbing principle. What retards absorption in the human frame? When is the impediment greatly removed? In what cases and by what means has the principle of absorption been successfully applied? How is the obstacle to absorption presented by the cuticle gen- erally overcome ? When is friction necessary and unnecessary ? What becomes of the perspiration when confined to the skin by injudicious clothing and want of cleanliness ? What is the effect to the health ? Illustrate this in the case of waterproof dresses worn by sportsmen and others. What reasons have we to believe that marsh miasmata are absorbed by the skin? What good effects have resulted from the wearing of woollen clothes ? Why ? Give some instances in men. In animals. What is the practical inference7 What general law of organic action explains some difficulties with regard to the functions of the skin? How do a dry and a moist atmosphere respectively affect the several processes of exhalation and absorption? Why is the predominance of the lymphatic system remarkable in the Dutch ? What adds to the probability of malaria being absorbed by the skin ? What prevent- ative should be adopted ? What course has been pursued with regard to the British army and navy in conformity with these views of the absorbing influences ? What has been the success ? How may the doctrine of exhalation and absorption bear upon the prevention or contraction of the plague ? Illustrate. How may the objection of two opposite functions being per- formed by the same organ, viz., exhalation and absorption, be an- swered ? To what constituent part is the office of touch and sen- sation intrusted? In what way does the skin act in this respect? In what respects does the skin resemble the other organs of sense ? What gives rise in all instances to the impressions received from the organs of sense 7 How is the skin provided in order to transmit the impression to the mind 7 What is essential to its texture and vitality ? Illus- trate the great utility of the nerves from the case mentioned by Dr. Yelloly. Is the principle of sensation in the surface of the body uniform 7 Where is it most predominant ? What proof is there that sensa- tion depends upon nervous endowment? Illustrate the fact. What is the difference in the distribution of the nervous papilla between man and fishes ? In what is the nervous tissue of the skin essential to our con- tinued existence? Illustrate this fact in the case of cold. Of heat. How are the spirits affected by the healthful or morbid ac tion of the nervous parts of the skin f Hh2 366 QUESTIONS. What is essential to the due exercise of sensation ? Give an exemplification of the causes of pain and insensibility. What is another essential ? How does the arterial blood affect sensation ? What is occasioned by the violent return of the arte- rial blood after its temporary expulsion 7 What important office does the nervous tissue of the skin per- form ? How does the accuracy of its decisions vary ? By what is the skin materially operated upon 7 How are the changes in the skin produced by mental operations 7 Mention some extraordinary cases. What is the reverse influence which the condition of the ner- vous matter exerts upon the rest of the system 7 Upon the menial operations in particular? What effects do sickness and literary pursuits produce on the nerves of the skin ? What may be ascribed as the reason ? What is the general complaint of sedentary persons, and how may it be removed ? What other parts and elements are noticeable in the substance of the skin ? Describe them. Relate their uses. CHAPTER III. In what sense is knowledge power 7 What is the subject of this chapter? What important fact is furnished us by the London bills of mortality with regard to infants ? To what may this extraordi- nary result be attributable? What is the state of the skin at birth? What connexion has the mortality among infants with the func- tions of the skin? What may be observed concerning the prac- tice of bathing infants in cold water 7 To what error may this practice be ascribed ? What is the real State of the case ? Support this by facts. By the custom in France. In what are legislators lamentably deficient ? What is the unhappy consequence ? Into what opposite pernicious evils do parents run? What may be said of too much heat and clothing as applied to infants? Re- late the effects produced by it. Of what is the insensible perspiration composed 7 Why should this be particularly removed in early life ? Why is daily washing and frequent change of clothing essential in that age 7 What are the several and particular properties of the skin in youth? How is the temperature kept up? What rule and cer- tain maxim may be laid down with regard to cold bathing ? What pernicious habit is observable in the young of both sexes ? State the circumstances which produce its severe consequences. How do these operate upon youths, especially females ? Upon those pf a consumptive habit ? What precaution is to be taken ? What remedy 7 What is to be said of excessive clothing 7 How are rules to be QUESTIONS. 367 laid down 7 What general rule may be deemed sufficient? What other mode of preserving necessary warmth ought to be pursued besides clothing? What beneficial effects has it? From what complaints does it secure us? In what important point is female dress faulty? What disor- ders arise from tightness in dress'' How does each part or func- tion of the body operate upon the other 7 How do wet and cold feet produce disease? Is it the mere state of wetness that causes the evil 7 Mention an instance in point. From what principles may the advantage of wearing flannel be proved? Slate its particular advantages, and how it operates on the skin. What should he its substitute in delicate constitutions? Why ? What general rule should be observed in the assumption of flannel clothing ? Why? Give the substance of the testimony adduced by Sir George Ballingal in favour of flannel clothing. Give the substance of Capt. Murray's testimony. To what may the superior health of the crew of the Valorous be attributable7 Why? What other rule of conduct may be practised to obviate the bad effects of cutaneous exhalations ? In the case of flannel ? What is the preferable practice 7 What excellent practice, common in Italy, should be adopted? Why is this so consonant to reason7 What is the reverse custom of the poor Irish in Edinburgh? What are its dangers? What influence has the solar light on the skin? What is ob- servable in those who are deprived of it 7 In the inhabitants of towns? In vegetables? To what else may paleness be attribu- ted ? What should be provided for in the erection of new streets? What is the consequence of not removing the exhalations of the skin? Why was ablution a religious observance? What proofs have we of its necessity i What ought to be as common as a change of apparel ? Where is it more frequently practised ? How is the importance of ablution compared with its observ- ance 7 Among the North Americans? In the United States? In England 7 In public charities and schools 7 Which is more suited for general use, the warm or the cold bath 7 Why 7 Mention the extraordinary connexion of the bowel complaint and cutaneous exhalation in the case of a lady. See note. When may the cold bath and the shower bath be used with ad- vantage 7 With what limitations and exceptions 7 How should the time of immersion in a cold bath be regulated 7 What has been found the most beneficial season of the day 7 What practice may be substituted in the case of those that are not robust? With what qualifications and limitations? What is the safest and most valuable lor habitual use 7 At what stage of temperature f For what length of immersion ? How may the most suitable temperature be best estimated? What is its effect ? How often may it be used 7 368 QUESTIONS. What is the best time for valetudinarians to receive the benefit of the bath? Why 7 What precautions are to be taken there- with? When ought bathing not to be employed ? In what cases is it beneficial? Has it any tendency to produce a cold ( What has been the testimony of experience in its favour? How does it op- erate in pulmonary disease? Note. What advantages would bathing have in being used in manu- factories? How has the waste warm water from the steam-en- gine been profitably used ? Note. What has been effected in the Caledonian Pottery at Glasgow f Note. What is the state of vapour bathing on continental Europe ? By what beneficial effects is it attended there ? W hat prejudices are there against its use ? On what are they founded 7 How are they falsified by the fact? How is this exemplified in Russia and in the north of Europe ? What difference is there in the state of per- spiration produced by exercise and in that generated by a vapour bath? Why? How does common experience illustrate the above principle in the case of a room imperfectly warmed and one comfortably warm 7 Explain the principle. In what cases may the vapour bath be hence a preservative and remedial agent? With what cautions must it be administered 7 In what cases may a vapour bath be prejudicial? Why 7 What may be a substitute? To what are the preceding remarks specially applied ? To what may they also be extended 7 Why 7 Illustrate the case. Give some instance. What objection has been made to the tepid or warm bath? How is it erroneous? Give some instances and testimonies in favour of it. When does it sometimes fail to be beneficial ? How has the affusion of cool water on the head during immer- sion in a warm bath been successfully applied 7 With what limitation and caution are the above facts to be re- ceived 7 What are always available substitutes for the warm bath? What the consequence of their neglect? To what reflections does man's inconsistency in his treatment of himself and animals give rise? Relate the process by which a diseased state of the skip operates upon the lungs and produces pulmonary complaints. What ef- fect will the restoration of the cutaneous circulation produce? . In some chronic affections ? What are the two remedies which enjoy the oldest reputation in the successful treatment of pulmonary consumption ? To what do they owe much of their influence? What has been their course of treatment of late 7 How far has this treatment proved service- able? How does riding prove efficacious? How does a voyage by sea benefit ? Mention in detail the benefits derived from sea. sickness in the case of the author. QUESTIONS. 369 Narrate at length the benefits which subsequently accrued to his health by the practice of riding on horseback. How far are the advantages to be derived from the healthy ac- tion of the skin to be insisted on? For what reasons ? What is a not unfrequent fallacy among medical men 7 To what is it ow- ing? What functions of the human system have had their re- spective patrons 7 How has the doctrine of each been sustained 7 What does this prove 7 With what qualification is the importance due to the state of the skin to be received ? Illustrate the case with an example. How will its treatment prove efficacious 7 What connexion has free perspiration with acidity in the stom- ach 7 Relate the case of Lord Byron, and give the principle of his cure. What is the doctrine of M. Donne? What facts corroborate the accuracy of bis views 1 CHAPTER IV. What is the subject of this chapter? What position do the muscles occupy in respect to the skin? What functions of the body are less familiarly known ? Why ought the muscular system to excite our altention 7 What are the muscles 7 What constitutes the red, fleshy part of meat 7 Of what is every muscle composed? Relate the manner in which the muscles are separated and connected with each other? What produces the roundness of the limbs, or the contrary, in persons 7 How do the muscles enjoy their freedom of motion' How may the muscles be divided? What are their names? Which is the most important? What is the belly? How are the muscles affected in the lifting of any weight or in overcoming any resistance? What would produce a violent contraction of the muscles 7 What is, in general, effected by the contraction of the muscles? In what manner? Explain the nature of the origin and insertion, and their mode of attachment. Draw the figure and explain its several parts. Show also the manner in which contraction of the muscles is effected from it. What difficulty presents itself in the attachment of the muscles 7 What considerations obviate this difficulty 7 In what do the fleshy fibres of the muscles terminate ? To what are tendons or sinews conducive 7 Have all muscles osseous attachments or tendons 7 Which have no bones ? Which no tendons 7 What is the usual colour of the muscles? Upon what does this depend? How is this ascertained? What is the conse- quence 7 What is the true characteristic of muscular fibres 7 How is the direction of muscular motion determined 7 Recount separately and distinctly the various directions of the muscular fibres. Give examples of some of the particular uses of these va- riations. 370 QUESTIONS. What is the chief use of the muscles? To what else are they conducive? Mention these uses severally and clearly. What is requisite for healthy and vigorous muscular action? What arrangement and law are observed in the animal economy to this effect ? What phenomena attend the action of the mus- cles? The reason? What result is produced to the muscular system from loss of blood ? What produces such misery upon the young manufacturing population and the inmates of boarding-schools 7 Explain the evils and their causes. What is necessary to sustain the growth of the animal system in youth 7 What if this be neglected 7 Where has this impor- tant principle been disregarded? To what is it owing? What regimen should be observed in the nourishment of the young? With what caution is this course to be adopted ? How is this il- lustrated in cases of shipwreck 7 What else besides mere muscle is required to produce regulated or voluntary motion 7 How is this stimulus conveyed to the mus- cle? What is this stimulus ? What produces intense excitement to muscular action? If this stimulus be withdrawn, what is the consequence 7 What three things must be in operation to effect voluntary mo- tion t How are the number and size of the muscles distributed, and why 7 Why have some smaller muscles a greater quantity of nerves than others double their size? What arrangement is adopted where bulk of muscle, though necessary in ordinary cases, would prove inconvenient? Give an illustration in the case of birds? Show the reverse adaptation in fishes. How does the nervous stimulus operate upon voluntary motion ? Injuries and diseases of the brain? Sleep and narcotics? Ardent spirits 7 How is semi-intoxication sometimes suddenly removed 7 What else is requisite, besides the soundness of the brain and mus- cles, to give effect to voluntary action ? What is the number of the muscles of the human body ? How are they distributed 7 How is muscular contraction effected? Show this in the sterno-mastoid muscle in the figure 7 In the rec- tus or straight muscle 7 In the sartorius or tailor's muscle 7 Relate the variety of operations and effects of the rectus or straight muscle. Show the wisdom and design of the muscular arrangement in the case of respiration. What wholesome impulse is thus given to the stomach and bowels 7 What is one cause of costiveness 7 Explain the action of the muscles a, k. I. What combinations are produced by the muscular system? To what extent are the muscles used ? Upon what does their simultaneous action de- pend I. Why ? From what necessity 7 Give an illustration. Why does the same muscle receive nerves from different quarters' What difficulty does this explain? Give a farther illustration of the influence of the nervous agen- QUESTIONS. 371 cy ? What characterizes healthy and sustained voluntary motion ? How is this stimulus adjusted? Give some instances in which its accuracy is discernible? What does the excess of action in the nerve effect, when not bal- anced by the operation of the muscular fibre ? What, if the mus- cles predominate 7 Are great muscular power and intense nervous action often con- joined 7 What do they constitute when united 7 In what in- stances has this been eminently displayed ? What error long obtained with regard to the functions of the muscular nerves? How has this been rectified? What distinc- tion is to be made between the muscular and cutaneous nerves ? What are their different sensations? What leads us to suppose that the muscular nerves, though running in one sheath, are double, and perform distinct functions? What is the doctrine of Sir Charles Bell on the subject ? How does Sir Charles divide the muscular nerves, and define their separate functions? What error does he contravene as to the office of the muscular ne,rve? What are his reasons? How does he query the difficulties and exigences of the case 7 What is his conclusion? Relate his views concerning the functions of two distinct fila- ments. What is the meaning of the muscular sense? What is its use and importance? What would be the several disadvantages to man arising from the want of this sense 7 How are we guided by this sense on ordinary occasions? What is essential to muscular power besides the nervous stim- ulus? What would be the result if the body were deprived of both ? What fact does this prove 7 By what law is muscular action governed? In what does it properly consist? What is the most fatiguing muscular employ- ment ? Why? Illustrate this. Give another illustration. What does the principle just stated explain ? What are most conducive to muscular development? What has been the pre- vailing system of female education7 What has been its inconve- niences and results? What evil effects proceed from some ordi- nary implements for sitting ? What awkward remedy has been perniciously attempted? In what has its evils been shown? In what is the formal walk deficient ? What remarkable fact is produced by Dr. Forbes as to the prac- tical results of the female boarding-school system 7 To what is the inadvertence of teachers and parents owing 7 Show to what their mistaken view of decorum have led. Give Mr. Carmichael's testimony with regard to St. Thomas's Parochial School, Dublin. With regard to the Bethesda School of the same city. Why should some salutary physiological reforms be adopted in the school system 7 What reforms ? Why should there be some 372 QUESTIONS. intermission for bodily relaxation during study hours 7 To what is weariness and uneasiness often owing? Give some illustra- tions of this of common occurrence. How ought the employments of the young to be regulated ! How is this preferable to the opposite system ( How does nature universally authorize this reformation 7 How does it operate on boys 7 Why should it be adopted in infant schools 7 What aids and co-operates with muscular activity? Give an illustration. To what is this difference owing 7 What may be referable to the same principle? What is necessary to give muscular action its full play? • In what extraordinary cases has the nervous stimulus shown itself to have been beneficial ? Show the different effects pro- duced by the absence and presence of the mental stimulus in a particular case. Show the difference in the case of the retreat of the French from Moscow. In Dr. Sparrman'a incident. In other cases. In that of an engineer. What is the story told in the Spectator? How does it apply? Relate the anecdote of an Englishman. How does it illustrate the principle ? W hat are t he necessary deductions and reflections 7 When may a walk simply for the sake of exercise be beneficial? Repeat the lines of Dr. Armstrong in favour of the principle of combining harmonious mental excitement with muscular activity. How may the union of mental impulse and muscular action be directed in the young7 In what particular case will this union fail to produce the desired effect? What is necessary in order that the union should be successful? Why? What has been sometimes the plea for neglecting bodily exer- cise ? In what consists its fallacy 7 What effects does exercise produce upon the organs employed ? What the cessation from exercise 7 What is the effect of exercise taken frequently and at moderate intervals? What if resumed too often or carried too far 7 What if neglected ? How does sensation serve as a guide to exercise ? Give the different cases. How may rules be deduced for the promotion of the healthy de- velopment of the muscular system by exercise 7 Give some illustrations of the general principle. How do these apply to the objections urged by many sedentary people? How may their inconsistency be ridiculed? Sum up and state the three conditions on which exercise may prove salutary to the human system. Why do those who resume it only at long intervals never advance ? CHAPTER V. What remains to be explained in this chapter with regard to muscular exercise? QUESTIONS. 373 How do the functions of man fit him for his condition? What is to be observed in the manner his organs are adapted to their purpose? What is to be observed with regard to the action of the muscles on the bloodvessels? Point out the muscles in the arm according to the figure. Point out and describe the humeral artery. The radial artery. The ulnar artery. What is the position of the bloodvessels in the system 7 What is the consequence of this position? How is the circulation of the blood exemplified in this instance? What expedient is made use of in blood-letting to accelerate the flow of the blood? For what purpose is muscular action provided? To what are seden- tary people subject 7 Show how the connexion between muscular exercise and the circulation of the blood operates upon the whole system. Show why the hurried breathing and quickened circulation re- sulting from exercise fit us to continue the exertion. Show the reason for the benefits arising from shampooing. Show why sedentary persons are habitually subject to costive- ness. What are the converse effects derived from the want of exercise? At what times ought exercise to be taken so as to prouuce ben- eficial results? In what state of the animal system 7 When does this take place? What does an opposite procedure produce? For what reason 7 Why is exercise immediately before meals injurious? If severe or protracted ? What is the rule 7 Why injurious immediately after a heavy meal? Prove this in he case of two dogs. What and when is the benefit of a mere stroll 7 Under what circumstances are we to take precautions in regu- lating our diet? Why is it injudicious to reserve the time of exercise till the close of the day? Why should part of the forenoon be chosen 7 How is the power of mental application increased or diminished? What practice should be imitated? How ought exercise to be rendered as beneficial as possible? Illustrate. How ought nature to be consulted in all respects ? What is the testimony of Dr. Forbes? How are stays and absence of exercise injurious to the beauty of the female figure ? What is the effect of prejudice and habit ? Are there any cases of health in which stays are beneficial? What does the comparison between savage and civilized man teach us 7 What is the testimony of Mr. Henry Marshall ? How is this testimony supported ? What singularity is to be observed in the terms of this corrobo- ration ? Il 374 QUESTIONS. What is Stevenson's testimony concerning the Araucanian In- dians? What is the object to be attained in the pursuit of exercise? Why is walking insufficient? What other methods should be adopted? How does nature intimate this? How might pedestrian excursions be beneficially directed ? How is this managed on Continental Europe 7 What is said of the ancients? Why is their practice discontinued? What is common among the young Scotchmen? How is this custom to be appreciated ? What abuse of the principle is com- mon among youths? What are its evil effects? What are Dr. Johnson's sentiments ? Give some instances. By what rule are we to be guided 7 What is the practice of sportsmen 7 Relate in full the cases of two students of Cambridge. Relate the case of a clerk in Edinburgh. Relate at length the salutary effects produced by riding. From what is its peculiar advantages derived? Give the advantages and disadvantages of dancing. How is the value of gymnastic and callisthenic exercises to be estimated ? What exercises may be said to be not only graceful, but benefi- cial? Why? What may be said of other exercises? What are they7 Why are they unnatural? Why dangerous? What is said in defence of some of them ? How is the fallacy of the argument shown ? What ought to guide us in the selection of exercises for the young? What ought to be particular objects kept in view? What may be said of fencing ? Of the club exercise ? Of shut- tlecock ? Of the play called the Graces ? What may be said of the advantages and disadvantages of dumb- bells ? What caution should be observed in the use of them ? What can be said of reading aloud and recitation ? How do they operate upon the human structure 7 What evils and benefits does public oratory produce on the speaker? How did this operate in the case of the celebrated Cuvier ? On what considerations is his recovery to be accounted for 7 What are the most perfect of all exercises 7 To what does the ignorance of parents tend 7 Illustrate. What has been the design of the preceding remarks 7 Illustrate the whole by the anecdote of a young gentleman, and show in every particular case how it accords with the foregoing principles. What order of muscles has been passed over, and why ? What is the use of the involuntary muscles? Which is the chief of them 7 Which are the next in importance 7 What are excellent examples of the same class 7 How is the beneficence of Providence in withdrawing them from our control manifest ? What, is to be observed of the different constitution of the vol- untary and involuntary muscles ? In what is exhibited the wisdom of the Divine arrangement 7 What would have been the effect of a different disposition of muscular activity? QUESTIONS. 375 CHAPTER VI. How are the bones adapted to their purposes ? What do they effect? For what are some bones designed ? What uses do they sub- serve in general 7 In what respects is the animal frame the most wonderful of all combinations of machinery ? Why are the bones composing the skeleton so numerous? What would have been the effect of an opposite arrangement? Recount the benefits of the present system. How is the safety of this disposition manifest? What is the fabric resulting from the combination of the bones called 7 What is the difference bei ween a natural and an artificial skeleton? How many bones enter into the composition of the human skeleton ? How are they connected with each other? What are the three great divisions of the skeleton recognised by anatomists7 What does the second include? What does the third comprise? < >f what does the head consist 7 What is the use of the scull ? How and for what reason are the bones of the scull constructed? Of what does the trunk consist7 Point them out in the figure. How is the spine, vertebral column, or back-bone constructed ? What is the use of the vertebra}? Why are they called so? What are the cervical vertebra;, and haw many ? The dorsal ? The lumbar ? Upon what does the base of the column rest? How are the ver- tenras connected ? What do they secure? Give an illustration. What prevents us from perceiving at once this to be the case? W hat is the use of the body of the vertebrae ? Of the projecting ridge behind and rugged processes at the sides 7 What is inter- posed between each of the vertebra? ? What triple purpose does it answer? What is the number of the ribs, and how are they attached ? What are the seven uppermost called, and why? What are the five lower called, and why? What is their use 7 What their ac- tion 7 How is the pelvis formed ? Point it out in the figure. How may a general notion of its bones and their uses be formed 7 What are the bones of the.upper extremities7 Point out the scapula. The clavicle. The humerus. The radius. The ulna. The carpal and metacarpal bones. The phalanges. What, is the scamda? How is it familiar to young ladies? What is its use 7 What is the collarbone ? What is its chief use ? Why wanting in the lower animals? How is the humerus adapted, and to what is it liable, and why? How are the radius and ulna connected ? What is peculiar to this articulation? How is the movement of turning round the hand effected ? Of what do the lower extremities consist ? Point them separ- ately out in the figure. 376 QUESTIONS. How is the thigh-bone ariticulated 7 What does it thus effect 7 How is the thighbone compared with the humerus ? What is the patella or kneepan? What is its use? What is the tibia? What does its lower end form? What is the fibula? To what do the tibia and fibula contribute, and how do they com- pare with the knee? What may be said of the tarsal bones? Of what importance are they to the subject ? Of what do bones consist? What are the properties of each kind? What does the animal portion constitute according to Berzelius, and of what does it consist 7 How do the animal and earthy por- tions vary ? In infancy 7 In middle life 7 In old age 7 What is the effect of muriatic acid on the bone, and how is its animal constituent procured 7 What is the effect of fire on the bone, and how is the earthy constituent procured 7 What do you mean by the animal constituent 7 What by the earthy constituent 7 What important purpose is served by the different proportions of the animal and earthy elements of bones 7 In early youth 7 In middle life 7 In old age ? What is the process of the formation of the bone? To which part do the vital properties essentially belong? Why may they be said to belong to both 7 With what organs are all parts of the body provided to carry on the processes of waste and renovation ? What is the use of the arteries? The exhalants 7 The veins? The absorbent vessels? The nerves 7 What may be said of the bones in these respects ? Prove the fact that the bones are provided with bloodvessels. With nerves. A Show by Duhamel's experiments that the bones are provided with absorbing and exhaling vessels. What objection may be raised against this view ? What circumstances may be satisfactorily alleged in answer to such objection 7 What is the nervous condition of the bones when in health? Why? In what is the benevolence of pain manifest when they are in a fractured state? What is the habit of surgeons in order to produce the reunion of broken bones 7 Apply the principle. What other advantage arises from the vitality of the bones ? Exemplify this in the case of water in the head. To what is this power of adaptation owing? How are the same phenomena exhibited in the bones of the chest 7 How is the same principle manifest in the diminution of the soft contents of the osseous cavities? In the case of the brain ? Why does the adaptation of the hard to the soft parts seem im- probable 7 Exemplify its reality in the various stages of human existence? By what two processes are bones expanded to suit the exigen- ces of the several occasions 7 Give illustrations. QUESTIONS. 377 What proportion does the cartilaginous matter bear to the earthy in bones in early life and old age, and what different results does this variation effect? ; What takes place in the osseous formation in some unhealthy states of ihe system 7 What is the practical application to be made of our knowledge of the constitution of the bones 7 On what does their healthy con- dition depend 7 How is ihe study of an organ or function often rendered incom- plete 7 In the case of the heart ? Of the eye ? Of the bones ? What effect is produced m any part of the system if it is deprived of its natural exercise or action? Give an exemplification in the case of the large artery which supplies the arm with blood. Of a muscle. In the case of the bones. When the case is not extreme. What purpose do the bones answer, and what law must they fulfil? What is one great requisite for the development and health of the osseous system? How must this be provided for? What is then a second requisite? Why is i his indispensable in the case of youth? What are the consequences of the non-fulfilment of this condition 7 How is the wasting effect of action best illustrated ? In the case of animals? What is the inference? What is the law of the constitution in relation to this principle? When the action is momentary ? When continued 7 What results from a partial action of the system? How is this manifest in the muscular system 7 What law, highly important in ils practical consequences, regu- lates the active and inactive states of the animal functions? In what is ihe benevolence of this arrangement manifest? How is this obvious principle daily disregarded 7 How does the law of exercise apply to the osseous system 7 What natural defects in the bones may be attributed to the neglect of exercise 7 Give the testimony of Sir John Sinclair in favour of the bene- fits accruing to the osseous structure from the enjoyment of ex- ercise. Give that of Delabere Blaine. Why do horses early and hard worked never arrive at their full size? From what other causes besides inadequate exercise does defec- tive nutrition arise? Among the poor? The rich? What are the consequences to both ? How may the relative uses of the bones and muscles be com- pared 7 How does this apply 7 In the case of infancy 7 In the diseased state called mollities ossium ? In the case of fevers, acute diseases, and sudden fright7 When is the maturity and perfection of all organs and functions attained 7 Exemplify this at large in the case of the infant. Of what practical use is the knowledge of this circumstance possessed? How is it often perniciously disregarded by some fond parents? What is said of the effects of leading-strings ? Il2 378 QUESTIONS. What may be said of the indiscriminate use of dumb-bells ? What is said of the use of stays and the inclined plane ? What excuse is given for the tautology of this and the last chapter ? CHAPTER VII. What is the subject of this chapter 7 What is necessary to be premised 7 How many different kinds of blood circulate through the body? What is the property of the former 7 How is it distributed 7 What is the aorta ? What great change does the blood undergo in its circulation through its two systems of vesspls 7 What two conditions are essential to the reconversion of venous into arterial blood 7 How is the first condition fulfilled ? How is the second ? Explain the manner in which respiration effects this reconver- sion. Into what do the venous ramifications terminate? What distinction is to be observed between the pulmonary artery and the pulmonary veins? See note. What circulations of the blood are there, and how are they car- ried on 7 What is the object of the former? Of the latter? Why is the function of respiration of pre-eminent importance in the animal economy? What are the particular and more general meanings of the term respiration ? What are the words sangwfica- tion and aeration used to denote? What influence have the quantity and quality of the blood on the system ? Exemplify in the case of quantity. In the case of quali- ty. In consumption. Why is a knowledge of the structure and functions of the lunga highly important? How is exposure of the blood to the action of the air carried on in man and the more perfect animals? In fishes? In worms? Why is this exposure necessary 7 Describe the lungs in man. How do they vary in different per- sons? Point out the position of the right and left lungs in the figure. Point out the large bloodvessels going to the superior ex- tremities. The liver. What is the position of the diaphragm or midriff? How is the stomach situated? Which is the gall blad- der? What is the intestinal canal? What is its use? What do yon mean by the peristaltic or vermicular motion 7 What does it resemble 7 Of what does the substance of the lungs consist ? What are the bronchial tubes ? The air-cells ? What is their appearance ? Their size? Their internal structure? Their use7 The extent of their lining membrane 7 Does not the lining membrane prevent the action of the air on the blood ? Prove the fact. What bloodvessels do the lungs possess in common with other parts, and what are peculiar to themselves ? What is their use 1 QUESTIONS. 379 What form the principal part of the structure of the lungs ? Why are they provided with nerves 7 What is pulmonary exhalation? How is it carried on? What is its use ? How is the air which we breathe vitiated 7 What renders the brealh offensive, and gives to rooms their sickening smell? In what part does pulmonary absorption take place?. How does it operate ? What are sometimes its effects 7 —4* What practical advantages may we derivefrom the!explanation of the structure and uses of the. lungs? What is the first condi- tion? How may this be applied to hereditary transmission of a constitutional liability to pulmonary disease? Where may instances be adduced of these lamentable results? How might they be prevented ? What course should be adopted by the young under such circumstances? For what reason ? What is the most frequent source of the more serious forms of pulmonary disease? How might medical men be useful in this case ? To what important fact has Dr. Clark drawn attention on the ■subject? How should this weigh with parents? What is the second condition requisite to the well-being of the lungs and to the free and salutary exercise of respiration? To what may the morbid state of the lungs be frequently attributable? In the lower animals? In the manufacturing population? Among fthe higher classes? What is the case of butchers? What is the third condition? How is this impeded? What are the consequences? What are Mr. Thackrah's calculations with respect to the relative pulmonary exhalations of males and females 1 To what two causes may be referred the minor quantity of the female exhalations? What may be said of the relative harmony of the constituent parts of the animal frame? In the case of* the muscular system and the function of respiration? By what other means is the same end greatly facilitated ? By what else, and for what reason ? Why do the depressing passions predispose to pulmonary con- sumption? Upon what principle? What effects do the depressing passions of the mind produce? The exhilarating passions 7 Why should such be the results of different kinds of mental emotion? What do these principles show? What is a fourth essential condition ? For what reason ? What does atmospheric air, when taken into the lungs, consist of? What changes has it undergone when expelled ? What simultaneous changes occur in the blood? What two explanations are adduced to account for these changes? Which explanation is received? Upon what fact are all physiologists agreed? What inference may be deduced from it? What estimates have been made by Sir Humphrey Davy and Dr. Menzies of the times and quantity of the human pulmonary exhalations? 380 QUESTIONS. What is a low estimate of the inhalation, and how is the vitiation of the exhaled air to be calculated 7 Give illustrations of the evil effects produced by inhaling vitia- ted air. In a mouse. What is the real cause which produces death in hanging 7 Exemplify the principle by the case of the 146 Englishmen shut up in the Black Hole of Calcutta in 1756. Relate the incident which occurred in the case of Crabbe the poet. What other instance is recorded in Walpole's Letters? What practical inferences may be deduced from these extreme cases of atmospheric vitiation ? What other instances may be ad- duced? What reason is there to believe lhat cases like these oc- cur more frequently than is supposed 7 Is it necessary to infer that the fatal results in all the above in- stances were produced exclusively by the vitiation of the air 7 Ap- ply Dr. Bostock's estimate to the elucidation of the last case. What conclusion may be at any rate admissible? What is the testimony of the most experienced medical officers of the army and navy 7 Of Sir George Ballingall 7 Of Sir John Pringle 7 Of Dr. Jackson 7 Give another example in the case of the 4th battalion of Royals quartered in Stirling Castle. What disease, according to Mr. Carmichael, is produced by im- pure air 7 Give his testimony in the case of the prevalence of the disease in the Dublin House of Industry. What is one great deficiency in the education of the profes- sional student? Give an instance of the truth of this charge. How does the case of the Professorship of Military Surgery in the University of Edinburgh become a general caution 7 How has the renovation of the air served as a preventive against disease 7 Mention Sir Walter Scott's case. Give Dr. Joseph Clark's testimony. What is Mr. Thackrah's testimony with regard to the first indi- cations of pulmonary disease? How are they to be accounted for 7 What is the imperceptible yet certain progress of the disease on the constitution 7 How is this ascertained? What is an error concerning its cause? How is it difficult to impress some persons with a sense of these facts ? What attention may be expected to be paid to these strictures? What is the testimony of experience with regard to their truth? What important fallacy did the discussions on the Factory Bill detect 7 To what should our attention be especially directed 7 What difficulty presents itself in persuading any rational and instructed mind that all care is superfluous 7 What would be the beneficial results of greater precautions? What instructive proof have we of this? Give the testimony of Sir John Sinclair. What is said of the Roman Athletas ? Of racehorses and gamecocks ? QUESTIONS. 381 Why is necessity for adequate ventilation so urgent in the Brit- ish manufactories? Give Dr. Clark's evidence. What other evils to the lungs attend cotton manufactories, spinning mills, and the work of many trades ? Why 7 How does the principle apply to our construction of houses? Of public rooms? Of bedrooms ? What may be observed of bed- curtains and cow-houses? Give an illustration in the case of the ill-constructed public rooms in Edinburgh. In what do the evils of the architecture consist ? How does a knowledge of physiology thus show itself essential ? How have these remarks been verified in the lecture-rooms of Edinburgh? To what is the nuisance chiefly attributable 7 How are they exemplified also in the case of the two British Houses of Parliament 7 Why is the renewal of the air more particularly required in houses lighted with gas? What plan of ventilation should be adopted in them ? What may be observed in the ventilation of churches and schools? What are its effects in the close of the afternoon ser- vice ? What is said of the ventilation of churches during the winter 7 What instructive incident was experienced by the author in the case of an imperfectly ventilated schoolroom? To what reflections did his observations give rise ? What con- firmed him in these views? To what may the effects produced by confinement in an ill-ventilated apartment be compared ? What are its chief effects according to Orfila 7 Mention the case related in the note to prove the salutary ef- fect attending the occasional relaxation of scholars and the ven- tilation of their schoolroom. What other illustrative incident of bad ventilation in a church occurred to the notice of the author? What is one of the evils of ignorance? How has this been universally manifest, time out of mind, in deficient ventilation? What has science failed to effect in one case, while it has been provident in another 7 In what is the inconsistency of ventilating only hospitals manifest? What would be the effect of making physiology a part of a liberal education? What detrimental effects were occasioned by the influence of vitiated air in a printing establishment ? What beneficial improve- ments were introduced into the apartments? Upon what natu- ral principle did this benefit depend > How did it act upon the workmen? In another instance? What caution should be ob- served in introducing free ventilation? What diseases maybe produced by extreme draughts of air? Give some instances. What admirable expedient for ventilation has been adopted in the surgical wards of the Edinburgh Infirmary ? What is Mr. Perkins's invention for the warming and ventdation of nouses and buildings ? 382 QUESTIONS. How does this admirably succeed in Mr. Cadell's establish- ment? How can the benefit of Mr. Perkins's apparatus be carried to any extent7 What are the chief merits of his plan ? How is it safe and ef- ficient under all circumstances 7 How does the attention paid by the Russians to warmth and ventilation compare with other nations 7 What subject for consideration does the intimate relation be- tween the functions of the skin and those of the lungs introduce 7 What are the true sources of animal heat ? Of what importance is its regular production7 Why? In winter7 In summer? In cholera 7 What relation has the production of animal heat with the state of the respiratory functions 7 How is this evinced 7 By what rule and in what case is animal heat the highest ? How is the rule carried out in other instances ? What next condition affects the production of animal heat? Il- lustrate the case in depression of mind. In exhalation. What are other important conditions? What appropriate ex- ample is mentioned by Franklin, Parry, and Richardson? How may this proposition be evinced 7 What phenomena may this ex- plain? Wh?t else produces and what obstructs the development of an- imal heat? How does exercise produce it ? What rule ought we to observe in attempting to increase the power of resistance to cold 7 How does the power of this resist- ance vary 7 What influence has the want or supply of adequate food on this resistance ? Exemplify. What influence has clothing in producing animal heat? To what is its failure in producing the desired warmth attributable? What are sometimes the effects of feather beds on animal heat ? How should a feather bed be used ? What sufferings are produced by confining young people for any length of time in rooms insufficiently heated 7 What rules ought to be observed to afford them comfortable warmth 7 What plea is set up in defence of an opposite.practice? Show its fallacy. What caution should be observed in heating rooms and public halls? For what reason? What is the practice on Continental Europe ? What subject with respect to the lungs remains now to be treated 7 In what respect is a judicious exercise of the lungs necessary 7 How should it be governed ? By what two methods may the lungs be exercised ? What ex- ercises are most serviceable when the object is their improvement' How should these be practised when the chest is unusally weak from hereditary predisposition ? Show how habitual exercise in a hilly country has a powerful QUESTIONS. 383 tendency to improve the wind and strengthen the lungs? How was this fact experienced in the case of the author 7 With what cautions is the foregoing exercise to be undertaken? In what case is it particularly advantageous? How far may these exercises be carried with profit? What ef- fects do they produce? What is the evidence of Jackson on the subject, and how far is it to be received ? W hat position of the body is unfavourable to the expansion of the lungs? In what does direct exercise of the lungs consist ? How far is it of value in these cases7 Under what circumstances may it be highly beneficial 7 What preventive measure is recommended by Dr. Clark? What effect have crying and laughing on the system7 Why should the latter be encouraged ? What is an incident before re- lated 7 How does it bear on the present occasion 7 What farther influence does the direct exercise of the lungs ex- ert upon the anatomy of the human structure 7 Relate the whole process according to the figure. How do the other functions of the body suffer when this exercise is neglected 7 In what light are we to view the practice of loud recitations in schools and of singing in infant schools 7 How may the efficacy of these exercises be improved 7 What precautions are to be observed in the practice of direct exercise of the lungs? How is the system to be prepared for it? What inconvenience frequently occurs to young preachers from neglect of these preparations? What is said of the illustrious Cuvier in illustration 7 What conditions must not be overlooked in the application of these principles? To what other obvious rule does the same principle lead 7 Il- lustrate. In what cases ought not the lungs to be exercised? When is it difficult to convince the patient of this ? Relate an in- stance in point. Why should violent exercise be avoided during the active stages of cold? What apparent inconsistency is explained on this prin- ciple?. In what stage of recovery from disease is exercise to be bene- ficially resumed 7 What is the error of parents in this respect 7 Why should sudden transitions to a different state of atmo- sphere be avoided ? By what expedient? Why? Which is the most important lime of life to a person predisposed to consumption? For what reasons? Why ought the health of the physical system to be then attended to ? What mental phe- nomena occur during this period? How is the deficiency after- ward compensated ? What course should be pursued under such circumstances ? To prevent what effects ? What has been too much neglected during this period of life 1 What would be the results of proper care ? 384 QUESTIONS. What evils arise to the young from their being left in entire ig- norance of the structure and uses of the different organs of their own bodies ? What is the character of the age between seventeen and twen- ty-four? How is the accuracy of these statements incontroverti- bly established ? Give some results from Count Chabrol's Sta- tistical Researches for the year 1819. Give similar results for the years 1820 and 1821. What do the above results prove, and what useful lessons do they teach7 What ought the combined testimony deduced from the changes in a million of people to establish 7 How is the earlier maximum of mortality in the male sex, espe- cially in cities, to be explained? Where is the means of their destruction first learned 7 What course of management may be observed with regard to- those who are predisposed to consumption or weakness of chest ? What is the consequence of too much attention being paid to mere intellectual education? What work may be satisfactorily consulted with regard to con- sumption and scrofula? CHAPTER VIII. Of what is the nervous system composed in man and the higher order of animals ' What is the subject of the present chapter?" What is the brain ? Of what is it the seat and centre 7 What is the structure of the brain 7 What are its principal di- visions? What is the dura mater? The cerebrum? The convo' lutionsl How are these represented in the figure? What does G G represent? What are the two hemispheres of the brain? What is thefalx or falciform process ? What is its chief purpose T How is each hemisphere divided ? Where is the anterior lobe situated ? The middle lobe 7 The posterior lobe 7 V What is the tentorium ! The cerebellum ? What is the pia mater ? What is its appearance when a little inflamed 7 Of what use is this minute subdivision 7 What is the arachnoid membrane? What may be observed of the convolutions of different brains ? Of the same brain 7 Exemplify. What is the medulla oblongata 7 What has been considered the connexion between the brain and spinal marrow? What is the true connexion 7 Describe the character and position of the nerves of the brain. The olfactory nerve. The optic nerve. The motor nerve. The Pons Varolii. What is the use of this? Describe the auditory nerve. The pneumogastric^nerve. What is its importance and influence ? -^ What other nerves are there, and how do they arise ? What is said of the blood of the brain and its circulation ? What is agreed upon by most physiologists with regairTHo the functions of the different parts of the brain? In what do they QUESTIONS. ■ 385 disagree ? What is the opinion of all physiologists and philoso. phers 7 What is the anterior lobe considered to be by a large majority ? What is the brain, by nearly universal consent, con- sidered to be the seat of7 V How do many animals stand in relation to man with respect to their nervous system? What is the property of a single organ? What is the doctrine of the Edinburgh Review with regard to the multiplication of the nervous mass? What does the constant relation between mental power and development of brain explain ? Give an example. Another. To what laws is every mental operation subject? Give an instance. Its practical application in opposite cases. What is the state of the ignorance of teachers on the subject of physiology ? V What has been said in answer to the above practical applitation of the organic laws? How far is this true, and yet no exception to the general statement of the case ? Give the reasons. How may the necessity for a long vacation of idleness be obvia- ted? Give an illustration. How would absence of exertion be irksome in both cases ? How must mind and brain be distinguished 7 Illustrate this in the case of the eye. How are they inseparable ? Show how the mind and brain re- ciprocate their influences. If the mind and brain are thus closely associated, what becomes the object of primary importance in education 7 \f What is the first condition of the healthy action of the brain, and why? Illustrate the case. In what case of minor importance may this hereditary influ- ence be evinced ? If the defect be on the mother's side ? When both parents are descended from tainted parents? Why is hered- itary predisposition a more usual cause of nervous disease among the aristocratic families of the old countries 7 Why is hereditary predisposition more particularly to be dread- ed ? How is safety to be found, and the rule to be practically ap- plied ? What else besides hereditary predisposition exerts an influence on the mental character and health of offspring? What is the testimony of M. Esquirol 7 In the case of the French revolution 7 In one remarkable instance 7 In the case of James VI. 7 In the case of a young lady 7 What is Dr. Caldwell's testimony and advice 7 What precau- tions ought to be taken 7 What is the evil of a contrary custom? What are the observations of the Margravine of Anspach? What is the second condition required for the health of the brain ? What are the extreme effects tirising from differences in the quality of the blood ? Give instances of two opposite extremes. What effects are produced by slighter variations in the quality of the blood 7 In what instances are these commonly evinced ? Why is the operation of the principle in these cases indisputable? Why is it not real debility which produces them ? What origi- 386 QUESTIONS. nates nervous disease and delicacy of constitution more common- ly than is imagined ? v Why are the beneficial results from intermissions in school hours to be ascribed to the same principles ? See note. What condition requisite for the health of the brain is implied in the preceding? How does starvation or inadequate nutrition affect the brain 7 What does defective nutrition often depend on ? What is the frequent consequence of insufficient food among the poor ? T* What is the third condition of health in the brain and nervous system 7 How does the brain compare with other organs of the body in respect to exercise ? If it be doomed to inactivity 7 If it be deeply exercised 7 If it be overtasked ? What is to be first explained 7 What is the consequence of disuse in other organs already men- tioned? How does the same principle apply to the brain? Why is this not surprising ? What renders solitary confinement so severe a punishment to the most daring minds 7 How is this also the case in continuous seclusion from society 7 Mention the hard position of governesses in families, and its effects upon them. The case of those who are cut off from social converse by any bodily infirmity. For what reason ? What is the inevitable result ? How is this fact particularly observed among the deaf and blind ? What is AndraFs testimony to this fact? How does he depict the situation and character of the deaf and dumb? Are the deaf and dumb to be considered inferior in mind to other men ? What are the cautions of Miss Harriet Martineau to her deaf fellow- sufferers 7 i To what conclusion may we reasonably come from the above facts ? What demonstrative evidence have we of this position 7 What examples of mental and nervous debility may we find in society, arising from want of objects of interest upon which to ex- ercise the mental faculties? What are the specific effects on the tone of the brain and mind? Why does the mind shrink within itself, and centre all its exertions in home? How is the mind called out from such a state of things? What is the effect of the change ? What is the real cause of this effect ? What example may be adduced in confirmation of these views? Mention a particular instance of a young military officer. Who are the most frequent victims of this kind of predisposition to derangement ? From what causes? How do their opinions be- come affected ? What is the result to the brain 7 Ultimately to the mind 7 What diseases arise from irritability of the brain 7 How 7 In what manner is this provided? Give a common instance. Apply the principle. What other instance may be adduced ? Give an additional illustration. What is one great evil attending the absence of some impera- QUESTIONS. 387 live employment to exercise the mind and brain 7 To what in- stability and kind of indulgences does it give rise 7 What defence is set up for these indulgences 7 In what is its fallacy evident? What is the true remedy for these evils? To what does the patient have recourse? What should be his proper resource? From what other cause do evils arise to the brain 7 By what may this be exemplified 7 What analogy do these phenomena bear to the brain 7 Whai is the only difference 7 In what particular cases has even this difference been removed and the analogy been verified 7 Relate the case detailed by Sir Astley Cooper. That of Dr. Caldwell. What expedient might be adopted to invigorate the mental op- erations? What proof have we of this effect? What confirms it? State the case of a senator at Washington. Of a member of the House. Of a member of the law of Transylvania. How may the cases of Whitbread, Romilly, Castlereagh, and Canning be explained? At what particular time of life is excessive and continued men- tal exertion hurtful? In what is the analogy here complete? What is the case of scrofulous and rickety children ? What is the cause of their early promise and their subsequent disappoint- ment7 How should they be treated? What guide do the necessities of the constitution advise in re- gard to precocious and dull children? What is the usual course? What is the consequence of the error? What is Dr. Brigham's testimony on the subject? To what does he ascribe the error of the infant school system? Where is this more especially prevalent? In what may it be ex- hibited ? What facts in American schools does Dr. Brigham adduce in illustration of his arguments 7 What is the state of the case in Great Britain 7 What relation does physical there bear to mental exercise 7 Adduce a case in proof of the fatal results. How has it been customary to treat the fatal effects produced by this pernicious system 7 What is the case mentioned by Dr. Brigham ? What purpose ought it to serve 7 What would ren- der infant schools excellent institutions? What is Wilderspin's plan ? What is the state of some schools ? .+- What is the source of much mischief in schools? Why should the occupations of the young be varied, and frequent intervals of active exercise be allowed in the open air? How does the pres- ent system fail 7 What other besides mental operations has the body to perform 7 To what lamentable effects of excessive mental activity in young men has ignorance of the organic laws given rise ? Adduce instances from the American Annals of Fducation, of the evils arising from the unnatural union of sedentary with stu- dious habits. \' What better system of training has been introduced to remedy 388 QUESTIONS. these evils? Describe its plan. What have been the results? What is the remarkable language of the Report? What is Dr. Fellenburg's plan ? What is a common case and consequence of an excessive and continued excitement of the brain? What is the case of Sir Humphrey Davy 7 What were his extraordinary habits and in- dulgences 7 To what predisposing causes are fever and death often the ef- fect, more than the intensity of the fever itself 7 Under what other form does nervous disease from excessive mental labour and exaltation of feeling sometimes show itself 7 Why should moderation in mental exertion be more observed as age advances? How does the fate of Sir Walter Scott occur as an illustration of this truth ? What takes place from excessive mental exertion where a pre- disposition to insanity exists ? Mention the case recorded by Pinel. In whom, according to Tissot, do disorders produced by the ef- forts of the mind fall the soonest? What is his reason 7 What was the case of Boerhaave 7 What field lies open for examples in this case ? Who may be adduced as an instance in addition to Davy and Scott? What reasons may be assigned 7 Upon what classes of persons do ner- vous disorders most frequently fall? What is said of Gretry? Of Weber? What is the reason that even educated people cannot assign the real causes of their nervous diseases ? Relate the case of a young Christian. With what reflections and course of conduct ought his case to be improved by ministers of the Word 7 CHAPTER IX. What is to be taken into consideration in this chapter 7 What is a law of the animal economy 7 What is hence the rule 7 Give an illustration What are the worst forms of indigestion and nervous depression? What are the circumstances of the case? In whom is this fact experienced7 Why are they insensible to it 7 How is this organic law observed in dogs and horses? What is the practice observed by some classes of people and in the United States? How is the objection, arising from this prac- tice, answered ? When do the bad effects of indigestion show themselves? To what is the extreme prevalence of dyspeptic complaints among Americans partly owing? What is Dr. Cald- well's testimony 7 What are the evils arising from studious application towards the period of night? At what separate times should the severer and lighter studies be engaged in ? For what reason ? To whom is this rule especially important? What was Sir W. Scott's practice ? QUESTIONS. 389 Who may be exceptions to the general rule, and what may be observed with regard to them ? What is periodicity, and what is it the characteristic of7 What does it hence require? What, examples have we of this periodi- city 7 What is its tendency 7 What organic law is brought into operation in our acquiring readiness and forming habits 7 By what change is this effected? How does the organ of mind compare with the organs of motion? What is little adverted to in mental and moral education? Why ? What is necessary to induce facility of action in the or- gans of the mind? In what manner? How does this apply to servants ? To reading ? V How ought the principle of repetition to regulate the continua- tion of our studies ? In schools f How is this principle familiar to us in physical education? To what should it hence be applied ? How does the same principle apply in the cultivation of our manners ? How should parents be governed in respect to their children? How does the same principle apply to the cultivation of morals ? Give an illustration. Another in an opposite case. What differences arise from this source? In the case of the negro 7 y What is the'next rule to be observed in the cultivation of the brain and mental faculties? Illustrate. "< What ought not to be forgotten as to the subject of education? How is this readily admitted in the external senses, but altogether denied or neglected in the internal? In what is the inconsistency manifest 7 What reformation would a general acquaintance with the laws of organization effect? In what would the merest savage surpass the philosopher? Give a full illustration. How are we to turn to account the physical and mental organs which God has given us? What occurred to the author after the publication of the third edition of his work? What important question was put to him, and what did it elicit? r Why is physiology first among the subjects which is important for teachers, as professional men, to be acquainted with 7 Why is the muscular system an example 7 Apply this principle to the exercise of a bodily power? How does the same principle precisely hold for the training of the mental powers 7 How does it apply to moral education ? What are the instances in which the love of approbation exem- plifies this principle 7 How might it also be exemplified in the case of our sense of justice, if exercised in its proper organ 7 In the case of religion f Kk2 390 QUESTIONS. Why should one or several faculties not be cultivated to the ex- clusion of the rest? What is the proper course to be taken to produce moral excel- lence in the young? How does the training of the moral and religious compare with that of the intellectual faculties in the best directed establishments and private families, and for what reasons? What is its condi- tion therein? How do sentiments act, and even in a stupid child? What is one of the most effectual methods of cultivating and ex- citing the moral feelings of children? By what considerations may this rule be enforced, or, rather, On what occasions has this rule been inconsistently violated ? i With what qualifications are the preceding strictures on teach- ers and conducters of boarding-schools to be received? What other delinquencies have come to the notice of the author, on the part of boarding school keepers, which have operated preju- dicially to the moral training in the young? With what feelings are these practices met in the first instance? What plea has been set up in defence of them? How is it an- swered ? What other immoral and disgraceful practice exists in many seminaries? Why is it so ? What excuse has been sometimes offered in justification of this practice ? How is it answered 7 Give some specimen of the above practice. See note. What similar practice once existed between physicians and apothecaries? /' To what, are such delinquencies in teachers to be attributed, and how may they be remedied 7 With what limitations is the above censure to be received ? What is necessary to be kept in mind with regard to the moral sentiments ? How is benevolence strongly excited 7 How should it be ordinarily exercised ? How does the cultivation of this fac- ulty compare with the cultivation of some intellectual or physical faculties? How should the attention paid to the latter be extend- ed to higher sentiments? What are the objects of benevolence, and what should be its extent ? What other moral principle should be cultivated 7 What is its nature, value, and use? How far are these illustrations sufficient? Why is the exclusive use of book-education as a means of con- veying instruction unnatural and inefficient? How is this exem- plified 7 What is M. Duppa's testimony on this subject ? What habit renders a man intelligent and judicious ? What is the evidence of a contrary state of mind being generally prevalent 7 What is the reason ? Why have they not the habit ? How are the observing powers to be directly cultivated ? What is the contrary opinion ? What is therefore wanted in a aystem of education in harmony with the mental constitution ? QUESTIONS. 391 What serious obstacle to entering upon the exercise here rec- ommended presents itself? How is it often injudiciously treated ? With what proper remedy should it be immediately met? How is this illustrated ? Why have the doctrines of phrenology not been alluded to in the precedingpages 7 What is the author's opinion upon that subject? What important influence has been already noticed, and now deserves attention ? What are the phenomena and nature of the nervous fluid or in- fluence ? What is all that can be said of it 7 Give an dlustration or two. What effect have the changes in the quality or amount of the nervous influence on any organ? Give some instances of these changes and their effects. What analogous to ihis is observable in the muscles? When is the quality of the nervous influence the best, and for what reason? What ought to be our great aim, and why? How do the efforts of the nervous influence vary ? When is it the most grateful and efficient 7 From what wise arrangement of the Creator 7 When is the stimulus far from beneficial? Why? What is the result? How does over-exercise of the intellect and inactivity of the feelings effect the same ? What is the case of persons so situated ? What is an opposite case and its treatment ? How does the influence of the brain and sudden emotions oper- ate upon the digestive organs? How do narcotics? How do the mind and brain operate on the lungs and heart? In what does the law of our constitution discover a beneficent Creator ? What is the result to it arising from shunning society and active duties? From engaging in the business and interests of life? From neglecting our faculties ? What does this harmony between the moral and physical world thus induce 7 By what facts is the state of the mind shown to be influential in the production and progress of disease 7 Give Sir John Ballin- gal's testimony. Vaidy's. Of what service are the feelings in curative measures? What is the reason ? How is the influence of the state of mind on the health exem- plified in recruits for the army? Give Mr. Marshall's testimony. How is it illustrated in France? How has its influence been illustrated in an opposite effect ? Give Sir Humphrey Davy's testimony. How do quacks profit largely by taking advantage of this principle, and how may it be im- proved by regular practitioners ? What are Baglivi's observations? Give another remarkable instance. How does the kind visit of a friend often alleviate the sick? What is the true reason 7 How far may this benefit be extended' How does the influence of a regulated and well-educated activ- 392 QUESTIONS. ity in the moral and intellectual faculties on the health compare with that of active and boisterous passions 7 How is this illus- trated by Dr. Caldwell in the case of the signers of the Declara- tion of Independence 7 In the case of mathematicians 7 Of poets? From what causes does a visit to a watering-place or a journey through an interesting country tend to the healthy excitement of the bodily functions? What attention has been paid to this prin- ciple in the medical departments of the army and navy ? In the exploring expeditions to the northern regions 7 What important practical rule does this naturally suggest? Where are other apposite illustrations to be met with 7 CHAPTER X. What is to be considered in this chapter ? In how many different lights may bad health be regarded ? What is the first? What is the second? What is the third? What are the practical results, if the first be the truth 7 If the second be true 7 If the third be true 7 How far does the strictest observance of the moral laws and the purest devotion contribute to the preservation of health ? What proof have we of this position ? How far is the second proposition tenable ? How faruntenable ? How far is the third view in accordance with observation and past experience 7 What facts with regard to mortality among infants may be ex- hibited in proof of the truth of this view 7 State them. How do the different rates of mortality in crowded cities and country villages equally demonstrate its truth 7 How has the progress of knowledge and the increasing ascen- dency of reason tended to show the same truth 7 How has it been shown in the case of the smallpox ? How in the case of ague ? How does the present condition of seamen in maritime expedi- tions, when compared with their former lot, show it? Relate the case of Commodore Anson in illustration. What does it show ? What took place afterward on the voyage ? What is particularly to be observed in the above case, as cor- roborative of the author's views 7 How was the distemper, ac- cording to the testimony of the writer, considerably augmented7 What is the case of the Spanish squadron which sailed nearly at the same time 7 How does this compare with some late ex- peditions 7 What case may admit of a fairer comparison with that of Anson ? What wholesome precautions did Captain Cook take for the health of his men ? Show the beneficial results of these precautions to the health of his men in the course of the narrative. How are the cases of the Resolution and Adventure to be com- pared with that of the Centurion ? QUESTIONS. 393 What was the success of Captain Cook's admirable care and unwearied watchfulness? What is said of Lord Nelson? How is the case of the Fury and Heclain point? In what particularities were all the conditions of health attend- ed to in these Northern Expeditions? SS To what three causes may the extraordinary prevalence of dis- ease at the Penitentiary of Milbank be attributed ? How far are these causes proved by subsequent changes and in- quiries 7 What is Dr. Latham's testimony in the case? What would probably have been the fate of the crews of Cook, or Ross and Parry, if they had been left to undergo the ordinary vicissitudes of life at home? To what practical reflections does this give rise 1 What other case is adduced by Dr. James Johnson, which il- lustrates those fatal effects of ignorance, which a little knowledge in physiology would have frustrated 7 What where the fatal maladies brought on, and to what were they attributable ? What else besides the lungs suffered in this case ? What would easily have prevented these disastrous results ? What beneficial effects has increased attention to the organic laws produced 7 In Kngland and Wales? In London ? In Man- chester and Glasgow 7 In France 7 In Austria 7 Russia? United States 7 In South America? In Paris? What may be observed of the great disparity of results obtained in Ehgland and abroad ? How is the principle, however, established even by many of the Continental returns? What do these statements sufficiently prove ? ^ What error has been common with regard to the simple food and hardy habits of the poor ? How is the reverse actually the case? In France? In London? What is Mr. Marshall's tes- timony? - , i ,- What important considerations does the corresponding dispro- portion between the rates of mortality in the different classes of society in Great Britain suggest ? What principle, frequently in- sisted upon, does it strikingly illustrate? What does blindness to this principle produce? .,„-,,. , What criterion would have been infallible in the angry discus- sions which lately took place with regard to the reality of over- working the manufacturer? How may the visitation of cholera to the British Isles be con- sidered the act of a beneficent Providence? vv What does the comparative exemption of the wealthier classes in Great Britain from cholera sufficiently show ? What human precautions tended to mitigate its ravages? How did those who regarded such visitations as the direct inflictions of a vengeful 394 QUESTIONS. Providence, nevertheless act as if the Creator intended the health of the race to depend on the laws of organization ? What cases are there in wh.ch many individuals suffer from nearly unavoidable causes? How do the number of these com- pare with those whose health has been ruined by causes capable of removal or modification 7 W hat important truth is here stated 7 What important remark repeated? How far may the influence of habit, in rendering situations and causes comparatively innocuous, which were at first dangerous, operate ? How do sudden and gradual changes respectively influence the system 7 What is the consequence of a sudden transition from a hot to a cold climate, or vice versa ? ^* What of a change from a healthy situation to one only a little less favourable? In what axiom do these facts terminate 7 How ought the argument for the adaptation of the constitution to circumstances be turned? How far have advances in physiological knowledge and prac- tice of late years been successful or deficient ? In what does the difficulty of illustration in the latter case consist ? What practice observed in the army may be adduced in illus- tration ? How is it physiologically irrational ? .What are the statements of Mr. Finlayson and Count Chabrol? y- How are these results to be viewed in connexion with the laws of animal economy in time of peace? What is Mr. Marshall's testimony ? What is that of Coche 7 How are these results to be viewed in time of war 7 How does this apply in the case of the army in Spain, according to Sir James Mac Grigor? What is the evidence of Marshall in the case of a French army ? What is the testimony of Bonaparte ? How is this circumstance illustrated in the East India service? What is Sir George Ballingal's evidence ? How does Mr. Marshall support his positions? What is Dr. Davies's asseverations 7 Why should recruits not be enlisted at so early an age 7 What is the cause of this erro- neous practice? Why has this topic been so long dwelt upon by the author? Why is the author compelled to pass over other practices in which public or private health is concerned ? CHAPTER XI. What has been the design of the preceding chapters ? What is the design of this 7 Why do this class of sufferers stand in need of attention? What is the condition of the nervous and insane? What are the consequences of proper attention not being paid to the subject QUESTIONS. 395 of insanity ? What similar treatment has the nervous disease met with 7 What prevents the correction of these evils 7 What is deficient on physiological principles in the state and condition of public and private asylums? How far are they ser- viceable7 What is said of their active moral treatment 7 Why is it necessary 7 What is hence an object of extreme importance in establishments for the insane 7 Why is the importance of mental and bodily occupation not ex- aggerated 7 Yet what is the case in the majority of asylums? What becomes indispensable in the treatment of this unhappy class of persons? From what considerations arising from our knowledge of the muscular structure ? Of the structure of the skin ? Of the functions of the lungs ? Of the nature of the mind ? What hence are the inevitable demands of the case 7 By what qualifications are these strictures to be limited 7 What is a deplorable mistake with regard to the feelings of the insane ? What rarely fail in the treatment of the insane when calmly persevered in? What hence becomes of inconceivable importance ? What has been the general remark with regard to keepers of asylums? What does this suggest? What maxim has become every day more evident ? , \ - - How do the above observations apply to the several stages of the disease 7 How should these be respectively treated 7 What should then be our grand aim in the construction and management of public and private asylums 7 How should the means of mental and bodily exercise be planned for the insane ? What would render it more pleasant, more per- severed in, and more salubrious to the individual? What would this latter condition tend greatly to effect 7 What employment would be best adapted to produce the desired effect, and why would not walking or riding be sufficient 7 What, should form part of an insane establishment in order to further these views 7 How have such additions to the asylums for the insane proved beneficial? What is the particular character of man as a social being? How far does disease operate upon this character 7 How far may this be turned to advantage in lunatic asylums ? ,-\ How may the patients of a higher class be profitably employed 7 How ought the talents of the patient to be made available 7 What is a great desideratum in asylums dedicated to the middle and higher classes of society 7 What benefits would accrue from this plan? What may be an obstacle to its adoption 7 Through what kind of channels might this obstacle be removed ? Illustrate these remarks. What striking analogy has Pinel observed with regard to the treatment of the insane? What are eminently useful in both situations 7 When are they productive of the fullest advantages ? Where is an establishment for the insane, endowed with attend- ants of the description desired, to be found? How has the fre- quent admission of visiters in some measure supplied the deficien- 396 QUESTIONS. cy? What is said of the Connecticut Retreat? Why should th» deficiency be made known ? Why are the higher classes of lunatics, as matters now stand, the most unfortunate of all 7 How is the deficiency very imper- fectly supplied 7 What is the case of the poorer patients ? Why are they less sensible of the change 7 From what has experience shown that great benefit is derived 7 Why is this subject of importance to the general reader as well as to the professional man 7 Why is the knowledge on this sub- ject, when confined to medical men, productive of no good effects 7 How may the justness of the author's strictures be best vindi- cated 7 Give an illustration of the defects of the present system in the cases of the City Asylum for the Poor in Edinburgh and the West Church Charity Workhouse. Give, as a contrast, an illustration of the Middlesex County Asy- lum at Hanwell. Why is it to be preferred to the excellent insti- tutions at Perth, Dundee, and Glasgow 7 In what respects does the establishment at Hanwell benefit from the superintendence of Sir William and Lady Ellis7 How does Miss H. Martineau confirm the author's representations, and in what does she err 7 What is the real state of the case? In what condition are the two great institutions of Bethlem and St. Luke's X What is the state of the Edinburgh Pauper Asylum ? How does the Hanwell Asylum compare with that of Edinburgh? What is the defective stale of the Edinburgh Asylum ? What is a common condition of health to the insane as well as sane 7 How do the institution at Hanwell and others similarly managed act in subservience to this condition ? What defects exist in many private asylums which urgently de- mand improvement? With regard to ventilation? Why is this a serious evil? With regard to cleanliness? With regard to occupation and employment of the mind? What injudicious course has been followed in this respect ? Upon what fatal mis- take is this treatment founded ? How has Ksquirol, in his private establishment, acted in this respect? Detail at length the excellence and suitableness of all his arrangements. Why are the French more successful than the English in procuring suitable attendants ? How far, accord- ing to Esquirol, does gaining the confidence of the lunatic patient go to his cure ? What is the value of this opinion ? What is the progressive course of treatment which Esquirol adopts? How may the necessity of adopting influential moral active treatment be conclusively shown ? In what light are the author's strictures on the Pauper Asylum of Edinburgh to be received 7 INDEX. Absorbent power of the skin, 62 ; of the lungs, 185. Ague, why less prevalent in Britain now than formerly, 314. Air, pure, necessary for health, 26, 30, 191, et seq. Why warm and moist air so oppressive and unwholesome, 60. Effect of moist air upon the Dutch, 66. Contagion prevented by its warmth ana dryness, 67. Its chymical composition, 191. American Annals of Education quoted, 263. Americans' deficient in cleanliness, 84. Much troubled by indiges- tion from neglecting repose after meals, 273. Anatomy ought not to be separated from physiology, 36. Andral quoted on the mental condition of the deaf and dumb, 248. Animal heat. See Heat. Animate and inanimate bodies distinguished, 21. Anson's voyage round the world, causes of the extraordinary dis- ease and mortality during, 314. Anspach, Margravine of, quoted on the regulation of the tem- per during pregnancy, 243. Architects often err from ignorance of physiology, 205, 209. Armstrong quoted on beneficial exercise, 125. Attitude ought to be frequently varied, 115. Baglivi quoted on the influence of the conversation of physicians on the health of their patients, 306. Ballingall, Sir George, quoted on the necessity of ventilating hos- pitals, 196 ; on the comparative health of soldiers in garrison and during a campaign, 304; on the mortality of young re- cruits, 335. Barlow, Dr., on the neglect of muscular exercise in boarding- schools, 117,118. Bateman, Dr., quoted, 70. Bathing, in what cases beneficial, 76. Recommended, 83. Warm, cold, and shower baths, 85. Tepid or warm bath generally best, 86. Time for bathing, 87. Vapour and hot-air baths, 88, 89. Fear of catching cold after warm bath groundless, 88. Warm bath not weakening, 91. Useful in nervous dis- eases, 91, 92. Bedclothes, airing of, 81. Ventilation of bedrooms, 203. Soft feather-beds improper, 216. Bell, Sir Charles, his discoveries respecting the muscular nervesj 112. Ll 398 INDEX. Belzoni's great muscular power, 111. Benevolence, education of that sentiment, 295. Birds, heat of their blood, 214. Black Hole of Calcutta, 193. Blaine, Delabere, quoted, 54. Blistering of the hands in labour, 44. Blood, its circulation increased by exercise, 103,104,171,189. In what manner, 131. Its circulation described, 178. Conditions of healthy state of the blood, 179. An ample supply of good blood necessary for the health of the lungs, 187. Influence of its condition upon the brain, 244. Boarding-schools, stinted diet in some, 104. Inadequate muscu- lar exercise at, 117. Injudicious times at which exercise is taken at, 138. Often insufficiently warmed, 217. Malprac- tices in, 230. Meanness of some conductors of, exemplified, 289-294. Boerhaave injured his brain by intense thinking, 269. Bones, attachment of the muscles to, 101. Their structure, uses, and conditions of health, 155. Animal and earthy constituents of bones, 161. Their structure at different ages, 162. Ves- sels of the, 163. Process of healing of broken bones, 165. Accommodate themselves to the soft parts, ] 66. Softened by some diseases, 168. Weakened by want of exercise, 169, 224 ; and by want of sufficient food, 171. Bowel-complaint, how produced by chill of the skin, 52. Not cu- rable in every case by the same remedy, 54. Bowels, their sympathy with the skin, 51, 54. Their slowness in sedentary persons, 134, 222. Brain, the source of voluntary motion, 105. Weak during rapid growth of the body, 227. Described, 232. The organ of the mind, ib. Different parts of it perform different functions, 236. More and more complicated in animals as they ascend in the scale of mentality, 237. Conditions of its healthy ac- tion, 240, et seq., 340. Laws of exercise of the, 246, et seq. Circulation of hlood in it, quickened by mental action, 254. Evils arising from its excessive and premature exercise, 254, 256. Influence of its condition on the health of the body at large, 300. Breathing. See Respiration. Breda, cure of garrison of, 306. Brigham, Dr., quoted on precocity of mind, 258. Bums and scalds often fatal by producing inflammation of the bowels, 56. Butchers almost exempt from pulmonary consumption, 188. Caldwell, Dr., quoted on the influence of the condition of mothers during pregnancy upon their children, 243. Case of expo- sure of the braip quoted from, 255. Quoted on the quickened circulation in the brain during mental exercise, 255. His Thoughts on Physical Education recommended, 262, note. INDEX. 399 Quotea on the prevalence of indigestion in the United States, 274; on the beneficial influence of well-regulated passions on health, 307. Callisthenic exercises, 146. Canb children, why robust and well-made, 140. Carmichael, Mr., on the production of scrofula by want of mus- cular exercise, 119, and by impure air, 198. Cerebellum, 233. Character modified by habit, 277. Cheerfulness conducive to health, 305. Children ought to indulge largely in active muscular exercise, 121, 139-141,150,151. Ought to be well fed, 171. Oughtnottobe made to walk too soon, 172. Noisy sports beneficial to them, 221. Their brains ought not to be overtasked, 256. Ought not to be sent too early to school, 259. Precocious children, 186, 257. See Infants. Cholera, benefits resulting from the late visitation of, 328. Churches often ill-ventilated, and evils thence arising, 206, 208. Circulation of the blood described, 178. See Blood. Clark, Dr. James, on hereditary tendency of scrofula and con- sumption, 187. Quoted on the importance of ventilating manufactories, 203; and on the means of improving the chest, 221. His work on Consumption and Scrofula recom- mended, 231. Cleanliness, necessity of, 64, 76, 83, 315, 316. Clergymen ought to train and strengthen their lungs, 223,-224. Often destroy their health in youth by excessive study, 263. Climate, change of, in consumption, 230. Its influence on the health, 330. Clothing ought to be porous, 64. Woollen clothing, 64, 65, 79. Ought not to be too warm or too cold, 75, et seq. Errors in female dress, 78, 139, 188. Cold destroys the sensibility of the skin, 69. When intense, im- pairs the mental faculties, 71. Cold feet how productive of disease, 78 Sensibility of consumptive patients to cold, 214. Coldness of the extremities produced by mental depression, 215. Colds, how produced by chill of the skin, 52, 89. Speaking and violent exercise improper during, 224. Colour of the skin, 45. Conscientiousness, education of that sentiment, 296. Consumption, pulmonary,77. Bathing useful in, 87,90. Sailing and riding on horseback powerful remedies, 94. Illustrative case, ib. How it causes death, 181. Importance of physio- logical knowledge to persons subject to it, ib. Hereditary transmission of, 185. Produced by inadequate nutrition, 187 ; by the pressure of stays, &c, 188 ; by the depressing pas- sions, 189. Consumptive patients very sensible to cold, 214. Means of warding off consumption, 218, et seq. Liability to it greatest during the period of growth, 227. Dr. Clark's 400 INDEX. Treatise on Consumption recommended, 231. Causes of, in the fleet, 323. See Lungs. Contagion, how prevented by dryness and warmth of the air, 66. Fear conducive to, 304. Conversation of intelligent friends favourable to health, 305-307. Convulsions, 110, 111. Cook's second voyage, excellent health of the sailors during, 316. Cooper, Sir Astley, case of exposure of the brain quoted from, 254. Corbaux quoted on mortality at different ages, 228. Corion or true skin, 46. Corsets, their use extremely injurious, 139, 188. Costiveness of sedentary persons, 134, 222. Coughing, utility of, 53. Crabbe nearly suffocated in his youth, 194. Cramp, 111. Cuticle or scarf-skin, 42. Cutis or true skin, 46. Cuvier, his lungs strengthened by lecturing, 150, 224. Quoted on the relation between the size of the cerebral lobes and the intelligence of animals, 236, note. Dancing, 145. Davies, Dr., quoted on the preservation of the health of soldiers, 17. Davy, Sir Humphrey, seized with fever in consequence of over- exertion of mind, 265. Deaf and dumb, deterioration of their minds by seclusion, 247. Dermis or true skin, 46. Diabetes, 62. Digestion promoted by free cutaneous perspiration, 97. Retarded by active exercise of body or mind immediately after eating, 137,272. Injured by impure air, 200. Influence of its condi- tion upon the heat of the body, 215. Promoted by muscular exercise, 222- Influenced by the state of the brain, 300. See Stomach. Disease, study of, improper except by medical men, 18. Acute and chronic distinguished, 32. The same disease requires different remedies according to its cause, 54. Hereditary, 185, 240. Often occasioned by slight causes operating silent- ly for a long period, 200, 327, 329. Causes of, considered, 309. See Health. Dog, its frothy mouth in warm weather, 59. Donne, Mons., his opinion of the secretions of the skin and diges- tive canal, 98. Dress, 64. See Clothing. Drunkenness not harmless, although some drunkards enjoy good health, 14. Dumb-bells, 149, 176. Duppa, Mr., quoted on the error of confining education to words, 297. INDEX. 401 Edinburgh Review quoted on the brains of animals, 237. Edinburgh pauper lunatic asylum, its defects, 351. Education, muscular exercise neglected in that of girls, 116. Ne- cessity of attending to the laws of exercise of the brain in, 238. Ought not to be too early commenced, 257. Importance oi repetition in, 276. Education of the moral and religious sen- timents, 288. 295. Children ought to study things as well as words, 296. See Boarding-schools. Brain. Children. In- fants. Schools. Enlisting of soldiers, 332. See Recruits. Epidermis or scarf-skin, 44. Esquirol's lunatic asylum, 356. Excretion from the skin, 18. Exercise, muscular, dissipates dullness of the skin, 70,78. Ben- eficial effects of, on the body in general, 103, 131. Condi- tions necessary for rendering it useful, 103, et seq. Neglected in the education of girls, 116. Scrofula produced by want of, 119. Most beneficial when we have an interesting aim, 124, 345. Its effects in strengthening the muscles, 127, 128, and lungs. 218. Rules for its regulation, 128. Quickens the cir- culation of the blood, 131, 254, and the breathing, 133, 189. Time at which it should be taken, 135. Different kinds of, namely, walking, 141 ; riding, 145 ; dancing, ib.; gymnastics, ib.; fencing, 149; shuttlecock, ib.; dumb-bells, ib., 176; read- ing aloud, 149, 223. Ought to be taken by mothers during gestation, 243. Bad effects of too violent or protracted exer- cise, 142, et seq. Illustrative cases, 144, 151. Prevents cos- tiveness, 134, 222. Muscular exercise of the insane condu- cive to recovery, 345. See Muscles. The bones weakened by want of exercise, 169. Exercise of the lungs recommended, 218, et seq. Improper when lungs are diseased, 224, and during colds, 225. -------of the brain, 238, 246, et seq. Too much hurtful, 254. Rules for mental exercise, 272. Improper immediately af- ter meals, ib., and late in the evening, 274. Importance of regularity in mental exercise, 275. Each cerebral organ must be exercised on its own objects, 279. Exhalation, pulmonary, 184. Factories, health of children in, 25, 327. Fatigue, a symptom that too much exercise has been taken, 128. Fear injurious to health, 190, 301. Predisposes to contagious diseases, 304. Feet, wet and cold, how productive of disease, 78. Rendered cold by mental depression, 215. Females, errors in their dress, 78. Bad effects of their neglect of muscular exercise, 116, 139. Frequently injured by tight lacing, 139, 188. Females in easy circumstances why so lia- ble to unhappiness and nervous disease, 249, 251. Fencing, 149. Ll2 402 INDEX. Fishes, respiration of, 181. Flannel clothing, 64, 79, 81. Food, abundance of, necessary for muscular efficiency, 104. Often deficient in boarding-schools, ib. Deficiency of, leads to con- sumption, 187. Influence of its quantity and quality on the heat of the body, 215, and on the health of the brain, 245. Mortality from deficiency of, 326. Forbes, Dr., quoted on the neglect of muscular exercise in board- ing-schools, 117. Gas, use of, in dwelling-houses, 206. Governesses, causes of their unhappiness and bad health, 247. Grief injurious to health, 190, 301, 304, 321. Growth, abundance of food necessary during, 104. Liability to consumption at that period, 227. Mind then weak, and ought not to be overworked, ib. Body also weak, 332. Gymnastic exercises, 146. Habits, formation of, 275-279. Influence of habit in disarming causes of disease, 329. Hanwell Lunatic Asylum, 351. Hawkins's Medical Statistics quoted, 324. Health ought to be carefully preserved, as well as sought for when lost, 29, 35, 38, 209. Maynwaringe's quaint description of, 38. How injured by grief and fear, 190, 301. Causes of bad health considered, 309. Importance of physiological knowl- edge for enabling individuals to preserve their health, 20, 25, et seq., 54, 201, 225, 227, 322. See Disease. Heart an organ of circulation, 17S. Heat of the human body, how regulated, 57. Its source, 213. Causes by which it is elevated and depressed, 214, et seq. Hereditary transmission of scrofula and consumption, 185; of dis- eases of the brain, 240. Horses ought not to be put to work at a too early age, 173. Hospitals, importance .of their proper ventilation, 197, 211. House of Commons, bad effects of its defective ventilation, 205. Idleness productive of nervous and other diseases, 249, 303, 340. Often leads to gormandizing, 253. Infants, errors in the treatment of, 27, 73, 200, 312. Crying and sobbing beneficial to, 221. Great mortality of, 28,73,200,312. Infant-schools, 122. 223, 259, 261. Inflammation requires rest. 224. Jnsanity often occasioned by inordinate mental exertion, 268. Ap- plication of the principles of physiology to the treatment of, 338. Hurtful ignorance of the public respecting it, 338, 339. Lunatic asylums, 340. Moral treatment of the insane, ib. Ought not to be without regular occupation, 342. The soci- ety of sane persons very conducive to their recovery. 343,347. Intoxication disturbs voluntary motion, 107. See Drunkenness. INDEX. 403 Involuntary muscles, 154. Ivry, Esquirol's lunatic asylum at, 356. Johnson, Dr. James, quoted on the use of the bath in nervous dis- eases, 92 ; on the bad effects of too violent exercise, 143; on the causes of diseases in the fleet, 322. Latham, Dr., quoted on the influence of mental depression on health. 321. Light, its beneficial influence on the body, 82. Literary men, diseases of, from too intense thinking, 71. Lon- gevity of different classes of them compared, 307. See Sed- entary. Living beings distinguished from inanimate, 21. Longevity of men with well-regulated minds, 307. See Mortality. Lunatic asylums, 340, et seq. Lungs, their over-exertion hurtful, 28. Affected by chill of the skin, 53, 77. Connexion between their health and the state of the skin, 93. Illustrative case, ib. Strengthened by read- ing aloud, 149. Their structure, functions, and health, 178. Their exhalation and absorption, J84, Conditions of their nealth, 185. Change of the blood in passing through them, 191. Their connexion with animal heat,214. Means of pro- moting theirdevelopment, and improving their functions, 218, et seq. See Consumption. Lymphatic vessels, 62. M'Grigor, Sir James, on the mortality of young recruits, 333. Malaria, 61, 64. Manufactories ought to be well ventilated. 203, 244. See Fac- tories. Marriage, evils arising from too early, or between unhealthy per- sons, 185, 241. Marshall, Mr. Henry, quoted on curvature of the spine, 140; on the great mortality of young recruits, 304, 333, and of the children of soldiers, 326. Value and importance of his statis- tical researches, 335, note. Martineau, Miss, quoted, 248, 353. Materialism, 240. Mathematicians long-lived, 307. Maynwaringe's quaint description of health, 38. Meals, exercise immediately before or after them improper, 135- 137. See Food. Medulla oblongata, 235. Memory improved by regular exercise, 275, note. Milbank penitentiary, disease in, 320. Mind, effect of its emotions upon the skin, 70. Disordered by in- tense cold, 71. Its influence on the muscular system, 121, et seq., 300. Mental depression injurious to the lungs, 189, and productivo of coldness of the extremities, 215. Weak 404 INDEX. during period of rapid growth. 227. Brain the organ of the mind, 232, 236. Mental faculties can be improved only by improving the brain, 238,280. Influence of mental emotions on the stomach, lungs, and heart, 302, 303. See Brain. Passions. Moral sentiments, education of the, 288, 295. Mortahty, at what age greatest, 228, 332. Vast diminution of, in consequence of increased attention to the organic laws of nature, 324. Mortality of infants, 28, 73, 200, 312, 326. Moscow, retreat of the French from, 123. Mothers, influence of their state during gestation upon the health of their children, 242. Murray, Captain, his mode of preserving the health of sailors, 80. Muscles, their slructure, 99; attachments, 101; contractility, 102; and functions, ib. Requisites of healthy and vigorous mus- cular exercise, ib. The muscles stimulated to action, and regulated, by the nervous system, 105, 112. Their combined and simultaneous action, 109. Sense of the state of the mus- cles, 114. Alternate contraction and relaxation of the mus- cles their proper mode of action, 115. Bad effects of long continuance in one attitude, 116. Involuntary muscles, 154. See Exercise. Nails of the fingers and toes, 44. Natural history, study of, advantageous, 125,126. Negroes, colour of their skin, 45. Nerves of the skin, 67. Of voluntary motion, 105, 109, et seq. Of the senses, 235. Nervous diseases, importance of attending to the skin in, 91. Often hereditary, 241. Predisposition to them sometimes caused by circumstances operating on mothers during ges- tation, 242. Frequently arise from non-exercise of the brain, 248,299, and from its over-exercise, 266. Application of the principles of physiology to the treatment of, 338. Hurtful ignorance of the public respecting them, ib. Nervous system described, 232. Periodicity of its action, 275. Newton, Sir Isaac, injured his brain by inordinate study, 269. Operative population sometimes injured by want of light, 82. Bathing recommended to them, 88. Suffer from too much labour and deficient food, 104,188; also from impure air, 202. See Poor. Orators, quickened circulation in their brains while speakine, 255. 256. Organic laws of nature must be obeyed in order to avoid disease, 315. Oxygen essential to respiration, 191, and to mental vigour, 244. Pain, its great utility, 67, 68. Paris, mortality in, 228, 229, 332. INDEX 405 Parry's northern expeditions, health of the sailors during, 316. Passions, their influence on health, 189, 301, 305, 321. Pedestrian excursions, 142. Pellico, Silvio, improvement of his memory by regular exercise, 276, note. Pelvis, 159. Periodicity of action of the nervous system, 275. Perkins's melhod of warming and ventilating houses, 211. Perspiration, insensible, 49, 58. Sensible, 50,58. Free perspira- tion beneficial to the digestive and other organs, 97, 220. Phrenology, 299. Physicians, beneficial influence of their conversation on the health of their patients, 306. Physiology, advantages of a knowledge of, 16, 25, et seq., 54, 201, 225, 228, 322. Defined, 21. Ought not to be separated from anatomy, 36. Pinel, Scipio, quoted on the bad effects of over-exertion of the brain, 268. Plague, 313. Poets, why generally short-lived, 308. Poor liable to consumption from deficiency of food, 188. Less healthy and shorter-lived than the rich, 326,328. See Oper- atives. Precocious children, 186. Erroneous treatment of, 256. Pregnancy, influence of mother's condition during it, on the mind of child, 242. Printing-offices, ventilation of, 210. Puberty, bodily weakness at, 227, 332, 333. See Growth. Reading aloud a wholesome exercise, 149,223, except when there is disease of the chest, 224. Recruits, young, causes of their great mortality, 304, 332. See Soldiers. Regularity of mental exertion very important, 275-277. Religion ought to include the study of God's works as well as of his word, 270. Disease considered in relation to, 309, 329. Repetition, its importance in education, 226. Respiration quickened by muscular exercise, 133, 189. Oxygen- ates the blood, 179. Conditions requisite for its healthy per- formance, 185. Its connexion with animal heat, 214. Its in fluence on the brain, 244. Rete mucosum of the skin, 45. Retirement from active life, why so frequently productive of un- happiness and nervous disease, 252. Ribs described, 159. Rickety children often display precocious talent, 257. Riding useful in the cure of pulmonary consumption, 94, 220. Considered as an exercise, 145. Rome, malaria of, 64. Jtowing of boats considered as an exercise, 144. 406 INDEX. Sailors, preservation of the health of, 80, 308, 314, '923. Sailing useful in the cure of pulmonary consumption, 94. Sauctorius, his experiments to determine the quantity of matter perspired by the skin, 48. Sanguification, 182. See Blood. Savages almost never deformed, and why, 140, 141. Scalds often fatal, by exciting inflammation of the bowels, 56. Scarf-skin or cuticle, 42. Schools, error of restricting children for a long time to the same attitude in, especially on seats without backs, 116, 119. Of- ten ill-ventilated, and evils thence arising, 207, 244. Ought to be well heated, 217. Vacations at, 239. Children should not be sent too early, 260. See Education. Scott, Sir Walter, destroyed his health by excessive mental toil, 268. Scrofula produced by want of muscular exercise, 118, and by im- ure air, 198. Hereditary, 185. Erroneous treatment of the rains of scrofulous children, 257. Sedentary persons, costiveness of, 34, 222. Examples of fatal ef- fects of sedentary habits, 263. See .Exercise. Literary. Stu- dents. Seguin's experiments to determine the quantity of matter per- spired by the skin, 49. Shampooing, how beneficial, 134. Shuttlecock exercise beneficial, 149. Sinclair, Sir John, quoted on training, 202. Sinews, 101. Skeleton, the, 158. Skin, its structure and functions, 41. Epidermis, cuticle, or scarf- skin, 42. Mucous coat, or rete mucosum, 45. Dark skin of Negroes, ib. True skin, or dermis, 46. Skin considered, (1) as an exhalant, 48 ; (2) as a regulator of the bodily heat, 57; (•) as an agent of absorption, 61 ; and (4) as the seat of sen- sation or touch, 66. Bowel-complaint and colds produced by chill of the skin, 52, 89. Sympathy of the skin with the stomach and bowels, 54. Its sensibility to pain very useful, 66, 67, 69. Rendered insensible by cold, 69. Effect of men- tal emotions upon it, 70. Apt to be cold in literary men and invalids, 71. Follicles or glands of the skin, 72. Health of the skin, and its influence on the general system, 73. Its cleanliness necessary, 64, 76, 83. Friction and sponging of it beneficial, 86. Attention to it very important in nervous diseases, 91, 92. Connexion of its state with the health of the lungs, 93. Scull described, 157. Sleep prevented by late studv, 274. Smallpox, vast diminution of mortality from, 313. Smith, Dr. Southwood, quoted, 20. Soldiers, preservation of the health of, 16, 80, 197, 198, 304, 332. Great mortality among their children, 326. INDEX. 407 Solitude injurious to the brain, 247, 251,299,304. Speaking a beneficial exercise, 149, 223, unless there be disease of the chest, 224. Spinal marrow, 235. Spine, curvature of the, 116,139, 176. Such a deformity never found among savages, 140. Bones of the spine, 157. Sports, muscular, very beneficial, 121, etseq., 139,141,189. Noisy sports of children ought not to be checked, 221. Spring, why apparently an unhealthy season, 30, 201. Starvation sometimes productive of insanity, 245. See Food. Statistics, medical, 335, note. Stays, their use extremely injurious, 139, 188. Stomach, its sympathy with the skin, 54. Its acidity relieved by cutaneous perspiration, 97. Disordered by disease of the brain, 302. See Digestion. Students often destroy their health by unremitted labour, 262. In- digestion of, 273, 302. Ought to relax their exertions in the evening, 274. See Brain. Mind. Sedentary. Suffocation, death from, 26, 193. Teachers ill remunerated, 294. Temperature of the body, 57. See Heat. Tendons, 101. Thackrah, Mr., quoted on the bad effects of tight-lacing on tbe respiration, 188. On the injury of digestion by impure air, 200. Tissot quoted on the injury of the brain by protracted study of one subject, 269. Touch, sense of, 66. Training, 202, 220, 221. Travelling, low diet proper in, 137. Beneficial to health, 308. Pedestrian excursions, 142. Vacations at schools, 239. Vaccination, 61. See Smallpox. Vapour-bath, 89. Ventilation, its necessity explained and illustrated, 26,30,82,193, et seq., 244. Vertebrs of the spine, 157. Walking considered as an exercise, 141. Too much very preju- dicial, 142. Children ought not to walk too soon, 175. Walpole's Letters quoted, 194. Warm bath, 86-92. Warming of houses, 211,217. Of schools, ib. Washing of the skin. See Cleaidiness. Skin. Watering-places, visits to, 308. Weather, why warm and moist so oppressive, 60. Weber hastened his death by inordinate mental application, 270. Wet feet, how productive of disease, 78. 408 INDEX. Women. See Females. Woollen clothing, 64, 65, 79, 81, 82. Working classes. See Operatives. Poor. Yelloly, Dr., quoted, 67. ».,,-. ,.. .j^ Youth, importance of abundant food m, 104. Liability of the body to disease about puberty, 227, 332. Baneful effects of dissi- pation in youth, 230. See Children. Infants. THE END. % "-# & 0 V- 1" <£ ' /■ / £ y^/-z M- Si