«?/ ./' ....... "*i I' Surgeon General's Office M>M&c$MSfe ■•x- ^Se©6r^ J?, N„.^3/G .7/>':/ton. \ ' -'S30.(j 0J3O&QJ3Q/U i * . , . '\\ 'r\ 1 / * ■ \ 1 THE PRINCIPLES OF PHYSIOLOGY APPLIED TO THE PRESERVATION OF HEALTH, AND TO THE IMPROVEMENT OF PHYSICAL AND MENTAL EDUCATION BY ANDREW COMBE, M.D., 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 I 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 ana 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 $vaic, nature, and Tioyoc, 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, C 26 UTILITY OF PHYSIOLOGICAL KNOWLEDGE. and had they been aware of the intimate dependence 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 preceeding 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 the 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 gee 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 induced 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 {woduce 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 tp 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 60 violent a nature as to have at once upset reason, and the same will be found to hold in almost all those 6low 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 6hall 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 in 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 habjt 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 ahead" 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 youreyes. " '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 toyhng, 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 V* * 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 Seal 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 tha 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 oi 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 i 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 the 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 nor 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 areola? 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 stiH 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, ithly, As the seat of sensation and touch. Besides performing the mechanical office of a shield to the parts beneath, the skin n> 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, the 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 reservation of health, and which is called insensible ecause 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 five 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. 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- E 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 w'hich, 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 witb- 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, symjlathize 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 wen- AND OTHER ORGANS. 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 adoption 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. 65. 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 bowels 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. L>r. 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 evenls 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 contributing 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 mouthy 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 neat. The dog perspires very little from its 6kin, 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, to 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 earned 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 .n 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 was 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 may be 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 mportant 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 unpleasa nt 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, suffering 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. ISO. 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 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.—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 auch 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 wo 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 chillness 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 oj 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 f 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.bf their young occupants. The circumstances in which wet and cold feet are most apt to cause disease, are ADVANTAGES OF FLANNEL. 79 those where the person remains inactive, and where, consequently, there is nothing to counterbalance the unequal flow of blood which then takes place towards the internal parts : for it is well known that a person in ordinary health may walk about or work in the open air with wet feet for hours together without in- jury, provided he put on dry stockings and shoes im- mediately on coming home. It is, therefore, not the mere state of wetness that causes the evil, but the check to perspiration and the unequal distribution of blood to which the accompanying coldness gives rise. I am acquainted with an instance in which a robust and healthy tradesman, by incautiously standing in the sea, when in a state of profuse perspiration, for five minutes, in repairing a steamboat, brought on severe constitutional disturbance, followed by pulmonary dis- ease, which confined him to the house during the whole of four winters. Nineteen years have now elapsed since the cause was applied; but although his health is gradually improving, he still suffers from cough and breathlessness, and is very susceptible of cold and illness from every trifling exposure. This person instantly shifted himself on coming out of the water, which at the time he had been led to believe was a sufficient precaution. But had he known some- thing of his bodily constitution, he would have seen the danger before he exposed himself to it, and would have escaped the heavy penalty which his ignorance brought upon him. The advantages of wearing flannel next the skin are easily explicable on the principles expounded above. Being a bad conductor of heat, flannel prevents that of the animal economy from being quickly dissipated, and protects the body in a considerable degree from the injurious influence of sudden external changes. From its presenting a rough and uneven, though soft surface to the skin, every movement of the body in labour or in exercise gives, by the consequent fric- tion, a gentle stimulus to the cutaneous vessels and nerves, which assists their action, and maintains their functions in health: and being, at the same time, of a 60 ADVANTAGES OF FLANNEL. loose and porous texture, flannel is capable of absorb- ing the cutaneous exhalations to a larger extent than any other material in common use. In some delicate constitutions, it proves even too irritating to the skin, and in hot climates sometimes excites too great a flow of perspiration. In the former case, fine fleecy hosiery, and in the latter cotton, will in general be easily endured, and will greatly conduce to the pres- ervation of health. Many are in the custom of wait- ing till winter has fairly set in before beginning to wear flannel. This is a great error in a variable cli- mate like ours, especially when the constitution is not robust. It is during the sudden changes from heat to cold, which are so common in autumn, before the frame has got inured to the reduction of temperature, that pro- tection is most wanted and flannel is most useful. The advantages of flannel as a preservative from disease, in warm as well as in cold climates, are now so well understood, that in the army and navy its use is cogently, and with great propriety, insisted on. Sir George Bullingal, in his valuable Lectures on Military Surgery (p. 92), has some very judicious remarks on the influence of warm clothing in preserving the health of soldiers. After adducing the testimony of Sir James Macgrigor, to show that in the Peninsula the best clothed regiments were generally the most healthy, Sir George mentions that, when in India, he had himself a striking proof of the utility of flannel in checking the progress of a most aggravated form of dysentery in the second battalion of the Royals. Captain Murray also, late of H. M. S. Valorous, told me that he was so strongly impressed from former experience with a sense of the efficacy of the protec- tion afforded by the constant use of flannel next the skin, that when, on his arrival in England in Decem- ber, 1823, after two years' service amid the icebergs on the coast of Labrador, the ship was ordered to sail immediately for the West Indies, he directed the pur- ser to draw two extra flannel shirts and pairs of draw- ers for each man, and instituted a regular daily in- SDection to see that they wers worn. These precau ADVANTAGES OF FLANNEL. 81 tions were followed by the happiest result. He pro- ceeded to his station with a crew of 150 men ; visited almost every island in the West Indies, and many of the ports in the Gulf of Mexico ; and, notwithstanding the sudden transition from extreme climates, returned to England without the loss of a single man, or having any sick on board on his arrival. It would be going too far to ascribe this excellent state of health solely to the use of flannel; but there can be little doubt that this was an important element in Captain Murray's success. Far, however, from trusting to it alone, Captain Murray was as careful in guarding against other sources of disease as against variations in tem- perature ; and with this view every precaution was at the same time used, by lighting stoves between decks and scrubbing with hot sand, to ensure the most thor- ough dryness, and proper means were put in practice to promote cheerfulness among the men. When in command of the Recruit gun-brig, which lay about nine weeks at Vera Cruz, the same means preserved the health of his crew, when the other ships of war anchored around him lost from twenty to fifty men each. That the superior health enjoyed by the crew of the Valorous was attributable chiefly to the means employed by their humane and intelligent commander, is shown by the analogy of the Recruit; for although constant communication was kept up between this vessel and the ships in which sickness prevailed, and all were exposed to the same external causes of dis- ease, yet no case of sickness occurred on board of it. Facts like these are truly instructive, by proving that. man possesses much power of protecting himself from injury when he has received the necessary in- struction, and chooses to adapt his conduct to circum- stances. The exhalation from the skin being so constant and extensive, the bad effects of it, when confined, sug- gest another rule of conduct, viz., that of frequently changing and airing the clothes, so as to free them from every impurity. In the case of flannel, for example. 82 VENTILATION OF BEDS AND CLOTHING. which imbibes perspiration very readily, it is an ex- cellent plan, instead of wearing the same for several successive days, either to change it frequently, or to make use of two sets of flannel, each being worn and aired by turns on every alternate day. A frequent change, however, is certainly the preferable practice. For the same reason, a practice common in Italy merits universal adoption. Instead of beds being made up in the morning the moment they are vaca- ted, and while still saturated with the nocturnal exha- lations, which, before morning, even become sensible to smell in a bedroom, the bedclothes are thrown over the backs of chairs, the mattresses shaken up, and the window thrown open for the greater part of the day, so as to secure a thorough and cleansing ventilation. This practice, so consonant to reason, imparts a freshness which is peculiarly grateful and conducive to sleep, and its real value maybe inferred from the well-known fact that the opposite practice, carried to an extreme—as in the dwellings of the poor, where three or four beds are often huddled up with all their impurities in a small room—is a fruitful source of fever and bad health, even where there is no deficiency of nourishment or of ventilation during the day. In the abodes of the poor Irish residing in Edinburgh, I have seen bedding for fourteen persons spread over one floor not exceeding twelve feet square: when morning came, the beds were huddled'above one another to make sitting room during the day, and at night were again laid down, charged with accumu- lated exhalations. If fever were not to appear in such circumstances, it would be indeed marvellous; and we ought to learn from this, that if the extreme be so injurious, the lesser degree implied in the preva- lent practice cannot be wholesome, and ought, there- fore, not to be retained when it can be so easily done away with. The salutary influence of the solar light as a stimu- lus to the skin has been much overlooked, and yet it must be obvious to everyone after a moment's reflec- tion. Those who live in mines or dark caves, and IMPORTANCE OF ABLUTION AND BATHING. 83 who are rarely exposed to the light of day, present a pale, relaxed sallowness of skin, which contrasts with the ruddy freshness of country people and others liv ing much in the open air. The inhabitants of towns may be known by the light colour and delicacy of Bkin which confinement induces. Part of the effect is owing, no doubt, to the agency of the external air, in the constitution of which the skin seems to produce changes analogous to those which take place in the lungs during respiration; but much is also attributa- ble to deprivation of the stimulus of light. Even ve- getables become pale, watery, and feeble in the dark; and, in like manner, men who work during the night and sleep during the day never present the vigorous look of health which distinguishes well-fed day la- bourers. The squalid paleness and depression of the poor population resident in the dark lanes of large and crowded cities, show the necessity of consulting the wants of nature more than is generally done when erecting new streets and manufactories, and provi- ding playground for the young. When the saline and animal elements left by the perspiration are not duly removed by washing or ba- thing, they at last obstruct the pores and irritate the skin. And it is apparently for this reason that, in the eastern and warmer countries, where perspiration is very copious, ablution and bathing have assumed the rank and importance of religious observances. Those who are in the habit of using the fleshbrush daily, are at first surprised at the quantity of white dry scurf which it brings off; and those who take a warm bath for half an hour at long intervals, cannot have failed to notice the great amount of impurities which it re- moves, and the grateful feeling of comfort which its use imparts. The warm, tepid, cold, or shower bath, as a means of preserving health, ought to be in as common use as a change of apparel, for it is equally a measure of necessary cleanliness. Many, no doubt, neglect this, and enjoy health notwithstanding; but many, very many, suffer from its omission, and even the former would be benefited by employing it. The 84 IMPORTANCE OF ABLUTION AND BATHING. Serception of this truth is gradually extending, and aths are now to be found in fifty places for one in which they could be obtained twenty years ago. Even yet, however, we are far behind our Continental neigh- bours iu this respect. They justly consider the bath as a necessary of life, while we still regard it as a luxury. I believe that I am within the truth when I say, that in one hospital in Paris, a greater number of baths have been administered to the poor during the last year, than to the whole working population of Great Britain during the last ten years. When we consider the importance of the exhaling functions performed by the skin, the extent to which ablution and bathing of every description are neglect- ed in charitable institutions, in seminaries for the young, and even by many persons who consider them- selves as patterns of cleanliness, is almost incredible. Mr. Stuart, in speaking of the North Americans, re- marks, that " the practice of travellers washing at the doors, or in the porticoes or stoops, or at the wells of taverns and hotels once a day, is most prejudicial to health; the ablution of the body, which ought never to be neglected, at least twice a day in a hot climate, being altogether inconsistent with it. In fact," he adds, " I have found it more difficult, in travelling in the United States, to procure a liberal supply of water at all times of the day and night in my bedchamber, than to obtain any other necessary. A supply for washing the face and hands once a day seems all that is thought requisite."* But bad as this is, I fear that numbers of sensible people may be found much near- er home, who limit their ablutions to the visible parts of their persons, and would even express surprise if told that more than this is necessary to health. Cer- tain it is, that many never wash their bodies unless they happen to be at seabathing quarters in summer, or are oppressed with heat, when they will resort to bathing as a means of comfort, but without thinking at all of its efficacy as a means of cleanliness in pre- * Three Years in America, vol. ii., p. 44a COLD, TEPID, AND WARM BATHS. 85 serving health. In many public charities and schools, in like manner, bathing or ablution is never thought of as a proper or practicable thing, except for the sick; and yet it is obviously of great importance to every one, especially to the young.* For general use, the tepid or warm bath seems to me much more suitable than the cold bath, especially in winter, and for those who are not robust and full of animal heat. Where the constitution is not suffi- ciently vigorous to secure reaction after the cold bath, as indicated by a warm glow over the surface, its use inevitably does harm. A vast number of persons are in this condition; while, on the contrary, there are few indeed who do not derive evident advantage from the regular use of the tepid bath, and still fewer who are hurt by it. Vt Where the health is good and the bodily powers are sufficiently vigorous, the cold bath during sum- mer, and the shower bath in winter, may serve every purpose required from them. But it should never be forgotten, that they are. too powerful in their agency to be used with safety by every one, especially in cold weather. In proportion as coldjbathing is influential in the restoration of health when judiciously used, it is hurtful when resorted to without discrimination: and invalids, therefore, ought never to have recourse to it without the sanction of their professional advi- sers. Even where cold bathing is likely to be of service when judiciously employed, much mischief often re- sults from prolonging the immersion too long, or from * While revising these pages, a friend has mentioned* to me a caae strikingly illustrative of the necessity of attending to the con- dition of the skin, and of the sympathy subsisting between it and the bowels. A lady, who is in other respects very cleanly in her habits, has never been accustomed to the use of the bath or to general ablution of any kind, and, in consequence, the action of the skin is very imperfect. As a substitute, however, for its exhala- tion, she has all her life been affected with bowel complaint, which no treatment diiecied to the bowels has been able to remove. It is probable that the natural course of the exhalation could not now be restored. H 86 COLD, TEPID, AND WARM BATHS. resorting to it when the vital powers are too languid to admit of the necessary reaction—before breakfast, for example, or after fatigue. For this reason, many persons derive much benefit from bathing early in the forenoon, who, when they bathe in the morning be- fore taking any sustenance, do not speedily recover their natural heat and elasticity of feeling. For those who are not robust, daily sponging of the body with cold water and vinegar, or with salt water, is the best substitute for the cold bath, and may be resorted to with safety and advantage in most states of the system ; especially when care is taken to ex- cite in the surface, by subsequent friction with the fleshbrushor hair-glove, the healthy glow of reaction. It then becomes an excellent preservative from the effects of changeable weather. When, however, a continued sensation of coldness or chill is percepti- ble over the body, sponging ought not to be persisted in : dry friction, aided by the tepid bath, is then great- ly preferable, and often proves highly serviceable in keeping up the due action of the skin. For habitual use, the tepid or warm bath is certain- ly the safest and most valuable, especially during the autumn, winter, and spring, and for invalids. A tem- perature ranging from 85° to 98°, according to the state of the individual, is the most suitable; and the duration of the immersion may vary from fifteen min- utes to an hour or more, according to circumstances. As a general rule, the water ought simply to be warm enough to feel pleasant without giving a positive sen- sation of heat; the degree at which this happens va- ries considerably, according to the constitution and to the slate of health at the time. Sometimes, when the generation of animal heat is great, a bath at 953 will be felt disagreeably warm and relaxing; while, at an- other time, when the animal heat is produced in de- ficient quantity, the same temperature will cause a chilly sensation. The rule, then, is to avoid equally the positive impressions of heat and of cold, and to seek the agreeable medium. A bath of the latter de- scription is the reverse of relaxing; it gives a cheer- COLD, TEPID, AND WARM BATHS. 87 ful tone and activity to all the functions, and may be used every day, or on alternate days, for fifteen or twenty minutes, with much advantage. A person of sound health and strength may take a bath at any time, except immediately after meals. But the best time for valetudinarians is in the forenoon 01 evening, two or three hours after a moderate meal, when the system is invigorated by food, but hot op- pressed by the labour of digestion. When the bath is delayed till five or six hours after eating, delicate peo- ple sometimes become faint under its operation, and, from the absence of reaction, are rather weakened by the relaxation it then induces. As a general rule, ac- tive exertion ought to be avoided for an hour or two after using the warm or tepid bath; and, unless we wish to induce perspiration, it ought not to be taken /nmediately before going to bed; or, if it is, it ought to be merely tepid, and not of too long duration. These rules apply, of course, only to persons in an ordinary state of health. If organic disease, headache, feverishness, constipation, or other ailment exist, bathing ought never to be employed without medical advice. When the stomach is disordered by bile, it also geneially disagrees. But that it is a safe and valuable preservative of health in ordinary circum- stances, and an active remedy in disease, is most cer- tain. Instead of being dangerous by causing liability to cold, it is, when well managed, so much the re- verse, that the author of these pages has used it much and successfully for the express purpose of diminish- ing such liability, both in himself and in others in whom the chest is delicate. In his own instance, in particular, he is conscious of having derived much advantage from its regular employment, especially in the colder months of the year, during which he has uniformly found himself most effectually strengthen- ed against the impression of cold, by repeating the bath at shorter intervals than usual.* ♦ I am delighted to find my opinion of the value of the bath, in the prevention of pulmonary disease, and indeed the whole prac- 88 WARM AND VAPOUR BATH. In many manufactories where warm water is always obtainable, it would be of very great advantage to have a few baths erected for the use of the operatives. Not only would these be useful in promoting health and cleanliness, but they would, by their refreshing and soothing influence, diminish the craving for stim- ulus which leads so many to the ginshop ; and, at the same time, calm the irritability of mind so apt to be induced by excessive labour. Where the trade is dirty, as many trades necessarily are, it is needless to say how conducive to health and comfort a tepid bath would be on quitting it for the day.* On the Continent, the vapour and hot air baths are had recourse to, both as a means of health and in the cure of disease, to a vastly greater extent than they are in this country. Their use is attended by the very best effects, particularly in chronic ailments, and where the water-bath is felt to be oppressive by its weight; and there can be no question that their action is chiefly on the skin, and, through its medium, on the nervous system. As a means of determining the blood to the surface, promoting cutaneous exhalation, and equalizing the circulation, they are second to no remedy now in use; and, consequently, in a variety of affections which the encouragement of these pro- cessess is calculated to relieve, they may be employ- ed with every prospect of advantage. The prevalent fear of catching cold, which deters many from using tical doctrines of the present chapter, corroborated by the author- ity of Dr. James Clark, in his admirable work on Consumption and Scrofula; a work well deserving the attention of parents and others interested in the health of the young, and especially of those who are delicately constituted. * Since the publication of the third edition in February, 1835, 1 have heard with great satisfaction that the above recommenda' tion has been acted upon in several manufactories, in which the waste warm water from the steam engine is made use of at a very trifling expense. At the Caledonian Pottery in Glasgow, the Messrs. Murray have fitted up comfortable baths, to which the whole of their work people, with their wives and families, amount- ing in all to several hundred, have weekly access. I trust that ere long, their excellent example will be extensively followed. VAPOUR BATH. 89 the vapour-bath, even more than from warm bathing, is founded on a false analogy between its effects and those of profuse perspiration from exercise or illness. The latter weakens the body, and, by diminishing the power of reaction, renders it susceptible of injury from sudden changes of temperature. But the effect of the vapour-bath, properly administered, is very dif- ferent. When not too warm or too long continued, it increases instead of exhausting the strength, and by exciting the vital action of the skin, gives rise to a power of reaction which enables it to resist cold better than before. This 1 have heard many patients remark; and the fact is well exemplified in Russia and the north of Europe, where, in the depth of winter, it is not un- common for the natives to rush out of a vapour-bath and roll themselves in the snow, and be refreshed by doing so; whereas, were they to attempt such a prac- tice after severe perspiration from exercise, they would inevitably suffer. It is the previous stimulus given to the skin by the vapour-bath which is the real safeguard against the coldness of the snow. Common experience affords another illustration of the same principle. If, in a cold winter day, we chance to sit for some time in a room imperfectly warmed, and feel, in consequence, a sensation of chillness over the body, we are much more likely to catch cold on going out than if we had been sitting in a room comfortably warm. In the latter case, the cutaneous circulation and nervous action go on vig- orously; heat is freely generated, and the vital action of the skin is in its full force. The change to a lower temperature, if accompanied with exercise to keep up vitality, is then felt to be bracing and stimulating rather than disagreeable. But it is widely different when the surface is already chilled before going out. The vitality of the skin being diminished, reaction cannot follow additional exposure; the circulation leaves the surface and becomes still more internal; and if weakness exist in the throat or chest, cold is the almost certain result. Many suffer from igno- rance of this principle. H8 90 VAPOUR-BATH. The vapour-bath is thus calculated to be extensively useful, both as a preservative and as a remedial agent. Many a cold and many a rheumatic attack arising from checked perspiration or long exposure to the weather, might be nipped in the bud by its timely use. In chronic affections, not only of the skin itself, but of the internal organs, with which the skin most close- ly sympathizes, as the stomach and intestines, the judicious application of the vapour-bath is productive of great relief. Even in chronic pulmonary com- plaints, it is, according to the Continental physicians, not only safe, but very serviceable, particularly in those affections of the mucous membrane which re- semble consumption in so many of their symptoms. Like all powerful remedies, however, the vapour-bath must be administered with proper regard to the con- dition and circumstances of the individual; and care must be taken to have the feet sufficiently warm du- ring its use. If, from an irregular distribution of the steam, the feet be left cold, headache and flushing are almost sure to follow. It happens occasionally, either from some peculi- arity of constitution, or from some unusual condition of the skin, indicated by great dryness and a liability to erysipelatous and scaly eruptions, that the moist- ure of the water or vapour-bath is at first rather pre- judicial and unpleasant, and becomes grateful only in proportion as the skin regains its healthy state. In such cases the warm air-bath is said to be remarkably successful, and it is gaining ground very rapidly in the metropolis. Although the preceding remarks apply specially to the skin considered as an exhalanl, yet most of them are equally applicable to it when viewed as the seat of an important nervous function. For so intimately and beautifully are all the parts of the frame connect- ed with each other, that what is really good for one, rarely if ever fails to be beneficial to the rest. Thus while exercise, adequate clothing, the bath, friction, and cleanliness, are very efficacious in promoting the insensible perspiration and equalizing the circulation, WARM BATH BENEFICIAL. 91 they are almost equally influential in promoting the vital action of the innumerable nervous filaments ram- ified on the skin, and the tone of which is as essential as that of the bloodvessels to the proper discharge of the cutaneous functions. In the large and afflicting class of nervous and mental diseases, attention to the skin becomes, therefore, almost a sine qua non of successful treatment. As a preservative, too, it is influential. In most nervous ailments, languor and inaction of the skin show themselves simultaneously with the earliest dawn of mental uneasiness, and often attract notice before the morbid feelings of the mind have acquired either permanence or strength. At this early period the use of the bath will frequently prove very efficacious in restoring health. Many imagine the tepid and warm bath to be weak- ening, but experience shows that they are so only when abused. When not too warm, and not prolong- ed beyond 15 or 20 minutes, the tepid bath may bi^ employed daily with advantage and perfect safety by persons in health; while invalids, whose condition re- quires its use, are often strengthened by a much lon- ger and equally frequent immersion. I have seen it resorted to for an hour daily, for months in succes- sion, by nervous invalids, with much benefit to health and strength ; and in France it is employed to a much greater extent. At the vast hospital of Salpetriere at Paris, and also at Charenton, M. Esquirol has for many years directed it to be extensively used for two, three, and even five or six hours a day, and with ex- cellent effect. When I visited the hospital for the insane at Charenton, and M. Esquirol's admirable pri- vate asylum at Ivry, in September, 1831, that gentle- man spoke to me in very strong terms of the benefits resulting from the practice, and declared that he had ever found it, when used with ordinary prudence, a safe and valuable remedy; and that, in reality, it fail- ed to do good in some cases more from the patient remaining in it too short a time, than from its want of power to relieve. In the Medico-Chirurgical Review for January and 92 WARM BATH BENEFICIAL. April, 1833, a very interesting outline is given of an article published in the Revue Medicate, illustrative of the efficacy of the tepid bath and the affusion of cool- er water on the head during the last few minutes of immersion, in the cure of a variety of nervous and head affections of considerable obstinacy and severity. Dr. Johnson, the editor of the Review, adds his testi- mony to the success of the practice, and the results obtained agree entirely with my own experience; but, as these papers relate to the treatment of disease, it would be out of place to do more here than recom- mend them to the attention of the professional reader. I may mention, however, that Dr. Recamier frequent- ly orders the bath to be repeated two, three, or even four times in a day. So little reality is there in its supposed debilitating effect. I notice these facts to show that attention to the health of the skin is really influential in preserving the tone of the nervous system, and in contributing to Tnental and bodily comfort, and not for the purpose of inducing persons in bad health to have recourse to the bath of their own accord, which they ought never to do, as they may chance to suffer from using it unsea- sonably. No rules of universal application can be laid down, and this is not the place for a professional disquisition. If the bath cannot be had at all places, soap and water may be obtained everywhere, and leave no apol- ogy for neglecting the skin ; or, as already mention- ed, if the constitution be delicate, water and vinegar, or water and salt, used daily, form an excellent and safe means of cleansing and gently stimulating the skin: to the invalid they are highly beneficial, when the nature of the indisposition does not render them improper. A rough and rather coarse towel is a very useful auxiliary in such ablutions. Few of those who have steadiness to keep up the action of the skin by the above means, and to avoid strong exciting causes, will ever suffer from colds, sore throats, or similar complaints; while, as a means of restoring health, they are often incalculably serviceable. If one tenth CONNEXION BETWEEN THE SKIN AND LUNGS. 93 of the persevering attention and labour bestowed to so much purpose in rubbing down and currying the skins of horses, were bestowed by the human race in keeping themselves in good condition, and a little at- tention were paid to diet and clothing, colds, nervous diseases, and stomach complaints would cease to form so large an item in the catalogue of human miseries. Man studies the nature of other animals, and adapts his conduct to their constitution; himself alone he continues ignorant of and neglects. He considers himself a being of superior order, and not subject to the laws of organization which regulate the functions of the inferior animals; but this conclusion is the re- sult of ignorance and pride, and not a just inference from the premises on which it is ostensibly founded. The writer of these remarks has, unfortunately for himself, had extensive experience, in his own person, of the connexion between the state of the skin and the health of the lungs ; and can, therefore, speak with some confidence as to the accuracy of his observa- tions, and the benefit to be derived from attending to the condition of the skin in chronic pulmonary com- plaints. Many affections of a consumptive character are preceded or begin by deficiency of vital action in the skin and extremities, and a consequent feeling of coldness in the feet and on the surface, and suscepti- bility of catarrhal affections from apparently inade- quate causes, often long before any pressing symp- tom, directly connected with the lungs, occurs to at- tract notice. In this state, means systematically di- rected to restoring the cutaneous circulation will fre- quently be successful in warding off consumption; and, even when the disease is formed, the same means will help to prolong life and relieve suffering, while they will go far to effect a cure in those chronic af- fections of the bronchial membrane which stimulate consumption, and are sometimes undistinguishable from it, and which, when mismanaged, are equally fatal. The two remedies which enjoy the oldest and most general reputation in the successful treatment of pul- 94 CONNEXION BETWEEN THE SKIN monary and consumptive disease, have this quality in common, that both owe much of their influence to their exciting the cutaneous functions and equalizing the circulation. 1 allude to sailing and riding on horseback. Many authors speak of both in the high- est terms, and Sydenham is well known to have con- sidered the latter as almost a specific. Dr. Rush, of Philadelphia, too, extols it with nearly equal force. Of late, a regular course of emetics has been very strongly recommended in the early stages of con- sumption, and apparently on good grounds. In whoop- ing-cough, chronic catarrh, and other obstinate pul- monary affections, they have also been long in vogue, both with the vulgar and with the profession. So far as my observation goes, all of these remedial means are productive of advantage, chiefly in proportion as they determine the blood to the surface, which squeamishness, seasickness, and riding all do in a powerful manner. Riding seems to have this effect, partly from the bodily exercise giving general vigour to the circulation, and partly from the continued gen- tle friction between the skin and the clothes stimula- ting the cutaneous vessels and nerves. This latter effect is of more importance than many believe. Those, accordingly, who are proof against seasick- ness, derive least benefit from a voyage ; while those who suffer under it long, are compensated by the ame- lioration which it induces in the more serious malady. The writer of these remarks became ill in the month of January, 1820, and soon presented many of the symptoms of pulmonary consumption. In spite of the best advice, he continued losing ground till the month of July, when he went by sea to London, on his way to the south of France; but, finding himself unable for the journey, he was obliged to return from London, ilso by sea. Being extremely liable to sea- sickness, he was squeamish or sick during the whole of both voyages ; so much so as to be in a state of gentle perspiration for a great part of the time. After this he became sensible, for the first, time, of a slight improvement in his health and strength, and of a AND THE LUNGS. 96 diminution of febrile excitement Some weeks af- terward, he embarked for the Mediterranean, and en- countered a succession of storms for the first four weeks, two of which were spent, in the month of No- vember, in the Bay of Biscay, in a very heavy sea. For more than three weeks he was generally very sick, and always in a state of nausea ; and during the whole time, although his bed was repeatedly partially wetted by salt water, and the weather cold, the flow of blood towards the skin was so powerful as to keep it generally warm, always moist, and often wet with perspiration, forced out by retching and nausea. The result was, that, on entering the Mediterranean at the end of a month, and there meeting fine weather, he found himself, though still more reduced in flesh and very weak, in every other respect decidedly im- proved; and on his arrival in Italy, at the end of seven weeks, recovery fairly commenced, after about ten mouths' illness; and, by great care, it went on with little interruption till the summer of 1821, when he returned home. To carry on what was so well begun, riding on horseback in the country was resorted to, and that ex- ercise was found to excite the skin so beneficially as to keep it always pleasantly warm and generally be- dewed with moisture, even to the extremities of the toes ; and in proportion to this effect was the advan- tage derived from it in relieving the chest, increas- ing the strength, and improving the appetite. A sec- ond winter was spent in the south with equal benefit; and in the summer of 1822, riding was resumed at home, and the health continued to improve. The ex- citement given to the skin by riding was sufficient to keep the feet warm, and to prevent even considerable changes of temperature from being felt, and rain was not more regarded, although special attention was of course paid to taking off damp or wet clothes the mo- ment the ride was at an end. Strength increased so much under this plan, combined with sponging, fric- tion, and other means, that it was persevered in through the very severe winter of 1822-3, with the 96 SKIN NOT TO BE EXCLUSIVELY ATTENDED TO. best effects. For nine years thereafter the health continued good, under the usual exposure of profes- sional life ; but in 1831 it again gave way, and pulmo- nary symptoms of a suspicious character once more made their appearance. The same system was pur- sued, and the same results have again followed the invigoration of the cutaneous functions and of the gen- eral health, by a sea-voyage, horseback exercise, and the regular use of the bath. These, as formerly, have proved beneficial in proportion to their influence in keeping up warmth and moisture of the surface and extremities. In thus insisting upon the advantages of maintain- ing the healthy action of the skin, I must not be sup- posed to ascribe the whole benefit to that circum- stance alone. So beautifully is the animal economy constituted, that, as I have already repeatedly had oc- casion to observe, it is impossible to use rational means for the invigoration of one organ or function without good being done to all; and so closely are the various parts allied to each other, that, to describe fully the functions and sympathies of any one, we would require to make the circle of the whole. From this appears the fallacy of those who select the de- rangements of any one organ as the origin and source of all existing diseases. Some functions are no doubt more important, and their disorders exercise a wider influence, over the general health, than others ; but no one who knows the structure of the human body and the relations of its parts, or has carefully observed the phenomena of disease, can be satisfied with such exclusive reasoning. The stomach, the bowels, the liver, and the nervous system, have each had their patrons, and the derangement of each has been spe- cially held out as the grand fountain of human misery. Each doctrine, too, has been demonstrated, by cases and cures, to be superior to all the rest, and each has proved successful in its turn, where the others had been tried and failed. Far, however, from proving the propriety of exclusiveness in favour of any one organ, such facts, rightly considered, demonstrate the SKIN NOT TO BE EXCLUSIVELY ATTENDED TO. 97 reverse, and show that successful practice requires views and remedies founded on a careful examination of every function; and afford a strong presumption that the man who traces every disease to the liver, the stomach, or the nerves, will be at least as often strikingly wrong as strikingly right. In saying, therefore, that attention to the state of the skin is influential in preserving and restoring health, I wish to represent it as an important, but by no means exclusive condition, and to ascribe to the means used for invigorating its functions their due share of action upon other organs and functions. Sail- ing, for example, is useful in pulmonary complaints, not only because its accompanying nausea causes a healthful flow of blood from the internal parts to the surface, but because the gentle and constant exercise occasioned by the movement of the ship is admirably adapted to a debilitated state of the system, when other exercise cannot be taken without hurrying the breathing or inducing fatigue; and because pure, fresh, bracing air is of infinite importance in all, and espe- cially in pulmonary affections. Attention to the skin, therefore, must never be considered for a moment as superseding attention to the other functions. That were a pernicious mistake. It must be regarded as a part only, though an important part, of a rational and consistent treatment; and its efficacy will often de- pend, in no small degree, on the care which is taken to support its effects by a scrupulous attention to the necessities of the rest of the system. 1 have often had occasion to remark the powerful influence which free perspiration from natural causes has in relieving acidity in the stomach and promoting digestion, and the fact that acidity is most prevalent when the skin is most inactive; and have thereby been led to prescribe with advantage the frequent use of the tepid and vapour-bath in calculous and other complaints arising from excess of acid. In accord- ance with the same principle, Lord Byron is found noting in his journal ('28th March, 1814), that after having, when previously very unwell, " sparred with I 98 SKIN NOT TO BE EXCLUSIVELY ATTENDED TO. Jackson ad sudorem" he felt " much better in health than for many days;" and remarking, that " the more Violent the fatigue, the belter his spirits for the rest of the day," and this, too, at a time When he was deriving little relief from his favourite remedies, abstinence and soda-water. These results seem to corroborate the doctrine of M. Donne, that in the healthy state an acid humour is secreted from the whole surface of the skin, while the mucus secreted from the digestive canal is every- where, except in the stomach, of an alkaline nature. I have often noticed that acidity in the stomach was much relieved by free action of the skin, particularly in gouty habits, after the use of the warm bath. On the other hand, the season of the year at which 1 have always heard most complaints of acidity was towards the end of autumn, when the colder weather was be- ginning to diminish perspiration and change the bal- ance of the circulation. These facts, if correctly ob- served, go far to corroborate the accuracy of M. Donne's views. The subject, however, still remains obscure, but its importance entitles it to the most careful examination. CHAPTER IV. NATURE OF THE MUSCULAR SYSTKM. 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 (James —A dull Walk the least useful Exercise.—In- fluence of mental Stimulus illustrated by Examples.—Exercise to be proportioned to Strength.—Laws of Strength. Having examined the nature and uses of the skin, we may next proceed to consider the important sys- tem of organs lying almost immediately under it, viz., the muscles, which, although in constant activity during our waking hours, and of indispensable neces sity to man in every movement which he makes, are perhaps less familiarly known than almost any other part of the body. As the study of the muscular sys- tem involves an exposition of the principles which ought to regulate exercise, it can scarcely fail to ex- cite the attention of the general reader, and especially of those who, as parents or teachers, are interested in the education of the young. The muscles are these distinct and compact bun- dles of fleshy fibres which are found on animals im- mediately on removing the skin and subjacent fat; and which, although perhaps not known to all under their generic or scientific name, are familiar to every one as constituting the red fleshy part of meat. Every muscle or separate bundle of fleshy sub- stance is composed of innumerable small fibres or threads, each separated from, and, at the same time, loosely connected with, the others by a sheath of eel- 100 STRUCTURE AND hilar membrane enveloping it, but which is so thin as not to obscure the colour of the fibre, or attract no- tice unless specially looked for. Each muscle is in its turn separated from the neighbouring muscles by thicker layers or sheaths of the same membrane, in some of the cells of which fat is deposited, especially where the interval between the muscles is consid- erable ; and hence the elegantly rounded form of the limbs, which, without this fat, would present the rigid, sharp, and prominent outline which we see occasion- ally in strong persons of a spare habit of body. From the loose texture of the connecting cellular mem- brane, the muscles enjoy perfect freedom of motion during life, and admit of being easily separated from each other after death, either by the knife, or by sim- ply tearing the cellular tissue. Muscles, speaking generally, may be divided into three parts, of which the middle fleshy portion, called the belly, is the most conspicuous and important. The other two are the opposite ends, commonly called the origin and insertion of the muscle. The belly is the bulky and fleshy part, by the contraction or shorten- ing of the fibres of which, the two ends are brought nearer to each other, while the belly itself swells out in a lateral direction. When we attempt to lift a heavy weight in the hand or to overcome any resist- ance, the muscles which bend the arm may be seen and felt to start out rigid and well defined in their whole extent, while their extremities tend powerfully to approach each other, and, of course, to carry along with them the bones to which they are attached. In consequence of this tendency, if a weight be unex- pectedly knocked out of the hand before we have time to obviate the result, the muscles, having then no resistance to overcome, will contract violently, and throw the hand up with a sudden jerk. Voluntary motion is, in fact, effected by the contraction of mus- cles acting upon and changing the relative positions of the bones or solid support of the system, and there- fore almost all muscles are attached to one bone by iheir origin, and to another *»y their insertion; the for- ATTACHMENTS OF MUSCLES. 101 mer being merely the fixed extremity, towards which the opposite and more moveable end, called the in- sertion, is carried by the shortening of the intervenin° belly of the muscle. The figure represents the bones of the arm and hand, having all the soft parts dissected off except one musclp OBI, of which the function is to bend the arm. O the origin of the muscle. B the belly. I the insertion. T T the ten dons. S the shoulder-joint. E the elbow. When the belly contracts, the lower extremity of the muscle I, is brought nearer to the origin or fixed point O, and, by thus bending the arm at the elbow-joint, raises up the weight W placed in the hand. If the muscles are in general attached to bones, it may be asked, How can the bones, which present comparatively so small a surface, afford space enough for the attachment of muscles which are so much lar- ger, and which even appear in successive layers above each other'? This difficulty is obviated in two ways. In Ibe first place, the heads and other parts of bones to which muscles are attached are enlarged so as to present a greater surface than the body of the bone, and form what are called processes, for the express purpose of affording greater room ; and, secondly, in- stead of all the fleshy fibres of a muscle being pro- longed to its points of attachment at the bone, they, with a few exceptions, terminate gradually, as they proceed from the belly, in a white shining tendon, of a much smaller size than the muscle, but of great strength, which is inserted into the bone. These ten- 12 102 NATURE OF MUSCLES dons, or sinews as they are occasionally named, con- duce greatly to symmetry, elegance, and freedom of motion; and may be traced under the skin on the back of the hand, and in the very powerful specimen at the heel, called the tendon of Achilles. The ham- strings are another obvious example, and may be easily felt becoming tight when an effort is made to bend the knee. There are a few muscles not attached to bones by either extremity, and also a few which have no tendons. Those which surround the eye- brows, the mouth, the gullet, and some of the other nat- ural passages, are of the former description; as is also the heart. Some of the muscles of the trunk have no tendons, but these are few in number, and may at present be considered exceptions to the general rule. In man, and in most of the animals with which we are familiar, the muscles are of a red colour. This, however, depends entirely on the blood which they contain; for so far is the colour from being essential to their constitution, that it may be destroyed by washing out the blood which produces it, the muscu- lar substance remaining in other respects unchanged. Hence the colour of the muscles varies with that of the blood; is dark where it is dark, pale where it is pale, and white where it is white. The true charac- teristic of muscular fibres is contractility, or the power of shortening their substance on the application of stim- uli, and again relaxing when the stimulus is withdrawn. The direction in which the fleshy fibres run, deter- mines the direction of the motion effected by their contraction. In some muscles the fibres are nearly parallel, and, consequently, act in a straight line. In others they run obliquely, producing, a corresponding obliquity of motion; while in others they are disposed like feathers in relation to a quill, and are therefore styled penniform. A few are circularly disposed round openings, and contract towards a common cen- tre, like the mouth of a purse dosed by its strings. When the direction varies, it is always to effect a par- ticular kind of action. Remarkable contrivances ap- pear for this end; one muscle of the lower jaw, for NATURE OF MUSCLES. 103 example, is divided into two distinct fleshy bellies by an intermediate thin strong tendon, which passes through and plays in a pulley adapted for its recep- tion ; its two portions being by this means enabled to operate with full effect almost at right angles to each other. A similar arrangement is found in the troch- learis, or pulley-muscle of the eyeball; and modifica- tions of a different kind oceur in other muscles, as in those of the fingers and toes, wherever a particular object is to be accomplished. The chief purpose of the muscles is obviously to enable us to carry into effect the various resolutions and designs—or volitions, as they are termed by phi- losophers—which have been formed by the mind. But while fulfilling this grand object, their active ex- ercise is, at the same time, highly conducive to the well-being of many other important functions. By muscular contraction, the blood is gently assisted in ♦ its course through the smaller vessels and more dis- tant parts of the body, and its undue accumulation in the internal organs is prevented. The important pro- cesses of digestion, respiration, secretion, absorption, and nutrition, are promoted, and the health of the whole body immediately influenced. The mind itself is exhilarated or depressed by the proper or improper use of muscular exercise ; and it thus becomes a point of no slight importance to establish general principles by which that exercise may be regulated. The first requisite for healthy and vigorous muscu- lar action is the possession of strong and healthy mus- cular fibres. In every part of the animal economy, the muscles are proportionate in size and structure to the efforts required from them ; and it is a law of nature, that whenever a muscle is called into frequent use, its fibres increase in thickness within certain limits, and become capable of acting with greater force and readiness; and that, on the other hand, when a muscle is little used, its volume and power decrease in a corresponding degree. When in a state of activity the quantity of blood which muscles re- ceive is considerably increased; and, in consequence, 104 CONDIirONS OF MUSCULAR ACTION. those which are much exercised become of a deeper red colour than those which are less used. The rea- son of this will be evident, when we recollect that to every organ of the body arterial blood is an indispen- sable stimulus, and that its supply is, during health, always proportioned to the extent and energy-of the action. When any part, therefore, is stinted of its usual quantity of blood, it very soon becomes weak- ened, and at last loses its power of action, although every other condition required for its performance may remain unimpaired. It is the infringement of this condition that entails so much misery upon our young manufacturing popu- lation, and even upon many of the inmates of our boarding-schools. Wasted by excessive labour, long confinement, and miserable diet, the muscular system is stinted in growth and weakened in structure; and the blood, impoverished by insufficiency of nourishing food and by a vitiated atmospiiere, is no longer capa- * ble of repairing the waste consequent upon exercise, or of affording a healthy stimulus to the vessels and nerves which animate the muscles. Languor, debil- ity, and exhaustion of mind necessarily follow; and the individual is left susceptible of no stimulus but that of ardent spirits or of excited and reckless pas- sion. In youth, not only must the waste of materials be replaced, but an excess of nourishment must be provi- ded, to admit of the continued growth which is the chief function of our earlier years. If this be denied, the development of the bodily organs often receives a check which no subsequent treatment can rem- edy, and a foundation is laid for diseases of debility which afterward imbitter and endanger life. From pretty extensive inquiry, 1 am satisfied that in board- ing-schools, especially for females, this important principle is often disregarded; while the conductors are, at the same time, without the least suspicion of the evil they are producing, and even take credit to themselves for only checking sensual appetites, and promoting temperance in eating as well as in drinking. CONDITIONS OF MUSCULAR ACTION. 105 Youth requires the best and most nutritious food, and such ought regularly to be provided. Weak broth, twice-cooked hashes, and quantities of vegeta- bles and watery milk, are not sufficient sustenance for a young and growing frame. Can we be surprised that, with such a diet, worm powders and stomachic medicines are in constant demand, and that, even with the assistance of these, the girl shoots up thin, pale, and fleshlessl Let it not be supposed that 1 wish to make a god of the belly; my object is the reverse of this, and I am sure that no better means can be used to effect it than to give a sufficiency (not an excess) of wholesome and nourishing food, which alone will satisfy the stomach, and obviate the constant craving which is a frequent and painful concomitant of defi- ciency of food. Let it be considered how soon, in cases of shipwreck for example, men previously well fed are wasted away by bodily labour, when deprived of a full allowance of food, and it will not be difficult to form some conception of the importance of this condition to the well-being of the muscular system. Something more than mere muscle, however, is re- quired for the production of regulated or voluntary motion. The muscle itself, though perfect in strength and in structure, would otherwise remain inert. A stimulus is required to excite it to activity and to di- rect its contraction, and this stimulus is conveyed to it by the nerves. As we write, the muscles which move and guide the pen obviously follow the commands of the will; and the moment the will is withdrawn they cease to operate. If the will be feeble and undecided, the muscular movements will be equally weak and ir- resolute ; whereas, if the mind be powerfully excited and the will energetic, strength, rapidity, and decision will equally characterize all the movements of the body. Under the intense excitement and headlong fury of madness, the muscular action of an otherwise feeble man acquires a force often exceeding all our powers of control. It will be at once perceived from this description, 106 CONDITIONS OF MUSCULAR ACTION. that, in effecting voluntary motion, we must have in operation, first, The brain, or organ of mind, as the source of the will; secondly, The nerves, which convey the intimations of the will to the muscles ; and, thirdly, The muscles themselves, by whose contractile powers motion is produced. It will be understood, also, why the number and size of the nerves distributed to a muscle are in proportion, not simply to its volume, but to the variety, frequency, and vivacity of the movements required from it; and why some small muscles employed in many combinations are there- fore supplied with a greater variety of nerves than others double their size, but with more simple func- tions. Muscular power is (other circumstances being equal) proportioned to the size of the muscle; but it often happens that great power is required where bulk of muscle would be inconvenient or cumbersome. In such cases, the mufecle is supplied with an increas- ed endowment of nervous filaments, which compen- sate, by the strength of stimulus, for what it wants in bulk of fibre. Many birds, for example, require great muscular power to sustain them in their long and rapid flights through the air, and owe its possession chiefly to the strong stimulus imparted to moderate- sized muscles by large nerves, which add extremely little to their weight; whereas, had the greater power been obtainable only from an augmentation of fleshy fibres, the consequent addition of weight would, from the greatly increased difficulty the animal must have felt in raising and sustaining itself in the air, have gone far to counterbalance any advantage gained on the side of power. But in fishes, which float without effort in their own^lement, size produces no such in- convenience ; and their strength, accordingly, is made to depend more on the volume of the muscle than on its nervous endowment, showing a beautiful adapta- tion to the mode of life and wants of the animal. As voluntary motion depends as much on nervous stimulus as on muscular agency, it happens that what- ever interrupts the action of the nerves puts a stop ON MUSCULAR ACTION. 107 to motion as effectually as if the muscular fibre itself were divided. Injuries and diseases of the brain, whence the will emanates, are well known to be ac- companied with palsy, or want of power in the muscles* although in their own structure the latter remain sound. Sleep and narcotics, too, suspend voluntary motion, solely in con- sequence of their action on the nervous system. Ardent spirits, in like manner, disturb the reg ularity of muscular ac ' tiqn in no other way than by previously dis- ordering the brain; and hence the unsteady gait and faltering elocution of a semi-intoxicated person are sometimes removed in an instant by some powerful men- tal impression being suddenly made, suffi- cient to restore the brain to its natural state, and thereby to give uni- ty and steadiness to the nervous impulse pro- ceeding from it to the muscles. For the same reason, although the brain and muscles be perfectly sound, yet if the communication be- tween them be impair- ed or destroyed by the compression or division of the nerves, the muscles cease to act. 108 INFLUENCE OF NERVES The muscles of the human body are upward of 400 in number, and form several layers lying over each other. That some conception may be formed of their arrangement and distribution, the superficial layer, or that which appears immediately on removing the skin, is represented in the annexed woodcut, taken from a little volume entitled "The Physician," published by the Society for the Diffusion of Useful Knowledge. To understand the uses of the various muscles, the reader has only to bear in mind that the object of mus- cular contraction is simply to bring the two ends of the muscle, and the parts to which they are attached, nearer to each other, the more moveable being al- ways carriqd towards the more fixed point. Thus, when the sterno-mastoid muscle/g- contracts, its ex- tremities approximate, and the head, being the movea- ble point, is pulled down and turned to one side. This may be easily seen in the living subject, the muscle being not less conspicuous than beautiful in its outline. Again, when the powerful rectus or straight muscle b on the front of the thigh contracts with force, as in the act of kicking, its lower end attached to the knee- pan and leg, tends to approximate to the upper or more fixed point, and pulls the leg strongly forward. This occurs also in walking. But when the sarlorius or tailors' muscle c is put in action, its course being ob- lique, the movement of the leg is no longer in a straight line, but in across direction,like that in which tailors sit; and hence the name sartorius. Another variety of effect occurs, when, as in the rectus or straight muscle of the belly i i, sometimes one end and sometimes both are the fixed points. When the lower end is fixed, the muscle bends the body forward, and pulls down the bones of the chest. When, as more rarely happens, the lower end is the moveable point, the effect is to bring forward and raise the pelvis and inferior extremities; and when both ends are rendered, immoveable, the contraction of the muscle tends to compress and diminish the size of the cavity of the belly, and thus not only assists the natural evacuations, but co-operates in the func- tion of respiration. ON MUSCULAR ACTION. 109 In contemplating this arrangement, it is impossible not to be struck with the consummate skill with which every act of every organ is turned to account. When the chest is expanded by a full inspiration, the bowels are pushed downward and forward to make way for the lungs; when the air is again expelled, and the cavity of the chest diminished, the very muscles i i i, which effect this by pulling down the ribs, contract upon the bowels also ; pushing them upward and in- ward, as can be plainly perceived by any one who at- tends to his own breathing. By this contrivance, a gentle and constant impulse is given to the stomach and bowels, which is of great importance to them in contributing to digestion and in propelling their con- tents ; and one cause of the costiveness with which sedentary people are so habitually annoyed, is the diminution of this natural motion in consequence of bodily inactivity. From the preceding exposition, the action of the muscles a, k, I, which bend the arm and forearm, will be easily understood, and some notion may be formed of the innumerable combinations into which a system composed of upward of 400 pieces may be thrown, in effecting all the movements required from the human frame. In some of the operations in which we en- gage, nearly the whole, and in others only a part, of the muscles are thrown into action atone time. The simultaneousness of action which obtains in such in- stances—which occurs in almost every act of life, however simple—and without which no dictate of the will could be harmoniously and successfully obeyed, depends solely on the distribution and connexions of the nerves which animate the muscles. Every indi- vidual fibre of every muscle is supplied with" nervous filaments, and different fibres of the same muscle are indebted for the simultaneousness of their excitement to the connexion established between each of them by these filaments. Wherever many muscles com- bine to execute an important movement, they are uniformly found to be provided with, and connected by, branches from the same system of nerves; as, 110 INFLUENCE OF NERVES without this means, simultaneousness and harmony of action could not be ensured. Thus the muscles which cover the upper part of the chest co-operate in the voluntary movements of the arm, and, at the same time, in the respiratory movements of the chest; but these, being two distinct purposes, require differ- ent combinations of the muscles among themselves. To effect these combinations, two sets of nerves are provided, as has been shown by Sir Charles Bell; the one regulating the respiratory, and the other the purely voluntary movements of the muscles. This is the true reason why the same muscle sometimes re- ceives nerves from two or three different quarters; a circumstance which, before the principle was discov- ered, and when all nerves were considered alike, was altogether inexplicable, and seemed a work of mere supererogation. The influence of the nervous agency may be still farther illustrated. When the trunk of a muscular nerve is irritated by the contact of an external body or by the electric spark, the muscles which it sup- plies instantly contract, but without either harmony or permanence of motion : the contraction is like the violent and ill-regulated start of convulsion. It is the influence of the brain and mind in the equal diffusion of the required stimulus to each muscle, in the exact proportion needful, that characterizes healthy and sustained voluntary motion, as opposed to the irreg- ular convulsive start. Nothing can be more wonder- ful than the accuracy with which, in the most delicate movements, this stimulus is adjusted and apportioned to such a variety of parts, particularly where practice, or, in other words, education, has rendered the combi- nation of powers easy and certain. Not to mention the more obvious and graceful movements of dancing, fencing, and riding, we discover, in the management of the hand and fingers by engravers, sculptors, watch- makers, jugglers, and other artists and mechanics, a minute accuracy of muscular adjustment to effect a given end, which is the more surprising the more we consider the complicated means by which it is ef- fected. ON MUSCULAR ACTION. Ill In consequence of the co-operation of both nerve and muscular fibre being required to effect motion, excess of action in each is followed by results peculiar to itself. If the nerves preponderate, either consti- tutionally or from over-exercise, as they are apt to do in highly nervous temperaments, their excessive irritability renders them liable to be unduly excited by ordinary stimuli; and hence, as in hysteric and nervous females, a proneness to sudden starts, cramps, and convulsions, from causes which would scarcely affect an individual differently constituted. Such per- sons have little muscular power, except under excite- ment ; they then become capable of great efforts of short duration, but sink proportionally low when the stimulus is past. If, on the other hand, the mus- cles predominate, as in athletic, strong-built men, the nervous system is generally dull and little sus- ceptible of excitement, and the muscles which it an- imates are, consequently, little prone to the rapid and vivacious action that accompanies the predominance of the nervous functions. Great strength and capa- bility of bodily labour are then the characteristics. Great muscular power and intense nervous action are rarely conjoined in the same individual; but, when they do happen to meet, they constitute a per- fect genius for muscular exertion, and enable their possessor to perforin feats of strength and agility, which appear marvellous to those who are deficient in either condition. The most successful wrestlers and gladiators among the ancients seem to have owed their superiority chiefly to the possession of both en- dowments in a high degree; and among the moderns, the most remarkable combination of the two qualities is exhibited by some of our harlequins, clowns, rope- dancers, and equestrian performers, and also by those who display their strength and power of equilibrium in balancing wheels, ladders, or other heavy bodies, on the chin; and whose performances require from the small muscles of the jaw and neck a force of con- traction which, when reduced to calculation, almost exceeds belief. Belzoni combined both conditions in a high degree. f 1*5 NATURE OF MUSCULAR ACTION. From the general resemblance which characterizes the different nerves, a similarity in function was long ascribed to them all, and no explanation could be given why one muscle sometimes received filaments from a variety of nervous trunks. Recently, howev- er, the labours of Sir Charles Bell, Mayo, Magendie, and Bellingeri have clearly established that in such cases each nerve serves a distinct purpose in com- bining the movements of the particular muscles with those of others necessary to effect a given end; and that without this additional nerve, such a combination could not have been produced. The muscular nerves must not be confounded with those which we have seen ramified on the skin for the purposes of sensa- tion. The former are provided for the purposes of motion and not of feeling, and hence muscles may be cut or injured with little pain, compared to what is felt by the skin. Weariness is the sensation recog- nised by one set of muscular nerves. So uniformly is a separate instrument provided for every additional function, that there is strong reason to regard the muscular nerves, although running in one sheath, as in reality double, and performing dis- tinct functions. Sir Charles Bell has the merit of this discovery, if such it shall ultimately prove to be. In his work on the Nervous System, he endeavours to show that one set of nervous fibres conveys the man- date from the brain to the muscle, and excites the con- traction ; and that another conveys from the muscle to the brain a peculiar sense of the state or degree ol contraction of the muscle, by which we are enabled to judge of the amount of stimulus necessary to ac- complish the end desired, and which is obviously an indispensable piece of information to the mind in reg- ulating the movements of the body. Sir Charles has shown that many of the sensations supposed to be derived from the sense of touch and the skin, arise from the muscular sense, and are wholly impercepti- ble to the skin, without the co-operation of muscular contraction. " The muscles have two nerves," says Sir Charles, NATURE OF MUSCULAR ACTION. 113 " which fact has not hitherto been noticed, because they are commonly bound up together. But when- ever the nerves, as about the head, go in a separate course, we find that there is a sensitive nerve and a motor nerve distributed to the muscular fibre, and we have reason to conclude that those branches of the spinal nerves which go to the muscles, consist of a motor and a sensitive filament. " It has been supposed hitherto, that the office of a muscular nerve is only to carry out the mandate of the will, and to excite the muscle to action; but this betrays a very inaccurate knowledge of the action of the muscular system; for, before the muscular sys- tem can be controlled under the influence of the will, there must be a consciousness or knowledge of the condition of the muscle. " When we admit that the various conditions of the muscle must be estimated or perceived in order to be under the due control of the will, the natural question arises, Is that nerve which carries out the mandate of the will capable of conveying, at the same moment, an impression retrograde to the course of that influ- ence which is going from the brain to the muscle ! If we had no facts in anatomy to proceed upon, still reason would declare to us that the same filament of a nerve could not convey a motion, of whatever na- ture that motion maybe, whether vibration or motion of spirits, in opposite directions at the same moment of time. " I find that, to the full operation of the muscular power, two distinct filaments of nerves are necessary, and that a circle is established between the sensori- um and the muscle ; that one filament or single nerve carries the influence orthe will towards the muscle,, which nerve has no power to convey an impression backward to the brain; and that another nerve con- nects the muscle with the brain, and, acting as a sen- tient nerve, conveys the impression of the condition of the muscle to the mind, but has no operation in a direction outward from the brain towards the muscle,, K2 114 NATURE OF MUSCULAR ACTION. and does not, therefore, excite the muscle, however irritated."* This consciousness of the state of the muscles, or muscular sense, as it may be truly called, is of great importance both to man and to animals, as it is neces- sarily by information thence derived, that every sub- sequent exertion is directed and apportioned in in- tensity to the effort required to be made. If we had no such sense, the delicate and well-directed touches of the engraver, painter, and sculptor, or of the inge- nious mechanic, would be at the mercy of hazard; and a single disproportioned movement might ruin the successful labour of months, supposing success to be in reality compatible with chance. Without this sense, man could not deliberately proportion the mus- cular efforts to his real wants; and, even in walking, his gait would be unsteady and insecure, because there would be no harmony between effort and resist- ance. The loss of equilibrium, and the concussion and disturbance of the system consequent upon ta- king a false step, as it is called,are a specimen of what we would always be subject to without the guidance of the muscular sense. When we imagine we have one step more of a stair to descend than really exists, we are placed nearly in the same circumstances as if we had no muscular sense to direct the extent of our intended movement; because,misled by an erroneous impression, we make an effort grievously unsuited to the occasion; and yet so habitually are we protected from this error by the assistance of the sense alluded to, and so little are we conscious of its operation, that it is only after mature reflection that we perceive the necessity of its existence. In chewing our food, in tun ingthe eye towards an • object looked at, in raising the hand to the mouth, and, in fact, in every variety of muscular movement which wc perform, we are guided by the muscular sense in proportioning the effort to the resistance to be overcome; and, where this harmony is destroyed * Bell's A-atomy, seventh edition, vol. ii., p. 372. NATURE OF MUSCULAR ACTION. 115 by disease, the extent of the service rendered us be- comes more apparent. The shake of the arm and hand which we see in drunkards, and their consequent incapability of carrying the morsel directly to the mouth, are examples of what would be of daily occur- rence, unless we were directed and assisted by a mus- cular sense. Life and the nervous stimulus are essential to mus- cular power. Separated from the body and deprived of both, the muscle which formerly contracted with a power equal to 100 pounds would be torn asunder by a weight of ten. This fact is of itself sufficient to give a tolerable notion of the extent to which muscu- lar contraction depends on other causes than the mere structure of the fleshy fibres ; for that structure continues unaltered for some time after death, and after the nervous communication has been suspend- ed ; and yet how feeble is the power of resistance which the muscle then possesses ! The required movement having been once effected by the nervous impulse stimulating the muscular fibre to contraction, relaxation speedily follows, and is in its turn succeeded by a fresh contraction proportion- ed to the object in view. Muscular action, therefore, consists properly in alternate contraction and relaxation of the fleshy fibres. A state of permanent contraction is both unnatural and impossible; and, accordingly, the most fatiguing muscular employment to which a man can be subjected, is that of remaining immovea- ble in any given attitude. To an unreflecting person it may seem a very easy and pleasant service to stand for half a day in the attitude of an Apollo or a Gladi- ator, as a model to a statuary; but, on trying it, he will find, to his astonishment, that stonebreaking or the treadmill are pastimes in comparison : in the one case, the muscles which preserve the attitude are kept incessantly on the strain ; while in the other, they en- joy that play and variety of motion for which they were destined by nature. We may easily put the fact to the test, by attempting to hold the arm extend- ed at a right angle to the body for the short space of 116 EVILS RESULTING FROM INACTIVITY ten minutes. He whose muscles, if indeed capable of the exertion, do not feel sore with fatigue at the end of that time, may think himself peculiarly fortu- nate in being blessed with a powerful constitution. The principle just stated explains very obviously the weariness, debility, and injury to health, which in- variably follow forced confinement to one position or to one limited variety of movement, as is often wit- nessed in the education of young females. Alternate contraction and relaxation, or, in other words, exer- cise of the muscles which support the trunk of the body, are the only means which, according to the Cre- ator's laws, are conducive to muscular development, and by which bodily strength and vigour can be se- cured. Instead of promoting such exercise, however, the prevailing system of female education places the muscles of the trunk, in particular, under the most unfavourable circumstances, and renders their exer- cise nearly impossible. Left to its own weight, the body would fall to the ground, in obedience to the ordinary law of gravitation : in sitting and standing, therefore, as well as in walking, the position is pre- served only by active muscular exertion. But if we confine ourselves to one attitude, such as that of sit- ting erect upon a chair, or, what is still worse, on benches without backs, as is the common practice in schools, it is obvious that we place the muscles which support the spine and trunk in the very disadvanta- geous position of permanent instead of alternate con- traction; which we have seen to be in reality more fatiguing and debilitating to them than severe labour. Girls thus restrained daily for many successive hours, invariably suffer, being deprived of the sports and ex- ercise after schoolhours which strengthen the mus- cles of boys, and enable them to withstand the op- pression. The muscles being thus enfeebled, the girls either lean over insensibly to one side, and thus con- tract curvature of the spine, or, their weakness being perceived, they are forthwith cased in stiffer and stronger stays, that support being sought for in steel and whalebone which Nature intended they should OF THE MUSCULAR SYSTEM. 117 obtain from the bones and muscles of their own bod- ies. The patient, finding the maintenance of an erect carriage (the grand object for which all the suf- fering is inflicted) thus rendered more easy, at first welcomes the stays, and, like her teacher, fancies them highly useful. Speedily, however, their effects show them to be the reverse of beneficial. The same want of varied motion, which was the prime cause of the muscular weakness, is still farther aggravated by the tight pressure of the stays interrupting the play of the muscles, and rendering them in a few months more powerless than ever. In spite, however, of the weariness and mischief which result from it, the same system is persevered in; and, during the short time allotted to that nominal exercise, the formal walk, the body is left almost as motionless as before, and only the legs are called into activity. The natural conse- quences of this treatment are debility of the body, curvature of the spine, impaired digestion, and, from the diminished tone of all the animal and vital func- tions, general ill health; and yet, while we thus set Nature and her laws at defiance, we presume to ex- press surprise at the prevalence of female deformity and disease ! It would be easy, were it required, to prove that the picture here drawn is not overcharged. A single in- stance, from a note appended by Dr. Forbes to an ex- cellent treatise on "Physical Education," by Dr. Bar- low, of Bath, will suffice. After copying the pro- gramme of a boarding-school for young ladies, which exhibits only one hour's exercise, consisting of a walk, arm in arm, on the high road, and that only when the weather is fine at the particular hour allotted to it, in contrast with nine hours at school or tasks, and three and a half at optional sudies or work, Dr. Forbes adds : " That the practical results of such an astound- ing regimen are by no means overdrawn in the pre- ceding pages, is sufficiently evinced by the following fact; a fact which, we will venture to say, may be veri- fied by inspection of thousands of boarding-shools in this country. We lately visited in a large town a board- 118 EVILS RESULTING FROM INACTIVITY ing-school containing forty girls; and we learned, on close and accurate inquiry, that there was not one of the girls who had been at the school two years (and the majority had been as long) that was not more or less crooked ! Our patient was in this predicament; and we could perceive (what all may perceive who meet that most melancholy of all processions, a boarding-school of young ladies in their walk) that all her companions were pallid, sallow, and listless. We can assert, on the same authority of personal observation, and on an extensive scale, that scarcely a single girl (more espe- cially of the middle classes) that has been at a boarding- school for two or three years, returns home with unim- paired health; and for the truth of the assertion we may appeal to every candid father whose daughters have been placed in this situation."* Dr. Barlow justly remarks, that the superintendents of such schools cannot generally be blamed for indif- ference about the welfare of their pupils ; that most of them are extremely anxious to do their utmost to improve those under their charge ; and that it is igno- rance alone which misleads them as to the proper means : he might have adverted also to the ignorance of parents, who insist on so many hours a day being dedicated to the study of accomplishments for which their children have neither taste, capacity, nor use. From similar ignorance, the young girls in a public hospital in this country used to be shut up in the hall and schoolroom during playhours from November till March, and no romping or noise, in other words, no real play, relaxation, or exercise, allowed; and in 1830,31, from fear of typhus fever, they were seldom, if ever, out of doors, except at church, from November to April; than which a more efficient method of infrin- ging the laws of health could scarcely have been de- vised. Here, too, the object was unquestionably be- nevolent, but the method was radically bad ; and, in consequence, a great deal of sickness prevailed. The reality of the mischief done in this way was « Cyclopaedia of Practical Medicine, Article Physical Educa- tion, vol. 1., p. 698. OF THE MUSCULAR SYSTEM. 119 forcibly pointed out by Mr. Carmichael, of Dublin, in his excellent " Essay on the Nature of Scrofula," pub- lished so long ago as 1810, and which contains many valuable practical truths, which were then little known and coolly received, but to which great importance is now generally attached. In noticing the want of ex- ercise as a cause of scrofula, Mr. Carmichael men- tions, that in St. Thomas's Parochial School, seven out of twenty-four girls were affected with that disease during the preceding summer, owing to their exercise having been entirely interrupted, first, by the flooding of the playground by heavy rains, and subsequently by the mistress having received orders " to keep the chil- dren perpetually within doors at their schoolfiooks." In a very short time after " this cruel and impolitic injunc- tion" was acted upon, scrofula began to make its ap- pearance, and afterward affected nearly a third of their number; although none of them had the disease when admitted, and there was no fault of diet or other cause to which it could be ascribed. Mr. Carmichael adds that, in the Bethesda School of the same city (Dublin), six out of thirty girls, fed in the best possible manner, and free from the disease on their admission, were badly affected with it during the same summer. In these cases it evidently arose from their having nei- ther yard nor playground attached to the institution, in consequence of which " the children were necessi- tated to remain either in the school or bedrooms during playhours." On ascertaining this fact, Mr. Carmi- chael remonstrated with the governors, and the evil no longer exists; but the circumstance itself affords an instructive example of the extent of misery which may arise, not from the institutions of Nature, as we are so apt to affirm, but from sheer ignorance on our own part of what these institutions are. Mr. Carmichael adduces other facts of a striking nature, for which I must refer to the work itself, to show the needless suffering which is still inflicted on thousands by the sedentary and unvaried occupations which follow each other for hours in succession in many of our schools, and I agree with him that it is 120 ADVANTAGE OF COMBINING MENTAL high time that a sound physiology should step in to root out all such erroneous and hurtful practices. Taken in connexion with the long confinement, the custom of causing the young to sit on benches without any suppor*. to the back, and without any variety of mo- tion, cannot be too soon exploded. If the muscles of the spine were so strengthened by the exercise which they require, but which is so generally denied; and if the school employments were varied or inter- rupted at reasonable intervals, to admit of change of position and of motion, nothing could be better adapt- ed for giving an easy and erect carriage than seats without backs, because the play of the muscles ne- cessary for preserving the erect position would give them activity and vigour; and, accordingly, the want is scarcely, if at all, felt in infant schools, for the very reason that such variety of motion is, in them, care- fully provided for. But it is a gross misconception to suppose that the same good result will follow the absence of support, when the muscles are weakened by constant straining and want of play. The inces- sant and fidgety restlessness observable after the Becond or third hour of common school confinement, shows the earnest call of Nature for a little whole- some exercise; and the quiet that ensues when it is granted, indicates clearly enough that the restlessness springs even more from bodily than from mental wea- riness. It is, in fact, a degree of what we all feel when kept long standing on our feet or sitting at a desk. We become weary and uneasy from the continued strain on the same muscles, and feel at once relieved by a walk, a drive, or any change whatever. The same principle explains the fatigue so often com- plained of, as experienced in " shopping" or in an ex- hibition-room. We saunter about till the muscles become sore from the fatigue of being always in the same attitude, and we are refreshed by a walk or a dance, or anything which alters the position. The same languor of the muscles is felt after witnessing a pantomime, or other continuous spectacle, by which we are induced to keep the neck for a long time in a WITH MUSCULAR EXERCISE. 121 constrained and unvaried position. Children with thin bodies, weak muscles, and large heads, some- times suffer much by being taken to church, and, that due respect may be shown to the sanctity of the place, not allowed by their parents to lean their heads on the board, or on the arm of the person sitting next them, so as to support themselves more easily. Instead, therefore, of so many successive hours being devoted to study and to books, the employments of the young ought to be varied and interrupted by proper intervals of cheerful and exhilarating exercise, such as is derived from games of dexterity, which de- mand the co-operation and society of companions, or from sonic kind of manual labour in which skill and ingenuity are required, such as carpentry, turning, or gardening. This is infinitely preferable to the solemn processions which are so often substituted for exercise, and which are hurtful, inasmuch as they delude parents and teachers into the notion that they constitute in reality that which they only counterfeit and supersede. We have already seen what an im- portant part the mental stimulus and nervous impulse perforin in exciting, sustaining, and directing mus- cular activity; and observation proves that muscular contraction becomes relatively difficult and inefficient, when the mind, which directs it, is languid, or absorbed by other employments.- The playful gambolling and varied movements which are so characteristic of the young of all animals, man not excepted, and which are at once so pleasing and so beneficial, show that, to render it beneficial in its fullest extent, Nature re- quires amusement and sprightliness of mind to be combined with, and be the source of, muscular exer- cise ; and that, when deprived of this healthful con- dition, it is a mere evasion of her law, and is not fol- lowed by a tithe of the advantages resulting from its real fulfilment. The buoyancy of spirit and compar- ative independence enjoyed by boys when out of school, prevent them suffering so much from this cause as girls do; but the injury inflicted on both is the more unpardonable, on account of the ease with L 122 ADVANTAGE OF COMBINING MENTAL which it might be entirely avoided. In some infant schools which have no playground attached to them, the necessity of frequent and playful muscular exer- cise in the open air is shamefully disregarded, to the great injury of the poor children confined in them. Facts illustrative of the influence of mental, co-op- erating with and aiding muscular activity, must be familiar to every one; but as the principle on which they depend is not sufficiently attended to, I shall add a few additional remarks. Everybody knows how wearisome and disagreeable it is to saunter along, without having some object to attain; and how listless and unprofitable a walk taken against the inclination and merely for exercise is, compared to the same exertion made in pursuit of an object on which we are intent. The difference is simply, that, in the former case, the muscles are obliged to work without that full nervous impulse which nature has decreed to be essential to their healthy and energetic action; and that, in the latter, the nervous impulse is in full and harmonious opera tion. The great superiority of active sports, botan- ical and geological excursions, gardening, and turning, as means of exercise, over mere measured move- ments, is referable to the same principle. Every kind of youthful play and mechanical operation in- terests and excites the mind, as well as occupies the body; and by thus placing the muscles in the best position for wholesome and beneficial exertion, ena- bles them to act without fatigue for a length of time, which, if occupied in mere walking for exercise, would utterly exhaust their powers. The elastic spring, bright eye, and cheerful glow of beings thus excited, form a perfect contrast to the spiritless and inanimate aspect of many of our board- ing-school processions; and the results in point of health and activity are not less different. So influ- ential, indeed, is the nervous stimulus, that examples have occurred of strong mental emotions having in- stantaneously given life and vigour to paralytic limbs. This has happened in cases of shipwrecks, fires, and WITH MUSCULAR EXERCISE. 123 aeafights, and shows how indispensable it is to have the mind engaged and interested along with the mus- cles. Many a person who feels ready to drop from fatigue after a merely mechanical walk, would have no difficulty in subsequently undergoing much con- tinuous exertion in active play or in dancing; and it is absurd, therefore, to say that exercise is not bene- ficial, when, in reality, proper exercise has not been tried. The amount of bodily exertion of which soldiers are capable, is well known to be prodigiously in- creased by the mental stimulus of pursuit, of fighting, or of victory. In the retreat of the French from Mos- cow, for example, when no enemy was near, the sol- diers became depressed in courage and enfeebled in body, and nearly sank to the earth through exhaustion and cold ; but no sooner did the report of the Russian guns sound in their ears, or the gleam of hostile bay- onets flash in their eyes, than new life seemed to per- vade them, and they wielded powerfully the arms which, a few moments before, they could scarcely drag along the ground. No sooner, however, was the enemy repulsed, and the nervous stimulus which animated their muscles withdrawn, than their feeble- ness returned. Dr. Sparrman, in like manner, after describing the fatigue and exhaustion which he and his party endured in their travels at the Cape, adds, M yet, what even now appears to me a matter of won- der is, that as soon as we got a glimpse of the game, all this languor left us in an instant." On the principle already mentioned, this result is perfectly natural, and in strict harmony with what we observe in sports- men, cricketers, golfers, skaters, and others, who, moved by a mental aim, are able to undergo a much greater amount of bodily labour than men of stronger muscular frames, actuated by no excitement of mind or vigorous nervous impulse. I have heard an intel- ligent engineer remark the astonishment often felt by country people at finding him and his town compan- ions, although more slightly made, withstand the fa- tigues and exposures of a day's surveying better than 124 ADVANTAGE OF COMBINING MENTAL themselves; but, said he, they overlooked the fact that our employment gives to the mind as well as to the body a stimulus which they were entirely without, as their only object was to afford us bodily aid when required, in dragging the chains or carrying our in- struments. The conversation of a friend is, in the same way, a powerful alleviator of the fatigue of walking. The same important principle was implied in the advice which the Spectator tells us was given by a physician to one of the eastern kings, when he brought him a racket, and told him that the remedy was con- cealed in the handle, and could act upon him only by passing into the palms of his hands when engaged in playing with it; and that, as soon as perspiration was induced, he might desist for the time, as that would be a proof of the medicine being received into the general system. The effect, we are told, was mar- vellous ; and, looking to the principle just stated, to the cheerful nervous stimulus arising from the confi- dent expectation of a cure, and to the consequent ad- vantages of exercise thus judiciously managed, we have no reason to doubt that the fable is in perfect accordance with nature. The story of an Englishman who conceived himself so ill as to be unable to stir, but who was prevailed upon by his medical advisers to go down from London to consult an eminent physician at Inverness who did not exist, may serve as another illustration. The stimulus of expecting the means of cure from the northern luminary was sufficient to enable the patient not only to bear, but to reap benefit from, the exer- tion of making the journey down; and his wrath at finding no such person at Inverness, and perceiving that he had been tricked, sustained him in returning, so that, on his arrival at home, he was nearly cured. Hence also the superiority of battledore and shuttle- cock, and similar games, which require society and Borne mental stimulus, over listless exercise. It is, in fact, a positive misnomer to call a solemn proces- sion exercise. Nature will not be cheated; and the WITH MUSCULAR EXERCISE. 125 healthful results of complete cheerful exertion will never be attained where the nervous impulse which animates the muscles is denied. It must not, however, be supposed, that, a walk simply for the sake of exercise can never be benefi- cial. I f a person be thoroughly satisfied that exercise is requisite, and perfectly willing, or, rather, desirous, to obey the call which demands it, he is from that very circumstance in a state fit for deriving benefit from it, because the desire then becomes a sufficient nervous impulse, and one in perfect harmony with the muscular action. It is only where a person goes to walk, either from a sense of duty or at the com- mand of another, but against his own inclination, that exercise is comparatively useless. The advantages of combining harmonious mental excitement with muscular activity have not escaped the sagacity of the late Dr. Armstrong, who thus no- tices them in his frequently reprinted Poem on the Art of Preserving Health, but without giving the phys- iological explanation: " In whate'er you sweat Indulge your taste. Some love the manly toils, The tennis some, and some the graceful dance; Others, more hardy, range the purple heath Or naked stubble, where, from field to field, The sounding covies urge their lab'ring flight, K.i2er amid the rising cloud to pour The gun's unerring thunder ; and there are Whom still the mead of the green archer charm. He chooses best whose labour entertains His vacant fancy most; THK TOIL YOU HATE Fatigues you soon, and scarce improves your limbs." Book III. This constitution of Nature, whereby a mental im- pulse is required to direct and excite muscular ac- tion, points to the propriety of teaching the young to observe and examine the qualities and arrangements of external objects. The most pleasing and health- ful exercise may be thus secured, and every step be made to add to useful knowledge and to individual L3 126 EFFECTS OF EXERCISE ON THE MUSCLES. enjoyment. The botanist, the geologist, and the nat- ural historian, experience pleasures in their walks and rambles, of which, from disuse of their eyes and observing powers, the multitude is deprived. This truth is acted upon by many teachers in (iermany. In our own country, too, it is beginning to be felt, and one of the professed objects of infant education is to correct the omission. It must not, however, be sup- posed that any kind of mental activity will give the necessary stimulus to muscular action, and that, in walking, it will do equally well to read a book or carry on a train of abstract thinking, as to seek the necessary nervous stimulus in picking up plants, ham- mering rocks, or engaging in games. This were a great mistake ; for in such cases the nervous impulse is opposed rather than favourable to muscular action. Ready and pleasant mental activity, like that which accompanies easy conversation with a friend, is in- deed beneficial by diffusing a gentle stimulus over the nervous system; and it may be laid down as a general rule, that any agreeable employment of the mind that does not require a considerable effort of at- tention adds to the advantages of muscular exercise : but wherever the mind is absorbed in reading or in abstract speculation, the muscles are drained, as it were, of their nervous energy, by reason of the great exhaustion of it by the brain ; the active will to set them in motion is proportionally weakened, and their action is reduced to that inanimate kind 1 have already condemned as almost useless. For true and benefi cial exercise, there must, in cases where the mind is seriously occupied, be harmony of action between the moving power and the part to be moved. The will and the muscles must be both directed to the same end at the same time, otherwise the effect will be imperfect. The force exerted by strong muscles, animated by strong nervous impulse or will, is prodigiously greater than when the impulse is weak; and as man was made not to do two things well at once, but to direct his whole powers to the one thing he is performing at the time, he has ever excelled most when he has followed this law of his nature. EFFECTS OF EXERCISE ON THE MUSCLES. 127 When a physician urges the necessity of exercise, it is very usual for him to be told by persons of an in- dolent or sedentary habit, that even a short walk fa- tigues them so much as to render them unfit for every- thing for some days after, and that they are never so well as when allowed to remain in the house. But if, in perfect reliance on the regularity of the Crea- tor's laws, we seek out the cause of this apparent ex- ception, we shall almost uniformly find, that, instead of beginning with a degree of exertion proportioned to the weakened state of the system, such persons have (under the notion that it was not worth while to go out for a short time) forced their muscles, already weakened by inactivity and confinement, to perform a walk to which only regularly exercised muscles were adequate. The amount of exertion which is always followed by exhaustion is thus, through mere impatience and ignorance, substituted for that lesser degree which always gives strength; and because the former is followed by headache and debility, it is ar- gued that the latter also must be prejudicial! Many sensible people delude themselves by such puerile plau- sibilit'.es; and it is only by the diffusion of a knowledge of the laws of exercise as part of a useful education, that individuals can be enabled to avoid such mis- takes. The effects of exercise upon the organs employed are very remarkable, and useful to be known. When any living part is called into activity, the processes of waste and renovation, which are incessantly going on in every part of the body, proceed with greater rapid- ity, and in due proportion to each other. At the same time the vessels and nerves become excited to higher action, and the supply of arterial or nutritive blood and of nervous energy becomes greater. When the active exercise ceases, the excitement thus given to the vital functions subsides, and the vessels and nerves return at length to their original state. If the exercise be resumed frequently and at mod- erate intervals, the increased action of the bloodves- sels and nerves becomes more permanent, and does 128 RULES FOR MUSCULAR EXERCISE. not sink to the same low degree as formerly ; nutri- tion rather exceeds waste, and the part gains, consequent- ly, in size, vigour, and activity. But if the exercise be resumed too often or be carried too far, so as to fa- tigue and exhaust the vital powers of the part, the re- sults become reversed : waste then exceeds nutrition, and a loss of volume and of power takes place, ac- companied with a painful sense of exhaustion and fa- tigue. When, on the other hand, exercise is alto- gether refrained from, the vital functions decay from the want of their requisite stimulus; little blood is sent to the part, and nutrition and strength fail in equal roportion. A limb which has been long in disuse ecomes weak and shrivelled from this cause, and its muscles present an unusual paleness and flabbiness, strongly contrasting with the florid redness and rigid fulness of the muscles of a well-exercised limb. Even sensation gives faithful notice of these chan- ges, and therefore serves as a guide to exercise. When muscular employment is neglected, the body becomes weak, dull, and unfit for powerful efforts, and all the functions languish. When exercise is taken regularly and in due proportion, a grateful sense of activity and comfort prevails, and we feel ourselves fit for every duty, both mental and bodily. Lastly, when we are subjected to excessive exertion, a pain- ful sense of weariness and exhaustion ensues, which is not relieved by rest, and which for a long time prevents sleep. A person who has greatly overfa- tigued himself in walking, for example, is feeble and restless; and, on lying down, either cannot sleep at all, and rises in the morning weak in body and languid in mind, or has uneasy and disturbed sleep till the ex- haustion is partially recovered from, after which he may enjoy sound and refreshing repose. From this exposition of the effects of exercise in its different stages, it becomes easy to deduce rules applicable to all for promoting the healthy develop- ment of the muscular system, and to trace the errors by which indolent people are accustomed to maintain that exercise is hurtful to their constitutions. The I RULES FOR MUSCULAR EXERCISE. 129 second stage of exercise, or that in which, by Us frequen- cy, moderation, and regularity, nutrition and vigour are preserved at their highest pilch, is, of course, to be aimed at; but the quantity of exercise which corresponds to it must vary according to the constitution and pre- vious habits of the individual, as is well exemplified in training for pedestrian feats, for the ring, and for racing. The assertion made by many, that exercise hurts them, arises entirely from overlooking this cir- cumstance. A person accustomed to daily activity will feel in- vigorated by a walk of four or five miles in the open air, whereas the same distance will weaken another who has not been in the habit of walking at all. But instead of inferring from this, as is often done, that exercise in the open air is positively hurtful to the latter, reason and experience coincide in telling us that he has erred only in over-tasking the powers of his system, and that, to acquire strength and activity, he ought to have begun with one mile, and to have gradually extended his walk in proportion as the mus- cles became invigorated by the increased nutrition consequent on well-regulated exercise. A person recovering from fever begins by walking across his room perhaps ten times in a day, and gradually ex- tends to twenty or thirty times, till he gains strength to go into the open air. On going out, a walk often minutes proves sufficient for him at first; but, by de- grees, his strength and flesh increase, and his exercise is prolonged till he arrives at his usual standard. Such is the order of Nature; but many sedentary peo- ple have no patience for such slow progress, and, when urged to take exercise, they grudge the trouble of going out for a short time, and think that, if a walk of half a mile does them good, one of a whole mile will do more ; and when they suffer from the error, they shelter their ignorance under the general assump- tion that exercise does not agree with them ! And the same persons who argue thus would think them- selves entitled to laugh at the Irishman who, finding himself relieved by five pills taken at night, inferred 130 MENTAL AND MUSCULAR EXERCISE. that he would necessarily be cured if he took the whole boxful at once, and, on doing so, narrowly es- caped with his life. From these principles it follows, first, that, to be beneficial, exercise ought always to be proportioned to the strength and constitution, and not carried be- yond the point, easily discoverable by experience, at which waste begins to succeed nutrition, and exhaus- tion to take the place of strength; secondly, that it ought to be regularly resumed after a sufficient inter- val of rest, in order to ensure the permanence of the healthy impulse given to the vital powers of the mus- cular system; and, lastly, that it is of the utmost con- sequence to join with it a mental and nervous stimu- lus. Those who go out only once in four or five days are always at work but never advancing; for the in- creased action induced by the previous exercise has fully subsided long before the succeeding effort is begun; and, so far as increased nutrition, strength, and greater aptitude for exertion are concerned, no progress whatever is made. CHAPTER V. EFFECTS OF, AMD 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 Kxercise.—Al- ways to be taken in the open Air.—Different Kinds—Walking —Ruling —Dancing — Gymnastics— Fencing— Shuttlecock — Reading aloud—Case illustrative of the Principles of Exer- cise.—Involuntary Muscles. Wk have seen that exercise is necessary for de- veloping and improving the health of the muscular system; but it still remains for us to explain how it acts in imparting tone and strength to the rest of the body, and to mention the circumstances by which its employment ought to be regulated. Man being intended for a life of activity, all his functions are constituted by Nature to fit him for this object, and they never go on so successfully as when his external situation is such as to demand the regular exercise of all his organs. It is, accordingly, curious to observe the admirable manner in which each is linked in its action and sympathies with the rest. When the muscular system, for example, is duly ex- ercised, increased action in its vessels and nerves takes place, as already observed; but the effect is not by any means limited to the mere organs of motion. The principal bloodvessels in all parts of the body he imbedded among muscles, both for the protection and for the aid which the latter afford them. Every con- traction of the muscles compresses and lessens the diameter of the vessels; and as the blood contained in them cannot retrograde in its course, it is pronc- ted in the arteries from the heart towards the .breme Earts, and in the veins from the latter t" ards the eart, with greater force and velocity than before. 132 BENEFIT OF MUSCULAR EXERCISE. This will be better understood on examining the annexed engraving of the bloodvessels of the arm, cop- ied from Fyfe's Anatomy. The letters A, B, C, D, E, represent the principal muscles of the arm, and F, G, H, I, K, M, N, those of the forearm; though, as the prepara- tion is dried, and the muscles, con- sequently, much shrunk, they do not appear in their natural situa- tion. The letters in italics point out the humeral artery, which is seen dividing at the elbow into two branches. The one, called the radial artery, passes on the outer side of the forearm towards the thumb, and is the branch in which the pulse is generally felt; the oth- er, called the ulnar, passes along the inner side of the forearm. In the natural state, these blood- vessels are covered and protected in almost their whole course by the adjacent muscles. In conse- quence of this position, the mus- cles cannot contract without at the same time compressing the bloodvessels and propel- ling their contents; for, as we saw in a former chapter, the muscles swell out laterally at every contraction. The assistance afforded to the circulation of the blood by this arrangement is familiarly exemplified in the operation of bloodletting from the arm. When the blood stops or flows slowly, it is customary to put a ball or other hard body into the hand of the patient, and desire him to squeeze and turn it round. The utility of this depends simply on the muscles of the arm compressing the interjacent bloodvessels, and forcing onward the current of the contained blood by their successive contractions. Muscular action is, indeed, one of the powers provided for effecting a BENEFIT OF MUSCULAR EXERCISE. 133 regular circulation; and hence, when its assistance is neglected, as it is by those who take no active ex- ercise, the blood begins to flow less freely, till at last it finds some difficulty in returning against the law of gravitation from the lower extremities, which then gradually swell. People engaged for years in seden- tary professions are thus very subject to varicose or dilated veins and swelled feet. The chain of connexion among all the living func- tions is nowhere more visible than in this relation between muscular exercise and the circulation of the blood. Action requires the presence of arterial blood, and, in the case of the muscles, the very circumstance of their being active favours the circulation and in- creases the supply. This increase, in its turn, ena- bles the parts to which it is sent to act with greater energy and effect, and the augmented action is at- tended by corresponding waste and exhalation, and proportionate nutrition of the parts. To replenish the blood thus exhausted of its nutritive principle, a greater quantity of food is required : and, to prompt us to attend to this condition, the appetite becomes keener and more imperative, and the power of diges- tion proportionally vigorous. The food taken is more speedily converted into chyle, and its absorption from the surface of the intestines and transmission into the circulating current more rapid. That the blood so improved may be properly and quickly animalized in the laboratory of the lungs, respiration becomes deep- er and more frequent, thus admitting a larger quantity of air and freer circulation through them than before; and the blood, in this way renewed and re-endowed with the pabulum of life, imparts fresh nutriment and vigour to all the organs of the body, and fits them for that active exertion which the proper discharge of his duties imperatively requires from every member of the human race. Considered in this point of view, the hurried breath- ing and quickened circulation, of which we are so apt to complain when engaged in muscular exercise, in- stead of being evils, are, in fact, the beneficent means M 134 EVILS OF DEFICIENT EXERCISE. by which we become fitted to continue the exertion. Without a more than usually rapid flow of blood to the part in use, the necessary stimulus to its vessels and nerves could not take place, and its action could not be sustained. But were the bloodvessels not so situated among the muscles as to have their contents propelled more quickly by the compression to which every muscular contraction necessarily subjects them, it is obvious that no increase of circulation could take place. And if respiration, on the other hand, were not to be accelerated, so as to oxygenate the venous blood more quickly as it arrived at the lungs, it is ob- vious that the requisite stimulus must again have failed; as, in that case, the blood must either have accumulated in the lungs and caused death, or have passed through them imperfectly prepared, and extin- guished life more slowly, but not less certainly. It is from this effect of muscular compression in promoting the flow of blood through the arteries and veins, that shampooing, which consists in a kind of kneading of the flesh, is so successfully resorted to in the warm climates of the east, and among the richer class of invalids in our own country, as a substitute for active exercise. Shampooing furnishes from with- Sut that impulse to the circulation which the Creator as destined it to receive from active muscular exer- tion ; and the principle of its action being the same, we cannot wonder that it should prove indisputably useful in promoting circulation, strength, and nutri- tion, in cases where active exercise cannot be en- joyed. Hence also its utility in dispersing indolent swellings, in restoring tone to weakened joints, and in the cure of rheumatism. It is a common observation, that sedentary persons are habitually subject to costiveness and its attendant evils. The reason is the same. In the natural state, the contents of the bowels are propelled partly by the successive contractions of the muscles, which form the walls of the belly and separate that cavity from the ehest, and partly by the contraction of the muscular fibres, which constitute an important part of BEST TIME FOR TAKING EXERCISE. 135 the structure of the intestines themselves. If, how- ever, exercise be refrained from, and the same posi- tion be preserved for many hours a day, as in sitting at a desk, the bowels are necessarily deprived of one important source of power; and, thus weakened, they arc unable to act upon and propel their contents with the same regularity as when assisted by exercise. A slowness of action ensues, which no course of medi- cine, and scarcely any modification of diet, can over- come, so long as sedentary habits are indulged .in; but which also may often be relieved by daily pressing over the region of the abdomen with a kind of knead- ing motion, imitating, though feebly, the effects of muscular action. Females suffer much from intes tinal debility caused by sedentary habits. The evils arising from deficiency of exercise to all the functions of the mind and body will now be equal- ly evident and intelligible, for they are the converse of what we have seen to be the advantages of ade- quate exercise. The circulation, from want of stim- ulus, becomes languid, especially in the extreme ves- sels ; the feebleness of action occasions little waste of materials, and little demand for a new supply ; the appetite and digestion consequently become weak, respiration heavy and imperfect, and the blood so ill conditioned, that, when distributed through the body, it proves inadequate to communicate the stimulus re- quisite for healthy and vigorous action. The concat- enation of causes and consequences thus exhibited, cannot fail, when the principle connecting them is perceived, to interest and instruct every thinking mind. The time at which exercise ought to be taken is of some consequence in obtaining from it beneficial re- sults. Those who are in perfect health may engage in it at almost any hour, except immediately after a full meal; but those who are not robust ought to con- fine their hours of exercise within narrower limits. To a person in full vigour, a good walk in the coun- try before breakfast may be highly beneficial and ex- hilarating; while to an invalid or delicate person, it 136 BEST TIME FOR TAKING EXERCISE. will prove more detrimental than useful, and will in- duce a sense of weariness which will spoil the pleas- ure of the whole day. Many are deceived by the cur- rent poetical praises of the freshness of morning, and hurt themselves in summer by seeking health in un- timely promenades. In order to prove beneficial, exercise must be re- sorted to only when the system is sufficiently vigor- ous to be able to meet it. This is the case after a lapse of from two to four or five hours after a mod- erate meal, and, consequently, the forenoon is the best time. If exercise be delayed till some degree of ex- haustion from the want of food has occurred, it speed- ily dissipates instead of increases the strength which remains, and impairs rather than promotes digestion. The result is quite natural; for exercise of every kind causes increased action and waste in the organ, and if there be not materials and vigour enough in the gen- eral system to keep up that action and supply the waste, nothing but increased debility can reasonably be expected. For the same reason, exercise immediately before meals, unless of a very gentle description, is injurious, and an interval of rest ought always to intervene. Muscular action causes an afflux of blood and nervous energy to the surface and extremities; and if food be swallowed whenever the activity ceases, and before time has been allowed for a different distribution of the vital powers to take place, the stomach is taken at disadvantage, and, from want of the necessary ac- tion in its vessels and nerves, is unable to carry on digestion with success. This is very obviously the case where the exercise has been severe or protract- ed ; and the consequence is so well known, that it is an invariable rule in the management of horses, never to feed them immediately after work, but always to allow them an interval of rest proportioned to the pre- vious labour. "Eat not" therefore, "until you be fully reduced to that temper and moderate heat as when you began, and when the spirits are retired to their BEST TIME FOR TAKING EXERCISE. 137 proper stations."* Even instinct would lead to this conduct, for appetite revives after repose. Active exercise ought to be equally avoided imme- diately after a heavy meal. In such circumstances, the functions of the digestive organs are in the highest dtate of activity; and if the muscular system be then called into considerable action, the withdrawal of the vital stimuli of the blood and nervous influence from the stomach to the extremities, is sufficient almost to stop the digestive process. This is no supposition, but demonstrated fact; and, accordingly, there is a natural and marked aversion to active pursuits after a full meal. In a dog, which had hunted for an hour or two directly after eating, digestion was found, on dissection, to have scarcely begun ; while in another dog, fed at the same time and left at home, digestion was nearly completed. A mere stroll, which requires no exertion and does not fatigue, will not be injurious before or after eat- ing ; but exercise beyond this limit is at such times hurtful. All, therefore, whose object is to improve or preserve health, and whose occupations are in their own power, ought to arrange these so as to observe faithfully this important law, for they will otherwise deprive themselves of most of the benefits resulting from exercise. When we know that we shall be forced to exertion soon after eating, we ought to make a very moderate meal, in order to avoid setting the stomach and mus- cles at variance with each other, and exciting fever- ish disturbance. In travelling by a stagecoach, where no repose is allowed, this precaution is inval- uable. If we eat heartily as appetite suggests, and then enter the coach, restlessness, flushing, and fa- tigue are inevitable; whereas, by eating sparingly, the journey may be continued for two or three days and nights with less weariness than is felt during one fourth of the time under full feeding I observed this when travelling as an invalid on rather iow diet, and * Maynwaringe, p. 141. MS 138 BEST TIME FOR TAKING EXERCISE. was surprised to find myself less fatigued at the end of seventy-two hours, than I had previously been, when in health and living fully, with half the journey ; and 1 have heard the same remark made by others, also from experience. It is the custom in many families and schools, ap- parently for the purpose of saving time, to take young people out to walk about the close of the day, because there is not light enough to do anything in the house. Nothing can be more injudicious than this plan; for, in the first place, exercise once a day is very insufficient for the young; and even supposing that it were enough, the air is then more loaded with moisture, colder, and proportionably more unhealthy, than at any other time ; and, secondly, the absence of the beneficial stimulus of the solar light diminishes not a little its invigorating influence. For those, consequently, who are so little out of doors, as the inmates of boarding- schools and children living in towns, and who are all at the period of growth, the very best times of the day ought to be chosen for exercise, particularly as in-door occupations are, after nightfall, more in ac- cordance with the order of nature. By devoting part of the forenoon to exercise, an- other obvious advantage is gained. If the weather prove unfavourable at an early hour, it may clear up in time to admit of going out later in the day ; where- as, if the afternoon alone be allotted to exercise, and the weather then proves bad, the day is altogether lost. In winter, indeed, it is not unusual for girls to be thus confined from Sunday to Sunday, simply be- cause the weather is rainy at the regular hour of go- ing out. When the muscular system is duly exer- cised in the open air early in the day, the power of mental application is considerably increased ; while, by delaying till late, the efficiency of the whole pre- vious mental labour is diminished by the restless cra- ving for motion which is evinced by the young of all animals, and which, when unsatisfied, distracts atten- tion, and leads to idleness in school. It would be well to copy in this respect the practice adopted in the in- BEST KINDS OF EXERCISE. 139 tant schools, where the children are turned out to play for a few minutes as soon as the wandering of mind and restlessness of body indicate that the one has been too much and the other too little exerted. After such an interval, work goes on briskly again, and every one is alive. To render exercise as beneficial as possible, par- ticularly in educating the young, it ought always to be taken in the open air, and to be of a nature to oc- cupy the mind as well as the body. Gardening, hoe- ing, social play, and active sports of every kind, cricket, bowls, shuttlecock, the ball, archery, quoits, hide-and-seek, and similar occupations and recrea- tions well known to the young, are infinitely prefera- ble to regular and unmeaning walks, and tend in a much higher degree to develop and strengthen the bodily frame, and to secure a straight spine, and an erect and firm, but easy and graceful, carriage. A for- mal walk is odious and useless to many girls, who would be delighted and benefited by spending three or four hours a day in spirited exercise and useful employment. Let those mothers who are afraid to trust to Na- ture for strengthening and developing the limbs and spines of their daughters, attend to facts, and their fears will vanish. It is notorious that a majority of those girls who, in opposition to the laws of Nature, are encased in stays, and get insufficient exercise, become deformed ; an occurrence which is, on the other hand, comparatively rare in boys, who are left, in conformi- ty with the designs of Nature, to acquire strength and symmetry from free and unrestricted muscular action. In a seminary for young ladies, for example, contain- ing forty pupils, it was discovered, on examination, by Dr. Forbes, that only two out of those who had been resident in it for two years had straight spines; while out of an equal number of boys, imperfect as their exercise often is, it would be difficult to discover as many whose spines were not straight. Here, then, is ample proof, that stays and absence of exer- cise, so far from contributing to an elegant carriage, 140 BEST KINDS OF EXERCISE. are directly opposed to its acquisition; and that the absence of stays and indulgence in exercise, even when not carried so far as the wants of the system require, instead of being hurtful to the spine, contrib- ute powerfully to its strength and security. Yet such is the dominion of prejudice and habit, that, with these results meeting our observation in every quar- ter, we continue to make as great a distinction in the physical education of the two sexes in early life, as if they belonged to different orders of beings, and were constructed on such opposite principles that what was to benefit the one must necessarily hurt the other. It is true that there are cases of disease in which the use of stays may be beneficially resorted to ; but, so far from sanctioning their general employ- ment, such cases are sufficient to prove, that, like every other remedy, they ought to be used only under the direction of the medical attendant. Were there any real difficulty in determining the best means of developing the body and preventing de- formity, the comparison of savage with civilized man would at once remove it. Mr. Henry Marshall, in his late excellent work " On the Enlisting, the Dis- charging, and the Pensioning of Soldiers," states, that " lateral curvature of the spine is intimately connect- ed with civilized life. In the male sex, it occurs more frequently among boys who study very closely, clerks, and persons who exercise sedentary trades. The ag- ricultural peasant is seldom affected with it, and the tribes of people commonly denominated savage perhaps never. 1 have had good opportunities of observing the form of the natives of India and of the Malay islands, and I do not recollect having seen a single case of this deformity among them."—P. 21. Mr. Marshall's testimony is strongly supported by an in- telligent old author, who, in describing the Caribs 170 years ago, says, in a tone of regret, " They do not swaddle their infants, but leave them to tumble about at liberty in their little hammocks, or on beds of leaves spread on the earth in a corner of their huts; and, nevertheless, their limbs do not become crooked, DIFFERENT KINDS OF EXERCISE. 141 and their whole body is perfectly well made!" And again, " Although the little creatures are left to roll about on the ground in a stale of nudity, they neverthe- less grow marvellously well, and most of them become so robust as to be able to walk without support at six months old."* The naivete of this expression of surprise at the little Caribs growing marvellously well with the assist- ance of Nature alone, and without the use of stays and bandages imported from Europe, is extremely amusing, and shows to what extent prejudice and custom, once established, will continue to prevail, even where we have before our eyes the strongest evidence of their being hurtful. Our excellent author seems never to have allowed the thought to enter his head, that the Europeans produced the deformity by means of swaddling and bandages, and that the Caribs escaped it simply by avoiding its causes, and giving liberty to both limbs and trunk of the body. It is mentioned of the Araucanian Indians, also, in Stevenson's Narrativeof Twenty Years'Residence in South America, that " the children are never swad- dled, nor their bodies confined by any tight clothing." " They are allowed to crawl about nearly naked until they can walk." " To the loose clothing," adds Mr. Stevenson, " which the children wear from their in- fancy, may doubtless be attributed the total absence of deformity among the Indians."—Vol. i., p. 9,10. Different kinds of exercise suit different constitu- tions. The object, of course, is to employ all the muscles of the body, and to strengthen those espe- cially which are too weak: and hence exercise ought to be often varied, and always adapted to the pecu- liarities of individuals. Speaking generally, walking agrees well with everybody-; but as it brings into play chiefly the lower limbs and the muscles of the loins, and affords little scope for the play of the arms and muscles of the chest, it is insufficient of itself to con- * Histoire Naturelle et Morale des Isles Antilles. Rotterdam M9& 142 WALKING--INJDRIOUS IN EXCESS. stitute adequate exercise; and hence the advantage of combining with it movements performed by the upper half of the body, as in rowing a boat, fencing, shuttlecock, and many other useful sports. Such ex- ercises have the additional advantage of animating the mind, and, by increasing the nervous stimulus, making exertion easy, pleasant, and invigorating. Nature, indeed, has shown her intention that the upper part of the body should always partake in the exer- cise of the lower, by rendering it impossible for us even to walk gracefully without the arms keeping time, as it were, with the movements of the legs. Pedestrian excursions, in pursuit of mineralogical or botanical specimens, or in search of scenery, com- bine in their results all the advantages which well- conducted exercise is capable of yielding, and are much resorted to in the German seminaries, for the purpose of developing the mental and bodily powers. On the Continent generally, more attention is paid to health in the education of the young than with us; and in many institutions a regular system of useful manual occupation is substituted for mere play, and with decided advantage. For not only is the physical organization thereby strengthened and developed, but the mental energy and dignity of character are in- creased, and the mind becomes better fitted for inde- pendent action. Among the ancients the training and invigoration of the body formed a leading object in ed- ucation ; but physical strength having become of less importance in war since the invention of gunpowder, the moderns have too generally restricted their at- tention to the direct improvement of the mind. In summer, walking excursions to the Highlands of Scotland are common among the youth of our cities; and, when proportioned in extent to the constitution and previous habits of the individual, nothing can be more advantageous and delightful. But not a season passes in which health is not sacrificed and life lost by young men imprudently exceeding their natural powers, and undertaking journeys for which they are totally unfit. It is no unusual thing for youths, still EXAMPLES OF VIOLENT EXERCISE. 143 weak from rapid growth, and perhaps accustomed to the desk, to set out in high spirits at the rate of twen- ty-five or thirty miles a day, on a walking excursion, and (in consequence of carrying exercise, for days in succession, to the third degree, or that in which waste exceeds nutrition) to come home so much worn out and debilitated that they never recover. Young sol- diers, whose growth is scarcely finished, are well known to die in great numbers when exposed to long and heavy marches, particularly when food is at the 6ame time scanty. Violent exercise is not less per- nicious, and, as well remarked by Dr. Johnson, " it did great harm even when nations were more in a state of nature than they now are. Galen, in his dis- course on Thrasibulus, inveighs against the athletic practices of the gymnasium. A smart walk of a mile is to a valetudinarian what a furious wrestle would be to an athletic. If we trace those dreadful aneu- rismal affections of the heart and arteries in early life, we shall find their origins in violent exercise or sudden over-exertion, in nine cases out of ten, where age and ossification are not concerned."* Even a single day of excessive fatigue will sometimes suffice to interrupt growth and produce permanent bad health; and I know one instance of a strong young man, who brought on a severe illness and permanent debility by sudden return to hard exercise for a single day, although some years before he had been accustomed to every species of muscular exertion in running, leap- ing, and swimming. Many young men hurry on the premature development of consumption by excessive fatigue during the shooting season, in cases where, by prudent management, they might have escaped it for years, if not altogether. The principle already laid down, of not exceeding the point at which exercise promotes nutrition and increases strength, will serve as a safe guide on all occasions, and indicate the rate at which it may be extended. Old sportsmen know the rulo by experience, and generally prepare themselves • Johnson on Derangement of the Liver, inc., p. 129 144 EXAMPLES OF VIOLENT EXERCISE. for the moors by several weeks of previous training The science and judgment which fox-hunters display in preparing their horses for their future exertions in coursing are well known, and might be still more usefully applied by their riders to the training of their own families. Since the above remarks appeared in the third edi- tion of this volume, I have had occasion to examine carefully two young gentlemen, who, during their at- tendance at Cambridge, were in the habit of using very violent and continued exertion in rowing. In the one the muscles of the arm and upper part of the chest were of an almost unnatural size and hardness from excess of nutrition, while the rest of the body was only mod- erately developed. In the other there was no such disproportion, but there was a liability to palpitations and severe pain in the region of the heart, which, he said, were first brought on by excessive exertion. On cautioning him against the probable consequences of continuing such trials of strength as occurred du- ring their frequent boat-races, he told me that, in look- ing back to his own companions at college, he could name several dead within the last four years whose lives were distinctly ascertained to have been sacri- ficed in this way; a fact strikingly corroborating Dr. Johnson's testimony, and which certainly ought to make a salutary impression in the minds of those who, in the pursuit of pleasure, rush so thoughtlessly into danger. As the subject is one of much practical importance, I may add another melancholy but instructive exam- ple, with which a friend has furnished me, of the op- eration of the principles just inculcated. He says, " A young gentleman whom I knew was employed as a clerk in one of the banks in Edinburgh. He was closely confined to his desk during the summer, and towards the end of July had become weak and ema- ciated from deficient exercise in the open air. His strength continued to decline till Friday the 12th of August, when he went to shoot on Falkirk Moor. On Friday and Saturday he was much fatigued by exces- RIDING ON HORSEBACK—DANCING. 145 fiive and unusual exertion, and on Sunday evening was feverish and heated, and perspired much during the night. In this condition, he rose about three or four o'clock on Monday morning, and returned to Edinburgh on the top of a coach. When he reached home he felt very unwell, but went to the bank. At two o'clock he became so sick as to be unable to sit at his desk. He was then bled by a medical gentle- man, but without much effect; and after passing three months in a feverish and sleepless condition, he died in the beginning of November. He was previously of a healthy constitution." It is more than probable that this young man's life became a sacrifice to his ignorance of the structure and functions of the human body. Riding is a most salubrious exercise, and, where the lungs are weak, possesses a great advantage over walking, as it does not hurry the breathing. It calls into more equal play all the muscles of the body, and, at the same time, engages the mind in the manage- ment of the animal, and exhilarates by the free con- tact of the air and more rapid change of scene. Even at a walking pace, a gentle but universal and constant faction of the muscles is required to preserve the seat, and adapt the rider's position to the movements of the horse; and this kind of muscular action is ex- tremely favourable to the proper and equal circula- tion of the blood through the extreme vessels, and to the prevention of its undue accumulation in the cen- tral organs. The gentleness of the action admits of its being kept up without accelerating respiration, and enables a delicate person to reap the combined advan- tages of the open air and proper exercise for a much longer period than would otherwise be possible. From the tendency of riding to equalize the circula- tion, stimulate the skin, and promote the action of the bowels, it is also excellently adapted as an exercise for dyspeptic and nervous invalids. Dancing is a cheerful and useful exercise, but has the disadvantage of being used within doors, in con- fined air, and often in dusty rooms and at most un- N 146 DANCING—GYMNASTICS. seasonable hours. Practised in the open air and in the daytime, as is common in France, dancing is cer- tainly an invigorating pastime; but in heated rooms and at late hours, it is the reverse, and often does more harm than good. Gymnastic and callisthenic exercises have been in vogue for some years, for the purpose of promoting muscular and general growth and strength, but they are now rather sinking in public estimation; entirely, I believe, from overlooking the necessity of adapting the kind and extent of them not only to the individ- ual constitution, but to the natural structure of the body; the consequence of which has been, that some of the more weakly pupils have been injured by ex- ertions beyond their strength, and discredit has thus been brought upon the system. It is certain, indeed, that some of the common gymnastic exercises are altogether unnatural and at variance with the design of the bodily organization; and that others are fit only for robust and healthy boys, and not at all for improving those who are delicately constituted, and who stand most in need of a well-planned training. It is impossible to enter minutely into this subject at present; but the best guide we can have is to follow, the footsteps of Nature, and, before adopting any ex- ercise, to consider whether it is in harmony with the mode of action assigned by the Creator to the parts which are to perform it. If it be so, we may proceed with perfect confidence that it will not only improve the health, but add to the freedom, elegance, precision, and strength of our movements; whereas, if it be op- posed to the obvious intention of the Creator, we may lest assured that no good can accrue from it. If, for example, we examine the various attitudes and motions of the body which occur in fencing, dancing, swimming, shuttlecock-playing, and some of the better class of gymnastic exercises, we find that they are3 not less graceful and beneficial to the young who engage in them, than pleasing to those by whom they are witnessed ; just because they are in perfect harmony with Nature, or, in other words, with tht GYMNASTICS. 147 structure and mode of action of the joints, ligaments, and muscles by which they are executed. But it is far otherwise with some of the anomalous exercises which were at one time so fashionable, and which are not yet extinct in schools and gymnasia, and whfch seem to have for their chief object the conversion of future men and women into foresters, firemen, or savages, rather than into beings who are to continue to have the use of stairs, ladders, carriages, steam- boats, and the other conveniences of civilized life. It is no doubt a good thing for a boy to be able to climb up a perpendicular pole or a slippery rope, when no other means present themselves of attaining an important object at its upper end; and it is an equally good thing for a young lady to be able to sustain her own weight hanging by one or both hands, when there is no possibility of resting her feet on terra firma; and where boys and girls are strong enough to take pleas- ure in such amusements, there is no great reason to hinder them, provided they are impelled to them, not by emulation or any secondary motive which may lead to over-exertion, but by the pure love of the ex- ercise itself. In all ordinary circumstances, those only who are vigorously constituted will attempt them, and, if left to themselves, will be sure to desist before any harm can be done. But the case is entirely al- tered when such extraordinary evolutions are not only encouraged, but taught to all indiscriminately, whether they be strong or weak, resolute or timid. We have only to reflect for a moment on the struc- ture of the shoulder-joint, and on the sphere of action of the muscles surrounding it, to perceive at once that the position of the one and the strain upon the other, caused by the exercises alluded to, are so forced and unnatural as to exclude the possibility of the Cre- ator having intended either to be practised except upon occasions of urgent necessity, and to discover how preposterous it is, therefore, to make them a subject of general instruction. Nay, the very violence of the effort required to sustain the body when hang- ing by the hands is far beyond that moderate exertion 148 GYMNASTICS. which adds to nutrition and to strength; and in deli- cate subjects it may even induce relaxation and stretching of the ligaments and bloodvessels, and thus, as jn the case of the young men at Cambridge, lay the foundation for future and fatal disease. The same remarks apply to a common practice of making the pupils slide down an inclined plane resting on the hands alone, by which unnatural effort the shoulders are pushed half way up the neck, and the wrists, arms, and chest severely tried. But in these and other simi- lar evolutions, it requires only to look at the dragging and distortion which they produce, and which form such a painful contrast to the ease and grace of all natural motions and attitudes, to perceive that they are out of the order of Nature, and that neither health nor elegance can result from them. I am aware that these exercises are said to stretch the spine and to remedy its deformities; but it would be quite as sound logic to maintain, that, because a broken leg requires to be tied up with splints and band- ages, therefore the best way to strengthen a sound leg must be to bandage it also; as to infer, that, because a few diseased spines require to be stretched, there- fore all healthy spines must also derive benefit from the same process; although, in the latter case, it is obvious to reason that the stretching will be much likelier to put the bones out of their places than to fix them more firmly in those which they already oc- cupy. It is not by such extravagant means that a soldierlike carriage is obtained in the army, and yet there the uniformity of result, the erect and steady gait, is scarcely less remarkable than the discordant materials and variety of slouching and awkward atti- tudes out of which it is formed, by perseverance in a rational system of drilling. In the selection of exercises for the young, then, we should not be misled by a vain desire of surmount- ing difficulties and performing feats at the serious risk of inducing aneurism or rupture, but rather endeavour to strengthen the body by active amusements, which shall call the social and moral feelings and iutelleot FENCING—D1MB-BELLS. 149 into play at the same time, and by the practice of such gymnastic evolutions only as tend to improve and give tone to the natural action of the moving powers. And in endeavouring to attain this object, we should be always careful to avoid great fatigue, and to mod- ify the kind, degree, and duration of the exercise, so as to produce the desired results of increased nutrition and strength; and to remember that the point at which these results are to be obtained is not the same in any two individuals, and can be discovered oruy by experience and careful'observation. For giving strength to the chest, fencing is a good exercise for boys, and what is called the club exercise for females; but the above limit ought never to be exceeded, as it often is, by measuring the length of a lesson by the hourhand of a clock, instead of its effects on the constitution. Shuttlecock, as an exercise which calls into play the muscles of the chest, trunk, and arms, is also very beneficial, and would be still more so were it transferred to the open air. After a little practice, it can be played with the left as easily as with the right hand, and is, therefore, very useful in preventing curvature and giving vigour to the spine in females. It is an excellent plan to play with a bat- tledore in each hand, and to strike with them alter- nately. The play called the graces is also well adapt- ed for expanding the chest, and giving strength to the muscles of the back, and has the advantage of being; practicable in the open air. Dumb-bells are less in repute than they were some years ago; but when they are not too heavy, and the various movements gone through are not too eccen- tric or difficult, they are very useful. They do harm occasionally from their weight being disproportioned to the weak frames which" use them; in which case they pull down the shoulders by dint of mere drag- ging. When this or any other exercise is resorted to< in the house, the windows ought to be thrown open,. so as to make the nearest possible approach to the external air. Reading aloud and recitation are more useful and iiK N3 150 READING ALOUD. vigorating muscular exercises than is generally im- agined, at least when managed with due regard to the natural powers Of the individual, so as to avoid effort and fatigue. Both require the varied activity of most of the muscles of the trunk to a degree of which few are conscious till their attention is turned to it. In forming and undulating the voice, not only the chest, but also the diaphragm and abdominal muscles, are in constant action, and communicate to the stomach and bowels a healthy and agreeable stimulus; and, con- sequently, where the voice is raised and elocution rapid, as in many kinds of public speaking, the mus- cular effort comes to be even more fatiguing than the mental, especially to those who are unaccustomed to it, and hence the copious perspiration and bodily ex- haustion of popular orators and preachers. When care is taken, however, not to carry reading aloud or reciting so far at one time as to excite the least sen- sation of soreness or fatigue in the chest, and it is duly repeated, it is extremely useful in developing and giving tone to the organs of respiration and to the general system. To the invigorating effects of this kind of exercise, the celebrated and lamented Cuvier was in the habit of ascribing his own exemption from consumption, to which, at the time of his appointment to a professorship, it was believed he would other- wise have fallen a sacrifice. The exercise of lectu- ring gradually strengthened his lungs and improved his health so much that he was never afterward threatened with any serious pulmonary disease. But, of course, this happy result followed only because the exertion of lecturing was not too great for the then existing condition of his lungs. Had the delicacy of which he complained been farther advanced, the fa- tigue of lecturing would only have accelerated his fate; and this must never be lost sight of in practi- cally applying the rules of exercise1. It appears, then, from the foregoing remarks, that the most perfect of all exercises are those sports which combine free play of all the muscles of the body, : mental excitement, and the unrestrained use of the DIFFERENT KINDS OF EXERCISE. 151 voice; and to such sports, accordingly, are the young bo instinctively addicted, that nothing but the strict- est vigilance and fear of punishment can deter them from engaging in them the moment the restraint of school is at an end. Many parents, absorbed in their own pursuits, forgetful of their own former experi- ence, and ignorant that such are the benevolent dic- tates of Nature, abhor these wholesome outpourings of the juvenile voice, and lay restrictions upon their children, which, by preventing the full development of the lungs and muscles, inflict permanent injury upon them in the very point where, in this climate, parents are most anxious to protect them. In accordance with this, we find that what are called wild romping boys or girls, or those who break through all such restrictions, often turn out the strongest and health- iest ; while those who submit generally become more delicate as they grow older. Enough has, I trust, been said to enable any ra- tional parent or teacher to determine the fitness of the different kinds of muscular exercise, and to adapt the time, manner, and degree of each to every indi- vidual under his care ; but, before taking leave of the subject, and with1 a view to impress the more deeply upon the mind of the reader the practical importance of the principles inculcated in the preceding pages, I cannot refrain from subjoining a case which affords an extremely apposite illustration of almost every one of thorn. The particulars were furnished to me by a young friend who was allowed to peruse the man- uscript of these pages, and who, as himself the subject of the case, was struck with the perfect accordance between his own experience and the doctrines here expounded. It is proper to keep in view, that, at the time of his experiment, my friend was about seven- teen years of age, and growing rapidly. I shall use nearly his own Words. Aftei having passed the winter, closely engaged in a sedentary profession, and accustomed to much ex- ercise, he was induced, by the beauty of returning spring, to dedicate a day to seeking enjoyment in a country excursion; and for that purpose set off one 152 CASE OF EXCESSIVE EXERCISE. morning in the month of May, without previous prep- aration, to walk to Haddington by way of North Ber- wick, a distance of thirty-four miles. Being at the time entirely unacquainted with the principles of physiology, he was not aware that the power of ex- erting the muscles depended in any degree upon the previous mode of life, but thought that, if a man were once able to walk thirty miles, he must necessarily continue to possess the same power, under all cir- cumstances, while youth and health remained. The nervous stimulus arising from his escape from the desk, and from the expected delights of the excursion, carried him briskly and pleasantly over the ground for the first twelve miles, but then naturally began to decrease. Unfortunately, the next part of the road lay through a dull, monotonous, and sandy tract, pre- senting no object of interest to the mind, and no va- riety of any description; so that the mental stimulus, already greatly impaired in intensity, became still weaker. Being alone, his intellect and feelings could not be excited by the pleasure of companionship and conversation; weariness consequently increased at every step; and long before his arrival at North Ber- wick (twenty-five miles)," every vestige of enjoyment had disappeared, time seemed to move at a marvel- lously tardy pace, and every mile appeared doubled in length." Not being aware that excessive exercise, without a succeeding period of repose, is unfavourable to diges- tion, and having a lively recollection of the pleasure and refreshment consequent upon eating a good din- ner with an appetite whetted by a proper degree of bodily labour in the open air, he looked forward with confidence to some recompense and consolation for his toils when dinner should make its appearance. In this, however, he was doubly disappointed; for, from having started with too light a breakfast, and walked so far, his digestive organs were, in common with every part of his system, so much impaired, that he looked upon the viands placed before him almost without appetite; and as they were in themselves not remarkably nutritive or digestible, he infringed still CASE OF EXCESSIVE EXERCISE. 153 further that condition of muscular action which con- sists in a full supply of nourishing arterial blood, made from plenty of nutritious food; a condition which I have stated to be essential, especially in youth and during growth. After a rest of two hours, and taking a moderate allowance of wine, which, however, he says, "seemed to have lost its ancient virtue of imparting cheerful- ness to the human heart," he set out to complete the remaining nine miles to Haddington. The country was more beautiftil and varied, but the charms of Na- ture had, by this time, lost all attractions, for our pe- destrian was "now wholly occupied in counting the tedious miles yet to be traversed, and in making a pious vow that this pleasure excursion, though not the first, should certainly be the last in his life." Being reduced to the utmost degree of exhaustion, it re- quired an extraordinary effort to persevere; but at last he arrived at Haddington, in a state of exquisite misery. Unable to read from fatigue, and having no- body to converse with, he sought refuge in bed at an early hour, in the expectation that " tired Nature's sweet restorer, balmy sleep," would visit his couch and bring him relief. But, in accordance with what is mentioned on page 128, he tossed and tumbled in- cessantly till four in the morning, a period of seven hours, after which sleep came on. Next day my youthful friend returned home in the stagecoach, wiser at least, if not happier, for his pleasure excursion; and now makes the observation, that if he had been in- structed in the least degree in the nature of the hu- man constitution, he would never, for a moment, have entertained an expectation of enjoyment from a pro- ceeding so utterly in defiance of all the laws of exer- cise, as that of which he reaped the unpalatable fruits. He adds justly, that the number of young men who suffer in a similar way is by no means small, and that he has reason to be thankful that he has not, like some of his companions, carried his transgressions so far as permanently to injure health, or even sacri- fice life. 154 INVOLUNTARY MUSCLES. My aim being practical utility, I have said nothing in this place on the subject of what are called the Involuntary Muscles, or those over which the will has no power, in contradistinction to the Voluntary, or those which obey the direction of the will. Most of the involuntary muscles are the agents of important vital functions, which are carried on by them uncon- sciously to ourselves, and which it would have been dangerous to leave under our control. The chief of them is the heart, which goes on in one unvarying round of alternate contraction and.relaxation, from the commencement till the close of existence. The next in importance are those connected with res- piration, which, like the heart, continue to act by night and by day for the whole period of a long life, without weariness and without interruption. The muscular fibres of the stomach, bowels, and other viscera, are excellent examples of the same class; and the beneficence of Providence in withdrawing them from our control cannot be sufficiently admired. Had the action of the heart and respiratory muscles depended on the will, as that of the muscles of loco- motion does, the circulation of the blood and the pro- cess of breathing would both have ceased whenever sleep or any other cause overcame the power of at- tention, and life would, in consequence, have been extinguished. From the different constitution of the voluntary and involuntary muscles, it is clear that the former were designed for alternate activity and repose. Had it so pleased the Creator, he could as easily have render- ed the one set of muscles incapable of fatigue, as he has actually rendered*the other ; but then the powers of man would not have been in harmony with the pur- pose of his existence. Incessant muscular activity would not only have been incompatible with the high- est human enjoyment, that arising from the gratifica- tion of the moral and intellectual faculties, but it would have lacked objects on which to expend itself usefully, and, unguided by intellect, would only have served to overturn and destroy the best provisions of Nature for our happiness. CHAPTER VI. THE BONES, THEIR STRUCTURE, USES, AND CONDITIONS OF HEALTH. The Bones essential to Motion, and to the security of the Vital Organs.—The Skeleton.—Bones are composed of Animal 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. The hardness, strength, and insensibility which form the distinguishing properties of healthy bones, fit them in a remarkable degree for serving as a basis of support to the softer and more active textures of the body. By their means, the human frame is ena- bled to unite the most finished symmetry of form with the most perfect freedom of motion and security to life. Some of the bones, such as those which compose the scull and the socket for the eye, are designed ex- clusively for the protection of important organs con- tained within them. But by far the greater number are constructed with a direct reference to voluntary motion, and serve only incidentally the purposes of protection. In proportion to the variety of movements which any piece of mechanism is required to perform, its component parts must be numerous and varied. Con- sidered in this light, the animal frame is the most wonderful of all combinations of machinery. No pro- duction of art can be compared with it for the multi- plicity and nicety of its evolutions; and yet all these are executed simply by muscular power, acting upon the bones or other parts, and changing their relative ositions. 156 DESCRIPTION OF THE SKELETON. The incalculable variety of movements required from man, isi the reason why the bones composing the skeleton are so numerous, and each so admirably connected with the others by articulations, construct- ed so as to admit of precisely that kind of motion which the animal requires of it, and of no other. The advantages of this arrangement are not less obvious than admirable. Had the osseous framework con- sisted of one entire piece, not only would man and animals have been incapable of motion, but every ex- ternal shock would have been communicated undi- minished to the whole system. Whereas, by the di- vision of its parts, and by the interposition of elastic cartilages and ligaments at the joints, free and ex- tensive motion is secured, and the impetus of every external shock is deadened in its force and diffused over the body, in the same way as, to a person riding in a carriage, the jolt of the wheel passing over a stone is diminished by being equally diffused over the whole vehicle, in consequence of the elasticity of the springs. The safety imparted by this arrangement to the deli- cate and important vital organs, is apt to be lost sight of from the very smoothness with which it enables us to move along; but it will be perceived if we reflect on the shock given to the whole system by taking a single false step in going up or down stairs. The parts have then no time to adapt themselves to the exigencies of the moment, and to put the proper springs in play for the equal distribution of the impe- tus. Death has been occasioned by accidents of this kind. The fabric resulting from the connexion of all these pieces, in their natural order of arrangement, is called the Skeleton. When the connexion is maintained by means of the ligaments which bound the pieces to- gether during life, the whole is called a natural skele- ton ; but if the place of the ligaments be supplied by wires, the skeleton is then said to be artificial. The bones entering into the composition of the human skeleton exceed 200 in number. Each is separated from, but intimately connected with, the rest; and of DESCRIPTION OF THE SKELETON. 157 a shape, size, and construction in exact harmony with the kind and extent of motion which it is destined to exercise. Dry and uninviting as such a subject may seem at first sight, there are found, nevertheless, on closer examination, many points of inquiry both in- teresting and instructive, to which 1 shall briefly ad- vert. The three great divisions of the skeleton recognised by anatomists are the head, trunk, and extremities. The first is well known ; the second includes the two great cavities, the thorax or chest, and the abdomen or belly; and the third comprises the arms and legs, or upper and lower extremities. Etich of these presents a structure beautifully adapt- ed to the purposes for which it is destined. The head consists of the scull and bones of the face. The scull affords complete protection to the brain from all ordinary accidents, and also to the organs of hearing, seeing, smelling, and tasting. Protection and not motion being the sole object of its construction, the numerous bones of which it is composed are joined to each other, not by moveable joints like other bones, but by a kind of dovetailing, which combines the so- lidity of continuous structure with the advantages which their separation gives to facilitating growth, and interrupting the extension to all, of the injuries inflicted on one. The trunk, as will be seen from the annexed cut, consists of the spine a a, the ribs r r, the sternum x, and the pelvis s s. The spine, vertebral column, or back-bone a a, which supports all the upper parts, is a very remarkable piece of mechanism. It is com- posed, in all, of twenty-four separate bones, called vertebra, from the Latin word vtrlere. to turn, as the body turns upon them as on a pivot. Of these, seven, called cervical vertebrae, belong to the neck; twelve, connected with the ribs, and called dorsal^lo the back; and five, called lumbar, to the loins. The base of the column rests on the sacrumw, which is closely com- pacted between the bones of the pelvis s s. The ver- tebras are firmly bound to each other in such a way as 158 DESCRIPTION OF THE SKELETON. lo admit of flexion a.nd extension, aitika certain degree of rotation, while, by their solidity and firm attach- ment to each other, great strength is secured. Some conception of this strength may be formed when we DESCRIPTION OF THE SKELETON. 159 consider the enormous loads which some athletic men are able to carry on their shoulders, or raise in their hands; the whole weight of which is necessarily borne by the vertebrae of the loins. As the space oc- cupied by the abdomen gives large outward dimen- sions to this region of the body, it is only upon reflec- tion that we perceive that the whole force exerted by the human frame in its most strenuous efforts cen- tres in the bony column we are now examining. While the smooth or rounded forepart or body of the vertebrae affords support to the superincumbent parts, the projecting ridge behind and rugged pro- cesses at the sides combine with it to form a large tube or canal, extending from the top to the bottom of the column, and in which the spinal marrow is contained and protected. Between each of the ver- tebrae a thick compressible cushion of cartilage and ligament is interposed, which serves the triple purpose of uniting the bones to each other, of diminishing and diffusing shocks received in walking or leaping, and of admitting a greater extent of motion than if the bones were in more immediate contact. The ribs r r, twelve in number on each side, are at- tached by their heads to the spine, and by their other (cartilaginous) extremities to the sternum or breast- bone x. The seven uppermost are called true ribs, because each of them is connected directly with the sternum by means of a separate cartilage. The five lower ribs are called false, because one or two of them are loose at one end, and the cartilages of the rest run into each other instead of being separately prolonged to the breast-bone. The use of the ribs is to form the cavity of the chest for the reception and protection of the lungs, heart, and great bloodvessels, and to assist in respiration by their alternate rising and falling. This action enlarges and diminishes by turns the size of the chest and the capacity of the lungs. The pelvis s s, is formed by the broad, flat bones which support the bowels, and serve for the articula- tion of the thigh. A general notion of their appear- 160 DESCRIPTION OF THE SKELETON. ance and uses may be obtained from inspection of the cut, which, however, does not represent with perfect accuracy the minuter structure. The bones of the upper extremities are, the scapula or shoulder-blade; the clavicle or collar-bone y; the humerus or arm-bone b; the radius d, and ulna e, or bones of the forearm ; and the small carpal and meta- carpal bones / and phalanges g, forming the wrist, hand, and fingers. The scapula is the broad flat bone lying at the upper part of the back, familiarly known as the shoul- der-blade, and so troublesome to many young ladies by its unseemly projection. It serves to connect the arm with the trunk of the body, and gives origin to many of the muscles by which the former is put in motion. The collar-bone y extends from the breast- bone outward to the scapula. Its chief use is to pre- vent the arms from falling forward in front of the body; and hence it is wanting in the lower animals, whose superior extremities are much closer to each other than those of man. The humerus, or arm-bone b, is adapted by a kind of ball and socket joint to a corresponding surface in the scapula, and hence enjoys great latitude of motion, and, from the shallowness of the receptacle, is some- what liable to dislocation. The radius and ulna d e constituting the forearm, are connected with the hume- rus by a hinge-like joint, which admits readily of flex- ion and extension, but not of rotation; and as the ar- ticulation is of a peculiar construction, it is rarely dis- located. The movements of pronation and supina- tion, or turning round the hand, are effected, not by the elbow-joint, but by the radius d moving upon the ulna e, by means of joints formed for this purpose. The wrist and finger-joints are too complicated to admit of explanation here. The lower extremities consist of the os femoris or thigh-bone i; the patella or knee-pan I; the tibia m, and fibula n, or leg bones; and the tarsal and metatar- sal bones o, and phalanges p, composing the ankle, foot, and toes. COMPOSITION OF BONES. 161 The thigh-bone i is articulated by means of a large round head deeply sunk into a corresponding hollow in the pelvis at h; freedom of motion being thus com- bined with greater security. The thigh may be moved backward and forward, as in walking; and also outward and inward, as when sitting on horseback, or with the legs crossed. The socket being much deeper than that of the shoulder-joint, the thigh-bone has not the same range of motion as the humerus, but it has proportionally greater security. The patella, or kneepan /, is well known. It is a small bone constituting the projection of the knee. It increases the power of the muscles which extend the leg, and protects the front of the knee-joint. The tibia m is the principal bone of the leg, and is the only one articulated with that of the thigh. Its lower end forms the projection at the inner ankle. The fibula n is the long slender bone at the outer side of the leg, the lower end of which forms the outer ankle. The tibia and fibula both contribute to the formation of the ankle-joint, which, like that of the knee, is almost limited to flexion and extension. The tarsal bones constituting the foot display an admirable mechanism, but without plates any descrip- tion of them would be unintelligible. My present aim being practical utility, I shall, therefore, pass over these details, and rather lay before the reader several considerations of a more general and directly useful nature. Bones consist of two kinds of substances, viz., those of an animal and those of an earthy nature. To the former belongs everything connected with the life and growth of bones, and to the latter the hardness and power of resistance by which they are character- ized. The animal portion of bones constitutes, according to the analysis of Berzelius, about 32.17 per cent, of their substance, and consists chiefly of albumen, gela- tine, cellular membrane, bloodvessels, nerves, and ab- sorbents. Of the remaining 67 per cent, of earthy 0 3 162 COMPOSITION OF BONES. matter, nearly 52 parts consist of phosphate, and 11 of carbonate, of lime. The relative proportions of the animal and earthy constituents vary, however, according to the period of life. In infancy, the ani- mal portion greatly predominates, and, consequent- ly, the bones are at that age comparatively soft, yield- ing, and elastic. In middle life, the portions are more equally balanced, and while the bones thereby acquire great hardness and solidity, they still preserve some elasticity. In old age, on the contrary, when the earthy constituents predominate, they become dry, brittle, and comparatively lifeless. If a bone be subjected for a time to the action of muriatic acid, the earthy portion is gradually decom- posed, and a cartilaginous-looking substance of the exact shape and size of the bone is procured, which is in reality its animal constituent. If, on the other hand, the bone be subjected to the action of fire, which decomposes and dissipates the animal elements, but scarcely affects the earths, a white, light, easily crumbled mass, of the shape and appearance of the original bone, is procured, which is simply the earthy part of bone, deprived of its connecting membrane. The latter is called the animal constituent of the bone, because it is the product of animal life, and does not exist in nature, except in the system of animals ; and the former is called the earthy constituent, because it may and does exist in nature, without relation to life. A very important purpose is served by the differ- ent proportions which the animal elements of bone bear to the earthy at different ages. In early youth, when much strength is not wanted, as the body is never exposed to severe efforts, but when a great growth of bone is required to complete the develop- ment of the human frame, the animal or living part of the bone is observed to preponderate. But in mid- dle life, when growth is finished, and the powers of resistance are at their maximum, and when nutrition is required only to repair waste, a larger proportion of the solid or earthy, and a smaller proportion of tha vital constituents, become necessary. In old age, GROWTH OF BONES. 163 again, when the wants of the system are reversed, and when positive diminution of existing masses is required to put the frame into harmony with the shrunk muscles and feebler powers of life, the absorb- ent vessels carry away more of the vital matter, leav- ing chiefly the earthy, which, being less susceptible of change, requires scarcely any support from within; and hence the brittle and compact hardness of the bones, and their little capability of uniting when frac- ture happens at an advanced period of life. At birth many of the bones are, properly speaking, of a cartilaginous nature. As ossification advances, the cartilage is removed by the absorbents, and its place supplied by a kind of cellular membrane, in the interstices of which the earthy particles are deposit- ed ; the two forming, by their union, the homogene- ous whole called Bone. Although, therefore, it is to the softer material alone that vital properties essen- tially belong, it is usual to speak of the life, the ves- sels, and the nerves of bones, as if life belonged equally to the earthy and animal portions. This is correct enough in reality, because the union between the earthy and animal tissues is always the product of life; and the parts thus united are, to all intents and purposes, living parts. To carry on the processes of waste and renovation, by which every living structure is distinguished, all parts of the body are provided, 1st, with arteries con- veying to them red or nutritive blood; 2dly, with ex- halants, by which the new matter is deposited, and which are believed to be the minute terminations of the aperies; 3dly, with veins, by which the blood is carried back to the heart; 4thly, with absorbent ves- sels, which take up and carry away the waste parti- cles to be thrown out of the system; and, lastly, with nerves to supply all these vessels and the organs on which they are distributed, with that nervous energy which is essential to their vitality, and to their con- nexion with other parts of the system. The bones, insensible as they may seem, possess all these attri- butes of living and organized parts. They are all 164 RENOVATION OF BONES. provided with bloodvessels, with nerves, and with exhaling and absorbing vessels; and they are con- stantly undergoing the same process of decay and of renovation, to which all other living parts are sub- jected. That bones are provided with bloodvessels, is shown by the fact, that anatomists are able to trace these vessels into their substance, and to inject those of a young subject with wax, so minutely as to make the bones appear of a lively red colour. That they are provided also with nerves, is evident, both from dis- section and from the effects of injuries and disease. A healthy bone may be cut or sawed across without causing pain; but when the same bone becomes in- flamed, the most excruciating torture is felt. And, as sensation is the exclusive attribute of the nervous system, this fact alone would authorize us to assume their existence, even although nervous fibres could not be traced entering the osseous substance. That the substance of the bones is continually un- dergoing a change, and that, while the old particles are withdrawn by absorbents, new particles are con- stantly deposited by the nutrient or exhalant vessels, is abundantly proved by the often-repeated experi- ments of Duhamel. If madder be mixed with the hod of fowls for a few days, and the fowls be then killed, the colouring matter deposited by the nutrient vessels will invariably be found to have died the bones of a deep red; and if the madder be withdrawn, the bones will then be found to be less and less red in proportion to the length of time which has been al- lowed to elapse—evidently showing that waste and renovation are constantly going on. It may be thought that bones are, in their very es- sence, so hard and durable, as to render any such supply of nourishment and change of parts altogether unnecessary. But if we look for a moment to the advantages consequent upon this order of things, we shall see abundant cause to reject such an opinion. It is only by means of the processes of growth and renewal that the bones can adapt themselves to the ADVANTAGES OF VITALITY IN BONES. 165 wants and state of the system. If the bones were not endowed with the principle of life, the stature of the infant must have been that of the future man. Or even supposing the osseous system to have grown to maturity, and then remain unchanged, the withered form of old age would necessarily have been op- pressed and overcome by the large and massive bones which the vigorous muscles of manhood alone can easily put in motion. Had the bones been created unsusceptible of internal change and unendowed with life, it is obvious that, when broken by accident, they must have remained for ever disunited, and therefore an encumbrance instead of an assistance to the animal. But, from possessing bloodvessels of their own to sup- ply them with nourishment, and nerves to give power of action to those bloodvessels, the very irritation of the broken end is made to serve the purpose of in- creasing the vital powers of the injured parts, and producing that excitement which is necessary for the formation of a new bond of union, and for filling up the gap that would otherwise have remained. In a state of health, the bones are insensible to pain; and here also the more provident benevolence appears. For, surrounded as they are by the softer and more sensitive parts, these afford them ample protection, while their insensibility enables them to act, for any length of time, without weariness or pain. But when a severe accident occurs to break them asunder or destroy their texture, pain then becomes their kindest guardian, and the surest promoter of their recovery. In such circumstances, indeed, no- thing can be more truly benevolent than pain. It ac- companies that inflammation and vascular activity, without which the work of reunion of the broken part cannot be accomplished ; and is the means of securing the repose and quietude which are essential to the exact adaptation of the parts to each other, and which can be effected only by causing great pain to follow even the slightest motion. Of such utility is inflam- mation on these occasions, that when, as sometimes happens, the requisite degree of it, from want of ner- 166 ADVANTAGES OF VITALITY IN BONES. vous sensibility in the part, does not take place, and the bone remains ununited for many weeks, surgeons are in the habit of using violence to produce the ne- cessary stimulus. In this case, they either rub the broken ends rudely against each other, or introduce an instrument between them, by which pain and irri- tation may be excited, and then reunion is accom- plished. On the other hand, if pain did not guard the limb from motion when the process of recovery is going on, the union would be incessantly disturbed by every heedless and unavoidable start altering the rel- ative position of the parts. This, also, is occasionally exemplified in practice. Looking at these facts, it is impossible not to admire the wisdom and the benev- olence manifested in the adaptation of the structure of bones in every particular to the circumstances and occurrences of life. Another advantage arising from the vitality of bones, is their susceptibility of change without injury to life. Thus it frequently happens, that, in infancy, water collects within the head in considerable quan- tity ; but, in consequence of the law that the form of the scull accommodates itself to the form and di- mensions of its soft contents, the bones yield to the pressure from within, become larger, and, by forming a larger cavity, permit the brain to execute its func- tions, and life to go on; whereas, had the scull been incapable of undergoing change, death would have to a certainty ensued. The scull owes this power of adaptation entirely to its possessing vessels and nerves, and to its undergoing a constant decay and renewal, like the other parts of the system. The same phenomena are exhibited by the bones of the chest. When tumours arise, or collections of fluid take place within that cavity, there is a constant effort on the part of nature to take advantage of this constitution of the bones, and to cause them so to expand as to save the lungs and heart from hurtful pressure, and allow respiration and circulation to go on unimpaired. In the opposite circumstances of diminished volume INCREASE AND DIMINUTION OF BONES. 167 of the soft contents of the cavities, the same law en- ables the bone to decrease in a corresponding propor- tion, and, consequently, to continue the protection which it affords to its contained organs. Thus, were the bone to remain unaltered, when, in cases of dis- ease and in old age, the brain diminishes in size, the cavity of the scull would be only partially filled, and the brain, so far from being protected, would be jolted backward and forward, upward and downward, by every motion of the head or body, till its structure should be utterly destroyed, and life itself extin- guished. To those who are unacquainted with the laws of nutrition of organized bodies, and who are accustomed to notice the hard and unyielding nature of bone, without having any adequate perception of the par- ticular uses of the adaptation of the hard to the soft parts, this adaptation may seem strange and improb- able ; but a little consideration will satisfy every one that it could not have been otherwise. In infancy, when the lungs are imperfectly devel- oped, the chest is narrow, flat, and confined, and the ribs almost in close juxtaposition. In youth and in middle age, when force and activity require fulness and vigour of respiration, the lungs enlarge, and to give them scope, the chest becomes full, broad, and capacious. In old age, again, when the season of active exertion is over, and the strength decays, the broad shoulders and capacious chest of manhood gradually disappear, and a totally different form oc- cupies its place. Now, at all the^e periods, the bones are the parts which, by their alteration, serve as an index of the changes going on within; and, on this large scale, the difference in their form is so great that it must be obvious to all. Where the whole of the soft contents of a bony cavity increase in size, as happens in the case of water in the head, the result is, as already mentioned, an expansion from interstitial growth of the osseous covering. But where the tumour or pressure is lim- ited to a small part, a process of a different kind often 168 CONDITIONS OF HEALTH IN BONES. akes place, which also has the preservation of life for its object, and which is accomplished by another of the natural actions—absorption. When a bone, say of four inches square, is required gradually to expand itself so as to protect a surface of six inches, or of double the extent, this is accomplished by the gradual removal of the old, and the deposition of new and additional particles, on, as it were, a new and enlarged mould. But in the other case, where the pressure is very limited—where, for instance, a small tumour develops itself on the surface of the brain, which, if allowed to grow within {unyielding walls, would soon cause death by pressure on the.brain— the ordinary process of absorption becomes greatly excited, and gradually eats away the whole thickness of the bone over the tumour, which then protrudes externally, and relieves the brain within from pres- sure, which would have been fatal to it. 1 have already stated, that, besides a large propor- tion of earthy matter, which gives to them dryness and hardness, bones contain a large quantity of animal matter, which is essential to their constitution. In early life, this cartilaginous matter preponderates, and the bones are consequently less heavy, more pliable and elastic, and possessed of greater vitality. In old age, again, the earthy parts predominate, and with them fragility, insensibility, and a lower degree of life. It is from this difference that bones broken in youth reunite in one third of the time necessary for their reunion in advanced life. In some unhealthy states of the system, the pro- portion of earthy matter is greatly diminished, and in some parts it is even altogether removed. The bones become soft, compressible, and incapable of affording protection or support to the other parts, to such a degree that instances have occurred in which the lower extremities could be twisted behind, as if made of wire. A slighter degree of the same affection is common in weak, rickety children; and hence the deformity of limbs, so often occurring from absolute CONDITIONS OF HEALTH IN BONES. 169 Insufficiency of the bones to support the weight of the body. The practical application to be made of our knowl- edge of the constitution of the bones, as parts of our animal frame, and as governed by the ordinary or- ganic laws, will now be obvious. Their health we have seen to depend on the regular supply of nour- ishment by the bloodvessels, on a due supply of ner- vous energy by the nerves, and on a due balance between the action of the nutrient and absorbent or removing vessels. To the steady fulfilment of these conditions, therefore, we are bound to attend. It is a common fault to consider the study of an or- gan or function complete, when we have viewed it on all sides as an isolated part, without regarding its external relations as constituting an essential portion of its history. Thus, although we examine the struc- ture and functions of the heart, and see that it is a muscle, and that its office is to contract, our knowledge is incomplete if we do not go still further, and see that blood is the stimulant which causes the contrac- tile power to act. And in like manner with the eye, whose relations to light are as essential a part of its constitution as the transparency of its membranes or the convexity of its lens. Now, in the case of the bones, we are apt to describe their hardness, their mo- bility, and other qualities, without sufficiently advert- ing to the fact that, being organs of support and resistance, the frequent and regular performance of a full but not excessive amount of their duties is as es- sential to their wellbeing as blood is to the heart, air to the lungs, or light to the eyes. And, accordingly, when that condition is not fulfilled, the bones become feeble, diseased, and unfit for their functions, just as the softer parts of the body do. In practice, it is of the utmost importance to be fully aware of this fact. It is familiar to the professional mind, that a part deprived of that exercise or action which nature des- tined it to fulfil, becomes weakened, diminishes in size, and at last shrivels and alters so much in ap pearancc as not to be recognisable. Thus, if an ar- P 170 CONDITIONS OF HEALTH IN BONES. tery—the large artery which supplies the arm with blood, for example—be tied, and the flow of blood obstructed, a change of structure immediately begins, and goes on progressively, till, at the end of a few weeks, what was formerly a hollow elastic tube pre- sents the appearance of a ligamentous inelastic cord. A muscle condemned to inaction is speedily reduced to half its original bulk; and, if long unexercised, at last loses entirely its power of contraction and mus- cular appearance. The same rule holds with all other parts of the system, and, in an especial manner, even with the hard and apparently unalterable fabric of the bones. It is ascertained by extensive experience, that complete inaction, besides diminishing the size of bone, injures its structure so much as to deprive it of hardness, and render it susceptible of being cut with a knife. Now, what is strongly marked in the ex- treme case is not less active, although it may be less palpably apparent, in cases where there is great, though not total, deprivation of exercise; and here is seen one cause of the bad health, crooked spines, and deformed figures, of which the habitual restraint and condemnation to attitude in modern education lay so wide-spreading and so deep a foundation; evils which could never stand for a moment before knowledge or reason. The bones are the solid frame- work of the body; and unless they are duly exercised in actual motion, they, like the muscles which move them, suffer and decay in virtue of that universal law which requires the exercise of voluntary organs as the condition of their wellbeing— as the stimulus ne- cessary to their efficient existence. One great requisite, then, for the development and health of the osseous system, is adequate exercise. But wherever matter is the subject, action implies waste of materials, and unless this waste be made up by proportionate supplies, exercise leads to speedy decay, such as we see take place where the exertion has been carried beyond the proper limits, and occa- sioned a waste beyond what any supply can compen- sate. A second requisite for the proper state of the CONDITIONS OF HEALTH IN BONES. 171 bones, therefore, is a sufficient amount of nourishment to counteract the waste now alluded to. In early youth, in particular, when every part teems with life and activity, and is almost hourly acquiring an increase of dimensions, the nutrient system is in a state of unceasing and powerful action, and a rich and abundant supply of food is indispensable to health. Nature points out this fact in the keen and vigorous appetite and strong powers of digestion which every healthy child uniformly manifests. To put ourselves in accordance with the intention of Nature at this period of life, it is therefore absolutely necessary to supply in abundance wholesome and nourishing food. The non-fulfilment of this condition, so often seen in times of distress among the labouring classes, gives rise to that tumid softness and consequent weakness of the bones and soft parts, which is known by the name of rickets; and which, if it continue till matu- rity, i. c., during the years of active nutrition and growth, invariably leads to distortion and deformity. The effect of exercise in causing the waste of the active organs, is well illustrated by the comparative absence of waste when they are unemployed. Inac- tion implies almost stagnation, and is always attended by diminution of the vital functions; as is exempli- fied in the extreme degree in hybernating animals, which pass months in sleep without food, and almost without breathing; and also in frogs found alive in stones and trees, where they must have been dormant for a great number of years. Inactive parts, then, re- quire little nutrition, because there is little expendi- ture ; and they require little force or energy, because it would be not only useless, but detrimental to them. By a law of the constitution, manifestly arranged with relation to this principle, when any part of the system is active, it attracts to itself, by the simple stimulus of that activity, an increased supply of blood ;ind nervous energy. The former repairs the waste of substance which action produces, and the latter gives an increased tone in harmony with the greater call made on its powers. If the exercise is moment- 172 CONDITIONS OF HEALTH IN BONES. ary and is not repeated, the extraordinary flow of blood soon disappears, and the nervous power falls to the usual standard: but if it is continued for a time, and is recurred to at regular intervals, a more active nutrition is established; a permanently greater supply of blood enters the vessels, even during the intervals of inaction; and an increase of development takes place, attended with increased facility and vigour ol function. If, again, any part is not duly exercised, there is no local stimulus to attract a large supply of blood or abundant flow of the nervous fluid; there is no activ- ity of nutrition, no perfection of development, and no vigour of function. And hence, in partial exercise, there is always predominance of some parts over others; the one too strong, the other too feeble. In the muscular system, the arms of a blacksmith con- trasted with those of a dancing-master are a sufficient illustration. This law of increased afflux of fluids and increased nutrition to exercised parts, and of diminished afflux and nutrition to inactive parts, is not only highly im- portant in its practical consequences, but in exact and obvious accordance with the plainest principles of reason. By this benevolent arrangement, parts acting strongly receive large supplies, and parts doing no- thing are left in the state of weakness befitting the demands made upon them. To every one who sees the principle, it must appear the height of folly to ex- pect great nutrition and great energy to follow inac- tion, and vice versa; and yet this is what is, in igno- rance, daily looked for by mankind at large. This law of exercise, as influencing nutrition and function, is universal in its application, and applies to the osseous as much as to any other system. If the bones are duly exercised, then active nutrition goes on, and they acquire dimension, strength, and solid- ity. If they are not exercised, the stimulus required for the supply of blood to them becomes insufficient; imperfect nutrition takes place; and debility, softness, and unfitness for duty follow in the train. This cause CONDITIONS OF HEALTH IN BONES. 173 of defective formation is most active and most com- monly seen in the bones of the spine in growing girls, who are denied free exercise in that part; and the consequent weakness in the bones and cartilages, as well as in the muscles, is a very frequent cause of the swollen joints and curvature in the bones of the limbs in young people, which no subsequent care can ever remove. The beneficial effects of exercise and diet in im- parting solidity to the bones, have not escaped the observation of trainers and veterinary surgeons. Sir John Sinclair expressly mentions that the bones of persons trained become, in a remarkable degree, harder and tougher, and less liable to be injured by blows or accidents.* Delabere Blaine, also, in speaking of the deposite of earthy matter, and the consequent consoli- dation of the bones of the horse being hastened by anything that permanently quickens the circulation through them, adds, that Nature gives to young ani- mals a playful disposition for the purpose of "increas- ing the flow of blood, and occasioning a more free de- posite of the earthy particles." " The earthy depos- ite," he continues, " is usually proportioned to the wants of the animal; it is thus most perfect in those whose exertions are most considerable; in the full- bred horse, therefore, the bones will be found more solid than in the bulky lower-bred varieties." But from this very circumstance, when the animal is sub- jected to premature exertion, the consolidation of the bones becomes complete before their softer portion has increased to its full dimensions, and hence " horses early and hard worked never arrive at their full size."I Testimony of this kind ought to be of great weight, as based, not on theory, but on the broad and well- marked experience of practical men. It must be observed, however, that defective nutri- tion may arise from other causes than inadequate ex- ercise ; but even then, the consequences attending it are analogous in their nature. Among the poor it • Code of Health, 5th edition. Appendix, p. 35. t Blaine's Outlines of the Veterinary Art. Third edition, p. 93. P2 174 CONDITIONS OF HEALTH IN BONES. often arises from deficiency of wholesome food, and from damp dark habitations; among the rich, from feeble digestive and assimilating powers, and pamper- ing in diet; and also from errors in clothing, and neg lect of sufficient ventilation, and due exposure to the open air. Rickets, softness of the bones, and white swelling, are accordingly observed to be almost con- fined to children belonging to one or other of these classes. To understand more clearly the relative uses of bones and muscles, we may be allowed to use a com- parison, although, like all other comparisons, it pre- sents many points of difference. The bones are to the body what the masts and spars are to a ship; they give support and the power of resistance: and the muscles are to the bones what the ropes are to the masts and spars. It is to the muscles that the bones are indebted for the preservation or change of their relative position. If the bones or masts are too fee- ble in proportion to the weight which they are re- quired to sustain, then a deviation from their shape or position takes place; and, on the other hand, if the muscles or ropes are not sufficiently strong and well braced, then insufficiency of support must necessarily result. Early infancy affords an instance of both im- perfections ; the bones being infirm, and the muscles small and destitute of true fleshy fibres. The diseas- ed state, called mollities ossium, or softness of the bones, is an instance of what may be called a weak mast of the body, which must yield if its muscles be strongly drawn. The state of muscular debility con- sequent on fever and many acute diseases, or even on sudden fright, is, on the other hand, an instance of the inability of the bones alone to preserve an attitude, or execute motion, when the muscular system is weakened by disease. These differences merit at- tention. In the regular order of Nature, the maturity and perfection of all organs and functions are attained at the precise time at which each is required. The bones of the infant are soft, vascular, cartilaginous, CONDITIONS OF HEALTH IN BONES. 175 full of life, and vigorous in growth; but, having no en- ergetic motions to perform, they possess little power of solid resistance. In accordance with this condition of the bones, the muscles which move them are small, gelatinous, imperfectly fibrous, and incapable of pow- erful contraction. If the bones had been made solid and heavy from the beginning, they would not only have been inert and cumbrous masses, destitute of muscles to put them in motion, but, from being less vascular and less alive, could not have grown with the rapidity necessary to adapt themselves to the growth of the other parts of the system. If, on the other hand, powerful muscles had existed from the first, they would have served only to twist the soft and yielding bones into fantastic shapes. Or, if both solid bones and strong muscles had been given from birth, then a complete power of locomotion would have been the result, which, from the absence of intellect and of knowledge of the external world to direct it, would have led to incessant evils, if not to speedy de- struction. But as things are arranged, the most pro- found wisdom and the purest benevolence show them- selves in the beautiful adaptation of all the parts and functions to each other and to one common end. Knowledge of the condition of the bones at differ- ent periods of life is not without its practical uses, particularly in regulating our treatment of children. Some fond parents, disregarding the fact that the bones are comparatively soft and pliable in infancy, and in their haste to see the little objects walk with- out support, are continually soliciting attempts at standing or walking, long before the bones have ac- quired sufficient power of resistance, and the mus- cles sufficient power of contraction, to cope with the laws of gravitation. The natural consequence is a curvature of the bone, which yields just like an elastic ?tick bending under a weight. The two ends ap- proach nearer to each other than they ought to do ; and, to accommodate themselves to the change, the muscles become shorter on one side, and perhaps long- 176 CONDITIONS OF HEALTH IN BONES. er on the other, each losing part of its efficiency in the unnatural change which it undergoes. From this view, it will be seen how hurtful lead- ing-strings must be. In the first place, by their me- chanical force, they compress the chest and impede respiration; and, in the second, by preventing the body from falling to the ground, or, rather, by pre- serving an upright position, they cause more of the weight to fall on the bones of the spine and lower ex- tremities than these parts are fitted to carry. From this noxious practice, flatness of the chest, confined lungs, distorted spine, and deformed legs, too often originate. The impropriety of the indiscriminate use of dumb bells in early life will also be easily understood. If the weight of these be disproportioned to the strength of the bones, it is obvious that we must produce the same kind of evil as by premature attempts to walk, viz., yielding of the bones, and stretching and relax- ation of their connecting ligaments. If, again, they be disproportionate to the muscular power, their effect will be to exhaust instead of increasing the strength of the body. From the exposition I have given of the laws of exercise, as affecting the muscular and osseous sys- tems, the absurdity of expecting to strengthen either the one or the other by the use of stays, or by lying for hours on a horizontal or inclined plane, will be abundantly manifest. There is no royal road to health* and strength, and no method by which, while exer- cise is dispensed with, its advantages can be obtained. In the intervals between exercise, reclining on a plane is very useful in delicate, fast-growing girls; but it should be resorted to only when the feeling of fatigue exists, either from previous exercise or from mere sitting up. As soon, however, as this feeling is en- tirely recovered from, it ought to be discontinued, and never employed for hours and days in succession, without reference to previous weariness, as it often is, on the false notion of its being conducive to strength. CONDITIONS OF HEALTH IN BONES 177 In this chapter, as well as that on the muscles, I have dwelt perhaps too long on the principles by which exercise ought to be regulated ; but as the sub- ject is little understood by those who have the direc- tion of youth, and is of paramount importance, I am inclined to hope that the tediousness of repetition may be forgiven, if clearness and conviction are obtained. 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.—■ 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—of Cheerfulness and of Depression of Mind—of pure Air and Ventilation.—Vitiation of the Air by Breathing—Ex- tent and 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. We come next to treat of the lungs and of the function which they perform; but, in order to be clearly understood, I must premise a few observa- tions on the circulation of the blood. The blood circulating through the body is of two different kinds ; the one red or arterial, and the other dark or venous blood. The former alone is capable of affording nourishment and of supporting life. It is dis- tributed from the left side of the heart all over the body, by means of a great artery or bloodvessel called the aorta, which subdivides in its course, and ultimately terminates in myriads of very minute ramifications closely interwoven with, and, in reality, constituting a part of, the texture of every living part. On reaching this extreme point of its course, the blood passes into ARTERIAL AND VENOUS BLOOD. 179 equally minute ramifications of the veins, which, in their turn, gradually coalesce and form larger and larger trunks, till they at last terminate in two large veins, by which the whole current of the venous blood is brought back in a direction contrary to that of the blood in the arteries, and poured into the right side of the heart. On examining the quality of the blood in these two systems of vessels, it is found to have un- dergone a great change in its passage from the one to the other. The florid hue which distinguished it in the arteries has disappeared, and given place to the dark colour characteristic of venous blood. Its prop- erties, too, have changed, and it is now no longer ca- pable of sustaining life. Two conditions are essential to the reconversion of venous into arterial blood, and to the restoration of its vital properties. The first is an adequate pro- vision of new materials from the food, to supply the place of those which have been expended in nutri- tion ; and the second is the free exposure of the nervous blood to the atmospheric air. The first condition is fulfilled by the chyle or nutri- ent principle of the food being regularly poured into the venous blood just before it reaches the right side of the heart; and the second, by the very important process of respiration, which takes place in the air- cells of the lungs, and which it is our present object to explain. The venous blood, having arrived at the right side of the heart, is propelled by the contraction of that organ into a large artery, leading directly, by separate branches, to the two lungs, and hence called the pul- monary artery.* In the innumerable branches of this artery expanding themselves throughout the substance » Taking the nature of the blood for our guide, the pulmonary artery ought to be named the pulmonary vein, for it contains ve- nous blood. But, from its structure and office in regard to the right side of the heart resembling those of the arteries, it has been called an artery. The pulmonary veins, or vessels which return the blood from the lungs to the left side of the heart, on the other hand contain arterial blood, although named veins. To prevent confusion, it is necessary to advert to this source u unbiguity. 180 CIRCULATION OF THE BLOOD. of the lungs, the dark blood is subjected to the con tact of the air inhaled in breathing; and a change in the composition both of the blood and of the inhaled air takes place, in consequence of which the former is found to have reassumed its florid or arterial hue, and to have regained its power of supporting life. The blood then enters minute venous ramifications, which gradually coalesce into larger branches, and at last terminate in four large trunks in the left side of the heart; whence the blood, in its arterial form, is again distributed over the body, to pursue the same course and undergo the same changes as before. There are thus two distinct circulations, each car- ried on by its own system of vessels : The one, from the left side of the heart to every part of the body, and back to the right side; and the other, from the right side of the heart to the two lungs, and back to the left. The former has for its object nutrition and the maintenance of life ; and the latter the restoration of the deteriorated blood, and the animalizalion or assimilation of the chyle from which that fluid is formed. As the food cannot become a part of the living ani- mal, or the venous blood regain its lost properties, until they have undergone the requisite changes in the air-cells of the lungs, the function of respiration, by which these are effected, is one of pre-eminent importance in the animal economy, and well deserves the most careful examination. The term respiration is frequently restricted to the mere inhalation and expiration of air from the lungs; but more generally it is employed to designate the whole series of phe- nomena which occurs in these organs. The words sanguification and aeration of the blood are other forms of expression occasionally used to denote that part of the process in which the blood, by exposure to the action of the air, passes from the venous to the arte. rial state; and, as the chyle does not become assim- ilated to the blood until it has passed through the lungs, the term sanguification or bloodmaking is not unaptly applied. RESPIRATION—THE LUNGS. 181 The quantity and quality of the blood have a most direct and material influence upon the condition of every part of the body. If the quantity sent to the arm, for example, be diminished by tying the artery through which it is conveyed, the arm, being then imperfectly nourished, wastes away, and does not regain its plumpness till the full supply of blood be restored. In like manner, when the quality of mat fluid is impaired by deficiency of food, bad digestion, impure air, or imperfect sanguification in the lungs, the body and all its functions become more or less disordered. Thus, in consumption, death takes place chiefly in consequence of respiration not being suffi- ciently perfect to admit of the formation of proper blood in the lungs. A knowledge of the structure and functions of the lungs, and of the conditions favourable to their healthy action, is therefore very important; for on their wel- fare depends that of every organ of the body. And when we recollect that, in the British Isles alone, above fifty thousand persons fall victims annually to pulmonary consumption, and that these are chiefly among the young and most gifted, we cannot but feel deeply interested in obtaining some acquaintance with the organization which is the seat of that affection, and with the conditions most conducive to the due performance of its functions and the preservation of its health. The exposure of the blood to the action of the air seems to be indispensable to every variety of animated creatures. In man and the more perfect of the lower animals, it is carried on in the lungs, the structure of which is admirably adapted for the purpose. In many animals, however, the requisite action is effected with- out the intervention of lungs. In fishes, for example, which live in a dense medium, and do not breathe, the blood circulates through the gills, which, from being constantly and directly in contact with the water, are more accessible than lungs would be to the action of the air which the water contains, and much better adapted to the medium in which fishes 182 SITUATION OF THE LUNGS. live. In worms and many similar animals, on the other hand, no distinct organ is set apart for the pur- pose, but the aeration of the blood takes place at the surface of the body, by means of pores in the skin, called spiracula, specially adapted to this end, and which cannot be shut up or obstructed, any more than the lungs or gills, without inducing death. So neces- sary, indeed, is atmospheric air to the vitality of the blood in all cases of animals, that its abstraction in evitably proves fatal; and a fish can no more live in water deprived of air, than a man could do in an at- mosphere devoid of oxygen. And thus the fish re- quires a renewal of air, and perishes when it is denied, exactly as man does in similar circumstances. In man the lungs are those large, light, spongy bodies, which, along with the heart, completely fill the cavity of the chest. They vary much in size in different persons; and as the chest is formed for their protection, we find it either large and capacious, or the reverse, according to the size of the lungs. Their position relatively to the other viscera may be under- stood on reference to the subjoined woodcut, which represents the various organs of the chest and belly, as they appear on removing the integuments, breast- bone, and part of the ribs. The sketch is rather rude, but it will serve the purpose. The letters R L and L L mark the right and left lungs, with the heart H lying between them, but chiefly on the left side. V is a not very accurate representation of the large blood- vessels going to the head, neck, and superior extrem- ities. Liv. is the liver, lying in the abdomen, or belly, and separated from the chest by the arched fleshy partition D D, called the diaphragm or midriff. The stomach appears on the other side marked Stm., but both it and the liver are removed a little from their natural situation. G is the gall-bladder. Ill are the various parts of the intestinal canal, through which the food is passed on its way from the stomach, by means of what is called the peristaltic or vermicular motion of the bowel, one circle of fibres narrowing after another, so as to propel its contents slowly but STRUCTURE OF THE LUNGS--AIR-CELLS. 183 steadily, and resembling, in some degree, the con traction of a common worm. The substance of the lungs consists of bronchial tubes, air-cells, bloodvessels, nerves, and cellular mem- brane or parenchyma. The first are merely continu- ations and subdivisions of the windpipe, and serve to convey the external air to the air-cells of the lungs. The air-cells constitute the chief part of the pulmo- nary tissue, and are, in one sense, the terminations of the smaller branches of the bronchial tubes. When fully distended, they are so numerous as in appear- 184 STRUCTURE OF THE LUNGS--AIR-CELLS. ance to constitute almost the whole lung. They are of various sizes, from the twentieth to the hundredth of an inch in diameter, and are lined with an exceed- ingly fine, thin membrane, on which the minute capil- lary branches of the pulmonary arteries and veins are copiously ramified; and it is while circulating in the small vessels of this membrane, and there exposed to the air, that the blood undergoes the change from the venous to the arterial state. So prodigiously numer- ous are these air-cells, that the aggregate extent of their lining membrane in man has been computed to exceed a surface of 20,000 square inches. It may be thought that the interposition of such a membrane must have the effect of preventing any ac- tion of the air upon the blood. But in addition to the proof to the contrary drawn from observation, it has been ascertained by experiment, that even the thick and firm texture of bladder is insufficient to prevent the occurrence of the change; venous blood confined in a bladder speedily acquiring a florid red colour, like that of arterial blood. Bloodvessels necessarily form a large constituent portion of the substance of the lungs. Besides the arteries and veins which the lungs possess in common with other parts for the purposes of nutrition, they have, as we have seen, the large pulmonary arteries and veins, dividing everywhere through their sub- stance into innumerable branches, conveying the whole blood of the body to and from the air-cells, and, therefore, of a magnitude proportioned to the quantity of blood which is destined to pass through them. These two tissues, air-tubes and bloodvessels, to- gether with the loose cellular texture or network which binds them together, called parenchyma, form the principal part of the structure of the lungs. But the latter, like all other organs, are provided also with nerves, without the active co-operation of which, in supplying the requisite nervous stimulus, their special functions, and, consequently, life itself, would speed- ily cease. Every one must have remarked the copious exhala- PULMONARY EXHALATION AND ABSORPTION. 185 Hon of moisture which takes place in breathing, and which presents a striking analogy to the exhalation from the surface of the skin. In the former, as in the latter instance, the exhalation is carried on by the innumerable minute capillary vessels, in which the small arterial branches terminate in the air-cells. Pulmonary exhalation is, in fact, one of the chief out- lets of waste matter from the system; and the air which we breathe is thus vitiated, not only by the subtraction of its oxygen and the addition of carbonic acid, but also by animal effluvia, with which it is load- ed when returned from the lungs. In some individu- als, this last source of impurity is so powerful as to render their vicinity offensive and even insupportable to the by-standers, and it is its presence which gives the disagreeable, sickening smell to crowded rooms. Absorption, in like manner, takes place from the lining membrane of the lungs, as we have seen it do in the skin. When a person breathes an atmosphere loaded with fumes of spirits, of tobacco, of turpentine, or of any other volatile substance, a portion of the fumes is taken up by the absorbing vessels of the lungs, and carried into the system, and there produces precisely the same effects as if introduced into the stomach; dogs, for example, have been killed by being made to inhale the fumes of prussic acid for a few minutes. The lungs thus become a ready inlet to contagion, miasmata, and other poisonous influen- ces diffused through the air which we breathe. From this general explanation of the structure and uses of the lungs, it will be obvious that several con- ditions, which it is our interest specially to know and observe, are essential to the healthy performance of the important function of respiration. First among these we may rank a healthy original formation of the lungs. No fact in medicine is better established than that which proves the hereditary transmission from parents to children of a constitutional liability to pulmonary disease, and especially to consumption; yet no condition is less attended to in forming matri- mi nial engagements. The children of scrofulous Q2 186 INFLUENCE OF HEREDITARY CONSTITUTION. and consumptive parents are generally precocious, and their minds being early matured, they engage early in the business of life, and often enter the mar- ried state before their bodily frame has had time to consolidate. For a few years, everything seems to go on prosperously, and a numerous family gathers around them. All at once, however, even while youth remains, their physical powers begin to give way, and they drop prematurely into the grave, exhausted by consumption, and leaving children behind them destined, in all probability, either to be cut off as they approach maturity, or to run through the same delu- sive but fatal career as that of the parents from whom they derived their existence. Many examples of this kind might be pointed out among the higher classes of society, who are not re- strained from following their predominant inclinations by any necessity of seeking subsistence in profes- sional pursuits. And many instances might be re- ferred to, in which no regard was shown to the man- ifest existence of the same disposition in the family of either parent, and in which, consequently, the mar- ried state was imbittered either by barrenness, which is then the most favourable result, or by the preva- lence of disease and delicacy in the progeny. It may ,not be easy to enforce upon the young and inexpe- rienced the requisite degree of attention to these cir- cumstances; but surely education, especially when backed by example, might do much, if the young were properly instructed at an early period in the leading facts and principles of the human constitution. Where there are hereditary precocity and delicacy of frame, marriage, instead of being hastened, ought in- variably to be delayed, at least, till the fullest maturity and consolidation of the system ; otherwise the con- sequences will be equally unhappy for the individual and for his progeny. During growth, and for a con- siderable time afterward, the constitution is still im- perfect even in healthy subjects, and wants the endu- ring strength which it acquires in mature age, and the possession of which marks the period which nature OF WHOLESOME FOOD AND GOOD DIGESTION. 187 has fixed for the exercise of the functions of produc- tion. Many young people of both sexes fall sacrifices to early marriages, who might have withstood the or- dinary risks of life, and lived together in happiness, if they had delayed their union for a few years, and al- lowed time for the consolidation of their constitu- tions. I have urged this point strongly, because heredita- ry predisposition is, avowedly and beyond all doubt, the most frequent source of the more serious forms of pulmonary disease, and it would be worse than folly to allow past and painful experience to go for nothing. Medical men have much in their power in preventing such violations of the laws of the Creator, at least where they are regarded, as they always ought to be, as the friends not less than the professional advisers of the family. As connected with this subject, I may mention that Dr. Clark has the merit of having drawn attention to the important fact, that a state of impaired health in the parent, whether constitutional or acquired, and particularly if caused by imperfect digestion and as- similation, is as productive of a tendency to scrofula and consumption in the children as if it had descend- ed by hereditary transmission. If parents in general were duly impressed with the truth and bearing of this fact, many of them might be induced, on account of their children, to take that rational care of their own health which they seem to be incapable of doing for its own sake. The SEcoNr requisite to the wellbeing of the lungs, and to the free and salutary exercise of respiration, is a due supply of rich and healthy blood. When, frona. defective food or impaired digestion, the blood is im- poverished in quality, and rendered unfit for adequate nutrition, the lungs speedily suffer, and that often to a fatal extent. So certain is this fact, that, in the lower animals, tubercles (the cause of incurable con- sumption) can be produced in the lungs to almost any extent, by withholding a sufficiency of nourishing food. The same circumstances operate to a lamentable ex 188 OF THE FREE EXPANSION OF THE LUNGS. tent among the poorly-fed population of our manu- facturing towns; whereas it is proverbial that butch- ers—a class of men who eat animal food twice or thrice a day, and live much in the open air—are al- most exempt from pulmonary consumption. Among the higher classes, again, the blood is impoverished, and the lungs are injured, not from want of food, but from want of the power of adequately digesting it; and hence we find, in every treatise on consumption, a section devoted specially to "dyspeptic phthisis," as it is called, or simply " consumption from bad digestion." The late hours, heavy meals, and deficient exercise, which are so generally complained of, but still so reg- ularly adhered to in society, are the chief sources of the evils to which we are now alluding. Thirdlv.—The free and easy expansion of the chest is obviously indispensable to the full play and dilatation of the lungs: whatever impedes it, either in dress or in position, is prejudii ial to health; and, on the other hand, whatever favours the free expan- sion of the chest, equally promotes the healthy fulfil- ment of the respiratory functions. Stays, corsets, and tight waistbands operate most injuriously, by compressing the thoracic cavity, and impeding the due dilatation of the lungs; and, in many instances, they give rise to consumption. I have seen one case, in which the liver was actually indented by the exces- sive pressure, and long-continued bad health and ulti- mately death were the results. In allusion to this subject, Mr. Thackrah mentions, that men can exhale at one effort from six to ten pints of air; whereas in women the average is only from two to four pints. In ten females, about 18 1-2 years of age, belonging to a flax-mill, and "who were labouring under no dis- ease," Mr. Thackrah found the average to be only 3 1-2 pints, while in young men of the same age it amounted to 6 pints. Some allowance is to be made for the naturally smaller capacity of the lungs in fe- males than in males, but Mr. Thackrah is satisfied that the above remarkable difference " is attributable OF THE FREE EXPANSION OF THE LUNGS. 189 chiefly to the lacing of the chest."* Having, howev- er, discussed this matter when treating of the muscu- lar system, it is unnecessary to enlarge on it again, further than to remark, that the constrained motion- less attitudes enforced upon young females in the course of education, are very unfavourable to the play of the lungs and to the full development of the chest. The admirable harmony established by the Creator between the various constituent parts of the animal frame, renders it impossible to pay regard to, or in- fringe the conditions required for, the health of any one, without all the rest participating in the benefit or injury. Thus, while cheerful exercise in the open air and in the society of equals is directly and emi- nently conducive to the wellbeing of the muscular system, the advantage does not stop there, the be- neficent Creator having kindly so ordered it that the same exercise shall be scarcely less advantageous to the important function of respiration. Active exer- cise calls the lungs into play, favours their expansion, promotes the circulation of the blood through their substance, and leads to their complete and healthy development. The same end is greatly facilitated by that free and vigorous exercise of the voice, which so uniformly accompanies and enlivens the sports of the young, and which doubles the benefits derived from them considered as exercise. The excitement of the social and moral feelings which children expe- rience while engaged in play, is another powerful tonic, the influence of which on the general health ought not to be overlooked ; for the nervous influence is as indispensable to the right performance of respi- ration, as it is to the action of the muscles or to the digestion of food. This latter principle explains the reason why the depressing passions predispose to pulmonary con- sumption, a fact which has been remarked from a • Thackrah on Employments as affecting Health and Longev- ity, p. 95. 190 OF CHEERFULNESS OR DEPRESSON OF MIND. 7ery early period. When the mind is in a state of depression, the whole nervous system becomes en- feebled ; the stimulus to the other organs, on which so much of their vital power depends, is impaired; and a general want of tone pervades the system, ren- dering the principal organs of the body, and the lungs among the rest, unusually susceptible of disease. Here, again, we may perceive the beautiful adaptation of all the functions to each other, and the exquisite harmony of design existing between the different parts of the body. It is curious indeed to trace the relations in which the animal functions stand to each other. Grief, sor- row, fear, and other depressing passions of the mind, diminish the activity of the circulation, impair respi- ration, lower vitality, and, consequently, render the organization more than usually susceptible of diseases arising from diminished action. Anger, joy, and the other exhilarating passions, on the other hand, stim- ulate the circulation, quicken respiration, increase the vital powers, and create a proneness to inflamma- tory or excited action. At first sight, it may seem strange that such should be the results of different kinds of mental emotion. On examination, how- ever, we perceive evident design in the arrangement. The tendency of grief, despondency, and sorrow, is to produce meditative inaction. These emotions re- quire no exercise of the bodily powers, and no unu- sual expenditure of vital energy; but rather the reverse. This, it will be observed, is a condition in- compatible with a quick supply of blood or a high degree of respiration; for if these were conjoined, they would only give rise to an amount of bodily ac- tivity at variance with the absorbed and concentrated state of the mind. The nature of the exciting pas- sions, again, is to impel us vigorously to action; but action cannot be sustained without a full supply of highly oxygenated blood, and hence a very manifest reason for the quick respiration and accelerated cir- culation which attend mental excitement. Great depression of mind thus leads naturally to imperfect OF PURE AIR AND VENTILATION. 191 respiration, a more sluggish flow of blood, and the va- rious diseases of diminished vitality ; while great ex- citement induces full respiration, quickened circula- tion, and the various diseases of exalted vitality. These principles show the paramount importance, in the treatment of disease, of carefully regulating the mental state of the patient, according to the object we have in view. A fourth essential condition of healthy respiration remains to be noticed, viz.: a regular supply of pure fresh air, without which the requisite changes in the constitution of the blood, as it passes through the lungs, cannot be effected. To enable the reader to appreciate this condition, we must premise some re- marks on the nature of the changes alluded to. Atmospheric air consists of about 78 per cent, of nitrogen or azotic gas, 21 percent, of oxygen, and not quite 1 percent, of carbonic acid or fixed air; and such is its constitution when taken into the lungs in the act of breathing. When it is expelled from them, however, its composition is found to be greatly alter- ed. The quantity of nitrogen remains nearly the same, but 8 or 8 1-2 per cent, of the ogygen or vital air have disappeared, and been replaced by an equal amount of carbonic acid. In addition to these changes, the expired air is loaded with moisture. Simultane- ously with these occurrences, the blood collected from the veins, which enters the lungs of a dark colour and unfit for the support of life, assumes a florid red hue, and acquires the power of supporting life. It is not easy to offer a satisfactory explanation of the processes by which these changes are effected in the lungs. According to one view, the carbonic acid contained in expired air is formed by the secretion of carbon from the venous blood in its passage through the lungs, this immediately uniting with the oxygen of the air, and forming carbonic acid, in which shape it is then thrown out in expiration. According to the other view, the carbonic acid exists in, and is separa- ted from, the venous blood in the state of acid, and the oxygen which disappears is absorbed into the cir- 192 EXTENT AND NATURE OF VITIATION OF AIR. culating current. The former explanation was long almost universally received, but Dr. Edwards has lately advanced very strong grounds for adopting the latter. Whatever may be the true theory, all physi- ologists are agreed as to the fact that the arterializa- tion of the blood in the lungs is essentially dependant on the supply of oxygen contained in the air which we breathe, and that air is fit or unfit for respiration in exact proportion as its quantity of oxygen ap- ?roaches to, or differs from, that contained in pure air. f, consequently, we attempt to breathe nitrogen, hy- drogen, or any other gas not containing oxygen, the result will be speedy suffocation; while, if we breathe air containing a too high proportion of oxygen, the vital powers will speedily suffer from excess of stim- ulus. From oxygen being thus essential to life and respiration, it is often called vital air, in contradis- tinction to those gases which are incapable of sup- porting life. We can now appreciate the importance of a due supply of fresh air wherever living beings are con- gregated. In man, the rate of vitiation produced by breathing, and the relative importance of ventilation, may easily be estimated. An individual is ascertain- ed to breathe, on an average, from 14 to 20 times in a minute, and to inhale from 15 to 40 cubic inches of air at each inspiration. Sir H. Davy and others rate the quantity so low as from 13 to 17 inches : but most observers agree with Dr. Menzies, who experimented with great care, in estimating it at 40 inches. The quantity, however, varies much in different individ- uals. Even taking the consumpt of air at 20 inches, as a very low estimation, and rating the number of inspi- rations at 15, it appears that, in the space of one min- ute, no less than 300 cubic inches of air are required for the respiration of a single person. In the same space of time, 24 cubic inches of oxygen disappear, and are replaced by an equal amount of carbonic acid; bo that, in the course of an hour, one pair of lungs will, at a low estimate, vitiate the air by the subtrac- DEATH PRODUCED BY VITIATED AIR. 193 tion of no less than 1440 cubic inches of oxygen, and the addition of an equal number of carbonic acid, thus constituting a source of impurity which cannot be safely overlooked. The fatal effects of breathing highly vitiated air may easily be made the subject of experiment. When a mouse is confined in a large and tight glass jar full of air, it seems for a short time to experience no in- convenience ; but in proportion as the consumption of oxygen and the exhalation of carbonic acid proceed, it begins to show symptoms of uneasiness, and to pant in its breathing, as if struggling for air; and in a few hours it dies, convulsed exactly as if drowned or strangulated. The same results follow the depri- vation or vitiation of air in man and in all animated beings; and in hanging, death results, not from dislo- cation of the neck, as is often supposed, but simply because the interruption of the breathing prevents the necessary changes from taking place in the constitu- tion of the blood. The horrible fate of the 146 Englishmen who were shut up in the Black Hole of Calcutta in 1756, is strikingly illustrative of the destructive consequences of an inadequate supply of air. The whole of them were thrust into a confined place 18 feet square. There were only two very small windows by which air could be admitted, and as both of these were on the same side, ventilation was utterly impossible. Scarcely was the door shut upon the prisoners, when their sufferings commenced, and in a short time a de- lirious and mortal struggle ensued to get near the windows. Within four hours, those who survived lay in the silence of apoplectic stupor; and at the end of six hours, ninety-six were relieved by death! In the morning, when the door was opened, 23 only were found alive, many of whom were subsequently cut off by putrid fever, caused by the dreadful effluvia and corruption of the air. But, it maybe said, such a catastrophe as the above could happen only among a barbarous and ignorant people. One would think so, and yet such is the ig- 194 VITIATED AIR DESTRUCTIVE OF HEALTH. norance prevailing among ourselves, that more than one parallel to it can be pointed out even in our own history. Of two instances to which I shall allude, one has lately been published in the Life of Crabbe, the poet. When ten or eleven years of age, Crabbe was sent to a school at Bungay. " Soon after his ar- rival he had a very narrow escape. He and several of his schoolfellows were punished for playing at sol- diers, by being put into a large dog-kennel, known by the terrible name of the' Black Hole;' George was the first that entered; and the place being crammed full writh offenders, the atmosphere soon became pestilen- tially close. The poor boy in vain shrieked that he was about to be suffocated. At last, in despair, he bit the lad next to him violently in the hand; ' Crabbe is dy- ing, Crabbe is dying,' roared the sufferer; and the sentinel at length opened the door, and allowed the boys to rush out into the air. My father said, 'A min- ute more and I must have died.' "* The other instance is recorded in Walpole's Letters, and is the more memorable, because it was the pure result of brutal ignorance, and not at all of cruelty or design. " There has been lately," says Walpole," the most shocking scene of murder imaginable ; a parcel of drunken constables took it into their heads to put the laws in execution against disorderly persons, and so took up every person they met, till they had col- lected five or six-and-twenty, all of whom they thrust into St. Martin's roundhouse, where they kept them all night with doors and windows closed. The poor creatures, who could not stir or breathe, screamed as long as they had any breath left, begging at least for water; one poor wretch said she was worth eighteen pence, and would gladly give it for a draught of wa- ter, but in vain! So well did they keep them there, that in the morning four were found stifled to death; two died soon after, and a dozen more are in a shock- ing way. In short, it is horrid to think what the poor creatures suffered; several of them were beggars, • Crabbe's Life by bis Son, p. 17. EXAMPLES. 195 who, from having no lodging, were necessarily found on the street, and others honest labouring women. One of the dead was a poor washerwoman, big with child, who was returning home late from washing. One of the constables is taken, and others absconded; but I question if any of them will suffer death: though the greatest criminals in this town are the officers of justice, there is no tyranny they do not exercise, no villany of which they do not partake. These same men, the same night, broke into a bagnio in Covent Garden, and took up Jack Spencer, Mr. Stewart, and Lord George Graham, and would have put them into the roundhouse with the poor women if they had not been worth more than eighteen pence."* These melancholy examples ought not to be lost upon us. If the results arising from extreme vitiation of the air be so appalling, we may rest assured that those arising from every minor degree, although they may be less obvious, are not less certain in their op- eration. It is, indeed, readily admitted in the ab- stract, that a constant supply of pure air is indispen- sable to the healthy performance of respiration ; but if we inquire how far this condition is attended to by mankind at large, we shall have no reason to think the present warning unnecessary. I have already no- ticed (at p. 26) the case of Captain Ganson, who was suffocated in the cabin of the Magnus Trail, in Leith Harbour, on 1st March, 1833, and whose brother was recovered with great difficulty from a state of stupor, induced apparently by an insufficient supply of respi- rable air. To these instances another may be added from the Globe newspaper of 1st April, in which it is mentioned that the captain and mate of the French Chasse-maree Royaliste lost their lives from suffoca- tion, in the harbour of Jersey, in a precisely similar way. In both vessels the cabin was very small, and the door having been carefully shut, the access of fresh air was completely prevented. It has been said that cases like these are of rare occurrence, and arise • Walpole's Letters, 1833. 196 VITIATED AIR DESTRUCTIVE OF HEALTH. only from extremely vitiated air; but there is, as we have seen, reason to believe that they occur more fre- quently than has been supposed; and if they have happened already, where is the security that they will not occur again, if we do not bestir ourselves to re- move the ignorance in which they originated ? I do not mean to say, that in all of the above in- stances the fatal results were attributable exclusively to vitiation of the air by breathing. Fixed air may have been disengaged also from some other source; but the deteriorating influence of respiration, where no ventilation is possible, cannot be doubted. Accord- ing to Dr. Bostock's estimate, an average sized man consumes about 45,000 cubic inches of oxygen, and gives out about 40,000 of carbonic acid in twenty-four hours, or 18,750 of oxygen, and 16,666 of carbonic acid in ten hours, which was nearly the time during which the sufferers had remained in the cabin before they were found. As they were two in number, the quantity of oxygen which would have been required for their consumption was of course equal to 37,500 cubic inches, while the carbonic acid given out would amount to upward of 32,000 inches ; a source of im- purity which, added to the constant exhalation of waste matter and animal effluvia from the lungs, was manifestly quite equal to the production of the seri- ous consequences which ensued from it, and which no one, properly acquainted with the conditions es- sential to healthy respiration, would ever have wil- lingly encountered. Even supposing that the cause of death was some disengagement of gas within the vessel, it is still certain that, had the means of venti- lation been adequately provided, this gas would have been so much diluted, and so quickly dispersed, that it would have been comparatively innocuous. The best and most experienced medical officers of the army and navy, are always the most earnest in insisting on thorough ventilation as a chief preserva- tive of health, and as indispensable for the recovery of the sick. Sir George Ballingall recurs to it fre- quently, and shows the importance attached to it by EXAMPLES. 197 Sir John Prmgle, Dr. Jackson, Sir Gilbert Blane, and others of equally high authority. Sir John Pringle speaks of hospitals being, in his day, the causes of much sickness and of frequent deaths, " on account of the bad air and other inconveniences attending them ;" and Dr. Jackson, in insisting on " height of roof as a property of great importance in a house appropriated to the reception of the sick of armies," adds as the reason, that " the air being contaminated by the breath- ings of a crowd of people in a confined space, disease is originated, and mortality is multiplied to an extra- ordinary extent. It was often proved in the history of the late war, that more human life was destroyed by accumulating sick men in low and ill-ventilated apart- ments, than by leaving them exposed, in severe and in- clement weather, at the side of a hedge or common dike.v* In the same volume (p. 114), the reader will find another example not less painful than instructive of the evils arising, first, from crowding together a great- er number of human beings than the air of the apart- ment can sustain, and, secondly, from the total neg- lect of scientific rules in effecting ventilation. In the summer of 1811, a low typhoid fever broke out in the 4th battalion of the Royals, then quartered in Stirling Castle. In many instances, violent inflammation of the lungs supervened, and the result of the two dis- eases was generally fatal. On investigating the cir- cumstances of this fever, it was found that rooms of 21 feet by 18 were occupied by sixty men, and that others of 31 feet by 21 were occupied by seventy-two men! To prevent suffocation, the windows were kept open all night, so that the men were exposed at once to strong currents of cold air and to " the heat- ed and concentrated animal effluvia necessarily exist- ing in such crowded apartments; thus subjecting them to the combined effects of typhus fever and of pneumonic inflammation. In the less crowded apart- ments of the same barrack, no instance of fever oc- curred." The men who were directly in the way of * Ballingall's Letters, p. 178. R3 198 VITIATED AIR DESTRUCTIVE OF HEALTH. the current of cold air, were, of course, those who suf- fered from inflammation. Mr. Carmichael justly regards impure air as one of the most powerful causes of scrofula, and accounts for the extreme prevalence of the disease in the Dublin House of Industry at the time he wrote (1809), by mentioning, that, in one ward of moderate height, sixty feet by eighteen, there were thirty-eight beds, each containing three children, or more than one hun- dred in all! The matron told Mr. Carmichael, that " there is no enduring the air of this apartment when the doors are first thrown open in the morning; and that it is in vain to raise any of the windows, as those children who happen to be inconvenienced by the cold close them as soon as they have an opportunity. The air they breathe in the day is little better; many are confined to the apartments they sleep in, or crowd- ed to the number of several hundreds in the school- room."* Can any one read this account, and wonder at the prevalence of scrofula under such circum- stances * In the preface to the present work, I have expiessed an opinion that the attention of the professional stu- dent is by far too little directed to the acquisition of an accurate acquaintance with the laws and condi- tions of health, as in reality one of the most directly useful branches of knowledge which he can attain. A stronger proof of the truth of this proposition can not be desired, than the simple statement of the above facts. If the medical officers then in charge of the sick at Stirling Castle had been as intimately conversant with the conditions required for the healthy perform- ance of the living functions, and as deeply impressed with the importance of preventing disease, as they were qualified to conduct its treatment when once excited, it is impossible that such causes could have been allowed to come into play, or to remain a single hour undetected and unremoved. When the Profes- sorship of Military Surgery was first established in * Carmichael's Essay on the Nature of Scrofula. Dublia, 1810. EXAMPLES. 199 the University of Edinburgh, it was contended by many that attendance on its lectures would be a hard- ship on the student rather than a benefit, as the infor- mation to be obtained from them was already commu- nicated in the ordinary courses on surgery. But when I state that one of the main purposes of the professor- ship is to teach the means of preserving the health and efficiency of soldiers under every vicissitude of garrison, tent, and field, the reader, instead of thinking its establishment superfluous, will rather be disposed to agree with me in regretting that no analogous course of instruction, having a reference to the exi- gences of civil life, is provided for those who are des- tined for the not less important duties of private prac- tice. Many would gladly avail themselves of such an opportunity, if it once existed. That the due renovation of the air which we breathe is really influential in protecting us against the inroads of disease, maybe inferred also from instances of an op- posite kind, those in which health has been preserved apparently through its agency, even in the midst of pestilence. In preventing contagion from fever, a constant circulation of air is known to be the most ef- fectual means; and Sir Walter Scott, in describing the old Tolbooth or prison of Edinburgh, or " Heart of Mid-Lothian," mentions that, " gloomy and dismal as it was, the situation in the centre of the High-street rendered it so particularly well aired, that, when the plague laid waste the city in 1645, it affected none within these melancholy precincts ;"* and yet, in other respects, a jail was precisely the place where it might have been expected to prevail with the greatest virulence. An equally striking example of the beneficial influence of fresh air is mentioned in a memoir by the late Dr. Joseph Clarke, of Dublin, read before one of the meet- ings of the British Association, at Edinburgh, in Sep- tember, 1834. The memoir consisted of an abstract of a Registry kept in the Lying-in Hospital, Dublin, from 1758 to the end of 1833; from which it appeared * Heart of Mid-Lothian, vol. i., chap. vL Note. 200 VITIATED AIR DESTRUCTIVE OF HEALTH. " that, in 1781, every sixth child died, within nine days after birth, of convulsive disease; and that, after means of thorough ventilation had been adopted, the mor- tality of infants, in five succeeding years, was reduced to nearly one in twenty."* Facts like these are very conclusive. Many writers have been at pains to point out the actual occurrence of the evils which sound physiology would lead us to anticipate from frequently breathing impure air. Among others, Mr. Thackrah, in his ex- cellent little work on the effects of trades and profes- sions on health, expresses himself very strongly, and specially notices that dyspeptic symptoms are often the first indications of the commencing disease, and that the lungs suffer only after the digestive system has been for a time disordered. It may not be easy to explain why the stomach and bowels should suffer even sooner than the lungs themselves, from a cause which seems exclusively directed to the latter; but observation substantiates the fact, and it is one of much interest in enabling us to trace to their true sources many of the forms of bad health prevalent in the middle ranks of life. Although, however, the first effects are so often ref- erable to the stomach, the lungs and general system sooner or later become implicated. An individual possessing a strong constitution may indeed withstand the bad consequences of occasionally breathing an impure atmosphere, but even he will suffer for a time. He will not experience the same amount of mischief from it as the invalid, but will be perfectly conscious of a temporary feeling of discomfort, the very purpose of which is, like pain from a burn, to impel him to shun the danger, and seek relief in a purer air. The comparative harmlessness of a single exposure is the circumstance which blinds us to the magnitude of the ultimate result, and makes us fancy ourselves safe and prudent, when every day is surely, though imper- ceptibly, adding to the sum of the mischief. But let * Report of Proceedings of the British Association, in Edia Phil. Jour, for Oct., 1834, p. 416. IMPURE AIR A CAUSE OF INSIDIOUS DISEASE. 201 any one who doubts the importance of this condition of health watch the dyspeptic, the pulmonary, or the nervous invalid, through a season devoted to attend- ance on crowded parties and public amusements, and he will find the frequency of headaches, colds, and other fits of illness, increase in exact proportion to the accumulated exposure, till, at the end of spring, a general debility has been induced, which impera- tively demands a cessation of festivity, and a change of scene and air. This debility is often erroneously ascribed to the unwholesome influence of spring—a season extolled by the poets, not as a cause of relax- ation and feebleness, but as the dispenser of renova- ted life and vigour to all created beings. It is in vain to warn such persons beforehand, that Nature is always consistent, and that, if bad air be really unfit for healthy respiration, it must be detri- mental to them, and to all who breathe it; and that its ill effects are not less real, because at first gradual and unperceived in their approach. They know too little of the animal economy and of Nature's laws, and are too much devoted to their own object, to be impressed by cautions of this kind; and, in looking forward to the ballroom or crowded evening party, few of them will believe that any possible connexion can exist between breathing its vitiated atmosphere, and the headaches, indigestion, and cutaneous erup- tions which so frequently follow, and to be delivered from which they would sacrifice almost every other enjoyment. If it be said that nobody will be troubled with all this trifling care, and that thousands who expose themselves in every way nevertheless enjoy good health and a long life, I can only answer that this is true; but that an infinitely greater proportion pass through life as habitual invalids, and scarcely know, from experience, what a day of good health really is. The late discussions on the Factory Bill have dem- onstrated, by an unassailable mass of evidence, that many circumstances, rarely considered as injurious, because they have no immediate effect in suddenly 202 IMPURE AIR A CAUSE OF INSIDIOUS DISEASE. destroying life by acute diseases, have, nevertheless, a marked influence in slowly undermining health and shortening human existence. There are trades, for ex- ample, at which workmen may labour for fifteen or twenty years, without having been a month confined by disease during all that time, and which are, therefore, said to be healthy trades; and yet, when the investi- gation is pursued a little farther, it is found that the general health is so steadily, although imperceptibly, encroached upon, that scarcely a single workman survives his fortieth or fiftieth year. It is this insidious influence of impure air to which I am anxious to direct attention. So long as delica- cy is the rule, and robust health the exception, espe- cially among females, and so long as nearly one fourth of the annual deaths in Great Britain are caus- ed by consumption alone, it will be difficult to per- suade any rational and instructed mind that every cause of disease is already removed, and that farther care is superfluous. My own conviction, on the con- trary, is that, by proper care and a stricter observance of the laws of the animal economy on the part of the parents and guardians of the young, the development of the disease might b« prevented in a large propor- tion of the number, and that even the robust would enjoy health in a higher degree and with increased security. It is an instructive proof of this, that those who have directed their chief attention to training ei- ther man or animals for athletic exercises or the racecourse, have been led by observation to attach the utmost importance to pure air. The late Sir John Sinclair was at pains to collect the rules fol- lowed by Jackson, the celebrated trainer, and others of the same profession, and he tells us that, by all of them, the necessity of pure air is uniformly insisted upon. Sir John adds, that the same condition was deemed so essential by the ancients, that the Roman Athletae established their principal schools at Capua and Ravenna, as enjoying the most pure and healthy air in all Italy; and that, in the training of racehorses, and even of gamecocks, the most sedulous attention is paid to the purity of the air in which they live. EXAMPLES OF DISEASE FROM IMPURE AIR. 203 The necessity for adequate ventilation is nowhere more urgent than in many of our manufactories, where, from the length of time (varying from 10 to 17 hours a day) during which the operatives are ex- posed to the evils of impure air, a great sacrifice of health and happiness is constantly going on. In ref- erence to this cause, Dr. Clarke mentions the striking fact, that among the forkgrinders of Sheffield, those resident in the country, and subjected to a more free circulation of air, live, on an average, eight years longer than those resident in towns. In both, the irritating cause and the habits of life are the same, but the rooms in which the country workmen carry on their labours are larger and much better ventila- ted. The latter live, on an average, forty years, while their town companions are cut off between the ages of twenty-eight and thirty-two.* I may add, that the dust floating in the air in cotton manufactories and spinning mills, and produced in many trades, is a very serious aggravation of the evil, as all foreign bodies thus inhaled into the lungs produce irritation in their structure, and sooner or later lead to the de- velopment of fatal pulmonary disease. Striking, however, as these and innumerable other facts of a similar nature are, we still remain so blind to the instructions of experience, until we acquire a knowledge of the principles which give it value, that we go on, especially in towns, constructing our houses in utter defiance of scientific rules. The public rooms, which can be easily ventilated at any time— which are, in fact, ventilated by the constant opening and shutting of the door, and by the draught of the chimney—and in which, therefore, large dimensions are less necessary for salubrity, are always the most spacious and airy. The bedrooms, on the other hand, in which, from the doors being shut, and from there being no current of air in the whole seven or eight hours during which they are occupied, the vitiation of the air is the greatest, and in which, consequently, * Cyclopaedia of Piactical Medicine, Part xxii., p. 312. 204 DEFICIENT VENTILATION IN PUBLIC HALLS. size is most required, are uniformly the smallest and most confined; and, as if this source of impurity were not sufficient, we still farther reduce the already too limited space by surrounding the bed closely with curtains, for the express purpose of preventing ven- tilation and keeping us enveloped in the same heated atmosphere. Can anything be imagined more direct- ly at variance than this with the fundamental laws of respiration* Or could such practices ever have been resorted to, had the nature of the human constitution been regarded before they were adopted 1 In this re- spect, we are more humane towards the lower ani- mals than towards our own species; for, notwith- standing all the refinements of civilization, we have int yet aggravated the want of ventilation in the sta- ble or the cowhouse, by adding curtains to the indi- vidual stalls of the inmates. So little, indeed, are we taught to think of the na- ture and wants of the human constitution, that in Edin- burgh, and almost every large town, we have instan- ces of large public rooms, capable of holding from 800 to 1000 persons, built within these few years, without any means of adequate ventilation being pro- vided, and apparently without the subject having ever cost the architect a thought! When these rooms are crowded and the meeting lasts for some hours, espe- cially if it be in winter, the consequences are suffi- ciently marked. Either such a multitude must be subjected to all the evils of a contaminated and un- wholesome atmosphere, or they must be partially re- lieved by opening the windows, and allowing a con- tinued stream of cold air to pour down upon the heat- ed bodies of those who are near them, till the latter are thoroughly chilled, and perhaps fatal illness is in- duced : and unfortunately, even at such a price, the relief is only partial; for the windows being all on one side of the room, and not extending much above half way to the ceiling, complete ventilation is im- practicable. This neglect is glaringly the result of ignorance, and could never have happened had either the architects or their employers known the laws of DEFICIENT VENTILATION IN PARLIAMENT. 205 the human constitution; and yet it is still doubted whether it be prudent or right to teach the intelligent portion of the community any knowledge of the struc- ture and uses of their own organs! These remarks have been fully verified since they were first printed. During the last winter an unusual number of courses of popular lectures weregiven in Edinburgh, many of which were very fully attended. From the utter impossibility of safe ventilation, those courses which were most crowded, were accessible only at such an expense of health and suffering on the part of their less robust auditors, as served to neu- tralize, in a great measure, the advantages which might otherwise have been derived from them. Sev- eral of my own friends were compelled to discon- tinue their attendance, while others persevered, al- though at the certain cost of a severe headache. This nuisance is the more to be regretted, as it has arisen solely from the architects and the public not having been sufficiently alive to the importance of that prime necessary of life, pure air; and not at all from any difficulty of obtaining it which could not, at the first, have been easily overcome. Nowhere, perhaps, have the evils arising from de- ficient ventilation been experienced in greater inten- sity than in the two Houses of Parliament, and more particularly in the House of Commons, where, from the great number of both members and strangers gen- erally in attendance, the length of the sittings, the small size of the apartment, and the vitiating effects of the lights, the air is rendered so impure, that few, indeed, are able to withstand its poisonous influence for many weeks. The effects of this vitiation gave rise to loud complaints during the busy and memora- ble session of 1835, when the importance of the in- terests at stake, and the equal balancing of parties, occasioned an unusually close attendance and very lengthened sittings. The lives of several of the mem- bers were sacrificed in consequence of it, and the health of many more, even the most robust among them, was very seriously impaired. The evil, hovv- S 206 DEFICIENT VENTILATION IN ever, at last attracted the attention of Parliament so forcibly, that there is every reason to hope that spe- cial care will be taken to guard against its occurrence in the construction of the new edifices. It will, in truth, be a disgrace to the country, and to the scien- tific talent with which it abounds, if so vital a defect be not entirely and permanently remedied. In dwelling houses lighted by gas, the frequent re- newal of the air acquires increased importance. A single gas-burner w ill consume more oxygen, and pro- duce more carbonic acid to deteriorate the atmosphere of a room, than six or eight candles. If, therefore, where several burners are used, no provision be made for the escape of the corrupted air, and for the intro- duction of pure air from without, the health will ne- cessarily suffer. A ventilator placed over the burn- ers, like an inverted funnel, and opening into the chimney, is an efficient and easy remedy for the former evil; and a small tube, forming a communication be- tween the external air and the room, would supply fresh air where necessary. The tube might be made to pass, like a distiller's worm, through a vessel con- taining hot water, by which means the air might be heated in very cold weather before being thrown into the room, and thus the danger arising from cold draughts and inequalities of temperature be avoided. Many of our churches and schools are extremely ill ventilated; and accordingly it is observed, that fainting and hysterics occur in churches much more frequently in the afternoon than in the forenoon, be- cause the air is then in its maximum of vitiation. In- deed, it is impossible to look around us in a crowded church, towards the close of the service, without per- ceiving the effects of deficient air in the expres-ion of the features of every one present. Either a relax ed sallow paleness of the surface, or the hectic flush of fever is observable ; and, as the necessary accom- paniment, a sensation of mental and bodily lassitude is felt, which is immediately relieved by getting into the open air. I have seen churches frequented by upward of a CHURCHES AND SCHOOLS. 207 thousand people, in which, during winter, not only no means of ventilation are employed during service, but even during the interval between the forenoon and afternoon services, the windows are kept as carefully closed as if deadly contagion lay outside, watching for an opportunity to enter by the first open chink; and where, consequently, the congregation must in- hale, for two or three hours in the afternoon, an ex- ceedingly corrupted air, and suffer the penalty in head- aches, colds, and bilious and nervous attacks. Few of our schools are well regulated in this re- spect. It is now several years since, on the occasion of a visit to one of the classes of a great public semi- nary, my attention was first strongly attracted to the injury resulting to the mental and bodily functions from the inhalation of impure air. About 150 boys were assembled in one large room, where they had been already confined nearly an hour and a half when I entered. The windows were partly open ; but, not- withstanding this, the change from the fresh atmo- sphere outside to the close contaminated air within, was exceedingly obvious, and most certainly was not without its effect on the mind itself, accompanied as it was with a sensation of fulness in the forehead and slight headache. The boys, with every motive to ac- tivity that an excellent system and an enthusiastic teacher could bestow, presented an aspect of weari- ness and fatigue which the mental stimulus they were under could not overcome, and which recalled forci- bly sensations long by-gone, which I had experienced to a woful extent when seated on the benches of the same school. These observations stirred up a train of reflections; and when I called to mind the freshness and alacrity with which, when at school, our morning operations were carried on, the gradual approach to languor and yawning which took place as the day advanced, and the almost instant resuscitation of the whole energies of mind and body that ensued on our dismissal, I could not help thinking that, even after making every necessary deduction for the mental fatigue of the les 208 DEFICIENT VENTILATION IN HOUSES, sons and the inaction of body, a great deal of the com- parative listlessness and indifference was owing to the continued inhalation of an air too much vitiated to be able to afford the requisite stimulus to the blood, on which last condition the efficiency of the brain so es- sentially depends. This became the more probable, on recollecting the pleasing excitement occasionally experienced for a few moments, from the rush of fresh air which took place when the door was opened to admit some casual visiter.* Indeed, on referring to the symptoms induced by breathing carbonic acid gas or fixed air, it is impossible not to perceive that the headache, languor, and debility consequent on confinement in an ill-ventilated apartment, or in air vitiated by many people, are nothing but minor de- grees of the same process of poisoning which ensues on immersion in fixed air. Of this latter state, "great heaviness in the head, tingling in the ears, troubled sight, a great inclination to sleep, diminution of strength, and falling down," are stated by Orfila as the chief symp- toms^ and every one knows how closely these re- semble what is felt in crowded halls. Another instance of the noxious influence of vitiated air, which made a very strong impression on my mind, was during a three hours' service in a crowded coun- try church, in a warm Sunday of July. The windows were all shut, and, in consequence, the open door was * The accuracy of the above remarks has been strikingly con- firmed, since the appearance of the first edition, by an intelligent teacher in Kdinburgh, who, in compliance with my advice, pays much attention to ventilation, and turns out his pupils to play in the open air for ten minutes at the end of the first hour. During this time the doors and windows are thrown open, and the air completely renewed. The effect of this proceeding was a marked increase in the mental activity and attention of the pupils, greater pleasure and success in the exercises, and a striking diminution in the number of absentees from sickness. The latter effect was so marked, that some of the parents observed the improved health of their children, without being aware to what it'was due. Since the publication of the second edition, an almost identical instance has been published in a very favourable review of the present vol- ume in the Quarterly Journal of Education for October, 1834. f Toxicologic, ii, 422. CHURCHES, AND SCHOOLS. 209 of little use in purifying the atmosphere, which was unusually contaminated, not only by the respiration and animal effluvia proceeding from so many people, but by their very abundant perspiration excited by the heat and confinement. Few of the lower classes, either in town or country, extend their cleanliness beyond the washing of the hands and face. Hence the cutaneous exudation, in such persons, is charac- terized by a strong and nauseous smell, which, when concentrated, as it was on this occasion, becomes ab- solutely overpowering. Accordingly, at the conclu- sion of the service, there was heard one general buzz of complaint of headache, sickness, and oppression; and the reality of the suffering was amply testified by the pale and wearied appearance even of the most robust. One of the evils of ignorance is, that we often sin and suffer the punishment without being aware that we are sinning, and that it is in our power to escape the suffering by avoiding the sin. For many gener- ations, mankind have experienced the evil results of deficient ventilation, especially in towns, and suffered the penalty of delicate health, headaches, fevers, con- sumptions, and cutaneous and nervous diseases; and yet, from ignorance of the true nature and importance of the function of respiration, and of the great con- sumption of air in its performance, architects have gone on planning and constructing edifices, without bestowing a thought on the means of supplying them with fresh air, although animal life cannot be carried on without it; and, while ingenuity and science have been taxed to the uttermost to secure a proper supply of water, the admission of pure air, though far more essential, has been left to steal in like a thief in the night, through any hole by which it can find an en- trance. In constructing hospitals, indeed, ventilation has been thought of, because a notion is prevalent that the sick require fresh air, and cannot recover without it; but it seems not to have been perceived, that what is indispensable for the recovery of the sick, may bo not less advantageous in preserving from sick- 210 DISEASE FROM ILL-REGULATED VENTILATION. ness those who are well. Were a general knowledge of the structure of man to constitute a regular part of a liberal education, such inconsistencies as this would soon disappear, and the scientific architect would speedily devise the best means for supplying oui houses with pure air, as the engineer has already sup plied them with pure water. The truth of the preceding remarks is strongly con firmed by the recent experience of the highly respect- able establishment by which this volume is printed. For years the workmen employed in it were exposed to the full influence of the vitiated air arising in print- ing-houses from the nature of the materials, the pres- ence of many persons in the same room, and the nu- merous lights required, especially in winter, the whole of which, combined, formed an atmosphere sickening and oppressive to those unaccustomed to it, but of the true nature of which, those habitually exposed to it received a much fainter impression. On the attention of the partners being drawn to the importance of pure air to bodily health and mental activity, they became anxious to effect a thorough ventilation of their own premises. The plan resorted to was very simple, viz., opening a hole of six or eight inches square into a disused chimney at each end of the principal apart- ments, the upper edge of it being on a level with the ceiling. The warm vitiated air naturally ascends, and having the benefit of the draught through the chimney, is readily carried up, and a good ventilation thus established. The consequent improvement in the comfort and working power of the men is, I un- derstand, not less remarkable than the difference in comfort and freshness to a stranger entering from the open air. The same simple plan has been adopted in the printing-office of the Scotsman newspaper, and I have been told by one of the proprietors, that there the workmen are now as little exhausted by two or three hours of extra labour, as they were be- fore with their ordinary exertion. But in admitting an abundant supply of fresh air, especially into hos- pitals, care must be taken that it do not form currents MEANS OF EFFICIENT VENTILATION. 211 which may be prejudicial to the persons within. A writer in the Lancet, of 29th December, 1832, after narrating a case of a patient who was carried off by pleurisy, while under treatment by Dr. Elliotson, in St. Thomas's Hospital, for disease of the pylorus, gives his opinion, that the pleurisy " was most likely occasioned by the extreme draughts of this ward. There is a great current of air in the ward, and I have seen many persons in it suffer very much indeed." In a note, it is added, " The number of patients ivho are thus carried off yearly, forms a startling list to be laid before the eyes of the governors of this institution. Such re- sults are shamefully frequent." I have already noticed the occurrence of pneumonic inflammation from the same causes in the garrison at Stirling Castle, and it is to be feared that there are still many hospitals as much in need of improvement in this respect as St. Thomas's. As a contrast to the above case, it is gratifying to observe the care which has been taken to effect a thorough and safe ventilation in fitting up the new surgical wards of the Edinburgh Infirmary, which may serve as a model of what ought to be done, not only with all public edifices, but, I may add, with all private dwellings. In these wards, fresh air is intro- duced by large circular openings in the floor, and the vitiated air escapes by similar openings in the roof. The apparatus is so constructed as to admit of the air being heated in winter before it enters the ward, by which means all danger from cold currents is pre- vented. Since the first publication of these pages, my atten- tion has been kindly drawn, by Mr. Robert Cadell, bookseller in this city, to the still more efficient and wholesome method of warming and ventilating houses and buildings, at present in use in his own extensive establishment, and which was first invented by Mr. Perkins. The apparatus consists simply of a furnace in the lowest part of the building, and of a continuous iron pipe, about an inch in diameter, filled with water and of a length sufficient to make it extend through 212 VITIATED AIR DESTRUCTIVE OF HEALTH. all the apartments in which heat is wanted, and re- turn to the point from which it started. The pipe is thus properly a circle, and has no end. The portion of it surrounded by the fire of the furnace becomes first heated, the water in it expands, and this, being specifically lighter than the colder water in the de- scending branch, begins to ascend, and continues to do so as its temperature rises. A regular current of ascending hot water and descending cooler water is thus established; and all that is required to heat any apartment is to have a quantity of the ascending pipe in it proportioned in length to the space to be heated. In ordinary rooms, this is done by having part of it coiled up in the usual fireplace ; but in large halls the pipe is carried round the edge of the floor, so as to diffuse the heat more equally over its most distant parts. From the small size of the pipe, and the distance to which it is carried in large establishments, like that of Mr. Cadell, there may seem at first sight an impos- sibility that it should be able to furnish an adequate supply of heat. But experience shows that it is great- ly more than adequate to this purpose. When I vis- ited Mr. Cadell's premises, I was struck with the genial and pleasant heat which pervaded every part of them, although there was only one furnace for the whole five stories. I was not less struck with the total absence of the empyreumatic odour and parched dryness so generally characteristic of heated air. By Mr. Perkins's apparatus, ventilation can be car ried, with safety, to any extent which may be requi- red. All that is necessary is to have the cold air from without conveyed into the lower part of the orna- mental metal box or stove, in which the coils of pipe are contained, and to have proper apertures at the top of the box to allow the warm air to escape into the room. To permit the vitiated air to get out, open- ings are left in the ceiling of the room or hall; and, by having stopcocks placed on both, the entrance of warm external air, and the issue of vitiated air, or, in other words, ventilation, can be regulated at pleas- SOURCES OF ANIMAL HEAT. 213 ure, without any risk either from draughts or from the entrance of cold damp air, such as prevails in this climate during the winter months. The efficacy, economy, safety, and agreeableness of warming by the above plan can scarcely be over- rated, particularly in large buildings, hospitals, and places liable to fire. The pipes may be conveyed through rooms full of paper or other inflammable ma- terials without the possibility of accident; and the apparatus being once fitted up, lobbies and every part of a house can be comfortably heated with as little trouble as a single room. This, too, is of much consequence, because numerous colds are caused by passing frequently from warm rooms to cool lobbies and bedrooms, without any additional clothing. The Russians and other northern nations owe their com- parative exemption from consumption partly to the whole interior of their houses being of a comforta- ble and uniform temperature, and partly to their warm clothing; and, so long as our modes of heating and ventilation remain so imperfect, and diseases of the chest continue so prevalent among us, we ought nev er to lose sight of the relation of cause and effect subsisting between the two circumstances, or relax in our endeavours to obviate the latter by the rectifi cation of the former. In the third chapter, I pointed out the necessity of protecting the skin by suitable clothing, and mentioned the intimate relation which subsists between its func- tions and those of the lungs. We have now to con- sider this subject a little farther, as regards the origin and regulation of the animal heal. The true sources of animal heat are still imperfect- ly known, and any discussion concerning them would be too abstract for the present volume. Its regular production, however, is an essential condition of life. If the human body did not. possess within itBelf the power of generating heat, so as to maintain nearly an equality of temperature in all climates, it could not long exist. In winter, and especially in the nor- thern regions, the blood would speedily be converted 214 SOURCES OF ANIMAL HEAT. into a solid mass, and life be extinguished, if no pro- vision existed for replacing the caloric withdrawn from the system by the cold air surrounding it. In most parts of the globe, the heat of the atmosphere is, even in summer, inferior to that of the human body, and, consequently, a loss of caloric is always going on, which must be made up in some way, other- wise disease and death would speedily ensue. In cholera a very remarkable diminution of heat occurs, and return to the natural temperature is an indispen- sable step towards recovery. The relation between the production of animal heat and the condition of the respiratory functions is the most direct and remarkable. In general, other condi- tions being alike, the quantity of heat generated'is in proportion to the size and vigour of the lungs ; and, when these are impaired, its production is diminished. Hence many persons, with imperfectly developed lungs and a predisposition to consumption, complain habitually of coldness of the surface and feet; and many who were previously in good health, become more and more sensible to cold, in proportion as the approach of disease weakens the functions of the lungs. I have noticed this increased sensibility to cold, as a precursor of chronic pulmonary disease, both in myself and in others, before any other very obvious symptom had appeared, and think 1 have seen its farther progress arrested by the timely use of proper means, where much greater difficulty would have been experienced had the warning not been at- tended to. The generation of heat in the living system being so immediately connected with the lungs, we find the temperature highest in those animals which possess them in the greatest perfection, namely, binls. In many species, the internal heat exceeds that of man by twenty or thirty degrees ; while that of man ex- ceeds, to as great an extent, the heat of such of the inferior animals as are remarkable for imperfect or- gans of respiration. The next condition affecting the production of ani- SOURCES OF ANIMAL HEAT. 215 mal heat, is the co-opetation of the nervous system. If the mind be depressed by grief, tormented by anxiety, or absorbed in sedentary meditation, all the bodily functions become weakened, the circulation lan- guishes, the breathing becomes slow and scarcely perceptible, digestion is ill performed, and coldness of the extremities ensues. If, on the other hand, the mind and nervous system be stimulated by cheerful and agreeable emotions, a pleasant glow pervades the frame, and external cold is much more easily re- sisted. The quantity and quality of the food, and slate of the digestive functions, are also important conditions. The enormous quantity of stimulating animal food, such as fat and oil, required for the support of life under exposure to the intense cold of the polar re- gions, as mentioned by Franklin, Parry, and Richard- son, is an appropriate example. The proposition will, indeed, be readily assented to, when the reader con- siders that a due supply of well-formed chyle is ne- cessary to restore the nourishing properties of the blood, and that if, in consequence either of insufficient food or of a weak digestion, this be rendered impos- sible, all the animal functions, among others the pro- duction of heat, must unavoidably be impaired. This is the reason why cold is felt most severely in the morning before breakfast, and why coldness of the feet and chillness of the surface are so generally com- plained of in indigestion and bilious complaints. Everybody knows that exercise favours and indo- lence obstructs the development of animal heat. Exercise produces its effects by the general stimulus which it gives directly to the respiratory and circula- ting systems, and indirectly to the nervous and diges- tive functions. In attempting, therefore, to increase the power of resistance to cold in the human body, we ought to take into account all the conditions which favour the generation of heat. Observation proves that the de- gree of cold required to overcome the internal gen- erating power and to extinguish life, varies in the 216 CONNEXION BETWEEN RESPIRATION game individual at different times; and,therefore,our protecting measures also ought to be varied accord- ing to the state of the constitution, the vigour of the respiratory and digestive functions, the kind and quan- tity of food, and the amount of exercise. When the food is inadequate and the mind depressed, the sys- tem resists the impression of cold with great difficulty ; and even in Scotland, where the temperature is rarely very low, scarcely a winter passes without several instances of death from exposure occuring in ill-fed and ill-clothed individuals, even when the thermome- ter is above the freezing point. This happens usually when a high wind aids the rapid abstraction of heat. WTell-fed guards of coaches, on the other hand, are remarkable examples of the power of withstanding low temperatures in very exposed situations, where the animal functions are in a state of vigour. The recent Arctic expeditions under Parry, Lyon, and Ross, afford similar instances. Having already, when treating of the skin, suffi- ciently explained the principles on which clothing ought to be adjusted, it is unnecessary to recur to its utility as a means of regulating the temperature of the human body. If the use of suitable clothing is found insufficient to keep the body warm, we may infer with certainty, although no other sign of bad health has appeared, that some internal cause exists, affecting and impairing one or other of the sources of animal heat already mentioned, and that, till the spe- cial cause be discovered and removed, the evil itself will continue undiminished. A not unfrequent cause of suffering from cold during the day in delicate per- sons is the common practice of sleeping on very soft feather beds, in which the body sinks so deep as to be almost surrounded by feathers. The undue warmth thence arising relaxes the surface of the body, weak- ens the action of the skin, and thus renders the indi- vidual unusually susceptible of the impression of cold when exposed out of doors. When a feather bed is used, it ought to be so well stuffed as to afford ample resistance to the weight of the body. | AND ANIMAL HEAT. 217 In winter, young people often suffer from being daily confined, for many hours in succession, without exercise, in rooms insufficiently heated. This is a | constant subject of complaint in large academies and boarding-schools, where economy in fuel is carried to its utmost limits. Nothing tends more than this to lower the general standard of health, and prepare the individual for the future inroads of insidious diseases. In scrofulous children especially, in whom the evo- lution of heat is rarely energetic, the evil is one of great magnitude; for the chilblains, colds, and head- aches more immediately complained of, are often its least important consequences. It is far from my wish to recommend that the young of either sex should be brought up in the relaxing atmosphere of overheated rooms. On the contrary, comfortable warmth ought, in every instance, to be drawn chiefly from its legiti- mate sources, free respiration in a pure air, abundant exercise out of doors, vigorous digestion, and an ac- tively employed mind. If these conditions be observ- ed, little fire will be required to supply warmth to the young. But if, as often happens, these be neglected, and the generation of animal heat be thereby reduced too low, we must either allow the mischief to go on increasing, or afford adequate warmth from without. It is in vain to think of rendering young creatures hardy by subjecting them to the continued influence of a low and chilling temperature. A few may es- cape, but the majority will certainly suffer. In the heating of rooms and public halls, it is proper to be on our guard against rendering the air too dry, a condition which is hurtful in causing too rapid evap- oration from the whole line of the air-passages, as well as from the surface of the body, and which is apt to produce considerable irritability in the system at large. On the Continent, where stoves are much in use, a vessel containing water is commonly placed in a sand-bath on the top, that moisture may be generated quickly or slowly, according to the de- gree of heat, and diffused through the top atmo- sphere. In such of our halls as are warmed by 218 EXERCISE OF THE LUNGS. heated air or stoves, some plan of this sort > uht to be adopted. Having thus examined the chief conditions required for healthy respiration, it only remains for me to throw out a few practical hints in regard to what may be called the education of the lungs, or the means by which their development may be favoured, and their functions improved in tone and extent. Most of these means have been already noticed at some length, and the only important one which still claims our atten- tion is the exercise of the lungs. Judicious exercise of the lungs is one of the most efficacious means which we can employ for promoting their development and warding off their diseases. In this respect the organs of respiration closely resemble the muscles and all other organized parts. They are made to be used, and if they are left in habitual inac- tivity, their strength and health are unavoidably im- paired ; while, if their exercise be ill-timed or exces- sive, disease will as certainly follow. The lungs may be exercised indirectly by such kinds of bodily or muscular exertion as require quicker and deeper breathing; and directly by the employment ol the voice in speaking, reading aloud, crying, or sing- ing. In general, both ought to be conjoined. But where the chief object is to improve the lungs, those kinds which have a tendency to expand the chest, and call the organs of respiration into play, ought to be especially preferred. Rowing a boat, fencing, quoits, shuttlecock, and the proper use of the skipping- rope, dumb-bells, and gymnastics, are of this descrip- tion. All of them employ actively the muscles of the chest and trunk, and excite the lungs themselves to freer and fuller expansion. Climbing up hill is, for the same reason, an exercise of high utility in giving tone and freedom to the pulmonary functions. Where, either from hereditary predisposition or ac- cidental causes, the chest is unusually weak, every effort should be made, from infancy upward, to favour the growth and strength of the lungs, by the habitual EXERCISE OF THE LUNGS. 219 use of such of the above-mentioned exercises as can most easily be practised. The earlier they are re- sorted to and the more steadily they are pursued, the more certainly will their beneficial results be experi- enced. In their employment, the principles explained in the chapter on the Muscles ought to be adhered to. Habitual exercise in a hilly country, and the fre- quent ascent of acclivities, especially in pursuit of an object, are well known to have a powerful effect in improving the wind and strengthening the lungs; which is just another way of saying that they increase the capacity of the chest, promote free circulation through the pulmonary vessels, and lead to the more complete oxygenation of the blood. Hence the vigorous appe- tite, the increased muscular power, and the cheerful- ness of mind so commonly felt by the invalid on his removal to the mountains, are not to be wondered at. I was myself sensible of advantage from this kind of exercise during a Highland excursion. The necessity of frequent and deep inspirations, and the stimulus thus given to the general and pulmonary circulation, had an obvious effect in increasing the capacity of the lungs and the power of bearing exertion without fatigue. Even when I was wearied, the fatigue went off much sooner than after a walk of equal length on a level road, and was unattended with the languor which generally accompanied the latter. In fact, the most agreeable feeling which I experienced during the whole time was while resting after undergoing, in the ascent of a hill, a degree of exertion sufficient to accelerate the breathing, and bring out a consider- able quantity of perspiration. A lightness and activ- ity of mind, and freedom about the chest, which I never felt to the same extent at any other time, fol- lowed such excursions, and made the fatigue com- paratively light. Before such practices, however, can be resorted to with advantage, or even with safety, there must be nothing in the shape of active disease existing. If there be, the adoption of such exercise will, in all probability, occasion the most serious injury. This 220 EXERCISE OF THE LUNGS. also I experienced in my own case, as, for many months at an earlier stage of convalescence, going up a stair, ascending the most gentle acclivity, or speak- ing aloud for a few minutes, was equally fatiguing and hurtful, and often brought on cough, and occa- sionally a slight spitting of blood. All that time, ri- ding on horseback, which exercises the body without hurrying the breathing, was especially useful. The advantage of these exercises in giving tone and capa- city to the lungs, where debility rather than disease is complained of, is shown in their being uniformly resorted to in preparing for the racecourse and for the field. The true sportsman puts himself in train- ing as well as his dog or his horse, and fits himself for the moors by regular excursions previous to the 12th of August. By so doing he improves his wind and increases his muscular strength to a remarkable extent in a very short time. When no active pulmonary disease exists, these ex ercises may, with the best effects, be frequently carried so far as to induce free perspiration; only great care ought to be taken immediately after, to rub the surface of the body thoroughly dry, and to change the dress. It is quite ascertained that, with these precautions, perspiration from exercise is the reverse of debilita- ting. It equalizes and gently stimulates the circula- tion, relieves the internal organs, improves digestion, and invigorates the skin. Jackson testifies strongly to these results, when he declares that the severe ex- ercise undergone in training not only improves the lungs, but always renders the skin " quite clear, even though formerly subject to eruptions."* These asser- tions are, of course, to be received as the statements of a man partial to his own art; but they are in ac- cordance with experience, and with the laws of the animal functions, so far as these are known. They therefore merit the consideration of professional men, and of those whose features are often disfigured by * Sir John Sinclair's Code of Health, 5th Edition. Appeodii, p. 37. EXERCISE OF THE LUNGS. 221 eruptions which they find it difficult to remove by any kind of medicine. 1 need hardly say, that, when wishing to favour the development of the lungs, we ought to be scrupu- lous in avoiding such positions of the body as hinder their full expansion. Tailors, shoemakers, clerks at a writing desk, and the like, are unfavourably situated in this respect, as their bent position constrains the chest, and impedes the breathing and circulation. Direct exercise of the lungs in practising deep in- spiration, speaking, reciting, singing, and playing on wind instruments, is very influential for good or for evil, according as it is indulged in with or without ref- erence to the constitution of the individual. If it is properly managed and persevered in, particularly be- fore the frame has become consolidated, nothing tends more to expand the chest, and give tone ?.nd health to the important organs contained in it; but if either ill-timed or carried to excess, nothing can be more detrimental. As a preventive measure, Dr. Clark is in the habit of recommending the full expan- sion of the chest in the following manner : " We de- sire the young person, while standing, to throw his arms and shoulders back, and, while in this position, to inhale slowly as much air as he can, and repeat this exercise at short intervals, several times in suc- cession ; when this can be done in the open air, it is most desirable, a double advantage being thus obtain- ed from the practice. Some exercise of this kind should be adopted daily by all young persons, more especially by those whose chests are narrow or de- formed, and should be slowly and gradually increas- ed."* In this recommendation I heartily concur. For the same reason, even the crying and sobbing: of children contribute to their future health, unless^ they are caused by disease, and carried to a very un- usual extent. The loud laugh and noisy exclamations: attending the sports of the young, have an evident relation to the same beneficial end; and ought, tiere- * Clark on Consumption and Scrofula, p. 298. T 3 222 EXERCISE OF THE LUNGS. fore, to be encouraged instead of being repressed, as they are often sought to be by those who, forgetting that they themselves were once young, seek in childhood the gravity and decorum of more advanced age. I have already noticed, at page 117, an instance on a large scale, in which the inmates of an institu- tion were, for the purpose of preserving their health, shut up within the limits of their hall for six months, and not allowed to indulge in any noisy and romping sports. The aim of the directors was undoubtedly the purest benevolence, but, from their want of knowl- edge, their object was defeated, and the arrangement itself became the instrument of evil. Beneficial as the direct exercise of the lungs is thus shown to be in strengthening the chest, its influ- ence extends still farther. If we examine the posi- tion of the lungs as represented in the figure on page 183, we shall see that, when fully inflated, they must necessarily push downward and flatten the moveable arch of the diaphragm D D, by which they are sep- arated from the belly or abdomen. This alteration, however, cannot take place without the diaphragm in its turn pushing down the liver, stomach, and bowels, which it accordingly does, causing them to project forward and outward. But no sooner are the lungs fully inflated, than the contained air is again thrown out. The lungs diminish in size, the diaphragm rises, and with it all the contents of the abdomen return to their former position. The whole digestive apparatus is thus subjected to a continual pressure and change | of place; and the stimulus thence arising is in truth | essential to the healthy performance of the digestive functions, and is one of the means arranged by the Creator for the purpose. Consequently, if the lungs be rarely called into active exercise, not only do they suffer, but an important aid to digestion being with- drawn, the stomach and bowels also become weakened, and indigestion and costiveness make their appear- ance. I have already alluded to this subject in the chapter on muscular exercise; but the principle will now be better understood with the aid of the figure. EXERCISE OF THE LUNGS DURING DISEASE. 223 After this exposition I need hardly say that the loud and distinct speaking enforced in many public schools is productive of much good to the young, and that the occasional songs in which all are requi- red to join in the infant schools and other institutions are much to be commended. Let any one who doubts their efficacy as exercises of the lungs, attend to what passes in his own body on reading aloud a single paragraph, and he will find that not only deep inspi- rations and full expirations are encouraged, but that a considerable impulse is communicated to the bow- els, affording a marked contrast to the slight breath- ing and quiescent posture of those whose voices never rise above a whisper. Reading aloud, public speaking, and lecturing, are excellent exercises for developing the lungs and the chest. But, as they require some exertion, they ought to be indulged in with prudence, and with con- stant reference to the constitution and health of the individual. The reviewer of a former edition of the present volume (himself a lecturer), in noticing this part of the book, adds the following testimony: "We know ourselves, from personal experience,that often, when preparing to go to lecture, a languor has crept upon us, inducing an unwillingness to exert our- selves. We have gone—the lecture has commenced —the mind was called into action—a perspiration broke forth on the brow—the circulation was equal- ized—and, at the conclusion of the lecture, the languor was gone." Hence he recommends " reading to one's family in the evening" as " an excellent practice, and one tending much to sweeten social life."* When early resorted to and steadily persevered in, such ex- ercises are very useful in warding off disease and communicating strength to an important function. But when begun suddenly, and carried to excess by persons with weak lungs, they are more directly inju- rious than almost any other cause. It is not uncom- mon for young divines to devote themselves to preach- * London Medical and Surgical Journal, No 134, p. IV 224 EXERCISE OF THE LINGS DURING DISEASE. ing, without any preparation for the effort which it requires, and to experience, in consequence, pains in the chest, spitting of blood, and other dangerous forms of disease, which often extinguish their bright- est prospects in the morning of life. Sacrifices of this kind are the more to be lamented, because it is probable that, by a well-planned system of gradual preparation, many who fall victims might find in their profession even a source of safety. The late illustrious Cuvier, as was mentioned at page 150, is considered to have been saved from an early death by his appointment to a professorship leading him to the moderate and regular exercise ol his lungs in teaching; a practice which soon removed the delicacy of chest to which he was subject, and enabled him to pass uninjured through a long life of active business. Other examples of the same kind might be mentioned. But it is important to observe, that in all of them the exercise was, at all times, ac- curately proportioned to the existing state of the lungs. Had active disease existed, or the exertion required been beyond what the lungs were fully able to bear, the effect would have been, not to improve health, but to destroy life; and this condition of ac- curate relation between the amount of exercise and the state of the organization must never for a moment be overlooked. With a little care, however, the point at which direct exercise of the lungs ought to stop may easily be determined by observing its effects. The same principle leads to another obvious rule : When disease of any kind exists in the chest, exercise of the lungs in speaking, reading, and singing, and also in ordinary muscular exertion, ought either to be entirely refrained from or strictly regulated by pro- fessional advice. When a joint is sore or inflamed, we know that motion impedes its recovery. When the eye is affected, we, for a similar reason, shut out the light; and when the stomach is disordered, we have respect to its condition, and become more care- ful about diet. The lungs demand a treatment found- ed on the same general principle. If they are infla- EXERCISE OF THE LUNGS AS A REMEDY 225 med, they must be exercised as little as possible, oth- erwise mischief will ensue. Hence, in a common cold of any severity, silence, which is the absence of direct pulmonary exercise, ought to be preserved, and will, in truth, be its own reward. In severe cases, and in acute inflammations of the chest, this rule is of the greatest importance. It is common to meet with patients who cannot speak three words without exciting a fit of coughing, and who, notwithstanding, cannot be persuaded that speaking retards their re- covery. In like manner, in spitting of blood, and in the early stage of tubercular consumption, when the breathing cannot be excited without direct mischief, it is often difficult to convince the patient of the ne- cessity of silence. He perhaps does not feel pain on attempting to speak, and says that " it merely raises a short tickling cough, which is nothing." But if he persists, dearly-bought experience will teach him his error, and dispose him to regret, as did a lamented friend of the author, that a few weeks out of the years which he had dedicated to the study of the classics had not been devoted to the acquisition of some little knowledge of the structure and functions of his own body. In the instance alluded to, after spitting of blood had been induced by severe bodily labour, the patient continued talking almost the whole day to the visiters and inmates of a large public establishment, and believed himself all the time to be very careful, as he said he was no longer exerting his body. When the error was pointed out, and the mechanism of the lungs explained to him, he deeply bewailed the igno- rance which had allowed him to act in a manner so pernicious. All violent exercise ought, for similar reasons, to be refrained from, during at least the active stages of cold. Everything which hurries the breathing, wheth- er walking fast, ascending an acclivity, or reading aloud, has the same effect on the diseased lungs that motion of the bone has on an inflamed joint. It seems to me, that many people hurt themselves much more by the active exercise they take during a severe cold 226 EXERCISE OF THE LUNGS AS A REMEDY. than by the mere exposure to the weather. It is well known, that a person, when suffering from cold, may go out for a short time even in an open carriage more safely than on foot; and there is much reason to be- lieve, that it is the absence of active exertion of the lungs in the former case which makes the exposure less hurtful. After all active disease has been subdued, or when nothing but delicacy remains, the adequate exercise of the lungs is one of the best means of promoting ef- fectual recovery. Those parents, therefore, act most erroneously who, in their apprehensive anxiety for the protection of their delicate children, scrupulously prohibit them from every kind of exercise which re- quires the least effort, and shut them up from the open air during winter, with the false hope of thereby warding off colds and protecting their lungs. I have seen the greatest delicacy of constitution thus en- gendered, especially where an undue quantity of warm clothing was at the same time employed. When tested by the principles above explained, such conduct is found to be as ill adapted as possible to the end in view, and utterly at variance with the laws of the animal economy. Considering the delicacy and extent of the lining membrane of the lungs, and the ready access to it which the external air has, it cannot be a matter of surprise that sudden or great changes in its tempera- ture or constitution should often operate injuriously on the lungs, and be the means of inducing not only colds,but more serious disease. Hence, especially in delicate subjects, the obvious propriety of diminishing the risk of sudden transitions, by breathing through several folds of woollen fabric or silk when obliged to pass from a warm room to the cold external air, or to breathe a cold or damp air for a length of time. The cold air becomes partially heated and deprived of its moisture in passing through such a medium, and the protection thus afforded is so marked, that few who have tried the precaution will ever afterward neg- lect it. PREVENTION OF DISEASES IN THE LUNGS. 227 Perhaps the most important time in the life of a person born with a predisposition to consumption is that of puberty, comprising from the commencement of rapid growth to the full consolidation of the sys- tem about or after the twenty-fourth year. In most young people, the transition from adolescence to ma- turity is so rapid, that for two or three years all the animal powers are tasked to enable nutrition to keep pace with growth, and a corresponding debility of both body and mind is often observed to co-exist, in- dicating in the clearest manner the necessity of a temporary remission from such studies and occupa- tions as require much mental exertion or confinement within doors. The development and health of the physical system ought then to be almost exclusively attended to ; and when the body has acquired its so- lidity, the mental faculties will again become active. I have seen instances where a knowledge of the lat- ter fact afforded substantial consolation to young men who, while their bodies were growing rapidly, were apt to become despondent, on account of the unusual sluggishness and inefficiency of their intellectual pow- ers. In the course of a few years, when growth and consolidation were completed, the brain vigorously resumed its functions. In such circumstances, relaxation from study, resi- dence in the country, exercise in the open air, plenty of food, and freedom from care, will often do immense good, if sufficiently persisted in, and go far to protect the careful patient against the future invasion of con- sumption. Whereas, if, under the mistaken notion that such precautionary measures are a waste of time, a delicate growing youth is allowed to continue at his studies or his desk till disease has actually com- menced, the disappointed parent may discover that it is too late to take alarm when health is gone. A good deal of observation has satisfied me, that too little attention is paid to the preservation of health at this critical period of life, and that, by proper man- agement during the transition from adolescence to maturity, many might be saved who now fall victims. 228 PREVENTION OF DISEASES IN THE LUNGS. Dr. Clark, in the excellent treatise already referred to, strongly advocates the same view, and his remarks cannot be too earnestly recommended to both profes- sional and general notice. Mr. Marshall has taken some pains to point out the disadvantages laboured under by very young recruits from their being neglectful of health, and ignorant how to take care of themselves. In common life the same disadvantages result from the same causes. The young being left in entire ignorance of the struc- ture and uses of the different organs of their own bodies, and without experience of the evils of expo- sure, heedlessly give way to their predominant incli- nations, and rashly subject themselves to the opera- tion of morbid causes, which, had they been instruct- ed, they might easily have avoided. The conse- quence is, that the body being weak at that age from the rapidity of growth and want of consolidation, external causes act with double energy, and lay the foundation of consumption, or other forms of disease, without any means being used to counteract their in- fluence ; and that a greater mortality takes place du- ring the few years of adolescence, than at an earlier or more advanced period of life. A late writer, who has bestowed infinite pains on the investigation of the laws of mortality, describes the period between seventeen and twenty-four years of age in the male sex, as " one of restlessness, toil, and danger; the human faculties are then exercised to the utmost, and life is more freely expended than at any other season. Inflammatory diseases, often of fatal termination, are most prevalent for both sexes during this period."* The accuracy of these state- ments is incontrovertibly established by a reference to the bills of mortality. It appears, for example, from the Count Chabrol's Statistical Researches of the City of Paris and Department of the Seine, that, in 1819, the total mortality was 22,445, of whom 10,865 * On the Natural and Mathematical Laws concerning Popula- tion, Vitality, and Mortality. By Francis Corbaux. P. 92. PREVENTION OF DISEASE IN THE LUNGS. 229 were males, and 11,580 were females. Of this num- ber there died— Males. Females. 298 238 420 391 815 650 374 567 Showing a remarkable increase in the number of deaths between 15 and 20 over those between 10 and 15, and again another increase of nearly double in those between 20 and 25 over those between 25 and 30. In the females, from circumstances not now to be ex- plained, the period of increased mortality extends to nearly 30 years of age. Similar results appear for other years. In 1820, the total deaths were 22,218, of whom 10,584 were males, and 11,634 females. Of this number there died— Males. Females. Between the ages of 10 and 15, 172 223 15 20, 396 303 " " 20 25, 749 590 " " 25 30, 381 524 And in 1821 we have a total of 22,648, of whom 11,167 were males, and 11,481 females. Of this number there died— Males Females. Between the ages of 10 and 15, 209 236 15 20, 367 337 20 25, 776 556 " " 25 30, 405 560 These tables, oonfirmed by others drawn up with equal accuracy, place in a striking point of view the dangers of the state of transition from youth to man- hood, and the necessity of attempting, by early in- fluence and timely prudence, to protect the young against the numerous causes of disease which then come into active and fatal operation. They ought also to serve as a warning to those who, in the spring- time of life, are inclined to trust implicitly for their safety to the strength of a good constitution, and to Between the ages of 10 and 15, 15 20, " " 20 25, " " 25 30, 230 PREVENTION OF DISEASE IN THE LUNGS. despise the prudence which dictates the avoidance of unnecessary exposure. The experience derived from the limited observation of one man may be set aside as undeserving of trust; But when the unvarying re- sults exhibited to us are deduced from the changes in nearly a million of people, it is impossible to ascribe them to chance, or to deny their bearing on ourselves. Many invaluable practical truths will, ere long, be fur- nished to the world by the statistical researches now in progress. The earlier maximum of mortality in the male sex, especially in cities, is explicable by the fact, that it is at the approach of manhood, when both mind and body are in a state of transition, that dissipation is most indulged in, and presses with its deadliest force. Many delicate youths are carried off, who would have escaped without injury if they could have been per- suaded to act with prudence during these two or three critical years. Many, I am constrained to say, first learn the means of their destruction in boarding- schools and places of public resort, and that often when no mischief is suspected by their respectable teachers. On this topic, however, the non-profes- sional character of the present work precludes me from entering into details. Before quitting this important subject, I may add another word of advice in regard to those who are predisposed to consumption or weakness of chest. As soon as active growth commences, permanent benefit may be derived from removal, for a few years, to a milder and less variable climate. Many who are sent abroad only to die painfully in a foreign land, in the noonday of life, might have lived for years, in 'he enjoyment of health and usefulness, had they been sent abroad before the appearance of disease, instead of after its unequivocal commencement. The previ- ous delicacy, whence the susceptibility to colds and pulmonary affections arises, ought to attract the ear- liest attention, and excite the most persevering efforts for its removal. If it be allowed to make progress till consumption has commenced, medicine may come PREVENTION OF DISEASE IN THE LUNGS. 231 armed with its most powerful remedies, and directed by the most consummate skill; but it will too often come in vain. The rage which now prevails for mere intellectual education, and the utter neglect of the bodily health to which it leads, is too often carried so far as to be a curse rather than a blessing; and till its fury be moderated by an increase of good sense in the parents, great mischief must, I fear, continue to ensue. I cannot dismiss this subject without again refer- ring the reader to Dr. Clark's work on Consumption and Scrofula, as affording, I may almost say for the first time, a comprehensive, philosophical, and practi- cal view of the causes, nature, and treatment of con- sumption. The able author has not,'it is true, greatly extended our power over that fatal disease in its most advanced periods, but he has done more to throw light upon its causes, to obviate its development, and to arrest it in its incipient stages, than any writer with whose works I am acquainted. 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. In man and the higher orders of animals, the ner- vous system is composed of, 1st, the brain; 2d, the spinal marrow; and, 3d, the nerves. ' But, on the present occasion, it will be necessary to confine our remarks chiefly to the brain; and, even regarding it, to offer observations only on such points as all are agreed upon, and the general reader can easily com- prehend. The brain is that large organized mass which, along with its enveloping membranes, completely fills the cavity of the scull. It is the seat of thought, of feeling, and of consciousness, and the centre towards which all impressions made on the nerves distributed over the body are conveyed, and from which the commands of the will are transmitted, to put the various parts in motion. The structure of the brain is so complicated, that less is known of its true nature than of that of almost any other organ. It would, therefore, be entirely ou* STRUCTURE OF THE BRAIN. 233 of place to attempt to describe it here, farther than by stating generally its principal divisions. On saw- ing off the top of the scull, and removing the firm, tough membrane called dura mater (hard mother), which adheres closely to its concave surface, the cerebrum or brain proper presents itself, marked on the surface with a great variety of undulating wind- ings or convolutions, and extending from the fore to the back part of the head, somewhat in the form of an ellipse. In the annexed woodcut, the convolu- tions are represented as seen on the base of the brain In the middle line from G to G, there is, on the upper aspect of the brain, a deep cleft or fissure, separating it, in its whole length, into two halves, or hemispheres as they are called. Into this cleft dips a tight stiff membrane, resembling a scythe in shape, and hence called the falx (scythe), or, sometimes, from its be- ing a mere fold of the dura mater, the falciform (scythe-like) process of the dura mater. From its dipping down between the two halves of the brain, the chief purpose of this membrane seems to be to relieve the one side from the pressure of the other, when the head is reclining to either side. Each half or hemisphere of the brain is, in its turn, divided—but in a less marked way, as the divisions are observable only on its inferior surface—into three portions, called, from their situations, the anterior, middle, and posterior lobes, each occupying nearly a third of the whole length of the brain. The ante- rior lobe, being the portion lying above the dotted line E E, occupies the forehead; the middle is all the portion lying between the two transverse lines E E and F F, above and a little in front of the ears; and the posterior lobe is that portion lying below the transverse line F F, and corresponding to the back part of the head. Beneath the posterior lobe, a strong fold of the dura mater, called the tentorium, is extended horizon- tally to support and separate it from the cerebellum A A, or little brain, lying below it. The cerebellum forms the last great division of the contents of the 234 STRUCTURE OF THE BRAIN. scull. Its surface is marked by convolutions, differ- ing, however, in size and appearance from those ob- served in the brain. Adhering to the surface of the convolutions, and, consequently, dipping down into and lining the sulci or furrows between them, another membrane of a finer texture and greater vascularity, called pia mater, is found. The bloodvessels going to the brain branch out so extensively on the pia mater, that, when a lit- tle inflamed, it seems to constitute a perfect vascular network. This minute subdivision is probably of use in preventing the blood from being impelled with too great force against the delicate tissue of the brain. A third covering, called the arachnoid membrane, from its fineness resembling that of a spider's web, is interposed between the other two, and is frequently the seat of disease. On examining the convolutions in different brains, STRUCTURE OF THE BRAIN. 235 they are found to vary a good deal in size, depth, and general appearance. In the various regions of the same brain they are also different, but preserve the same general aspect. Thus they are always small and numerous in the anterior lobe, larger and deeper in the middle, and still larger in the posterior. The thick cord or root C, springing from the base of the brain, is named the medulla oblongata, or oblong por- tion of the spinal marrow, which is continued down- ward, and fills the cavity of the spine or backbone. At one time the brain has been regarded as proceed- ing from, and at another as giving rise to, the spinal marrow; but, in reality, the two are merely connect- ed, and neither grows from the other. The false analogy of a stem growing from a root has led to this abuse of language. The small round filaments or cords seen to proceed from the sides of the medulla oblongata, and from near the base of the brain, are various nerves of sen- sation and motion, some of them going to the organs of sense, and others to the skin and muscles of the face, head, and other more distant parts. The long, flat-looking nerve a a, lying on the lower surface of the anterior lobe, is the olfactory nerve, or nerve of smell, going to the nose. The round, thick nerve 4 4, near the roots of the former, is the optic nerve, or nerve of vision, going to the eye. That marked b is the motor nerve, which supplies the muscles of the eyeball. A little farther back, the fifth pair C, is seen to issue apparently from the arch D, called Pons Va- rolii, or bridge of Varolius. It is a large compound nerve, and divides into three branches, which are ram- ified on almost all the parts connected with the head and face, and the upper and under jaw. It comprehends nerves both of sensation and motion, and one branch of it, ramified on the tongue, is the nerve of taste. Other branches supply and give sen- sibility to the teeth, glands, and skin. The seventh or auditory nerve e, is distributed on the internal ear, and serves for hearing. The eighth or pneumogastrie nerve d, sends filaments to the windpipe, lungs, heart, 236 THE BRAIN THE ORGAN OF MIND. and stomach, and is one of great importance in the production of the voice and respiration. It also in- fluences the action of the heart and the process of digestion. Such are the principal nerves more immediately connected with the brain, but which it is impossible to describe more minutely here. Those which sup- ply the trunk of the body and the extremities, issue chiefly from the spinal marrow; but they also must, for the present, be passed over in silence, that we may return to the consideration of the brain. The brain receives an unusually large supply of blood, in comparison with the rest of the body; but the nature of its circulation, although a very interest- ing object of study, being only indirectly connected with our present purpose, cannot now be discussed. Most physiologists are agreed that the different parts of the brain perform distinct functions^ and that these functions are the highest and most important in the animal economy; but there is great discrepan- cy of opinion as to what the function of each part is, and as to the best mode of removing the obscurity in which the subject is involved. It would be useless to examine here the merits of the respective theories and modes of inquiry, as the attempt would lead us too far from the practical aim of the work. Suffice it to say, that all physiologists and philosophers regard the brain as the organ of mind; that most of them consider it as an aggregate of parts, each charged with a specific function; and that a large majority regard the anterior lobe as more immediately the seat of the intellectual faculties.* Farther, by nearly universal consent, the brain is held to be also the seat of the passions and moral feelings of our nature, as well as of consciousness and every other mental act, and to * In speaking of the cerebral lobes being the place " where all the sensations take a distinct form and leave durable impres- sions," Cuvier adds, " L'anatomie comparee en offre une autre confirmation dans la proportion constante du volume de ces lobes avec le degri a"intelligence des Animaux."—Vide Report to the Institute on Flourens's Experiments in 1822. CONNEXION BETWEEN THE MIND AND BRAIN. 237 be the chief source of that nervous influence which is indispensable to the vitality and action of every organ of the body. There are so few exceptions to the general belief of these propositions, that I consider myself fairly entitled to hold them as established. Many animals possess individual senses or instincts in greater perfection than man, but there is not one which can be compared with him in the number and range of its faculties; and, as a necessary conse- quence, there is not one which approaches him in the development and perfection of its nervous system. No organ can execute more than a single function; and, accordingly, even the Edinburgh Review (which has evinced great hostility to some of the above views) admits, that, exactly in proportion as we ascend in the scale of creation, and the animal acquires a sense, a power, or an instinct, do its nerves multiply, and "its brain improve in structure and augment in vol- ume ; each addition being marked by some addition or amplification of the powers of the animal, until in man we behold it possessing some parts of which animals are destitute, and wanting none which they possess," so that " we are enabled to associate every faculty which gives superiority, with some addition to the nervous mass, even from the smallest indications of sensation and will, up to the highest degree of sensibility, judgment, and ex- pression."* It is extremely important to bear in mind this con- stant relation between mental power and development of brain. It not only explains why capacities and dispositions are so different, but shows incontrover- tibly that the cultivation of the moral and intellectual faculties can be successfully carried on only by act- ing in obedience to the laws of organization, and as- sociating together those faculties, the organs of which are simultaneously progressive in their growth. When, in infancy, for example, the intellectual powers are feeble and inactive, this arises solely from the inapti- tude of a still imperfect brain ; but, in proportion as * Edinburgh Review, No xciv., p. 442-3. 238 CONNEXION BETWEEN THE MIND AND BRAIN. the latter advances towards its mature state, the men- tal faculties also become vigorous and active. In like manner, when we engage in intense thought so long as to induce confusion of mind and headache, these results follow solely because the brain has been over- tasked, and its action carried beyond the limits of health. Every mental operation, in fact, takes place in subjection to the laws of organization; and it is worse than useless for us to attempt to disjoin that which an all-wise Creator has connected together. It is a law, for instance, that alternate periods of ac- tivity and repose conduce to the strength and devel- opment of every organ, and to the easy performance of its function, and that excess in either direction is alike hurtful in its consequences. If, therefore, in our anxiety for the advancement of a child in a fa- vourite pursuit, we urge it to incessant and unvaried exertion of the same kind for many hours a day, we violate this law in neglecting the necessary intervals of rest, and thus run the risk of injuring the health of the brain, and entirely defeating our object. And, on the contrary, if we withdraw the child altogether from the pursuit, for weeks or months at a time, as hap- pens during the vacation of a school, we violate the organic law again, in depriving the faculties of their necessary exercise, and thus run the risk of sacrificing the improvement already gained, and of diminishing the mental power. In neither case is the brain exer- cised in conformity with the organic laws, and, conse- quently, we look in vain for the same amount of im- provement which would have followed their fulfil- ment ; and yet, so far is the physiology of the brain from being considered as the only sound basis on which the science of education can rest, that very few teachers or moralists are aware that the organic laws have any connexion with the operations of mind, and still fewer have ever thought of adapting their practice to the dictates of these laws; although no truth in education or philosophy can be more clearly proved or more beneficially applied than that on which I am now insisting. CONNEXION BETWEEN THE MIND AND BRAIN. 239 It has been said, in answer to the above proposi- tion, that a month's vacation and idleness in the coun- try, after ten or eleven months spent at schools in town, is beneficial in increasing the aptitude for men- tal exertion. This is true, but it is, in reality, no ex- ception to what I have stated. According to the pres- ent system of education, intellectual cultivation and school tasks are pushed so far as to impair health and injure the constitution; and after ten months of this unwholesome discipline, the vigour of mind and readi- ness of application are so much diminished, that the school is regarded with loathing, and the vacation is longed for with all the ardour of an exile panting for his home. If a young person, in this unnatural situa- tion, be sent to the country to enjoy exercise and play in the open air for two months without opening a book, there cannot be a doubt that he will return better dis- posed for his lessons, and more able to keep pace with his companions, than if he had continued to receive daily instruction at school during all that time. This result, however, will follow simply because his health, which had been impaired by confinement and over- tasking, will now be restored by country air, idleness, and exercise ; and his brain will have regained its lost tone, and be able to manifest the mental faculties with greater vigour. But it does not by any means follow from this cir- cumstance, that, if the brain and mind be always duly e xcrcised according to their strength and the laws of Nature, a month or two of idleness will then be ad- vantageous. As well might we say that because two or three weeks of bodily inaction may be relished after many months of exhaustion from hard labour, there- fore a long interval of inactivity will be equally agree- able to a person who is getting daily no more exer- cise than enough. In the one case as in the other, the absence of exertion, so far from being desirable, would be not less hurtful than irksome to the individ- ual ; and if a healthy young person were so situated, idleness would be so unpleasant to him, that he would devise active occupation of some kind or other fol 240 INFLUENCE OF HEREDITARY CONSTITUTION. himself. This distinction must not be lost sight of. In thus treating of the brain as the indispensable instrument or organ of the mental faculties, I must not be understood as representing mind and brain to be one and the same thing. 1 mean only that the brain is necessarily engaged in every intellectual and moral operation, exactly as the eye is in every act ol vision; and that, as the mind cannot see without the intervention of the eye, so neither can it think or feel, during life, except through the instrumentality of the brain. Consequently, it would be as reasonable and logical to infer from the former proposition that the eye is the mind or the mind the eye, as to infer from the latter, that the brain is the mind or the mind the brain. It requires, however, to be distinctly understood, that activity of mind and activity of brain are not only inseparable, but that, so long as life remains, the men- tal operations are directly influenced by the condition of the brain. If, by the excessive use of stimulants, the brain be highly excited, the mind will be disturbed in an equal degree, as is exemplified every day in the phenomena of intoxication; and if, on the other hand, the mind be suddenly roused by violent passions, the vessels of the brain will instantly take on increased action, redness will suffuse the face, and the cerebral excitement will show itself in characters as legible as if produced by a physical cause. The mind and brain being thus so closely associated during life that the former acts in strict obedience to the laws which regulate the latter, it becomes an ob ject of primary importance in education to discover what these laws are, that we may yield them willing obedience, and escape the numerous evils consequent on their violation. To this inquiry the following pages shall be devoted. The brain being a part of the animal system, and subject to the same general laws as the other organs, the reader will not be surprised that I should, as in the case of the lungs, state a. sound original constitution as the first condition of its healthy action. If the ON THE FUTURE HEALTH OF THE BRAIN. 241 brain possess from birth a freedom from all hereditary taints and imperfections, and have acquired no unusual susceptibility from injudicious treatment in infancy, it will withstand a great deal in after-life, before its health will give way. But if, on the other hand, either it inherit deficiencies, or early mismanagement have subsequently detailed upon it an unusual proneness to morbid action, it will give way under circumstances which would otherwise have been perfectly innocu- ous ; and, accordingly, it may be truly said that the most powerful of all the causes which predispose to nervous and mental disease, is the transmission of a hereditary tendency from parents to children, produ- cing in the latter an unusual liability to the maladies under which the parents have laboured. Even where the defect in the parent is merely some peculiarity of disposition or temper, amounting, per- haps, to eccentricity, it is astonishing how clearly its influence on some one or other of the progeny may often be traced, and how completely a constitutional bias of this description may interfere with a man's happiness or success in life. I have seen instances in which it pervaded every member of a family, and others in which it affected only one or two. When the original eccentricity is on the mother's side, and she is gifted with much force of character, the evil ex- tends more widely among the children than when it is on the father's side. Where both parents are descend- ed from tainted families, the progeny is, of course, more deeply affected than where one of them is from a pure stock; and seemingly for this reason, heredi- tary predisposition is a more usual cause of nervous disease in the higher classes, who intermarry much with each other, than in the lower, who have a wider choice. Unhappily, it is not merely as a cause of disease that hereditary predisposition is to be dreaded. The obstacles which it throws in the way of permanent recovery are even more formidable, and can never be entirely removed. Safety is to be found only in avoiding the perpetuation of the mischief; and, there- 242 ON THE FUTURE HEALTH OF THE BRAIN. fore, if two persons, each naturally of an excitable and delicate nervous temperament, choose to unite for life, they have themselves to blame for the con- centrated influence of similar tendencies in destroying the health of their offspring, and subjecting them to all the miseries of nervous disease, madness, or mel- ancholy. Even where no hereditary defect exists, the state of the mother during pregnancy has an influence on the mental character and health of the offspring of which few parents have any adequate conception. In my work on Mental Derangement, I referred, in proof of this fact, to the testimony of M. Esquirol, whose talent, general accuracy, and extensive expe- rience, give great weight to all his well-considered opinions. It is often, he says, in the maternal womb that we are to look for the true cause, not only of imbecility, but also of the different kinds of mania. During the agitated periods of the French revolution, many ladies then pregnant, and whose minds were kept constantly on the stretch by the anxiety and alarm inseparable from the epoch in which they lived, and whose nervous systems were thereby rendered irri- table in the highest degree compatible with sanity, were afterward delivered of infants whose brains and nervous systems had been affected to such a degree by the state of their parent, that, in future life, as chil- dren they were subject to spasms, convulsions, and other nervous affections, and in youth to imbecility or dementia almost without any exciting cause. The extent to which the temporary state of the mother during gestation may influence the whole future life of the child, may be conceived from a single fact re- corded by the same author. A pregnant woman, oth- erwise healthy, was greatly alarmed and terrified by the threats of her husband when in a state of intoxi- cation. She was afterward delivered, at the usual time, of a very delicate child. The child had, how- ever, been so much affected by its mother's agitation, that, up to the age of eighteen, it continued subject to panic terrors, and then became completely maniacal. INFLUENCE OF HEREDITARY CONSTITUTION. 243 The nervous timidity of James VI., so ludicrously exhibited by Sir Walter Scott in the Fortunes of Nigel, is said to have had a similar origin. I have myself seen several instances of the same kind, ana among others, one of a young lady, whose extreme nervous sensibility was partly attributable to pro- longed excitement and alarm in her mother, who, when pregnant with her, spent several days half im- mersed in water during a storm at sea, and in the hourly expectation of shipwreck and death. Dr. Caldwell, too, the able and philanthropic advo- cate of an improved system of physical, moral, and intellectual education in America, is very urgent in enforcing rational care during the period of gestation on the part of every mother who values the future health and happiness of her progeny. Among other things, he insists on the necessity of mothers taking more exercise in the open air than they usually do; and cautions them against allowing a feeling of false delicacy to keep them confined in their rooms for weeks or months.* For the same reason, the mind ought to be kept free from gloom or anxiety, and in that state of cheerful activity which results from the proper exercise of the moral and social feelings and intellect. But if seclusion and depression be hurtful to the unborn progeny, thoughtless dissipation, late hours, dancing, waltzing, and rough exercise on horse- back, irritability of temper and peevishness of dispo- sition, are not less injurious. Hence the Margravine of Anspach most justly remarks, that " when a female is likely to become a mother, she ought to be doubly careful of her temper, and, in particular, to indulge no ideas that are not cheerful and no sentiments that are not kind. Such is the connexion between the mind and body, that the features of the face are moulded commonly into an expression of the internal disposition; and is it not natural to think that an in- fant, before it is born, may be affected by the temper of its mother V—Memoirs, vol. ii., chap. viii. ♦ Thoughts on Physical Education, by Charles Caldwell. M.D. Boston, 1833 244 IMPERFECTLY OXYGENATED BLOOD. The second condition required for the health of the brain is a due supply of properly oxygenated blood. The effects of slight differences in the quality of the blood are not easily recognised, but, when extreme, they are too obvious to be overlooked. If the stimulus of arterial blood be altogether withdrawn, the brain ceases to act, and sensibility and consciousness become extinct. Thus, when fixed air is inhaled, the blood circulating through the lungs does not undergo that process of oxygenation which is essential to life ; and as it is in this state unfit to excite or support the action of the brain, the mental functions become im- paired, and death speedily closes the scene. If, on the other hand, the blood be too highly oxygenated, as by breathing oxygen gas instead of common air, the brain is too much stimulated, and an intensity of ac- tion, bordering on inflammation, takes place, which also soon terminates in death. Such are the consequences of the two extremes; but the slighter variations in the state of the blood have equally sure, although less palpable effects. If its vitality be impaired by breathing an atmosphere so much vitiated as to be insufficient to produce the proper degree of oxygenation, the blood then affords an imperfect stimulus to the brain; and, as a neces- sary consequence, languor and inactivity of the mental and nervous functions ensue, and a tendency to head- ache, syncope, or hysteria, makes its appearance. This is seen every day in the listlessness and apathy preva- lent in crowded and ill-ventilated schools; and in the headaches and liability to fainting which are so sure to attack persons of a delicate habit in the contami- nated atmospheres of crowded theatres, churches, and assemblies. It is seen less strikingly, but more permanently, in the irritable and sensitive condition of the inmates of cotton manufactories and public hospitals. In these instances, the operation of the principle cannot be disputed, for the languor and ner- vous debility consequent on confinement in ill-venti- lated apartments, or in air vitiated by the breath of many people, are neither more nor less than minor IMPERFECTLY OXYGENATED BLOOD. 245 degrees of the same process of poisoning to which I have formerly alluded. It is not real debility which produces them ; for egress to the open air almost in- stantly restores activity and vigour to both mind and body, unless the exposure has been very long, in which case more time is required to re-establish the exhausted powers of the brain. A good deal of ob- servation has convinced me, that the transmission of imperfectly oxygenated blood to the brain is greatly more influential in the production of nervous disease and delicacy of constitution, than is commonly ima- gined ; and I am delighted to see the same truth so powerfully insisted on by Mr. Thackrah, from exten- sive experience in the manufacturing district about Leeds. Having, however, dwelt on this subject in the preceding chapter, I need not repeat the observa- tions already made.* Although, in delicate constitutions, the health of the brain and nervous system is often impaired by inadequate nutrition, and a due supply of nourishing food is therefore indispensable to their wellbeing; yet, as this condition is implied in the preceding, and its separate consideration would lead us too far from our main object, I shall not dwell upon it here. I shall merely state, that starvation often affects the brain so much as to produce ferocious delirium, and that in the Milanese, a species of insanity arising from defective nourishment is very prevalent, and is easily cured by the nourishing diet provided in the hospitals to which the patients are sent. I have seen the mental functions weakened, and the brain disor- dered, by the same cause—inadequate nutrition—at * The intelligent teacher to whom I have already alluded as acting on the above views, by turning his pupils out to play, and throwing open the door and windows for ten minutes at the end of the first hour's confinement, assures me that the difference be- tween the languor and little power of sustained attention exhibit- ed under the old system, and the activity shown under the new, is very marked, and that the interval of relaxation is most profita- bly spent time both to his pupils and to himself, as they return to work with new life. Its influence on the health of his pupils has been already noticed. X2 246 EXERCISE OF THE MIND AND BRAIN. the period of rapid growth. This defective nutrition, however, it must be observed, does not always depend on want of proper food. On the contrary, it is often the result, among the higher classes, of too much or too stimulating food over-exciting and ultimately im- pairing the digestive powers. The proneness to mor- bid excitement in the brain, induced by insufficient food, is one cause why, in times of public distress, the lower orders are so apt to resort to violence to remove the sources of their discontent. The third condition of health in the brain and ner- vous system, and that to which it is my chief object in the present chapter to direct attention, is the reg- ular exercise of their respective functions, according to the laws already so frequently referred to, and so fully explained in a preceding part of this work.* The brain, being an organized part, is subject, in so far as regards its exercise, to precisely the same laws as the other organs of the body. If it be doomed to inactivity, its health decays, and the mental operations and feelings, as a necessary consequence, become dull, feeble, and slow. If it be duly exercised, after regular intervals of repose, the mind acquires readi- ness and strength; and, lastly, if it be overtasked, in either the force or the duration of its activity, its functions become impaired, and irritability and disease take the place of health and vigour. The consequence of inadequate exercise may be first explained. We have seen that, by disuse, muscles become emaciated, bone softens, bloodvessels are obliterated, and nerves lose their characteristic structure. The brain is no exception to this general rule. Of it also the tone is impaired by permanent inactivity, and it becomes less fit to manifest the mental powers with readiness and energy. Nor will this surprise any re- flecting person, who considers that the brain, as a part of the same animal system, is nourished by the same * See Chapter iv., p. 127, and also p. 171. EFFECTS OF MENTAL INACTIVITY. 247 blood, and regulated by the same vital laws, as the muscles, bones, and nerves. It is the weakening and depressing effect upon the brain of the withdrawal of the stimulus necessary for its healthy exercise, which renders solitary confine- ment so severe a punishment even to the most daring minds; and it is a lower degree of the same cause which renders continuous seclusion from society so injurious to both mental and bodily soundness, and which often renders the situation of governesses one of misery and bad health, even where every kindness is meant to be shown towards them. In many families, especially in the higher ranks, the governess lives so secluded, that she is as much out of society as if she were placed in solitary confinement. She is too much above the domestics to make companions of them, and too much below her employers to be treated by them either with confidence or as their equal. With feelings as acute, interests as dear to her, and a judg- ment as sound as those of any of the persons who scarcely notice her existence, she is denied every opportunity of gratifying the first or expressing the last, merely because she is "only the governess;" as if governesses were not made of the same flesh and blood, and sent into the world by the same Crea- tor, as their more fortunate employers. It is, I be- lieve, beyond question, that much unhappiness, and, not unfrequently, madness itself, are unintentionally caused by this cold and inconsiderate treatment. For the same reason, those who are cut off from social converse by any bodily infirmity, often become dis- contented and morose in spite of every resolution to the contrary. The feelings and faculties of the mind, which had formerly full play in their intercourse with their fellow-creatures, have no longer scope for suffi- cient exercise, and the almost inevitable result is irri- tability and weakness in the corresponding parts of the brain. This fact is particularly observed among the deaf and blind, in whom, from their being precladed from a full participation in the same sources of interest as 248 EFFECTS OF MENTAL INACTIVITY. their more favoured brethren, irritability, weakness of mind, and idiocy, are known to be much more preva- lent than among other classes of people. In the Dtctionnaire de Medecine (vol. xx., p. 87), Andral gives a description of the deaf and dumb, every word of which bears a direct reference to the above principle; and a nearly similar account has been lately given of he blind by an equally intelligent observer. " The deaf and dumb," says Andral, "presents, in intel- ligence, character, and the development of his pas- sions, certain modifications which depend on his state of isolation in the midst of society. He remains ha- bitually in a state of half childishness, is very credu- lous, but, like the savage, remains free from many of the prejudices acquired in society. In him the tender feelings are not deep; he appears susceptible neither of strong attachment nor of lively gratitude; pity moves him feebly; he has little emulation, few en- joyments, and few desires. This is what is com- monly observed in the deaf and dumb, but the picture is far from being of universal application; some, more happily endowed, are remarkable for the great development of their intellectual and moral nature; but others, on the contrary, remain immersed in complete idiocy." Andral adds, that we must not infer from this that the deaf and dumb are therefore constitutionally inferior in mind to other men. " Their powers are not developed, because they live isolated from society: place them, by some means or other, in relation with their fellow-men, and they will become their equals." This is the cause of the rapid brightening up of both mind and features, which is so often observed in blind or deaf children, when transferred from home to pub- lic institutions, and there taught the means of con- verse with their fellows. In these instructive in- stances, the whole change is from a state of inactiv- ity of the mind and brain to that of theii wholesome and regular exercise. The truth of these remarks has since been confirmed by an admirable letter on deafness, from the pen of Miss H. Martineau, which appeared in Tait's Magazine for April, 1834. Miss V0DS DISEASE FROM MENTAL INACTIVITY. 249 Martineau cautions her fellow-sufferers against in dulging in seclusion from society, for the very reason I have just stated. The letter is full of sound prac- tical observations, and does infinite credit to the mor- al courage and talent of its author. Keeping the above principle in view, we shall not be surprised to find that non-exercise of the brain and nervous system, or, in other words, inactivity of in- tellect and of feeling, is a very frequent predisposing cause of every form of nervous disease. For de- monstrative evidence of this position, we have only to look at the numerous victims to be found among females of the middle and higher ranks, who have no call to exertion in gaining the means of subsistence, and no objects of interest on which to exercise their mental faculties, and who consequently sink into a state of mental sloth and nervous weakness, which not only deprives them of much enjoyment, but lays them open to suffering, both of mind and body, from the slightest causes. If we look abroad upon society, we shall find innu- merable examples of mental and nervous debility from this cause. When a person of some mental capacity is confined for a long time to an unvarying round of employment, which affords neither scope nor stimulus for one half of his faculties, and, from want of education or society, has no external resour- ces, his mental powers, for want of exercise to keep up due vitality in their cerebral organs, become blunt- ed, and his perceptions slow and dull; and he feels any unusual subjects of thought as disagreeable and painful intrusions. The intellect and feelings not being provided with interests external to themselves, must cither become inactive and weak, or work upon themselves and become diseased. In the former case the mind becomes apathetic, and possesses no ground of sympathy with its fellow-creatures; in the latter, it becomes unduly sensitive, and shrinks within itself and its own limited circle, as its only protection against every trifling intrusion. A desire to continue an unvaried round of life takes strong 250 NERVOUS DISEASE FROM MENTAL INACTIVITY. possession of the mind; because to come forth into society requires an exertion of faculties which have been long dormant, and cannot be awakened without pain, and which are felt to be feeble when called into action. In such a state, home and its immediate in- terests become not only the centre, which they ought to be, but also the boundary of life; and the mind, originally constituted to embrace a much wider sphere, is thus shorn of its powers, and the tone of mental and bodily health is lowered, till a total inapti- tude for the business of life and the ordinary inter- course of society comes on, and often increases till it becomes a positive malady. Such are the effects of inactivity on the tone of the brain. But let the situation of such persons be changed; bring them, for instance, from the listlessness of re- tirement to the business and bustle of a town; give them a variety of imperative employments, and place them in society so as to supply to their cerebral or- gans that extent of exercise which gives health and vivacity of action; and, in a few months, the change produced will be surprising. Health, animation, and acuteness will take the place of former inspidity and dulness. In such instances it would be absurd to suppose that it is the mind itself which becomes heavy and feeble, and again revives into energy by these changes in external circumstances; the effects arise entirely from changes in the state of the brain; and the mental manifestations and the bodily health have been improved solely by the improvement of its con- dition. Examples of this kind are not rare among retired officers, annuitants, merchants, and other persons liv- ing on certain incomes, without fixed occupations to interest them ; and a curious enough instance occurred lately in a young military officer, who spent three years in Canada, commanding a small detachment in a remote station, where he was completely separated from all society of his own rank. During all that period he spent his time in sauntering, shooting, or fishing, without that excitement to his various facul- EXEMPLIFIED IN RETIRED OFFICERS, ETC. 251 ties which is afforded by the society of equals. The consequence of this compulsory mental apathy, and the corresponding inactivity of brain, was that, on re- turning to England, his nervous system had become so weak and irritable, that, although by nature fond of society, he feared to meet even with the members of his own family, and for many weeks would never venture to walk out to take necessary exercise except in the dark. And it was only at the end of several months that the renewed stimulus of society and em- ployment restored the tone of his nervous system so far as to allow him to regain his natural character of mind and to return to his former habits of life. In this predisposed state of the system, a very slight cause would obviously have sufficed to convert the depression into absolute derangement. But, as mentioned above, the most frequent victims of this kind of predisposition are females of the middle and higher ranks, especially those of a nervous con- stitution and good natural abilities; but who, from ill-directed education, possess nothing more solid than mere accomplishments, and have no materials of thought, and no regular or imperative occupations to excite interest or demand attention. Such persons have literally nothing on which to expend half the nervous energy which nature has bestowed on them for better purposes. They have nothing to excite and exercise the brain, nothing to elicit activity; their own feelings and personal interests necessa- rily constitute the grand objects of their contem- plation ; these are brooded over till the mental ener- gies become impaired, false ideas of existence and of Providence spring up in the mind, the fancy is haunted by strange impressions, and every trifle which relates to self is exaggerated into an object of im- mense importance. The brain, having almost no em- ployment, becomes weak, and the mental manifesta- tions are enfeebled in proportion; so that a person of good endowments thus treated, will often not only exhibit somewhat of the imbecility of a fool, but grad- ually become irritable, peevish, and discontented, and 252 IN FEMALES OF THE HIGHER CLASSES. open to the attack of every form of nervous disease and of derangement from causes which, under differ ent circumstances, would never have disturbed her for a moment. Persons so situated too often fly for relief to opium or drinking. That the liability of such persons to melancholy, hysteria, hypochondriasis, and other varieties of men- tal disease, really depends on a state of irritability of brain, induced by imperfect exercise, is proved by the vast and rapid improvement we often witness in con- sequence of the sudden supervention of occurrences which excite and employ the mental powers and their cerebral organs. Nothing is more usual than to see a nervous young lady, who for years had been unfit for anything while ease and indolence were her por- tion, deriving the utmost advantage from apparent misfortunes, which throw her upon her own resour- ces, and force her to exert her utmost energies to maintain a respectable station in society. Where, as in such circumstances, the mental faculties and brain, the intellect and moral and social feelings, are blessed with a stimulus to act, the weakness, the tremours, and the apprehensions which formerly seemed an in- born part of herself, disappear as if by enchantment, and strength, vigour, and happiness take their place; solely because now God's law is fulfilled, and the brain, with which he has connected the mind, is supplied with that healthful stimulus and exercise which he ordained to be indispensable to its healthy existence. The same principle explains the conversion which often occurs of a timid, sensitive, and nervous young lady, into a firm-minded and healthy matron. An additional illustration, and I venture upon it be- cause the principle is an important one in the produc- tion of many distressing forms of disease, will be found in the case of a man of mature age and of ac- tive habits, who has devoted his life to the toils of business, and whose hours of enjoyment have been few and short. Suppose such a person to retire to the country in search of repose, and to have no deep moral, religious, or philosophical pursuits to oc- MENTAL ACTIVITY IN FEMALES. 253 eupy his attention and keep up the active exercise of his brain, this organ will lose its health, and the inevitable result will be ennui, weariness of life, de- spondency, or some other variety of nervous disease.* One great evil attending the absence of some im- perative employment or object of interest to exercise the mind and brain, is the tendency which it generates to waste the mental energies on every trifling occur- rence which presents itself, and to seek relief in the momentary excitement of any sensation, however un- worthy. Not only does painful instability of purpose and interest arise from this cause, especially among females, but, by degrees, enjoyment is sought for more from the indulgence of the sensual appetites of eating and drinking than from any higher occupation ; till at last the habit of gormandizing is established, and quantities of food and wine are daily swallowed, which add disease to indolence, and oppress both mind- and body. Patients labouring under this form of in- disposition complain much of debility, and of the exhaustion left by every effort. It is common to hear them defending the excesses which they commit, by affirming, that with less support they would die of weakness; but the plea, though plausible, is utterly groundless. No doubt they may feel stronger after a good dinner and a few glasses of wine, but the strength is that of feverish excitement, and the sub- sequent languor is proportionally great. Ere long, too, the power of mental application gives way; the digestive organs fail under the task imposed upon them, and headache, flushing, sickness, and bilious at- tacks ensue in such rapid succession, that life at last becomes a state of habitual indisposition. The best remedy for these evils is to create occu- pation to interest the mind, and give that wholesome exercise to the brain which its constitution requires. * It may be proper to state, that several of the preceding pages have been taken, with little alteration, from my " Observations m Mental Derangement," published some time ago. But as that work is designed moie for the profession than for the general reader, 1 have thought it nccessarv to repeat them here. Y 254 EFFECTS OF MENTAL ACTIVITY Unless this can be done, the services of the physician will be available only so long as their novelty con- tinues a source of excitement; and then, in all proba- bility, he will be discharged to make way for another, who will, in his turn, be dismissed to give place to a third. The principle on which this is done is perfect- ly sound, and, in such cases, no sensible physician will take it amiss that his assistance is declined. The error lies in the patient seeking the necessary mental stimulus in a change of attendance, instead of in sal- utary occupation. But there cannot be a doubt, that where the patient is either unable or unwilling to seek recovery from engaging in proper employment, the mere change of physician is often of temporary ser- vice. The evils arising from excessive or ill-timed exer- cise of the brain or any of its parts, are numerous and equally in accordance with the ordinary laws of phys- iology. When we use the eye too long or in too bright a light, it becomes bloodshot, and the increased action of its vessels and nerves gives rise to a sensa- tion of fatigue and pain requiring us to desist. If we turn away the eye, the irritation gradually subsides, and the healthy state returns; but if we continue to look intently, or resume our employment before the eye has regained its natural state by repose, the irri- tation at last becomes permanent, and disease, follow- ed by weakness of sight or even blindness, may en- sue ; as often happens to glass-blowers, smiths, and others, who are obliged to work in an intense light. Precisely analogous phenomena occur when, from intense mental excitement, the brain is kept long in a state of excessive activity. The only difference is, that we can always see what happens in the eye, but rarely what takes place in the brain. Occasionally, however, cases of fracture of the scull occur, in which, from part of the bone being removed, we can see the quickened circulation in the vessels of the brain as easily as in those of the eye. Sir Astley Cooper had a young gentleman brought to him who had lost a portion of his scull just above the eyebrow. " On ON THE BRAIN. 255 examining the head," says Sir Astley, " I distinctly saw the pulsation of the brain was regular and slow; but at this time he was agitated by some opposition to his wishes, and directly the blood was sent with in- creased force to the brain, the pulsation became frequent and violent; if, therefore," continued Sir Astley, " you omit to keep the mind free from agitation, your other means will be unavailing" in the treatment of injuries of the brain.* A still more remarkable case is men- tioned by Dr. Caldwell, as having occurred to Dr. Pierquin, in the hospital of Montpelier, in 1821. " The subject of it was a female at the age of 26, who had lost a large portion of her scalp, scull-bone, and dura mater, in a neglected attack of lues venerea. A cor- responding portion of her brain was consequently bare, and subject to inspection. When she was in a dreamless sleep, her brain was motionless, and lay within the cranium. When her sleep was imperfect and she was agitated by dreams, her brain moved and protru- ded without the cranium, forming cerebral hernia. In vivid dreams, reported as such by herself, the protru- sion was considerable ; and when she was perfectly awake, especially if engaged in active thought or sprightly conversation, it was still greater."! This protrusion arose, of course, from the greater quantity of blood sent to the brain during its activity than when it was quiet; and, if the case be accurately re- ported, it is certainly one of the most interesting on record. In alluding to this subject, Dr. Caldwell remarks, that, if it were " possible, without doing an injury to other parts, to augment the constant afflux of healthy arterial blood to the brain, the mental operations would be invigorated by it. I state this opinion con- fidently, because we often witness its verification. When a public speaker is flushed and heated in de- bate, his mind works more freely and powerfully than at any other time. Why 1 Because his brain is in better tune. What has thus suddenly improved its * See Sir A. Cooper's Lect. on Surg., by Tyrrel, vol. i. p. 279 t Annals of Phrenology, No. i., p. 37. Boston, 1833. Z56 EFFECTS OF EXCESSIVE MENTAL ACT1.. condition ? An increased current of blood into it, produced by the excitement of its own increased ac- tion. That the blood does, on such occasions, flow more copiously into the brain, no one can doubt who is at all acquainted with the cerebral sensations which the orator himself experiences at the time, or who witnesses the unusual fulness and flush of his coun- tenance, the dewiness, flashing, and protrusion of his eye, and the throbbing of his temporal and carotid ar- teries. It is well known, that, while intensely en- gaged in a memorable debate last winter in Washing- ton, a distinguished senator became so giddy, by the inordinate rushing of blood into his brain, that he was obliged to sit down, and the Senate adjourned to give him time to recover. And, more recently, a new member of the House of Representatives fell while speaking, and suddenly expired from the same cause. A member of the law class of Transylvania, more- over, experienced, a few weeks ago, a convulsive af- fection from a congestion of blood in the head, indu- ced by excessive excitement of the brain in the ar- dour of debate."* In many instances, indeed, the in- creased circulation in the brain attendant on high mental excitement, reveals itself by its effects when least expected, and leaves traces after death which are but too legible. How many public men, like Whitbread, Romilly, Castlereagh, and Canning, urged on by ambition or natural eagerness of mind, have been suddenly arrested in their career by the inordi- nate action of the brain induced by incessant toil! And how many more have had their mental power for ever impaired by similar excess! When tasked beyond its strength, the eye becomes insensible to light, and no longer conveys any impressions to the mind. In like manner, the brain, when much ex- hausted, becomes incapable of thought, and conscious- ness is almost lost in a feeling of utter confusion. At any time of life, excessive and continued mental exertion is hurtful; but in infancy and early youth, * Caldwell's Thoughts on Physical Education, p. 114. EFFECTS OF EXCESSIVE MENTAL ACTIVITY. 257 when the structure of the brain is still immature and delicate, permanent mischief is more easily inflicted by injudicious treatment than at any subsequent peri- od; and, in this respect, the analogy is complete be- tween the brain and the other parts of the body, as we have already seen exemplified in the injurious ef- fects of premature exercise of the bones and muscles. Scrofulous and rickety children are the most usual sufferers in this way. They are generally remarka- ble for large heads, great precocity of understanding, and small, delicate bodies. But, in such instances, the great size of the brain and the acuteness of mind are the results of morbid growth; and, even with the best management, the child passes the first years of its life constantly on the brink of active disease. Instead, however, of trying to repress its mental ac- tivity, the fond parents, misled by the early promise of genius, too often excite it still farther, by unceas- ing cultivation and the never-failing stimulus of praise ; and finding its progress, for a time, equal to their warmest wishes, they look forward with ecsta- sy to the day when its talents will break forth and shed, a lustre on its name. But in exact proportion as the picture becomes brighter to their fancy, the Srobability of its being realized becomes less ; for the rain, worn out by premature exertion, either becomes diseased or loses its tone, leaving the mental powers slow and depressed for the remainder of life. The expected prodigy is thus utimately and easily out- stripped in the social race by many whose dull out- set promised him an easy victory. Taking for our guide the necessities of the consti- tution, it will be obvious that the modes of treatment commonly resorted to ought to be reversed, and that, instead of straining to the uttermost the already irri- table powers of the precocious child, and leaving his dull competitor to ripen at leisure, a systematic at- tempt ought to be made, from early infancy, to rouse to action the languid faculties of the latter, while no pains ought to be spared to moderate and give tone to the activity of the former. Instead of this, how- 258 EXEMPLIFIED IN PRECOCIOUS CHILDREN. ever, the prematurely intelligent child is generally sent to school, and tasked with lessons at an unusu- ally early age; while the healthy, but more backward boy, who requires to be stimulated, is kept at home in idleness, perhaps for two or three years longer, merely on account of his backwardness. A double error is here committed, and the consequences to the clever boy are frequently the permanent loss both of health and of his envied superiority of intellect. In speaking of children of this description, Dr. Brigham, in an excellent little work on the influence of mental excitement on health, lately published in America, says, " Dangerous forms of scrofulous dis- ease among children have repeatedly fallen under my observation, for which I could not account in any other way than by supposing that the brain had been exercised at the expense of other parts of the sys- tem, and at a time of life when nature is endeavour- ing to perfect all the organs of the body; and after the disease commenced, I have seen with grief the influence of the same cause in retarding or preventing recovery. 1 have seen several affecting and melan- choly instances of children five or six years of age, lingering a while with diseases from which those less gifted readily recover, and at last dying, notwithstand- ing the utmost efforts to restore them. During their sickness, they constantly manifested a passion for books and mental excitement, and were admired for the maturity of their minds. The chance for the re- covery of such precocious children is, in my opinion, small, when attacked by disease; and several medi- cal men have informed me, that their own observa- tions had led them to form the same opinion, and have remarked, that in two cases of sickness, if one of the patients was a child of superior and highly cultivated mental powers, and the other one equally sick, but whose mind had not been excited by study, they -should feel less confident of the recovery of the former than of the latter. This mental precocity Jesuits from an unnatural development of one or EFFECTS OF EXCESSIVE MENTAL ACTIVITY. 259 gan of the body at the expense of the constitu- tion" (p. 45).* Dr. Brigham justly remarks, that it is ignorance in the parents which leads to the too early and exces- sive cultivation of the minds of children, especially those who are precocious and delicate ; but from the examples which he gives, and the general bearing of his admonitions, the error of commencing systematic education too soon, and stimulating the infant mind too highly, seems to be decidedly more prevalent in the United States than in this country. Among the " children's books" in the United States, many are announced as purposely prepared " for children from two to three years old!" and among others are " In- fant Manuals" for Botany, Geometry, and Astrono- my !! That mode of teaching is considered the best which forces on the infant mind at the most rapid rate, without regard to health or any other consider- ation. Dr. Brigham adds from personal observation, that, in many families, children under three years of age are not only required to commit to memory many verses, texts of Scripture and stories, but are often sent to the ordinary schools for six hours a day. Few chil- dren are kept back later than the age of four. At home, too, they are induced by all sorts of excite- ment to learn additional tasks or peruse juvenile books and magazines, till the nervous system becomes enfeebled and the health broken. " I have myself," he continues, " seen many children who are supposed to possess almost miraculous mental powers, experi- encing these effects and sinking under them. Some of them died early, when but six or eight years of age, but manifested to the last a maturity of under- standing which only increased the agony of separ- ation. Their minds, like some of the fairest flowers, were • no sooner blown than blasted;' others have * Remarks on the Influence of Mental Cultivation and Men tal Excitement upon Heal/h. By Amariah Brigham, M.D., Boston, 1633. 260 EFFECTS OF EXCESSIVE MENTAL ACTIVIT* grown up to manhood, but with feeble bodies and dis- ordered nervous system, which subjected them to hypochondriasis, dyspepsy, and all the protean forms of nervous disease ;" " others of the class of early prodigies exhibit in manhood but small mental pow- ers, and are the mere passive instruments of those who, in early life, were accounted far their infe- riors" (lib. cit., p. 59). In well-conducted infant schools, these evils are carefully guarded against. In this country children are not generally sent to school so early; but education is still too much re- stricted to the exclusive exercise of the mental pow- ers, to the neglect of the physical, and, in the instance of delicate children, is pushed on too rapidly. I lately witnessed the fate of one of these early prodigies, and the circumstances were exactly such as those above described. The prematurely developed intellect was admired, and constantly stimulated by injudicious praise, and by daily exhibition to every visiter who chanced to call. Entertaining books were thrown in the way; reading by the fireside encouraged; play and exercise neglected; the diet allowed to be full and heating, and the appetite pampered by every del- icacy. The results were the speedy deterioration of a weak constitution, a high degree of nervous sensi- bility, deranged digestion, disordered bowels, defect- ive nutrition, and, lastly, death, at the very time when the interest excited by the mental precocity was at its height- Such, however, is the ignorance of parents on all physiological subjects, that when one of these infant prodigies dies from erroneous treatment, it is not un- usual to publish a memoir of his life, that other pa- rents may see by what means such transcendent qual- ities were called forth. Dr. Brigham refers to a me- moir of this kind, in which the history of John Moo- ney Mead, aged four years and eleven months, is narrated as approved of by " several judicious persons, ministers and others, all of whom united in the re- quest that it might be published, and all agreed in the opinion that a knowledge of the manner in which the IN YOUTH. 261 child was treated, together with the results, would be prof- itable both to parents and children, and a benefit to the cause of education" This infantine philosopher was " taught hymns before he could speak plainly;" " rea- soned with" and constantly instructed until his last illness, which, " without any assignable cause," put on a violent and unexpected form, and carried him off. As a warning not to force education too soon or too fast, this case may be truly " profitable both to parents and children;" but, as an example to be followed, it assuredly cannot be too strongly or loudly condemned. Infant schools, however, in which physical health and moral training are duly attended to, are excellent institutions. Such are those established and regulated on the plan of the benevolent Wilderspin, whose ex- ertions have gone so far to demonstrate the impor- tance of early infant training. But I regret to say that many schools lately opened under the same name have scarcely one sound principle in action, and threaten to do more injury to the children by forced and injudicious intellectual cultivation and close con- finement than will be easily remedied even by the best management in after life. I know some schools, con- sisting of a single small apartment, without any play ground, and with very imperfect means of ventilation, where upward of 150 children are crowded together for four or five hours a day, with no free access to the open air, no adequate muscular or pulmonary ex- ercise, no mental recreation worthy of the name, no systematic cultivation of the moral and social feelings in actual intercourse with each other; and where, with a few intervals of rest, an occasional march round the room, and a frequent change of subject, the time is consumed in intellectual tasks, to the almost com- plete exclusion of everything else. Schools of this description cannot be too strongly denounced as fraught with mischief to the young, and as flagrant abuses of a most valuable principle. But in thus cen- suring what is radically wrong, we must be careful not to go to the other extreme, and, like Cobbett, condemn as bad that which is so only in its abuses. 262 EFFECTS OF EXCESSIVE MENTAL ACTIVITY A well-regulated infant school is an instrument of great power in improving and humanizing mankind.* In youth, too, much mischief is done by the long daily periods of attendance at school, and the contin- ued application of mind which the ordinary system of education requires. The law of exercise, that long- sustained action exhausts the vital powers of an organ, applies, I cannot too often repeat, as well to the brain as to the muscles; and hence the necessity of varying the occupations of the young, and allowing frequent intervals of active exercise in the open air, instead of enforcing the continued confinement now so common. This exclusive attention to mental culture fails, as might be expected, even in its essential object; for experience shows that, with a rational distribution of employment and exercise, a child will make greater progress than in double the time employed in contin- uous mental exertion. If the human being were made up of nothing but a brain and nervous system, it would be very well to content ourselves with sedentary pur- suits, and to confine ourselves entirely to the mind. But when observation tells us that we have numerous other important organs of motion, sanguification, di- gestion, circulation, and nutrition, all demanding exer- cise in the open air as essential both to their own health and to that of the nervous system, it is worse than folly to shut our eyes to the truth, and to act as if we could, by denying it, alter the constitution of nature, and thereby escape the consequences of our misconduct. Reason and experience being thus set at naught by both parents and teachers in the management of chil- dren, young people naturally grow up with the notion * Many of my readers will be glad to learn that Dr. Brigham's little work has lately been reprinted in this country in a very cheap form, under the care of Dr. Macnish, of Glasgow, who is already well known as a very able and successful writer, and who has en- riched his edition with a number of excellent notes. Dr. Cald- well's " Thoughts on Physical Education" arc also in the course of republication. Both works contain facts and principles of great interest to every parent and teacher, and are calculated to be highly useful in advancing the cause of rational education. EXEMPLIFIED IN YOUTH. 263 that no such influences as the laws of organization exist, and that they may follow any course of life which inclination leads them to prefer, without injury to health, provided they avoid what is called dissipa- tion. It is owing to this ignorance that we find young men of a studious or literary habit enter heed- lessly upon an amount of mental exertion, unallevia- ted by bodily exercise or intervals of repose, which is quite incompatible with the continued enjoyment of a sound mind in a sound body. Such, however, is the effect of the total neglect of all instruction in the laws of the organic frame during early education, that it becomes almost impossible to warn an ardent student against the dangers to which he is exposing himself, and nothing but actual experience will convince him of the truth. 1 have seen several instances of almost total incapacity for future useful exertion brought on by long-protracted and severe study in subjects whose talents, under a better system of cultivation, would have raised them to that eminence, the injudicious pursuit of which had defeated their own object and ruined their general health. Two of these persons made the remark, that early instruction in the struc- ture and laws of the animal economy, such as that which I am now attempting to communicate, might have saved them. Both meant well, and erred from ignorance more than headstrong zeal. In the first number of the " American Annals of Education," the reader will find an instructive article on the necessity of combining bodily with mental ex- ercise. " For twenty years and more," says the wri- ter, in reference to what had taken place in an Ameri- can seminary, " the unnatural union of sedentary with studious habits, contracted by the monastic system, has been killing in the middle age. The Register of Education shows in one year 120 deaths. Examine into the particular cases, and these will be found the undoubted effects of sedentary habits. Look at one name there. He had valuable gifts, perfected by two years' academic, four years' collegiate, and three years' theological studies. He preached, gave much 264 EXCESSIVE MENTAL ACTIVITY promise, and then died of a stomach disease. He con- tracted it when a student. He did not alternate bodily with mental labour, or he had lived and been a bless- ing to the church. When he entered on his studies, he was growing into full size and strength. He sat down till his muscles dwindled, his digestion became disorder- ed, his chest contracted, his lungs congested, and his head liable to periodical pains. He sat four years in college, and three years in theological application. Look at him now. He has gained much useful knowledge and has improved his talents; he has lost his health. The duties of his mind and heart were done, and faithfully so; but those of his body were left undone. Three hundred and seventy-five muscles, organs of motion, have been robbed of their appropriate action for nine or ten years, and now they have become, alike with the rest of his frame, the prey of near one hundred and fifty diseased and irritable nerves."—" Look at another case. Expo- sure incident to the parson or missionary has devel- oped the disease in his chest, planted there while fit- ting himself for usefulness. He contracted a seden- tary, while he was gaining a studious habit. That which he sows that also shall he reap. The east winds gave him colds; a pulpit effort causes hoarse ness and cough, oppression and pain. He becomes alarmed and nervous. His views of usefulness begin to be limited. He must now go by direction, and not so much to labour where otherwise he would have been most wanted, as to nurse his broken constitution. He soon adds to the number of mysterious providences; to the number of innocent victims, rather, of cultiva- ting the mind and heart, at the unnecessary and sinful expense of the body; to the number of loud calls to alternate mental and corporeal action daily, for the reciprocal sanity and vigour of both body and mind." To remedy these evils and introduce a better sys- tem of training, so as to make bodily health and men- tal and rational education go hand in hand, an estab- lishment called the Manual Labour Academy was open- ed near Philadelphia in 1829, and has already proved the soundness of its principles by the success of its EXEMPLIFIED IN YOUTH. 265 results. The usual branches of study in classical schools, with the addition of the Bible, are pursued; and the " hours of recreation are employed in useful bodily labour, such as will exercise their skill, niake them dexterous, establish their health and strength, enable each to defray his own expenses, and fit him for the vicissitudes of life." From this systematic union of bodily labour in gardening, farming, carpen- try, and other work, with the usual academic studies, many comforts are said to have arisen. The health of the inmates has been uninterrupted, except in a few who were ill when received ; and, at the date of the report, in 1830, " every invalid remaining there had been restored to health." Young men thus trained to practical obedience to the organic laws are much less likely to run into excess in after life, than those who have been left in ignorance of the constitution of their own bodies. " When thought shall need no brainf the Report continues, "and nearly four hundred organs of motion shall cease to constitute the principal portion of the human body, then may the student dispense with mus- cular exertion;" but, till then, let him beware what he does, and, looking to the laws which the Creator has established for his guidance, seek his happiness, "not in denying their existence, but in yielding them will- ing and cheerful obedience. De Fellenberg has done much at his agricultural school near Berne, to adapt the physical and mental education of the lower orders to their situation in society, and it would be well were his methods belter known and more practised in this country. In early and middle life, fever, with an unusual de- gree of cerebral disorder, is a common consequence of the excessive and continued excitement of the brain, which is brought on by severe study, unremit- ted mental exertion, anxiety, and watching. Some very marked cases of this kind have come under my observation; but that of Sir Humphrey Davy is so strikingly illustrative of the dangers alluded to, that I cannot do better than lay it before the reader. In November 1807, Sir Humphrey Davy was seized with 266 EXCESSIVE MENTAL ACTIVITY very severe fever, in consequence of the excitement and fatigue which he underwent when engaged in the researches which led to his splendid discovery of the alkaline metals. " The laboratory of the institution was crowded with persons of every rank and descrip- tion ; and Davy, as may be readily supposed, was kept in a continued state of excitement throughout the day. This circumstance co-operating with the effects of the fatigue he had previously undergone, produced a most severe fit of illness, which, for a time, caused an awful pause in his researches, broke the thread of his pursuits, and turned his reflections into different channels." Davy ascribed his illness to contagion caught in experimenting on the fumigation of hospitals. "Upon conversing, however, with Dr. Babbington, who, with Dr. Frank, attended Davy throughout this illness, he assured me that there was not the slightest ground for this opinion, and that the fever was evidently the effect of fatigue and an over- excited brain. The reader will not feel much hesita- tion in believing this statement, when he is made ac- quainted with the habits of Davy at this period. His intellectual exertions were of the most injurious kind, and yet, unlike the philosophers of old, he sought not to fortify himself by habits of temperance." " Such was his great celebrity at this period of his career, that persons of the highest rank contended for the honour of his company at dinner, and he did not possess suf- ficient resolution to resist the gratification thus afford- ed, although it generally happened that his pursuits in the laboratory were not suspended until the appointed dinner hour had passed. On his return in the evening, he resumed his chymical labours, and commonly contin- ued them till three or four d'clock in the morning, and yet the servants of the establishment not unfrequently found that he had risen before them." Such was the alarm- ing state of his health, that for many weeks his phy- sician regularly visited him four times in the day ; and the housekeeper, Mrs. Greenwood, never retired to bed, except one night, during eleven weeks. In the latter part of his illness "he was reduced to the ex- IN MIDDLE LIFE. 26? treme of weakness, and his mind participated in the debility of his body."* Instances sometimes occur of persons, exhausted by anxiety and long attendance on others, being them- selves attacked by fever, and dying, more from the unfavourable state to which previous exhaustion had reduced them, than from the intensity of the fever itself. Nervous disease from excessive mental labour and exaltation of feeling sometimes shows itself in anoth- er form. From the want of proper intervals of rest, the vascular excitement of the braifi, which always accompanies activity of mind, has never time to sub- side, and a restless irritability of temper and disposi- tion comes on, attended with sleeplessness and anx- iety, for which no external cause can be assigned. The symptoms gradually become aggravated, the di- gestive functions give way, nutrition is impaired, and a sense of wretchedness is constantly present, which often leads to attempts at suicide. While all this is going on, however, the patient will talk or transact business with perfect propriety and accuracy, and no stranger could tell that anything ails him. But in his intercourse with his intimate friends or physician, the havoc made upon the mind becomes apparent; and, if not speedily arrested, it soon terminates ac- cording to the constitution and circumstances of the individual case, in derangement, palsy, apoplexy, fe- ver, suicide, or permanent weakness. As age advances, moderation in mental exertion becomes still more necessary than in early or mature years. Scipion Pinel, in adverting to the evil conse- quences of excessive moral or intellectual excitement, acutely remarks, that although in youth and manhood the wear of the brain thus induced may be repaired, no such salutary result follows over-exertion in the decline of life; " what is lost then, is lost forever. At that period, we must learn to wait for what the brain is willing to give, and allow it to work at its own • Paris's Life of Sii H. Davy, p. 183. 268 IN ADVANCED LIFE—SIR W. SCOTT. time : to attempt to force it is to weaken it to no pur- pose ; it becomes excited and quickly exhausted when forced to vigorous thinking." " Men of exalt- ed intellect perish by their brains, and such is the no- ble end of those whose genius procures for them that immortality which so many ardently desire.''* ' Who can peruse these lines without the fate of Scott instantly occurring to his mind as a practical illustration of their truth 1 In the vigour of manhood, few ever wrote so much or with greater ease. But when, on the verge of old age, adversity forced him to unparalleled exertion, the organic waste could no longer be repaired, and perseverance only " weaken- ed the brain to no purpose," till morbid irritability be- came the substitute of healthy power, and he perish- ed by that brain which had served him so faithfully and so efficiently, but which could no longer perform with safety the gigantic efforts which he continued to demand from it. Where a predisposition to insanity exists, the cer- ebral excitement induced by excessive activity of mind often leads to disease. Examples of this kind abound in the works of authors. Pinel mentions several. One of them is the case of a young man distinguished for his talents and his profound knowl- edge of chymistry, who was occupied with a discov- ery which he hoped would lead him to fortune and distinction. To effect it the sooner, he resolved to shut himself up in his laboratory for several succes- sive days; and, the better to banish sleep and to raise himself to the level of his labours, he prepared a va- riety of stimulants. A singing girl shared his retreat; he drank spirits, smelled frequently odoriferous sub- stances, and sprinkled the room with eau de Co- logne. The combined action of all these means, ad- ded to the heat of his furnace, caused such a degree of cerebral excitement, that, at the end of eight days, the most furious delirium took place, followed by a regular attack of mania. If anything can demon* * Physiologie de l'Homme Aliend, p. 177. HEALTH RUINED BY EXCESSIVE APPLICATION. 269 Btrate the mutual influence of mind and brain, it is surely a case like this; a case which it is impossible to read without perceiving how easily the cerebral affection might have been of the violent inflammato- ry character, which terminates after a few days, in life or in death : or of the febrile character, that lasts for one or two months, and leaves the mind for ever reduced in tone and vigour. It is well remarked by Tissot, that the disorders produced by efforts of the mind fall soonest upon such as are incessantly engaged in the contemplation of the same object. In this case, he adds, there is only one part of the sensorium (brain) acted upon, and that is kept always on the stretch: it is not relieved by the action of the other parts, and, therefore, is sooner fa- tigued and injured; the same rule holding with the brain as with the muscles, that the exercise, which, if divided among the different parts of which it is composed, will strengthen them, will, if confined to a few, exhaust and impair them. Boerhaave himself, after a long period of intense thinking, suffered for six weeks from excitement of the brain, bordering on madness, and characterized by that want of sleep, irritability, and indifference to ordinary in- terests which so often appear as the harbingers of insanity. The number of literary and public men, students and persons in business, who do themselves irrepa- rable injury in this way, is so great, that few of my readers who have had experience of the world will be at a loss for examples even among their own ac- quaintances. In addition to Davy, Scott, and others already mentioned, Sir Isaac Newton may be referred to, as it is now certain that his mind was for a time disordered by excessive application, and there is much reason to believe that he never altogether re- covered from the shock. The more limited the sphere of talent, the greater the danger of the brain being over-exercised, particularly where the temperament is quick and irritable; and hence the frequency of nervous affections in musicians and others of sus- Z 3 270 GRETRY, WEBER, AND OTHER EXAMPLES. ceptible minds, who dedicate their lives to the ex- clusive cultivation of their arts. It is said that Gre- try not only ruined his own health, but lost three highly-gifted and beautiful daughters in succession from over-excitement of the nervous system thus in- duced ; and there can be no doubt that the melan- choly fate of Weber was greatly hastened by intense application. He continued deeply engaged in musi- cal composition long after his health was undermined ; and, even when the hand of death was almost upon him, his avocations pressed so heavily that he could not help exclaiming, " Would that I were a tailor, for then I should have a Sunday's holyday /" The philan- thropic physician will rather be inclined to exclaim, "Would that mankind would study their bodily structure and functions, and thus learn to preserve longer the health and existence of those whose ge- nius is the source of so many pleasures to the world at large!" So little, however, is this close connexion of the mind with the brain generally unde/stood, even among educated people, that instances are constant- ly occurring of the health of the nervous system be- ing ruined by excessive application of mind, without the sufferer in the least suspecting the true cause of his ailments. This fact is well exemplified in the pa- ges of a very sound and able American writer, who says, " I once knew a young Christian, who resolved that he would pass the whole day in prayer. But very soon he became exhausted and weary. He, however, persevered through the whole day, with the exception of a few necessary interruptions; and, when night came, he felt a deadness and exhaustion of feeling, which he unhappily mistook for spiritual deser- tion."* I need scarcely add, that no one at all ac- quainted with the laws under which God has placed the functions of the human body, could ever have ex- pected his blessing to attend so flagrant a violation of his designs, or have felt surprise at the apparent • Jacob's Young Christian, 2d Edinburgh edition, p. 830. EXAMPLE. 271 spiritual desertion increasing in exact proportion to the excess of the bodily fatigue. Cases like that of the young Christian show, in a strong light, the evils arising from confining ourselves too exclusively to the word, and neglecting the study of the works, of God, as if the latter were quite of a secondary character, and did not proceed from the same infalli- ble source ; whereas it is only by duly investigating the laws of God, as operating in the varied works of creation, that we become enabled rightly to interpret and to apply to our conduct what is revealed in His word. 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 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. Having thus pointed out the evils arising both from inadequate and from excessive mental exertion, it remains for me to direct attention to some of the rules which ought to guide us in the proper exercise of the brain. It seems to be a law of the animal economy, that two classes of functions cannot be called into vigor- ous action at the same time, without one or other, or both, sooner or later sustaining injury. Hence the important rule, never to enter upon continued mental exertion, or to rouse deep feeling, immediately after a full meal, as the activity of the brain is sure to in- terfere with that of the stomach, and disorder its functions. Even in a perfectly healthy person, unwel- come news, sudden anxiety, or mental excitement, occurring after eating, will put an entire stop to diges- tion, ana cause the stomach to loathe at the sight of food. In accordance with this, we learn by experi- MENTAL EXERTION BAD AFTER A MEAL. 273 ence, that the worst forms of indigestion and nervous depression are those which arise from excessive ap- plication of mind or turmoil of feeling, conjoined with unrestrained indulgence in the pleasures of the table. In such circumstances, the stomach and brain react upon and disturb each other, till all the horrors of nervous disease make their unwelcome appearance, and render life miserable. Literary men and hard students know this fact from sad experience; but as they are not aware of the incompatibility of the two processes of active thinking and active digestion go- ing on at the same time, it is extremely difficult to give them a sense of their danger, and to convince them that an hour or an hour and a half after a meal is more profitably spent in easy relaxation than in the labour of composition. As regards the lower ani- mals, indeed, we are careful enough to observe this organic law; for we do not allow our horses or dogs to be actively exercised till digestion is in some de- gree completed. It may be said that mechanics, labourers, and oth- ers, hurry away to work immediately after meals without any apparent injury; and that, in the United States, the practice of hastily swallowing dinner and instantly returning to business is almost universal. My answer to this objection is simply that experience proves the fact that digestion goes on better when exertion is refrained from and repose is enjoyed; and that the tendency to sleep and inactivity which besets most animals after a full meal, shows repose to be, in such circumstances, the intention of Nature. It must be observed, also, that the bad effects of imme- diate exertion are not among those which ensue in- stantly, or are felt from day to day. They may show themselves only at the end of months and years, when the influence has, as it were, accumulated by repetition. Although, therefore, the system possess- es a certain power of resistance, and many persons seem to escape even for years, it cannot be doubted that opposition to the law of Nature will eventually prove injurious. The extreme prevalence of dys- 274 BEST TIME FOR MENTAL APPLICATION. peptic complaints and of insanity among Americana 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 ol 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 oi 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; tb 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 A A 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 maybe 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 cf 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 teach 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- 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 ho 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 I attached so much importance to physiology as a practical science, 1 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 Georok Combs." In this w/)rk, 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 ise- fiilness, and not rttre speculation, is the characteristic of the vufume. 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 I 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 Ian 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; Idly, 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 gravel 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! 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 leaching 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 1 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 ? 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 1 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 I 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? 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 percentage 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. For The pupil is charged per qiurter, The teacher receives, And, consequently, the annual sur-charge amounted to, Dancing, Drawing, Singing, Harp, Guitar, German, French, Writing, &c.. Geography, . Elocution, Annual total of surcharge on the above branches, 1.2 2 0 3 3 0 4 4 0 4 4 0 4 4 0 3 3 0 2 2 0 1 1 0 1 1 0 1 1 0 l. 1 1 0 2 2 0 3 3 0 3 3 0 3 3 0 2 2 0 1 11 6 0 10 6 0 10 6 0 10 6 1.4 4 0 4 4 0 4 4 0 4 4 0 4 4 0 4 4 0 2'2 0 2 2 0 2 2 0 2 2 0 I. 33 12 0 B b2 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- spect 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 I 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 obiects. the exclusive THE LNTELLECTUAL FACULTIES. 297 nse 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 299 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- alar 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 CommittPe, and richly deserves the attentive consideration of every 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, 1 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 irrfluence 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 nervous 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 stimulus, 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 stare of mind to be the best and hap- piest for man himself, and therefore took care to sur- Cc 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 * Park's Life of Davy. p. 51. t F. V. Mye, De Morbis et Symptonatibus, &c, quoted by Dr. Johnston in his Treatise on Derangements of the Liver, &c, p. 206. 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 »he 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 i3 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 Ira- 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 in different 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, I 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, Thirdly, 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 laws, 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- uitions 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 it? 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 he long remembered. Smallpox is another scourge which annually carried off its thousands, and from which modem 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 D D 314 KNOWLEDGE MAS 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. 8a 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 feu- 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 to 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 Bpared 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 sailed from the Cape in search of a southern continent. On the 29th, a violent storm, attended with hail and ram, came on, and caused the loss of most of the live Dd2 318 EXCELLENT HEALTH IN C^OK'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 121 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 swectwort 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 acomplication 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 * 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^e 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 112! 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 Ballingall's 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 establi>hment, 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 lime, 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 tent ary, 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 Atmnephere on the Health and Funo- •ions of the Human Frame, &c, 8vo, 2d edition, p. 193. CAUSES OF DISEA3E 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 h?voc; while, in its middle and ulterior periods, these diseases al- most disappeared, and pneumonia (inflammation of the lungs), with its too frequent consequence, phthi- bis, 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 pulritonic 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 1B22 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 I 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's own conduct; and that, when the conditions of health E E 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 in their growth, scrofulous in constitution, and bad in morals.* If, as seems to be the case, a corresponding dispro- Sortion occurs between the rates of mortality in the ifferent classes of society in Great Britain, it sug- gests some most important considerations, the firs4 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 I 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 averageof 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 60 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 De 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 numbei 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- E b 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, cateris 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 lawt 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 hospita., 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- bides.'" 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, &c, p. S. 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 details, 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 1 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 unproved 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 which 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 unbodied, 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 use/ul. 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- 342 USE OF PHYSIOLOGICAL KNOWLEDGE IN tem, 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 thai 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 1 now refer. To the nervous invalid the rule is still more extensively applicable. To secure regular and animating exercise of all the 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 their current expenses, while scarcely a single accident is on record as having arisen from an improper use of the liberty allo-ved 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- posed to him as an individual or as one of a tew, he 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 bas"ket-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 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 wJiich 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? 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 show ing 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 whicn 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 asjlum 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 indts- Go 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 httle 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, therefor*:, 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 ASYLOMS 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 Hanwell, 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 riot 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 Eerson and in clothes, also, is too little enforced, and aths 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, I must again repeat, to suppose that, because a person is insane, lie 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 Bhelter 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 1VRY. 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 upan 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 d 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. 1 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 1 cannot help con- sidering the asylum, in its present state, as a disgrace to the metropolis of the country. QUESTIONS ON THE PRINCIPLES OF PHYSIOLOGY. BY RBV. 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 physiology called T What is vegetable physiology ? Comparative f 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 physiology eminently useful? What do you mean by hygiene? How are the mental and moral powers of man manifested ? What would be Ihe most successful plan for their cultivation ? 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 ? 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 1 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 ? 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? 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 had brought on spitting of blood by bodily labour at the spade, be deemed perfectly safe and cautious by relinquishing that occupation and confining himself toharangu 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 corne 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 or in spring by invalids and persons of delicate constitution, more particularly owing? 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 spring season? From what then? Why is not this fact immedi- ately perceived 1 What may be said in corroboration of this view ol 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 qf a just knowledge on this subject 1 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 H H 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 1 What is the general inference to be deduced? CHAPTER II. On what principle are the following essays conducted ? 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 ? 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 ? Show the wisdom of this arrangement. In what cases is a thicker cuticle provided ? What reason have we to think this provision is intentional ? When does the cuticle become thicker than its original consist- ence, and for what purposes7 Give some illustrations. What organization of the cuticle would have been less beneficial? To which layer of the skin do the nails belong? Why ? What are their use ? What are their substitute in the lower animals ? How must the thickening of the cuticle be produced I Why ? Give an illustration. What is between the scarfskin and the true skin? 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 present ? 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 ? What are proofs of the cellular nature of the skin ? 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? Explain 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 Sanotorius ? What distinctions did Lavoisier and M. Seguin 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 T 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 f 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 m to be deduced ? What is the lowest estimate of the cutaneous excretion made by Lavoisier 1 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 t What great danger is obviated by the convulsive effort of cough- ing I 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 ? Illustrate. To what class of per- sons does popular ignorance give currency ? 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? 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 ? 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 1 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? 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 1 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 inference ? 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 ? How is the skin provided in order to transmit the impression to the mind ? What is essential to its texture and vitality ? Illus- trate the great utility of the nerves from the case mentioned by Dr. Yellolv. Is the principle of sensation in the surface of the body uniform ? 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 ? 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 ? 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 ? How are the changes in the skin produced by mental operations ? Mention some extraordinary cases. What is the reverse influence which the condition of the ner- vous matter exerts upon the rest of the system ? Upon the mental 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 IIL In what sense is knowledge power ? 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 ? 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? Why should this be particularly removed in early life ? Why is daily washing and frequent change of clothing essential in that age ? 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 of a consumptive habit ? What precaution is to be taken ? What remedy ? What is to be said of excessive clothing ? How are rules to be QUESTIONS. 367 laid down ? What general rule may be deemed sufficient ? What other mods 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 ? How do wet and cold feet produce disease? Is it the mere state of wetness that causes the evil? Mention an instance in point. From what principles may the advantage of wearing flannel be proved? State its particular advantages, and how it operates on the skin. What should be 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 attributable? 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 ? What excellent practice, common in Italy, should be adopted ? Why is this so consonant to reason ? What is the reverse custom of the poor Irish in Edinburgh 1 What are its dangers ? What influence has the solar light on the skin? What is ob- servable in those who are deprived of it ? 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 ? 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? Among the North Americans? In the United States? In England? In public charities and schools? Which is more suited for general use, the warm or the cold bath ? Why ? 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 ? With what limitations and exceptions ? How should the time of immersion in a cold bath be regulated ? What has been found the most beneficial season of the day? 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 for habitual use ? At what stage of temperature ! 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? 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 I 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 ? Note. What is the state of vapour bathing on continental Europe ? By what beneficial effects is it attended there ? What prejudices are there against its use ? On what are they founded ? 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 ? Explain the principle. In what cases may the vapour bath be hence a preservative and remedial agent ? With what cautions must it be administered ? In what cases may a vapour bath be prejudicial? Why? What may be a substitute ? To what are the preceding remarks specially applied ? To what may they also be extended? Why? 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 ? With what limitation and caution are the above facts to be re- ceived ? 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 skin 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 ? 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 ? To what is it ow- ing? What functions of the human system have had their re- spective patrons ? How has the doctrine of each been sustained? What does this prove ? 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? j What connexion has free perspiration with acidity in the stom- ach ? 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 his views ? 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 attention ? What are the muscles ? What constitutes the red, fleshy part of meat ? 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 ? How do the muscles enioy 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 ? 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? What considerations obviate this difficulty ? In what do the fleshy fibres of the muscles terminate ? To what are tendons or sinews conducive? Have all muscles osseous attachments or tendons? Which have no bones ? Which no tendons? What is the usual colour of the muscles? Upon what does this depend ? How is this ascertained ? What is the conse- quence ? What is the true characteristic of muscular fibres ? How is the direction of muscular motion determined ? Recount separately and distinctly the various directions of the muscular fibres. Give examples of some of the particular uses of these *&■ nations. 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? Explain the evils and their causes. What is necessary to sustain the growth of the animal system in youth ? What if this be neglected ? 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 ? What else besides mere muscle is required to produce regulated or voluntary motion ? 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 ? What three things must be in operation to effect voluntary mo- tion ? How are the number and size of the muscles distributed. and why? 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 ? How is semi-intoxication sometimes suddenly removed ? 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 ? How is muscular contraction effected ? Show this in the sterno-mastoid muscle in the figure ? In the rec- tus or straight muscle ? In the sartorius or tailor's muscle ? 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 ? What is one cause of costiveness ? 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 ? Why? From what necessity? 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 ? Are great muscular power and intense nervous action often con- joined? What do they constitute when united? 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 nerve ? 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? Hnw 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? 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 education? 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? To what is the inadvertence of teachers and parents owing? 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 ? What reforms ? Why should there be some 372 QUESTIONS. intermission for bodily relaxation during study hours ? 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 F How does nature universally authorize this reformation ? How does it operate on boys? Why should it be adopted in infant schools ? What aids and co-operates with muscular activity ? Give an illustration. To what is this difference owing ? What maybe 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. Span man's 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 ? What are the necessary deductions and reflections ? 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 yotmg? 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 ? What effects does exercise produce upon the organs employed ? What the cessation from exercise ? What is the effect of exercise taken frequently and at moderate intervals? What if resumed too often or carried too far ? 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 ? 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 t 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 ? 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 ? 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 exerciwe ? At what times ought exercise to be taken so as to produce ben- eficial results? In what state of the animal system ? When does this take place ? What does an opposite procedure produce ? For what reason ? Why is exercise immediately before meals injurious ? If severe or protracted ? What is the rule ? 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? 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 ? 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 ana 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 ? 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 T 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? What is said of the ancients? Why is their practice discontinued7 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 ? What is the practice of sportsmen ? 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 a nd 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 ? 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 ? What are the most perfect of all exercises? To what does the ignorance of parents tend ? Illustrate. What has been the design of the preceding remarks? 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? Which are the next in importance ? What are excellent examples of the same class ? 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 ? 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 ? 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 ? What is the difference between 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 anatomists? What does the second include? What does the third comprise ? Of what does the head consist ? What is the use of the scull ? How and for what reason are the bones of the scull constructed? Of what does the trunk consist 1 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 vertebras, and how many ? The dorsal ? The lumbar 1 Upon what does the base of the column rest ? How are the ver- tebraj connected ? What do they secure? Give an illustration. What prevents us from perceiving at once this to be the case? What is the use of the body of the vertebras ? Of the projecting ridge behind and rugged processes at the sides ? 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 ? What their ac- tion ? How is the pelvis formed ? Point it out in the figure. How may a general notion of its bones and their uses be formed? What are the bones of the upper extremities ? Point out the scapula. The clavicle. The humerus. The radius. The ulna. The carpal and metacarpal bones. The phalanges. What is the scapula?. How is it familiar to young ladies? What is its use ? What is the collar bone ? 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 oui in the figure. 376 QUESTIONS. How is the thigh-bone ariticulated 7 What does it thus effect ? How is the thigh-bone 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 arid 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 ? How do the animal and earthy por tions vary 7 In infancy? 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 ? What is the effect of fire on the bone, and how is the earthy constituent procured ? What do you mean by the animal constituent ? What by the earthy constituent ? What important purpose is served by the different proportions of the animal and earthy elements of bones 7 In early youth ? In middle life? 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 ? 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 7 The exhalants ? The veins ? The absorbent vessels 7 The nerves ? What may be said of the bones in these respects? Prove the fact that the bones are provided with bloodvessels. With nerves. 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 ? 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? 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 ? 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 ? _ 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 ? 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 the system? What is the practical application to be made of our knowledge of the constitution of the bones ? On what does their healthy con- dition depend ? How is the study of an organ or function often rendered incom- plete ? In the case of the heart ? Of the eye ? Of the bones ? What effect is produced in 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 7 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 this indispensable in the case of youth? What are the consequences of the non-fulfilment of this condition? 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 ? What results from a partial action of the system 7 How is this manifest in the muscular system ? What law, highly important in its practical consequences, regu- lates the active and inactive states of the animal functions? In what is the benevolence of this arrangement manifest? How is this obvious principle daily disregarded ? How does the law of exercise apply to the osseous system ? What natural defects in the bones may be attributed to the neglect of exercise ? 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 Blame. W hy do horses early and hard worked never arrive at their full size 7 From what other causes besides inadequate exercise does defec- tive nutrition arise? Among the poor? The rich 7 What are the consequences to both ? How may the relative uses of the bones and muscles be com- pared ? How does this apply? In the case of infancy ? In the diseased 6tate called mollities ossium ? In the case of fevers, acute diseases, and sudden fright? When is the maturity and perfection of all organs and functions attained ? 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 7 . What is said of the effects of leading-strings I 11 2 378 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? What is necessary to be premised ? How many different kinds of blood circulate through the body ? What is the property of the former ? How is it distributed ? What is the aorta ? What great change does the blood undergo in its circulation through its two systems of vessels ? What two conditions are essential to the reconversion of venous into arterial blood ? 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 7 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 sanguifica- tion and aeration used to denote 7 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 lungs 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 ? Describe the lungs in man. How do they vary in different per- sons 7 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 7 What is its use ? What do you mean by the peristaltic or vermicular motion? What does it resemble ? 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 use? The extent of their lining membrane ? 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 t 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 on7 What is its use? How is the air which we breathe vitiated? What renders the breath offensive, and gives to rooms their sickening smell? 8 In what part does pulmonary absorption take place ? How does it operate ? What are sometimes its effects ? What practical advantages may we derive from 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 the 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 ? 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? Why should such be the results of different kinds of mental emotion? What do these principles show? What is & fourth essential condition ? For what reason 7 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 7 380 QUESTIONS. What is a low estimate of the inhalation, and how is the vitiation of the exhaled air to be calculated ? 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? 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 that cases like these oc- cur more frequently than is supposed ? Is it necessary to infer that the fatal results in all the above in- stances were produced exclusively by the vitiation of the air ? 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 ? Of Sir George Ballingall ? Of Sir John Pringle ? Of Dr. Jackson ? 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 ? 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 1 How has the renovation of the air served as a preventive against disease ? Mention Sir Walter Scott's case. Give Dr. Joseph Clark's testimony. What is Mr. Thackrah's testimony with regard fo the first indi- cations of pulmonary disease 7 How are they to be accounted for? What is the imperceptible yet certain progress of the disease on the constitution? 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 ? To what should our attention be especially directed ? What difficulty presents itself in persuading any rational and instructed mind that all care is superfluous ? 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 Athletes ? Of racehorses and gamecocks ? QUESTIONS. 381 Why is necessity for adequate ventilation so urgent in the Brit- ish manufactories 7 Give Dr. Clark's evidence. What other evils to the lungs attend cotton manufactories, spinning mills. and the work of many trades ? Why5? How does the principle apply to our construction of houses ? Of public rooms ? Of bedrooms 7 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 7 To what is the nuisance chiefly attributable 7 How are they exemplified also in the case of the two British Houses of Parliament ? 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 chifrches and schools 7 What are its effects in the close of the afternoon ser- vice 7 What is said of the ventilation of churches during the winter? 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 7 How has this been universally manifest, time out of mind, in deficient ventilation 7 What has science failed to effect in one case, while it has been provident in another ? 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 7 What diseases may be 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 ventilation of houses 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 extent? • What are the chief merits of his plan? How is it safe and ef- ficient under all circumstances? How does the attention paid by the Russians to warmth and ventilation compare with other nations? What subject for consideration does the intimate relation be- tween the functions of the skin and those of the lungs introduce? What are the true sources of animal heat 7 Of what importance is its regular production '. Why? In winter? In summer? In cholera ? What relation has the production of animal heat with the state of the respiratory functions ? How is this evinced ? 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 7 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 7 How may this proposition be evinced 7 What phenomena may this ex- plain ? What 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 ? How does the power of this resist- ance vary ? 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 ? 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 ? In what respect is a judicious exercise of the lungs necessary? 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 ? With what cautions is the loregoi.ig exercise to be undertaken 7 In what case is it particularly advantageous? How far may these exercises be carried with profit? What of- 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 cases t Under what circumstances may it be highly beneficial 7 What preventive measure is recommended bv Dr. Clark 7 What effect have crying and laughing on the system 1 Why should the latter be encouraged 7 W hat is an incident before re- lated 7 How does it bear on the present occasion ? W hat farther influence does the direct exercise of the lungs ex ert upon the anatomy of the human structure? Relate the whole process according to the figure. How do the other functions of the body suffer when this exercise is neglected ? 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 cola? What apparent inconsistency is explained on this prin- ciple? In what stage of recovery from disease is exercise to be bene- ficially resumed ? What is the error of parents in this respect 7 Why should sudden transitions to a different state of atmo- sphere be avoided 7 By what expedient 7 Why 7 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 7 What mental phe- nomena occur during this period? How is the deficiency after- ward compensated 7 What course should be pursued under such circumstances 7 To prevent what effects ? What has been too much neglected during this period of life? What would be the results of proper care 7 384 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 theu 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 1920 and 1821. What do the above results prove, and what useful lessons do they teach1 What ought the combined testimony deduced from the changes in a million of people to establish ? 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 Wh.it 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 ? What is the structure of the brain 7 What are its principal di- visions? What is the dura mater? The cerebrum? The convo- lutions' How are these represented in the figure? What does G G represent? What are the two hemispheres of the brain? What is tbefalx or falciform process ? What is its chief purpose 7 How is each hemisphere divided 7 Where is the anterior lobe situated ? The middle lobe ? The posterior lobe 7 What is the tentorium 7 The cerebellum ? What is the pia mater ? What is its appearance when a little inflamed ? Of wnat 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 ? Exemplify. What is the medulla oblongata ? What has been considered the connexion between the brain and spinal marrow 7 What i9 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 7 What other nerves are there, and how do they arise ? What is said of the blood of the brain and its circulation 7 What is agreed upon by most physiologists with regard to the functions of the different parts of the brain? In what do they QUESTIONS. 385 5. *?e Ln.What II the °Pimon of al1 Physiologists and philoso. pliers 7 What is the anterior lobe considered to be by a laree y"'jy? u uat ls the bram> bv nearly universal consent, coil- sidered to be the seat of? 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 7 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 wf°ranCe teachers on the subject of physiology ? What has been said in answer to the above practical application 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 ? 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 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 7 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 7 How is safety to be found, and the rule to be practically ap- plied 7 y What else besides hereditary predisposition exerts an influence on the mental character and health of offspring? What is the testimony of M. Esquirol ? In the case of the French revolution? In one remarkable instance ? In the case of James VI. 7 In the case of a young lady 7 What is Dr. Caldwell's testimony and advice? What precau- tions ought to be taken ? 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 7 What are the extreme effects arising from differences in the quality of the blood? Give instances of two opposite extremes. What effects are produced by slighter variations jn the quality of the blood ? 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- Kk 386 QUESTIONS. nates nerVous disease and delicacy of constitution more common- ly than is imagined ? 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 braint What does defective nutrition often depend on? What is the frequent consequence of insufficient food among the poor? What is the third condition of health in the brain and nervous system ? How does the brain compare with other organs of the body in respect to exercise ? If it be doomed to inactivity ? If it be deeply exercised ? If it be overtasked 7 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 7 Why is this not surprising ? What renders solitary confinement so severe a punishment to the most daring minds ? How is this also the case in continuous seclusion from society ? 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 7 What is the inevitable result 7 How is this fact particularly observed among the deaf and blind ? What is Andral's 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 To what conclusion may we reasonably come from the above facts 7 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 causes7 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? How? In what manner is this provided 7 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 tive employment to exercise the mind and brain ? To what in stability and kind of indulgences does it give rise ? 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 What is the only difference ? 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- ment? How should they be treated? What guide do the necessities of the constitution advise in re- gard to precocious and dull children 7 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 1 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 ? What relation does physical there bear to mental exercise ? Adduce a case in proof of the fatal results. How has it been customary to treat the fatal effects produced by this pernicious system ? 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? What other besides mental operations has the body to perform ? To what lamentable effects of excessive mental activity in young men has ignorance of the organic laws given rise 7 Adduce instances from the American Annals of Education, 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 7 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? 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? 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? What was the case of Boerhaave ? 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 ? 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 experienced" Why are they insensible to it ? How is this organic law observed in dogs and horses 7 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 ? 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 7 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? What is its tendency? What organic law is brought into operation in our acquiring readiness and forming habits? 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 whatlmanner? How does this apply to servants ? To reading ? 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 cultivalion 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 ? 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 7 In what would the merest savage surpass the philosopher 7 Give a full illustration. How are we to turn to account the physical and mental organs which God has given us 7 What occurred to the author after the publication of the third edition of his work 7 What important question was put to him, and what did it elicit? Why is physiology first among the subjects which is important for teachers, as professional men, to be acquainted with? W liy is the muscular system an example 7 Apply this principle to the exercise of a bodily power 7 How does the same principle precisely hold for the training of the mental powers ? How does it apply to moral education? What are the instances in which the love of approbation exem- plifies this principle ? 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 ? Kk2 390 QUESTIONS. Why should one or several faculties not be cultivated to the ex- clusion of the rest 7 What is the proper course to be taken to produce moral excel- lence in the young? How docs 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 7 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 7 By what considerations may this rule be enforced, or, rather, on what occasions has this rule been inconsistently violated 7 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 7 Why is it so 7 What excuse has been sometimes offered in justification of this practice 7 How is it answered ? Give some specimen of the above practice. See note. What similar practice once existed between physicians and Bpothecaries ? To what are such delinquencies in teachers to be attributed, and how may they be remedied ? 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 7 How does the cultivation of this fac- ulty compare with the cultivation of some intellectual or physical faculties 7 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 ? 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 ? 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 ? 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 system of education in harmony wild, the mental constitution? QUESTIONS. 391 What serious obstacle to entering upon the exercise here rec- ommended presents itself 7 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 preceding pages? 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 ? Give an illustration 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 this 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 ? From what wise arrangement of the Creator? When is the stimulus far from beneficial? Why? What is the result 7 How does over-exercise of the intellect and inactivity of the feelings effect the same 7 What is the case of persons so situated 7 What is an opposite case and its treatment 7 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 I What is the true reason ? How far may this benefit be extended i 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 ? Inthecaseof mathematicians? 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? What important practical rule does this naturally suggest? Where are other apposite illustrations to be met with f CHAPTER X. What is to be considered in this chapter ? In how many different lights may bad health be regarded ? What is the first7 What is the second? What is the third? What are the practical results, if the first be the truth? 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 7 What proof have we of this position 7 How far is the second proposition tenable ? How far untenable? 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? How has the progress of knowledge and the increasing ascen- dency of reason tended to show the same truth ? 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 ? How was the distemper, ac- cording to the testimony of the writer, considerably augmented 7 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? 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 Hecla in point? In what particularities were all the conditions of health attend- ed to in these Northern Expeditions? To what three causes may the extraordinary prevalence of dis- ease at the Penitentiary of Milbank be attributed 7 How far are these causes proved by subsequent changes and in- quiries? What is Dr. Latham's testimony in the case 7 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 J 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 ? In England and Wales? In London? In Man- chester and Glasgow? In France? In Austria? Russia? United States ? In South America? In Paris? What may be observed of the great disparity of results obtained in England and abroad ? How is the principle, however, established even by many of the Continental returns? What do these statements sufficiently prove 7 What error has been common with regard to the simple food and hardy habits of the poor 7 How is the reverse actually the case? In France? In London? What is Mr. Marshall's tes- What important considerations does the corresponding dispro- portion between the rates of mortality in the different classes of society in Great Britain suggest 7 What principle, frequently in- sisted upon, does it strikingly illustrate? What does blindness to this principle produce 7 .,„.., • .,. .■ 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 ? 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 ca^es are there in which 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 What 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? What is the consequence of a sudden transition from a "not 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 7 In what does the difficulty of illustration in the latter case consist 7 What practice observed in the army may be adduced in illus- tration 7 How is it physiologically irrational ? What are the statements of Mr. Finlayson and Count Chabrol? 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? How are these results to be viewed in time of war? How does this apply in the case of the army in Spain, according to Sii James Mac Grigor? * What is the evidence of Marshall in the case of a French army 7 What is the testimony of Bonaparte 7 How is this circumstance illustrated in the East India service? What is Sir George Ballingal's evidence 7 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? What is the cause of this erro- neous practice 7 Why has this topic been so long dwelt upon by the author 7 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 7 What n the design of this? W hy do this class of sufferers stand in need of attention 7 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- viceable ' 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 7 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 7 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? What is a deplorable mistake with regard to the feelings of the insane 7 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 7 What maxim has become every day more evident? How do the above observations apply to the several stages of the disease? How should these be respectively treated ? 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 7 What would render it more pleasant, more per- severed in, and more salubrious to the individual 7 What would this latter condition tend greatly to effect? 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? 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 ? What benefits would accrue from this plan? What may be an obstacle to its adoption ? 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? When are thoy productive of the fullest advantages 7 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 thedeficien- 396 QUESTIONS. cy ? What is said of the Connecticut Retreat ? Why should the deficiency be made known 7 Why are the higher classes of lunatics, as matters now stand, the most unfortunate of all ? 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 ? 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? 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? In what respects does the establishment at Hanwell benefit from the superintendence of Sir William and Lady Ellis7 How doos Miss H. Martmeau confirm the author's representations, and in what does she err 7 What is the real state of the case 7 In what condition are the two great institutions of Bethlem and St. Luke's? What is the state of the Edinburgh Pauper Asylum 7 How does the Hanwell Asylum compare with that of Edinburgh ? What is the defective state of the Edinburgh Asylum ? What is a common condition of health to the insane as well as sane? How do the institutional 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 7 How has Esquirol, 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 7 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 ? 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 and 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 nervouB 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 nerve* 112. Li 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 bv 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, 166. Softened by some diseases, 168. Weakened by want of exercise, 169, 224 ; and by want of sufficient food, 171. Bowel-complaint, how produced by chili of the skin, 52. Not cu- rable in every case by the same remedy, 64. 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 blood in it, quickened by mental action, 254. Evil«, arising from its excessive and premature exercise, 254, 256. Influence of its condition on the health of the body at large, 300. Breathing. ? v* ■ VK >t A ^1