A Practical Physiology Part 39

There are certain articulate sounds called vowel or vocal, from the fact that they are produced by the vocal cords, and are but slightly modified as they pa.s.s out of the mouth. The true vowels, _a, e, i, o, u_, can all be sounded alone, and may be prolonged in expiration. These are the sounds chiefly used in singing. The differences in their characters are produced by changes in the position of the tongue, mouth, and lips.

Consonants are sounds produced by interruptions of the outgoing current of air, but in some cases have no sound in themselves, and serve merely to modify vowel sounds. Thus, when the interruption to the outgoing current takes place by movements of the lips, we have the _l.a.b.i.al_ consonants, _p_, _b_, _f_, and _v_. When the tongue, in relation with the teeth or hard palate, obstructs the air, the _dental_ consonants, _d_, _t_, _l_, and _s_ are produced. _Gutturals_, such as _k_, _g_, _ch_, _gh_, and _r_, are due to the movements of the root of the tongue in connection with the soft palate or pharynx.

To secure an easy and proper production of articulate sounds, the mouth, teeth, lips, tongue, and palate should be in perfect order. The modifications in articulation occasioned by a defect in the palate, or in the uvula, by the loss of teeth, from disease, and from congenital defects, are sufficiently familiar. We have seen that speech consists essentially in a modification of the vocal sounds by the accessory organs, or by parts above the larynx, the latter being the essential vocal instrument.

Many animals have the power of making articulated sounds; a few have risen, like man, to the dignity of sentences, but these are only by imitation of the human voice. Both vowels and consonants can be distinguished in the notes of birds, the vocal powers of which are generally higher than those of mammals. The latter, as a rule, produce only vowels, though some are also able to form consonants.

Persons idiotic from birth are incapable of producing any other vocal sounds than inarticulate cries, although supplied with all the internal means of articulation. Persons deaf and dumb are in the same situation, though from a different cause; the one being incapable of imitating, and the other being deprived of hearing the sounds to be imitated.

[Ill.u.s.tration: Fig. 153.--Direction of Pull of the Lateral Crico-Arytenoids, which adduct the Vocal Cords. (Dotted lines show position in adduction.)]

In _whispering_, the larynx takes scarcely any part in the production of the sounds; the vocal cords remain apart and comparatively slack, and the expiratory blast rushes through without setting them in vibration.

In _stammering_, spasmodic contraction of the diaphragm interrupts the effort of expiration. The stammerer has full control of the mechanism of articulation, but not of the expiratory blast. His larynx and his lips are at his command, but not his diaphragm. To conquer this defect he must train his muscles of respiration to calm and steady action during speech.

The _stutterer_, on the other hand, has full control of the muscles of expiration. His diaphragm is well drilled, but his lips and tongue are insubordinate.

355. The Care of the Throat and Voice. The throat, exposed as it is to unwholesome and overheated air, irritating dust of the street, factories, and workshops, is often inflamed, resulting in that common ailment, _sore throat_. The parts are red, swollen, and quite painful on swallowing. Speech is often indistinct, but there is no hoa.r.s.eness or cough unless the uvula is lengthened and tickles the back part of the tongue. Slight sore throat rarely requires any special treatment, aside from simple nursing.

The most frequent cause of throat trouble is the action of cold upon the heated body, especially during active perspiration. For this reason a cold bath should not be taken while a person is perspiring freely. The muscles of the throat are frequently overstrained by loud talking, screaming, shouting, or by reading aloud too much. People who strain or misuse the voice often suffer from what is called "clergyman's sore throat." Attacks of sore throat due to improper methods of breathing and of using the voice should be treated by judicious elocutionary exercises and a system of vocal gymnastics, under the direction of proper teachers.

Persons subject to throat disease should take special care to wear suitable underclothing, adapted to the changes of the seasons. Frequent baths are excellent tonics to the skin, and serve indirectly to protect one liable to throat ailments from changes in the weather. It is not prudent to m.u.f.fle the neck in scarfs, furs, and wraps, unless perhaps during an unusual exposure to cold. Such a dress for the neck only makes the parts tender, and increases the liability to a sore throat.

Every teacher of elocution or of vocal music, entrusted with the training of a voice of some value to its possessor, should have a good, practical knowledge of the mechanism of the voice. Good voices are often injured by injudicious management on the part of some incompetent instructor. It is always prudent to cease speaking or singing in public the moment there is any hoa.r.s.eness or sore throat.

The voice should not be exercised just after a full meal, for a full stomach interferes with the free play of the diaphragm. A sip of water taken at convenient intervals, and held in the mouth for a moment or two, will relieve the dryness of the throat during the use of the voice.

356. Effect of Alcohol upon the Throat and Voice. Alcoholic beverages seriously injure the throat, and consequently the voice, by causing a chronic inflammation of the membrane lining the larynx and the vocal cords. The color is changed from the healthful pink to red, and the natural smooth surface becomes roughened and swollen, and secretes a tough phlegm.

The vocal cords usually suffer from this condition. They are thickened, roughened, and enfeebled, the delicate vibration of the cords is impaired, the clearness and purity of the vocal tones are gone, and instead the voice has become rough and husky. So well known is this result that vocalists, whose fortune is the purity and compa.s.s of their tones, are scrupulously careful not to impair these fine qualities by convivial indulgences.

357. Effect of Tobacco upon the Throat and Voice. The effect of tobacco is often specially serious upon the throat, producing a disease well known to physicians as "the smoker's sore throat." Still further, it produces inflammation of the larynx, and thus entails disorders of the vocal cords, involving rough voice and harsh tones. For this reason vocalists rarely allow themselves to come under the narcotic influence of tobacco smoke. It is stated that habitual smokers rarely have a normal condition of the throat.

Additional Experiments.

Experiment 189. _To ill.u.s.trate the importance of the resonating cavity of the nose in articulation_. Pinch the nostrils, and try to p.r.o.nounce slowly the words "Lincoln," "something," or any other words which require the sound of _m_, _ln_, or _ng_.

[Ill.u.s.tration: Fig. 154.]

Experiment 190. _To ill.u.s.trate the pa.s.sage of air through the glottis._ Take two strips of India rubber, and stretch them over the open end of a boy's "bean-blower," or any kind of a tube. Tie them tightly with thread, so that a c.h.i.n.k will be left between them, as shown in Fig. 154. Force the air through such a tube by blowing hard, and if the strips are not too far apart a sound will be produced. The sound will vary in character, just as the bands are made tight or loose.

Experiment 191. "A very good ill.u.s.tration of the action of the vocal bands in the production of the voice may be given by means of a piece of bamboo or any hollow wooden tube, and a strip of rubber, about an inch or an inch and a half wide, cut from the pure sheet rubber used by dentists.

"One end of the tube is to be cut sloping in two directions, and the strip of sheet rubber is then to be wrapped round the tube, so as to leave a narrow slit terminating at the upper corners of the tube.

"By blowing into the other end of the tube the edges of the rubber bands will be set in vibration, and by touching the vibrating membrane at different points so as to check its movements it may be shown that the pitch of the note emitted depends upon the length and breadth of the vibrating portion of the vocal bands."[51]--Dr. H. P. Bowditch.

[NOTE. The limitations of a text-book on physiology for schools do not permit so full a description of the voice as the subject deserves. For additional details, the student is referred to Cohen's _The Throat and the Voice_, a volume in the "American Health Primer Series." Price 40 cents.]

Chapter XIII.

Accidents and Emergencies.

358. Prompt Aid to the Injured. A large proportion of the accidents, emergencies, and sudden sicknesses that happen do not call for medical or surgical attention. For those that do require the services of a physician or surgeon, much can be often done before the arrival of professional help. Many a life has been saved and much suffering and anxiety prevented by the prompt and efficient help of some person with a cool head, a steady hand, and a practical knowledge of what to do first. Many of us can recall with mingled admiration and grat.i.tude the prompt services rendered our families by some neighbor or friend in the presence of an emergency or sudden illness.

In fact, what we have studied in the preceding chapters becomes tenfold more interesting, instructive, and of value to us, if we are able to supplement such study with its practical application to the treatment of the more common and less serious accidents and emergencies.

While no book can teach one to have presence of mind, a cool head, or to restrain a more or less excitable temperament in the midst of sudden danger, yet a.s.suredly with proper knowledge for a foundation, a certain self-confidence may be acquired which will do much to prevent hasty action, and to maintain a useful amount of self-control.

s.p.a.ce allows us to describe briefly in this chapter only a few of the simplest helps in the more common accidents and emergencies which are met with in everyday life.[52]

359. Hints as to what to Do First. Retain so far as possible your presence of mind, or, in other words, keep cool. This is an all-important direction. Act promptly and quietly, but not with haste. Whatever you do, do in earnest; and never act in a half-hearted manner in the presence of danger. Of course, a knowledge of what to-do and how to do it will contribute much towards that self-control and confidence that command success. Be sure and send for a doctor at once if the emergency calls for skilled service. All that is expected of you under such circ.u.mstances is to tide over matters until the doctor comes.

[Ill.u.s.tration: Fig. 155.--Showing how Digital Compression should be applied to the Brachial Artery.]

Do not presume upon any smattering of knowledge you have, to a.s.sume any risk that might lead to serious results. Make the sufferer comfortable by giving him an abundance of fresh air and placing him in a restful position. Do all that is possible to keep back the crowd of curious lookers-on, whom a morbid curiosity has gathered about the injured person.

Loosen all tight articles of clothing, as belts, collars, corsets, and elastics. Avoid the use of alcoholic liquors. They are rarely of any real service, and in many instances, as in bleeding, may do much harm.

360. Incised and Lacerated Wounds. An incised or cut wound is one made by a sharp instrument, as when the finger is cut with a knife. Such a wound bleeds freely because the clean-cut edges do not favor the clotting of blood. In slight cuts the bleeding readily ceases, and the wound heals by primary union, or by "first intention," as surgeons call it.

Lacerated and contused wounds are made by a tearing or bruising instrument, for example, catching the finger on a nail. Such wounds bleed but little, and the edges and surfaces are rough and ragged.

If the incised wound is deep or extensive, a physician is necessary to bring the cut edges together by st.i.tches in order to get primary union.

Oftentimes, in severe cuts, and generally in lacerations, there is a loss of tissue, so that the wound heals by "second intention"; that is, the wound heals from the bottom by a deposit of new cells called _granulations_, which gradually fill it up. The skin begins to grow from the edges to the center, covering the new tissue and leaving a cicatrix or scar with which every one is familiar.

361. Contusion and Bruises. An injury to the soft tissues, caused by a blow from some blunt instrument, or a fall, is a contusion, or bruise. It is more or less painful, followed by discoloration due to the escape of blood under the skin, which often may not be torn through. A black eye, a knee injured by a fall from a bicycle, and a finger hurt by a baseball, are familiar examples of this sort of injury. Such injuries ordinarily require very simple treatment.

The blood which has escaped from the capillaries is slowly absorbed, changing color in the process, from blue black to green, and fading into a light yellow. Wring out old towels or pieces of flannel in hot water, and apply to the parts, changing as they become cool. For cold applications, cloths wet with equal parts of water and alcohol, vinegar, and witch-hazel may be used. Even if the injury is apparently slight it is always safe to rest the parts for a few days.

When wounds are made with ragged edges, such as those made by broken gla.s.s and splinters, more skill is called for. Remove every bit of foreign substance. Wash the parts clean with one of the many antiseptic solutions, bring the torn edges together, and hold them in place with strips of plaster. Do not cover such an injury all over with plaster, but leave room for the escape of the wound discharges. For an outside dressing, use compresses made of clean cheese-cloth or strips of any clean linen cloth. The antiseptic _corrosive-sublimate gauze_ on sale at any drug store should be used if it can be had.

Wounds made by toy pistols, percussion-caps, and rusty nails and tools, if neglected, often lead to serious results from blood-poisoning. A hot flaxseed poultice may be needed for several days. Keep such wounds clean by was.h.i.+ng or syringing them twice a day with hot _antiseptics_, which are poisons to _bacteria_ and kill them or prevent their growth. Bacteria are widely distributed, and hence the utmost care should be taken to have everything which is to come in contact with a wounded surface free from the germs of inflammation. In brief, such injuries must be kept _scrupulously neat_ and _surgically clean_.

[Ill.u.s.tration: Fig. 156.--Dotted Line showing the Course of the Brachial Artery.]

The injured parts should be kept at rest. Movement and disturbance hinder the healing process.