A Treatise on Anatomy, Physiology, and Hygiene Part 8

[Ill.u.s.tration: Fig. 30. The position a child naturally a.s.sumes when the seat is so high that the feet are not supported.]

134. What is said of the benches or chairs in a school-room? What is represented by fig. 29? By fig. 30? What is the effect when the lower limbs are not supported?

135. _Compression of the chest should be avoided._ In children, and also in adults, the ribs are very flexible, and a small amount of pressure will increase their curvature, particularly at the lower part of the chest, and thus lessen the size of this cavity. The lower ribs are united to the breast-bone, by long, yielding cartilages, and compression may not only contract the chest, but an unseemly and painful ridge may be produced, by the bending of the cartilages, on one or both sides of the sternum.

[Ill.u.s.tration: Fig. 31. A natural and well-proportioned chest.]

[Ill.u.s.tration: Fig. 32. A chest fas.h.i.+onably deformed.]

135. Why should compression of the chest be avoided? What is represented by fig. 31? By fig. 32?

136. Again, the cartilages on one side may be bent outward, while those on the opposite side are bent inward, thus forming a depression parallel with the sternum. In some instances, the anterior extremity of the lower ribs on each side are brought nearly or quite together.

In these instances, the movable extremities of the ribs are drawn down toward the haunch-bones, while the s.p.a.ce between the ribs is lessened.

All this may be effected by tight or "snug" clothing. Therefore the apparel of a child should be loose, and supported over the shoulders, to avoid the before-mentioned evils. The same may be said of the clothing for adults.

137. _The erect position in sitting and standing should be a.s.siduously observed._ The spinal column, in its natural position, curves from front to back, but not from side to side The admirable arrangement of the bones, alternating with cartilages, permits a great variety of motions and positions; and when the spine is inclined to either side, the elasticity of its cartilages tends to restore it to its natural position. For this reason we may incline the spinal column in any direction for a short time, without danger of permanent curvature, if, afterward, the erect position is a.s.sumed.[4]

[4] Compare 1, 1, Fig. 28, with 2, 2, 2, Fig. 48.

138. But if a stooping position, or a lateral curved posture, is continued for a long time, the spinal column does not easily recover its proper position, for the compressed edges of the cartilages lose their power of reaction, and finally one side of the cartilage becomes thinned, while the other is thickened; and these wedge-shaped cartilages produce a permanent curvature of the spinal column. In a similar way, the student, seamstress, artisan, and mechanic acquire a stooping position, and become round shouldered, by inclining forward to bring their books or work nearer the eyes.

136. May simply "snug" clothing compress the cartilages? How should the apparel of a child be worn? 137. In what direction does the spinal column, in its natural position, curve? What restores it to its natural position when curved laterally? 138. What is the effect if a lateral curved position of the spinal column is continued for a long time? 139. When one shoulder is elevated for a long time, what is the effect upon the spinal column?

139. Pupils, while writing, drawing, and sometimes while studying, frequently incline the spinal column to one side, in order to accommodate themselves to the desks at which they are seated. Often, these are higher than the elbow as it hangs from the shoulder while at rest. This att.i.tude elevates one shoulder while it depresses the other; consequently, the upper part of the spinal column is inclined toward the elevated shoulder, and the lower part is curved in the opposite direction, giving the form of the letter _S_ to the supporting column of the body.

[Ill.u.s.tration: Fig. 33. The table is of proper height, the position is correct, and the spinal column, 1, 1, is straight, while the shoulders are of equal height.]

What does fig. 33 represent?

_Experiment._ Let a pupil be placed at a desk or table with one elbow raised, as is frequently seen while writing, or at study, and observe the condition of the shoulder and spinal column in this position.

Place another pupil at a table no higher than the elbow when it hangs by the side while sitting, and observe the appearance of the shoulders and spinal column. By a comparison of the two att.i.tudes, the preceding remarks will be comprehended and appreciated.

[Ill.u.s.tration: Fig. 34. The table is too high, and the position is oblique and improper. The right shoulder is seen higher than the left, while the spinal column, 1, 1, exhibits three curves.]

140. One shoulder may be elevated, and no injurious results follow, provided care is taken not to keep it in the raised position too long, or if the opposite shoulder is elevated for the same period of time.

The right shoulder projects more frequently than the left. This arises from the greater use of the right hand with the shoulder elevated, and not unfrequently the oblique positions a.s.sumed in performing the daily vocations of life. With proper care, and by calling into action the left shoulder, this deformity can be prevented.

What experiment is mentioned? What does fig. 34 represent? 140. How can one shoulder be elevated and no injurious results follow?

[Ill.u.s.tration: Fig. 35. A representation of a deformed trunk.]

141. The loss of symmetry and diminution of height from deformed spines are minor considerations, compared with the distortions that the chest experiences, thereby impairing respiration and inducing diseases of the heart and lungs. The invasion of the functions of these two important organs lessens the vitality of the whole system, and causes general ill health. Again, the curvature of the spinal column is frequently attended by irritation and disease of the spinal cord.

Why does the right shoulder project more frequently than the left? How can this deformity be prevented? 141. What is said of deformed spinal columns?

142. Eminent physicians, both in this country and France state that not more than one female in ten, who has been fas.h.i.+onably educated, is free from deformities of the shoulder or spinal column. Teachers, as well as mothers, should notice the positions of the child in performing the tasks allotted to it, whether studying or pursuing any employment. The feebler the organization of the child, the more frequently should there be a change of position.

143. When a slight projection of the shoulder, with a curvature of the spine, exists, it can be improved by walking with a book, or something heavier, upon the head; to balance which, the spinal column must be nearly erect. Those people that carry burdens upon their heads seldom have crooked spines.

_Observation._ Persons from the North, in travelling through the Southern States, are surprised to see the heavy burdens that the porters carry on their heads. It is not unusual to see them walking at a rapid pace, with one or two trunks, weighing fifty or eighty pounds each, upon their heads. Occasionally, we meet an itinerant toy-man, with his tray of fragile merchandise upon his head, walking with as much apparent security, as though his toys, or images, were in his hands. This is the easiest method of carrying burdens, because the position of the head and spinal column is erect.

144. _If the animal and earthy matter of the bones is not deposited in proper proportions, they are deficient in strength._ If the gelatin predominates, the bones are weak, and become distorted. When nutrition is defective in the cylindrical bones, the heads are generally enlarged, and the shafts crooked; if in the spinal column, it may be curved; or in the cranium, it may be enlarged. This disease is familiarly known by the name of rickets. It is most common among these who have poor and insufficient food, live in dark, damp rooms, and breathe a vitiated air. The prevention and remedies for this disease are cleanliness, regular exercise, pure air, and nutritious food.

142. What statement by eminent physicians respecting deformities of the spine? What caution to teachers and mothers? 143. Why should we stand and sit erect? How may slight deformities of the spine be prevented? What is frequently noticed in travelling South? 144. What is the effect upon the bones when the gelatin preponderates?

145. When a bone is broken, some days elapse before the substance that reunites it is thrown out from the blood. In young persons, it may be secreted during the second or third week, and in individuals advanced in life, usually during the third and fourth week. When the bone is uniting, during the second, third, or fourth week, the attention of a surgeon is more needed than during the first week. At this time, the ends of the bone should be placed together with accuracy, which requires the careful application of proper dressing. After the bones have united, it will take some weeks to consolidate the uniting material and render the "callus," or union, firm. During this time, the limb should be used with care.

_Observation._ When a bone is fractured, a surgeon is immediately called, and the bone is "set." While the limb remains swelled and painful, the surgeon is required to attend and keep the dressings (bandages and splints) on. When the swelling has abated, and the pain subsided, frequently the patient intimates to the surgeon that his services can be dispensed with, as the "limb is doing well." This is the most important period, as the bone is uniting, and, unless the ends are nicely adjusted, the dressing properly applied, the person will find, on recovery, a shortened and crooked limb. The surgeon is then censured, when he is not blamable.

What is one cause of rickets? What are the prevention and remedies for this disease? 145. Does the time vary when the reuniting substance of the bone is secreted from the blood? When is the surgeon's care most needed? Why?

146. It is seldom that a bone is displaced without injury to the connecting ligaments and membranes. When these connecting bands are lacerated, pain, swelling, and other symptoms indicating inflammation succeed, which should be removed by proper treatment, directed by a surgical adviser.

147. In sprains, but few, if any, of the fibres of the connecting ligaments are lacerated; but they are unduly strained and twisted, which occasions acute pain at the time of the injury. This is followed by inflammation and weakness of the joints. The treatment of these injuries is similar to that of a dislocated bone after its reduction.

The most important item in the treatment during the few first days, is rest.

148. In persons of scrofulous const.i.tutions, and those in whom the system is enfeebled by disease, white swellings and other chronic diseases of the joints frequently succeed sprains. Such persons cannot be too a.s.siduous in adopting a proper and early treatment of injured joints.