1. The first step which should be taken for the prevention of disease, is to make provision for the health of the unborn child. Greater care should be exercised with women who are in a way to become mothers. Those who are surrounded by all the luxuries which health can bestow, indulge too much in rich food, and take too little exercise; while the poor get too little nourishment, and work too hard and too long. A woman in this condition should avoid over-exertion, and all scenes which excite the passions or powerful emotions. She should take moderate exercise in the open air; eat moderately of wholesome food, and of meat not oftener than twice a day; take tea or coffee in limited quantities, and avoid the use of all alcoholic liquors; she should go to bed early and take not less than nine hours sleep; her clothing should be loose, light in weight, and warm. She should take every precaution against exposure to contagious or infectious diseases.
2. There is no better method for preventing the spread of contagious diseases than perfect isolation of the infected, and thorough disinfection of all articles of clothing or bedding which have been in contact with the infected. Many persons erroneously believe that every child must necessarily have the measles, and other contagious diseases, and they, therefore, take no precautions against the exposure of their children. The liability to infection diminishes as age advances, and those individuals are, as a rule, the strongest and best developed who [pg 289]have never suffered from any of the contagious diseases. Although, vaccination is the great safeguard against-pox, yet it should never prevent the immediate isolation of those who are suffering from this disease.
3. To avoid the injurious effects of impure air, the following rules, should be carefully observed. The admission of air which contains anything that emits an unpleasant odor into closed rooms should be avoided. The temperature of every apartment should be kept as near 70° Fahr. as possible, and the air should not be overcharged with watery vapor. Provisions should be made for the free admission into and escape of air from the room at all times. When an apartment is not in use, it should be thoroughly ventilated by opening the windows. Those who are compelled to remain in an atmosphere tilled with dust, should wear a cotton-wool respirator.
4. To insure a healthy condition of the body, the diet of man ought to be varied, and all excesses should be avoided. The total amount of solid food taken in the twenty-four hours should not exceed two and a half pounds, and not more than one-third of this quantity should consist of animal food. Many persons do not require more than one pound and a half of mixed food. To avoid parasitic diseases, meat should not be eaten rare, especially pork. The amount of drink taken should not be more than three pints in twenty-four hours. The excessive use of tea and coffee should be avoided. Pickles, boiled cabbage, and other indigestible articles should never be eaten.
5. To avoid the evil effects of alcoholic liquors, perfect abstinence is the only safe course to pursue. Although one may use spirituous liquors in moderation for a long period of time and possibly remain healthy, yet such an indulgence is unnecessary and exceedingly dangerous. A person who abstains entirely from their use is safe from their pernicious influence; a person who indulges ever so moderately is in danger; a person who relies on such stimulants for support in the hour of need is lost.
6. While the use of tobacco is less pernicious than alcohol in its effects, et it exerts a profound disturbing influence upon the nervous system, and gives rise to various functional and organic diseases. This is the verdict of those who [pg 290]have given the subject the most study, and who have had the best opportunities for extensive observation. Suddenly fatal results have followed excesses in the use of tobacco. Therefore, the habit should be avoided, or if already acquired, it should be immediately abandoned.
7. The clothing should be light and porous, adapted in warmth to the season. It is especially important that persons in advanced life should be well protected against vicissitudes of heat and cold. Exposure is the cause of almost all those inflammatory diseases which occur during winter, and take off the feeble and the aged. The under-garments should be kept scrupulously clean by frequent changes. Corsets or bands which impede the flow of blood, compress the organs of the chest or abdomen, or restrict the movements of the body, are very injurious, and should not be worn. Articles of dress which are colored with irritating dye-stuffs, should be carefully avoided.
8. It matters not how varied a person's vocation may be, change, recreation, and rest are required. It is an error to suppose that more work can be done by omitting these. No single occupation which requires special mental or physical work, should be followed for more than eight hours out of the twenty-four. The physical organism is not constructed to run its full cycle of years and labor under a heavier burden than this. Physical and mental exercise is conducive to health and longevity, if not carried too far. It is erroneous to suppose that excessive physical exertion promotes health. Man was never intended to be a running or a jumping machine. In mental work, variety should be introduced. New work calls into play fresh portions of the brain, and secures repose for those parts which have become exhausted. Idleness should be avoided by all. Men should never retire from business as long as they enjoy a fair degree of health. Idleness and inactivity are opposed to nature.
9. The average length of time which a person ought to sleep is eight hours out of the twenty-four, and, as a rule, those who take this amount enjoy the best health. The most favorable time for sleep is between the hours of 10 P.M. and 6 A.M. All excitement, the use of stimulants, and excessive fatigue [pg 291]tend to prevent sleep. Sleeping rooms should be well ventilated, and the air maintained at a equable temperature of as near 60° Fahr. as possible. An inability to sleep at the proper time, or a regular inclination to sleep at other than the natural hours for it, is a certain indication of errors of habit, or of nervous derangement.
10. Prominent among all other measures for the maintenance of Health, is personal cleanliness. Activity in the functions of the skin is essential to perfect health, and this can only be secured by thoroughly bathing the entire body. Strictly, a person should bathe once every twenty-four or forty-eight hours. The body should be habituated to contact with cold water at all season of the year, so that warm water may not become a necessity. The simplest and most convenient bath, is the ordinary sponge-bath. An occasional hot-air, or Turkish bath, exerts a very beneficial influence. It cleans out the pores of the skin and increases its activity.
11. The emotions and the passions exert a powerful influence over the physical organism. It is important, therefore, that they be held under restraint by the reasoning faculties. This rule applies equally to joy, fear, and grief; to avarice, anger, and hatred; and, above all, to the sexual passion. They are a prolific source of disease of the nervous system, and have caused the dethronement of some of the most gifted intellects.
Effects Upon the Circulation and Nutrition. The influence of motion on these functions is as follows: The contents of the blood-vessels are moved onward by the pressure and motion transmitted by the manipulator, all backward movement of the blood being prevented by the valves of the veins and by the propelling power of the heart and arteries. Fluids outside these vessels pass through their walls, to take the place of the stagnant blood that has been moved onward. Other blood flows into the part, and thus active and healthy circulation is induced, and nutritive material, capable of affording vital support is also brought to refresh the local part.
We have found mechanical movements especially effectual in paralysis, neuralgia, sleeplessness, and other nervous affections; in derangements of the liver, constipation, and dyspepsia; in [pg 374]displacements of the uterus, and congestion, and inflammation of the pelvic organs.
For a complete description of the mechanical movements and the machinery employed in the treatment of diseases at the Invalids' Hotel and Surgical Institute, the reader is referred to the appendix to this work.
[pg 375]
nd influences which affect the nerves. The emotions exert a remarkable influence upon the action of the perspiratory glands. Intense fear causes great drops of perspiration to accumulate on the skin, while the salivary glands remain inactive.
Tears. The lachrymal glands are small lobular organs, situated at the outer and upper orbit of the eye, and have from six to eight ducts, which open upon the conjunctiva, between the eyelid and its inner fold. This secretion is an alkaline, watery fluid. According to Dr. Dalton, its composition is as follows:
Water,
882.0
Albuminous matter,
5.0
Chloride of Sodium,
13.0
Mineral Salts, a trace,
————
1000.0
The function of this secretion is to preserve the brilliancy of the eye. The tears are spread over this organ by the reflex movement of the eyelid, called winking, and then collected in the puncta lachrymalia and discharged into the nasal passage. This process is constant during life. The effect of its repression is seen in the dim appearance of the eye after death. Grief or excessive laughter usually excite these glands until there is an overflow.
Sebaceous Matter. Three varieties of this secretion are found in the body. A product of the sebaceous glands of the skin is found in those parts of the body which are covered with hairs; also, on the face and the external surface of the organs of generation. The sebaceous glands consist of a group of flask-shaped cavities, opening into a common excretory duct. Their secretion serves to lubricate the hair and soften the skin. The ceruminous glands of the external auditory meatus, or [pg 78]outer opening of the ear, are long tubes terminating in a glandular coil, within which is secreted the glutinous matter of the ear. This secretion serves the double purpose of moistening the outer surface of the membrana tympani, or ear-drum, and, by its strong odor, of preventing the intrusion of insects. The Meibomian glands are arranged in the form of clusters along the excretory duct, which opens just behind the roots of the eyelashes. The oily nature of this secretion prevents the tears, when not stimulated by emotion, from overflowing the lachrymal canal.
Mucus. The mucous membranes are provided with minute glands which secrete a viscid, gelatinous matter, called mucus. The peculiar animal matter which it contains is termed mucosin. These glands are most numerous in the Pharynx, Esophagus, Trachea, Bronchia, Vagina and Urethra. They consist of a group of secreting sacs, terminating at one extremity in a closed tube, while the other opens into a common duct. The mucus varies in composition in different parts of the body; but in all, it contains a small portion of insoluble animal matter. Its functions are threefold. It lubricates the membranes, prevents their injury, and facilitates the passage of food through the alimentary canal.
Saliva. This term is given to the first of the digestive fluids, which is secreted in the glands of the mouth. It is a viscid, alkaline liquid, with a specific gravity of about 1005. If allowed to stand, a whitish precipitate is formed. Examinations with the microscope show it to be composed of minute, granular cells and oil globules, mingled with numerous scales of epithelium. According to Bidder and Schmidt, the composition of saliva is as follows:
Water,
995.16
Organic matter,
1.34
Sulpho-cyanide of Potassium,
0.06
Phosphates of Sodium, Calcium and Magnesium,
.98
Chlorides of Sodium and Potassium,
.84
Mixture of Epithelium,
1.62
1000.00
Two kinds of organic matter are present in the saliva; one, termed ptyalin, imparts to the saliva its viscidity, and it [pg 79]obtained from the secretions of the parotid, submaxillary and sublingual glands; another, which is not glutinous, is distinguished by the property of coagulating when subjected to heat. The saliva is composed of four elementary secretions, derived respectively, from the mucous follicles of the mouth, and the parotid, the submaxillary, and the sublingual glands. The process of its secretion is constant, but is greatly augmented by the contact of food with the lining membrane. The saliva serves to moisten the triturated food, facilitate its passage, and has the property of converting starch into sugar; but the latter quality is counteracted by the action of the gastric juice of the stomach.
Gastric Juice. The minute tubes, or follicles, situated in the mucous membrane of the stomach, secrete a colorless, acid liquid, termed the gastric juice. This fluid appears to consist of little more than water, containing a few saline matters in solution, and a small quantity of free hydrochloric acid, which gives it an acid reaction. In addition to these, however, it contains a small quantity of a peculiar organic substance, termed pepsin, which in chemical composition, is very similar to ptyalin, although it is very different in its effects. When food is introduced into the stomach, the peristaltic contractions of that organ roll it about, and mingle it with the gastric juice, which disintegrates the connective tissue, and converts the albuminous portions into the substance called chyme, which is about the consistency of pea-soup, and which is readily absorbed through the animal membranes into the blood of the delicate and numerous vessels of the stomach, whence it is conveyed to the portal vein and to the liver. The secretion of the gastric juice is influenced by nervous conditions. Excess of joy or grief effectually retard or even arrest its flow.
Intestinal Juice. In the small intestine, a secretion is found which is termed the intestinal juice. It is the product of two classes of glands situated in the mucous membrane, and termed respectively, the follicles of Lieberkuhn and the glands of Brunner. The former consist of numerous small tubes, lined with epithelium, which secrete by far the greater portion of this fluid. The latter are clusters of round follicles [pg 80]opening into a common excretory duct. These sacs are composed of delicate, membranous tissue, having numerous nuclei on their walls. The difficulty of obtaining this juice for experiment is obvious, and therefore its chemical composition and physical properties are not known. The intestinal juice resembles the secretion of the mucous follicles of the mouth, being colorless, vitreous in appearance, and having an alkaline reaction.
Pancreatic Juice. This is a colorless fluid, secreted in a lobular gland which is situated behind the stomach, and runs transversely from the spleen across the vertebral column to the duodenum. The most important constituent of the pancreatic juice is an organic substance, termed pancreatin.
The Bile. The blood which is collected by the veins of the stomach, pancreas, spleen, and intestines, is discharged into a large trunk called the portal vein, which enters the liver. This organ also receives arterial blood from a vessel called the hepatic artery, which is given off from the aorta below the diaphragm. If the branches of the portal vein and hepatic artery be traced into the substance of the liver, they will be found to accompany one another, and to subdivide, becoming smaller and smaller. Finally, the portal vein and hepatic artery will be found to terminate in capillaries which permeate the smallest perceptible subdivisions of the liver substance, which are polygonal masses of not more than one-tenth of an inch in diameter, called the lobules. Every lobule rests upon one of the ramifications of a great vessel termed the hepatic vein, which empties into the inferior vena cava. There is also a vessel termed the hepatic duct leading from the liver, the minute subdivisions of which penetrate every portion of the substance of that organ. Connected with the hepatic duct, is the duct of a large oval sac, called the gall-bladder.
Each lobule of the liver is composed of minute cellular bodies known as the hepatic cells. It is supposed that in these cells the blood is deprived of certain materials which are converted into bile. This secretion is a glutinous fluid, varying in color from a dark golden brown to a bright yellow, has a specific gravity ranging from 1018 to 1036, and a [pg 81]slightly alkaline reaction. When agitated, it has a frothy appearance. Physiologists have experienced much difficulty in studying the character of this secretion from the instability of its constituents when subjected to chemical examination.
Illustration: Fig. 52. Section of the Liver, showing the ramifications of the portal vein. Fig. 52. Section of the Liver, showing the ramifications of the portal vein. 1. Twig of portal vein. 2, 2', 2", 2"'. Interlobular vein. 3, 3', 3", Lobules.
Biliverdin is an organic substance peculiar to the bile, which imparts to that secretion its color. When this constituent is re-absorbed by the blood and circulates through the tissues, the skin assumes a bright yellow hue, causing what is known as the jaundice. Cholesterin is an inflammable crystallizable substance soluble in alcohol or ether. It is found in the spleen and all the nervous tissues. It is highly probable that it exists in the blood, in some state or combination, and assumes a crystalline form only when acted upon by other substances or elements. Two other constituents, more important than either of the above, are collectively termed biliary salts. These elements were discovered in 1848, by Strecker, who termed them glycocholate and taurocholate of soda. Both are crystalline, resinous substances, and, although resembling each other in many respects, the chemist may distinguish them by their reaction, for both yield a precipitate if treated with subacetate of lead, but only the glycocholate will give a precipitate with acetate of lead. In testing for biliary substances, the most satisfactory method is the one proposed by Pettenkoffer. A solution of cane-sugar, one part of sugar to four parts of water, is mixed with the suspected substance. Dilute sulphuric acid is then added until a white precipitate falls, which is re-dissolved in an excess of the acid. On the addition of more sulphuric acid, it becomes opalescent, and passes through the successive hues of scarlet, lake, and a rich purple. Careful experiments have proved [pg 82]that it is a constant secretion; but its flow is mere abundant during digestion. During the passage through the intestines it disappears. It is not eliminated, and Pettenkoffer's test has failed to detect its existence in the portal vein. These facts lead physiologists to the conclusion, that it undergoes some transformation in the intestines and is re-absorbed.
After digestion has been going on in the stomach for some time, the semi-digested food, in the form of chyme, begins to pass through the pyloric orifice of the stomach into the duodenum, or upper portion of the small intestine. Here it encounters the intestinal juice, pancreatic juice, and the bile, the secretion of all of which is stimulated by the presence of food in the alimentary tract. These fluids, mingling with the chyme, give it an alkaline reaction, and convert it into chyle. The transformation of starch into sugar, which is almost, if not entirely, suspended while the food remains in the stomach, owing to the acidity of the chyme, is resumed in the duodenum, the acid of the chyme, being neutralized by the alkaline secretions there encountered.
Late researches have demonstrated that the pancreatic juice exerts a powerful effect on albuminous matters, not unlike that of the gastric juice.
Thus, it seems that while in the mouth only starchy, and while in the stomach only albuminous substances are digested, in the small intestine all kinds of food materials, starchy, albuminoid, fatty and mineral, are either completely dissolved, or minutely subdivided, and so prepared that they may be readily absorbed through the animal membranes into the vessels.
Milk. The milk is a white, opaque fluid, secreted in the lacteal glands of the female, in the mammalia. These glands consist of numerous follicles, grouped around an excretory duct, which unites with similar ducts coming from other lobules. By successive unions, they form large branches, termed the lactiferous ducts, which open by ten to fourteen minute orifices on the extremity of the nipple. The most important constituent of milk is casein; it also contains oily and saccharine substances. This secretion, more than any other, as influenced by nervous conditions. A mother's bosom will [pg 83]fill with milk at the thought of her infant child. Milk is sometimes poisoned by a fit of ill-temper, and the infant made sick and occasionally thrown into convulsions, which in some instances prove fatal. Sir Astley Cooper mentions two cases in which terror instantaneously and permanently arrested this secretion. It is also affected by the food and drink. Malt liquors and other mild alcoholic beverages temporarily increase the amount of the secretion, and may, in rare instances, have a beneficial effect upon the mother. They sometimes affect the child, however, and their use is not to be recommended unless the mother is extremely debilitated, and there is a deficiency of milk.
