_Table showing the results of injecting carbolic acid
into the blood of animals suffering from the cattle
plague._
+-----+------------+-------------+---------+--------+-----------+
| | Grains of | Temperature | | | |
| No. | Carbolic | before | Second | Third | |
| | Acid | Injection | Day. | Day. | |
| | Injected. | | | | |
+-----+------------+-------------+---------+--------+-----------+
| | | F. | F. | | |
| 10 | 26-1/2 | 105·4 | 103·8 | Better.| Died on |
| | | | | | 6th day. |
| 11 | 52-1/2 | 103·8 | 102·8 | " | Died on |
| | | | | | 6th day. |
| 12 | 78-3/4 | 104·8 | 104·4 | " | Died on |
| | | | | | 6th day. |
| 14 | 105 | 103·7 | 103·1 | " | Recovered.|
+-----+------------+-------------+---------+--------+-----------+
If future experiments prove that injection of carbolic acid or other
antiseptic will do good, it is an operation very easily performed. I have
injected five animals, and taken thermometric observations within an hour.
Sulphite or bisulphite of soda apparently occasions some pain, as the
animals struggle very much; with carbolic acid I found them tolerably
quiet. I have calculated the proportion which the carbolic acid bore to
the whole quantity of blood in these operations. Taking the whole amount
of blood in the animal at 150 lbs., there were injected into--
No. 10, 1 part of carb. acid, in 40,000 of blood.
" 11, " " 20,000 "
" 12, " " 13,300 "
" 14, " " 10,000 "
It is worth mentioning incidentally, that in the case of cow No. 14 (which
recovered) the proportion of carbolic acid injected into the blood would
have been enough to keep from decomposition the whole quantity of that
liquid for a considerable time. In Nos. 10, 11, and 12 the proportion of
carbolic acid would probably not have been sufficient for that purpose. I
am informed by Dr Calvert that cresylic acid has much less coagulating
power on albumen than carbolic acid, and my own experiments entirely
confirm this statement."
We have described under "CHARCOAL" the disinfecting properties of that
substance. These properties have been turned to excellent account by Dr
Stenhouse, who has invented a charcoal respirator, which, causing the
wearer to breathe air drawn through a layer of that substance, and by thus
depriving the air so inspired of any noxious gases or exhalations, if
present, becomes, if worn in an infected atmosphere, a great safeguard
against disease. Dr Letheby was accustomed to use a charcoal respirator
when analysing dead bodies and other putrid matters of suspected
poisoning, and by so doing never experienced any ill effects, nor was he
conscious of the offensive odour which but for its adoption he must have
encountered.
Professor Tyndall has suggested for the same purpose a respirator of
cotton wool, by means of which the air, being filtered before it enters
the lungs, becomes deprived of minute particles of various substances
suspended in it, as well as of the germs, which so many pathologists
believe to be always present during the prevalence of epidemic maladies,
and the cause, when inhaled, of the maladies themselves.
=DISINFECTING CHAMBERS.= The sanitary authorities of most large cities
have made provision for the purification of mattresses, linen, wearing
apparel, &c., by means of disinfecting chambers or ovens, in which
receptacles the infected articles are subjected for a certain time to hot
air. The simplest form of apparatus for this purpose, and one that could
be used on an emergency, provided the articles to be disinfected were not
too bulky, is a baker's oven. The drying closet of a good laundry would be
so far unsafe, because it would occasionally fail to give a heat
sufficient for the destruction of the noxious principles.
The disinfecting chambers employed in Liverpool are arched ovens of solid
brickwork, having a depth of 7 feet from front to back, a width of 5 feet
from side to side, and a height of 6-1/2 feet from the floor to the crown
of the arch. The doors are made of wrought iron, tightly fitting into
cast-iron framework. The floors are made of double iron gratings, having
alternate openings, so arranged as to admit at pleasure hot air into the
chamber. At the top of the arch there is an opening fitted with an iron
valve, by which the air of the chamber escapes into an exhausting shaft
which is connected with the chimney. The heating is accomplished by means
of a cast-iron cockle, the smoke from which escapes by two cast-iron smoke
flues, which, after forming a coil for the purpose of affording as great a
heating surface as possible, pass along the hot-air passage under the
chamber, into a chimney situated at the opposite end.
The cold air is drawn into a brick flue placed underneath the floor of the
stokehole into a cavity on each side of the cockle, and thence into a
space underneath the chamber, whence it becomes heated by the radiation
from the surface of the two cast iron flues. From this cavity or passage
it is conveyed at will through the gratings as already described. At the
entrance of the cold air flue there is a damper, by which the temperature
of the air may be regulated. A heat equal to 280° F. has been registered
in this chamber, and as high as 380° in a drying closet over the cockle.
Dr French, the medical officer of health for Liverpool, says "that, if
necessary, a temperature reaching 500° F. can be attained in these
chambers; but this temperature is of course never employed. Experience has
proved that from 220° to 250° F. is the most suitable. Instances have been
known where fabrics, after being exposed for some length of time to a
temperature above 212° F., have sustained injury from being scorched.
In some of the chambers, carbolic acid powder is sprinkled on the floor.
We have taken the liberty of transcribing the following description and
plates illustrative of the disinfecting stove used in the Royal Victoria
Yard, Deptford, from that very useful publication, 'Chemistry,
Theoretical, Practical, and Analytical,' published by Mr W. Mackenzie.
"This stove consists of a brick chamber with a slightly arched roof, and
an iron movable floor in two pieces. The chamber is 7 feet deep, 6 feet 9
inches wide, and 5 feet 8-1/2 inches high in the centre of the arch. It is
heated by a flue below the iron floor passing round 3 sides of the chamber
and up a chimney. There is an opening in the upper part of the chamber in
its centre, which passes along in the roof to the side, from thence down
in the wall entering beneath the fire; this carries away any of the foul
air of the clothes from the chamber through the fire and up the flue. This
proceeding takes place after the clothes have been in the chamber say an
hour and a half in the following manner:--The damper in the foul air shaft
is withdrawn, and the furnace door is shut; any draught that gets to the
fire comes to the chamber. Over the opening into the furnace is a square
opening, fitted with a glass, inside of which is a fixed thermometer. When
this shows a temperature of 200° F., the interior of the chamber is at
250° F., the highest point at which it is allowed to be. In the interior
of the chamber at the sides there are little movable cranes, three rows of
three supporting rods of iron on which wooden trays rest, and on which the
clothes are placed when the iron cart is not used. The cranes move fore
and aft to be out of the way when the cart is used. The cart is of iron on
wheels, and runs into the chamber on tramways to keep it in position; in
the interior of the cart are three iron trays for laying the clothes on.
The lowest tray is always the hottest, so that it is prudent to use the
cart, the iron bottom of which prevents burning. The iron ends of the cart
are removed when it is placed in the chamber; so is the handle. It is
usual to keep the clothes at the temperature of 250° F. for two hours.
There is a trap door 8 inches square about 14 inches above the upper edge
of the furnace, and on a level with the iron floor of the chamber, for
disinfectants. Carbolic acid and sulphur are used; the former is placed on
a flat plate, the latter is sprinkled over the floor. These are used as
the last, and after that has been the clothes are fit to be used without
danger to any one.
_Elevation plan_ (fig. 5) shows the front of the chamber with the doors
closed; the openings (Nos. 1, 2, and 3) are for inserting the long
thermometer, which is pushed into the clothing to be disinfected; they
correspond with the three trays. The thermometer can be withdrawn and
examined without allowing much cold air to enter; plugs fit into these
three openings when not used for the thermometer.
[Illustration]
_Section._--The chamber is shown about the centre of its depth; the
foul-air shaft (B) passes along the roof down the side wall, and beneath
the fire (C); the opening where the fixed thermometer is placed is marked
with dotted lines. The damper for the foul-air shaft (E) is represented as
shut, and the damper for the chimney (F) is also shut.
[Illustration]
_The ground plan_ shows the flue beneath the iron plates, which form the
floor of the chamber, the dotted lines showing the foul-air flue (B), as
it passes beneath the fire. In the flue (C) there are openings at D, D, D,
for the purpose of cleaning it.
[Illustration]
Another form of disinfecting chamber is that invented by Dr Esse, of
Berlin, and employed in that city. The apparatus consists of two iron
cylinders, one fitted within the other, with a space between, into which
steam under pressure is introduced. The outer cylinder is surrounded with
wood and the top with felt, to prevent the escape of heat. The articles to
be disinfected are put in at the top of the inner cylinder, the inside of
which soon becomes heated up by the surrounding steam. A pulley is used to
lift the lid of the inner cylinder, around which the clothes are hung on
pegs, not being allowed to touch the side of the cylinder. At the top of
the inside cylinder is a brass box pierced with holes at the bottom, which
dips a little way down, through which the air from the interior can rise.
In this box the bulb of a thermometer being placed, the temperature of the
inner chamber can be registered.
When the steam condenses in the space between the cylinders it is carried
off by means of a valve, which is lifted when the water reaches a certain
point in the condenser. In an hour's time the temperature of the interior
cylinder can be raised to 235° Fahr.
For heating mattresses another apparatus has been devised by Dr Esse. It
consists of an iron case with a spiral steam pipe in the centre, the steam
inside the pipe being compressed to two atmospheres.
Dr Ransome has invented, for the use of the Nottingham hospital, a gas
stove in the form of an iron box, well packed with a non-conducting
material, which surrounds the outside. A channel leads to the interior of
the box, and inside this channel gas is kept burning in such a manner by a
modification of Kemp's regulator, that the temperature of the box shall
range day and night between 235° and 255° Fahr.
An apparatus put to great use by the Holborn District Board during the
epidemic of smallpox in 1871 was one made by Fraser's patent. Mr Fraser's
disinfecting chamber consists of an oven or receptacle made of brick, with
doors in front. Situated on the lower portion of this chamber is a covered
furnace connected with flues, by means of which the interior space is
heated to the desired temperature. By a particular arrangement the air
laden with the noxious vapours given off by the tainted clothing is
conveyed into the furnace, and so consumed. Belonging to the apparatus is
a covered truck or cart, fitted with doors and dampers, and provided
inside with racks and shelves for holding the materials to be purified,
which are thus brought from the infected dwelling and placed, truck and
all, inside the chamber. The infected materials, as well as the truck
containing them, are then heated to the necessary point, disinfection
being assisted by sulphurous acid gas, or some other material adapted for
the purpose. When the process is finished the carriage with its contents
is drawn back to the house from which they were originally taken, and the
purified articles are restored to the owners. It will be seen that by this
arrangement the vehicle is disinfected as well as the clothes it contains.
=DISLOCA'TION.= _Syn._ LUXATION; DISLOCATIO, L. The forcible displacement
of a bone from its socket, either by violence or disease. The latter
happens when the textures forming the joint have been destroyed by some
independent organic affection. "A considerable share of anatomical
knowledge is required to detect the nature of these accidents; and it is
much to be lamented that students neglect to inform themselves
sufficiently on the subject." (Sir A. Cooper.) In common cases the bones
may be frequently replaced by forcibly extending the limb. This should be
done as early as possible, and before inflammation sets in. The latter
should be combated by aperients, local bleeding, refrigerant lotions, &c.
Dislocations frequently exist without the fact being suspected, the
swelling and inflammation being referred to other causes.
=DISPLACE'MENT.= See PERCOLATION.
=DISTEM'PER.= A disease among dogs, usually characterised by a running
from the nose and eyes, and a short dry cough; followed by wasting of the
flesh, and loss of strength and spirits. At length the brain suffers, and
fits, paralysis of the extremities, or convulsions come on. Laxatives and
emetics are the best remedies. If there is much diarrh[oe]a, astringents
may be afterwards given. The violence of the fits may be mitigated by the
administration of antispasmodics, and by the warm bath. The distemper is a
contagious disease, and is generally fatal to weakly and very young dogs.
Fits in the advanced stages of the disease are seldom followed by
recovery. Impatience of light, red eyes, obstinate diarrh[oe]a, spasmodic
twitchings, a yellow colour of the skin, and a pustular eruption, are also
bad symptoms.
=Distemper Powders (Blane's).= The basis of these is said to be '_aurum
musivum_,' or bisulphide of tin. That of another advertised nostrum is a
mixture of mercury and chalk, with a little rhubarb and ipecacuanha.
=DISTILLA'TION.= The evaporation and subsequent condensation of the vapour
of fluids, by means of a still and refrigerator, or other similar
apparatus. DRY DISTILLATION is a term applied to the distillation of
substances _per se_, or without the addition of water or other volatile
fluid. DESTRUCTIVE DISTILLATION is the distillation of substances at
temperatures sufficiently high to decompose them, by which their elements
are separated, or evolved in new combinations. FRACTIONAL DISTILLATION is
the separation of substances having different boiling-points, by
distilling the mixture with a gradually increasing heat, and collecting
the products which come over at different temperatures in separate
receivers. See HYDROCARBON, STILL, &c.
=Distillation.= The art of the distiller; the manufacture of spirituous
liquors as practised on the large scale.
The process of distillation, as carried on in the distilleries of Great
Britain, may be divided into four general operations, viz.--1. The
mashing, or formation of a saccharine infusion from certain vegetable
matters, as malt, barley, oats, rye, &c. 2. The cooling of this wort or
liquor. 3. The fermentation, or process by which the sugar of the cooled
wort is converted into alcohol. 4. The separation of the spirit so formed
by means of a still and refrigerator. By the first operation the materials
for the formation of the alcohol are obtained; by the second, they are
brought to a temperature most favorable to the transformation that takes
place in the third, after which it only remains to free the product of the
last operation from the foreign matter with which it is associated; this
is done in the fourth, which, correctly speaking, constitutes the only
part of the process which can be called distillation.
The general principles of the first three of the preceding operations are
noticed in the articles BREWING, FERMENTATION, &c. It will there be seen
that the amylaceous or starchy matter of the grain is first
'saccharified,' and afterwards converted into alcohol, and that certain
precautions are necessary to render the process successful and economical.
In many of the distilleries of Great Britain molasses and analogous
saccharine substances are employed, in which case the vegetable principle
(sugar) essential to the formation of alcohol is already present, and
merely requires simple solution in water of a proper temperature, to be
ready to be subjected to immediate fermentation. In general, however, the
sources of spirit in England are the various kinds of grain; barley, rye,
maize, and rice are those commonly employed. These are ground and mixed
with bruised malt, in various proportions, and are mashed in a similar
manner to malted grain. The fermentation is carried on until the density
of the liquor ceases to lessen or 'attenuate,' which is determined by an
instrument called a saccharometer. When this point is arrived at, the
'wash' is submitted to distillation, to prevent the access of the acetous
fermentation, which would lessen its alcoholic value.
During the process of distilling off the spirit of the fermented 'wash' or
'wort' a hydrometer is employed to ascertain the 'strength' of the liquor
that passes over. As soon as this has fallen to a certain point, the
operation is stopped, and the 'spent wash' removed. The spirits obtained
by the first distillation are generally called 'low wines,' and have a
specific gravity of about ·975. By rectification or 'doubling,' a crude
milky spirit, abounding in oil, at first comes over, followed by clear
spirit, which is received in a separate vessel. The process is continued
until the alcoholic content of the distilled liquor has considerably
diminished, when the remaining weak spirit that distils over, called
'faints,' is caught separately, and mixed with the low wines preparatory
to another distillation. The strongest spirit passes over first, and the
condensed liquor gradually becomes weaker, until it ceases to contain
alcohol. By receiving in separate vessels any given portion of the
product, spirit of any required strength, within certain limits, may be
obtained. The same object is more conveniently effected by surrounding the
top of the capital of the still with a water bath, of a temperature
corresponding to that of alcoholic vapour of the strength it is desired to
obtain. Thus, if we keep the temperature of the water at about 198° Fahr.,
we shall obtain proof spirit; if at 192°, a spirit 20 o. p.; and so on for
other strengths.
It is found from experience, and is readily accounted for by theory, that
the lower the temperature at which the distillation is conducted, the
stronger will be the product, and the less quantity of oil or other
volatile matter will come over along with it. To promote this, it has been
proposed to carry on the process _in vacuo_, but on the large scale this
has never been adopted. The distillation of the wash is usually performed
in a separate set of stills to those employed for the rectification of the
low wines. For very strong and tasteless spirit, a third and even a fourth
rectification is employed, conjointly with other methods, to abstract the
water and to remove any foreign matter that vitiates its odour or flavour.
A portion of soap is generally put into the still with the wash, to
prevent excessive frothing.
We have said that the processes of mashing, &c., in the distillery are
similar to those adopted in brewing beer. We may add that, as richness in
alcohol, and not flavour, is the object aimed at in the distiller's wash,
not only is a large quantity of unmalted grain employed, but the process
of boiling the wort with hops is omitted altogether. The wort is commonly
'set' at 70° Fahr., and the fermentation and attenuation of the liquor
pushed as far as possible by large and repeated doses of the best
'top-yeast' of the porter brewers.
It often happens that raw spirit prepared from damaged grain is
contaminated with a highly acrid and volatile fatty substance, which is
powerfully intoxicating and irritating to the eyes and nostrils, and
possesses an odour very similar to that of an alcoholic solution of
cyanogen. This may be got rid of by dilution with water and skilful
rectification, when most of it passes over with the first and last
'runnings,' the intermediate portion being less loaded with it. Another
plan is to filter the spirit successively through 6 or 7 separate vessels
containing pine or willow charcoal before rectifying it. In some
distilleries the contaminated spirit is well agitated with a considerable
quantity of olive oil, and after repose decanted, diluted with water, and
rectified as before. The ordinary corn oil or fusel oil of raw spirit is
generally, for the most part, intercepted by a self-regulating bath
arranged between the still-head and the refrigeratory.
The quantity of spirit obtained from various substances, and even from
pure sugar, depends upon the skill with which the several operations are
conducted. By theory, pure sugar should yield 51% of alcohol; but in
practice 11·925 galls. of proof spirit is the largest quantity which has
yet been obtained from 112 lbs. of sugar. By the revenue authorities this
weight of sugar is estimated to afford 11-1/2 galls. of proof spirit. The
average product is, perhaps, about 1 gall. of spirit of this strength for
every 10 lbs. of sugar. According to Harmstädt, 100 lbs. of starch yield
35 lbs. of alcohol, or 7·8 galls. of proof spirit; and 100 lbs. of the
following grains produce the accompanying quantities by weight of spirit
of sp. gr. ·9427, or containing 45% of pure alcohol:--wheat, 40 to 45%;
rye, 36 to 42%; barley, 40%; oats, 36%; buckwheat, 40%; maize, 40%; the
mean being 3·47 galls. of proof spirit. It is found that a bushel of good
malt yields 2 galls. of proof spirit, and that the largest quantity of
proof spirit obtained from raw grain, mashed with 1/5 or 1/6 of malt, does
not exceed 22 galls. per quarter.
The distiller is allowed to produce worts from any substance, and at any
specific gravity, provided such gravity can be correctly ascertained by
the saccharometer approved of by the Board of Inland Revenue. He is not,
however, allowed to mash and distil at the same time. See ALCOHOL, BRANDY,
FERMENTATION, FUSEL OIL, GIN, STILL, &c.
=DISTOMATA.= A genus of fluke-like parasites infesting men and the higher
vertebrate animals. The egg is about the 1/280th of an inch long and
1/270th inch wide.
[Illustration]
The embryo is frequently met with in sewage water, from which, if it be
removed and placed in pure or distilled water, it soon dies. The embryo
which does not become a distoma gives rise to a progeny (gradually formed
from germ-cells within it) consisting sometimes of one, but much more
often of a number of bodies of various forms and structures, each of which
possesses powers of movement and locomotion. But the creatures of this
second development are not distomata; neither are the offspring to which
they in their turn give rise. Like their immediate progenitors, this
offspring produce in their interior germ-cells which develop into minute
worms having tails, and displaying great vivacity when placed in water.
These latter alone exhibit the characters of true distomata. "These
cercaria now either become enclosed, like a chrysalis in a pupa state, or
they penetrate into the bodies of soft animals, become encysted and
parasitic. It appears probable that the distomata enter the human
intestinal canal as cercaria, and then pass into the biliary
passages."[260]
[Footnote 260: Blyth.]
A case is on record of two distomata having been extracted from the foot
of a woman, into which it has been surmised they gained an entrance as
cercaria whilst the woman was bathing.
It is thought that shell-fish, as well as uncooked fish when eaten, may be
the means of introducing these parasites into the human system. The
embryos of the _Distomata hepaticum_ swim about and live in water, which
may probably, when drunk, be the means of conveying them into the bodies
of men and sheep. The ailments and symptoms to which these pests give rise
depend upon the particular organ or portion of the body in which they
establish themselves.
In man they are a frequent cause of hæmaturia and dysentery. In sheep they
occasion fearful mortality, giving rise to the disease known as 'the rot,'
and killing thousands of flocks annually.
"The number of species affecting men are usually enumerated as nine--viz.
_Fasciola hepatica_, _Distoma crassum_, _D. lanceolatum_, _D.
ophthalmobium_, _D. heterophyes_, _Bilharzia hæmatopia_, _Tetrastoma
renale, Hexathrydium renarum_, and _H. pinguicola_."[261]
[Footnote 261: Blyth.]
=DISTORTIONS.= In treating of this subject we shall confine ourselves to
those distortions which are preventable--or rather, we may say, of two out
of the three which will be discussed, which are voluntary.
One very common form of bodily distortion is crooked or curved spine. It
is mostly met with in young girls of from ten to sixteen years of age; and
first shows itself either in the elevation of one shoulder above the
other, or in a growing out of one of the shoulder blades, or of one side
of the bosom beyond the other. The elevated shoulder is generally the
right one. At the same time the right side of the chest is unnaturally
high, and rounded; whilst the opposite or left shoulder and chest are on
the contrary depressed and concave. Very frequently these conditions are
accompanied by a projection of the left hip, and a curving inwards of the
loins on the right side. With persons so afflicted the spine presents an
appearance that has not inaptly been compared to a long italic _f_.
Spinal curvature arises from a weakened state of the muscles, ligaments,
and bones of the backbone. It is most frequently met with in those whose
occupation compels them to stand the greater part of the day; as well as
in persons who pass many hours at the desk or at needlework. Spinal
curvature is also common in young fragile girls acting as nursemaids, and
as such unduly subjected to carrying heavy infants on one side. Amongst
the children of the poor, those of tender years are much too frequently
put to this objectionable form of drudgery. Any one's recollections of a
walk through a poor neighbourhood will enable them to call to mind many
instances they must have seen of smaller babes being nursed by larger
ones. Those subjected to too long standing, no doubt because the posture
affords them relief, unconsciously contract the habit of frequently
standing on the right leg--of _standing at ease_ on it, as it is
called--and at the same time of bending the left knee a little; and since
this position causes the right shoulder to be raised, and the left side of
the pelvis to be thrown out of its place, it will be evident from what has
been already said that, if persisted in, it will end in distorting the
spine in the manner above indicated.
[Illustration]
The same results will also follow in those other cases, such for instance
as in too long an application at the desk or at the needle, as well as the
carrying for an undue length of time a heavy child in the arms; these all
being occupations in which one side of the body is subjected to an undue
and unequal strain over the other.
"Why one-sided postures should cause distortion must be evident, when it
is considered that the intervertebral substance is compressible to such an
extent that an adult man of middle stature loses about an inch of his
height after having been in the erect posture during the day, and does not
regain it till after some hours of rest. Since the united thickness of the
intervertebral substance in an adult man is about 3·875 inches, we see
that they lose nearly one fourth by compression, which they do not recover
till after some hours of rest. But if the weight of the body falls
unequally on the spine day after day, it must be evident that they will
become compressed on one side more than the other; and that if their
elasticity be impaired, and the muscles and ligaments be weak, and the
bones soft, as they are in young persons who have not a sufficiency of
fresh air, wholesome food and active exercise, this lateral distortion
will become permanent.[262]
[Footnote 262: Dr Druitt.]
Another cause tending to distortion of the spine is the foolish habit of
using corsets, a practice which contributes to weaken the dorsal muscles.
When the shoulders are continually supported by a corset, the dorsal
muscles upon which the support ought to fall have their functions usurped
by the corset, and hence fail to receive their proper development, and
consequently lose their power; the result being an inability on the part
of the body to support itself without the corset, and a sinking and
bending of the spine when it is removed. In boys, who never wear corsets,
spinal curvature is rarely met with. In girls, who do, it is constantly to
be found. To guard against spinal distortions, bad and awkward positions
of the body should, wherever possible, be prohibited. Amongst the
prejudicial postures indulged in by the young, we have already mentioned
the habit of standing on one leg and of carrying heavy loads on one side
of the body.
To these may be added the habit of lying crooked in bed, and that of young
girls spending a long time in a constrained position in dressing their own
hair. Every one-sided motion may lead to distortion if it be frequently
repeated, and the tendency once existing, the evil grows day by day. The
use of corsets should be strenuously discountenanced. The early detection
of spinal distortion is a matter of considerable importance. Hence the
advisability of mothers, nurses, governesses, and other guardians of
children or young girls, frequently examining the bodies of their charges
to note if they present any of the peculiarities we have indicated at the
commencement of this article. Should any of these develop themselves, aid
should immediately be sought of a skilful medical practitioner.
Dr Lewis Sayre, in his work 'Spinal Disease and Spinal Curvature'
says:--"The great object in the treatment of Pott's disease is to maintain
_rest of the affected part_ by such means as will not debar the patient
from the benefits of fresh air, sunlight, and change of scene. The patient
should not be permitted to assume the upright position before he has been
fitted with some artificial support capable of removing all pressure from
the bodies of the diseased vertebræ. This object may be obtained by
straightening the spinal column in such a manner that the weight of the
body is borne by _the transverse_ processes and not by the bodies of the
vertebræ." Acting on these principles, Dr Sayre partially envelopes the
patient in a jacket of plaster of Paris, surrounding the body from the
pelvis to the axillæ.
Although Dr Sayre's work is almost entirely devoted to a much more serious
affection of spinal curvature than that treated of here--viz. posterior
angular curvature, in which actual disease of the bones of the vertebræ is
concerned--his treatment is no less applicable to the milder form of
distortion to which our remarks have been directed. Dr Sayre himself
states that 300 cases have been treated by his method with very signal
success, and very many eminent surgeons bear testimony to the soundness of
the principles concerned in it. For the details of its application consult
the author's work before alluded to.
Serious as are the effects very frequently arising from spinal curvature,
amongst which may be included lameness, lung disease, and inability to
perform the functions of maternity; still worse results in addition to the
two last of these ensue in the case of a persistence in another form of
distortion, which is none the less dangerous because it is voluntary. The
distortion to which we refer is that caused by the practice of
tightlacing.
Foremost among the conditions absolutely essential for the preservation of
health and bodily well-being, is the due performance of the function of
the lungs, heart, liver, kidneys, stomach and other important organs. The
object of the ribs within which most of these organs are more or less
wholly contained is to protect these latter from external pressure, and
therefore injury; as well as to allow them unimpeded and unrestricted
action. To ensure this freedom of movement for the parts and organs within
the ribs, it will be evident that every possible obstacle tending in any
degree to compress them, or circumscribe their limits should be especially
avoided.
Instead of the avoidance of such dangers, however, what course do the
silly votaries and dupes of that most senseless and remorseless of all
tyrants--Fashion--pursue? One the very reverse; and which is opposed, not
only to personal comfort and common sense, but, since it mars nature's
outlines, to symmetry and our proper canons of the grace of the female
figure. By means of corsets, tight stays, and other implements of torture
the ribs are pressed _inwards_ to such an extent that all the conditions
we have insisted on as essential to health are imperilled, and eventually
become overthrown. Now, this mischievous and unnatural pressure exerted on
the stomach pushes that organ out of its proper position, and in doing so
forces the diaphragm also out of its place; a disturbance which so
curtails the space in which the movements of the lungs and the heart are
performed, that if the pernicious custom be persevered in these latter
organs become seriously and incurably diseased. The liver also shares in
the damage inflicted, and frequently becomes incapable of discharging its
office. The very much larger number of young women than of young men who
die of consumption is undoubtedly referable to the fact that a large
proportion of the majority are the victims of tightlacing. Nor is it
difficult to understand why this should be, since we know that if the
lungs are prevented exercising their full powers of expansion, unnaturally
diminished function will set up disease in them, which, if there be a
predisposition, will probably be consumption. This cause also, by
preventing the blood becoming properly oxygenated, gives rise to a large
class of disorders due to impurity of the vital fluid. Organic disease of
the heart is by no means an uncommon contingency if tightlacing be
persevered in; for that organ is not allowed room to beat, nor the blood
to circulate. One effect of this is seen in frequent fainting fits.
Again, tightlacing not infrequently stops the growth and arrests the
development of a young girl's _mammæ_, thus seriously incapacitating her
from suckling her babe when she becomes a mother. It also indirectly has a
very prejudicial effect upon health by preventing its votaries from taking
sufficient walking exercise; free bodily movement with accompanying
expansion of the lungs becomes impossible with those encased in a vice of
unyielding armour, such as constitutes pestilent stays and corsets.
Amongst the minor evils wrought by the baleful custom, we may mention
indigestion (for the pressure of the stays weakens the stomach, and sets
up this troublesome complaint), with its accompaniments of flatulence,
heartburn, pain in the chest, &c. Constipation is also another of its
attendant ills; so also are bad breath and a red nose.
"I recollect Dr A. Todd Thomson, in his excellent lectures, relating a
case he had attended where a young lady appeared to be dying from the evil
effects of tightlacing. He cut open her stays and she gradually came to
herself. If the worthy doctor had not quickly done what he did, she would
soon have been a corpse! Dr Thomson has kindly favoured me with the
following interesting particulars of the case for publication:[263]--'Some
years since I was requested to hasten to a house not far from my own to
see a lady who had fallen from her chair in a fit whilst eating her
dinner. On being ushered to the drawing room of the house where the
circumstance had taken place, I saw a lady lying upon a sofa, apparently
dead, and several ladies hanging over the couch in great distress. I found
little appearance of life except that the temperature of the body was
natural; the pulse had ceased to beat, and no respiratory action could be
detected. On laying my hand over the region of the heart, I felt that the
stays were extremely tightly laced; and conceiving that the suspension of
animation arose from that cause, I requested a penknife to be given me,
with which I instantly ripped down the stays and gown. In an instant the
chest dilated, on the binding matter giving way, which was almost like
splitting an overbraced drum; and in a few seconds respiration recommenced
and animation returned. In this case the waist was drawn in to a degree
that gave a complete hour-glass appearance to the figure, and prevented
the descent of the diaphragm, whilst the blood could not circulate, or be
renewed in the lungs from the general obstruction of many of the cells and
smaller tubes. The quantity of residual air also in the lungs was too
small; and this was still diminished by the warmth of some soup, which the
lady was eating when she fell from the chair, dilating the gas in her
stomach, and consequently pressing that enlarged organ upwards on the
lungs. Had I not lived close by, the time necessary to get medical aid
from a greater distance might have rendered it unavailable.' The above
narrative by Dr Thomson is valuable not only as illustrating the dangers
arising from tightlacing, but also as emphasizing the rationale of its
action as stated by ourselves. In the present article we have explained
why it is the use of corsets is to be deprecated. We hope we have
succeeded in showing how imperatively the abandonment of stays is called
for.
[Footnote 263: Dr Chavasse, 'Counsels to a Mother.']
Another variety of distortion is that brought about by wearing tight boots
and shoes, or boots and shoes constructed upon false principles; for, a
boot or shoe may be productive of considerable inconvenience to the
wearer, as well as the cause of a certain amount of twisting out of place
of the bones of the foot, without necessarily being too small. Amongst the
consequences arising from the adoption of tightly fitting or badly
constructed boots or shoes may be mentioned the following:--Considerable
bodily discomfort, and pain in walking; corns and bunions; growing in of
the nails; chronic enlargement of the base of the great toe; caries or
ulceration of the bones of the feet; and flat feet. That these are not
altogether minor evils may be inferred when it is stated that, in order to
obtain relief from the effects of a bunion, partial amputation of the foot
has been sometimes found necessary; that the first attacks of gout mostly
seize the joint of the ball of the great toe when that joint has become
weakened by displacement following the use of faulty boots and shoes; and
that a flat foot interferes with the proper performance of walking.
[Illustration]
The above figure (No. 1) represents the skeleton of the foot with the
bones which form it in their natural position, and in which they are
admirably adapted for executing the various movements required of them.
It will be seen to consist of twenty-six bones, fourteen of which
constitute the toes; the remaining twelve bones enter into the formation
of what are termed the _tarsus_ and _metatarsus_.
The five long bones (_a_) are the _metatarsal_ bones. The toes form joints
with the fore part of these _metatarsal_ bones. The remaining seven are
the _tarsal_ bones; _b_, which is one of these, is named the _astragalus_,
and being gripped on each side by a continuation from the bones of the leg
called the _malleolus_, thus forms the ankle-joint.
[Illustration: FIG. 2.]
Fig. 2 gives a representation of the inner aspect and side view of the
foot. It will be seen that it is an arch resting in front on the anterior
heads of the five metatarsal bones, _a_, but chiefly on that of the great
toe, and on the _calcaneum_ or heel (_b_) behind.
The astragalus, _c_, forms the key-stone of the arch. This arch, which
supports the superincumbent weight of the body, retains its curved form by
means of strong ligaments or bands, which unite the bones which compose it
into a compact but withal flexible mass. The arch, owing to the pressure
thrown upon it from above, becomes flattened when the foot is resting on
the ground; but when this pressure is removed and the foot hangs free, the
curvature of the arch increases. In front of the metatarsal bones are
placed the toes, which are connected with the metatarsal bones by joints.
The great toe has one joint; each of the smaller ones has two.
[Illustration: FIG. 3.]
Fig. 3 depicts the skeleton of a foot with the bones thrown out of their
natural position, the contortion being the result of wearing tightly
fitting or unscientifically constructed boots or shoes. The following
extracts from Dr Hermann Meyer will best illustrate how nature's simple
mechanical arrangements must be thwarted when coverings for the feet are
permitted to be constructed which can give rise to distortions such as
those represented in Figure 3. Dr Meyer says "the great toe plays by far
the most important part in walking; because when the foot is raised from
the ground with the intention of throwing it forwards, we first raise the
heel, then rest for a second on the great toe, and in lifting this from
the ground the point of it receives a pressure which impels the body
forwards. Thus, in raising the foot the whole of the sole is gradually, as
it were, 'unrolled' up to the point of the great toe, which again receives
an impetus by contact with the ground.
[Illustration: FIG. 4.]
[Illustration: FIG. 5.]
The great toe ought, therefore, to have such a position as will admit of
its being unrolled in the manner described; that is to say, it must so lie
_that the line of its axis, when, carried backwards, will emerge at the
centre of the heel; and this is its position in the healthy foot_. The
sole of an almost sound foot is given in Fig. 4, and the true position of
the great toe is indicated by the dotted line. This relation is still
better brought out in Fig. 5, which represents the well-preserved foot of
a child about two years old. The line drawn through both figures is that
in which the foot _unrolls_ itself from the ground. The smaller toes,
however, are by no means without their uses. In standing they rest on the
ground and give lateral support to the foot; while in walking they are
bent in a peculiar manner, so that they are firmly pressed against the
ground; and here too they support the foot laterally. The first joint is
strongly bent upwards, while the second is hollow above. This peculiar
curvature enables the toe in a measure to lay hold of the ground as with
bird's claws."
Dr Meyer then proceeds to show how the application of these principles is
entirely disregarded in the manufacture of our boots and shoes, and to
demonstrate that their neglect gives rise to the objectionable
consequences we have before alluded to. As boots and shoes are at present
constructed, the foot is made to adapt itself to the sole, not the sole to
the foot. This pernicious system must be abandoned if we wish to preserve
our feet, as well as our personal comfort.
"A sole," says Dr Meyer, "is of the proper construction when a line (see
Fig. 6, _c d_) drawn at half the breadth of the great toe distant from,
and parallel to, the inner margin of that toe shall, when carried
backwards, pass through the centre of the heel. In the usual form of a
sole this line passes out of the inner margin of the heel (see Fig. 7).
If, then, the preservation of the primary straight line is, as has been
already shown, the principal point in the formation of a proper sole, it
follows that, if it be thought desirable to have pointed shoes, the
pointing must be effected from the outer side, as indicated in the annexed
Fig. 8. In a pair of shoes made on these principles, placed side by side
with the heels in contact, the inner margins of the front part of the foot
are also brought close together" (Fig. 9).
Dr Meyer's pamphlet contains the following strictures on 'High heels' to
boots and shoes: "It is usual, in all shoes of even moderate strength, to
make the heel a little higher by means of what is called the _heel-piece_.
These heel-pieces are generally of some little use, especially in dirty
weather, and we cannot wholly deny their right to existence. But at the
same time they ought to be as low as possible, and heels an inch thick, as
is at present very commonly the case, have very serious disadvantages
indeed.
"The weight of the body is by this means thrown in a disproportionate
ratio on the toes, the joints of which are consequently overstrained.
Moreover, with a high heel the sole is so oblique in its direction that
the foot must be constantly gliding forwards and forcibly pressing the
toes into the point of the shoe. The toes, therefore, even when the shoe
is sufficiently long, are subjected to the same injuries and
disfigurations as if it were too short, and the effects are doubly hurtful
when the form of the sole is also incorrect. High heels, especially if
they are also very small; are peculiarly liable to wear obliquely, and so
the shoe gets trodden on one side; they must, therefore, be peculiarly
favorable to origin of flat-foot.
[Illustration: FIG. 6. and FIG. 7.]
[Illustration: FIG. 8. and FIG. 9.]
High and small heels are therefore quite unsuitable. The heel-piece ought
to be as low and broad as possible."
Further and more explicit knowledge on this subject may be obtained from
Dr Meyer's excellent little pamphlet entitled 'Procrustes ante portas,'
very ably translated into English by Mr J. T. Craig, L.R.C.E., under the
title of 'Why the Shoe Pinches.'
=DIURE'SIS.= See URINE.
=DIURET'ICS.= _Syn._ DIURETICA. Medicines which promote the secretion of
urine. The principal diuretics are--aqueous fluids, which act by
increasing the watery portion of the blood, and--substances which promote
the action of the kidneys. Most of the first produce copious diuresis if
the skin is kept cool. Among the last are acetate, bitartrate, and nitrate
of potassa; oils of juniper, turpentine, cajeput, and copaiba; dilute
spirit, and sweet spirits of nitre; decoction of common broom, &c.
=DIVIDIVI.= An astringent substance imported from Jamaica. It contains
above 5% of tannin; whilst gall-nuts contain less than 3·5%, and the best
oak-bark only 1·35%. Hence its value in tanning.
=DOBEREINER'S LAMP.= A portable apparatus for obtaining instantaneous
light by the action of a jet of hydrogen on a small piece of spongy
platinum.
=DOCHMIUS DUODENALIS.= An intestinal parasitic worm. Its length is from
1/3 to 1/2 an inch and its breadth about 1/60th of an inch. It is
furnished with hooklets. It is found in the duodenum, the ileum, and the
jejunum of man, and Greisinger seems to have pretty conclusively
established that it is the cause of the disease so prevalent in Egypt, and
known as the Egyptian chlorosis. Anemia, dysentery, and hemorrhoids and
liver diseases are also frequently caused by it amongst the natives of
Arabia, Brazil, and Northern Italy. In India it is also stated to give
rise to some very alarming maladies. Leuchart affirms that it obtains an
entrance into the system through drinking impure water.
=DOC'IMACY or DOCIMAS'TIC ART.= See ASSAYING.
=DOG.= The effect of medicines on dogs is much the same as on man; but
there are some striking exceptions to this rule. Thus, whilst the dog can
take a dose of aloes six or eight times as large as that given to man, the
administration of half as much calomel or oil of turpentine would be
productive of serious injury to the animal. The idea usually entertained,
therefore, that medicines may be given to dogs in doses equalling those
taken by man requires considerable modification. Dogs have a short and
straight alimentary canal, in consequence of which purgative medicines act
more quickly upon them than they do on other veterinary subjects. The
facility with which dogs can be made to vomit is also another peculiarity
possessed by them. Vomiting may be produced by their swallowing nauseous
or unpalatable matters, as well as from their eating various sorts of
grass. A good plan to prevent dogs vomiting their medicines is to keep the
head well raised for an hour after the administration; and this may be
easily accomplished by attaching a chain or cord to the collar, and fixing
it at the requisite height, to any object. The kidneys are acted upon with
much more difficulty than with the horse, whilst the skin seems nearly, if
not altogether incapable of being affected. We give below a list of
medicines for dogs; premising that the doses required vary considerably
according to the strength, size, and age of the dog, all of which should
always be duly taken into account. The doses prescribed in the following
formulæ are for moderately large dogs:--