GIFT OF MICHAEL REESE AMERICAN SCIENCE SERIES— ADVANCED COURSE THE HUMAN BODY AN .ACCOUNT OF ITS STRUCTURE AND ACTIVITIES AND THE CONDITIONS OF ITS HEALTHY WORKING BY II. NEWELJj MARTIN, D.Sc., M.A., M.D., F.R. Late Professor of Biology in the Johns Hopkins University and of Physiology in the Medical Faculty of the same EIGHTH EDITION, REVISED NEW YORK Mr/ HOLT AND COMPANY 1898 BIOLOGY LIBRARY G Copyright, 1881, 1836, BY HENRY HOLT & CO. x PUBLISHEBS' NOTE. THE Appendix on Reproduction of the earlier editions appears in this as Chapter XXXIX. Copies of the book without the chapter can be had when specially ordered. iii PKEFACE TO THE SEVENTH EDITION. THIS edition has been very thoroughly worked over and, I trust, improved. A considerable amount of new matter has been added, especially in connection with the cardiac and vascular nerves, and the physiology of the brain; but throughout the whole book many paragraphs have been re- written; and many corrections, rendered necessary by the discoveries of the last three or four years, have been made. I hope therefore that the edition will be found as well up to date as it is possible for a text-book to be : for a text-book must always incline to the conservative side, and deal with well-established facts rather than with even the most fasci- nating novelties. Still, as in previous editions, I have tried to show where the outposts and the outlooks of Physiology are. H. N. M. May 1, 1896. PKEFACE TO THE FIEST EDITION. IN the following pages I have endeavored to give an account of the structure and activities of the Human Body, which, while intelligible to the general reader, shall be accu- rate, and sufficiently minute in details to meet the require- ments of students who are not making Human Anatomy and Physiology subjects of special advanced study. Wherever it seemed to me really profitable, hygienic topics have also been discussed, though at first glance they may seem less fully treated of than in many School or College Text-books of Physiology. Whoever will take the trouble, however, to examine critically what passes for Hygiene in the majority of such cases will, I think, find that, when correct, much of it is platitude or truism : since there is so much that ic of impor- tance and interest to be said it seems hardly worth while to occupy space with insisting on the commonplace or obvious. It is hard to write a book, not designed for specialists, without running the risk of being accused of dogmatism, and some readers will, no doubt, be inclined to think that, in several instances, I have treated as established facts matters which are still open to discussion. General readers and students are, however, only bewildered by the production of an array of observations and arguments on each side of every question, and, in the majority of cases, the chief responsi- bility under which the author of a text-book lies is to select what seem to him the best supported views, and then to state them simply and concisely: how wise the choice of a side has been in each case can only t>e determined by the discoveries of the future. Others will, I am inclined to think, raise the contrary objection that too many disputed matters have been dis- VI PREFACE TO TEE FIRST EDITION. cussed : this was deliberately done as the result of an experi- ence in teaching Physiology which now extends over more than ten years. It would have been comparatively easy to slip over things still uncertain and subjects as yet unin- vestigated, and to represent our knowledge of the workings of the animal body as neatly rounded off at all its contours and complete in all its details — totus, teres, et rotimdus. But by so doing no adequate idea of the present state of physiological science would have been conveyed; in many directions it is much farther travelled and more completely known than in others; and, as ever, exactly the most inter- esting points are those which lie on the boundary between what we know and what we hope to know. In gross Anatomy there are now but few points calling for a suspension of judg- ment; with respect to Microscopic Anatomy there are more; but a treatise on Physiology which would pass by, unmen- tioned, all things not known but sought, would convey an utterly unfaithful and untrue idea. Physiology has not fin- ished its course. It is not cut and dried, and ready to be laid aside for reference like a specimen in an Herbarium, but is comparable rather to a living, growing plant, with some stout and useful branches well raised into the light, others but part grown, and many still represented by unfolded buds. To the teacher, moreover, no pupil is more discouraging than the one who thinks there is nothing to learn; and the boy who has " finished " Latin and " done " Geometry finds some- times his counterpart in the lad who has " gone through " Physiology. For this unfortunate state of mind many Text- books are, I believe, much to blame : difficulties are too often ignored, or opening vistas of knowledge resolutely kept out of view: the forbidden regions may be, it is true, too rough for the young student to be guided through, or as yet pathless for the pioneers of thought; but the opportunity to arouse the receptive mental attitude apt to be produced by the rec- ognition of the fact that much more still remains to be learned — to excite the exercise of the reasoning faculties upon dis- puted matters — and, in some of the better minds, to arouse the longing to assist in adding to knowledge, is an inesti- mable advantage, not to be lightly thrown aside through the desire to make an elegantly symmetrical book. While I trust, therefore, that this volume contains all the more impor- tant facts at present known about the working of our Bodies, PREFACE TO THE FIRST EDITION. vn I as earnestly hope that it makes plain that very much is yet to be discovered. A work of the scope of the present volume is, of course, not the proper medium for the publication of novel facts; but, while the " Human Body," accordingly, professes to be merely a compilation, the introduction of constant references to authorities would have been out of place. I trust, how- ever, that it will be found throughout imbued with the influ- ence of my beloved master, Michael Foster; and on various hygienic topics I have to acknowledge a special indebtedness to the excellent series entitled Health Primers. The majority of the anatomical illustrations are from Henle's Anatomie des Menschen, and a few from Arendt's Schulatlas, the publishers of each furnishing electrotypes. A considerable number, mainly histological, are from Quain's Anatomy, and a few figures are after Bernstein, Carpenter, Frey, Haeckel, Helmholtz, Huxley? McKendrick, and Wundt. About thirty, chiefly diagrammatic, were drawn specially for the work. Quantities are throughout expressed first on the metric sys- tem, their approximate equivalents in American weights and measures being added in brackets, H. NEWELL MAKTIN. BALTIMORE, October, 1880. CONTENTS. CHAPTER I. THE GENERAL STRUCTURE AND COMPOSITION OF THE HUMAN BODY. PAGE Definitions. Tissues and organs. Histology. ZoSlogical position of man. The vertebrate plan of structure. The mammalia. Chemical composition of the Body 1 CHAPTER II. THE FUNDAMENTAL PHYSIOLOGICAL ACTIONS, The properties of the living Body. Physiological properties. Cells. Cell division. Indirect, karyokinetic or mitotic cell division. Assimilation ; reproduction. Contractility. Irritability. Con- ductivity. Spontaneity. Protoplasm. The fundamental physi- ological properties 15 C CHAPTER III. THE DIFFERENTIATION OF THE TISSUES AND THE PHYSIOLOGICAL DIVISION OF EMPLOYMENTS. Development. The physiological division of labor. Classification of the tissues. Undifferentiated tissues. Supporting tissues. Nutritive tissues. Storage tissues. Irritable tissues. Coordi- nating and automatic tissues. Motor tissues. Conductive tissues. Protective tissues. Reproductive tissues. Organs. Physiological mechanisms. Anatomical systems. The Body as a working whole „ . 29 CHAPTER IV. THE INTERNAL MEDIUM. The external medium. The internal medium. The blood. The lymph. Histology of blood. Blood crystals. Histology of lymph 40 ix X CONTENTS. CHAPTER V. THE CLOTTING OF BLOOD. PAGE Coagulation of the blood. Cause of coagulation. Whipped blood. The buffy coat. The source of blood fibrin. Artificial clot. Fibrin ferment. Proximate causes of normal blood coagulation. Relation of the blood-vessels to coagulation. Chemical com- position of the blood. Quantity of blood. The life-history of the blood-corpuscles. Chemical composition of lymph ........ 51 * CHAPTER VI. THE SKELETON. Exoskeleton and endoskeleton. The bony skeleton. Segmentation of the skeleton. Homologies of the bones of the anterior and posterior limbs. Peculiarities of the human skeleton ...... , . . 63 CHAPTER VII. THE STRUCTURE AND COMPOSITION OF BONE. JOINTS. Gross structure of the bones. Microscopic structure of bone. Chem- ical composition of bone. Articulations. Joints. Hygiene of the joints .................................................. 85 CHAPTER VIII. CARTILAGE AND CONNECTIVE TISSUE. Temporary and permanent cartilages. Varieties of cartilage. The connective tissues. Elastic cartilage and fibre-cartilage. Ho- mologies of the supporting tissues. Hygiene of the developing skeleton. Adipose tissue .................................. 98 CHAPTER IX. THE STRUCTURE OF THE MOTOR ORGANS. Motion in animals and plants. Amoeboid cells. Ciliated cells. The muscles. Histology of striated muscle. Structure of un- striated muscular tissue. Cardiac muscular tissue. The chem- istry of muscular tissue. Beef -tea and Liebig's extract ........ 109 CHAPTER X. THE PROPERTIES OF MUSCULAR TISSUE. Contractility. Irritability. A simple muscular contraction. Phys- iological tetanus. Causes affecting degree of contraction. Measure of muscular work. Muscular elasticity. Electrical currents of muscle. Secondary contraction. Secondary tetanus. Source of muscular energy. Physiology of plain muscular tissue . . .127 CONTENTS. xi CHAPTER XI. MOTION AND LOCOMOTION. HYGIENE OF MUSCLES. PAGE Special physiology of the muscles. Levers in the Body. Postures. Walking. Running. Hygiene of muscles. Exercise. Train- ing 144 CHAPTER XII. ANATOMY OF THE NERVOUS SYSTEM. ** Nerve-trunks. Nerve-centres. Cerebro-spinal centre and its mem- branes. Spinal cord. Spinal nerves. Brain. Cranial nerves. Sympathetic system. Sporadic ganglia. Histelogy of nerve- fibres. Histology of nerve-cells. Neuroglia. Histology of spinal cord. Structure of a spinal ganglion 158 CHAPTER XIII. THE GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. The properties of the nervous system. Functions of nerve-centres and nerve-trunks. Excitant and inhibitory nerves. Classifica- tion of nerve-fibres. Electrical phenomena of nerves. Stimuli of nerve-fibres. General nerve stimuli. Special nerve stimuli. Specific nerve energies. Proof that all nerve-fibres are physio- logically alike. The nature of a nervous impulse. Rate of trans- mission of a nervous impulse. Functions of special nerve roots. Cranial nerves. Intercommunication of nerve-centres. Degen- eration of nerve-fibres when separated from their centre 186 CHAPTER XIV. THE ANATOMY OF THE HEART AND BLOOD-VESSELS. General statement. Position of heart. Membranes of heart. Anat- omy of heart. Valves of heart. The arterial system. Aorta and its branches. The capillaries. The veins. The pulmo- nary circulation. The portal circulation. Arterial and venous blood. Structure of the arteries, of the capillaries, and of the veins 211 CHAPTER XV. THE WORKING OF THE HEART AND BLOOD-VESSELS. The beat of the heart. Cardiac impulse. Use of papillary muscles. Sounds of the heart. A cardiac cycle. Work done by the heart. The circulation in the blood-vessels. Conversion of intermit- tent into a continuous flow 227 CHAPTER XVI. ARTERIAL PRESSURE. THE JP&LSE. Weber's schema. Arterial pressure. The pulse. The rate of the blood flow. Secondary causes of the circulation. Aspiration of the thorax. Proofs of the circulation of the blood . . .240 Xli CONTENTS. CHAPTER XVII. THE NERVES OF THE HEART AND SOME PHYSIOLOGICAL PECULIARITIES OF CARDIAC MUSCLE. The coordination of heart and blood-vessels. Physiological peculi- arities of cardiac muscle. The beat of the frog's heart. Heart- beat not tetanic. Ventricular contraction always maximal. Extrinsic nerves of mammalian heart. Cardio-inhibitory fibres. The arterial manometer. The cardio- inhibitory centre. The cardio-accelerator nerves. The iniluence of temperature changes and of calcium salts on the heart-beat 253 CHAPTER XVIII. THE VASO-MOTOR NERVES AND NERVE-CENTRES. The nerves of the blood-vessels. Vaso-constrictor nerves. Vaso- constrictor centre. Blushing. Taking cold. Vaso-dilator nerves and centre. Vascular phenomena of inflammation . „ . . . 273 CHAPTER XIX. THE SECRETORY TISSUES AND ORGANS. Organs of secretion. Glands. Physical processes in secretion. Chemical processes of secretion. Mode of activity of secretory cells. Influence of nervous system on secretion. Secretion by the subrnaxillary and parotid glands. ..„...., 282 CHAPTER XX. THE INCOME AND EXPENDITURE OF THE BODY. The material losses of the Body. The losses of the Body in energy. The conservation of energy. Potential and kinetic energy. The energy of chemical affinity. Relation between matters removed from the Body and energy spent by it. Conditions of oxidation in the living Body. The fuel of the Body. Utilization of en- ergy in the living body 399 CHAPTER XXI. FOODS. Foods as tissue-formers. The food of plants. Non-oxidizable foods. Definition of foods. Conditions which a food must fulfil. Pro- teid or albuminous alimentary principles. Albuminoid or gela- tinoid alimentary principles. Hydrocarbons. Carbohydrates. Inorganic foods. Mixed foods. Flesh. Eggs. Milk. Veg- etable foods. Alcohol. Advantage of a mixed diet 313 CHAPTER XXII. THE ALIMENTARY CANAL AND ITS APPENDAGES. General arrangement. Subdivisions of alimentary canal. Mouth. Teeth. Tongue. Salivary glands. Fauces. Pharynx. CEsoph- THE HUMAN BODY. CHAPTER I. THE GENERAL STRUCTURE AND COMPOSITION OF THE HUMAN BODY. ' , Definitions. The living Human Body may be considered from either of two aspects. Its structure may be especially examined, and the forms, connections and mode of growth of its parts be studied, as also the resemblances or differences in such respects which appear when it is compared with other animal bodies. Or the living Body may be more especially studied as an organism presenting definite properties and performing certain actions; and then its parts will be investi- gated with a view to discovering what duty, if any, each ful- fils. The former group of studies constitutes the science of Anatomy, and in so far as it deals with the Human Body alone, of Human Anatomy; while the latter, the science con- cerned with the uses — or in technical language the functions —of each part is known as Physiology. Closely connected with physiology is the science of Hygiene, which is concerned with the conditions which are favorable to the healthy action of the various parts of the Body; while the activities and structure of the diseased body form the subject-matters of the sciences of Pathology and Pathological Anatomy. Tissues and Organs. Histology. Examined merely from the outside our Bodies present a considerable complexity of structure. We easily recognize distinct parts as head, neck, trunk and limbs; and in these again smaller constituent parts, as eyes, nose, ears, mouth; arm, forearm, hand; thigh, leg and foot. We can, with such an external examination, go even farther and recognize different materials as entering into the formation of the larger parts. Skin, hair, nails and teeth are obviously different substances; simple examination 2 THE HUMAN BODY. by pressure proves that internally there are harder and softer solid parts; while the blood that flows from a cut finger shows that liquid constituents also exist in the Body. The concep- tion of complexity which may be thus arrived at from exter- nal observation of the living, is greatly extended by'dissection of the dead Body, which makes manifest that it consists of a great number of diverse parts or organs, which in turn are built up of a limited number of materials; the same material often entering into the composition of many different organs. These primary building materials are known as the tissues^ ,and that branch" of anatomy which deals with the characters tof the. tissues -.amd their arrangement in various organs is known as. Histology j or, since it is mainly carried on with the aid of the itik-rc^oope, as Microscopic Anatomy. If, with the poet, we compare the Body to a house, we may go on to liken the tissues to the bricks, stone, mortar, wood, iron, glass and so on, used in building ; and then walls and floors, stairs and windows, formed by the combination of these, would answer to anatomical organs. Zoological Position of Man. External examination of the human Body shows also that it presents certain resemblances to the bodies of many other animals: head and neck, trunk and limbs, and various minor parts entering into them, are not at all peculiar to it. Closer study and the investigation of internal structure demonstrates further that these resem- blances are in many cases not superficial only, but that our Bodies may be regarded as built upon a plan common to them and the bodies of many other creatures: and it soon becomes further apparent that this resemblance is greater between the Human Body and the bodies of ordinary four-footed beasts, than between it and the bodies of birds, reptiles or fishes. Hence, from a zoological point of view, man's Body marks him out as belonging to the group of Mammalia (see Zoology), which includes all animals in which the female suckles the young ; and among mammals the anatomical resemblances are closer and the differences less between man and certain apes than between man and the other mammals; so that zoologists still, with Linnaeus, include man with the monkeys and apes in one subdivision of the Mammalia, known as the Primates. That civilized man is mentally far superior to any other animal is 010 valid objection to such a classification, for zoological groups are defined by anatomical and not by GENERAL STRUCTURE AND COMPOSITION. 3 physiological characters; and mental traits, since we know that their manifestation depends upon the structural integ- rity of certain organs, are especially phenomena of function and therefore not available for purposes of zoological ar- rangement. As man walks erect with the head upward, while the great majority of Mammals go on all lours with the head forward and the back upward, and various apes adopt intermediate positions, confusion is apt to arise in considering correspond- ing parts in man and other animals unless a precise mean- ing be given to such terms as "anterior" and "posterior." Anatomists therefore give those words definite arbitrary sig- nifications. The head end is always an_tej'ior whatever the natural position of the animal, and the opposite end posterior; the belly side is spoken of as ventral, and the opposite side as dorsal ; rigid and left of course present no difficulty: the terms cephalic and caudal as equivalent, respectively, to ante- rior and posterior, are sometimes used. Moreover, that end of a limb nearer the trunk is spoken of as proximal with refer- ence to the other or distal end. The words upper and loiver may be conveniently used for the relative position of parts in the natural standing position o.f the animal. The Vertebrate Plan of Structure. Neglecting such merely apparent differences as arise from the differences of normal posture above pointed out, we find that man's own zoological class, the Mammals, differs very widely in its broad structural plan from the groups including sea-anemones, in- sects or oysters, but agrees in many points with the groups of fishes, amphibians, reptiles and birds. These four are there- fore placed with man and all other Mammals in one great division of the animal kingdom known as the Vertebrata. The main anatomical character of all vertebrate animals is the presence in the trunk of the body of two cavities, a dorsal and a ventral, separated by a solid partition: in the adults of nearly all vertebrate animals a hard axis, the vertebral column (backbone or spine), develops in this partition and forms a central support for the rest of the body (Fig. 2, ee). The dorsal cavity is continued through the neck, when there is one, into the head, and there widens out. The bony axis is also continued through the neck and extends into the head in a modified form. The ventral cavitf, on the other hand, is confined to the trunk. It contains the main organs con- 4 THE HUMAN BODY. nected with the blood-flow and is often called the hcemal cavity. Upon the ventral side of the head is the mouth-opening leading' into a tube, the alimentary canal, /', which passes back through the neck and trunk and opens again on the outside at the posterior part of the latter. In its passage through the trunk-region -this canal lies in the ventral cavity. The Mammalia. In many vertebrate animals the ven- tral cavity is not subdivided, but in the Mammalia it is; a FIG. 1.— The Body opened from the front to show the contents off its ventral cavity, lu, lungs; h, heart, partly covered by other things; le, le', right and left liver-lobes respectively ; ma, stomach ; we, the great omentum, a membrane con- taining fat which hangs down from the posterior border of the stomach and covers the intestines. membranous transverse partition, the midriff or diaphragm (Fig. ], z), separating it into an anterior chest or thoracic GENERAL STRUCTURE AND COMPOSITION. O cavity, and a posterior or abdominal cavity. The alimentary canal and whatever else passes from one of these cavities to the other must therefore perforate the diaphragm. In the chest, besides part of the alimentary canal, lie important or- gans, the hearty h, and lungs, lu; the heart being on the ventral side of the alimentary canal. The ab- dominal cavity is mainly occupied by the alimentary canal and organs con- nected with it and concerned in the digestion of food, as the stomach, ma, the liver, le, the pancreas, and the intestines. Among the other more prominent organs in it are the kidneys and the spleen. In the dorsal or neural cavity lie the brain and spinal cord, the former occupying its anterior enlargement in the head. Brain and spinal cord together form the cerebro-spinal nervous centre; in addition to this there are found in the ventral cavity a number of small nerve-centres united together by connecting cords, and with their offshoots forming the sympathetic nervous system. The walls of the three main cavi- ties are lined by Smooth, moist the brain; ee, vertebrae form- . ing the solid partition between SerOUS membranes. That lining the the dorsal and ventral cavities; . ,, , . , ,, . &, the pleural, and c, the abdom- QOrsal Cavity IS the arachnoid; that inal division of the ventral cav- -, . . i J.T 7 i. ily» separated from one another lining the chest the pleura; that by the diaphragm, d\ i, the Fm. 2._Diagrammatic the'neuSfSe?^ lining the abdomen the peritoneum; the abdominal cavity is in conse- quence often called the peritoneal pavitv T^Yfprrmllv flip walls nf fTioco nervous chain. From the stom- .avity. Externally t nese ach, /, the intestinal tube leads cavities are covered by the skin, through the abdominal cavity •* ' to the posterior opening of the Which Consists Of two layers : 'an Outer alimentary canal. horny layer called the epidermis, which is constantly being shed on the surface and renewed from below; and a deeper layer, called the dermis and containing blood, which the 6 HUMAN BODY. epidermis does not. Between the skin and the lining serous membranes are bones, muscles (the lean of meat), and a great number of other structures which we shall have to consider hereafter. All cavities inside the body, as the alimentary canal and the air-passages, which open directly or indirectly on the surface are lined by soft and moist prolongations of the skin known as mucous membranes. In these two layers are found as in the skin, but the superficial bloodless one is called epithelium and the deeper vascular one corium. Diagrammatically we may represent the Human Body in longitudinal section as in Fig. 2, where aa' is the dorsal or neural cavity, and b and c, respectively, the thoracic and abdominal subdivisions of the ventral cavity; d represents the diaphragm separating them ; ee is the vertebral column with its modified prolongation into the head beneath the anterior, enlargement of the dorsal cavity; / is the ali- mentary canal opening in front through the nose, ?', and mouth, 0; li is the heart, I a lung, s the sympathetic nervous system, and k a kidney. A transverse section through the chest is represented by the diagram Fig. 3, where x is the neural canal containing the spinal cord. In the thoracic cavity are seen the heart, h, FIG. 3.— A diagrammatic section across the Body in the chest region, x, the dorsal tube, which contains the spinal cord; the black mass surrounding it is a vertebra; a, the gullet, a part of the alimentary canal; h, the heart; sy, sympa- thetic nervous system; M, luags; the dotted lines around them are the pleurae; IT, ribs; st, the breast-bone. the lungs, II, part of the alimentary canal, a, and the sympa- thetic nerve-centres, sy ; the dotted line on. each side covering the inside of the chest- wall and the outside of the lung represents the pleura. Sections through corresponding parts of any other Mam- mal would agree in all essential points with those represented in Figs. 2 and 3. GENERAL STRUCTURE AND COMPOSITION. 1 The Limbs. The limbs present no such arrangement of cavities on each side of a bony axis as is seen in the trunk. They have an axis formed at different parts of one or more bones (as seen at U and R in Fig. 4, which represents a cross- section of the forearm near the elbow-joint), but around this are closely-packed soft parts, chiefly muscles, and the whole is enveloped in skin. The only cavities in the limbs are branching tubes which are filled with liquids during life, either blood or a watery-looking fluid known as lymph. These tubes, the blood and lymph vessels respectively, are not, how- u FIG. 4.— A section across the forearm a short distance below the elbow-joint. R and £7, its two supporting bones, the radius and ulna; e, the epidermis, and d, the dermis of the skin; the latter is continuous below with bands of connective tissue, s, which penetrate between and invest the, muscles, which are indicated by nuin bers ; n n. nerves and vessels. ever, characteristic of the limbs, for they are present in abundance in the dorsal and ventral cavities and in their walls. Chemical Composition of the Body. In addition to the study of the Body as composed of tissues and organs which are optically recognizable, we may consider it as composed of a number of different chemical substances. This branch of knowledge, which is still very incomplete, really presents two classes of problems. On the one hand we may limit ourselves to the examination of the chemical substances which exist in or may be derived from the dead Body, or, if such a thing were possible, from the living Body entirely at rest; such a study is essentially one of structure and may be called Chem- ical Anatomy. But as long as the Body is alive it is the seat of constant chemical transformations in its material, and these arc inseparably connected with its functions, the great majority of which are in the long-run dependent upon chem- ical changes. From this point of view, then, the chemical study of the Body presents physiological problems, and it is usual to include all the facts known as to the chemical com- position and metamorphoses of living matter under the name 8 THE HUMAN BODY. of Physiological Chemistry. For the present we may confine ourselves to the more important substances derived from or known to exist in the Body, leaving questions concerning the chemical changes taking place within it for consideration along with those functions which are performed in connection with them. Elements Composing the Body. Of the elements known to chemists only sixteen have been found to take part in the formation of the human Body. These are carbon, hydrogen, nitrogen, oxygen, sulphur, phosphorus, chlorine, fluorine, silicon, sodium, potassium, lithium, calcium, magnesium, iron and manganese. Copper and lead have sometimes been found in small quantities, but are probably accidental and occa- sional. Uncombined Elements. Only a very small number of the above elements exist in the Body uncombined. Oxygen is found in small quantity dissolved in the blood; but even there most of it is in a state of loose chemical combination. It is also found in the cavities of the lungs and alimentary canal, being derived from the inspired air or swallowed with food and saliva; but while contained in these spaces it can hardly be said to form a part of the Body. Nitrogen also exists un- combined in the lungs and alimentary canal, and in small quantity in solution in the blood. Free hydrogen has also been found in the alimentary canal, being there evolved by the fermentation of certain foods. Chemical Compounds. The number of these which may be obtained from the Body is very great; but with regard to very many of them we do not know that the form in which we extract them is really that in which the elements they contain were united while in the living Body; since the methods of chemical analysis are such as always break down the more complex forms of living matter and leave us only its de- bris for examination. We know in fact, tolerably accurately, what compounds enter the Body as food and what finally leave it as waste; but the intermediate conditions of the ele- ments contained in these compounds during their sojourn inside the Body we know very little about; more especially their state of combination during that part of their stay when they do not exist dissolved in the bodily liquids, but form part of a solid living tissue. For present purposes the chemical compounds existing in GENERAL STRUCTURE AND COMPOSITION. (9 or derived from the Body may be classified as organic and in- organic, and the former be subdivided into those which con- tain nitrogen and those which do not. Nitrogenous or Azotized Organic Compounds. These fall into several main groups: proteids, peptones, albuminoids, enzymes, crystalline substances, and coloring matters. Proteids are by far the most characteristic substances obtained from the Body, since they are only known as exist- ing in or derived from living things, either animals or plants. The type of this class of bodies may be found in the white of an egg, where it is stored up as food for the developing chick-; from this typical form, which is called egg-albumin, the pro- teids in general are often called albuminous- bodies. Each of them contains carbon, hydrogen, oxygen, sulphur and nitrogen united to form a very complex molecule, and although different members of the family differ from one another in minor points they all agree in their broad features and have a similar percentage composition. The latter in different examples varies within the following limits: Carbon 50 to 55 per cent. Hydrogen 6.8 to 7.3 Oxygen 22.8 to 24.1 " Nitrogen.. 15.4 to 18.2 " Sulphur ." 0.4 to 5.0 " In addition a small quantity of ash is usually left when a proteid is burnt. Proteids are recognized by the following characters: 1. Boiled, either in the solid state or in solution, with strong nitric acid they give a yellow liquid which becomes orange on neutralization with ammonia. This is the xantho-proteic test. 2. Boiled with a solution containing subnitrate and per- nitrate of mercury they give a pink precipitate, or, if in very small quantity, a pink-colored solution. This is known as Millon's testf 3. If a solution containing a proteid be strongly acidulated with acetic acid and be boiled after the addition of an equal bulk of a saturated watery solution of sodium sulphate, the proteid will be precipitated. Among the more important pfoteids obtained from the Human Body are the following: Serum-albumin. 0 This exists in solution in the blood and 10 THE HUMAN BODY. is very like egg-albumin in its properties. It is coagulated (like the white of an egg) when boiled, arid then passes into the state of coagulated proteid which is, unlike the original serum-albumin, insoluble in dilute acids or alkalies or in water containing neutral salts in solution. All other proteids can by appropriate treatment be turned into coagulated proteid. Fill-in. This forms in blood when it " clots," either in- side or outside of the Body; it is insoluble in water and dilute acids or alkalies; soluble in strong acids and alkalies and, though slowly, in ten per cent neutral saline solutions. Myosin. This is derived from the muscles, in which it develops and solidifies after death, causing the "death-stiffen- ing." Globulin exists in the red globules of the blood and dis- solved in some other liquids of the body. In the blood-cor- puscles it is combined with a colored non-proteid substance to form licemoglolin, which is crystallizable. Allied sub- stances, paraglolulin and fibrinogen, are found dissolved in the blood-liquid. When blood clots the fibrinogen gives rise to fibrin. Casein or, as it is better named, caseinogen exists in milk. Its solutions do not coagulate spontaneously or, like that of serum-albumin, on boiling. When milk turns sour on keeping, or when it is very slightly acidulated with dilute acetic acid, the casein is precipitated. The clot or curd which forms when milk is gently warmed with gastric juice or with rennet, is also derived from caseinogen; it differs from true casein and is named tyrein : it is the chief constituent of cheese. Peptones. These are formed in the alimentary canal by the action of some of the digestive liquids upon the proteids swallowed as food. They contain the same elements as the proteids and give the xantho-proteic and Millon's reactions, but are not precipitated by boiling with acetic acid and sodium sulphate. Their great distinctive character is, how- ever, their diffusibility. The proteids proper will not dialyze (see Physics), but the peptones in solution pass readily through moist animal membranes. Albuminoids or Gelatinoids. These contain carbon, hydrogen, oxygen and nitrogen, but rarely any sulphur. Like the proteids, the nearest chemical allies of which they seem GENERAL STRUCTURE AND COMPOSITION. 11 to be, they are only known in or derived from living beings. Gelatin, obtained from bones and ligaments by boiling, is a typical albuminoid; as is chondrin, which is obtained similarly from gristle. Mucin, which gives their glairy tenacious char- acter to the secretions of the- mouth and nose, is anothei albuminoid. Enzymes or Soluble Ferments are a group of substances which seem to be allied in chemical composition to the true proteids, but it is so difficult to be sure of the purity of any specimen that their composition is still in doubt. The enzymes have the power, even when present in very small quantity, of bringing about extensive changes in other sub- stances, and they are not themselves necessarily used up or destroyed in the process. Many enzymes of great physiologi- cal importance exist in the digestive fluids and play a part in fitting food for absorption from the alimentary canal. For example, pepsin found in the gastric juice and trypsin found in the pancreatic secretion convert, under suitable conditions, albuminous substances into peptones; and ptyalin, found in the saliva, converts starch into sugar. Other ferments cause the clotting of various animal liquids: rennin from the gastric juice clots the caseinogen of milk preparatory to its digestion; and a ferment which forms in drawn blood con- verts fibrinogen into fibrin. We shall have occasion later to study several enzymes more in detail in connection with their physiological uses. Crystalline Nitrogenous Substances. These are a heter- ogeneous group, the great majority of them being materials which have done their work in the Body and are about to be got rid of. Nitrogen enters the Body in foods for the most part in the chemically complex form of some proteid. In the vital processes these proteids are broken down into simpler substances, their carbon being partly combined with oxygen and passed out through the lungs as carbon dioxide; their hydrogen is similarly in large part combined with oxygen and passed out as water; while their nitrogen, with some carbon and hydrogen and oxygen, is usually passed out in the form of a crystalline compound, containing what chemists call an "ammonium residue/' Of these the most important is urea (Carbamide, 2NH2, CO), which is eliminated through the kid- neys. Uric acid is another nitrogenous waste product, and many others, such as kreatin and leucin, seem to be inter- 12 THE HUMAN BODY. mediate stages between the proteids which enter the body and the urea and uric acid which leave it. In the bile or gall, two crystallizable nitrogen-containing bodies, glycocholic and taurocholic acid, are found combined with soda. Nitrogenous Coloring Matters. These form an artificial group whose constitution and origin are ill known. Among the most important are the following: Hcematin, derived from the red corpuscles of the blood in which a residue of it is combined with a proteid residue to form haemoglobin. Bilirubin and liliverdin, which exist in the bile; the former predominating in the bile of man and of carnivorous . animals and giving it a reddish-yellow color, while biliverdin predominates in the bile of Herbivora, which is green. Non-Nitrogenous Organic Compounds. These may be conveniently grouped as hydrocarbons or fatty bodies; carbo- hydrates or amyloids / and certain non-azotized acids. Pats. The /ate all contain carbon, hydrogen and oxygen, the oxygen being present in small proportion as compared with the hydrogen. TTlT1fifl , fqfg npf>ip- *'" ^^ ^oriy in large qnantities1 vig^ palmatin (C^H^O,.'). stearin (CB,H1I006), fl,i)rl nlp;ip_^r^ H |u( }j. The two fanner when pure are solid at the temperature of the Body, but in it are mixed with olein (which is liquid) in such proportions as to be kept fluid. The total quantity of fat in the Body is subject to great vari- ations, but its average quantity in a man weighing 75 kilo- grams (165 pounds) is about 2.75 kilograms (6 pounds). Each of these fats when heated with a caustic alkali, in the presence of water, breaks up into a fatty acid (stearic, palmitic or oleic as the case may be), and glycerin. The fatty acid unites with the alkali present to form a soap. Carbohydrates. These also contain carbon, hydrogen and oxygen, but there is one atom of oxygen present for every two of hydrogen in the molecule of each of them. Chemically they are related to starch. The more important of them found in the Body are the following: Glycogen (G^H^OJ, found in large quantities in the liver, where it seems to be a reserve of material answering to the starch stored up by many plants. It exists in smaller quanti- ties in the muscles. Glucose, or grape-sugar (C6H]206), which exists in the I STRUCTURE AND COMPOSITION. 13 liver in ,'rnall quantities; also in the blood and lymph. It is largely derived from glycogen, which is very readily Converted into it. Lactose, or sugar of ntilJc (CiaH3aOn -f H20), found in considerable quantity in milk. Inosit (C6H1206 -f 2H20), also called muscle -sn gar aiv" formerly classed in this group, is now known to be chf cally not a real sugar or true carbohydrate. It exi^ muscles, liver, spleen, kidneys, etc. Organic Non-Nitrogenous Acids. Of these the most im- portant is carbon dioxide (C02), which is the form in which by far the greater part of the carbon taken into the Body ultimately leaves it. United with calcium it is found in the bones and teeth in large proportion. Formic, acetic and butyric acids are also found in the Body; stearic, palmitic, and oleic have been above mentioned as obtainable from fats. Lactic acid is sometimes found in the stomach, and when milk turns sour is formed from lactose.- A body of the same percentage composition, C3H603 (sarco- lactic acid), is formed in muscles when they work or die. Glycerin phosphoric acid (C3H9P06) is obtained on the de- composition of lecithin, a complex nitrogenous fat found in nervous tissue. Inorganic Constituents. Of the simpler substances en- tering into the structure of the Body the following are the most important : Water; in all the tissues in greater or less proportion and forming about two thirds of the weight of the whole Body. A man weighing 75 kilos (1G5 Ibs.), if completely dried would therefore lose about 50 kilos (110 Ibs.) from the evapo- ration of water. Of the constituents of the Body the enamel of the teeth contains least water (about 2 per cent), and the saliva most (about 99.5 per cent) ; between these extremes are all intermediate steps — bones containing about 22 per cent, muscles 75, blood 79. Common salt — Sodium chloride — (NaCl); found in all the tissues and liquids, and in many cases playing an important part in keeping other substances in solution in water. Potassium chloride (KC1) ; in the blood, muscles, nerves and most liquids. Calcium phosphate (Ca32P04) ; in the bones and teeth in large quantity. In less proportion in all the other tissues. 14 THE HUMAN BODY. Besides the above, ammonium chloride, sodium a id potas- sium phosphates, magnesium phosphate, sodium sulphate, potassium sulphate and calcium fluoride have been obtained ?rom the body. * Uncombined hydrochloric acid (HC1) is found in the ga?*^ juice. V CHAPTER II. THE FUNDAMENTAL PHYSIOLOGICAL ACTIONS. The Properties of the Living Body. When we turn from the structure and composition of the living Body to consider its powers and properties we meet again with great variety and complexity, the most superficial examination be- ing sufficient to show that its parts are endowed with very different faculties. Light falling on the eye arouses in us a sensation of sight, but falling on the skin has no such effect; pinching the skin causes pain, but pinching a hair or a nail does not; when the ears are stopped, sounds arouse in us no sensation; we readily recognize, too, hard parts formed for support, joints to admit of movements, apertures to receive food and others to get rid of waste. We thus perceive that different organs of our Bodies have very different endow- ments and serve for very distinct purposes; and here also the study of internal organs shows us that the varieties of quality observed on the exterior are but slight indications of differences of property which pervade the whole, being some- times dependent on the specific characters of the tissues con- cerned and sometimes upon the manner in which these are combined to form various organs. Some tissues are solid, rigid and of constant shape, as those composing the bones and teeth; others, as the muscles, are soft and capable of changing their forms; and still others are capable of working chemical changes by which such peculiar fluids as the bile and the saliva are produced. We find elsewhere a number of tissues combined to form a tube adapted to receive food and carry it through the Body for digestion, and again similar tissues differently arranged to receive the air which we breathe- in, and expel it after abstracting part of its oxygen and adding to it certain other things; and in the heart and blood- vessels we find almost the same tissues arranged to propel and carry the blood over the whole Body. The working of 15 16 THE HUMAN BODY. the Body offers clearly even a more complex subject of study than its structure. Physiological Properties. In common with inanimate objects the Body possesses many merely physical properties, as weight, rigidity, elasticity, color, and so on; but in addi- tion to these we find in it while alive many others which it ceases to manifest at death. Of these perhaps the power of executing spontaneous movements aiid of maintaining a high bodily temperature are the most marked. As long as the Body is alive it is warm and, since the surrounding air is nearly always cooler, must be losing heat all day long to neighboring objects; nevertheless we are at the end of the day as warm as at the beginning, the temperature of the Body in health not varying much from 37° 0. (98.4° F.), so that clearly our Bodies must be making heat somehow all the time. After death this production of heat ceases and the Body cools down to the temperature in its neighborhood; but so closely do we associate with it the idea of warmth that the sensation experienced on touching a corpse produces so powerful an impression as commonly to be described as icy cold. The other great characteristic of the living Body is its power of executing movements; so long as life lasts it is never at rest; even in the deepest slumber the regular breath- ing, the tap of the heart against the chest-wall, and the beat of the pulse tell us that we are watching sleep and not death. If to this we add the possession of consciousness by the living Body, whether aroused or not by forces immediately acting upon sense-organs, we might describe it as a heat-producing, moving, conscious organism. The production of heat in the Body needs fuel of some kind as much as its production in a fire ; and every time we move ourselves or external objects some of the Body is used up to supply the necessary working powerp just as some coals are burnt in the furnace of an engine for every bit of work it does; in the same way every thought that arises in us is ac- companied with the destruction of some part of the Body. Hence these primary actions of keeping warm, moving, and being conscious, necessitate many others for the supply of new materials to the tissues concerned and for the removal of their wastes; still others are necessary to regulate the pro- duction and loss of heat in accordance with changes in the exterior temperature, to bring the moving tissues into rela- THE FUNDAMENTAL PHYSIOLOGICAL ACTIONS. 17 tion with the thinking, and so on. By such subsidiary ar- rangements the working of the whole Body becomes so com- plex that it would fill many pages merely to enumerate what is known of the duties of its various parts. However, all the proper physiological properties depend in ultimate analysis on a small number of faculties which are possessed by all living things, their great variety in the human Body depend- ing upon special development and combination in different tissues and organs; and before attempting to study them in, their most complex forms it is advantageous to examine them in their simplest and most gen- eralized manifestations, as exhibited by some of the lowest living things or by the simplest con- stituents of our own Bodies. Cells. Among the anatomical elements which the histologist meets with as entering into the composition of the human Body are minute granular masses of a soft consistence, about 0.012 millimeter (-g^Vcr °^ an incn) in diameter (Fig. 5, b). Imbedded in each lies a central portion, not so granular and therefore different in appearance from the rest. These anatomical units are known as cells, the granular substance Fio.5.— Forms being the cell-body and the imbedded clearer por- gf0|jel's from the tion the cell-nucleus,. Inside the nucleus may often be distinguished a still smaller body — the nucleolus. Cells of this kind exist in abundance in the blood, where they are known as the white blood-corpuscles, and each exhibits of itself certain properties which are distinctive of all living things as compared with inanimate objects. Cell Growth. In the first place, each such cell can take up materials from its outside and build them up into its own peculiar substance; and this does not occur by the deposit of new layers of material like its own on the surface of the cell (as a crystal might increase in an evaporating solution of the same salt), but in an entirely different way. The cell takes up chemical elements, either free or combined in a manner different from that in which they exist in its own living sub- stance, and works chemical changes in them by which they are made into part and parcel of itself. Moreover, the new material thus formed is not deposited, at any rate necessarily or always, on the surface of the old, but is laid down in the 18 THE HUMAN BODY. substance of the already existing cell among its constituent molecules. The new-formed molecules therefore contribute to the growth of the cell not by superficial accretion, but by interstitial deposit or intussusception.^ Cell Division. The increase of size, which may be brought about in the above manner, is not indefinite, but is limited in two ways. Alongside of the formation and deposit of new material there occurs always in the living cell a breaking down and elimination of the old; and when this process FIG. 6.— Diagrams illustrating direct cell-division, a, cell, body; 6, nucleus; c, uucleoJus. equals the accumulation of new material, as it does in all the cells of the Body when they attain a certain size, growth of course ceases. In fact the work of the cell increases as its mass, and therefore as the cube of its diameter; while the receptive powers, dependent primarily upon the superficial area, only increase as the square of the diameter. The breaking down in the cell increases when its work does, and so comes at last to equal the reception and con- struction. The second limitation to indefinite growth is connected with the power of the cell to give rise to new cells by division. Until recently it was believed that cell division was in all ^ases a comparatively simple process (Fig. 6). It was thought that the nucleus, without any important structural change, enlarged somewhat, became elongated, and then divided by simple constriction into two equal parts, forming two smaller daughter nuclei; and that the rest of the cell then divided, its halves arranging themselves around the new nuclei. The nucleolus when present was supposed to divide before the nucleus. Such a mode of cell multiplication is known as direct division : it possibly occurs in some cases, but in the great majority of cells division is preceded by marked changes in the structure of the nucleus and by a rearrangement of its material: such cell division is named indirect, and the attend- ant nuclear changes are known as the phenomena of karyoki- nesis or mitosi* THE FUNDAMENTAL PHYSIOLOGICAL ACTIONS. 19 Indirect, Karyokinetic or Mitotic Cell Division. Before attempting to describe the phenomena of indirect cell divi- sions it is necessary to give some account of the structure of a typical primitive cell as made out in speci- mens carefully prepared and studied with the highest powers of the microscope. The main bulk of the cell, surrounding the nucleus, is the cell-body, and in some cases is en- closed in an envelope or sac, which, however, when present, plays but a secondary or passive part in cell divi- ium; e, nucleus." aaudt. together __, r,. . form the cell-body. sion. The cell-body, known also as the cell-protoplasm (Fig. 7), consists of a network of extremely fine threads,"the reticulum or spongioplasm, the meshes of which are occupied by a different substance, the hyaloplasm : the proportions of hyaloplasm and spongioplasm vary in different cells and often in different parts of the same cell; in fact a layer of hyaloplasm unmixed with spongioplasm frequently exists on the exterior of the cell, and the hyaloplasm appears to be the more immediately concerned in the activities of the living cell. In addition there is to be found, imbedded in the cell-body and near the nucleus or attached to it, an extremely minute particle, the attraction-particle or cent r.o some, near which a radial arrangement of the cell-substance may often be ob- served. The nucleus (Fig. 8) of a resting cell, that is of a cell not in process of division, consists of an amorphous material (nucleo- plasm] which is perhaps similar in composition to the hyaloplasm, and a filamentous material, dif- ferent from spongioplasm, and named chromoplnsm or karyo- SS^pl^r^f'SrS?"^ ?*««»• ^ P«™*1 ^ "S behavior h staining fluids and other reagents karyoplasm is quite different chemically from the spongioplasm of the cell-body. One or more granules (nit- cleoli) which may be found within most nuclei are probably FIG. 8. — Diagram of a resting nucleus, a, nuclear membrane; fo, nucleoplasm; c, nucleolus; d, chro- ome of the surround- m of the cell, the structure of which is not indicated. 20 THE HUMAN BODY. local accumulations of chromoplasm; a membrane (nuclear membrane) which surrounds the nucleus of cells not in process of division is also probably composed of chromoplasm. The first observed step in cell division is binary division of the attraction-particle: its halves evolve a set of very fine achromat in filaments uniting them, so that each half is one of the poles of a spindle-shaped collection of fibres, the nuclear spindle. Meanwhile the nucleolus and nuclear membrane disappear, being probably taken up into the rest of the chro- moplasm, which now, instead of its original reticular arrange- - d. b FIG. 0.— Diagrams ot a nucleus in an early stage of karypkinesis, A showing the polar, B the anripolar region; o, nuclear or achromatin spindle; />, part of general cell-protoplasm around the nucleus; c, looped chromatic filament; d, nucleoplasm. ment, takes the form of a single long chromatic filament coiled in the nucleoplasm. At one portion of the nucleus (pole) the loops of the chromatic filament leave a space free from them (Fig. 9, ^4), and in the neighborhood of this space the nuclear spindle is first seen within the nucleus. At the opposite side of the nucleus or antipole (Fig. 9, B) the loops of the chromatic filament leave no clear space, but cross ir- regularly. In the next stage the loops at the antipolar end break through, and in this way the filament is divided into a number of irregular elongated Vs, each with its closed angle near the pole and its open end near the antipole. The spindle meanwhile passes to the centre of the nucleus and takes a posi- tion in which its long axis coincides with that joining pole and antipole, and then the Vs of chromoplasm become shorter and their limbs thicker, and they also shift position so as to group themselves radially around the equator of the spindle (A, Fig. 10) with their angles directed centrally. Each V then di- vides along its whole length, and one half passes towards the THE FUNDAMENTAL PHYSIOLOGICAL ACTIONS. 21 pole, the other towards the antipole. The whole nucleus elongates in the direction of the long axis of the spindle; the achromatin filaments disappear, and the nucleus dividing in B FIG. 10. — Diagrams representing more advanced stages of karyokinesis than those illustrated in Fig. 9. a, polar, and e, antipolar end of nuclear spindle; b and c, por- tions of the chromatic filament; rf, nucleoplasm; /, cell protoplasm with indications of a radial arrangement in the neighborhood of the pole and antipole. The nuclear spiudle is seen to have lengthened and become placed in the centre of the nucleus, the pole and antipole of which its ends reach. In A the Vs which resulted from divisions of the chromatic filament at its antipolar loops are seen to have become much shorter and thicker and to have changed position, so that in- stead of lying lengthwise in the nucleus, with their points towards the pole, they lie equatorially, with their points towards the spindle and their open ends towards the periphery of the nucleus. For the sake of clearness only two are represented out of the set of them which surrounds the spindle; 6 is still uncleft; c has nearly com- pleted its longitudinal division into two Vs, the angle of one of which is commencing to travel towards the pole and of the other towards the antipole. In B the splitting of the Vs and the progress of their halves towards the ends of the nucleus is more advanced. the equatorial plane, two nuclei are formed, each with nucleo- plasm and chromoplasm : the chromoplasm of each is derived, as follows from the preceding description, from both polar and antipolar regions of the parent nucleus. The chromoplasm in each daughter nucleus unites into a single convoluted chro- matic filament like that represented for the parent nucleus in Fig. 9, and this filament breaks up and becomes arranged into reticulum, nucleolus and nuclear membrane as in the resting cell (Figs. 7 and 8). Around the new nuclei the cell- protoplasm rearranges itself and divides to form a new cell-body enveloping each; during its rearrangement its material fre- quently presents a radial structure, the radii converging to- wards the ends of the nuclear spindle. The poles of the nuclear spindle, which it will be remembered represent the halves of 22 THE HUMAN BODY. the original centrosome, probably pass out of the new nuclei and become the attraction particles of the new cells. The phenomena of karyokinesis show clearly that in spite of its small size the animal cell is a complicated structure, made up of very distinct parts possessing very distinct properties and no doubt very different functions. Assimilation: Reproduction. The two powers, that of working up into their own substance materials derived from outside, known as assimilation, and that of, in one way or an- other, giving rise to new beings like themselves, known as re- production, are possessed by all kinds of living beings, whether animals or plants. There is, however, this important differ- ence between the two: the power of assimilation is necessary for the maintenance of each individual cell, plant or animal,. since the already existing living material is constantly break- ing down and being removed as long as life lasts, and the loss must be made good if any of them is to continue its existence. , *Fhe power of reproduction, on the other hand, is necessary only for the continuance of the kind or race, and need be, and often is, possessed only by some of the individuals composing it. Working bees, for example, cannot reproduce their kind, that duty being left to the queen-bee and the drones of each hive. The breaking down of already existing chemical compounds into simpler ones, sometimes called dissimilation, is as inva- riable in living beings as the building up of new complex mole- cules referred to above. It is associated with the assumption of uncombined oxygen from the exterior, which is then com- bined directly or indirectly with other elements in the cell, as, for example, carbon, giving rise to carbon dioxide, or hydro- gen, producing water. In this way the molecule in which the carbon and hydrogen previously existed is broken down and at the same time energy is liberated, which in all cases seems to take in part the form of heat just as when coal is burnt in a fire, but may be used in part for other purposes, such as pro- ducing movements. The carbon dioxide is usually got rid of by the same mechanism as that which serves to take up the oxygen, and these two processes constitute the function of respiration which occurs in all living things. Assimilation and dissimilation, going -on side by side and being to a certain extent correlative, are often spoken of together as the process of nutrition : the assimilative or chemically constructive pro- cesses are also named anabolic, and the dissimilative katabolic. THE FUNDAMENTAL PHYSIOLOGICAL ACTIONS. 23 Contractility. Nutrition and (with the above-mentioned partial exception) reproduction characterize all living creat- ures; and both faculties are possessed by the simple nucleated cells already referred to as found in our blood. But these cells possess also certain other properties which, although not so absolutely diagnostic, are yet very characteristic of living things. Examined carefully with a -microscope in a fresh- drawn drop of blood, they exhibit changes of form independent of any pressure which might distort them or otherwise mechani- cally alter their shape. These changes may sometimes show themselves as constrictions ultimately leading to the division of the cell ; but more commonly (Fig. 15*) they have no such result, the cell simply altering its form by drawing in its sub- stance at one point and thrusting it out at another. The portion thus protruded may in turn be drawn in and a pro- cess be thrown out elsewhere ; or the rest of the cell may col- lect around it, and a fresh protrusion be then made on the same side ; and by repeating this manoeuvre these cells ma change their place and creep across the field of the micro- scope. Such changes of form from their close resemblance to those exhibited by the microscopic animal known as the Amceba (see Zoology) are called amoeboid, and the faculty in the living cell upon which they depend is known in physiol- ogy as contractility. It must be borne in mind that physiol- ogical contractility in this sense is quite different from the so-called contractility of a stretched india-rubber band, which merely tends tp reassume a form from which it has previously freen forcibly removed. Irritability. Another property exhibited by these blood- cells is known as irritability. An Amoeba coming into con- tact with a solid particle calculated to serve it as food will throw around it processes of its substance, and gradually carry the foreign mass into its own body. The amount of energy expended by the animal under these circumstances is altogether disproportionate to the force of the external contact. It is not that the swallowed muss pushes-in mechanically the surface of the Amoeba, or burrows into it, but the mere touch arouses in the animal an activity quite disproportionate to the exciting force, and comparable to that set free by a spark falling into gunpowder or by a slight tap on a piece of gun- cotton. It is this disproportion between the excitant (known * P. 48. 24 THE HUMAN BODY. in Physiology as a stimulus) and the result, which is the es- sential characteristic of irritability when the term is used in a physiological connection. The granular cells of the blood can take foreign matters into themselves in exactly the same manner as an Amoeba does; and in this and in other ways, as by contracting into rigid spheres under the influence of elec- trical shocks, they show that they also are endowed with irri- tability. Conductivity. Further, when an Amoeba or one of these blood-cells comes into contact with a foreign body and pro- ceeds to draw it into its own substance, the activity excited is not merely displayed by the parts actually touched. Dis- tant parts of the cell also co-operate, so that the influence of the stimulus is not local only, but in consequence of it a change is brought about in other parts, arousing them. This prop- erty of transmitting disturbances is known as conductivity. Finally, the movements excited are not, as a rule, random. They are not irregular convulsions, but are adapted to attain a certain end, being so combined as to bring the external par- ticle into the interior of the cell. This capacity of all the parts to work together in definite strength and sequence to fulfil some purpose, is known as co-ordinations These Properties Characteristic but not Diagnostic. These four faculties, irritability, conductivity, contractility and co-ordination, are possessed in a high degree by our Bodies as a whole. If the inside of the nose be tickled with a feather, a sneeze will result. Here the feather-touch (stim- ulus) has called forth movements which are mechanically altogether disproportionate to the energy of the contact, so that the living Body is clearly irritable. The movements, which are themselves a manifestation of contractility, are not exhibited at the point touched, but at more or less distant parts, among which those of abdomen, chest and face are visible from the exterior ; our Bodies therefore possess physio- logical conductivity. And finally these movements are not random, but combined so as to produce a violent current of air through the nose tending to remove the irritating object; and in this we have a manifestation of co-ordination. Speak- ing broadly, these properties are more manifest in animals than in plants, though they are by no means absolutely con- fined to the former. In the sensitive plant touching one leaflet will excite regular movements of the whole leaf, and many of THE FUNDAMENTAL PHYSIOLOGICAL ACTIONS. 25 the lower aquatic plants exhibit movements as active as those of animals. On the other hand, no one of these four faculties is absolutely distinctive of living things in the way that growth by intussusception and reproduction are. Irritability is but a name for unstable molecular equilibrium, and is as marked in nitroglycerin as in any living cells; in the telephone the influence of the voice is conducted as a molecular change along a wire, and produces results at a distance; and many inanimate machines afford examples of the co-ordination of movements for the attainment of definite ends. Spontaneity. There is, however, one character belonging to many of the movements exhibited by amoeboid cells, in which they appear at first sight to differ fundamentally from the movements of inanimate objects. This character is their apparent spontaneity or automat icity. The cells frequently change their form independently of any recognizable external cause, while a dead mass at rest and unacted on from outside remains at rest. This difference is, however, only apparent and depends not upon any faculty of spontaneous action pe- culiar to the living cell, but upon its nutritive powers. It can be proved that any system of material particles in equi- librium and at rest will forever remain so if not acted upon by an external force. Such a system can carry on, usder cer- tain conditions, a series of changes when once a start has been given; but it cannot initiate them. Each living cell in the long-run is but a complex aggregate of molecules, composed in their turn of chemical elements, and if we sup- pose this whole set of atoms at rest in equilibrium at any moment, no change can be started in the cell from inside; in other words, it will possess no real spontaneity. When, how- ever, we consider the irritability of amoeboid cells, or, ex- pressed in mechanical terms, the unstable equilibrium of their particles, it becomes obvious that a very slight external cause, such as may entirely elude our observation, may serve to set going in them a very marked series of changes, just as pressing the trigger will fire off a gun. Once the equilibrium of the cell has been disturbed, movements either of some of its constitu- ent molecules or of its whole /mass will continue until all the molecules have again settled down into a stable state. But in living cells the reattainment of this state is commonly in- definitely postponed by the reception of new particles, food in one form or another, from the exterior. The nearest ap- 26 THE HUMAN BODY. proach to it is probably exhibited by the resting state into which some of the lower animals, as the wheel-animalcules, pass when dried slowly at a low temperature; the drying act- ing by checking the nutritive processes, which would other- wise have prevented the reattainment of molecular equilib- rium. All signs of movement or other change disappear under these circumstances, but as soon as water again soaks into their substance and disturbs the existing condition, then the so-called "spontaneous" movements recommence. If, therefore, we use the term spontaneity to express a power in a resting system of particles of initiating changes in itself, it is possessed neither by living nor not-living things. But if we simply employ it to designate changes whose primary cause we do not recognize, and whose cause was in many cases long antecedent to the changes which we see, then the term is unobjectionable and convenient, as it serves to ex- press briefly a phenomenon presented by many living things and finding its highest manifestation in many human actions. It then, however, no longer designates a property peculiar to them. A steam-engine with its furnace lighted and water in its boiler may be set in motion by opening a valve, and the movements thus started will continue spontaneously, in the above sense, until the coals or water are used up. The differ- ence between it and the living cell lies not in any spontaneity of the latter, but in its nutritive powers, which enable it to replace continually what answers to the coals and water of the engine. Protoplasm. The cell-body was formerly regarded as es- sentially made up of a single substance, which was named protoplasm : and now that its structure is known to be com- plex the term is retained as a convenient one for that mixture of spongioplasm and hyaloplasm which constitutes the main bulk of the bodies of most cells. With the protoplasm other . things are frequently presen^the most important ofjyjikili are either materials undergoing anabolic changes butno-t ^vet completely built up into protoplasm, or katabolic materials rpsnmnfr from the chemical degradation of protoplasm": these secondary matters, mingled with the completed proto- plasm, are conveniently spoken of as the cell deutoplasm or par a plasm. As between the spongioplasm and hyaloplasm there are still some differences of opinion as to which is the more immediate agent in the manifestation of the vital activ- THE FUNDAMENTAL PHYSIOLOGICAL ACTIONS. 27 ities of the cell. So far as the manifestation of the power of movement is concerned the evidence seems in favor of the hyaloplasm : the outermost parts of a white blood-corpuscle, for example, exhibit active contractile power, yet they con* tain no spongioplastic filaments; and many unicellular living things are known in which no reticular structure can be dis- covered and which nevertheless nourish themselves and are reproductive, irritable, contractile, conductive, co ordinative and automatic. It is therefore possible that the filaments when present are to be regarded as secondary in importance to the hyaloplasm, partly serving as a mechanical support; but in addition they may play an important part in the inter- nal economy of the cell. The study of the physiology of in- dividual cells presents very great difficulties and is yet in its beginnings, so that we can do little more than speak of the properties of the cell as a whole, though from the frequent radial arrangement of the cell-protoplasm, in its neighborhood and from the part it plays in the initiation of cell division, the attraction-particle appears to have a very important role. Of the actual chemical composition of living matter we know only that its molecule is one of great complexity: all methods of chemical analysis break it up and alter it funda- mentally, so that what is really analyzed is not living matter but a mixture of the products of its decomposition, among which proteid substances are always prominent. Cell-protoplasm no doubt varies a little in different cells, so that the name is to be regarded as a general term designat- ing a number of closely-allied substances agreeing with one another chemically in main points, as the proteids do, but differing in minor details, in consequence of which one cell differs from another in faculty. On proximate analysis every mass of protoplasm is found to contain much water and a certain amount of mineral salts; the water being in part con- stituent or entering into the structure of the particles of pro- toplasm, and in part probably deposited in layers between them. Of organic constituents protoplasm always yields one or more proteids, some fats, and some starchy or saccharine / body/ So that the original protoplasm is probably to be re- garded as containing chemical "residues" of proteids, fats and carbohydrates, combined with salts and water. The name nuclein has been given to a substance or mix- ture of substances which are left behind when the cell-proto- 28 THE HUMAN BODY. plasm has been dissolved away by various reagents : it con- tains a considerable quantity of phosphorus. In the living nucleus nuclein seems to be combined with various proteids to form nudeo-albumins. The Fundamental Physiological Properties. All living animals possess in greater or less degree the properties con- sidered in this chapter; and since the science of physiology is virtually concerned with considering how these properties are acquired, maintained and manifested,, and for what ends they are employed, we may call them the fundamental physi- ological properties. CHAPTER III. THE DIFFERENTIATION OF THE TISSUES AND THE PHYSIOLOGICAL DIVISION OF EMPLOYMENTS. Development. Every Human Body commences its indi- idual existence as a single nucleated cell. This cell, known s the ovum, divides or segments and gives rise to a mass con- FtG. llA.-^l, an ovum; B to E, successive stages in its segmentation until the orula, F, is produced; a, cell-sac; 6, cell contents; c, nucleus. sting of a number of similar units and called the mulberry mss or the morula. At this stage, long before birth, there re no distinguishable tissues entering into the structure of Body, nor are any organs recognizable. For a short time the morula increases in size by the rowth and division of its cells, but very soon new processes ccur which ultimately give rise to the complex-adult body ith its many tissues and organs. Groups of cells ceasing to row and multiply like their parents begin to grow in ways eculiar to themselves, and so come to differ both from the riginal cells of the morula and from the cells of other groups, ad this unlikeness becoming more and more marked, a iried whole is finally built up from one originally alike in 29 30 THE HUMAN BODY. ail its parts. Peculiar growth of this kind, forming a com plex from a simple whole, is called development; and the pro cess itself in this case is known as the differentiation of tli tissues, since by it they are, so to speak, separated or special izcd from the general mass of mother-cells forming th morula. As the differences in the form and structure of the con ells of the morula become marked, differences ii property arise, and it becomes obvious that the whole cell gate is not destined to give rise to a collection of hide pendent living things, but to form a single human being, ii whom each part, while maintaining its own life, shall hav duties to perform for the good of the whole. In other words a single compound individual is to be built up by the unio] and co-operation of a number of simple ones represented b the various cells, each of which thenceforth, while primaril looking after its own interests and having its own peculia faculties, has at the same time its activities subordinated t the good of the entire community. The Physiological Division of Labor. The fundaments physiological properties, originally exhibited by all the cells become ultimately distributed between the different modifie cells which form the tissues of the fully developed Bod much in the same way as different employments are dis tributed in a civilized state; for the difference between th full} developed Human Body and the collection of amosboi cells from which it started is essentially the same as tha between a number of wandering savages arid a civilized natioi In the former, apart from differences dependent on sex, eac individual has no one special occupation different from tha of the rest, but has all his own needs to look after: he mug collect his own food and prepare it for eating, make his ow clothes, if he wear any, provide his own shelter, and defen himself from wild beasts or his fellow men. In the civilize country, on the other hand, we find agriculturists to rais food and cooks to prepare it, tailors to make clothes, an policemen and soldiers to provide protection. And just £ we find that when distribution of employments in it is moi minute a nation is more advanced in civilization, so is a annual higher or lower in the scale according to the degre in which it exhibits a division of physiological duties betwee its different tissues. THE DIFFERENTIATION OF TISSUES. From the subdivision of labor in advanced communities several important consequences arise. In the first p! man devoting himself to one kind of work mainly and relying upon others for the supply of his other needs, every sort of work is better done. The man who is constantly making boots becomes more expert than one whose attention is con- stantly distracted by other duties, and he can not only make more boots in a given time, but better ones; and so with the performance of all other kinds of work. In the second place, a necessity arises for a new sort of industry, in order to con- vey the produce of one individual in excess of the needs of limself and his family to those at a distance who may want it, and to convey back in return the excess of their produce which he needs. The carriage of food from the country to cities, and of city produce to country districts, and the occu- pation of shopkeeping, are instances of these new kinds of labor which arise in civilized communities. In addition there is developed a need for arrangements by which the work of .ndividuals shall be regulated in proportion to the wants of ;he whole community, such as is in part effected by the agency of large employers of labor who regulate the activities of a number of individuals for the production of various articles in the different quantities required at different times. Exactly similar phenomena result from the subdivision of iabor in the Human Body. By the distribution of employ- ments between its different tissues, each one specially doing one work for the general community and relying on the others for their aid in turn, every necessary work is better performed. And a need arises for a distributive mechanism by which the excess products, if any, of various tissues shall be carried to others which require them, and for a regulative mechanism by which the activities of the various tissues shall be rendered proportionate to the needs of the whole Body at different times and under different circumstances. Classification of the Tissues. — As we might separate the inhabitants of the United States into groups, such as lawyers, doctors, clergymen, merchants, farmers, and so forth, so we may classify the tissues by selecting the most distinctive properties of each of those entering into the construction of the adult Body and arranging them into physiological groups; those of each group being characterized by some one promi- nent employment. No such classification, however, can be THE HUMAN BODY. nore than approximately accurate, since the same tissue has often more than one well-marked physiological property. The following arrangement, however, is practically convenient 1. UNDIFFERENTIATED TISSUES. These are composed oil cells which have developed along no one special line, but retain very much the form and properties of the cells forming the very young Body before different tissues were recognizable! in it. The lymph-corpuscles and the colorless corpuscles oJ the blood belong to this class. 2. SUPPUKIJNG TISSUES. Including cartilage (gristle), and connective tissue. Of the latter there are seven subsidiary varieties, the two more important being -whiti fibrous connective tissue, composed mainly of colorless inex- tensible fibres, and yelloio fibrous tissue, composed mainly of yellow elastic fibres. All the supporting tissues are used in the Body for mechanical purposes : the bones and cartilage form the hard framework by which softer tissues are supporte and protected; and the connective tissues unite the various bones and cartilages, form investing membranes around dif- ferent organs, and in the form of fine networks penetrate their substance and support their constituent cells. The functions of these tissues being for the most part to passively resist strain or pressure, none of them has any very marked phy- siological property; they are not, for exai( ^ .\ fri-i table or contractile, ;iiid their mass is chiefly made up o'i an intercell- ular substance which has been formed by the actively living cells sparsely scattered through them, as for instance in cartilage, Fig. 45, where the cells are seen imbedded in cavi- ties in a matrix which they have formed around them; and this matrix by its firmness and elasticity forms the func- tionally important part of the tissue. * 3. NUTRITIVE TISSUES. These form a large group, the members of which fall into three main divisions, viz. : [ssimilative tissues, concerned in receiving and preparing food materials, and including — (a) Secretory tissues, com- posed of cells which make the digestive liquids poured into the alimentary canal and used to bring about chemical or other changes in the food, (b] Receptive tissues, represented by cells which line parts of the alimentary canal and take up the digested food. Eliminative or feretory tissues, represented by cells in the THE DIFFERENTIATION OF TISSUES, 33 kidneys, skin, and elsewhere, whose main business it is to get rid of the waste products of the various parts of the Body. Respiratory tissues. These are concerned in the gaseous interchanges between the Body and the surrounding air. They are constituted by the cells lining the lungs and by the colored corpuscles of the blood. As regards the nutritive tissues it requires especially to be borne in mind that although such a classification as is here given is useful, as helping to show the method pursued in the domestic economy of the Body, it is only imperfect and largely artificial. Every cell of the Body is in itself assimi- lative, respiratory, and excretory, and the tissues in this class are only those concerned in the first and .ast interchanges of material between it and the external world. They provide or get rid of substances for the whole Body, leaving the feed- ing and breathing and excretion of its individual tissues to be ultimately looked after by themselves, just as even the mandarin described by Robinson Crusoe who found his dignity promoted by having servants to put the food into his mouth, had finally to swallow and digest it for himself. Moreover, there is no logical distinction between a secretory and an excretory cell: each of them is characterized by the separation of certain sub- stances which are poured out on a free surface on the exterior or interior of tl^ * ^ . Many secretory cells too have no concern with the digestion of food, as for example those which form the tears and sweat. 4. STORAGE TISSUES. The Body does not live from hand to mouth: it has always in health a supply of food-materials accumulated in it beyond its immediate needs. This lies in part in the individual cells themselves, just as in a prosperous community nearly every one will have some little pocket- money. But apart from this reserve there are certain cells, a sort of capitalists., which store up considerable quantities of material and constitute what we will call the storage tissues. These are especially represented by the liver-cells and fat- cells, which contain in health a reserve fund for the rest of the Body. Since both of these, together with secretorv and excretory cells, are the seats of great chemical changes they are all often called metabolic tissues. 5. IRRITABLE TISSUES. The maintenance, or at any rate the best prosperity, of a nation is not fully secured wheu a division of labor has taken place in food-supply and food-dis- 34 THE HUMAN BODY. tribution employments. It is extremely desirable that means shall be provided by which it may receive information of ex ternal changes which may affect it as a whole, such as the policy of foreign countries; or which shall enable the inhabi- tants of one part to know the needs of another, and direct their activity accordingly. Foreign ministers and consuls and newspaper correspondents are employed to place it in com- munication with other states and keep it informed as to its interests; and we find also organizations, such as the meteor- ological department, to warn distant parts of approaching storms or other climatic changes which may seriously affect the pursuits carried on in them. In the Human Body we have a comparable class of intelligence-gaining tissues lying in the sense-organs, whose business it is to obtain and com- municate to the whole information of external changes which occur around it. Since the usefulness of these tissues depends upon the readiness with which slight causes excite them to activity, we may call them the irritable tissues. 6. CO-ORDINATING AND AUTOMATIC TISSUES. Such in- formation as that collected by ministers in foreign parts or by meteorological observers is usually sent direct to some central office from which it is redistributed; this mere redistribution is, however, in many cases but a small part of the work carried on in such offices. Let us suppose information to be obtained that an Indian chief is collecting his men for an attack on some point. The news is probably first transmitted to Wash- ington, and it becomes the duty of the executive officers there to employ certain of the constituent units of the nation in such definite work as is needed for its protection. Troops, have to be sent to the place threatened perhaps; recruits en- listed ; food and clothes, weapons and ammunition, must be provided for the army; and so on. In other words, the work of the various classes composing the society has to be organ- ized for the common good ; the mere spreading the news of the danger would be of little avail. So in the Body: the information forwarded to certain centres from the irritable tissues is used in such a way as to arouse to orderly activ- ity other tissues whose services are required ; we find thus in these centres a group of co-ordinating tissues, represented by nerve-cells and possibly by certain other constituents of the nerve-centres. Certain nerve-cells are also automatic in the physiological sense already pointed THE DIFFERENTIATION OF TISSUES. 35 out. The highest manifestation of this latter faculty, shown objectively by muscular movements, is subjectively known as the " will," a state of consciousness; and other mental phe- nomena, as sensations and emotions, are also associated with the activity of nerve-cells lying in the brain. ^JHow it is that any one state of a material cell should give rise to a particular state of consciousness is a matter quite beyond our powers of conception Abut not really more so than how it is that every portion 01 matter attracts every other portion according to the law of gravitation. In the living Body, as elsewhere in the universe, we can study phenomena and make out their relations of sequence or coexistence; but why one phenom- enon is accompanied by another, why in fact any cause pro- duces an effect, is a matter quite beyond our reach in every case; whether it be a sensation accompanying a molecular change in a nerve-cell, or the fall of a stone to the ground in obedience to the force of gravity. 7. MOTOR TISSUES. These have the contractility of the original protoplasmic masses highly developed. The more important are ciliated cells and muscular tissue. The former line certain surfaces of the body, and possess on their free surfaces fine threads which are in constant movement. One finds such cells, for example (Fig. 50), lining the inside of the windpipe, where their threads or cilia serve, by their motion, to sweep any fluid formed there towards the throat, where it can be coughed up and got rid of. Muscular tissue occurs in two main varieties. One kind is found in the mus- cles attached to the bones, and is that used in the ordinary vol- untary movements of the Body. It is composed of fibres which present cross-stripes when viewed under the microscope (Fig. 56), and is hence known as striped or striated muscular tis- sue. The other kind of muscular tissue is found in the walls of the alimentary canal and some other hollow organs, and con- sists of elongated cells (Fig. 60) which present no cross-stria- tion. It is known as plain or unstriated muscular tissue. The cells enumerated under the heading of "undiffer- entiated tissues" might also be included among the motor tissues, since they are capable of changing their form. 8. THE CONDUCTIVE TISSUES. These are represented by the nerve-fibres, slender threads, each of which has as its essen- tial part a branch of a nerve-cell having the property of physio- logical conductivity highly developed; the fibres therefore 36 THE HUMAN BODY. readily transmit molecular disturbances. When its equilib- rium is upset at one end, a nerve-fibre transmits to its other end a molecular movement known as a "nervous impulse" and so can excite parts distant from the original exciting force. Nerve-fibres place, on the one hand, the irritable tissues in connection with the automatic, co-ordinating, and sensory; and on the other put the three latter in communica- tion with the muscular, secretory and other tissues. 9. PROTECTIVE TISSUES. These consist of certain cells lin- ing cavities inside the body and called epithelial cells, and cells covering the whole exterior of the Body and forming epider- mis, hairs and nails. The enamel which covers the teeth belongs also to this group. The class of protective tissues is, how- ever, even, more artificial than that of the nutritive tissues, and cannot be defined by positive characters. Many epithelial cells are secretory, excretory or receptive; and ciliated cells have already been included \r^ FI -th amorig the motor tissues, although from lium-ceiis from the sur- the fact that the movements of their cilia face of the peritoneum. , , _, _ . _, «, cell-body ; c, nucleus; so on in separated cells and independently 6, nucleoli. &. • ui i *.- v ^ of recognizable external stimuli, they might well have been put among the automatic. The protec- tive tissues may be best defined as including cells which cover free surfaces, and whose functions are mainly mechanical or physical. In their simplest form epithelial cells are flat scales, as, for example, those represented in Fig. HB, from the lining membrane of the abdominal cavity. 10. THE EEPRODUCTIVE TISSUES. These are concerned in the production of new individuals, and in the Human Body are of two kinds, located in different sexes. The conjunction of the products of each sex is necessary for the origination of offspring, since the female product, egg-cell or ovum, which directly develops into the new human being, remains dormant until it has \>QZ\\ fertilized, and fertilization consists essentially in the fusion of its nucleus with the nucleus of a cell produced by the male. The Combination of Tissues to Form Organs. The va- rious tissues above enumerated forming the building materials of the Body, anatomy is primarily concerned with their struc- THE DIFFERENTIATION OF TISSUES. 37 ture, and physiology with their properties, If this, however, were the whole matter, the problems of anatomy and physi- ology would be much simpler than they actually are. The knowledge about the living Body obtained by studying only the forms and functions of the individual tissues would be com- parable to that attained about a great factory by studying separately the boilers, pistons, levers, wheels, etc., found in it, and leaving out of account altogether the way in which these are combined to form various machines; for in the Body the various tissues are for the most part associated to form organs, each organ answering to a complex machine like a steam-engine with its numerous constituent parts. And just as in different machines a cogged wheel may per- form very different duties, dependent upon the way in which it is connected with other parts, so in the Body any one tissue, although its essential properties are everywhere the same, may by its activity subserve very various uses according to the manner in which it is combined with others. For ex- ample: A nerve-fibre uniting the eye with one part of the brain will, by means of its conductivity, when its end in the eye is excited by the irritable tissue attached to it on which light acts, cause changes in the sensory nerve-cells connected with its other end and so arouse a sight sensation; but an ex- actly similar nerve-fibre running from the brain to the mus- cles will, also by virtue of its conductivity, when its ending in the brain is excited by a change in a nerve-cell connected with it, stir up the muscle to contract under the control of the will. The different results depend on the different parts connected with the ends of the nerve-fibres in each case, and not on differences in the properties of the nerve-fibres them- selves. It becomes necessary then to study the arrangement and uses of the tissues as combined to form various organs, and this is frequently far more difficult than to make out the structure and properties of the individual tissues. An ordi- nary muscle, such as one sees in the lean of meat, is a very complex organ, containing not only contractile muscular tis- sue, but supporting and uniting connective tissue and con- ductive nerve-fibres, and in addition a complex commissariat arrangement, composed in its turn of several tissues, con- cerned in the food-supply and waste removal of the whole muscle. The anatomical study of a muscle has to take into 38 THE HUMAN BODY. account the arrangement of all these parts within it, and also its connections with other organs of the Body. The physi- ology of any muscle must take into account the actions of all these parts working together and not merely the functions of the muscular fibres themselves, and has also to make out under what conditions the muscle is excited to activity by changes in other organs, and what changes in these it brings about when it works. Physiological Mechanisms. Even the study of organs added to that of the separate tissues does not exhaust the matter. In a factory we frequently find machines arranged so that two or more shall work together for the perform- ance of some one work: a steam-engine and a loom may, for example, be connected and used together to weave carpets. Similarly in the Body several organs are often arranged to work together so as to attain some one end by their united actions. Such combinations are known as physiological ap- paratuses. The circulatory apparatus, for example, consists of various organs (each in turn composed of several tissues) known as heart, arteries, capillaries and veins. The heart forms a force-pump by which the blood is kept flowing through the whole mechanism, and the rest, known together as the blood-vessels , distribute the blood to the various organs and regulate the supply according to their needs. Again, in the visual apparatus we find the co-operation of (a) a set of optical instruments which bring the light proceeding from external objects to a focus upon (b) the retina, which con- tains highly irritable parts; these, changed by the light, stimulate (c) the optic nerve, which is conductive and trans- mits a disturbance which arouses in turn (d) sensory parts in the brain. In the production of ordinary sight sensations all these parts are concerned and work together as a visual appa- ratus. So, too, we find a respiratory apparatus, consisting primarily of two hollow organs, the lungs, which lie in the chest and communicate by the windpipe with the back of the throat, from which air enters them. But to complete the respiratory apparatus are many other organs, bones, muscles, nerves and nerve-centres, which work together to renew the air in the lungs from time to time; and the act of breathing is the final result of the activity of the whole apparatus. Many similar instances, as the alimentary apparatus, the THE DIFFERENTIATION OF TISSUES. 39 auditory apparatus, and so on, will readily be thought of. The study of the working of such complicated mechanisms forms a very important part of physiology. Anatomical Systems. From the anatomical side a whole collection of bodily organs agreeing in structure with on,e another is often spoken of as a system ; all the muscles, for example, are grouped together as the muscular system, and all the bones as the osseous system, and so on, without any reference to the different uses of different muscles or bones. The term system is, however, often used as equivalent to "apparatus": one reads indifferently of the "circulatory sys- tem " or the " circulatory apparatus." It is better, however, to reserve the term system for a collection of organs classed together on account of similarity of structure; and "appa- ratus " for a collection of organs considered together on ac- count of their co-operation to execute one function. The former term will then have an anatomical, the latter a phy- siological, significance. The Body as a Working Whole. Finally it must all through be borne in mind that not even the most complex system or apparatus can be considered altogether alone as an independently living part. All are united to make one living Body, in which there is throughout a mutual interdepend- ence, so that the whole forms one human being, in whom the circulatory, respiratory, digestive, sensory and other appara- tuses are constantly influencing one another, each modifying the activities of the rest. This interaction is mainly brought about through the conductive and co-ordinating tissues of the nervous system, wrhich place all parts of the Body in com- munication. But in addition to this another bond of union is formed by the blood, which by the circulatory apparatus is carried from tissue to tissue and organ to organ and so, bring- ing materials derived in one region to distant parts, enables each organ to influence all the rest for good or ill. Besides the blood another liquid, called lymph, exists in the Body. It is contained in vessels distinct from those which carry the blood, but emptying into the blood-vessels at certain points. This liquid being also in constant movement forms another agency by which products are carried from part to part, and the welfare or ill-fare of one member en- abled to influence all. V CHAPTER IV. « THE INTEKNAL MEDIUM. • » The External Medium. During the whole of life inter- changes of material go on between every living being and the external world; by these exchanges material particles that one time constitute parts of inanimate objects come at an- other to form part of a living being; and later on these same atoms, after having been a part of a living thing, are passed out from it in the form of lifeless compounds. As the foods and wastes of various organisms differ more or less, so are more or less different environments, suited for their existence; and there is accordingly a relationship be- tween the plants and animals living in any one place and the conditions of air, earth and water prevailing there. Even such simple unicellular animals as the amoebae live only in water or mud containing in solution certain gases, and in sus- pension solid food-particles; and they soon die if the water be changed either by essentially altering its gases or by taking out of it the solid food. So in yeast we find a unicellular plant which thrives and multiplies only in liquids of certain composition, and which in the absence of organic compounds of carbon in solution will not grow at all. Each of these simple living things, which corresponds to one only of the in- numerable cells composing the full-grown Human Body, thus requires for the manifestation of its vital properties the pres- ence of a surrounding medium suited to itself: the yeast would die, or at the best lie dormant, in a liquid containing only the solid, organic particles on which the amoeba lives ; and the amoeba would die in such solutions as those in which yeast thrives best. The Internal Medium. A similar close relationship be- tween the living being and its environment, and an inter- change between the two like that which we find in the amoeba and the yeast-cell, we find also in even the most complex living beings. When, however, an animal comes to be com- TEE INTERNAL MEDIUM. 41 p03ed of many cells, some of which are placed far away from the surface of its body and from immediate contact with the environment, there arises a new need — a necessity for an internal medium o\* plasma which shall play the same part toward the individual cells as the surrounding air, water and food to the whole animal. This internal medium kept in movement and receiving at some regions of the bodily sur- faces materials from the exterior, while losing substances to the exterior at the same or other surfaces, forms a sort of middleman between the individual tissues and- the surround- ing world, and stands in the same relationship to each of the cells of the Body as the water in which an amoeba lives does to that animal, or beer-wort does to a yeast-cell. We find accordingly the Human Body pervaded by a liquid plasma, containing gases and food-material in solution, the presence of which is necessary for the maintenance of the life of the tissues. Any great change in this medium will affect in- juriously few or many of the groups of cells in the Body, or may even cause their death; just as altering the media in which they live will kill an amoeba or a yeast-cell. The Blood. In the Human Body the internal medium is primarily furnished by the Uood, which, as every one knows, is a red liquid very widely distributed over the frame, since it flows from any part when the skin is cut through. There are in fact very few portions of the Body into which the blood is not carried. One of the exceptions is the epidermis or outer layer of the skin : if a cut be made through it only, leaving the deeper skin-layers intact, no blood will flow from the wound. Hairs and nails also contain no blood. In the interior of the Body the epithelial layers lining free surfaces, such as the inside of the alimentary canal, contain no blood, nor do the hard parts of the teeth, the cartilages, and the refracting media of the eye (see Chap. XXXII), but these interior parts are moistened with liquid of some kind, and unlike the epidermis are protected from rapid evaporation. All these bloodless parts together form a group of non-vas- cular tissues; they alone excepted, a wound of any part of the Body will cause bleeding. In many of the lower animals there is no need that the liquid representing their blood should be renewed very rapidly in different parts. Their cells live slowly, and so require but little food and produce but little waste. In a sea-anemone, 42 THE HUMAN BODY. for example, there is no special arrangement to keep the blood moving; it is just pushed about from part to part by the general movements of the body of the animal. But in higher animals, especially those with an elevated temperature, such an arrangement, or rather absence of arrangement, as this would not suffice. In them the constituent cells live very fast, making much waste and using much food, and altering the blood in their neighborhood very rapidly. Be- sides, we have seen that in complex animals certain cells are set apart to get food for the whole organism and certain others to finally remove its wastes, and there must be a sure and rapid interchange of material between the feeding and excreting tissues and all the others. This can only be brought about by a rapid movement of the blood in a definite course, and that is accomplished by shutting it up in a closed set of tubes, and placing somewhere a pump, which constantly takes in blood from one end of the system of tubes and forces it out again into the other. Sent by this pump, the hearf, through all parts of the Body and back to the heart again, the blood gets food from the receptive cells, takes it to the working cells, carries off the waste of these latter to the ex- creting cells; and so the round goes on. The L'ymph. The blood, however, lies everywhere in closed tubes formed by the vascular system, and does not come into direct contact with any cells of the Body except those which float in it and those which line the interior of the blood-vessels. At one part of its course, how- ever, the vessels through which it passes have extremely thin coats, and through the walls of these capillaries liquid transudes from the blood and bathes the various tissues. The transuded liquid is the lymph, and it is this which forms Fro. 12.— Adia- the immediate nutrient plasma -of the tissues fug" Apparatus" except the few which the blood moistens di- containing two vppHv liquids, 6 and c, r 'UJ; separated by a Dialysis. When two liquids containing dif- moist animal . ° membrane. ferent matters in solution are separated from one another by a moist animal membrane, an interchange of material will take place under certain conditions. If A be a vessel (Fig. 12) completely divided vertically by such a mem- brane, and a solution of common salt in water be placed on the side Z>, and a solution of sugar in water on the side c, it THE INTERNAL MEDIUM. 43 will be found after a time that some salt has got into c and some sugar into b, although there are no visible pores in the partition. Such an interchange is said to be due to dialysis or osmosis, and if the process were allowed to go on for some hours the same proportions of salt and sugar would be found in the solution on either side of the dividing membrane. The Renewal of the Lymph. Osmotic phenomena play a great part in the nutritive processes of the Body. The lymph present in any organ gives up things to the cells there and gets things from them ; and thus, although it may have originally been tolerably like the liquid part of the blood, it soon acquires a different chemical composition. Diffusion or dialysis then commences between the lymph outside and the blood inside the capillaries, and the latter gives up to the lymph new materials in place of those which it has lost and takes from it the waste products it has received from the tis- sues. When this blood, altered by exchanges with the lymph, gets again to the neighborhood of the receptive cells, having lost some food-materials it is poorer in these than the richly supplied lymph around those cells, and takes up a supply by dialysis from it. When it reaches the excretory organs it has previously picked up a quantity of waste matters and loses these by dialysis to the lymph there present, which is special- ly poor in such matters, since the excretory cells constantly deprive it of them. In consequence of the different wants and wastes of variou-s cells, and of the same cells at different times, the lymph must vary considerably in composition in various organs of the Body, and the blood flowing through them will gain or lose different things in different places. But renewing during its circuit in one what it loses in another, its average composition is kept pretty constant, and, through interchange with it, the average composition of the lymph also. The Lymphatic Vessels. The blood, on the whole, loses more liquid to the lymph through the capillary walls than it receives back the same way. This depends mainly on the fact that the pressure on the blood inside the vessels is greater than that on the lymph outside, and so a certain amount of nitration of liquid- from within out occurs through the vas- cular wall in addition to the dialysis proper. The excess is collected from the various organs of the Body into a set of lymphatic vessels which carry it directly back into some of 44 THE HUMAN BODY. the larger blood-vessels near where these empty into the heart; by this flow of the lymph, under pressure from behind, it is renewed in various organs, fresh liquid filtering through the capillaries to take its place as fast as the old is carried off. The Lacteals. Jn the walls of the alimentary canal cer- tain food-materials after passing through the receptive cells into the lymph are not transferred locally, like the rest, by dialysis into the blood, but are carried off bodily in the lymph- vessels and poured into the veins of a distant part of the Body. The lymphatic vessels concerned in this work, being frequently filled with a white liquid during digestion, are called the milky or lacteal vessels. Summary. To sum up: the blood and lymph form the internal medium in which the tissues of the Body live; the lymph is primarily derived from the blood and forms the im- mediate plasma for the great majority of the living cells of the Body; and the excess of it is finally returned to the blood. The lymph moves but slowly, but is constantly reno- vated by the blood, which is kept in rapid movement, and which, besides containing a store of new food-matters for the lymph, carries off the wastes which the various cells have poured into the latter, and thus is also a sort of sewage stream into which the wastes of the whole Body are primarily col- lected. Microscopic Characters of Blood. If a finger be pricked, and the drop of blood flowing out be spread on a glass slide, covered, protected from evaporation, and examined with a microscope magnifying about 400 diameters, it will be seen to consist of innumerable solid bodies floating in a liquid. The solid bodies are the blood-corpuscles, and the liquid is the blood-plasma or liquor sanguinis. The corpuscles are not all alike. While currents still exist in the freshly-spread drop of blood, the great majority of them are readily carried to and fro; but a certain number more commonly stick to the glass and remain in one place. The former are the red, the latter the pale or colorless blood- corpuscles. Red Corpuscles. Form and Size. The red corpuscles as they float about frequently seem to vary in form, but by ^ little attention it can be made out that this appearance is due to their turning round as they float, and so presenting differ- ent aspects to view; just as a silver dollar presents a different THE INTERNAL MEDIUM. 45 outline according as it is looked at from the front or edge- wise or in three-quarter profile. Sometimes the corpuscle (Fig. 13, B] appears circular; then it is seen in full face; sometimes linear ((?), and slightly narrowed in the middle; sometimes oval, as the dollar when half-way between a full and a side view. These appearances show that each red corpuscle is a circular disk, slightly hol- lowed in the middle (or biconcave) and about four times as wide as it is thick. The average transverse diameter is 0.008 milimeter (^Vo inch). Shortly after blood is drawn the FIG. 13.— Blood-corpuscles. A, magnified about 400 diameters. The red corpus- cles have arranged themselves in rouleaux ; a, a, colorless corpuscles ; B, red cor- puscles more magnified and seen in focus : E. a red corpuscle slightly out of focus. Near the right-hand top corner is a red corpuscle seen in three-quarter face, and at Cone seen edgewise.' F, (?, H, I, white corpuscles highly magnified. corpuscles arrange themselves in rows, or rouleaux, adhering to one another by their broader surfaces. Color. — Seen singly each red corpuscle is of a pale yellow color; it is only when collected in masses that they appear red. The blood owes its red color to the great numbers of these bodies in it; if it is spread out in a very thin layer it, too, is yellow. In a cubic millimeter (^ inch) of blood there are about five million red corpuscles. Structure.— Seen from the front the central part of each red corpuscle in a certain focus of the microscope appears dimmer or darker than the rest (Fig. 13, B), ex- 46 THE HUMAN BODY. cept a narrow band near the outer rim. If the lens of the microscope be raised, however, this previously dimmer central part becomes brighter, and the previously brighter part ob- scure (E). This difference in appearance does not indicate the presence of a central part or nucleus different from the rest, but is an optical phenomenon due to the shape of the corpuscle, in consequence of which it acts like a little bicon- cave lens. Rays of light passing through near the centre of the corpuscles are refracted differently from those passing through elsewhere; and when the microscope is so focussed that the latter reach the eye, the former do not, and vice versa ; thus when the central parts look bright, those around them look obscure, and the contrary. There is no satisfactory evidence that these corpuscles have any enveloping sac or cell-wall. All the methods used to bring one into view under the microscope are such as would coagulate the outer layers of the substance composing the corpuscle and so make an artificial envelope. So far as optical analysis goes, then, each corpuscle is homogeneous throughout. By other means we can, however, show that at least two materials enter into the structure of each red cor- puscle. If the blood be diluted with several times its own bulk of water and examined with the microscope, it will be found that the formerly red corpuscles are now colorless and the plasma colored. The dilution has caused the coloring matter to pass out of the corpuscles and dissolve in the liquid. This coloring constituent of the corpuscle is h&moglolin, and the colorless residue which it leaves behind and which swells up into a sphere in the diluted plasma is the stroina. In the living corpuscle the two are intimately mingled throughout it, and so long as this is the case the blood is opaque; but when the coloring matter dissolves in the plasma, then the blood becomes transparent, or, as it is called, laky. The difference may be very well seen by comparing a thin layer of fresh blood diluted with ten times its volume of ten-per-cent salt solution with a similar layer of blood diluted with ten volumes of water. The watery mixture is a dark transparent red; the other, in which the coloring matter still lies in the corpuscles, is a brighter opaque red. Consistency. — Each red corpuscle is a soft jelly-like mass which can be readily crushed out of shape. Unless the pres- sure be such as to rupture it, the corpuscle immediately reas- & THE INTERNAL MEDIUM. 47 sumes its proper form when the external force is removed. The corpuscles are, then, highly elastic; they frequently can be seen much dragged out of shape inside the vessels when the circulation of the blood is watched in a living animal (Chap. XV), but immediately springing back to their normal form when they get a chance. Blood-crystals. Haemoglobin is, as above shown, readily soluble in water. In this it soon decomposes if kept in a warm room, breaking up into a colorless proteid substance called globulin and a red body, Jicematin. By keeping the haemoglobin solution very cold, however, this decomposition, can be greatly retarded, and at the same time the solubility of the haemoglobin in the water much diminished. In dilute alcohol haemoglobin is still less soluble, and so if its ice-cold watery solution have one j ^~ z^a . fourth of its volume of % ^r f ^ -— cold alcohol added to it iP^ rd^ ^H and the mixture be put in, ^0^ <|j a refrigerator for twenty- S^"~ 3 ^ittK f°U1' hours, a part of the haemoglobin will often crystallize out and sink to the bottom of the vessel, FIG. 14,-Biood.crystais, or haemoglobin where it can be collected for crystals, examination. The haemo- globin of the rat is less soluble than that of man, and there- fore crystallizes out especially easily; but these haemoglobin crystals, or, as they are often called, blood-crystals, can also be obtained from human blood. In 100 parts of dry human red blood-corpuscles there aro of 90 haemoglobin. The haemo- globin is the essential constituent of the red blood-corpuscles, enabling them to pick up Targe quantities of oxygen in the lungs and carry it to other parts. (See Respiration.) Haemoglobin contains a considerable quantity of iron, much, more than any other proximate constituent of the Body. The Colorless Blood -corpuscles (Fig. 13, F, H, G). The colorless, pale or white corpuscles of the blood are far less numerous thai: the red; in health there is on the average about one white to three hundred red, but the proportion may vary considerably Each is finely granular and consists of a soft mass of protoplasm enveloped in no definite cell-wall, but containing a nucleus. The granules in the protoplasm. 48 THE HUMAN BODY. commonty hide the nucleus in a fresh corpuscle, but dilute acetic acid dissolves most of them and brings the nucleus into view. These pale corpuscles belong to the group of undiffer- entiated tissues, and differ in no important recognizable character from the cells which make up the whole very young Human Body, nor indeed from such a unicellular animal as an Amoeba. They have the power of slowly changing their form spontaneously. At one moment a pale corpuscle will be seen as a spheroidal mass; a few seconds later (Fig. 15) processes will be seen radiating from this, and soon after these processes may be retracted and ot hers thrust out; and so the corpuscle goes on changing its shape. These slow amoeboid movements are greatly promoted by keeping the specimen of blood at the temperature of the Body. By thrusting out a process on one side, then drawing FIG. 15. -A white blood- the rest of its body up to it, and then \enterfaiseof aa sfew sending out a process again on the same fW^dS VIS side, the corpuscle can slowly change its movements. I^QQ and creep across the field of the microscope. Inside the blood-vessels these corpuscles often execute similar movements; and they sometimes bore right through the capillary walls and, getting out into the lymph- spaces, creep about among the other tissues. This migration is especially frequent in inflamed parts, and the pus or "matter" which collects in abscesses is largely made up of whiue blood-corpuscles which have in this way got out of the blood-vessels. The average diameter of the white corpuscles is one third greater than that of the red. The colorless corpuscles, or some of them, are capable of taking into themselves foreign particles present in the blood; this they do in a manner similar to that in which an amoeba feeds: the process is known as phagocytosis and the cells ex- hibiting it as phagocytes. Among the substances observed to be taken up by white corpuscles are the minute organisms known as Bacteria, certain species of which have been proved to be the causes of some diseases (zymotic diseases). The white corpuscles may in this way play an important part in the cure of such diseases, or in their prevention in persons exposed to infection. The accumulation of white corpus- cles in inflamed or injured parts is probably primarily as- THE INTERNAL MEDIUM. 49 sociated with the removal of dead and broken-down tissues, though it may be carried to excess as in the case of purulent accumulations. The Blood Platelets or Plaques are a third kind of blood- corpuscle, considerably smaller than the red, but somewhat resembling them in form. They adhere together, break down and form sticky clumps with great rapidity in drawn blood unless special precautions are taken. Blood of Other Animals. In all animals with blood the pale corpuscles are pretty much alike, but the red corpuscles, which with rare exceptions are found only in Vertebrates, vary considerably. In all the classes of the mammalia they are circular biconcave disks, with the exception of the camel tribe, in which they are oval. They vary in diameter from 0.02 mm. (ygVo inch) (musk deer) to .011 mm. (^^Vo inch) (ele- phant). In the dog they are nearly the same size as those of man. In no mammals do the fully-developed red corpuscles possess a nucleus. In all other vertebrate classes the red cor- puscles possess a central nucleus, and are oval slightly bi- convex disks, except in a few fishes in which they are cir- cular. They are largest of all in the amphibia. Those of the frog are 0.02 mm. (r/ffQ inch) long and .007 mm. (^¥ inch) broad. Histology of Lymph. Pure lymph is a colorless watery- looking liquid; examined with a microscope it is seen to con- tain numerous pale corpuscles closely resembling those Of the blood, and no doubt many are pale blood-corpuscles which have migrated. These lymph-corpuscles or leucocytes have, however, another more important origin. In many parts of the Body there are collections of a peculiar lymphoid or adenoid tissue, sometimes in nodular masses (lymphatic glands). This tissue consists essentially of a fine network, the meshes of wnich are occupied with leucocytes which frequently show signs of division. The meshes of the network communicate with lymphatic vessels and the lymph flowing through picks up and-cairies off the new-formed leucocytes. The lymph being ultimately poured into the blood, the leucocytes be- come the colorless corpuscles of the latter; and the migrating cells of the blood are therefore but lymph-corpuscles restored to the lymph, perhaps somewhat changed during their life in the blood-plasma. The lymph flowing from the intestines during digestion 50 THE HUMAN BODY. is, as already mentioned, not colorless, but white and milky. It is known as chyle, and will be considered with the process of digestion. During fasting the lymph from the intestines is colorless, like that from other parts of the Body. CHAPTEE V. THE CLOTTING OF BLOOD. The Coagulation of the Blood. When blood is first drawn from the living Body it is perfectly liquid, flowing in any direction as readily as water. This condition is, however, only temporary; in a few minutes the blood becomes viscid and sticky, and the viscidity becomes more and more marked until, after the lapse of five or six minutes, the whole mass sets into a jelly which adheres to the vessel containing it, so that this may be inverted without any blood whatever being spilled. This stage is known as that of gelatinization and is also not permanent. In a few minutes the top of the jelly- like mass will be seen to be hollowed or " cupped " and in the concavity will be seen a small quantity of nearly colorless liquid, the blood-serum. The jelly next shrinks so as to pull itself loose from the sides and bottom of the vessel containing it, and as it shrinks squeezes out more and more serum. Ulti- mately we get a solid clot, colored red and smaller in size than the vessel in which the blood coagulated though retain- ing its form, floating in a quantity of pale yellow serum. If, however, the blood be not allowed to coagulate in perfect rest, a certain number of red corpuscles will be rubbed out of the clot into the serum and the latter will be more or less reddish. The longer the clot is kept the more serum will be obtained: if the first quantity exuded be decanted off and the clot put aside and protected from evaporation, it will in a short time be found to have shrunk to a smaller size and to have pressed out more serum; and this goes on until putrefactive changes commence. Cause of Coagulation. If a drop of fresh-drawn blood be spread out- very thin and watched for a few minutes with a microscope magnifying 600 or 700 diameters, it will be seen that the coagulation is due to the separation of very fine solid threads which run in every direction through the plasma and form a close network entangling all the corpuscles. These 51 THE HUMAN BODY. threads are composed of the proteid substance fibrin. When they first form, the whole drop is much like a sponge soaked full of water (represented by the serum) and having solid bodies (the corpuscles) in its cavities. After the fibrin threads have been formed they tend to shorten; hence when blood clots in mass in a vessel, the fibrinous network tends to shrink in every direction just as a network formed of stretched india-rubber bands would, and this shrinkage is greater the longer the clotted blood is kept. At first the threads stick too fkmly to the bottom and sides of the vessel to be pulled away, and thus the first sign of the contraction of the fibrin is seen in the cupping of the surface of the gelatinized blood where the threads have no solid attachment, and there the contracting mass presses out from its meshes the first drops of serum. Finally the contraction of the fibrin overcomes its ad- hesion to the vessel and the clot pulls itself loose on all sides, pressing out more and more serum, in which it ultimately floats. The great majority of the red corpuscles are held back in the meshes of the fibrin, but a good many pale corpuscles, by their amoeboid movements, work their way out and get into the serum. Whipped Blood. The essential point in coagulation being the formation of fibrin in the plasma, and blood only forming a certain amount of fibrin, if this be removed as fast as it forms the remaining blood will not clot. The fibrin may be separated by what is known as" whipping" the blood. For this purpose fresh-drawn blood is stirred up vigorously with a bunch of twigs, and to these the sticky fibrin threads as they form, adhere. If the twigs be withdrawn after a few minutes a quantity of stringy material will be found attached to them. This is at first colored red by adhering blood-cor- puscles: but by washing in water they may be removed, and the pure fibrin thus obtained is perfectly white and in the form of highly "elastic threads. It is insoluble in water and in dilute acids, but swells up to a transparent jelly in the latter. The " whipped " or " defibrinated blood " from which the fibrin has been in this way removed, looks just like ordinary blood, but has lost the power of coagulating spontaneously, The Buflfy Coat. That the red corpuscles are not an essential part of the clot, but are merely mechanically caught up in it, seems clear from the microscopic observation of the process of coagulation; and from the fact that perfectly THE CLOTTING OF BLOOD. 53 formed fibrin can be obtained free from corpuscles by whip- ping the blood and washing the threads which adhere to the twigs. Under certain conditions, moreover, one gets a natu- rally formed clot containing no red corpuscles in one part of it. The corpuscles of human blood are a little heavier, bulk for bulk, than the plasma in which they float; hence, when the blood Is drawn and left at rest they sink slowly in it; and if for any reason clotting take place more slowly or the corpuscles sink more rapidly than usual, a colorless top stratum of plasma, with no red corpuscles in it, is left before gelatinization occurs and stops the further sinking of the corpuscles. The uppermost part of the clot formed under such circumstances is colorless or pale yellow, and is known as the buffy coat; it is especially apt to be formed in the blood drawn from febrile patients, and was therefore a point to which physicians paid much attention in the olden times when bloodletting was thought to be almost a panacea. In horse's blood the difference between the specific gravity of the corpuscles and that of the plasma is greater than in human blood, and horse's blood also coagulates more slowly, so that its clot has nearly always a buffy coat. The colorless buffy coat seen sometimes on the top of the clot must, how- ever, not be confounded with another phenomenon. When a blood-clot is left floating exposed to the air its top becomea bright scarlet, while the part immersed in the serum assumes a dark purple-red color. The brightness of the top layer is due to the action of the oxygen of the air, which forms a scarlet compound with the coloring matter of the red cor- puscles. If the clot be turned upside down and left for a short time, the previously dark red bottom layer, now exposed to the air, becomes bright; and the previously bright top layer, now immersed in the serum, loses iis oxygen and be- comes dark. Uses of Coagulation. The clotting of the blood is so im- portant a process that its cause has been frequently investi- gated; but it is not yet completely understood. The living circulating blood in the healthy blood-vessels does not clot; it contains no solid fibrin, but this forms in it, sooner or later, when the blood gets by any means out of the vessels or when the lining of these is injured. In this way the mouths of the small vessels opened in a cut are clogged up, and the bleed- ing, which would otherwise go on indefinitely, is stopped. 64 THE HUMAN BODY. So, too, when a surgeon ties up an artery before dividing it, the tight ligature crushes or tears its delicate inner surface, and the blood clots where that is injured, and from there a •coagulu'm is formed reaching up to the next highest branch of the vessel. This becomes more and more solid, and by the time the ligature is removed has formed a firm plug in the cut end of the artery, which greatly diminishes the risk of bleeding. The Source of Blood-fibrin. Since fresh blood-plasma contains no fibrin but does contain considerable quantities of other proteids, we look first to these as a possible source of the fibrin formed during coagulation. Blood drawn from a living animal into one third of its bulk of a cold saturated solution of magnesium sulphate and kept cold will not clot for a long time. The corpuscles slowly sink in the mixture, and after a time considerable quantities of colorless " salted " plasma can be drawn off from its upper part. The salted plasma still contains something which can form fibrin, for if diluted with six or seven times its volume of water it clots in a manner quite similar to pure blood-plasma (though the clot is a little less firm); and also, fibrin can be obtained by whipping it. If salted plasma be saturated with sodium chloride it yields a whitish rather sticky precipitate, called plasmim. The remaining liquid is then found to have lost the power of clotting, but if the plasmine be treated with a little dilute saline solution it dissolves, and the solution soon clots, with the formation of fibrin. The plasmine is not a single body. If its solution before it clots have sodium chloride added to it in the proportion of about 15#, a white sticky precipitate is formed, and may be collected on a filter; it is a substance named fibrinogen. If more sodium chloride or some magnesium sulphate be added to the filtrate a second white precipitate is obtained : this is par a globulin. Paraglobulin dissolves in dilute solutions of common salt: such solutions cannot be made to yield fibrin, though they are coagulated with the formation of coagulated proteid (p. 10) at the temperature 75° C. (167° F). Purified fibrin- ogen also- dissolves in dilute solution of common salt, and such solution is coagulated by heat (56° C. or 133° F.) : but under certain conditions it clots with the formation of true fibrin. During the clotting the fibrinogen disappears, but THE CLOTTING OF BLOOD. 55 the quantity of fibrin formed never is quite equal in weight to the fibrinogen which, disappears, so the process is not a mere direct transformation of one substance into the other. We are thus led to the conclusion that the natural clot- ting of fresh blood is due to the formation of fibrin from fibrinogen which existed in solution in the plasma of the circulating blood and has been altered in the clotted, giving origin to fibrin. But as normal blood circulating in healthy uninjured blood-vessels does not clot nor do pure solutions of fibrinogen, we have still to seek the exciting cause of the change. If to a solution of fibrinogen there be added a few drops of blood or of blood-serum, or of the washings of a blood-clot, fibrin will be forme^; therefore drawn blood and serum and natural clot each contain something which can effect the con- version of fibrinogen into fibrin. This substance is the enzyme named fibrin -ferment. The Fibrin-ferment. When blood-serum is treated with several times its volume of strong alcohol its various proteids and most of its salts are precipitated : if the precipitate be left standing in alcohol for some months the proteids become almost entirely insoluble in water, but a few drops of the watery extract cause clotting in a saline solution of fibrin- ogen, and clearly contain some of tho ferment. A very minute quantity of the ferment will cause the conversion of an indefinite quantity of fibrinogen and does not appear to be itself used up in the process: it acts somehow by its mere presence, and the clotting of blood is to be relegated to that obscure group of physico-chemical processes known as cata- lytic. Solutions containing the ferment always give some proteid reactions and it may be a proteid, but this is doubt- ful; for the proteid present may be only an impurity. Watery solutions of ferment completely lose their activity when boiled. If fibrinogen be dissolved in the least possible amount of dilute caustic potash and a few drops of as pure as possible a solution of fibrin ferment, freed from its salts by dialysis, be added, clotting does not occur: but it may be brought about by the addition of a very small quantity of a calcium salt. The presence of some calcium seems to be an essential, but the part it plays is unknown. Of the four substances which take part in the coagulation of blood, the fibrinogen 56 THE HUMAN BODY. primarily determines the quantity of fibrin formed : the more fibrinogen the more fibrin, though never quite so much as the fibrinogen which disappears. The ferment acting on fibrin- ogen in the presence of a salt of calcium, in some way causes it to become fibrin, but does not itself enter into the fibrin ; it is not used up in the process, and the amount of fibrin ulti- mately formed is the same whether much or little ferment be present; but the more ferment the quicker the clotting. The presence in small quantity of many neutral salts seems to favor coagulation, but none except the lime-salts are essential. The part they play is obscure; and when present in large pro- portions they prevent coagulation of blood or plasma, prob- ably by hindering the formation of ferment. If fresh blood be mixed with an equal bulk of a saturated solution of mag- nesium sulphate (Epsom salts) 'or of common salt, it will not clot; but if this mixture be largely diluted with water, then some ferment is formed and clotting takes place. The Proximate Causes of Normal Blood Coagulation. As all the phenomena of clotting, with the formation of fibrin agreeing in all respects with that formed during the natural coagulation of drawn blood, can be obtained in artificial solu- tions of fibrinogen, it is obvious that the process is not, as was once supposed, a so-called vital but a purely chemical one : but we still are far from a satisfactory explanation why the fibrinogen of the plasma does not clot in normal circulating blood contained in healthy blood-vessels. It is, in fact, much easier to point out what are not the proximate causes of the coagulation of drawn blood than what are. Blood when removed from the Body and received in a vessel comes to rest, cools, and is exposed to the air, from which it may receive or to which it may give off gaseous bodies. But it is easy to prove that none of these three things is the cause of coagulation. Stirring the drawn blood and so keeping it in movement does not prevent but hastens its coagulation: and blood carefully imprisoned in a living blood-vessel, and so kept at rest, will not clot for a long time; not until the inner coat of the vessel begins to change from the want of fresh blood. Secondly, keeping the blood at the temperature of the Body hastens coagulation, and cooling re- tards it; blood received into an ice-cold vessel and kept sur- rounded with ice will clot more slowly than blood drawn and left exposed to ordinary temperatures. Finally, if the blood THE CLOTTING OF BLOOD. 57 be collected over mercury from a blood-vessel, without having been exposed to the air even for an instant, it will clot per- fectly. The formation of fibrin is then due to changes taking place in the blood itself when it is removed from the blood- vessels; the clotting depends solely upon some rearrangement of the blood-constituents, and the primary change seems to be the formation of fibrin-ferment. That healthy circulating blood contains no ferment but that this forms in drawn blood may be shown as follows: Blood is drawn from an artery into four separate vessels. To one specimen a large quantity of alcohol is added at once; to a second after five minutes, to a third after ten, to the fourth after fifteen. The precipitate in each is collected and dried, and then treated with water which will dissolve any ferment present. The watery extract from the first specimen will not cause clotting when added to a fibrinogen solution: from the second only slowly; the third more quickly, and the fourth quickest of all. It is hence con- cluded that there is no ferment in perfectly fresh blood, but that this begins to form as soon as blood is drawn and for some time goes on increasing, so that there is more in blood drawn ten minutes than in blood drawn only five. The alcohol in each sample precipitates all the ferment already present and prevents the formation of more. There is some evidence that a good many pale corpuscles disintegrate when blood is drawn, and it has been maintained that they then give origin to the fibrin-ferment along with other things : but of late evidence seems rather to point to the platelets as the main source of the ferment. As already stated they rapidly break down when blood is removed from the body, part of their substance going into solution in the plasma and part remaining as a sticky mass which tends to adhere to its fellows to form little clumps. If the formation of fibrin in clotting blood be watched with the aid of a microscope the fibrin threads are seen to appear first in the neighborhood of these clumps, and in many cases to radiate from them. More- over those substances which check or retard the clotting of blood also hinder the disintegration of the platelets: 'and if a fine thread be passed through the blood-vessel of a living animal fibrin forms around it after a time, and this formation is preceded by adhesion to the thread and disintegration of platelets. But be the source of the ferment platelets or pale 58 THE HUMAN BODY. corpuscles or both, we have still the problem why, under normal conditions, do not these break down in the circulating blood : have perchance the blood-vessels some part in the matter ? Relation of the Blood-vessels to Coagulation. As to the role of the blood-vessels with respect to coagulation, two views are held, between which the facts at present known do not permit a decisive judgment to be made; and there may be some truth in both. One theory is that the vessels actively prevent coagulation by constantly absorbing from the blood some substance, as the fibrin-ferment, the presence of which is a necessary condition for the formation of fibrin and which is supposed to be constantly forming in the blood, but to be as steadily removed from it or destroyed by the lining cells of the blood-vessels. In support of this opinion is brought for- ward the fact that it is possible to inject considerable quanti- ties of a solution of fibrin-ferment into the blood of a living animal without causing intravascular coagulation. The other view is that the blood-vessels are passive. They simply do not excite those changes in the blood constituents which give rise to the formation of fibrin-ferment, while foreign bodies in contact with the blood do excite these changes and so lead to coagulation. In support of this view are brought forward the facts that drawn blood clots faster in vessels of such shapes that a large surface of blood is exposed to foreign contact; and that coagulation takes place rapidly in a vessel with a rough interior, while in a chemically clean glass vessel it occurs slowly. The experiment already men- tioned of getting a clot around a thread passed through a blood- vessel, and also that of getting extensive clotting within the blood-vessels by the injection into a vein of extract of the thymus body, may be cited as tending to show that the linings of the blood-vessels cannot actively prevent coagulation; but it may be objected that in the one case locallys and in the other generally, the ferment is set free in the blood so fast that the vessels cannot remove it in time to prevent the formation of fibrin. Blood poured out from a torn vessel among other tissues of the body often clots very slowly; this may be due either to the tissues in general possessing the power of de- stroying fibrin-ferment or to their being merely indifferent substances not exciting the changes which lead to fibrin formation. THE CLOTTING OF BLOOD. 59 Whatever the part played by the blood-vessels in reference to coagulation it is only exhibited when their inner surfaces are healthy and uninjured. If their lining be ruptured or diseased the blood clots. Accordingly, after death, when post-mortem changes have affected the blood-vessels, the blood clots in them; but often very slowly, since the vessels only gradually alter. If the Body be left in one position after death the clots formed in the heart have often a marked buffy coat, because the corpuscles have had a long time to sink in the plasma before coagulation occurred. In medico- legal cases it is thus sometimes possible to say what was the position of a corpse for some hours after death, although it has been subsequently moved. Lymph clots like the blood, but not so firmly. The clot formed is colorless. Composition of the Blood. The average specific gravity of human blood is 1055. It has an alkaline reaction, which becomes less marked as coagulation occurs. About one half of its mass consists of moist corpuscles and the remainder of plasma. Exposed in a vacuum, 100 volumes of blood yield about 60 of gas consisting of a mixture of oxygen, carbon dioxide and nitrogen. Chemistry of Serum. Blood -serum is plasma which has lost its fibrinogen and gained fibrin-ferment and probably some additional paraglobulin; from an analysis of it we can draw conclusions as to the plasma. In 100 parts of serum there are about 90 parts of water, 8.5 of proteids, and 1.5 of fats, salts and other less-known solid bodies. Of the proteids present the most abundant are serum-albumin and para- globulin. Serum-albumin agrees with egg-albumin in coagu- lating when heated : for this reason serum when boiled sets into an opaque white mass, just as the white of an egg does. Serum-albumin differs from egg-albumin in not being coagu- lated by ether; and in the fact that although present in such large quantities in the blood, it is not excreted by the kid- neys, as egg-albumin is, if injected into a blood-vessel. The paraglobulin is also precipitated by heat, but may be pre- cipitated alone by saturation of the serum with magnesium sulphate. Fats are present in the serum in small quantity except after a meal at which fatty substances have been eaten; serum obtained from the blood of an animal soon after such a meal is often milky in appearance from the large 60 THE HUMAN BODY. amount of fats present, instead of being colorless or pale yel- low and transparent as it is after fasting. The salts dissolved in the serum are mainly sodium chloride and carbonate; small quantities of sodium, calcium, and magnesium phos- phates are also present. Chemistry of the Red Corpuscles. In these in the fresh moist state there are, in 100 parts, 56 of water and 44 of solids. Of the solids about one per cent is salts, chiefly potas- sium phosphate and chloride. The remaining solids contain, in 100 parts, 90 of hsemoglobin and about 8 of other proteids; the residue consists of less well-known bodies. Chemistry of the White Corpuscles. Besides much water, these yield several proteids, some fats, glycogen (see Chap. XXIX) and salts; and smaller quantities of other bodies. The predominant salts, like those of the red corpuscles, are potassium phosphates. Variations in the Composition of the Blood. The above statements refer only to the average composition of the healthy blood and to its better known constituents. From what was said in the last chapter it is clear that the blood flowing from any organ will have lost or gained, or gained some things and lost others, when compared with the blood which entered it. But the losses and gains in particular parts of the Body are in such small amount as, with the exception of the blood-gases, to elude analysis for the most part: and the blood from all parts being mixed in the heart, they balance one another and produce a tolerably constant average. In health, however, the specific gravity of the blood may vary from 1045 to 1075; the red corpuscles also are present in greater proportion to the plasma after a meal than before it. Healthy sleep in proper amount leads to increase in the pro- portion of red corpuscles, and want of it tends to diminution of their number, as may be recognized in the pallid aspect of a person who has lost several nights' rest. The proportion of the red corpuscles has a great impor- tance since, as we shall subsequently see, they serve to carry oxygen, which is necessary for the performance of its func- tions, all over the Body. Ancemia is a diseased condition characterized by pallor due to deficiency of red blood-corpus- cles, and accompanied by languor and listlessness. It is not unfrequent in girls on the verge of womanhood, and in per THE CLOTTING OF BLOOD. 61 sons overworked and confined within doors. In such cases the best remedies are open-air exercise and good food. Summary. Practically the composition of the blood may be thus stated: It consists of (1) plastna, consisting of watery solutions of serum -albumin, paraglobulin, fibrinogen, sodi- um and other salts, and extractives of which the most con- stant are urea, kreatin, and grape-sugar; (2) red corpuscles, containing rather more than half their weight of water, the remainder being mainly haemoglobin, other proteids, and pot- ash salts; (3) white corpuscles, consisting of water, various proteids, glycogen, and potash salts; (4) the platelets ; (5) gases, partly dissolved in the plasma or combined with its sodium salts, and partly combined (oxygen) with the haemo- globin of the red corpuscles. Quantity of Blood. The total amount of blood in the Body is difficult of accurate determination. It is about -fa of the whole weight of the Body, so the quantity in a man weighing 75 kilos (165 Ibs.) is about 5.8 kilos (12.7 Ibs.). Of this at any given moment about one fourth would be found in the heart, lungs and larger blood-vessels; and equal quantities in the vessels of the liver, and in those of the muscles which move the skeleton; while the remaining fourth is distributed among the remaining parts of the Body. The Origin and Fate of the Blood-corpuscles. The white blood-corpuscles vary so rapidly and frequently in number in the blood that they must be constantly in process of altera- tion or removal, and formation ; their number is largely in- creased after taking food, even more than that of the red, so that their proportion to the red rises, from 1 to 1000 during fasting, to 1 to 250 or 300 after a meal. This increase is mainly due to increased flow of lymph at this time through the lymphatics of the alimentary canal which have much lymphoid tissue on their course; and, as already pointed out, lymph-corpuscles are constantly multiplying in this tissue and are gathered from it by the lymph, to be poured into the blood (see also Chap. XXIII). Migrated pale corpuscles of the blood and the leucocytes of the lymph retain many of the characters of undifferentiated and unspecialized embryonic cells; and there is some evidence that they may develop new tissues in the repair of injured parts. Amphioxus, the lowest undoubted vertebrate animal (see Zoology), possesses only colorless corpuscles in its blood. 62 THE HUMAN BODY. Higher and more complex animals need more oxygen and, as blood-plasma dissolves very little of that gas, they develop in addition the haemoglobin-containing corpuscles which pick it up in the gills or lungs and carry it to all parts of the Body, leaving it where wanted (see Chap. XXVI). In cold- blooded vertebrates the red corpuscles are not nearly so many in proportion as in the warm-blooded, which use far more oxygen. The older view, was that the mammalian red cor- puscle represented the nucleus of one of the white, in which haemoglobin had been formed and from about which the rest of the corpuscle had disappeared. This, however, does not seem to be the case. In adults new red blood -corpuscles are formed by the segregation of portions of the protoplasm of peculiar cells (hcematoblasts) found in various parts of the Body, but especially in the red marrow of certain bones (p. 95). In the embryo some cells of the liver, and in new-born animals (possibly also in adult) some connective-tissue cor- puscles (p. 112) form new red blood-corpuscles. How long an individual red corpuscle lasts is not known, nor with certainty how or where it disappears : there is, how- ever, some reason to believe that many are finally destroyed in the spleen (see Chap. XXIII). Their average rate of dis- appearance and new formation is unknown, but in emergen- cies (as after severe haemorrhages) they can be reproduced with great rapidity. Chemistry of Lymph. Lymph is a colorless fluid when pure, feebly alkaline, and with a specific gravity of about 1045. It may be described as blood minus its red corpuscles and much diluted, but of course in various parts of the Body it will contain minute quantities of substances derived from neighboring tissues. It contains a considerable quantity of carbon dioxide gas which it gives up in a vacuum, but no un- combined oxygen, since any of that gas which passes into it by diffusion from the blood is immediately picked up by the living tissues among which the lymph flows. CHAPTER VL THE SKELETON. Exoskeleton and Endoskeleton. The skeleton ol an animal includes all its hard protecting or supporting parts, and is met with in two main forms. One is an exoskeleton developed in connection with either the superficial or deeper layer of the skin, and represented by the shell of a clam, the scales of fishes, the horny plates of a turtle, the bony plates of an armadillo, and the feathers of birds. In man the exoskeleton is but slightly developed, but it is represented by the hairs, nails and teeth; for although the latter lie within the mouth, the study of development shows that they are developed from an offshoot of the skin which grows in and lines the mouth long before birth. Hard parts formed from structures deeper than the skin constitute the endoskeleton, which in man is highly developed and con- sists of a great many bones and cartilages or gristles, the bones forming the mass of the hard framework of the Body, while the cartilages finish it off at various parts. This frame- work is what is commonly meant" by the skeleton; it pri- marily supports all the softer parts and is also arranged so as to surround cavities in which delicate organs, as the brain, .heart or spinal cord, may lie with safety. The gross skeleton thus formed is completed and supplemented by another made of the connective tissues, which not only, in the shape of tough bands or ligaments, tie the bones and cartilages to- gether, but also in various forms pervade the whole Body as a sort of subsidiary skeleton running through all the soft organs and forming networks of fibres around their other constituents; they make, as it were, a microscopic skeleton for the individual modified cells of which the Body is so largely composed, and also form partitions between the mus- cles, cases for such organs as the liver and kidneys, and sheaths around the blood-vessels. The bony and cartilagin- ous framework with its ligaments might be called the skele- 63 64 THE HUMAN BODY. ton of the organs of the Body, and this finer supporting meshwork the skeleton of the tissues. Besides forming a support in the substance of various organs, the connective tissues are often laid down as a sort of packing material in the crevices between them ; and so widely are they distributed everywhere from the skin outside to the lining of the alimen- tary canal inside, that if some solvent could be employed which would corrode away all the rest and leave only these tissues, a very perfect model of the whole Body would be left; something like a " skeleton leaf," but far more minute in its tracery. The Bony Skeleton (Fig. 16). If the hard framework of the Body were joined together like the joists and beams of a house, the whole mass would be rigid; its parts could not move with relation to one another, and we should be unable to raise a hand to the mouth or put one foot before another. To allow of mobility the bony skeleton is made of many sepa- rate pieces which are joined together, the points of union be- ing called articulations, and at many places the bones enter- ing into an articulation are movably hinged together, forming what are known &s joints. The total number of bones in the Body is more than two hundred in the adult; and the number in children is still greater, for various bones which are dis- tinct in the child (and remain distinct throughout life in many lower animals) grow together so as to form one bone in the full-grown man. The adult bony skeleton may be de- scribed as consisting of an axial skeleton, found in the head, neck and trunk; and an appendicular skeleton, consisting of the bones in the limbs and in the arches (u and s, Fig., 16) by which these are carried and attached to the trunk. Axial Skeleton. The axial skeleton consists primarily of the vertebral column or spine, a side view of which is rep- resented in Fig. 17. The upper part of this column is com- posed of twenty-four separate bones, each of which is a ver- tebra. At the posterior part of the trunk, beneath tjie movable vertebrae, comes the sacrum (8 1), made up of five vertebrae, which in the adult grow together to form one bone, and below the sacrum is the coccyx (Co 1-4), consisting of four very small tail vertebrae, which in advanced life also unite to form one bone. On the top of the vertebral column is borne the skull, made up of two parts, viz., a great box above which incloses THE SKELETON. 65 the brain and is called the cranium, and a large number of FIG. 16. — The bony and cartilaginous skeleton. FIG. 17.— Side view of the spinal column. bones on the ventral side of this which form the skeleton of 66 THE HUMAN BODY. the face. Attached by ligaments to the under side of the cranium is the Jiyoid lone, to which the root of the tongue is fixed. • Of the twenty-four separate vertebrae of the adult the seven nearest the skull (Fig. 17, C 1-7) lie in the neck and are known as the cervical vertebra. These are followed by twelve others which have ribs attached to them (see Fig. 16) and lie at the back of the chest; they are the thoracic or dorsal vertebrae (D 1-12). The ribs (Fig. 28) are slender curved bones attached by their dorsal ends, called their heads, to the thoracic vertebrae and running thence round the sides of the chest. In the ventral median line of the latter is the breast- bone or sternum (d, Fig. 16). Each rib near its sternal end ceases to be bony and is composed of cartilage. These parts — skull, hyoid bone, vertebral column, ribs, and sternum — constitute the axial skeleton. The Thoracic or Dorsal Vertebras. If a single vertebra, say the eleventh from the skull, be examined carefully it will be found to consist of the following parts (Figs. 18 and 19) : First a bony mass, C, rounded on the sides and flattened on each end where it is turned towards the vertebrae above and below it. This stout bony cylinder is the "body " or centrum of the vertebra, and the series of vertebral bodies (Fig. 17) forms in the trunk that bony partition between the dorsal and ventral cavities of the body spoken of in Chapter I. To the dorsal side of the body is attached an arch — the neural arch, A9 which with the back of the body incloses a space, Fv, the neural ring. In the tube formed by the rings of the successive vertebrae lies the spinal cord. Projecting from the dorsal side of the neural arch is a long bony bar, Ps, the spinous process : and the projections of these processes from the various vertebrae can be felt through the skin all down the middle of the back. Hence the name of spinal column often given to the whole back-bone. Six other processes arise from the arch of the vertebra: two project forwards, i.e., towards the head; these, Pas, are the anterior articular processes and have smooth surfaces, covered with cartilage, on their dorsal sides. A pair of simi- lar posterior articular processes, Pai, runs back from the neural arch, and these have smooth surfaces on their ventral aspects. In the natural position of the vertebra, the smooth surfaces of its anterior articular processes fit upon the poste- THE SKELETON. 67 rior articular processes of the vertebra next in front, forming a joint, and the two processes are united by ligaments. Sim- FIG. 18. FIG. 19. FIG. 18.— A thoracic vertebra seen from behind, i.e., the end turned from the head. FIG. 19.— Two thoracic vertebrae viewed from the left side, and in their natural relative positions. C, the body ; A, neural area ; Fv, the neural ring ; Ps, spinous process; Pas, anterior articular process; Pai, posterior articular process; Pt, transverse process ; Ft, facet for articulation with the tubercle of a rib ; Fes, Fci, articular surfaces on the centrum for articulation with a rib. ilarly its posterior articular processes form joints (Fig. 19) with the anterior articular processes of the vertebra next be- hind. The remaining processes are the transverse, Pt, which run outwards and a little dorsally. Each of these has a smooth articular surface, Ft, near its outer end. On the " body " are seen two articular surfaces on each side : one, Fes, at its anterior, the other, Fci, at its posterior end, and both close to the attachment of the neural arch. Each of these surfaces forms with corresponding areas on the vertebrae in front and behind a pit into which the end of a rib fits and the rib attached in this way to the anterior part of the " body " is also fitted on, a little way from its dorsal end, to the articular surface at the end of the transverse process. The Segments of the Axial Skeleton. If a thoracic verte- bra, say the first (Fig. 20), be detached with the pair of ribs, Cv9 belonging to it and the bit of the sternum, S, to which these ribs are fixed ventrally, we would find a bony parti- tion formed by the body of the vertebra, lying between 68 THE HUMAN BODY. two arches which surround cavities. The dorsal cavity inclosed by the "body" and "neural arch" contained origi- nally part of the spinal cord. The other ring, made up by the body of the vertebra dor- ^^^^11 i^r-^^ sally, the sternum ventrally, j ^^ and the ribs on the sides, sur- rounds the chest-cavity with its contents. All of these parts together form a typical seg- ment of the axial skeleton, which, however, only attains this completeness in the tho- racic region of the trunk. In FIG. 20.— Diagrammatic representa- ,, elrnll if is m-patlv rnnHifiprl • tiou of a segment of the axial skeleton, tne SKlll I It IS glCdliy n and in the neck and the lower Part of the trunk tv~ 'ibs are is the rib-cartilage. either absent or -V. small, appearing only as processes of the vertebrae; and the sternal portion is wanting altogether. Nevertheless we may regard the whole axial skeleton as made up of a series of such segments placed one in front of another, but having different portions of the complete seg- ment much modified or rudimentary or even altogether wanting in some regions. Parts which in this way really correspond to one another though they differ in detail, which are so to speak different varieties of one thing, are said in anatomical language to be homologous to one another; and when they succeed one another in a row, as the trunk seg- ments do, the homology is spoken of as serial. The Cervical Vertebrae. In the cervical region of the vertebral column the bodies of the vertebrae are smaller than in the dorsal, but the arches are larger; the spinous pro- BB ' Frt cesses are short and often bifid and the transverse processes appear to be perforated by a canal, the vertebral foramen. The bony bar bounding this Jf \) \, aperture on the ventral side, FIG. 21.— A cervical vertebra. Frt, however, IS in reality a Very vertebral foramen; Pat, anterior ar- small rib which has grown into ticuIarPro continuity with the body and true transverse process of THE SKELETON. 69 the vertebra, although separate in very early life: the trans- verse process proper bounds the vertebral foramen dorsally. In this latter during life runs an artery, which ultimately enters the skull-cavity. The Atlas and Axis. The first and second cervical verte- brae differ considerably from the rest. The first, or atlas (Fig. 22), which carries the head, has a very small body, Aa, and a large neural ring. This ring is subdivided by a cord, the transverse ligament, L, into a dorsal moiety in which the spinal cord lies and a ventral into which the bony process D projects. This is the odontoid process, and arises from the front of the axis or second cervical vertebra (Fig. 23). Around this peg the atlas rotates when the head is turned from side to side, carrying the skull (which articulates with the large hollow surfaces Fas) with it. The odontoid process really represents a large piece of the body of the atlas which in early life separates from its own vertebra and becomes united to the axis. The Lumbar Vertebrae (Fig. 24) are the largest of all the movable vertebra and have no ribs attached to them. Their spines are short and stout and lie in a more horizontal plane FIG. 22. FIG FIG. 22.— The atlas. FIG. 23.— The axis. Aa, body of atlas; D, odontoid process; Fas, facet on frout of atlas with which the skull articulates; and in Fig. 23, ante- rior articular surface of axis; L. transverse ligament; Frt, vertebral foramen; Ap, neural arch; Tp, spinous process. than those of the vertebrae in front. The articular and trans- verse processes are also short and stout. The Sacrum, which is represented along with the last lum- bar vertebra in Fig. 25, consists in the adult of a single bone; but cross-ridges on its ventral surface indicate the limits of the five separate vertebrae of which it is composed in childhood. It is somewhat triangular in form, its base 70 THE HUMAN BODY. being directed upwards and articulating with the under surface of the body of the fifth lumbar vertebra. On its sides are large surfaces to which the arch bearing the lower Pni Pa * FIG. 24. — A lumbar vertebra seen from the left side. Ps, spinous process; Pas, anterior articular process; Pai, posterior articular process; Pt> transverse process. Fsa FIG. 25. — The last lumbar vertebra and the sacrum seen from the ,entral side. Fsa, anterior sacral foramina. limbs is attached (see Fig. 16). Its ventral surface is con- cave and smooth and presents four pairs of anterior sacral THE SKELETON. . 71 foramina, Fsa, which communicate with the neural canal. Its dorsal surface, convex and roughened, has four similar pairs of posterior sacral foramina. The coccyx (Fig. 26) calls for no special description. The four bones which grow together, or ankylose, to form it, represent only the bodies of vertebrse, and even those incompletely. It is in reality a short tail, although not visible as such from the exterior. The Spinal Column as a Whole. The ver- tebral column is in a man of average height about twenty- eight inches long. Viewed from the side (Fig. 17) it presents four curvatures; one with the convexity forwards in the cervical region is followed, in the thoracic, by a curve with its concavity towards the chest. In the lumbar region the curve has again its convexity turned ventrally, while in the sacral and coccy- geal regions the reverse is the case. These curvatures give the whole column a good deal of springiness such as would be absent were it a straight rod, and this is farther secured by the presence of compressible elastic pads, the intervertebral disks, made up of cartilage and connective tissue, which lie between Ihe bodies of those vertebras which are not ankylosed together, and fill iip completely the empty spaces left between the bodies of the vertebrae in Fig. 17. By means of these pads, moreover, a certain amount of movement is allowed between each pair of vertebras; and so the spinal column can be bent to considerable extent in any direction; while the movement between any two vertebrae is so limited that no sharp bend can take place at any one point, such as might tear or other- wise injure the spinal cord contained in the neural canal. The amount of movement permitted is greatest in the cervical region. In the case of the movable vertebrae, the arch is somewhat narrowed where it joins the body on each side ; this nar- rowed stalk is the pedicle (li, Fig. 19), while the broader remaining portion of the arch is its lamina. Between the pedicles of two contiguous vertebrae there are in this way left apertures, the intervertebral holes which form a series on each side of the vertebral column, and one of which, Fi, is shown between the two dorsal vertebras in Fig. 19. Through these foramina nerves run out from the spinal cord THE HUMAN BODY. to various regions of the Body. The sacral foramina, anterior and posterior, are the representatives of these apertures, but modified in arrangement, on account of the fusion of the arches and bodies of the vertebrae between which they lie. Sternum. The sternum or breast-bone (Fig. 27 and d, Fig. 16) is wider from side to side than dorso-ventrally. It consists in the adult of three pieces, and seen from the ven- tral side has somewhat the form of a dagger. The piece M nearest the head is called the handle or manubrium, and pre- sents anteriorly a notch, Id, on each side, with which the collar-bone articulates (u, Fig. 16); farther back are two other notches, Id and Jc2, to which the sternal ends of the first and second ribs are attached. The middle piece, C, of the sternum is called the body; it completes the notch for the second rib and has on its sides others, Ic 3-7, for the third, fourth, fifth, sixth, and seventh ribs. The last piece of the sternum, P9 is the ensiform or xiphoid process; it is composed of cartilage, and has no ribs attached to it. The Ribs. (Fig. 28). There are twelve pairs of ribs, each being a slender curved bone attached dorsally to the body and transverse process of a vertebra in the manner already mentioned, and continued ventrally by a costal cartilage. In the case of the anterior seven pairs, the costal cartilages are attached directly to the sides of the breast-bone; the next three carti- lages are each attached to the cartilage of the preceding rib, while the cartilages of the eleventh and twelfth ribs are quite FIG. 27.— The sternum ,, .-, TI j seen on its ventral aspect, unattached ventrally, so these are called the free or floating ribs. The convexity of each curved rib is turned outwards so rib-cartiiages. " " as io ^ rouil(jnes8 to the sides of the chest and increase its cavity, and each slopes downwards from its vertebral attachment, so that its sternal end is consider- ably lower than its dorsal. The Skull. (Fig. 29) consists of twenty-two bones in the adult, of which eight, forming the cranium, are arranged so as to inclose the brain-case and protect the auditory organ, THE SKELETON. while the remaining fourteen support the face round the mouth, the nose, and the eye-sockets. and 73 sur- Fio. 28.— The ribs of the left side, with the dorsal and two lumbar vertebrae, the rib-cartilages and the sternum: a, first and, 6, twelfth thoracic vertebra; c, first lumbar vertebra. Cranium. The cranium is a box with a thick floor and thinner walls and roof. Its floor or base represents in the •head (as is depicted in the diagram Fig. 2) that partition be- tween the dorsal and ventral cavities which in the trunk is made up of the bodies of the vertebrae. In very early life it 74 THE HUMAN BODY. presents in the middle line a series of four bones, the basi- occipital, basi-sphenoid, presphenoid, and basi-ethmoid, which answer pretty much to the bodies of four vertebra?, and have attached to them the thin bones which inclose the skull-cavity (which may be likened to an enlarged neural canal) on the sides and top. In the Human Body, however, these bones o FIG. 29.— A side/viexv of the skull. O, occipital bone : T, temporal ; Pr, parie- tal; F, frontal; &', sphenoid ; Z, malar ; MX, maxilla; N, nasal; E, ethmoid; £,, lachrymal; Md, inferior maxilla. very soon ankylose with others or with one another; although they remain distinct throughout life in the skulls of very many lower animals. On the base of the skull, besides many small apertures by which nerves and blood-vessels pass in or out, is a large aperture, the foramen magnum, through which the spinal cord passes in to join the brain. THE SKELETON. 75 The cranial bones are the following: 1. The occipital bone (Fig. 29, 0), unpaired and having in it the foramen magnum. It is made up by the fusion of the basi-occipital with other flatter bones. 2. The frontal lone (Fig. 29, F), also unpaired in the adult, but in the child each half is a separate bone. 3. A pair of thin platelike parietal bones (Fig. 29, Pr] which meet one another along the middle line in the top of the skull, and roof-in a great part of the cranial cavity. 4. A pair of temporal bones (Fig. 29, T), one on each side of the skull below the parietal. On each temporal bone is a large aperture leading into the ear-cavity, the essen- tial parts of the organs of hearing Fra. ^^ ^ of the being contained in these bones. 5. skull. The lower jaw has been .,,, -. . -, , , 1,1 removed. At the lower part The Sphenoid OOne, made Up by the of the figure is the hard palate » , T 7 • 7 . 7 , forming the roof of the mouth UniOll OI the OaSl- SplienQld and pre- and surrounded by the upper sphenoid (lying on the base of skull in ' front of the basi-occipital) with one another and with flatter bones, is seen partly (Fig. 29, 8) on the sides of the cranium in front of tho temporals. 6. at las, on its sides. The ethmoid, like the sphenoid, single in the adult, is really made up by the union of a single median basi-ethmoid with a pair of lateral bones. It closes the skull-cavity in front, and lies between it and the top of the nasal chambers, being perforated by many small holes through which the nerves of smell pass. A little bit of it is seen on the inner side of the eye-socket at E in Fig. 29. Facial Skeleton. The majority of the face-bones are in pairs; two only being single and median. One of these is the lower jaw-bone or inferior maxilla (Fig. 29, Mrl)', the other is the vomer, which fcrms part of the partition between the two nostrils. The paired face-bones are: 1. The maxilla, or upper jaw- bones (Mx, Fig. 29), one on each side, carrying the upper row of teeth and forming a great p^rt of tlie hard palate, which separates the mouth from the nose. 2. The palatine 'bones, completing the skeleton of the hard palate, and behind 76 THE HUMAN BODY. which the nose communicates by the posterior nares (Fig. 30) with the throat-cavity, so that air can pass in or out in breath- ing. 3. The malar bones, or cheek-bones, (Z, Fig. 29.) lying beneath and on the outside of the orbit on each side. 4. The nasal bones (N, Fig. 29), roofing in the nose-. 5. The lach- rymal bones (L, Fig. 29), very small and thin and lying be- tween the nose and orbit. 6. The inferior turbinate bones, lying inside the nose, one in each nostril-chamber. The Hyoid. Besides the cranial and facial bones there is, as already pointed out, one other, the hyoid (Fig. 31), which really belongs to the skull, although it lies in the neck. It can be felt in the front of the throat, just above " Adam's apple." The hyoid bone is U-shaped, with its con- vexity turned ventrally, and consists of a body and two pairs of processes called cor- nua. The smaller corima (Fig. 31, 3) are attached to the base of the skull by long Fro. 81.— The hyoid ligaments. These ligaments in many ani- great cornua3; ' I mals are represented by bones, so that the small corima. ' hyoid, with them, forms a bony arch at- tached to the base of the skull much as the ribs are attached to the bodies of the vertebrae. In fishes behind this Jiyoidean arch come several others which bear the gills; and in the very young Human Body these also are represented, though they almost entirely disappear long before birth. The hyoid, then, with its cornua and ligaments answers pretty much to a gill-arch, or really to parts of two gill-arches, since the great and small cornua belong to originally separate arches present at an early stage of development. It is a remnant of a structure which has no longer any use in the Human Body; but in the young frog-tadpole parts answering to^it carry gills and have clefts between them which extend into the throat just as in fishes. The gills are lost afterwards and the clefts closed up when the frog gets its lungs and begins to breathe by them. In the embryonic human being these gill- clefts are also present and several more behind them, but the arches between them do not bear gills, and the clefts them- selves are closed long before birth. As they have no use their presence is hard to account for; those who accept the doc- trine of evolution regard them as developmental reminis- cences of an extremely remote ancestor in which they were of functional importance somewhat as in the tadpole: of THE SKELETON. 77 course this does not mean that men were developed from tadpoles. The Appendicular Skeleton. This consists of the shoulder-girdle and the bones of the fore limbs, and the pelvic girdle and -the bones of the posterior limbs. The two supporting girdles in their natural position with reference to the trunk skeleton are represented in Fig. 32. The Shoulder-girdle, or Pectoral Arch. This is made up, on each side, of the scapula or shoulder-blade, and the clavicle or collar-bone. The scapula (S, Fig. 32) is a flattish triangular bone which can readily be felt on the back of the thorax. It is not directly articulated to the axial skeleton, but lies im- bedded in the muscles and other parts outside the ribs on each side of the vertebral column. From its dorsal side arises a crest to which the outer end of the collar-bone is fixed, and on its outer edge is a shallow cup into which the top of the arm-bone fits: this hollow is known as the glenoid fossa. The collar-bone (C, Fig. 32) is cylindrical and attached at its inner end to the sternum as shown in the figure, fitting into the notch represented at Id in Fig. 27. The Fore Limb. In the limb itself (Fig. 33) are thirty bones. The largest, a, lies in the upper arm, and is called the humerus. At the elbow the humerus is succeeded by two bones, the radius and ulna, c and b, which lie side by side, the radius being on the thumb side. At the distal ends of these bones come eight small ones, closely packed and forming the wrist, or carpus. Then corno five cylindrical bones which can be felt through the soft parts in the palm of the hand; one for the thumb, and one for each of the fingers. These are the metacarpal bones, and are distinguished as first, second, third, and so on, the first being that of the thumb. In the thumb itself are two bones, and in each finger three, arranged in rows one after the other; these bones are all called phalanges . The Pelvic Girdle (Fig. 32). This consists of a large bone, the os innominatum, Oc, on each side, which is firmly fixed dorsally to the sacrum and meets its fellow in the mid- dle ventral line. In the child each os innominatum consists of three bones, viz., the ilium, the ischium, and pubis. Where these three bones meet and finally ankylose there is a deep socket, the acrtabulum, into which the head of the thigh- 78 THE HUMAN BODY. bone fits (see Fig. 16). Between the pubic and ischial bones , is the largest foramen in the whole skeleton, known as the doorlike or thyroid foramen. The pubic bone lies above FIG. 32.— The skeleton of the trunk and the limb arches seen from the front. C, clavicle; S, scapula; Oc, innominate bone attached to the side of the sacrum dor- sally and meeting its fellow at t.hepufoic symphysis in the ventral median line. and the ischial below it. The ilium forms the upper expanded portion of the os innominatum to which the line drawn from Oc in Fig. 32 points. The Hind Limb. In this there are thirty bones, as in the fore limb, but not quite similarly arranged; there being one less at the ankle than in the wrist, and one at the knee not present at the elbow-joint. The thigh-bone or femur (a, Fig. 34) is the largest bone in the body and extends from the hip to the knee-joint. It presents above a large rounded head which fits into the acetabulum and, below, it is also THE SKELETON. 79 enlarged and presents smooth surfaces which meet the bones of the leg. These latter are two in number, known as the tibia, c, or shin-bone, and fibula, d; the tibia being on the great-toe side. In front of the knee-joint is the knee-cap, or patella, b. FIG. 33. FIG. 34. FIG. 33. — The hones of the arm. a, hunierus; 6. ulna; c, radius; d, the carpus; e, the fifth metacarpal; f, the three phalanges of the fifth digit (little finger); g, the phalanges of the poliex (thumb). FIG. 34. -Bones of the leg. a, femur; 6, patg.Ha; c, tibia: d, fibula; h, calca- neum; e, remaining tarsal bones; /, metatarsal bones; g, phalanges. At the distal end of the leg-bones comes the foot, consist- ing of tarsus, metatarsus, and phalanges. The tarsus, which answers to the carpus of the fore limb, is made up of seven irregular bones, the largest being the heel-bone, or calcaneum, 80 THE HUMAN BODY. h. The metatarsus consists of five bones lying side by side, and each carries a toe at its distal end. In the great toe (or hallux) there are two phalanges, in each of the others three, arranged as in the fingers, but smaller. Comparison of the Anterior and Posterior Limbs. It is clear that the skeletons of the arm and leg correspond pretty 0 P FIG. 35.— The skeleton of the arm and leg:. H, the humerus; Cd, its articular head which fits into the glenoid fossa of the scapula; U. the ulna: R, the radius; O, the olecranon; Fe, the fernur; P, the patella; Ft, the fibula; T, the tibia. closely to one another. They are in fact quite alike in very early life, and their differences at birth depend upon their taking different ways as they develop from their primitive THE SKELETON. 81 simplicity; as both may be regarded as modifications of the same original structure, they are homologous. The pelvic girdle clearly corresponds generally to the pectoral arch, the tibia and fibula to the radius and ulna; the five metatarsal bones to the five metacarpal, and the phalanges of the toes to those of the thumb and fingers. On the other hand, there is in the arm no separate bone at the elbow-joint corresponding to the patella at the knee, but the ulna bears above a bony process, the olecranon (0, Fig. 35), which at first is a separate bone and is the representative of the pafcella. There are in the carpus eight bones and in the tarsus but seven. The FIG. 36.— Diagram showing the relation of the pectoral arch to the axial skeleton. astragalus of the tarsus (Ta, Fig. 38) represents, however, two bones which have grown together. The elbow-joint bends ventrally and the knee-joint dorsally. Comparing the limbs as a whole, greater differences come to light, differences which are mainly correlated with the dif- ferent uses of the two limbs. The arms, serving as prehensile ,A organs, have all their parts as movable as is consistent with the requisite strength, while ,1 , TIT- i FIG. 37.— Diagram showing • the at- tne lower limbs, having to bear tachment of the pelvic arch to the axial the whole weight of the Body, s require to have their parts much more firmly knit together. Accordingly we find the shoulder-girdle, represented red in the diagram (Fig. 36), only directly attached to the axial skeleton by the union of the inner ends of the clavicles with the sternum, and capable of considerable independent move- ment, as seen, for instance, in " shrugging the shoulders." 82 THE HUMAN BODY. The pelvic arch, on the contrary, is firmly and immovably fixed to the sides of the sacrum. The socket of the scapula, into which the head of the humerus fits, is very shallow and allows a far greater range of movement than is permitted by the deeper socket on the pelvis, into which the head of the femur fits. Further, if we hold the right humerus tightly in the left hand and do not allow it to move, we can still move the forearm bones so as to turn the palm of the hand either up or down: no such movement is possible between the tibia and fibula. Finally, in the foot the bones are much less movable than in the hand, and are arranged so as to make a springy arch (Fig. 38) which bears behind on the calcaneum, Ca, and in front on the distal ends of the metatarsal bones, Os ; over the crown of the arch, at Ta, is the surface with Sfhl FIG. 38.— The bones of the foot. Ca, calcaneum, or os calcis ; Ta. articular sur- face for tibia on the astragalus ; N, scaphoid bone ; CL CII, first and second cuneiform bones ; Cb, cuboid bone ; Ml, metatarsal bone of great toe. which the leg-bones articulate and on which the weight of the Body bears in standing. The toes, too, are far less movable than the fingers, and this difference is especially well marked between the great toe and the thumb. The latter can be made to meet each of the finger-tips and so the hand can seize and manipulate very small objects, while this power of opposing the first digit to the rest is nearly absent in the foot of civilized man. In children, however, who have never worn boots, and in savages, the great toe is far more movable, though it never forms as complete a thumb as in many apes, which use their feet, as well as their hands, for prehension. By practice, however, our own toes can be made much more mobile than they usually are, so that the foot can to a certain extent replace the hand; as has been illustrated in the case of persons born THE SKELETON. without hands who have learned to write and paint with their toes. Peculiarities of the Human Skeleton. These are largely connected with the division of labor between the fore and hind limbs referred to above, which is carried farther in man than in any other creature. Even the highest apes frequently use their fore limbs in locomotion and their hind limbs in prehension, and we find accordingly that anatomically they present less differentiation of hand and foot. The other more important characteristics of the human skeleton are correlated for the most part with the maintenance of the erect posture, which is more complete and habitual in man than in the animals most closely allied to him anatomically. These peculiarities, however, only appear fully in the adult. In the infant the head is proportionately larger, which gives the centre of gravity of the Body a comparatively very high posi- tion and renders the maintenance of the erect posture difficult and insecure. The curves of the vertebral column are nearly absent, and the posterior limbs are relatively very short. In all these points the infant approaches more closely than the iidult to the ape. The subsequent great relative length of the posterior limbs, which grow disproportionately fast in child- hood as compared with the anterior, makes progression on them more rapid by giving a longer stride and at the same time makes it almost impossible to go on "all fours" except by crawling on the hands and knees. In other Primates this disproportion between the anterior and posterior limbs does not occur to nearly the same extent. In man the skull is nearly balanced on the top of the vertebral column, the occipital condyles which articulate with the atlas being about its middle (Fig. 30), so that but little effort is needed to keep the head erect. In four-footed beasts, on the contrary, the skull is carried on the front end of the horizontal vertebral column and needs special ligaments to sustain it. For instance, in the ox and sheep there is a great elastic cord running from the cervical vertebrae to the back of the skull and helping to hold up the head. Even in the highest apes the skull does not balance on the top of the spinal column; the face part is much heavier than the back? while in man the face parts are relatively smaller and the cra- nium larger, so that the two nearly equipoise. To keep th,e head erect and look things straight in the face, "like a man," 84 THE HUMAN BODY. is for the apes far more fatiguing, and so they cannot long maintain that position. The human spinal column, gradually widening from the neck to t-he sacrum, is well fitted to sustain the weight of the head, upper limbs, etc., carried by it; and its curvatures, which are peculiarly human, give it considerable elasticity combined with strength. The pelvis, to the sides of which the lower limbs are attached, is proportionately very broad in man, so that the balance can be more readily maintained during lateral bending of the trunk. The arched instep and broad sole of the human foot are also very characteristic. The majority of four-footed beasts, as horses, walk on the tips of their toes and fingers; and those animals, as bears and apes, which like man place the tarsus also on the ground, or in technical language are plantigrade, have a much less marked arch there. The vaulted human tarsus, composed of a num- ber of small bones, each of which can glide a little over its neighbors, but none of which can move much, is admirably calculated to break any jar which might be transmitted to the spinal column by the contact of the sole with the ground at each step. A well-arched instep is therefore rightly con- sidered a beauty; it makes progression easier, and by its springiness gives elasticity to the step. In London flat-footed candidates for appointment as policemen are rejected, as they cannot stand the fatigue of walking the daily " beat/' CHAPTER VII. THE STRUCTURE AND COMPOSITION OF BONE. JOINTS. Gross Structure of the Bones. The bones of the Body have all a similar structure and composition, but on account of differences in shape they are divided by anatomists into the following groups: (1) Long bones, more or less cylindrical in form, like the bones of the thigh and arm, leg and forearm, metacarpus, metatarsus, fingers and toes. (2) Tabular bones, in the form of expanded plates, like the bones on the roof and sides of the skull, and the shoulder-blades. (3) Short bones, rounded or angular in form and not much greater in one diameter than in another, like the bones of the tarsus and carpus. (4) Irregular bones, including all which do not fit well into any of the preceding groups, and commonly lying in the middle line of the Body and divisible into similar halves, as the vertebrae. Living bones have a bluish-white color and possess considerable elasticity, which is best seen in long slender bones such as the ribs. To get a general idea of the structure of a bone, we may select the humerus for examination. Externally in the fresh state it is covered by a dense white fibrous membrane very closely adherent to it and containing many small blood-vessels. This membrane is the periosteum ; on its under side new osseous tissue is formed while the bone is still growing, and all through life it is concerned in maintaining the nutrition of the bone, which dies if it be stripped off. The periosteum covers the whole surface of the bone except its ends in the elbow and shoulder joints; the surfaces there which come into contact with other bones and glide over them in the move- ments of the joint have no periosteum, but are covered by a thin layer of gristle, known as the articular cartilage. Very early in the development of the Body the bone in fact -was represented entirely by cartilage; but afterwards nearly all this was replaced by osseous tissue, leaving only a thin car- tilaginous layer at the ends. 85 86 THE HUMAN BODY. The bone itself, Fig. 39, consists of a central nearly cylin- drical portion or shaft, extending between the dotted lines x and z in the figure, and two enlarged articular extremities. Cpi FIG. 39.— The right humenis, seen from the front. For description, see text. FIG. 40.— The humerus bisected lengthwise, a, marrow-cavity; 6, hard bone; c, spongy bone; d, articular cartilage. On the upper articular extremity is the rounded surface, Cp, which enters into the shoulder- joint, fitting against the STRUCTURE AND COMPOSITION OF BONE. JOINTS. 87 glenoid cavity of the scapula; and on the lower are the simi- lar surfaces, Cpl and Tr, which articulate with the radius and ulna respectively. Besides carrying the articular surfaces, each extremity presents several prominences. On the upper are those marked Tmj and Tm (the greater and smaller tro~ chanters), which give attachment to muscles; and similar eminences, the external and internal condoles, El and Em, are seen on the lower end. Besides these, several bony ridges and rough patches on the shaft indicate places to which mus- cles of the arm were fixed. Internal Structure. If the bone be divided longitudinally, it will be seen that its shaft is hollow, the space being known as the medullary cavity, and in the fresh bone filled with marrow. Fig. 40 represents such a longitudinal section. It will be seen that the marrow-cavity does not reach into the ar- ticular extremities, but that there the bone has a loose spongy texture, except a thin layer on the surface. In the shaft, on the other hand, the outer compact layer is much the thicker, the spongy or cancellated bone forming only a thin stratum immediately around the medullary cavity. To the naked eye the cancellated bone appears made up of a trellis-work of thin bony plates which intersect in all directions and sur- round cavities rather larger than the head of an ordinary pin; the compact bone, on the contrary, appears to have no cavities in it until it is examined with a magnifying-glass. In the spaces of the spongy portion lies, during life, a sub- stance known as the red marroiv, which is quite different from the yellow fatty marrow lying in the central cavity of the shaft. Microscopic Structure of Bone. The microscope shows that the compact bone contains cavities and only differs from the spongy portion in the fact that these are much smaller, and the hard true bony plates surrounding them much more numerous in proportion than in the spongy parts. If a thin transverse section of the shaft of the humerus be examined (Fig. 41) with a microscope magnifying twenty diameters, it will be seen that numerous openings exist all over the compact parts of the section and gradually become larger as this passes into the cancellated part, next the medul- lary cavity. These openings are the cross-sections of tubes known as the Haversian canals, which ramify all through the bone, running mainly in the direction of its long axis, but 88 THE HUMAN BODY. united by numerous cross or oblique branches as seen in the longitudinal section (Fig. 42). The outermost ones open on the surface of the bone beneath the periosteum, and in the living bone blood-vessels run from this through the Haversian canals and convey materials for its growth and nourishment. B FIG. 41.— A, a transverse section of the ulna, natural size; showing the medullary cavity. B, the more deeply shaded part of A magnified twenty diameters. The average diameter of the Haversian canals is 0.05 mm. (^ of an inch). Around each Haversian canal lies a set of plates, or lamellae, of hard bony substance (see the transverse section Fig. 41), each canal with its lamellae forming an Haversian system : and the whole bone is made up of a number of such systems, with the addition of a few lamellae lying in the corners be- tween them, and a certain number which run around the whole bone on its outer and inner surfaces. In the spongy STRUCTURE AND COMPOSITION OF BONE. JOINTS. 89 parts of the bone the Haversian canals are very large and the intervening lamellae few in number. Between the lamellae lie small cavities, the lacunce, each of which is lenticular in form, somewhat like the space which would be inclosed by two watch- glasses joined by their edges. From the lacunae many extremely fine branching canals, the canali- culi, radiate and penetrate the bony lamellae in all directions. The innermost canaliculi of each system open into the central Ha- . FIG. 42.-A thin'ion^tudinai^ec- versian canal; and those of various tion of bone, magnified about 350 lop1irijYi infprpnmTrmrnnufiTirr fViaao diameters, oo, Haversian canals. 1RCl1 miCdtlllg, tnese fine tubes form a set of passages through which liquid which has transuded from the blood- vessels in the Haversian canals can ooze all through the bone. The lacunae and canaliculi are shown in Fig. 42. In the living bone a granular nucleated cell lies in each lacuna. These cells, or bone-corpuscles, are the remnants of those which built up the bone, the hard parts of the latter being really an intercellular substance or skeleton formed around and by these cells, much in the same way as a calca- reous skeleton is formed around a Foraminifer by the activity of its protoplasm. By the co-operation of all the bone- corpuscles, and the union of their skeletons, the whole bone is built up. In other bones we find the same general arrangement of the parts, an outer dense layer and an inner spongy portion. In the flat and irregular bones there is no medullary cavity, and the whole centre is filled up with cancellated tissue with red marrow in its spaces. For example, in the thin bones roofing in the skull we find an outer and an inner hard layer of compact bone known as the outer and inner table respectively, the inner especially being very dense. Between the two tables lies the spongy bone, red in color to the naked eye from the marrow within it, and called the diploe. The interior of the vertebrae also is entirely occupied by spongy bone. Every- where, except where a bone joins some other part of the skel- eton, it is covered by the periosteum. Chemical Composition of Bone. Apart from the bone- corpuscles and the soft contents of the Haversian canals and 90 THE HUMAN BODY. of the spaces of the cancellated bone, the bony substance proper, as found in the lamellae, is composed of earthy and organic portions intimately combined, so that the smallest distinguishable portion of bone contains both. The earthy matters form about two thirds of the total weight of a dried bone, and may be removed by soaking the bone in dilute hydrochloric acid. The organic portion left after this treat- ment constitutes a flexible mass, retaining the form of the original bone; it consists chiefly of an albuminoid, ossein, which by long boiling, especially under pressure at a higher temperature than that at which water boils when exposed freely to the air, is converted into gelatin, which dissolves in the hot water. Much of the gelatin of commerce is pre- pared in this manner by boiling the bones of slaughtered animals, and even well-picked bones may be used to form a good thick soup if boiled under pressure in a Papin's digester; much nutritious matter being, in the common modes of do- mestic cooking, thrown away in the bones. The earthy salts of bone may be obtained free from organic matter by calcining a bone in a clear fire, which burns away the organic matter. The residue forms a white very brittle mass, retaining perfectly the shape and structural details of the original bone. It consists mainly of normal calcium phosphate, or bone-earth (Ca3, 2P04) ; but there is also pres- ent a considerable proportion of calcium carbonate (CaC03) and smaller quantities of other salts. Hygiene of the Bony Skeleton. In early life the bones are less rigid, from the fact that the earthy matters then pres- ent in them bear a less proportion to the softer organic parts. Hence the bones of an aged person are more brittle and easily broken than those of a child. The bones of a young child are in fact tolerably flexible and may be distorted by any con- tinued strain ; therefore children should never be kept sitting for hours, in school or elsewhere, on a bench which is so high that the feet are not supported. If this be insisted upon (for no child will continue it voluntarily) the thigh-bones will al- most certainly be bent over the edge of the seat by the weight of the legs and feet, and a permanent distortion may be pro- duced. 'For the same reason it is important that a child be made to sit straight while writing, to avoid the risk of producing a lateral curvature of the spinal column. The facility with which the bones may be moulded by prolonged STRUCTURE AND COMPOSITION OF BONE. JOINTS. 91 pressure in early life is well seen in the distortion of the feet of Chinese ladies, produced by keeping them in tight shoes; and in the extraordinary forms which some races of man produce in their skulls, by tying boards on the heads of the children. Throughout the whole of life, moreover, the bones remain amoug the most easily modified parts of the Body ; although judging from the fact that dead bones are the most permanent parts of fossil animals we might be inclined to think other- wise. The living bone, however, is constantly undergoing changes under the influence of the protoplasmic cells im- bedded in it, and in the living Body is constantly being ab- sorbed and reconstructed. The experience of physicians shows that any continued pressure, such as that of a tumor, will cause the absorption and disappearance of bone almost quicker than that of any other tissue; and the same is true of any other continued pressure. Moreover, during life the bones are eminently plastic; under abnormal pressures they are found to quickly, assume abnormal shapes, being absorbed and disappearing at points where the pressure is most powerful, and increasing at other points; tight lacing may in this way produce a permanent distortion of the ribs. When a bone is fractured a surgeon should be called in as soon as possible, for once inflammation has set in and the parts have become swollen it is much more difficult to place the broken ends of the bone together in their proper position than before this has occurred. Once the bones are replaced they must be held in position by splints or bandages, or the muscles attached to them will soon displace them again. With rest, in young and healthy persons complete union will commonly occur in three or four weeks; but in old persons the process of healing is slower and is apt to be imperfect. Articulations. The bones of the skeleton are joined together in very various ways; sometimes so as to admit of no movement at all between them; in other cases so as to permit only a limited range or variety of movement; and elsewhere so as to allow of very free movement in many directions. All kinds of unions between bones are called ar- ticulations. Of articulations permitting no movements, those which 92 THE HUMAN BODY. unite the majority of the cranial bones afford a good example. Except the lower jaw, and certain tiny bones inside the tem- poral bone belonging to the organ of hearing, all the skull- bones are immovably joined together. This union in most cases occurs by means of toothed edges which fit into one another and form jagged lines of union known as sutures. Some of these can be well seen in Fig. 29 between the frontal and parietal bones (coronal suture) and between the parietal and occipital bones (lambdoidal suture)', while an- other lies along the middle line in the top of the crown between the two parietal bones, and is known as the sagittal suture. In new-born children where the sagittal meets the coronal and lambdoidal sutures there are large spaces not yet covered in by the neighboring bones, which subsequently extend over them. These openings are known asfontanelles, At them a pulsation can often be felt synchronous with each beat of the heart, which, driving more blood into the brain, distends it and causes it to push out the skin where bone is absent. Another good example of an articulation admitting of no movement is that between the rough surfaces on the sides of the sacrum and the innominate bones. We find good examples of the second class of articulations —those admitting of a slight amount of movement — in the vertebral column. Between every pair of vertebrae from the second cervical to the sacrum is an elastic pad, the interqer- tebral disk, which adheres by its surfaces to the bodies of the vertebras between which it lies, and only permits so much movement between them as can be brought about by its own compression or stretching. When the back-bone is curved to the right, for instance, each of the intervertebral disks is compressed on its right side and stretched a little on its left, and this combination of movements, each individually but slight, gives considerable flexibility to the spinal column as a whole. Joints. Articulations permitting of movement by the glid- ing of one bone over another are known as joints, and all have the same fundamental structure, although the amount of movement permitted in different joints is very different. Hip-joint. We may take this as a good example of a true joint permitting a great amount and variety of movement. On the os innominatum is the cavity of the acetabulum (Fig. 43), which is lined inside by a thin layer of articular carti- STRUCTURE AND COMPOSITION OF BONE. JOINTS. 93 lage which has an extremely smooth surface. The bony cup is also deepened a little by a cartilaginous rim. The proximal end of the femur consists of a nearly spherical smooth head, borne on a somewhat narrower neck, and fitting into the ace- tabulum. This head also is covered with articular cartilage; and it rolls in the acetabulum like a ball in a socket. To keep the bones together and limit the amount of movement, ligaments pass from one to the other. These are composed of white fibrous connective tissue (Chap. VIII) and are ex- tremely pliable, but quite inextensible and very strong and FIG. 43.— Section through the hip-joint. tough. One is the capsular ligament, which forms a sort of loose bag all round the joint, and another is the round liga- ment, which passes from the acetabulum to the head of the femur. Should the latter rotate above a certain extent in i'ts socket, the round ligament and one side of the capsular ligament are put on the stretch, and any further movement which might dislocate the femur (that is, remove the head from its socket) is checked. Covering the inside of the cap- sular ligament and the outside of the round ligament is a layer of flat cells, which are continued in a modified form over the articular cartilages and form the synovial membrane. This, which thus forms the lining of the joint, is always 94 THE HUMAN BODY. moistened in health by a small quantity of glairy synovial fluid, something like the white of a raw egg in consistency, and playing the part of the oil with which the contiguous moving surfaces of a machine are moistened; it makes all run smoothly with very little friction. In the natural state of the parts, the head of the femur and the bottom and sides of the acetabulum lie in close contact, the two synovial membranes rubbing together. This contact is not maintained by the ligaments, which are too loose and serve only to check excessive movement, but by the numerous stout muscles which pass from the thigh to the trunk and bind the two firmly together. Moreover, the atmospheric pressure exerted on the surface of the Body and transmitted through the soft parts to the outside of the air-tight joint helps also to keep the parts in contact. If all the muscles and ligaments around the joint be cut away, it is still found in the dead Body that the head of the femur will be kept in its socket by this pressure, and so firmly as to bear the weight of the whole limb without dislocation, just as the pressure of the air will enable a boy's " sucker " to lift a tolerably heavy stone. Ball-and-socket Joints. Such a joint as that at the hip is called a ball-and-socket joint and allows of more free move- ment than any other. Through movements occurring in it the thigh can be flexed, or bent so that the knee approaches the chest; or extended, that is, moved in the opposite direc- tion. It can be abducted, so that the knee moves outwards; and adducted, or moved back towards the other knee again. The limb can also by movements at the hip-joint be circum- ducted, that is, made to describe a cone of which the base is at the foot and the apex at the hip. Finally, rotation can occur in the joint, so that with knee and foot joints held rigid the toes can be turned in or out, to a certain extent, by a rolling around of the femur in its socket. At the junction of the humerus with the scapula is another ball-and-socket joint permitting all the above movements to even a greater extent. This greater range of motion at the shoulder-joint depends mainly on the shallowness of the glenoid cavity as compared with the acetabulum, and upon the absence of any ligament answering to the round ligament of the hip-joint. Another ball-and-socket joint exists between the carpus and the metacarpal bone of the thumb; and others STRUCTURE AND COMPOSITION OF BONE. JOINTS. 95 with the same variety, but a much less range, of movement between each of the remaining metacarpal bones and the proximal phalanx of the finger which articulates with it. Hinge-joints. Another form of synovial joint is known as a hinge-joint. In it the articulating bony surfaces are of such shape as to permit of movement, to and fro, in one plane only, like a door on its hinges. The joints between the pha- langes of the fingers are good examples of hinge-joints. If no movement be allowed where the finger joins the palm of the hand it will be found that each can be bent and straight- ened at its own two joints, but not moved in any other way. The knee is also a hinge-joint, as is the articulation between the lower jaw and the base of the skull whicli allows. us to open and close our mouths. The latter is, however, not a perfect hinge- joint, since it permits of a small amount of lateral movement such as occurs in chewing, and also of a gliding movement by which the lower jaw can be thrust for- ward so as to protrude the chin and bring the lower row of teeth outside the upper. Pivot-joints. In this form one bone rotates around another which remains stationary. We have a good example of it between the first and second cervical vertebrae. The first cervical vertebra or atlas (Fig. 22) has a very small body and a very large arch, and its neural canal is subdivided by a transverse ligament (L, Fig. 22) into a dorsal and a ven- tral portion ; in the former the spinal cord lies. The second vertebra or axis (Fig. 23) has arising from its body the stout bony peg, D, called the odontoid process. This projects into the ventral portion of the space surrounded by the atlas, and, kept in place there by the transverse ligament, forms a pivot around which the atlas, carrying the skull with it, rotates when we turn the head from side to side. The joints on each side between the atlas and the skull are hinge-joints and per- mit only the movements of nodding and raising the head. When the head is leaned over to one side, the cervical part of the spinal column is bent. Another kind of pivot- joint is seen in the forearm. If the limb be held straight out, with the palm up and the elbow resting on the table, so that the shoulder-joint be kept steady while the hand is rotated until its back is turned upwards, it will be found that the radius has partly rolled round the ulna. When the palm is upwards and the thumb outwards, the 96 THE HUMAN BODY. fr- lower end of the radius can be felt on the outer side of the forearm just above the wrist, and if this be done while the hand is turning over, it will be easily discerned that during the movement this end of the radius, carrying the hand with it, travels around the lower end of the ulna so as to get to its inner side. The relative position of the bones when the palm is upwards is shown at A in Fig. 44, and when the palm is down at B. The former position is known as supination ; the latter as pronation. The elbow end of the humerus (Fig. 39) bears a large articular surface: on the inner two thirds of this, Tr, the ulna fits, and the ridges and grooves of both bones interlock- ing form a hinge-joint, allowing only of bending or straightening the forearm on the arm. The radius fits on the rounded outer third, Cpl, and forms there a ball- and-socket joint at which the movement takes place when the hand is turned from the supine to the prone position ; the ulna forming a fixed bar around which the lower end. of the radius is moved. Gliding Joints. These per- mit as a rule but little movement: examples are found between the closely packed bones of the tarsus (Fig. 38) and carpus, which slide a little over one another when subjected to pressure. Hygiene of the Joints. When a bone is displaced or dislocated the ligaments around the joint are more or less torn and other soft parts injured. This soon leads to inflam- mation and swelling which make not only the recognition of the injury but, after diagnosis, the replacement of the bone, or the reduction of the dislocation, difficult. Moreover the muscles attached to it constantly pull on the displaced bone and drag it still farther out of place; so that it is of great importance that a dislocation be reduced as soon as possible. In most cases this can only Ipe attempted with safety by one FIG. 44.— A, arm in supiuation; B, arm in pronation. H, humerus; R, radius; U, ulna. STRUCTURE AND COMPOSITION OF BONE. JOINTS. 97 who knows the form of the bones, and possesses sufficient ana- tomical knowledge to recognize the direction of the displace- ment. No injury to a joint should be neglected. Inflamma- tion once started there is often difficult to check and runs on, in a chronic way, until the synovial surfaces are destroyed, and the two bones perhaps grow together, rendering the joint permanently stiff. A sprained joint should get immediate and complete rest, for weeks if necessary, and if there be much swelling, or continued pain, medical advice should be obtained. An improperly cared-for sprain is the cause of many a useless ankle or knee. CHAPTER VIII. CAKTILAGE AND CONNECTIVE TISSUE. Temporary and Permanent Cartilages. In early life a great many parts of the supporting framework of the Body, which afterwards become bone, consist of cartilage. Such for example is the case with all the vertebrae, and with the bones of the limbs. In these cartilages subsequently the process known as ossification takes place, by which a great portion of the original cartilaginous model is removed and replaced by true osseous tissue. Often, however, some of the primitive cartilage is left throughout the whole of life at the ends of the bones in joints where it forms the articular cartilages; and in various other places still larger masses remain, such as the costal cartilages, those in the external ears forming their framework, others finishing the skeleton of the nose which is only incompletely bony, and many in internal parts of the Body, as the cartilage of " Adam's apple/7 which can be felt in the front of the neck, and a number of rings around the windpipe serving to keep it open. These persistent masses are known as the permanent, the others as the temporary cartilages. In old age many so-called permanent cartilages become calcified— that is, hardened and made unyielding by deposits of lime-salts in them — without assuming the histo- logical character of bone, and this calcification of the perma- nent cartilages is one chief cause of the want of pliability and suppleness of the frame in advanced life. Hyaline Cartilage. In its purest form cartilage is flexi- ble and elastic, of a pale bluish-white color when alive and seen in large masses, and cuts readily with a knife. In thin pieces it is quite transparent. Everywhere except in the joints it is invested by a tough adherent membrane, the peri- chondrium, which resembles in structure and function the periosteum of the bones. When boiled for a long time in water, such cartilages yield a solution of chondrin, which differs from gelatin in minor points, but agrees with it in the fact that its solution in hot water " sets " or gelatinizes on cool- 98 CARTILAGE AND CONNECTIVE TISSUE. 99 ing. When a thin slice of hyaline cartilage is examined with a microscope it is found (Fig. 45) to consist of granular nucle- ated cells, often collected into groups of two, four, or more, scattered through a homogeneous or faintly granular ground- substance or matrix. Essentially, cartilage resembles bone, being made up of protoplasmic cells and a proportionately large amount of non-protoplasmic intercellular substance, the FIG. 45.— A thin slice of cartilage, magnified, to show the cells imbedded in the homogeneous matrix, a, a cell in which the nucleus has divided; 6, a cell in which division is just complete; c, e, a group of four cells resulting from further division of a pair like 6; the new cells have formed some matrix between them, separating them from another; d. d. cavities in the matrix from which cells have dropped out during the preparation of the specimen. cells being the more actively living part and the matrix their product. Examples of this hyaline variety (so called from its glassy transparent appearance) are found in all the tempo- rary cartilages, and in the costal and articular among the permanent. Cartilages rarely contain blood-vessels except at points where a temporary cartilage is being removed and replaced by bone; then blood-vessels run in from the perichondrium and form loops in the matrix, around which it is absorbed and bony tissue deposited. In consequence of the usual absence of blood-vessels the nutritive processes and exchanges of material must be small and slow in cartilage, as might in- deed be expected from the passive and merely mechanical role which this tissue plays. Hyaline cartilage is the type, or most characteristically developed form, of a tissue found with modifications else- where in the Body. One of its other modifications is the so- called cellular cartilage, which consists of the cells with hardly any matrix, only just enough to form a thin capsule around each. This form is that with which all the carti- 100 THE HUMAN BODY lages commence, the hyaline variety being built up by the in- crease of the cell- capsules and their fusion to form the ma- trix. It persists throughout life in the thin cartilaginous plate of a mouse's external ear. Other varieties of cartilage are really mixtures of true cartilage and connective tissues, and will be considered after the latter. The Connective Tissues. These complete the skeleton, marked out in its coarser features by the bones and cartilages, and constitute the final group of the supporting tissues. They occur in all forms, from broad membranes and stout cords to the finest threads forming networks around the other ultimate histological elements of various organs. In addition to subsidiary forms, three main varieties of this tissue are readily distinguishable, viz., areolar, white fibrous, and yellow elastic. Each consists of fibres and cells, the fibres being of two kinds, mixed in nearly equal proportions in the areolar variety, while one kind predominates in one and another in the second of the remaining chief forms. Areolar Connective Tissue. This exists abundantly be- neath the skin, where it forms a loose layer which permits the skin to be moved, more or less, to and fro over the sub- jacent parts. Areolar tissue consists of innumerable bands and cords interlacing in all directions, and can be greatly dis- tended by blowing air in at any point, from whence it travels widely through the intercommunicating meshes: if dried while distended it is somewhat like raw cotton in appearance but not so white. In dropsy of the legs or feet the cavities of this tissue are distended with lymph, which in health is present only in sufficient quantity to moisten them. From beneath the skin the areolar tissue extends all through the Body between the muscles and around the blood-vessels and nerves; and still finer layers of it enter into these and other organs and -unite their various parts together. It constitutes in fact a soft packing material which fills up the holes and corners of the Body, as for instance around the blood-vessels and between the muscles in Fig. 4. Microscopic Structure of Areolar Tissue. When exam- ined with the microscope areolar tissue is seen to consist of nucleated cells imbedded in a ground-substance which is per- meated by fibres. The fibres everywhere form the predomi- nant feature of the tissue (the homogeneous matrix and the cells being inconspicuous) an'd are of two very different kinds. CARTILAGE AND CONNECTIVE TISSUE. 101 In a strict sense indeed the areolar tissue ought to be consid- ered as a mixture of two tissues, one corresponding to each variety of fibres in it. It is characterized by its loose texture and by the fact that the two forms of fibres are present in about equal quantities. In many places a tissue containing the same histological elements as the areolar tissue is found in the form of dense membranes, as for example periosteum and perichondrium. White Fibrous Tissue. One of the variiet]e> bt fibres per- vading the matrix of areolar tissue exists "olmSst unmixed' with the other kind in the cords or tendSns whifch miffce'-r-i US- FIG. 46. Fro. 46a. FIG. 46.— White fibrous connective tissue, highly magnified. The nucleated cor- puscles, seen edgewise and appearing spindle-suaped, are seen here and there on the surface of the bundles of fibres. FIG. 46a.— Yellow elastic tissue, magnified after its fibres have been torn apart. cles to the bones. This form, known as the white fibrous con- nective tissue, is also found fairly pure in the ligaments around most joints. Physically it is very flexible but extremely tough and inextensible, so that it will readily bend in any direction but is very hard to break; when fresh it has an opaque white color. White fibrous tissue (Fig. 46) consists of a matrix, contain- ing cavities in which cells lie, and pervaded by bundles of extremely fine fibres. These fibres run in each bundle toler- 102 THE HUMAN BODY. ably parallel to one another in a wavy course (Fig. 46) and never branch or unite. Their diameter varies from 0.0005 to 0.001 millimeter (-5-00-00- to ^-jhrTr °f an inch). Chemically this tissue is characterized by the fact that its fibres swell up and become indistinguishable when treated with dilute acetic acid, and by the fact that it yields gelatin when boiled in water. The substance in it, called ossein in bones, which is turned into gelatin by such treatment, is here known us i.oU'.tgen. Glue is impure gelatin obtained from tendons and ligaments, and calf s-foot jelly, so often recom- mended, to invalids, Is a purer form of the same substance oiriained by boiling' the feet of calves, which contain the ten- dons of many muscles passing from the leg to the foot. Elastic Tissue. This is almost invariably mixed in some proportion in all specimens of white fibrous tissue, even the purest, such as the tendons of muscles; but in certain places it exists almost alone, as for example in the ligaments (liya- menta sub/lava) between the arches of the vertebrae, and in the coats of the larger arteries. In quadrupeds it forms the great ligament already referred to (p. 83), which helps to sus- tain the head. This tissue, in mass, is of a dull yellow color and extremely extensible and elastic; when purest nearly as much so as a piece of india-rubber. Sometimes it appears under the microscope to be made up of delicate membranes, but more often it is in the form of fibres (Fig. 46«) which are coarser than those of white fibrous tissue and frequently branch and unite. It is unaffected by acetic acid and does not yield gelatin when boiled in water. Connective-tissue Corpuscles. The fibres of white fi- brous tissue, wherever it is found, are united into bundles by a structureless ground-material known as the cement-sub- stance, which also invests each bundle, or skein as we may call it, with a delicate coating. In this ground-substance are numerous cavities, branched and flattened in one diameter, and often intercommunicating by their branches. In these cavities lie nucleated masses of protoplasm (Fig. 47), fre- quently also branched, known as the connective-tissue cor- puscles. These it is which build up the tissue, each cell in the course of development forming around it a quantity of intercellular substance, which subsequently be- comes fibrillated in great part, the remainder forming the cement. The cells do not quite fill the cavities in which they CARTILAGE AND CONNECTIVE TISSUE. 103 lie, and these opening into others by their offsets there is formed a set of minute tubes ramifying through the con- nective tissues; and (since these in turn permeate nearly all the Body) pervading all the organs. In these cell-cavities and their branches the lymph flows before it enters definite lymphatic vessels, and they are accordingly known as lymph FIG. 47.— Connective-tissue corpuscles : a. from areolar tissue ; 6, from tendon ; c, wandering cells. canaliculi. In addition to the fixed branched connective- tissue corpuscles there are often found other cells, when livi-ng connective tissue is examined. These cells much resemble white blood-corpuscles, and probably are such which have bored through the walls of the finer blood-vessels. They creep about along the canaliculi by means of their faculty of amoeboid movement, and are known as the "wandering cells. » Subsidiary Varieties of Connective Tissue — In various parts of the Body are connective-tissue structures which have not undergone the typical development, but have departed from it in one way or another. The cells having formed a non-fibrillated intercellular substance around them, develop- ment may go no farther and the mass remain permanently as the jellylike connective tissue ; or, as in the vitreous humor of the eye (Chap. XXXI), the cells having formed the soft matrix, may disappear and leave the latter only. In other cases the intercellular substance disappears and the cells branching, and joining by the ends of their branches, form a network themselves, nucleated or not at the points answering to the centre of each originally separate cell. This is known as adenoid connective tissue. In other cases the cells almost alone constitute the tissue, becoming flattened, closely fitted at their edges, and united by a very small amount of cement- substance. Membranes formed in this way lie beneath epithelium in many places and are known as basement- 104 THE HUMAN BODY. membranes : the flat cells (Fig. 11, I) which form the epithelium of the serous cavities are themselves a layer of modified connective-tissue corpuscles. In brain and spinal cord, protecting and supporting the nerve-tissues, are found branched cells forming the neuroglia. They are not true connective tissue, but correspond to cells of the horny layer of the epidermis, shut in when the medullary canal was closed in the embryo. Elastic Cartilage and Fibro-cartilage. We may now return to cartilages and consider those forms which are made up of more or less true cartilage mixed with less or more con- nective tissue of one kind or another. The cartilages of the ear and nose and some others have their matrix pervaded by fine branching fibres of yellow elastic tissue, which form net- works around the groups of cartilage-cells. Such cartilages are pliable and tough and possess also considerable extensibil- ity and elasticity. They are known as elastic or, from their color, as yellow cartilages. Elsewhere, especially in the carti- lages which lie between the bones in some joints, we find forms which have the matrix pervaded by white fibrous tissue and known as fibro-cartilage. For example the articular cartilage on the end of the lower jaw does not come into FIG. 48.— Section through the joint of the lower jaw showing its interarticular fibre-cartilage, x, with the sy no vial cavity on each side of it. direct contact with that covering its socket on the skull, but lying between the two in the joint (Fig. 48) is an interartic- ular fibro-cartilage : similar cartilages exist in the knee-joint; CARTILAGE AND CONNECTIVE TISSUE. 105 and the intervertebral disks are also made up of this tissue. Both elastic cartilage and fibro-cartilage often shade off insensibly into pure elastic or pure white fibrous connective tissue. Homologies of the Supporting Tissues. Bone, cartilage, and connective tissue all agree in broad structural characters, and in the uses to which they are applied in the Body. In each of them the cells which have built up the tissue, with few exceptions, form an inconspicuous part of it in its fully developed state, the chief mass of it consisting of intercellular substance. In hyaline cartilages this latter is not fibrillated; but these cartilages pass insensibly in various regions of the Body into elastic or fibro-cartilages, and these latter in turn into elastic or fibrous connective tissue. The lamellae of bone, too, when peeled off a bone softened in acid and examined with a very high magnifying power, are seen to be pervaded by fine fibres. Structurally, therefore, one can draw no hard and fast line between these tissues. The same is true of their chemical composition; bone and white fibrous tissue contain a substance (collagen) which is converted into gelatin when boiled in water; and in old people many carti- lages become hardened by the deposit in their matrix of the same lime-salts which give its hardness to bone. Further, the developmental history of all of them is much alike. In very early life each is represented by cells only : these form an intercellular substance, and this subsequently may become fibrillated, or calcified, or both. Finally they all agree in manifesting in health no great physiological activity, their use in the Body depending upon the mechanical properties of their intercellular portions. The close alliance of all three is further shown by the frequency with which they replace one another. All the bones and cartilages of the adult are at first represented only by collections of connective tissue. Before or after birth this is in some cases substituted by bone directly (as in the case of the collar-bone and the bones on the roof of the skull), while in other cases cartilage supplants the connective tissue, to be afterwards in many places replaced by bone, while elsewhere it remains throughout life. Moreover in different adult animals we often find the same part bony in one, cartilaginous in a second, and com- posed of connective tissue in a third: so that these tissues 106 THE HUMAN BODY. not only represent one another at different stages in the life of the same animal but permanently throughout the whole life of different animals. Low in the animal scale we find them all represented merely by cells with structureless inter- cellular substance: a little higher in the scale the latter becomes fibrillated and forms distinct connective tissue. In the highest Mollusks (as the cuttle-fishes) this is partly replaced by cartilage, and the same is true of the low- est fishes; while in some other fishes and the remaining Vertebrates we find more or less bone appearing in place of the original connective tissue or cartilage. From the similarity of their modes of development and fundamental structure, the transitional forms which exist between them, and the frequency with which they replace one another, histologists class the three (bone, cartilage, and connective tissue) together as homologous tissues and regard them as differentiations of the same original structure. Hygienic Remarks. Since in the new-born infant many parts which will ultimately become bone consist only of car- tilage, the young child requires food which shall contain a large proportion of the lime-salts which are used in building up bone. Nature provides this in the milk, which is rich in such salts (see Chap. XXI), and no other food can thoroughly replace it. Long after infancy milk should form a large part of a child's diet. Many children though given food abundant in quantity are really starved, since their food does not contain in sufficient amount the mineral salts requisite for their healthy development. At birth even those bones of a child which are most ossi- fied are often not continuous masses of osseous tissue. In the humerus, for example, the shaft of the bone is well ossified and so is each end, but between the shafts and each of the articular extremities there still remains a cartilaginous layer, and at those points the bone increases in length, new cartilage being formed and replaced by bone. The bone increases in thickness by new osseous tissue formed beneath the perios- teum. The same thing is true of the bones of the leg. On account of the largely cartilaginous and imperfectly knit state of its bones, it is cruel to encourage a young child to walk beyond its strength, and may lead to "bow-legs" or other permanent distortions. Nevertheless here as elsewhere in the animal body, moderate exercise promotes the growth of CARTILAGE AND CONNECTIVE TISSUE. 107 the tissues concerned, and it is nearly as bad to wheel a child about forever in a baby-carriage as to force it to over exertion. The best rule is to let a healthy child use its limbs when it feels "inclined, but not by praise or blame to incite it to efforts which are beyond its age, and so sacrifice its healthy growth to the vanity of parent or nurse. The final knitting together of the bony articular ends with the shaft of many bones takes place only comparatively late in life, and the age at which it occurs varies much in different bones. Generally speaking, a layer of cartilage re- mains between the shaft and the ends of the bone, until the latter has attained its full adult length. To take a few examples : the lower articular extremity of the humerus only becomes continuous with the shaft by bony tissue in the sixteenth or seventeenth year of life. The upper articular extremity only joins the shaft by bony continuity in the twentieth year. The upper end of the femur joins the shaft by bone from the seventeenth to the nineteenth year, and the lower end during the twentieth. In the tibia the upper extremity and the shaft unite in the twenty-first year, and the lower end and the shaft in the eighteenth or nineteenth : while in the fibula the upper end joins the shaft in the twenty-fourth year, and the lower end in the twenty-first. The separate vertebras of the sacrum are only united to form one bone in the twenty-fifth year of life; and the ilium, ischium, and pubis unite to form the os innominatum about the same period. Up to about twenty-five then the skeleton is not firmly "knit," and is incapable, without risk of injury, of bearing strains which it might afterwards meet with im- punity. To let lads of sixteen or seventeen row and take other exercise in plenty is one thing, and a good one; but to allow them to undergo the severe and prolonged strain of training for and rowing a long race is quite another, and not devoid of risk. Adipose Tissue. Fatty substances of several kinds exist in considerable quantity in the Human Body in health, some as minute droplets floating in the bodily liquids or imbedded in various cells, but most in special cells, nearly filled with fat, and collected into masses with supporting and nutritive parts to form adipose tissue. In fact almost in every spot where the widely distributed areolar tissue is found, there is adipose tissue in greater or less proportion mixed with it. 108 THE HUMAN BODY. Considerable quantities exist for example in the subcuta- neous areolar tissue, especially in the female sex, giving the figure of the woman its general more graceful roundness of contour when compared with that of the male. Large quanti- ties commonly lie in the abdominal cavity around the kid- neys; in the eye-sockets, forming a pad for the eyeballs ; in the mar- row of bones; around the joints, and so on. Examined with the microscope (Fig. 49) adipose tissue is found to consist of small vesicles from 0.2 mm. to 0.09 mm. (T-J-Q to ^-J-^ inch) in diameter, clustered together into little masses and bound to one an- FIG. 49. — Fat-cells imbedded ., , ,. ,. -, , -, ^ in areolar tissue, a, nucleus; Other by Connective tlSSlie and blood- 6, protoplasmic, oil-droplet.^ veggels ^^ intertwine around them; in this way the little angular masses which are seen in beef-suet are formed, each mass being separated by a some- what coarser partitioii of areolar tissue from its neighbors. The individual fat-cells are spherical or ovoid except when closely packed ; then they become polygonal. Each consists of a delicate envelope containing oily matter, which in life is liquid at the temperature of the Body. Besides the oily matter, a nucleus is commonly present in each fat-cell; and a thin layer of protoplasm, exaggerated in Fig. 49, forms a lining to the cell-wall. The oily matter consists of a mixture of palmatin, olein and stearin, which are compounds of pal- mitic, stearic and oleic acids with glycerin, three molecules of the acid being combined with one of glycerin, with the elimination of water; as for example: 3(C,,H3S0 | Q) +OA J Q _ 3(0,^0) J0s + 3H20 Stearic acid. Glycerin. Stearin. Water. CHAPTER IX. THE STRUCTURE OF THE MOTOR ORGANS. Motion in Animals and Plants. If one were asked to point out the most distinctive property of living animals, the answer would probably be, their power of executing spontane- ous movements. Animals as we commonly know them are rarely at rest, while trees and stones move only when acted upon by external forces, which are in most cases readily re- cognizable. Even at their quietest times some kind of motion is observable in the higher animals. In our own Bodies during the deepest sleep the breathing movements and the beat of the heart continue; their cessation is to an onlooker the most obvious sign of death. Here, however, as elsewhere in Biology, we find that precise boundaries do not exist; at any rate so far as animals and plants are concerned we cannot draw a hard and fast line between them with reference to the presence or absence of apparently spontaneous motility. Many a flower closes in the evening to expand again in the morning sun; and in many plants comparatively rapid and extensive movements can be called forth by a slight touch, which in itself is quite insufficient to produce mechanically that amount of motion in the mass. The Venus's flytrap (Dioncea musci- pula) for example has fine hairs on its leaves, and when these are touched by an insect the leaf closes up so as to imprison the anirial, which is subsequently digested and absorbed by the leaf. The higher plants it is true have not the power of locomotion, they cannot change their place as the higher ani- mals can; but on the other hand some of the lower animals are permanently fixed to one spot; and among the lowest plants many are known which swim about actively through the water in which they live. The lowest animals and plants are in fact those which have undergone least differentiation in their development, and which therefore resemble each other in possessing, in a more or less manifest degree, all the fundamental physiological properties of that simple mass of 109 HO THE HUMAN BODY. protoplasm which formed the starting-point of each individ- ual. With the physiological division of labor which takes place in the higher forms we find that, speaking broadly, plants especially develop nutritive tissues, while animals are characterized by the high development of tissues with motor and irritable properties; so that the preponderance of these latter is very marked when a complex animal, like a dog or a man, is compared with a complex plant, like a pine or a hick- ory. The higher animal possesses in addition to greatly de- veloped nutritive tissues (which differ only in detail from those of the plant, and constitute what are therefore often called organs of vegetative life] well-developed spontaneous, irritable and contractile tissues, found mainly in the nervous and muscular systems, and forming what have been called the organs of animal life. Since these place the animal in close relationship with the surrounding universe, enabling slight external forces to excite it, and it in turn to act upon external objects, they are also often spoken of as organs of relation. In man they have a higher development on the whole than in any other animal, and give him his leading place in the ani- mate world, and his power of so largely controlling and direct- ing natural forces for his own good, while the plant can only passively strive to endure and make the best of what happens to it; it has little or no influence in controlling the happening. Amoeboid Cells. The simplest motor tissues in the adult Human Body are the amoeboid cells (Fig. 15) already de- scribed, which may be regarded as the slightly modified descendants of the undifferentiated cells which at one time made up the whole Body. In the adult they are not attached to other parts, so that their changes of form only affect them- selves and produce no movements in the rest of the Body. Hence with regard to the whole frame they can hardly be called motor tissues, and are classed in the group of undiffer- entiated tissues. Ciliated Cells. As the growing Body develops from its primitive simplicity we find that the cells lining some of the tubes and cavities in its interior undergo a very remark- able change, by which each cell differentiates itself into a nu- tritive and a highly motile and spontaneous portion. Such cells are found for example lining the windpipe, and are represented in Fig. 50. Each has a conical form, the base of the cone being turned to the cavity of the air-tube, and con- THE STRUCTURE OF THE MOTOR ORGANS, 111 tains an oval nucleus with a nucleolus. On the broader free end are a number (about thirty on the average) of extremely fine processes called cilia. During life these are in constant rapid movement, lashing to and fro in the liquid which moistens the interior of the passage; and as the cells are very closely packed, a bit of the inner surface of the windpipe, ex- amined with a microscope, looks like a field of wheat or barley when the wind _ . .f. FIG. 50.— Ciliated cells. blows over it. .bach cilmm strikes with more force in one direction than in the opposite, and as this direction of more powerful stroke is the same for all the cilia on any one surface, the resultant effect is that the liquid in which they move is driven one way. In the case of the wind- pipe for example it is driven up towards the throat, and the tenacious liquid or mucus which is thus swept along is finally coughed or "hawked" up and got rid off, instead of accumu- lating in the deeper air-passages away down in the chest. These cells afford an extremely interesting example of the division of physiological employments. Each proceeds from a cell which was primitively equally motile, automatic and nutritive in all its parts. But in the fully developed state the nutritive duties have been especially assumed by the conical cell-body, while the automatic arid contractile prop- erties have been condensed, so to speak, in that modified portion of the primitive protoplasmic mass which forms the cilia. These, being supplied with elaborated food by the rest of the cell, are raised above the vulgar cares of life and have the opportunity to devote their whole attention to the per- formance of automatic movements; which are accordingly far more rapid and precise than those executed by the whole cell before any division of labor had occurred in it. That the movements depend upon the structure and com- position of the cells themselves, and not upon influences reaching them from the nervous or other tissues, is proved by the fact that they continue for a long time in isolated cells, removed and placed in a liquid, as blood-serum, which does not alter their physical constitution. In cold-blooded animals, as turtles, whose constituent tissues frequently retain their individual vitality long after that bond of union has been destroyed which constitutes the life of the whole animal as 112 THE HUMAN BODY. distinct from the lives of its different tissues, the ciliated cells in the windpipe have been found still at work three weeks after the general death of the animal. The Muscles. These are the main motor organs ; their general appearance is well known to every one in the lean of butcher's meat. While amoeboid cells can only move them- selves, and (at least in the Human Body) ciliated cells the layer of liquid with which they may happen to be in contact, the majority of the muscles, being fixed to the skeleton, can, by alterations in their form, bring about changes in the form and position of nearly all parts of the Body. With the skele- ton and joints, they constitute pre-eminently the organs of motion and locomotion, and are governed by the nervous system which regulates their activity. In fact skeleton, muscles, and nervous system are correlated parts: the degree of usefulness of any one of them largely depends upon the more or less complete development of the others. Man's highly endowed senses and his powers of reflection and reason would be of little use to him, were his muscles less fitted to carry out the dictates of his will or his joints less numerous or mobile. All the muscles are under the control of the nervous system, but all are not governed by it with the co-operation of will or consciousness; some move without our having any direct knowledge of the fact. This is especially the case with certain muscles which are not fixed to the skeleton but surround cavities or tubes in the Body, as the blood-vessels and the alimentary canal, and by their movements control the passage of substances through them. The former group, or skeletal muscles, are also from their microscopic characters known as striped muscles, while the latter, or visceral muscles, are called unstriped or plain muscles. The skeletal muscles being generally more or less subject to the control of the will (as for example those moving the limbs) are frequently spoken of as voluntary, and the visceral muscles, which change their form independently of the will, as involuntary. The heart- muscle forms a sort of intermediate link; it is not directly attached to the skeleton, but forms a hollow bag which drives on the blood contained in it and that quite involuntarily; but in its microscopic structure it resembles somewhat the skeletal voluntary muscles. The muscles of respiration might perhaps be cited as another intermediate group. They are striped skeletal muscles and, as we all know, are to a certain extent THE STRUCTURE OF THE MOTOR ORGANS. 113 subject to the will; any one can draw a deep breath when he chooses. But in ordinary quiet breathing we are quite un- conscious of their working, and even when attention is turned to them the power of control is limited; no one can voluntar- ily hold his breath long enough to suffocate himself. As we shall see hereafter, moreover, any one or all of the striped muscles of the Body may be thrown into activity independ- ently of or even against the will, as, to cite no other instances, is seen in the "fidgets" of nervousness and the irrepressible trembling of extreme terror; so that the names voluntary and involuntary are not good ones. The functional differences between the two groups depend really more on the nervous connections of each than upon any essential difference in the properties of the so-called voluntary or involuntary muscular tissues themselves. The Skeletal Muscles. In its simplest form a skeletal muscle consists of a red soft central part, the belly, which tapers at each end and there passes into one or more dense white cords which consist almost entirely of white fibrous connective tissue. These terminal cords are called the tendons of the muscle and serve to attach it to parts of the bony or cartilaginous skeleton. In Fig. 51 is shown the biceps muscle of the arm, which lies in front of the humerus. Its fleshy belly is seen to divide above and end there in two tendons, one of which, Bl', is fixed to the scapula, while the other, Bl), joins the tendon of a neighboring muscle (the coraco-brachial, Cb), and is also fixed above to the shoulder-blade. Near the elbow-joint the muscle is continued into a single tendon, B', which is fixed to the radius, but gives an offshoot, B", to the connective -tissue membranes lying around the elbow- joint. The belly of every muscle possesses the power of shorten- ing forcibly under certain conditions. In so doing it pulls upon the tendons, which being composed of inextensible white fibrous tissue transmit the movement to the hard parts to which they are attached, just as a pull at one end of a rope may be made to act upon distant objects to which the other end is tied. The tendons are merely passive cords and are sometimes very long, as for instance in the case of the mus- cles of the fingers, the bellies of many of which lie away in the forearm. If the tendons at each end of a muscle were fixed to the 114 THE HUMAN BODY. I O ? ^ & THE STRUCTURE OF THE MOTOR ORGANS. 115 same bone the muscle would clearly be able to produce no movement, unless by bending or breaking the bone; the probable result in such a case would be the tearing of the muscle by its own efforts. In the Body, however, the two ends of a muscle are always attached to different parts, usually two bones, between which more or less movement is permitted, and so when the muscle pulls it alters the relative positions of the parts to which its tendons are fixed. In the great majority of cases a true joint lies between the bones on which the muscle can pull, and when the latter contracts it produces movement at the joint. Many muscles even pass over two joints and can produce movement at either, as the biceps of the arm which, fixed at one end to the scapula and at the other to the radius, can move the bones at either the shoulder or elbow joint. Where a muscle passes over an ar- ticulation it is nearly always reduced to a narrow tendon; otherwise the bulky bellies lying around the joints would make them extremely clumsy and limit their mobility. Origin and Insertion of Muscles. Almost invariably that part of the skeleton to which one end of a muscle is • FIG. 52.— The biceps muscle and the arm-bones, to illustrate how, under ordinary circumstances, the elbow-joint is flexed when the muscle contracts. fixed is more easily moved than the part on which it pulls by its other tendon. The less movable attachment of a muscle is called its origin, the more movable its insertion. Taking for example the biceps of the arm, we find that when the belly of the muscle contracts and pulls on its upper and lower tendons, it commonly moves only the forearm, bending the elbow-joint as shown in Fig. 52. The shoulder is so much more firm that it serves as a fixed point, and so that end is 116 THE HUMAN BODY. the origin of the muscle, and the forearm attachment, P, the insertion. It is clear, however, that this distinction in the mobility of the points of fixation of the mnscle is only rela- tive, for, by changing the conditions, the insertion may become the stationary and the origin the moved point; as for instance in going up a rope " hand over hand." In that case the radial end of the muscle is fixed and the shoulder is moved through space by its contraction. Different Forms of Muscles. Many muscles of the Body have the simple typical form of a belly tapering to a single tendon at each end as A, Fig. 53; but others divide at one end and are called two-headed or biceps muscles; while some are even three- headed or triceps muscles. On the other hand some muscles have no tendon at all at one end, the belly run- ning quite up to the point of attachment; and some have no tendon at either end. In many muscles a tendon runs along one side and the fibres of the belly are at- tached obliquely to it: such muscles (B, Fig. 53) are called penniform or featherlike; or a tendon runs obliquely down the middle of the muscle and has the fibres of the belly fixed obliquely on each side of it (C, Fig. 53), forming a bipenniform muscle : or even two tendons may run down the belly and so form a tripenniform muscle. In a few cases a tendon is found in the middle of the belly FIG. 53.— Diagrams . illustrating typical as well as at each end oi it; such muscles muscle with a central -\-iii- * • * ^ .c j_i • j? belly and two termi- are called diastric. A muscle of this form (Fig. 54) isfonnd in connection with the bipenniform muscle. IQ^ ^ ^ ^^ by ft tend(m attached to the base of the skull; from there its first belly runs down- wards and forwards to the neck by the side of the hyoid bone, where it ends in a tendon which passes through a loop serving as a pulley. This is succeeded by a second belly directed upwards towards the ciiin, where it ends in a tendon inserted into the lower jaw. Running along the front of the abdomen from the pelvis to the chest is a lonqr muscle on each side of the middle line called the rectus abdominis: it is polygastric, con sisting of four bellies separated by short tendons. Many muscles moreover are not rounded but form wide flat masses, THE STRUCTURE OF THE MOTOR ORGANS. 117 us for example the muscle Ss seen on the ventral side of the shoulder-blade in Fig. 51. G-ross Structure of a Muscle. However the form of the skeletal muscles and the arrangement of their tendons may vary, the essential structure of all is the same. Each consists of a proper striped muscular tissue, which is its essential part, but which is supported by connective tissue, nourished by blood-vessels and lymphatics, and has its activity governed by nerves; so that a great variety of things go to form the complete organ. A loose sheath of areolar connective tissue, called the peri- mysium, envelops each muscle, and from this partitions run in and subdivide the belly into bundles or fasciculi which run from tendon to tendon, or for the whole length of the muscle when it has 110 tendons. The coarseness or fineness of butcher's meat depends upon the size of these primary fasciculi, which differs in different muscles of the same ani- rnal. These larger fasci- culi are subdivided by finer connective tissue, mem- branes into smaller ones (as shown in Fig. 55, which represents a few primary fasciculi of a muscle and the secondary fasciculi into which these are divided), FlG. 55._A smaTi bit of muscle composed each of which consists of a of five g^^Bgvdfl^thne dKnwters^to Certain number Of micro- show the secondary fasciculi of which the primary are composed. scopic muscular fibres bound together by very fine connective tissue and enveloped in a close network of blood-vessels. Where a muscle tapers the fibres in the fasciculi become less numerous, and when a tendon is formed disappear altogether, leaving little but the connective tissue. Histology of Muscle. For the present we need only concern ourselves with the muscular fibres. Each of these is from eight to thirty-five millimetres (£ to H inches) long, but only from 0.034 to 0.055 mm. (Tfo to rhr inch) in diameter in its widest part and tapering to a blunt point at each end. In cross-section the fibres are irregularly polygonal. In long muscles with terminal tendons, no fibre runs the whole length of a fasciculus, which may be a foot or more long, but the 118 THE HUMAN BODY. fasciculus is made up of many successive fibres, the narrow end of each fitting in between the ends of those which follow it. In muscles with short fasciculi, the fibres may run the whole length of each of the latter. The tissue of the skeletal muscles is very easily recognized under the microscope: even when magnified only two or three hundred diameters each fibre is seen to be crossed for its whole width by regularly alternating dim- mer and brighter bands (Fig. 56) or stripes. In a relaxed fibre each band is about jrfo min. (V^TTTr inch) in width, but the brighter FIG. 56.-A small V 1 ? 0 ( 0 / & part of a muscle-fibre, bands are a little broader than the darker. itl^cross^tV' Yo0rTandIn the contracted fibre both kinds of bands become narrower, especially the brighter, and these latter at the same time undergo an optical change and divert the light so that but little of it reaches the eye when the fibre is in focus ; in consequence they then look darker than the original dimmer bands lying between them and now appearing as the brighter of the two. A fresh muscle-fibre shows on close examination a faint longitudinal striation. This is much more marked in specimens which have been preserved in alcohol> and these may be teased out into very fine threads which have been named fibrillai. On careful examination each fibre can be made out to possess an external envelope, the sarco- lemma, enveloping a softer material which makes up the main mass of the fibre; but there are in addition a number of oval nuclei which lie im- mediately under the sarcolemma and are placed muscuia lengthwise in the fibre. On account of its extreme fibre hat thinness and transparency the sarcolemma cannot fwStSf FIG. be recognized when lying in its natural position, closely applied to the striped contents, but being tougher than these it sometimes remains unbroken where so ciose- ly applied to when they are crushed and then (Fiff. 57) comes the rest as to . . . be invisible, into view as an apparently structureless mem- remains un- brane bridging over the gap. The sarcolemma spiSuous. cc is imperforate except at one point where the central por- THE STRUCTURE OF THE MOTOR ORGANS. 119 tion (or axis cylinder, see Chap. XII) of a nerve-fibre pene- trates it. The striped contents which occupy most of the cavity en- closed by the sarcolemma are the essential contractile portion of the fibre and during life are soft or semi-fluid: soon after death they solidify or clot and thus death-stiffening (rigor mortis] is produced. At intervals, corresponding to the middle zone of each bright band of the relaxed fibre, an extremely delicate membrane (membrane of Krause, K, Fig. 58) crosses the fibre, thus dividing the rest of the contents into a series of disks, each consisting of a dim centre answering K K FIG. 58.— Diagrams to illustrate the structure of a small piece of a striped muscle-fibre. A, in the relaxed, B, in the contracted condition; K, K, membranes of Krause; H, H, bands of Hensen ; aa, bb, parts of sarcostyles, showing their con- strictions near Krause's membranes, and the tubulated sarcosomes in each ; c,d,e,/, a sarcous element; o, hyaloplasm; g, sarcoplasm. to the whole of a dark band, and two brighter ends, each cor- responding to half of a bright band. Each disk is a sar comer e. Under certain conditions, in fact, a fibre may be split up crosswise into a number of such disks. When a fresh muscle- fibre is artificially stretched and examined with a very high magnifying power there may further be made out in the middle of each dim band a transverse line (band of Hensen, H, Fig. 58) slightly brighter than the rest of the dim band. The main bulk of each fibre consists of polygonal rods, the muscle-columns or sarcostyles (aa, bb, Fig. 58), which are inter- 120 THE HUMAN BODY. rupted in their course by Krause's membranes. That portion of a sarcostyle, cdef, included between two consecutive mem- branes is a sarcous element. The terminal portions of each sarcous element are of softer consistence than most of the mid- dle part and correspond to the hyaloplasm (Fig. 7) of a typical primitive cell, and the material composing them may be designated by the same name. The central portion of each sarcous element is mainly made up of a firmer material which stains with hemotoxylin and answers in general to the reticulnm of a primitive cell : it is named the sarcous substance or, better, the sarcosome. Each sarcosome is permeated by fine longi- tudinal tubules which commence at its ends bat do not reach to its centre and are thus divided into two sets by a median transverse partition in which the band of Hensen lies. These tubules are filled with hyaloplasm. The sarcous elements are constricted where they abut on Krause's membrane and in consequence each sarcostyle is narrowed at regular intervals along its course. The spaces between the sarcostyles are filled by a very soft sarcoplasm, which is of course more abundant in the regions of Krause's membranes, where the muscle-columns are constricted. In mammalian muscle the sarcoplasm is present in relatively much smaller amount than indicated in Fig. 58. In fresh specimens it can, however, be made out in the form of fine dark lines with swollen ends, lying between contiguous sarcous elements. Gold chloride stains the sarcoplasm deeply but leaves the sarcostyles un- colored : hence in specimens so prepared the edges or ends of the sarcoplastic septa appear as very conspicuous lines, which look, especially in cross-sections, as if due to a network of fibres, as which they have been described by several observers, and been regarded as the essential contractile part of the fibre. In a relaxed muscle-fibre (A, Fig. 58) the sarcosomes are comparatively long and narrow; but during contraction (B) they become shorter and thicker and bulged out in the middle, and more hyaloplasm passes into their tubules, which become distended, especially near their deeper ends: the band of Hensen also ceases to be visible. Contraction of the whole fibre is thus accompanied by or, rather, is due to a transfer- ence of hyaloplasm from the ends of each sarcomere into the interior of the sarcosomes of its central portion, in conse- quence of which the whole fibre becomes shorter and thicker. The swelling of the sarcosome pushes aside some of the THE STRUCTURE OF THE MOTOR ORGANS. 121 sarcoplasm lying between them and the displaced portion ac- cumulates nearer the ends of the sarcous elements, in the space left by that portion of the hyaloplasm which has entered the tubules: compare gg in A and B, Fig. 58. Arguing from the analogy of the amoeboid cell in which, as we have seen (p. 27), parts consisting only of hyaloplasm can exhibit movements, it would seem probable that in the muscle-fibre the hyaloplasm is to be regarded as the active contractile portion and the sarcosomes as a framework directing the form which the contracted hyaloplasm shall assume, and assuring that it shall be a precise and definite shortening in the direction of the long axis of the fibre with a widening in the transverse direction, instead of such irreg- ular changes of form as are exhibited by the amoeboid cell with its irregularly arranged or, sometimes, entirely absent reticulum. That the hyaloplasm and not the sarcoplasm form the contractile part of the fibre is proved by the fact that in some insect-muscles in which they are unusually large, it is possible to isolate them while alive and observe them still contracting. The nuclei of the fibres lie in the sarcoplasm, which rep- resents a part of the original protoplasm of the row of cells from which each muscle-fibre develops, that has remained but little changed while the rest was differentiated into sarcous elements. The blood-vessels and nerve-fibres supplied to the skeletal muscles are numerous. The larger blood-vessels run in the coarser partitions of the connective tissue lying between the fasciculi and give off fine branches which form a network be- tween the individual fibres but never penetrate the sarcolemma. Connected with each muscle-fibre is a nerve-fibre of the white variety (Chap. XII). The central core of the nerve-fibre ends in an oval expansion (end plate) which contains many nuclei and lies close under the sarcolemma, its deeper side being in immediate contact and possibly continuous with the striated contents. These nerve-fibres are motor or con- cerned in exciting a contraction of the muscle-fibre. Other white nerve-fibres are connected with very peculiar bodies found scattered throughout the muscle, but especially numer- ous near the tendons. They are usually of a size just visible to the unaided eye and from their form have been named muscle-spindles. They appear to be sensory in function. 122 THE HUMAN BODY. Somewhat similar bodies (Golgi's tendon-organs] are found in the tendons and are also richly supplied with nerve-fibres. In histological structure the tendon-organs and the muscle- spindles appear to be allied to Pacinian bodies (Chap. XXXV). Structure of the Unstriped Muscles. Of these the muscular coat of the stomach (Fig. 59) is a good example. FIG. 59.— The muscular coat of the stomach. They have no definite tendons, but form expanded membranes surrounding cavities, so that they have no definite origin or insertion. Like the skel- etal muscles they consist of proper contractile elements, with accessory connective tissue, blood-vessels and nerves. Their fibres, how- ever, have a very different microscopic struc- ture. They present a slightly marked longi- tudinal but no cross striation and are made up of elongated cells (Fig. 60), bound to- gether by a small quantity of cementing material. The cells vary considerably in size, but on the average are about ^ mm. (•{T^g- inch) in length. Each is flattened in one plane, tapers off at each end, and possesses a very thin enveloping membrane; in its interior lies an elongated nucleus with one or two nucleoli. These cells have the — Unstriped power of shortening in the direction of their muscle-ceils. long axes, and so of diminishing the capacity of the cavities in the walls of which they lie. THE STRUCTURE OF THE MOTOR GROANS. 123 Cardiac Muscular Tissue. This consists of nucleated branched cells which unite to form a network, in the inter- stices of which blood-capillaries and nerve-fibres run. The cells present transverse striations, but riot so distinct as those of the skeletal muscles, and are said to have no sarcolemma. The Chemistry of Muscular Tissue. The chemical structure of the living- muscular fibre is unknown, but some idea as to it may be obtained from ex- amination of the substances it yields on proximate analysis. Muscle contains 75 Fl«^._Cardiacmuscu- per cent of water; and, among other Jg; ^^gpT'^S inorganic Constituents, phosphates and boundaries and cell-nuclei 0 ' r -t are indicated only in the Chlorides Of potassium, SOdium, and right-hand portion of the * ' . figure. magnesium. When at rest a living muscle is feebly alkaline, but after hard work, or when dying, this reaction is reversed through the formation of sarcolactic acid (C3H603). Muscles contain small quantities of grape- sugar and glycogen, and of organic nitrogenous crystalline compounds, especially kreatin (C4H9N3Oa). As in the case of all other physiologically active tissues, however, the main post-mortem constituents of the muscular fibres are proteid substances, and it is probable that like protoplasm itself (p. 27) the essential contractile part of the tissue consists of a complex body containing proteid, carbohydrate and fatty residues; and that during muscular work this is broken up, yielding proteids, carbon dioxide, sarcolactic acid, and prob- ably other things. During life and for a certain time after general death the muscles are soft, translucent, extensible and elastic, and neutral or feebly alkaline in reaction; after a period which in warm-blooded animals is brief (varying from a few minutes to three or four hours) they gradually become harder, more opaque, less extensible and less elastic, and distinctly acid in reaction. The result of these changes is the well-known cadaveric rigidity or rigor mortis. The rigid condition lasts for a day or longer and then it gradually and finally disappears and more marked decomposition changes commence. Until a short time before the commencement of rigor the muscles remain contractile and can be thrown into activity by various 124 THE HUMAN BODY. excitants, as electric shocks; that is to say, although the body in general is dead and the beat of the heart and the flow of blood have ceased, yet the muscles retain their vitality for a while. This is especially the case with the muscles of cold- blooded animals, as frogs and turtles, the muscles of wjiich may, especially if kept cool, retain their living propertied for several hours after removal from the body of the animal/ If muscles be taken in an early stage of rigor, rapidly^reed as much as possible from tendons, fats and connective tissue, and then finely minced and thoroughly washed with water, most of the salts and crystallizable muscle ingredients eanjpe dissolved away, along with a small amount of albumens; but by far the greater part of the albumen is left behind in the form of myosin, a proteid which is insoluble in water. On treating the residue with a 10 per cent solution of ammonium chloride the myosin dissolves and may be obtained as a flocculent white precipitate by allowing the solution to fall drop by drop into a large quantity of water, or by adding to it a consider- able proportion of common salt. Myosin is related chemically to fibrinogen and globulin, and its solutions in 10 per cent neutral saline are coagulated by heat at the same temperature (56° C. or 158° F.) as the former. Although myosin is apparently the least altered form in which its chief proteid constituent can be separated from muscle, it does not appear to exist, or at least exists in small quantity if at all, in. living muscle; it is an early product of post-mortem chemical changes. Its precursor in living muscle has been named myosinogen, and a solution containing that substance may be obtained as follows: Perfectly fresh and still contractile muscles are cut out from a frog which has just been killed by destruction of its brain and spinal cord, a proceeding which entirely deprives the animal of conscious- ness and the power of using its muscles, but leaves these lat- ter unaltered and alive for some time. The excised muscles are thrown into a vessel cooled below 0° C. by a freezing mix- ture and are thus frozen hard before any great chemical change has had time to occur in them. The solidified mus- cles are then cut up into thin slices, the bits thrown on a cooled filter and let gradually warm up to the freezing-point of water, after the addition of some ice-cold 0.5 per cent solu- tion of common salt. Gradually a small quantity of a tena- cious alkaline and transparent liquid filters through. This THE CHEMISTRY OF MUSCLE. 125 liquid, known as the muscle-plasma, contains myosinogen and like blood-plasma is spontaneously coagulable. It quickly sets into a transparent jelly and this soon separates into mus- cle-serum and muscle-clot, the latter consisting of myosin. Dissolved in the muscle-serum are found small quantities of several albumens, one much resembling the serum-albumen of blood. The spontaneous clothing of the plasma, and presum- ably the natural formation of myosin during rigor mortis, are due to the action on myosinogen of an enzyme, muscle-fer- ment, much resembling fibrin-ferment. The clotting is accompanied by a change of reaction from the alkaline or neutral of the plasma to a markedly acid one: this appears to be mainly due to the formation of sarcolactic acid, the quan- tity of which bears a proportion to that of the myosin formed, suggesting that both may be products of the breaking-down of a pre-existent more complex substance. It has further been shown that when a muscle passes into the state of rigor it evolves a certain amount of carbon dioxide, and that the quantity of this varies with the quantity of myosin and of sarcolactic acid formed. Hence it has been suggested that in the living muscle there is a substance which after death breaks up yielding (with possibly other things) myosinogen, sarcolactic acid and carbon dioxide; and further that this chemical change is associated with the liberation of energy (Chap. XX) which in the dead muscle is set free mainly as the heat which is known to be evolved by muscles passing into rigor. The precipitate produced when myosin solutions are heated is coagulated proteid (p. 10) and insoluble in dilute acids and alkalies in which myosin itself is very soluble. When dissolved in dilute acids myosin is converted into syn- tonin, which was formerly supposed to be the chief form of proteid present in dead muscles. Syntonin is insoluble in water and neutral saline solutions, but soluble in dilute acids and alkalies, and its solutions are not coagulated by boiling. Beef Tea and Liebig's Extract. From the above-stated facts it is clear that when a muscle is boiled in water its myo- sin is coagulated and left behind in the meat : even if cook- ing be commenced by soaking in cold water the myosin still remains, as it is as insoluble in cold water as in hot. Beef tea as ordinarily made, then, contains little but the flavoring matters and salts of the meat, traces of some albumens and 126 THE HUMAN BODY. some gelatin, the latter derived from the connective tissues of the muscle. The flavoring matters and salts make it decep- tively taste as if it were a strong solution of the whole meat, and the gelatin causes it to " set " on cooling, so the cook feels quite sure she has got out " all the strength of the meat/' whereas the beef tea so prepared contains but little of the most nutritious proteid portions, which in an insipid shrunken form are left when the liquid is strained off. Various pro- posals have been made with the object of avoiding this and getting a really nutritive beef tea; as for example chopping the raw meat fine and soaking it in strong brine for some hours to dissolve out the myosin; or extracting it with dilute acids which turn the myosin into syntonin and dissolve it and at the same time render it non-coagulable by heat when subse- quently boiled. Such methods, however, make unpalatable compounds which invalids will not take. Beef tea is a slight stimulant, and often extremely useful in temporarily main- taining the strength and in preparing the stomach for other food, but its direct value as a food is slight, and it cannot be relied upon to keep up a patient's strength for any length of time. There can be no doubt that thousands of sick persons have in the past and are being to-day starved to death on it. Liebig's extract of meat is essentially a very strong beef tea; containing much of the flavoring substances of the meat, nearly all its salts and the crystalline nitrogenous bodies, such as kreatin, which exist in muscle, but hardly any of its really nutritive parts, as was pointed out by Liebig himself. From its stimulating effects it is often useful to persons in feeble health, but other food should be given with it. It may also be used on account of its flavor to add to the " stock " of soup and for similar purposes ; but the erroneousness of the com- mon belief that it is a highly nutritious food cannot be too strongly insisted upon. Under the name of liqiiid extracts of meat other substances have been prepared by subjecting meat to chemical processes in which it undergoes changes similar to those experienced in digestion: the myosin is thus rendered soluble in water and uncoagulable by heat, and such extracts if properly prepared are nutritious and can often be absorbed when meat in the solid form cannot be digested: they may thus help the stomach over a crisis, but are not, even the best of them, to be depended on as anything but temporary substitutes for other food; or in some cases as use- ful additions to it. CHAPTER X. THE PROPERTIES OF MUSCULAR TISSUE. Contractility. The characteristic physiological property of muscular tissue, and that for which it is employed in the Body, is the faculty possessed by its fibres of shortening forcibly under certain circumstances. The direction in which this shortening occurs is always that of the long axis of the fibre in both plain and striped muscles, and it is accompanied by an almost equivalent thickening in other diameters, so that when a muscle contracts it does not shrivel up or diminish its bulk in any appreciable way; it simply changes its form. When a muscle contracts it also becomes harder and more rigid, especially if it has to overcome any resistance. This and the change of form can be well felt by placing the fingers of one hand over the biceps muscle lying in front of the bu- rn erus of the other arm. When the muscle is contracted so as to bend the elbow it can be felt to swell out and harden as it shortens. Every schoolboy knows that when he appeals to another to " feel his muscle " he contracts the latter so as to make it thicker and apparently more massive as well as harder. In statues the prominences on the surface indicating the muscles beneath the skin are made very conspicuous when violent effort is represented, so as to indicate that the muscles are in vigorous action. In a muscular fibre we find no longer the slow, irregular, and indefinite changes of form seen in amoeboid slightly differentiated cells; they are replaced by a precise, rapid and definite change of form. Muscular tissue represents a group of cells in the bodily community which have taken up the one special duty of executing changes of form, and in proportion as these cells have fewer other things to do, they do that one better. This contractility of the muscular fibres may be briefly described as a passage from the state of rest, in which the fibres are long and narrow, into the state of activity, in which they are shorter and thicker: this change is made with considerable force, and thus the mus- 127 128 THE HUMAN BODY. cles move parts attached to their tendons. AVhen the state of activity has passed off the fibres suffer themselves to be ex- tended again by any force pulling upon them, and so regain their resting shape; and since in the living Body almost in- variably other parts are put upon the stretch when any mus- cle contracts, these by their elasticity serve to pull the latter back again to its primitive shape.' No muscular fibre is known to have the power of actively expanding after it has contracted: in the active state it forcibly resists extension, but once the contraction is completely over, it suffers itself readily to be pulled back to its resting form. The contracted state lasts always longer, however, than the mere time occupied by the muscle in shortening: as will be seen later, the full state of contraction is gradually attained and gradually disappears. Irritability. With that modification of the primitive protoplasm of an amoeboid embryonic cell which gives rise to a muscular fibre with its great contractility, there goes a loss of other properties. Nearly all spontaneity disappears; mus- cles are not automatic like primitive protoplasm or ciliated cells; except under certain very special conditions they remain at rest unless excited from without. The amount of external change required to excite the living muscular fibre is, how- ever, very small; muscle tissue is highly irritable, a very little thing being sufficient to call forth a powerful contrac- tion. In the living Human Body the exciting force, or stim- ulus, acting upon a muscle is almost invariably a nervous impulse, a molecular movement transmitted along the nerve- fibre attached to it, and upsetting the molecular equilibrium of the muscle. It is through the nerves that the will acts upon the muscle-fibre, and accordingly injury to the nerves of a part, as the face or a limb, causes paralysis of its muscles. They may still be there, intact and quite ready to work, but there are no means of sending commands to them, and so they remain idle. Although a nervous impulse is the natural physiological muscular stimulus it is not the only one known. If a muscle be exposed in a living animal and a slight but sudden tap be given to it, or a hot bar be suddenly brought near it, or an elec- tric shock be sent through it, or a drop of glycerin or of solu- tion of ammonia be placed on it, it will contract; so that in addition to the natural nervous stimulus, muscles are irritable under the influence of mechanical, thermal, electrical, and THE PROPERTIES OF MUSCULAR TISSUE. 129 chemical stimuli. One condition of the efficacy of each. of them is that it shall act with some suddenness; a very slowly increased pressure, even if ultimately very great, or a very slowly raised temperature, or a slowly increased electrical cur- rent passed through it, will not excite the muscle; although far less pressure, warmth, or electricity more rapidly applied would stimulate it powerfully. Once an electric current has been set up through a muscle, its steady passage does not act as a stimulus; but a sudden diminution or increase of it does It may perhaps still be objected that it is not proved that any of these stimuli excite the muscular fibres, and that in all these cases it is possible that the muscle is only excited through its nerves. For the various stimuli named above also excite nerves (see Chap. XIII), and when we apply them to the muscle we may really be acting first upon the fine nerve-endings there, and only indirectly and through the mediation of these upon the muscular fibres. That the mus- cular fibres have a proper irritability of their own, independ- ently of their nerves, is, however, shown by the action of cer- tain drugs — for example curare, a South American Indian arrow poison. When this substance is introduced into a wound all the striped muscles are apparently poisoned, and the animal dies of suffocation because of the cessation of the breathing movements. But the poison does not really act on the muscles themselves: it kills the muscle-nerves, but leaves the muscle intact; and it has been proved to kill the very endings of the muscle-nerves right down in the muscle-fibres themselves. Yet after its administration we still find that the various non-physiological stimuli referred to alove make the muscles contract just as powerfully as before the poison- ing, so we must conclude that the muscles themselves are irritable in the absence of all nerve stimuli — or, what amounts to the same thing, when all their nerve-fibres have been poi- soned. The experiment also shows that the contractility of a muscle is a property belonging to itself, and that its contract- ing force is not something derived from the nerves attached .to it. The nerve stimulus simply acts like the electric shock or sudden blow and arouses the muscle to manifest a property which it already possesses The older physiologists observing that muscular paralysis followed when the nervous connection between a muscle and the brain was interrupted, concluded that the nerves gave the muscles the power of contracting, 130 THE HUMAN BODY. They believed that in the brain there was a great store of a mysterious thing called vital spirits, and that some of this was ejected from the brain along the nerve to the muscle, when the latter was to be set at work, and gave it its working power. A\ v3 now know that such is not the case, but that a muscle-fibre is a collection of highly irritable material which can have its equilibrium upset in a definite way, causing it to change its shape, under the influence of certain slight disturb- ing forces, one of which is a nervous impulse; and since in the Body no other kind of stimulus usually reaches the mus- cles, they remain at rest when their nervous connections are severed. But the muscles paralyzed in this way can still, in the living Body, be made to contract by sending electrical shocks through them. Physiologically, then, muscle is a con- tractile and irritable, but not an automatic, tissue. A Simple Muscular Contraction. Most of the details con- cerning the physiological properties of muscles have been studied on those of cold-blooded animals. A frog's muscle will retain all its living properties for some time after re- moval from the body of the animal, and so can be experi- mented on with ease, while the muscles of a rabbit or cat soon die under those circumstances. Enough has, however, been observed on the muscles of the higher animals to show that in all essentials they agree with those of the frog or ter- rapin. AVhen a single electric shock is sent through a muscle, the nerves of which have been thrown out of action by curare, it rapidly shortens and then, if a weight be hanging on it, rap- idly lengthens again. The whole series of phenomena from the moment of stimulation until the muscle regains its rest- ing form is known as a simple muscular contraction or a "twitch" : it occupies in frog's muscle about one tenth of a second. So brief a movement as this cannot be followed in its details by direct observation, but it is possible to record it and study its phases at leisure. This may be done by firmly fixing the upper tendon of an isolated muscle, M, Fig. 62, and attaching the other end at d to a lever, I, which can move about the fulcrum/: the end cf the long arm of the lever bears a point, p, which scratches on a smooth smoked surface, S. Suppose the surface to be placed so that the writing point of the lever is at «; if the muscle now contracts it will raise the point of the lever, and a line ac will be drawn on the THE PROPERTIES OF MUSCULAR TISSUE. 131 THE HUMAN BODY. smoked surface, its vertical height, cm, being dependent, first, on the extent of the shortening of the muscle, and second, on the proportion between the long and short arms of the lever: the longer fp is as compared with fd, the more will the actual shortening of the muscle be magnified. With the lever shown in the figure this magnification would be about ten times, so that one tenth of cm would be the extent of the shortening of the muscle. Suppose, next, the smoked surface to be moved to such position that the writing point of the lever touches it at i, and, the muscle being left at rest, the surface to be moved evenly from left to right; the horizontal line io would then be traced, its length depending on the distance through which 8 moved during the time the lever was marking on it : and it is clear that if S move uniformly, and we know its rate of movement, we can very readily calculate from the length of io how long 8 was moving while that line was being traced: for example, if we know the rate of movement to be ten inches per second, and on measurement find io to be an inch long, the time during which the surface was moving must have been -3^ of a second; and each tenth of io correspond to YJ-Q- of a second. If we set the recording surface in motion and while the lever point is tracing a horizontal line cause the muscle to contract, the point will be raised as long as the muscle is contracted, and the line drawn by it will be due to a combination of two .simultaneous movements — a horizontal, due to the motion of 8, a nearly vertical, due to the shorten- ing of the muscle; the resulting line is a curve known as the curve of a simple muscular contraction. Let the surface 8 be placed so that the writing point is at q and then be set in uniform motion from left to right at the same rate as before (ten inches per second). When the point is opposite t, stimulate the muscle by an electric shock; the result, until the muscle has fully lengthened again, will be the curve tuvwxy, from which many things may be learned. In the first place we see that the muscle does not commence to con- tract at the very instant of stimulation, but at an appreciably later time, and during the interval the lever draws the hori- zontal line tu\ this period, occupied by preparatory changes within the muscle, is known as the period of latent excitation. Then the muscle begins to shorten and the lever to rise, at first slowly from u to v, then more rapidly, and again more slowly THE PROPERTIES OF MUSCULAR TISSUE. 133 until the summit of the contraction is reached at w. The muscle does not now instantly relax, but only gradually passes back to the resting state : beginning at w, we see the descent of the curve is for a time slow, then more rapid, and finally slow again from x to y, when the contraction is completed and the lever once more traces only the horizontal line yp, due to the continued movement of the recording surface. The curve then shows three distinct phases in the contraction : the period of latent excitation; the period of shortening; the period of elongating. Knowing the rate of horizontal move- ment, we can measure off the time occupied by each phase. The horizontal distance from I to u represents the time taken by the latent excitation 5 from u to z, the time occupied in shortening; from z to y, the time taken in elongation: in a fresh frog's muscle these times are respectively Tf^, T^, Tf¥ of a second. In the muscles of warm-blooded animals they are all shorter, but the difficulties in the way of accurate ex- periment are very great. If we know the relative lengths of the arms of the lever we can of course readily calculate from the height, wz, of the curve the extent of shortening of the muscle. With a single electrical stimulation this is never more than one fourth the total length of the muscle. In Fig. 62 the accessory apparatus used in practice to in- dicate on the moving surface the exact instant of stimulation and to measure the rate at which S moves have been omitted. Physiological Tetanus. It is obvious that the ordinary movements of the Body are not brought about by such tran- sient muscular contractions as those just described. Even a wink lasts longer than one tenth of a second. Our movements are, in fact, due to more prolonged contractions which may be described as consisting of several simple contractions fused together, and known as " tetanic contractions "; it might be better to call them "compound contractions," since the word tetanus has long been used by pathologists to signify a dis- eased stato, such as occurs in strychnine poisoning and hydro- phobia, in which most of the muscles of the Bcdy are thrown into prolonged and powerful involuntary contractions. If, while a frog's muscle is still shortening under the in- fluence of one electric shock, another stimulus be given it, it will contract again and the new contraction will be added on to that already existing, without any period of elongation occurring between them. While the muscle is still contract- 134 THE HUMAN BODY. ing under the influence of the second stimulus a third electric shock will make it contract more, and so on, until the muscle is shortened as much as is possible to it for that strength of stimulus. If now the stimuli be repeated at the proper in- tervals, each new one will not produce any further shortening, but, each acting on the muscle before the effect of the last has begun to pass off, the muscle will be kept in a state of permanent or "tetanic" contraction; and this can be main- tained, by continuing the application of the stimuli, until the organ begins to get exhausted or " fatigued "; elongation then commences in spite of the stimulation. When our muscles are stimulated in the Body, from the nerve-centres through the nerves, they receive from the latter a sufficient number of stimuli in a second (the exact number is still doubtful) to throw them into tetanic contractions. In other words, not even in the most rapid movements of the Body is a muscle made to execute a simple muscular contraction; it is always a longer or a shorter tetanus. When very quick movements are executed, as in performing rapid passages on the piano, the result, is obtained by contracting two opposing muscles and alternately strengthening and weakening a little the tetanus of each. Causes affecting the Degree of Muscular Contraction. The extent of shortening which can be called forth in a mus- cle varies with the stimulus. In the first place, a single stim-N ulus can never cause a muscle to contract as much as rapidly repeated stimuli of the same strength — since in the latter case we get, as already explained, several simple contractions such as a single stimulus would call forth, piled on the top of one another. With powerful repeated electrical stimuli a muscle can be made to shorten to one third of its resting length, but in the Body the strongest effort of the Will never produces a contraction of that extent. Apart from the rate of stimulation, the strength of the stimulus has some influ- ence, a greater stimulus causing a greater contraction; but very soon a point is reached beyond which increase of stimu- lus produces no increased contraction; the muscle has reached its limit. The amount of load carried by the muscle (or the resistance opposed to its shortening) has also an influence, and that in a very remarkable way. Suppose we have a frog's calf-muscle, carrying no weight, and find that with a stimulus of a certain strength it shortens two millimeters (T^ inch). THE PROPERTIES OF MUSCULAR TISSUE. 135 Then if we hang one gram (15.5 grains) on it and give it the same stimulus, it will be found to contract more, say four or five millimeters, and so on, up to the point when it carries eight or ten grams. After that an increased weight will, with the same stimulus, cause a less contraction. So that up to a certain limit, resistance to the shortening of the muscle makes it more able to shorten : the mere greater extension of the muscle due to the greater resistance opposed to its short- ening, puts it into a state in which it is able to contract more powerfully. Fatigue diminishes the working power of a muscle and rest restores it, especially if the circulation of the blood be going on in it at the same time. A frog's muscle cut out of the body will, however, be considerably restored during a period of rest, even although no blood flow through it. Cold increases the time occupied by a simple muscular contraction, and also impairs the contractile power, as we find in our own limbs when " numbed" with cold, though in that case the hurtful influence of the cold on the nerves no doubt also plays a part. Moderate warmth on the other hand, up to near the point at which death stiffening (often in this case spoken of as heat rigor] occurs, diminishes the time foikeii by a contraction, and increases its height. Heat rigor is produced in excised frog's muscle by heating it to about 40° 0. (104° F.) The required temperature is higher in warm blooded animals, especially while the circulation through the muscle is maintained: in fevers temperatures considerably greater than the above have been observed without the occur- rence of muscular rigor. The Measure of Muscular Work. The work done by a muscle in a given contraction, when it lifts a weight verti- cally against gravity, is measured by the weight m'oved, mul- .tiplied by the distance through which it is moved. When a muscle contracts carrying no load it does very little work, lifting only its own weight; when loaded with one gram and lifting it five millimeters it does five gram-millimeters of work, just as an engineer would say an engine had done so many kilogrammeters or foot-pounds. If loaded with ten grams and lifting it six millimeters it would do sixty gram- millimeters of work. Even after the weight becomes so great that it is lifted through a less distance, the work done by the muscle goes on increasing, for the heavier weight lifted more than compensates for the less distance through which it is 136 THE HUMAN BODY. raised. For example, if the above muscle were loaded with fifty grams it would maybe lift that weight only 1.5 millime- ters, but it would then do seventy-five gram-millimeters of work, which is more than when it lifted ten grams six milli- meters. A load is, however, at last reached with which the muscle does less work, the lift becoming very little indeed, until at last the weight becomes so great that the muscle can- not lift it at all and so does no work when stimulated. Starting then from the time when the muscle carried no load and did no work, we pass with increasing weights, through phases in which it does more and more work, until with one particular load it does the greatest amount possible to it with that stim- ulus: after that, with increasing loads less work is done, until finally a load is reached with which the muscle again does no work. What is true of one muscle is of course true of all, and what is true of work done against gravity is true of all muscular work, so that there is one precise load with which a beast of burden or a man can do the greatest possible amount of work in a day. With a lighter or heavier load the distance through which it can be moved will be more or less, but the actual work done always less. In the living Body, however, the working of the muscles depends so much on other things, as the due action of the circulatory and respira- tory systems and the nervous energy or "grit" (upon which the stimulation of the muscles depends) of the individual man or beast, that the greatest amount of work obtainable is not a simple mechanical problem as it is with the excised muscle. From what precedes it is % clear that the molecular changes which take place in a contracting muscle fibre are eminently susceptible of modification by slight changes in its environ- ment. The evidence indicates that the contractility of a muscle depends, not upon a vital force entirely distinct from ordinary inanimate forces, but upon an arrangement of its material elements which is only maintained under certain conditions and is eminently modifiable by changes in the surroundings. Influence of the Form of the Muscle on its Working Power. The amount of work that any muscle can do de- pends of course largely upon its physiological state; a healthy well -nourished muscle can do more than a diseased or starved one; but allowing for such variations the work which can be THE PROPERTIES OF MUSCULAR TISSUE. 137 done by a muscle varies with its form. The thicker the mus- cle, that is the greater the number of fibres present in a sec- tion made across the long axes of the fasciculi, the greater the load that can be lifted or the other resistance that can be overcome. On the other hand, the extent through which a muscle can move a weight increases with the length of its fasciculi. A muscle a foot in length can contract more than a muscle six inches long, and so would move a bone through a greater distance, provided the resistance were not too great for its strength. But if the shorter muscle had double the thickness, then it could lift twice the weight that the longer muscle could. We find in the Body muscles constructed on both plans; some to have a great range of movement, others to overcome great resistance, besides numerous intermediate forms which cannot be called either long and slender or short and thick; many short muscles for example are not specially thick, but are short merely because the parts on which they act lie near together. It must be borne in mind, too, that many apparently long muscles are really short stout ones — those namely in which a tendon runs down the side or middle of the muscle, and has the fibres inserted obliquely into it. The muscle (gastrocnemius) in the calf of the leg for instance (Fig. 53, B) is really a short stout muscle, for its working length depends on the length of its fasciculi and these are short and oblique, while its true cross-section is that at right angles to the fasciculi and is considerable. The force with which a muscle can shorten is very great. A frog's muscle of 1 square centimeter (0.39 inch) hi section can just lift 2800 grams (98.5 ounces), and a human muscle of the same area more than twice as much. Muscular Elasticity. A clear distinction must be made between elasticity and contractility. Elasticity is a physical property of matter in virtue of which various bodies tend to assume or retain a certain shape, and when removed from it, forcibly to return to it. When a spiral steel spring is stretched it will, if let go, "contract" in a certain sense, by virtue of its elasticity, but such a contraction is clearly quite different from a muscular contraction. The spring will only contract as a result of previous distortion; it cannot originate a change of form, while the muscle can actively contract or change its shape when a stimulus acts upon it, and that without being previously stretched. It does not merely tend to return to a 138 ^ ^ THE HUMAN BODY. natural shape from which it has been removed, but it assumes a quite new natural shape, so that physiological contractility is a different thing from mere physical elasticity; the essen- tial difference being that the coiled spring or a 'stretched band only gives back mechanical work which has already been spent on it, while the muscle originates work independently of any previous mechanical stretching. In addition to their contrac- tility, however, muscles are highly elastic. If a fresh muscle be hung up and its length measured, and then a weight be hung upon it, it will stretch just like a piece of india-rubber, and when the weight is removed, provided it has not been so great as to injure the muscle, the latter will return passively, without any stimulus or active contraction, to its original form. In the Body all the muscles are so attached that they are usually a little stretched beyond their natural resting length; so that when a limb is amputated the muscles divided in the stump shrink away considerably. By this stretched state of the resting elastic muscles two things are gained. In the first place when the muscle contracts it is already taut, there is no "slack" to be hauled in before it pulls on the parts attached to its tendons: and, secondly, as we have already seen the working power of a muscle is increased by the presence of some resistance to its contraction, and this is always provided for from the first, by having the origin and insertion of the muscles so far apart as to be pulling on it when it begins to shorten. The Electrical Currents of Muscle. When a muscle is exposed in the body or carefully removed from it and suitable electrodes connected with a sensitive galvanometer are applied to different parts of its surface, there is nearly always to be found evidence of a difference of electric potential between different parts of the muscle. These differences give rise to currents which are shown by the galvanometer to travel through the wires of the circuit from any central portion of the muscle to any part nearer one end, or from any part of the belly to a tendon. The less injured the muscle the more feeble are these currents, and in very fresh and very carefully exposed muscles they may be absent altogether. They are probably altogether absent from perfectly uninjured resting muscles, and when present in a resting muscle are due to the fact that any more living part of a muscle is electrically posi- tive to a more injured or dead. When a muscle is exposed THE PROPERTIES OF MUSCULAR TISSUE. 139 its thinner ends die more quickly than its central parts, or the ends are directly injured when the muscle is cut across to remove it from the animal; and in that way the currents so usually observable arise. When all of a muscle is dead, its surface is isoelectric; no currents can be led oif from it. Even a quite uninjured muscle is however, capable, of giv- ing rise to currents when it contracts, and these currents pass in such direction as to show that a portion of muscle in contraction is electronegative to a portion at rest. If a curarized muscle be stimulated at one point, its contraction commences at that point and travels from it over the remainder of the muscle; so that by the time a distant portion is in con- traction the part which just contracted has come to rest. By electrodes suitably applied it can be observed that immedi- ately after the stimulation the region of muscle close to the point of stimulation is electro-negative to a more distant part; but that afterwards, when a distant portion is in contraction and the stimulated region has returned to rest, the reverse is the case. Electrically, therefore, any contracting part of a muscle has to any resting part a relation similar to that of a dying or injured part of a muscle to an uninjured. The cur- rents which arise in consequence of the changes going on in contracting muscle are known as the action currents to dis- tinguish them from the resting currents due to unequal rates of death usually found between different parts of an exposed' muscle in rest. When a muscle is stimulated through its nerve the action current is less easy to demonstrate, because the nerve fibres branch all through the muscle and stimulate all parts of it at once, and throw all simultaneously into contraction. The cur- rent may, however, be shown indirectly. A muscle is removed with its nerve attached and electrodes put on it — one, for ex>- ample, on the middle of the belly and the other on the tendon, so as to show on the galvanometer a resting current. If the muscle be now made to contract by stimulating its nerve the current is diminished, or, as is said, shows a negative varia- tion. The cause of this is as follows : The amount of resting current depends on the difference between the less injured belly of the muscle and the injured end; anything which makes these two less different electrically must diminish this current; and as contracted muscle is electrically like dying muscle, when we throw the whole into activity the previously 140 THE HUMAN BODY. existing difference is less than it was, and this the galva- nometer shows as the negative variation. Secondary Contraction. It is possible to use the action current of one muscle to stimulate the nerve of a second and produce a contraction. For this purpose two frogs' muscles, A and B, are carefully dissected out with their nerves at- tached. The nerve of B is laid over A so that one part of it lies on the belly and another on the tendon. If the nerve of A be stimulated by a single induction shock, for each contraction of A we get a contraction of B, the negative variation of the muscle current of A being the stimulus for the nerve of B. Secondary Tetanus. If the nerve of A be given rapidly repeated stimuli so as to throw that muscle into tetanic con- traction, B is also tetanized. This is of importance, as tend- ing to show that the tetanus of A is really a compound con- traction, although to the eye or as recorded by a lever it is one unbroken shortening. If the electrical condition of A remained uniform during contraction, there should be no fetanus of B, but merely a simple contraction due to the set- ting up of the action current or negative variation when A commenced to contract, and a second due to the cessation of this current when A came to rest again. The tetanus of B must be due to rapidly repeated electrical variations in A, and these probably correspond to the potentially separate con- tractile changes going on in A, and fused into its apparently uniform tetanic contraction. The Source of Muscular Energy will be more fully dis- cussed in the chapter on nutrition, but a few of the main points may be mentioned here. A muscle where it contracts is able to do work by using energy set free by chemical changes occurring within it, as a steam-engine does work by using the energy set free by the chemical changes occurring in the combustion of its fuel; and as in the steam-engine, so here, the fundamental change is an oxidative one, though in the muscle a very indirect oxidation. A fresh frog's muscle deprived of blood contains no uncombined oxygen; hung up in an atmosphere of pure nitrogen it can be made to contract and do a great deal of work before it dies and passes into rigor mortis. While doing this work it gives off carbon-diox- ide gas and becomes acid from the formation (probably) of sarcolactic acid, but there does not appear to occur any ap- THE PROPERTIES OF MUSCULAR TISSUE. 141 preciable increase of oxygen-containing nitrogen compounds in it. As, under the conditions of the experiment, no free oxygen is available, the carbon dioxide must be derived from the breaking down of something present in the muscle; and as the formation of sarcolactic acid varies in amount with that of carbon dioxide, and both increase with the work done by the muscle, it would seem as if the energy set free were obtained by the breaking down of some highly unstable non-nitrogenous energy-yielding matter stored in the muscle. And such a view gains support from the fact that a man doing hard muscular work gives off per hour a great deal more carbon dioxide through his lungs than a man at rest, and does not give off any or very little more nitrogenous waste matter. But a muscle placed as above described and made to work passes into rigor sooner than a muscle similarly situated and left at rest : and this shows that work tends to favor the pro- duction of myosin, or rather of its immediate precursor myo- sinogen, in the muscle : so here we get some evidence that the nitrogenous muscle constituents are influenced and altered though not oxidized during work. Further, when a muscle passes into rigor it gives off carbon-dioxide gas, whether it has been worked previously or not; if so situated as to be deprived of all exterior sources of supply, it gives off less when becoming rigid after work than when becoming rigid without having been worked; but the difference is almost accurately accounted for by the greater quantity of carbon dioxide the working muscle had previously given out. This suggests that the chemical phenomena of rigor and of work are essentially alike, being merely carried to an extreme in the former. Most of the facts can be accounted for by the supposition that there is in living muscle a store of an unstable substance containing nitrogen, hydrogen, carbon, and oxygen. For this hypothetic substance the name inogen has been proposed. During work inogen is used up and broken into a highly oxidized part, carbon dioxide; an oxidized body containing carbon and hydrogen, as sarcolactic acid (C3H603); and a third body allied to myosinogen and containing all the nitro- gen and some of the oxygen, carbon, and hydrogen of the original inogen. In the products of this alteration stronger chemical affinities are satisfied than in the original compound, 142 THE HUMAN BODY. and thus energy is liberated and used by the muscle. In the ordinary course of events the carbon dioxide is carried off by blood and lymph and eliminated from the Body; the sarco- lactic or other similar substance or substances are also carried off and oxidized elsewhere to form carbon dioxide and water and be then eliminated ; but the nitrogen-containing product remains behind, and with the help of fresh oxygen and of other food material brought by the blood is reconstructed into the original inogen. In the excised muscle there is but scant store of material for repair; carbon dioxide is given off when the muscle contracts, and the sfrcolactic acid and nitrogen-containing product accumulate: the latter then undergoes further changes, and ultimately becomes myosin. If the excised muscle be thrown into rigor quickly (as by heat), then the inogen is at once broken up, forming myosin and carbon dioxide and sarcolactic acid: if it be worked for a time before being thrown into rigor, then some of its inogen will have been already broken up, so there will be less to give rise to carbon dioxide at the moment of rigor, but the missing amount is found in that given off during work. If some such view as this, which may be called the " inogen theory," be the correct one, then the energy liberated by a resting muscle passing into rigor must take some other form than muscular work. As a matter of fact a good deal of heat is liberated during death stiffening, but whether sufficient to account for all the missing energy is by no means clear. The whole subject of the immediate source of muscular work is still in much need of elucidation. Physiology of Plain Muscular Tissue. What has hither- to been said applies especially to the skeletal muscles; but in the main it is true of the unstriped muscles. These also are irritable and contractile, but their changes of form are much more slow than those of the striated fibres. Upon stimulation, a longer period of latent excitement elapses before the contraction commences and when, finally, this takes place it is comparatively very slow, gradually attaining a maximum and gradually passing away. Unstriped muscular tissue has a remarkable power of remaining in the contracted state for long periods : the mus- cular coats of many small arteries, for example, are rarely relaxed ; sometimes they may be more contracted, sometimes less, but in health seldom if eyer completely at rest. There THE PROPERTIES OF MUSCULAR TISSUE. 143 seems to be some connection between that arrangement of the contractile substance which shows itself under the micro- scope as striation and the power of rapid contraction, since we find that the heart, which is not a skeletal or voluntary muscle but yet one that contracts rapidly, agrees with these in having its fibres striated. This connection is further illus- trated by facts of comparative anatomy: insects are, as a rule, rapidly moving animals, and they are characterized by very marked striation of nearly all their muscular tissue; while in the slow-moving molluscs nearly all the muscular tissue is unstriped except in a few, as Pecten, which make rapid movements, and in that genus the muscles concerned in producing these movements are striated.. CHAPTER XL MOTION AND LOCOMOTION. The Special Physiology of the Muscles. Having now considered separately the structure and properties in general of the skeleton, the joints, and the muscles, we may go on to consider how they all work together in the Body. Although the properties of muscular tissue are everywhere the same, the uses of different muscles are very varied, by reason of the different parts with which they are connected. Some are muscles of respiration, others of deglutition; many are known as flexors because they bend joints, others as extensors because they straighten them. The exact use of any particular mus- cle, acting alone or in concert with others, is known as its special physiology, as distinguished from its general physiol- ogy, or properties as a muscle without reference to its use as a muscle in a particular place. The functions of those mus- cles forming parts of the physiological mechanisms concerned in breathing and swallowing will be studied hereafter; for the present we may consider the muscles which co-operate in maintaining postures of the Body; in producing movements of its larger parts with reference to one another; and in pro- ducing locomotion or movement of the whole Body in space. In nearly all cases the striped muscles carry out their func- tions with the co-operation of the skeleton, since nearly all are fixed to bones at each end, and when they contract pri-' marily move these, and only secondarily the soft parts attached to them. To this general rule there are, however, exceptions. The muscle for example which lifts the upper eyelid and opens the eye arises from bone at the back of the orbit, but is inserted, not into bone, but into the eyelid directly; and similarly other muscles arising at the back of the orbit are directly fixed to the eyeball in front and serve to rotate it on the pad of fat on which it lies. Many facial muscles again have no direct attachment whatever to bones, as for example 144 MOTION AND LOCOMOTION. 145 the muscle (orMcularis oris) which surrounds the mouth- opening, and by its contraction narrows it and purses out the lips; or the orlicularis palpebrarum which similarly sur- rounds the eyes and when it contracts closes them. Levers in the Body. When the muscles serve to move bones the latter are in nearly all cases to be regarded as levers whose fulcra lie at the joint where the movement takes place. Examples of all the three forms of levers recognized in me- chanics are found in the Human Body. Levers of the First Order. In this form (Fig. 63) the fulcrum or fixed point of support lies between the " weight " I F \ P jj^ W FIG. 63.— A lever of the first order. .F, fulcrum ; P, power ; W, resistance or weight. or resistance to be overcome and the " power " or moving force, as shown in the diagram. The distance PF, from the power to the fulcrum, is called the "power-arm;" the dis- tance FW is the " weight-arm." When power-arm and weight-arm are equal, as is the case in the beam of an ordi- nary pair of scales, no mechanical advantage is gained, nor is . there any loss or gain in the distance through which the weight is moved. For every inch through which P is depressed, W will be raised an equal distance. When the power-arm is longer than the other, then a smaller force at P will raise a larger weight at W, the gain being proportionate to the dif- ference in the lengths of the arms. For example if PF is twice as long as FW, then half a kilogram applied at P will balance a whole kilogram at Tf, and just more than half a kilogram would lift it ; but for every centimeter through which P descended, W would only be lifted half a centimeter. On the other hand when the weight-arm in a lever is longer than the power-arm, there is loss in force but a gain in the distance through which the weight is moved. Examples of the first form of lever are not numerous in the Human Body. One is afforded in the nodding move- ments of the head, the fulcrum being the articulations be- tween the skull and the atlas. When the chin is elevated the power is applied to the skull, behind the fulcrum, by 146 THE HUMAN BODY. small muscles passing from the vertebral column to the occi- put; the resistance is the excess in the weight of the part of the head in front of the fulcrum over that behind it, and is not great. To depress the chin as in nodding does not neces- sarily call for any muscular effort, as the head will fall for- ward of itself if the muscles keeping it erect cease to work, as those of us who have fallen asleep during a dull discourse on a hot day have learnt. If the chin however be depressed forcibly, as in the athletic feat of suspending one's self by the chin, the muscles passing from the chest to the skull in front of the atlanto-occipital articulation are called into play. Another example of the employment of the first form of lever in the Body is afforded by the curtsey with which a lady salutes another. In curtseying the trunk is bent forward at the hip-joints, which form the fulcrum; the weight is that of the trunk acting as if all concentrated at its centre of gravity, which lies a little above the sacrum and behind the hip-joints; and the power is afforded by muscles passing from the thighs to the front of the pelvis. Levers of the Second Order. In this form the weight or resistance is between the power and the fulcrum. The power-arm PFis always longer than the weight-arm WF, and so a comparatively weak force can overcome a consider- able resistance. But it is disadvantageous so far as regards rapidity and extent of movement, for it is obvious that when P is raised a certain distance W will be moved a less distance in the same time. As an example of the employment of such levers (Fig. 64) in the Body, we may take the act of standing on the toes. Here the foot represents the lever, the fulcrum is at the contact of its fore part with the ground ; the weight F W FIG. 64.— A lever of the second order. F, fulcrum ; P, power ; TF, weight. The arrows indicate the direction in which the forces act. is that of the Body acting down through the ankle-joints at Ta, Fig. 65; and the power is the great muscle of the calf acting by its tendon inserted into the heel-bone (Ca, Fig. 65). Another example is afforded by holding up the thigh when one foot is kept raised from the ground, as in hopping on the MOTION AND LOCOMOTION. 147 other. Here the fulcrum is at the hip-joint, the power is ap- plied at the knee-cap by a great muscle (rectus femoris) which Spl FIG. 65. — The skeleton of the foot from the outer side. Ta, surface with which the leg-bones articulate ; Ca, the calcaueum into which the tendon (tendo Achillis) of the calf muscle is inserted ; M5. the metatarsal bone of the fifth digit ; N, the scaphoid boue-, C/, CII, GUI, first, second, and third cuneiform bones ; Cb, the cuboid bone.\ is inserted there and arises from the pelvis; and the weight is that of the whole lower limb acting at its centre of gravity, which lies somewhere in the thigh between the hip and knee-joints, that is between the fulcrum and the point of ap- plication of the power. Levers of the Third Order. In these (Fig. 66) the power- is between the fulcrum and the weight. In such levers the weight-arm is always longer than the power-arm, so the power works at a mechanical disadvantage, but swiftness and range of movement are gained. It is the lever most commonly used in the Human Body. For example, when the forearm is bent up towards the arm, the fulcrum is the elbow-joint, the power is applied at the insertion of the biceps muscle (Fig. 52) into the radius and of another muscle (not represented in the figure, the brachialis anticus, into the ulna), and the W F FIG. 66. -A lever of the third order. F, fulcrum ; P, power ; W, weight. weight is that of the forearm and hand, with whatever may be contained in the latter, acting at the centre of gravity of the whole somewhere on the distal side of the point of appli. 148 THE HUMAN BODY. cation of the power. In the Body the power-arm is usually very short so as to gain speed arid range of movement, the muscles being powerful enough to still do their work in spite of the mechanical disadvantage at which they are then placed. The limbs are thus made much more shapely than would be the case were the power applied near or beyond the weight. It is of course only rarely that simple movements as those described above take place. In the great majority of those executed several or many muscles co-operate. The Loss to the Muscles from the Direction of their Pull. It is worthy of note that, owing to the oblique direction in which the muscles are commonly inserted into the bones, much of their force is lost so far as producing movement is concerned. Suppose the log of wotid in the diagram (Fig. 67) to be raised by pulling on the rope in the direction a\ it is clear at first that the rope will act at a great disadvantage; most of the pull transmitted by it will be exerted against the pivot on which the log hinges, and only a small fraction be available for elevating the latter. But the more the log is lifted, as for example into the position indicated by the dotted lines, the more useful will be the direction of the pull, and the more of it will be spent on the log and the less lost unavail- ingly in merely increasing the pressure at the hinge. If we now consider the action of the biceps (Fig. 52) in flexing the elbow-joint, we see similarly that the straighter the joint is, the more of the pull of the muscle is wasted. Beginning FIG. 67.— Diagram illustrating the disadvantage of an oblique pull. with the arm straight, it works at a great disadvantage, but as the forearm is raised the conditions become more and more MOTION AND LOCOMOTION. 149 * favorable to the muscle. Those who have practised the gym- nastic feat of raising one's self by bending the elbows when hanging by the hands from a horizontal bar know practically that if the elbow-joints are quite straight it is very hard to start; and that, on the other hand, if they are kept a little flexed at the beginning the effort needed is much less; the reason being of course the more advantageous direction of traction by the biceps in the latter case. Experiment proves that the power with which a muscle can contract is greatest at the commencement of its short- ening, the very time at which, we have just seen, it works at most mechanical disadvantage; in proportion as its force becomes less the conditions become more favorable to it. There is, however, it is clear, nearly always a considerable loss of power in the working of the skeletal muscles, strength being sacrificed for variety, ease, rapidity, extent, and ele- gance of movement. Postures. The term posture is applied to those positions of equilibrium of the Body which can be maintained for some time, such as standing, sitting, or lying, compared with leap- ing, running, or falling. In all postures the condition of stability is that the vertical line drawn through the centre of gravity of the body shall fall within the basis of support afforded by objects with which it is in contact ; and the security of the posture is proportionate to the extent of this base, for the wider it is the less is the risk of the perpendicu- lar through the centre of gravity falling outside of it on slight displacement. The Erect Posture. This is pre-eminently characteristic of man, his whole skeleton being modified with reference to it. Nevertheless the power of maintaining it is only slowly learnt in the first years after birth, and for a long while it is unsafe. And though finally we learn to stand erect without conscious attention, the maintenance of that posture always requires the co-operation of many muscles, co-ordinated by the nervous system. The influence of the latter is shown by the fall which follows a severe blow on the head, which may nevertheless have fractured no bone nor injured any muscle : the concussion of the brain, as we say, "stuns" the man, and until its effects have passed off he cannot stand upright. In standing with the arms straight by the sides and the feet together the centre of gravity of the whole adult Body lies 150 THE HUMAN BODY. (L in the articulation between the sacrum and the last lumbar vertebra, and the perpendicular drawn from it will reach the ground between the two feet, within the basis of support af- forded by them. With the feet close together, however, the posture is not very stable, and in standing we commonly make it more so by slightly separating them so as to increase the base. The more one foot is in front of the other the more swaying back and forward will be compatible with safety ; and the greater the lateral distance separating them the greater will be the lateral sway which is possible without falling. Conse- quently we see that a man about to make great movements with the upper part of his Body, as in fencing or boxing, or a sol- I J*H dier preparing for the bayonet exercise, always commences by thrusting one foot forwards obliquely, so as to increase his basis of support in both directions. The ease with which we can stand is largely dependent upon the way in which the head is almost balanced on the top of the vertebra] column, so that but little muscular effort is needed to keep it up- right. In the same wray the trunk is almost balanced on the hip joints, but not quite> its centre of gravity falling rather behind them; so that just as some muscular effort is needed to keep the head from falling forwards, some is needed to keep the trunk from toppling backwards at the hips. In a similar manner other muscles are called illto PlaJ at otner Joints : as between the lines) which pass before vertebral column and the pelvis, and at and behind the joints r and by their balanced the knees and ankles i and thus a certain activity keep the joints . _ ,, rigid and the body erect, rigidity, due to muscular effort, extends all along the erect Body : which, on account of the flexibility of its joints, could not otherwise be balanced on its feet, as a statue can. Beginning (Fig. 68) at the ankle-joint, we find it kept stiff in standing by the combined and balanced con- traction of the muscles passing from the heel to the thigh, and from the dorsum of the foot to the shin-bone (tibia). il I J FIG. 68.— Diagram ii- MOTION AND LOCOMOTION. 151 Others passing before and behind the knee- joint keep it from yielding; and so at the hip-joints: and others again, lying in the walls of the abdomen and along the vertebral column, keep the latter rigid and erect on the pelvis; and finally the skull is kept in position by muscles passing from the sternum and vertebral column to it, in front of and behind the occipi- tal condyles. Locomotion includes all the motions of the whole Body in space, dependent on its own muscular efforts: such as walking, running, leaping, and swimming. Walking. In walking the Body never entirely quits the ground, the heel of the advanced foot touching the ground in each step before the toe of the rear foot leaves it. The ad- vanced limb supports the Body, and the foot in the rear at the commencement of each step propels it. Suppose a man standing with his heels together to com- mence to walk, stepping out with the left foot; the whole Body is at first inclined forwards, the movement taking place mainly at the ankle-joints. By this means the centre of gravity would be thrown in front of the base formed by the feet and a fall on the face result, were not simultaneously the left foot slightly raised by bending the knee and then swung forwards, the toes just clear of the ground and, in goojd walking, the sole nearly parallel to it. When the step is completed the left knee is straightened and the sole placed on the ground, the heel touching it first, and the base of sup- port being thus widened from before back, a fall is prevented. Meanwhile the right leg is kept straight, but inclines for- wards above with the trunk when the latter advances, arid as this occurs the sole gradually leaves the ground, commencing with the heel. When the step of the left leg is completed the great toe of the right alone is in contact with the support. With this a push is given which sends the trunk on over the left leg, which is now kept rigid, except at the ankle-joint; and the right knes being bent that limb swings forwards, its foot just clearing the ground as the left did before. The Body is meanwhile supported on the left foot alone, but when the right completes its step the knee of that leg is straight- ened and the foot thus placed, heel first, on the ground. Meanwhile the left foot has been gradually leaving the ground, and its toes only are at that moment upon it: from these a push is given, as before, with the right foot, and the 152 THE HUMAN BODY. knee being bent so as to raise the foot, the left leg swings for wards at the hip-joint to make a fresh step. During each step the whole Body sways up and down and also from side to side. It is highest at the mo- ment when the advancing trunk is vertically over the foot supporting it, and then sinks until the moment when the advancing foot touches the ground, when it is lowest. From this moment it rises as it swings forward on this foot, until it is vertically over it, and then sinks again until the other touches the ground; and so on. At the same time, as its weight is alternately transferred from the right to the left foot and vice versa, there is a slight lateral sway, commonly more marked in women than in men, arid which when excessive produces an ugly "waddling" gait. The length of each step is primarily dependent on the length of the legs; but can be controlled within wide limits by special muscular effort. In easy walking little muscular work is employed to carry the rear leg forwards after it has given its push. When its foot is raised from the ground it swings on, like a pendulum; but in fast walking the muscles, passing in front of the hip- joint, from the pelvis to the limb, by their contraction forcibly carry the leg forwards. The easiest step, that in which there is most economy of labor, is that in which the limb is let swing freely, and since a short pendulum swings faster than a longer, the natural step of short-legged people is quicker than that of long-legged ones. In fast walking the advanced or supporting leg also aids in propulsion; the muscles passing in front of the ankle-joint contracting so as to pull the Body forwards over that foot and aid the push from the rear foot. Hence the fatigue and pain in front of the shin which is felt in prolonged, very fast walking. From the fact that each foot reaches the ground heel first, but leaves it toe last, the length of each stride is increased by the length of the foot. Running. In this mode of progression there is a moment in each step when both feet are off the ground, the Body being unsupported in the air. The toes alone come in con- tact with the ground at each step, and the knee-joint is not straight when the foot reaches the ground. When the rear foot is to leave the support, the knee is suddenly straight- ened, and at the same time the ankle-joint is extended so as MOTION AND LOCOMOTION. 153 to push the toes forcibly on the ground and give the whole Body a powerful push forwards and upwards. Immediately after this the knee is greatly flexed and the foot raised from the ground, and this occurs before the toes of the forward foot reach the latter. The swinging leg in each step is vio- lently pulled forwards and not suffered to swing naturally, as in walking. By this the rapidity of the succession of steps is increased, and at the same time the stride is made greater by the sort of one-legged leap that occurs through the jerk given by the straightening of the knee of the rear leg just before it leaves the ground. Leaping. In this mode of progression the Body is raised completely from the ground for a considerable period. In a powerful leap the ankles, knees, and hip-joints are all flexed as a preparatory measure, so that the Body assumes a crouch- ing attitude. The heels, next, are raised from the ground and the Body balanced on the toes. The centre of gravity of the Body is then thrown forwards, and simultaneously the flexed joints are straightened, and by the resistance of the ground, the Body receives a propulsion forwards; much in the same way as a ball rebounds from a wall. The arms are at the same time thrown forwards. In leaping backwards, the Body and arms are inclined in that direction; and in jumping ver- tically there is no leaning either way and the arms are kept by the sides. Hygiene of the Muscles. The healthy working of the muscles needs of course a healthy state of the Body gener- ally, so that they shall be supplied with proper materials for growth and repair, and have their wastes rapidly and effi- ciently removed. In other words, good food and pure air are necessary for a vigorous muscular system, a fact which train- ers recognize in insisting upon a strict dietary, and in super- vising generally the mode of life of those who are to engage in athletic contests. The muscles should also not be exposed to any considerable continued pressure, since this interferes with the flow of blood and lymph through them. As far as the muscles themselves are directly concerned, exercise is the necessary condition of their best development. A muscle which is permanently unused degenerates and is absorbed, little finally being left but the connective tissue of the organ and a few muscle fibres filled with oil-drops. This is well seen in cases of paralysis dependent on injury to the 154 THE HUMAN BODY. nerves. In such cases the muscles may themselves be per* fectly healthy at first, but lying unused for weeks they become altered, and finally, when the nervous injury has been healed, the muscles may be found incapable of functional activity. The physician therefore is often careful to avoid this by exer- cising the paralyzed muscles daily by means of electrical shocks sent through the part, while at the same time he tries to restore the nerves; passive exercise, as by proper massage, is frequently of great use in such cases. The same fact is illustrated by the feeble and wasted condition of the muscles of a limb which has been kept for some time in splints. After the latter have been removed it is only slowly, by judicious and persistent exercise, that the long-idle muscles regain their former size and power. The great muscles of the " brawny " arm of the blacksmith or wrestler illustrate the reverse fact, the growth of the muscles by exercise. Exer- cise, however, must be judicious; repeated frequently to the point of exhaustion it does harm; the period of repair is' not sufficient to allow replacement of the parts used in work, and the muscles thus waste under too violent exercise as with too little. Rest should alternate with work, and that regularly, if benefit is to be obtained. Moreover, violent exercise should never be suddenly undertaken by one unused to it, not only lest the muscles suffer, but because muscular effort greatly increases the work of the heart, not merely because more blood has to be sent to the muscles themselves, but they produce great quantities of carbon dioxide, which must be carried off in the blood to the lungs for removal from the Body, and the heart must work harder to send the blood faster through the lungs, and at the same time the breathing be hastened so as to renew the air in those organs faster. The least evil result of throwing too violent work on the heart and lungs in this way is represented by being " out of breath," which is advantageous insomuch as it may lead to a cessation of the exertion. But much more serious, and sometimes permanent, injuries of either the circulatory or respiratory organs may be caused by violent and prolonged efforts without due previous training. No general rule can be laid down as to the amount of exercise to be taken; for a healthy man in business the minimum would perhaps be rep- resented by a daily walk of five miles. Varieties of Exercise. In walking and running the MOTION AND LOCOMOTION. 155 muscles chiefly employed are those of the lower limbs and trunk. This is in part true of rowing, which when good is performed much more by the legs than the arms: especially since the introduction of sliding seats. Hence any of these exercises alone is apt to leave the muscles of the chest and arms imperfectly exercised. Indeed, no one exercise employs equally or proportionately all the muscles: therefore gym- nasia in which various feats of agility are practised, so as to call different parts into play, have very great utility. It should be borne in mind, however, that the legs especially need strength; while the upper limbs, in which delicacy of movement, as a rule, is more desirable than power, do not re- quire so much exercise; and the fact that gymnastic exercises are commonly carried on indoors is a great drawback to their value. When the weather permits, out-of-door exercise is far better than that carried on in even the best ventilated and lighted gymnasium. For those who are so fortunate as to possess a garden there is no better exercise, at suitable sea- sons, than an hour's daily digging in it; since this calls into play nearly all the muscles of the Body; while of games, the modern one of lawn tennis is perhaps the best from a hygienic view that has ever been invented, since it not only demands great muscular agility in every part of tne Body, but trains the hand to work with the eye in a way that walking, run- ning, rowing, and similar pursuits do not. For the same reasons baseball, cricket, and boxing are excellent. Exercise in Infancy and Childhood. Young children have not only to strengthen their muscles by exercise, but also to learn to use them. Watch an infant trying to con- vey something to its mouth, and you will see how little control it has over its muscles. On the other hand, the healthy infant is never at rest when awake; it constantly throws its limbs around, grasps at all objects within its reach, coils itself about, and so gradually learns to exercise its powers. It is a good plan to leave every healthy child more than a few months old several times daily on a large bed, or even on a rug or carpeted floor, with as little covering as is safe, and that as loose as possible, and let it wriggle about as it pleases. In this way it will not only enjoy itself thoroughly, but gain strength and a knowledge of how to use its limbs. To keep a healthy child swathed all day in tight and heavy clothes is cruelty. 156 THE HUMAN BODY. When a little later the infant commences to crawl it is safe to permit it to as much as it wishes, but unwise to tempt it to do so when disinclined : the bones and muscles are still feeble and may be injured by too much work. The same is true of learning to walk. From four or five to twelve years of age almost any form of exercise should be permitted, or even encouraged. During this time, however, the epiphyses of many bones are not firmly united to their shafts, and so anything tending to throw too great a strain on the joints should be avoided. After that up to commencing manhood or maidenhood any kind of out- door exercise for healthy persons is good, and girls are all the better for being allowed to join in their brothers' sports. Half of the debility and general ill-health of so many of our women is the consequence of deficient exercise during early life; and the day, which fortunately seems approaching, which will see dolls as unknown to or as despised by healthy girls as by healthy boys will see the beginning of a great im- provement in the stamina of the female portion of our popu- lation. Exercise in Youth should be regulated largely by sex; not that women are to be shut up and made pale, delicate, and unfit to share the duties or participate fully in the pleasures of life; but the other calls on the strength of the young woman render vigorous muscular work often unadvisable, especially under conditions where it is apt to be followed by a chill. A healthy boy or young man may do nearly anything; but until twenty-two or twenty-three very prolonged effort is un- advisable. The frame is still not firmly knit or as capable of endurance as it will subsequently become. Girls should be allowed to ride or play out-door games in moderation, and in any case should not be cribbed in tight stays or tight boots. A flannel dress and proper lawn tennis shoes are as necessary for the healthy and safe enjoyment of an afternoon at that game by a girl as they are for her brother in the baseball field. Eowing is excellent for girls if there be any one to teach them to do it properly with the legs and back, and not with the arms only, as women are so apt to row. Properly practised it strengthens the back and improves the carriage. Exercise in Adult Life. Up to forty a man may carry on safely the exercises of youth, but after that sudden efforts MOTION AND LOCOMOTION. 157 should be avoided. A lad of twenty-one or so may, if trained, safely run a quarter-mile race, but to a man of forty-five it would be dangerous, for with the rigidity of the cartilages and blood-vessels which begins to show itself about that time comes a diminished power of meeting a sudden violent de- mand. On the other hand, the man of thirty would more safely than the lad of nineteen or twenty undertake one of the long-distance walking matches which have lately been in vogue; the prolonged effort would be less dangerous to him, though a six-days' match, with its attendant loss of sleep, cannot fail to be more or less dangerous to any one. Prob- ably for one engaged in active business a walk of two or three miles to it in the morning and back again in the after- noon is the best and most available exercise. The habit which Americans have everywhere acquired, of never walking when they can take a street car, is certainly detrimental to the general health; though the extremes of heat and cold to which we are subject often render it unavoidable. For women during middle life the same rules apply: there should be some regular but not violent daily exercise. In Old Age the needful amount of exercise is less, and it is still more important to avoid sudden or violent effort. Exercise for Invalids. This should be regulated under medical advice. For feeble persons gymnastic exercises are especially valuable, since from their variety they permit of selection according to the condition of the individual; and their amount can be conveniently controlled. Training. If any person attempt some unusual exercise he soon finds that he loses breath, gets perhaps a " stitch in the side," and feels his heart beating with unwonted violence. If he persevere he will probably faint — or vomit, as is frequently seen in the case of imperfectly trained men at the end of a hard boat-race. These phenomena are avoided by careful gradual preparation known as " training." The immediate cause of them lies in disturbances of the circula- tory and respiratory organs, on which excessive work is thrown. CHAPTEE XH. \ ANATOMY OF THE NERVOUS SYSTEM. Nerve-Trunks. In dissecting the Human Body numerous white cords are found which at first sight might be taken for tendons. That they are something else however soon becomes clear, since a great many of them have no connection with muscles at all, and those which have usually enter somewhere into the belly of the muscle, instead of being fixed to its ends as most tendons are. These cords are nerve-trunks : followed in one direction each (Fig. 69) will be found 'to break up into finer and finer branches, until the subdivisions become too small to be followed without the aid of a microscope. Traced the other way the trunk will in most cases be found to in- crease by the union of others with it, and ultimately to join a much larger mass of different structure, from which other trunks also spring. This mass is a nerve-centre. That end of a nerve attached to the centre is naturally its central, and the other its distal or peripheral end. Nerve-centres, then, give origin to nerve-trunks; these latter spread all over the Body, usually branching and becoming smaller and smaller as they proceed from the centre; they finally become very small, and how they ultimately end is not in__alLcas_es certain, but it is known that some have sense-organs at their termina- tions and others muscular fibres. The general arrangement of the larger nerve-trunks of the Body is shown in Fig. 69. Physically a nerve is not so tough or strong as a tendon of the same size; it may readily be split up into longitudinal strands, each of which consists of a number of microscopic threads, the nerve-fibres, bound together by connective tissue. Plexuses. Very frequently several neighboring nerve- trunks send off communicating branches to one another, each branch carrying fibres from one trunk to the other. Such networks are called plexuses (Fig. 72), and through the inter- changes taking place in them it often happens that the distal 158 ANATOMY OF THE NERVOUS SYSTEM. 159 brandies of a nerve-trunk contain fibres which it does not possess as it leaves the centre to which it is connected. FIG. 69.— Diagram illustrating the general arrangement of the nervous system. Nerve-Centres. The great majority of the nerves take their origin from the brain and spinal cord, which together form the great cerebro-spinal centre. Some, however, com- 160 THE HUMAN BODY. mence in rounded or oval masses which vary in size from that of the kernel of an almond down to microscopic dimensions, and which are widely distributed in the Body. Each of these smaller scattered centres is called a ganglion, and the whole of them are arranged in three sets. A considerable num- ber of the largest are united directly to one another by nerve-trunks, and also give off nerves to various organs, espe- 'cially to the blood-vessels and the viscera in the thoracic and abdominal cavities. These ganglia and their branches form the sympathetic nervous system, as distinguished from the cerebro-spinal nervous system consisting of the brain and spinal cord and the nerves springing from them. Of the re- maining ganglia some are connected with various cerebro- spinal trunks near their origin, while the rest, for the most part very small and connected with the peripheral branches of sympathetic or other nerves, are known as the sporadic ganglia. The Cerebro-Spinal Centre and its Membranes. Lying inside the skull is the brain and in the neural canal of the vertebral column the xpinal cord or spinal marrow, the cwo being continuous through the foramen magnum of the oc- cipital oone and forming the great cerebro-spinal nerve-centre. This centre is bilaterally symmetrical throughout except for slight differences on the surfaces of parts of the brain, which are often found in the higher races of mankind. Both brain and spinal cord are very soft and easily crushed, the con- nective tissue and a peculiar supporting tissue (neuroglia) which pervade them being delicate; accordingly both organs are placed in nearly completely closed bony cavities and are also enveloped by membranes which give them support. These membranes are three in number. Externally is the dura mater, very tough and strong and composed of white fibrous and elastic connective tissues. In the cranium the dura mater adheres by its outer surface to the inside of the skull chamber, serving as the periosteum of its bones; this is not the case in the vertebral column, where the dura mater forms a loose sheath around the spinal cord and is only at- tached here and there to the surrounding bones, which have a separate periosteum of their own. The innermost membrane of the cerebro-spinal centre, lying in immediate contact with the proper nervous parts, is the pia mater, also made up of white fibrous tissue interwoven with elastic fibres, but less ANATOMY OF THE NERVOUS SYSTEM. 161 B D F-; closely than in the dura mater, so as to form a less dense and tough membrane. The pia mater contains many blood-vessels which break up in it into small branches before entering the nervous mass beneath. Covering the outside of the pia mater is alayer of flat closely fitting cells; a similar layer lines the inside of the dura mater, and these two layers are described as the third membrane of the cerebro-spinal cen- tre, called the arachnoid. In the space between the two layers of the arachnoid is contained a small quan- tity of watery cerebro-spinal liquid. The surface of the brain is folded and the pia mater follows closely these folds; the arachnoid often stretches across them : in the spaces thus left between it and the pia mater is con- tained some of the cerebro-spinal liquid. The Spinal Cord (Fig. 70) is nearly cylindrical in form, being however a little wider from side to side than dorsoventrally, and taper- ing off at its posterior end. Its average diameter is about 19 milli- meters (f inch) and its length 0.43 meter (17 inches). It weighs 42.5 grams (1^ ounces). There is no marked limit between the spinal cord and the brain, the one passing grad- ually into the other (Fig. 77)^ but the cord is arbitrarily said to com- mence opposite the outer margin of the foramen magnum of the occipital bone: from there it 'extends to the articulation between the first and second lumbar verteTira^here it narrows off to a slender filament, the different levels. filum terminate (cut off and represented separately at B in Fig -8 F G H FIG. 70. — The spinal cord and medulla oblongata. A. from the 162 THE HUMAN BODY. 70), which runs back to the end of the neural canal behind the sacrum. In its course the cord presents two expansions, an upper, 10, the cervical enlargement, reaching from the third cervical to the first dorsal vertebrae, and a lower or lumbar enlargement, 9, opposite the last dorsal vertebra. Running along the middle line on both the ventral and the dorsal aspects of the cord is a groove, and a cross-section shows that these grooves are the surface indications of fissures which extend deeply into the cord (C, Fig. 71) and nearly divide it into right and left halves. The anterior fissure (1, Fig. 71) is wider and shallower than the posterior, 2, which indeed is hardly a true fissure, being completely filled up by an ingrowth of pia mater. The transverse section, C, shows also that the substance of the FIG. 71. — The spinal cord and nerve-roots. A, a small portion of the cord seen from the ventral side; B, the same seen laterally ;•, the pons Varolii ;* the fissure of Sylvius. the sake of clearness, but lie close together, as represented in Fig. 74, only some folds of the membranes extending be- tween them ; and the mid-brain is entirely covered in on its dorsal aspect. Nearly everywhere the surface of the brain is folded, the folds, "known as gyri or convolutions being deeper and more numerous in the brain of man than in that of the animals nearest allied to him; and in the human species more marked in the higher than in the lower races. It should however be added that some species of animals 168 THE HUMAN BODY. which are not markedly intelligent have much convoluted cerebral hemispheres. The brain like the spinal cord consists of gray and white nervous matter, but somewhat differently arranged, for while the brain, like the cord, contains gray matter in its interior, a great part of its surface is also covered with it. By the external convolutions of the cerebellum and the cerebral hemispheres the surface over which this gray substance is spread is very much increased (see Fig. 74). The Ventricles of the Brain. The minute central canal of the spinal cord is continued into the brain and expands FIG. 75.— Diagram of the right half of a vertical median section of the brain. Hi H, convoluted inner surface of right cerebral hemisphere; 5, the fifth ventricle; the figure is placed on the thin inner wall of the right lateral ventricle; Cc, cor- pus catlosum; 3, the third ventricle ; the partition separating it from the fifth ven- tricle is the fornix, and just behind the anterior thickened end of the fornix is shown part of the right foramen of Monro m, leading to the right lateral ven- tricle ; t, the soft commissure cut across; in the fore part of the fornix is the anterior commissure; the anterior portion of the floor of the third ventricle shows two downward prolongations, one directed to the optic commissure, z, the other (iiifundibnluni) to the pituitary body, pt; «, the pineal body; the thickening immediately beneath its root is the posterior commissure; the mass forming the exposed wall of the ventricle and on which the figure 3 is placed is the inner side of the right optic thalamus ; o, d, the anterior and posterior corpora quadri- ffemina of the right side; 4, the fourth ventricle lying near the dorsal side of the medulla oblongata, Mo, and connected by the tier with the third ventricle; pos- teriorly it is continued to join the central canal of the spinal cord; CV, right crus cerebri; P, pans Varolii; Cb, cerebellum.; where it is divided in the middle line the radial arrangement of its central white matter forming the so-called arbor vitce is seen; op. right optic nerve proceeding from the optic commissure ; oc, the third cranial nerve arising from the crus cerebri; 1, callosal convolution. there at several points into chambers known as the ventri- cles. Entering the medulla oblongata it approaches its upper surface and dilates into- the fourth ventricle, 4, Fig. 75, ANATOMY OF THE NERVOUS SYSTEM. 169 which has a very thin roof, lapped over by the cerebellum. From the front of the fourth ventricle rims a narrow pas- sage (aqueduct of sylvius or iter) which enters another dila- tation, 3, Fig. 75, lying in the middle line near the under side of the fore-brain and known as the third ventricle. From the third ventricle two apertures (the foramens of Monro), one of which is partly seen at m in the diagram, lead into the first and second, or lateral ventricles, one of which lies in each of the cerebral hemispheres. The front ends of these two ventricles are seen in the vertical trans- verse section of the brain represented in Fig. 76. VI FIG. 76.— A vertical section across the cerebral hemispheres taken in front of the fifth ventricle. Cci2, anterior part of corpus callopum ; VI, the anterior end of the right lateral ventricle: the gray mass on its exterior is the front end of the corpus striatum. On the left side the superficial gray matter covering the convolutions is shaded. The ventricles contain a small amount of cerebro-spinal liquid, and are lined by epithelium which is ciliated in early life. Part of the posterior wall of the third ventricle is ex- tremely thin, consisting of little but this epithelium sup- ported by a thin layer of pia mater: this part is pushed in or doubled into the cavity of the ventricle in the form of a triangular membrane, the velum interpositum, which lies beneath the fornix and sends offshoots into the lateral ven- tricles. Between the upper and lower layers of the indupli- cated velum interpositum arteries enter and there break up into plexuses — the choroid plexuses— covered everywhere by 170 THE HUMAN BODY. the pushed-in epithelium. These plexuses occupy a consid- erable part of the third and lateral ventricles: and a pair of similar vascular tufts drive in before them part of the thin roof of the fourth ventricle and encroach on its cavity. Note. A frequent cause of apoplexy is a hemorrhage into one of the lateral ventricles; the outpoured blood accu- mulating and pressing upon the cerebral hemispheres, their functions are suppressed and unconsciousness produced. When a person is found in an apoplectic fit therefore the best thing to do is to leave him perfectly quiet until medical aid is obtained: for any movement may start afresh a bleed- ing into the ventricle which had been stopped by clots formed in the mouths of the torn blood-vessels. Sections of the Brain. Having got a general idea of the parts composing the brain, the best way to continue the study of its anatomy is to examine sections taken in various direc- tions. Two such are given in Figs. 75 and 7G. Fig. 75 rep- resents the right half of a vertical section of the brain, taken from before back in the middle line and viewed from the inner side. Above, the knife has passed between the two cerebral hemispheres, in the longitudinal fissure, without cut- ting either, and the convoluted inner surface of the right one is seen. The sickle-shaped mass lower down, Cc to Cc, rep- resents the cut surface of a connecting band of white nervous tissue called the corpus callosum^ which runs across the mid- dle line from one cerebral hemisphere to the other and puts them in communication. Beneath the corpus callosurn the knife has opened, a cavity, the fifth ventricle, 5, bounded on each side by a very thin wall, which forms part of the inner wall of the corresponding lateral ventricle; the median partition formed by these two walls and containing the\slit-like fifth ventricle is the septum lucidum. The fifth is quite different in origin from the remaining cerebral ven- tricles, not being a continuation of the canalis centralis of the spinal cord. Forming the floor of the fifth ventricle and separating it from the third ventricle, 3, is the for nix, mainly made up of fibres running from before back. The anterior downward- curved end of the fornix is thickened, and contains the an- terior commissure, a small cord of transverse nerve-fibres. The cavity of the third ventricle is narrow from side to side, and is bounded laterally by the optic tlialami, of which the ANATOMY OF THE NERVOUS SYSTEM. 171 right, having the figure 3 placed on it, has its median side exposed in the section. The third ventricle is crossed about its middle by the middle commissure, t, and from its anterior end the foramina of Monro, of which the right, m, is partly exposed in the section, lead to the lateral ventricles. From the fore%part of the third ventricle two conical extensions pass downward, one directed to z, the optic commissure, from which the optic nerves pass, and the other, named the infundibulum, to the pituitary body, fit. The latter consists of an anterior and posterior lobe, and in the human brain contains no ner- vous elements. The anterior lobe, indeed, is an outgrowth from the pharynx of the embryo, and only secondarily be- comes attached to the brain. It is not known to have any function in existing vertebrates. From the posterior part of the floor of the third ventricle the iter leads as a narrow pas- sage dorsal to the crura cerebri, Cr, and ventral to the corpora quadrigemina, o, d, to the fourth ventricle, 4. Projecting from the posterior wall of the third ventricle is a small coni- cal non-nervous mass, the pineal body, which, though of no functional importance, is of interest, in the first place be- cause the philosopher Descartes considered it the special seat of the soul, and in the second because embryology and com- parative anatomy show that it is the remnant of a third median eye, which primitive vertebrates possessed on the dorsal side of the head. In some existing reptiles its original structure is more complete than in man, but in none is it functional. Just beneath the attachment of the pineal body is a slight thickening of the posterior wall of the third ven- tricle containing transverse fibres, and named the posterior commissure. The third ventricle and the parts immediately surrounding it constitute the inter-brain or thalamencephalon, which with the two cerebral hemispheres and the corpus cal- losum and fornix makes up the fore brain. The mid-brain, consisting mainly of the crura cerebri, Cr, and the corpora quadrigemina, o, d,and traversed by the nar- row iter, is continuous posteriorly with the hind brain, con- sisting of pons Varfilii, P; cerebellum, Cb; and medulla oblon- gata, Mo. The 'thin-roofed cavity of the fourth ventricle, 4, lies near its dorsal side. Where cut in making the section the cerebellum shows a curious branching core of white nerve matter, surrounded by gray, named arbor vitce by the old anatomists. The pons consists mainly of transverse fibres 172 THE HUMAN BODY. uniting the right and left halves of the cerebellum; the medulla oblongata and crura contain mainly longitudinal fibres, but there are many transverse. Fig. 76 represents a vertical transverse section of the brain taken through the forepart of the corpus callosum (CcF) and altogether in front of the third ventricle. It shows the foldings of the cerebrum and its superficial layer of gray substance; the anterior ends of the lateral ventricles, VI, with a gray mass, the corpus striatum lying beneath and on the outer side of each. If the section had been taken a little farther back the optic tlialami would have been found reaching the floor of each ven- tricle. Like the optic thalamus, to the front of and partly to the outer side of which it lies, the corpus striatum is mainly composed of gray nerve matter. It is, however, divided in its posterior region into an inner and outer portion by a well marked band of white substance, consisting of nerve fibres, passing through on the way to or from the surface of the cerebral hemispheres: this band is the internal capsule. The Base of the Brain and the Cranial Nerves. Twelve pairs of nerves leave the skull by apertures in its base, and are known as the cranial nerves. Most of them spring from the under side of the brain, and so they are best studied in connection with the base of that organ, which is represented in Fig. 77. The first pair, or olfactory nerves, spring from the under sides of the olfactory lobes, 1, and pass out through the roof of the nose. They are the nerves of smell. The second pair, or optic nerves, II, spring from the optic thalami and corpora quadrigemina, and, under the name of optic tracts, run down to the base of the brain, where they appear passing around the crura cerebri, as represented in the figure. In the middle line the two optic tracts unite .to form the optic com- missure (seen in section at z, in Fig. 75), from which an optic nerve proceeds to each eyeball. Behind the optic commis- sure is seen the conical stalk of the pituitary body or hy- pophysis cerebri (pt in Fig. 75), and still further back a pair of hemispherical masses, about the size of split peas, known as the corpora albicantia. All the remaining cranial nerves arise from the hind- brain. The third pair (motor es oculi) arise from the front of the pons Varolii, and are distributed to most of the muscles which move the eyeball and also to that which lifts the upper eyelid. The four-sided space bounded by the optic tracu; ANATOMY OF THE NEUVOUS SYSTEM. 173 and commissure in front and the third pair of nerves behind, and having on it the pituitary body and the corpora albi- cantia, lies beneath the third ventricle, so that a probe pushed in there would enter that cavity (see Fig. 75). in FIG. 77.— The base of the brain. The cerebral hemispheres are seen overlap- ping all the rest. 7, olfactory lobes; II, optic tract passing tothe optic commissure from which the optic nerves proceed ; HI, the third nerve or motor oculi ; 1 V, the fourth nerve or patheticus ; V, the fifth nei*ve or trigeminalis; VI. thn sixth nerve or abducens; VII, the seventh or facial nerve or portio dura; VIII, the auditory nerve or portio mollis; IX, the ninth or glosso-pharyngeal ; X, the tenth or pneu- mogastric or vagus; XI, the spinal accessory; XII, the hypoglossal; ncl, the first cervical spinal nerve. The fourth pair of nerves, IV (patlietici\ arise from the front part of the roof of the fourth ventricle. From there, each curls around a crus cerebri (the cylindrical mass seen beneath it in the figure, running from the pons Varolii to enter the under surface of" the cerebral hemispheres) and ap- pears on the base of the brain. Each goes to one muscle of the eyeball. The fifth pair of nerves (trigeminales), V, resemble the 174 THE HUMAN BODY. spinal nerves in having two roots; one of these is much larger than the other and possesses a ganglion (the Gasserian ganglion) like the dorsal root of a spinal nerve. Beyond the ganglion the two roots form a common trunk which divides into three main branches. Of these, the ophthalmic is the smallest and is mainly distributed To~the muscles and skin over the forehead and upper eyelid; but also gives branches to the mucous membrane lining the nose,, and to the integument over it. The second division (superior maxil- lary nerve) of the trigeminal gives branches to the skin over the temple, to the cheek between the eyebrow and the angle of the mouth, and to the upper teeth; as well as to the mucous membrane of the nose, pharynx, soft palate and roof of the mouth. The third division (inferior maxillary) is the largest branch of the trigeminal; it receives some fibres from the larger root and all of the smaller. It is distributed to the side of the head and the external ear, the lower lip and lower part of the face, the mucous membrane of the mouth and the anterior two thirds of the tongue, the lower teeth, the salivary glands, and the muscles which move the lower jaw in mastication. The sixth pair of cranial nerves (Fig. 77), VI, or abdu- centes arise from the posterior margin of the pons Varolii, and each is distributed to one muscle of the eyeball. The seventh pair (facial nerves), VII, appear also at the posterior margin of the pons. They are distributed to most of the muscles of the face and scalp. The eighth pair (auditory nerves) arise close to the facial. They are the nerves of hearing and are distributed entirely to the internal ear. The ninth pair (glossopharyngeals), IX, arising close to the auditories, are distributed to the mucous membrane of the pharynx, the posterior part of the tongue, and the middle ear. The tenth pair (pneumo gastric nerves or vagi), X, arise from the sides of the medulla oblongata. Each gives branches to the pharynx, gullet and stomach, the larynx, windpipe and lungs, and to the heart. The vagus runs farther through the body than any other cranial nerve. The eleventh pair (spinal accessory nerves), XI, do not arise mainly from the brain but by a number of roots attached to the lateral columns of the cervical portion of the spinal ANATOMY OF THE NERVOUS SYSTEM. 175 cord, between the anterior and posterior roots of the proper cervical spinal nerves. Each, however, runs into the skull cavity alongside of the spinal cord and, getting a few fila- ments from the medulla oblongata, passes out along with the glossopharyngeal and pneumogastric nerves. Outside the skull it divides into two branches, one of which joins the pneumogastric trunk, while the other is distributed to mus- cles about the shoulder. The twelfth pair of cranial nerves (liypoglossi), XII, arise from the sides of the medulla oblongata; they are distributed mainly to the muscles of the tongue and hyoid bone. Deep Origins of the Cranial Nerves. The places referred to above, at which the various cranial nerves appear on the surface of the brain, are known as their superficial origins. From them the nerves can be traced for a lesser or greater way in the substance of the brain until each is followed to one or more masses of gray matter, which constitute its proper start- ing-point and are known as its deep origin. The deep origins of all except the first and second and part of the eleventh lie in the medulla oblongata, midbrain, and thalamen cephalon. The Ganglia and Communications of the Cranial Nerves. Besides the Gasserian ganglion above referred to, many others are found in connection with the cranial nerves. Thus for example there is one on each of the main divisions of the trigeminal, two are found on each pneumogastric and two in connection with the glossopharyngeal. At these ganglia and elsewhere, the various nerves often receive branches from neighboring cranial or spinal nerves, so that very soon after it leaves the brain hardly any, except the olfactory, optic, and auditory, remains free from fibres derived from other trunks. This often makes it difficult to say from where the nervej of a special part have come; for example, the nerve-fibres going to the submaxillary salivary gland from the trigeminal leave the brain first in the facial and only afterwards enter the fifth; and many of the fibres going apparently from the pneumogastric to the heart come originally from the spinal accessory. The Sympathetic System. The ganglia which form the main centres of the sympathetic nervous system lie in two rows (s, Fig. 2, and sy, Fig. 3), one on either side of the bodies of the vertebrae. Each ganglion is united by a nerve- .trunk with the one in front of it, and so two great chains are 176 THE HUMAN BODY. formed reaching from the base of the skull to the coccyx. In the trunk region these chains lie in the ventral cavity, their relative position in which is indicated by the dots sy in the diagrammatic transverse section represented on p. 6 in Fig. 3. The ganglia on these chains are forty-nine in num- ber, viz., twenty-four pairs, and a single one in front of the coccyx in which both chains terminate. They are named from the regions of the vertebral column near which they lie; there being three cervical, twelve thoracic, four lumbar, and five sacral pairs. Each sympathetic ganglion is united by communicating brandies with the neighboring spinal nerves, and near the skull with various cranial nerves also; while from the gan- glia and their uniting cords arise numerous trunLs, many of which, in the thoracic and abdominal cavities, form plexuses, from which in turn nerves are given olf to the viscera. These plexuses frequently possess numerous ganglia of their own; two of the most important are the cardiac plexus which lies on the dorsal side of the heart, and the solar plexus which lies in the abdominal cavity and supplies nerves to the stomach, liver, kidneys, and intestines. Many of the sympa- thetic nerves finally end in the walls of the blood-vessels of various organs. To the naked eye they are commonly grayer in color than the cerebro-spinal nerves. Tho Sporadic Ganglia. These are found scattered in nearly all parts of the Body except the limbs. They are for the most part small, even microscopic in size, though several large ones exist in the abdominal cavity. The}7 are especially abundant in the neighborhood of secretory tissues and about blood-vessels, while a very important set is found in the heart. Nerves unite them with the cerebro-spinal and sym- pathetic centres, and probably most of them should be classi- fied as belonging to the sympathetic system. The Histology of Nerve-Fibres. The microscope shows that in addition to connective tissue and other accessory parts, such as blood-vessels, the nervous organs contain tis- sues peculiar to themselves and known as nerve-fibres and nerve-cells. The cells are found in the centres only; while the fibres, of which there are two main varieties known as the white and the gray, are found in both trunks and cen- tres: the white variety predominating in most cerebro-spinal nerves and in the white substance of the centres, and the ANATOMY OF THE NERVOUS SYSTEM. 177 gray in the sympathetic trunks and the gray portions of the central organs. If an ordinary cerebro-spinal nerve-trunk be examined it will be found to be enveloped in a loose sheath of areolar connective tissue, which forms a packing for it and unites it to neighboring parts. From this sheath, or perineurium, bands of connective tissue penetrate the nerve and divide it up into a number of smaller cords or funiculi, much as a muscle is subdivided into fasciculi; each funiculus has a sheath of its own called the neurilemma, composed of several FIG. 78. FIG. 79. FIG. 78. — White nerve-fibres soon after removal from the Body and when they have acquired their double contour. FIG. 79.— Diagram illustrating the structure of a white or medullated nerve-fibre. I, 1, primitive sheath; 2, 2, medullary sheath; 3, axis cylinder. concentric layers of a delicate membrane, within which the true nerve-fibres lie. These, which would be nearly all of the white kind, consist of extremely delicate threads, on the average, 0.0125 mm. (^oVo- incn) in diameter, though often considerably smaller, and of a length which is in proportion very great. The core of each nerve-fibre in fact is continuous from a nerve-centre to the organ in which it ends, so that the fibres, e.g., which pass out through the sacral plexus and then run on through the sciatic nerve and its branches to the skin 178 THE HUMAN BODY. B of the toes, are three to four feet long. If a fresh while nerve* fibre be examined with the microscope it presents the appear- ance of a perfectly homogeneous glassy thread ; but soon it acquires a characteristic double contour (Fig. 78) from the coagulation of a portion of its substance. By proper treatment with re- agents three layers may be brought into view. Outside is a fine transparent envelope (1, Fig. 79) called the primitive sheath ; inside this is a fatty substance, 2, forming the medullary sheath (the coagulation of which gives the fibre its double border), and in the centre is a core, the axis cylinder, 3, which is longitudinally fibrillated and is clearly the essential part of the fibre, since near the end- ing the primitive and medullary sheaths are frequently absent. At intervals of about one millimeter (fa inch) along the fibre are found nuclei (c, Fig. 80), around each of which lies a little protoplasm. These are indications of the primitive cells which have elongated and formed an envelope for the axis cylinder, which itself is a branch given off by a nerve-cell in some centre. The medullary sheath is interrupted half-way between each pair of nuclei at a point called the node of Ranvivr (R, Fig. 80), which is the boundary between two of the enveloping cells. In the course of a nerve-trunk its fibres rarely divide; when a branch is given off some fibres merely separate from the °f four hundred diame- rafced out at one end into smaller bundles terse they nsivc ot*cn _^ _ . -. treated with, osmic containing fewer threads. .Near their ends, acid, which stains the , , -, •, medullary sheath however, nerve-fibres frequently brancn, ana 8r^ *£*!£& then a division of the axis cylinder goes to c, c, and nodes of , , , Ranvier, R. The axis each branch. Gray Nerve-Fibres. Some of these are merely white fibres which near their peri- pheral ends have lost their medullary sheaths; others have no medullary sheath throughout their whole course, and consist merely of an axis cylinder (often striated) and nuclei, with the nodes. ANATOMY OF THE NERVOUS SYSTEM. 179 or without a primitive sheath. Such fibres are especially abundant in the sympathetic trunks; and they alone form the olfactory nerve. In the communicating branches between the sympathetic ganglia and the spinal nerves both white and gray fibres are found; the former are cerebro-spinal fibres passing into the sympathetic system, while the grav fibres originate in the sympathetic system and pass to the membranes and blood-vessels of the spinal cord and spinal column. Another group of gray nerve-fibres may be called nerve-fibrils : they are extremely fine,, and result from the subdivision of axis cylinders, close to their final endings in many parts of the Body, after they have already lost both primitive and medullary sheaths. Many fine gray fibres exist in the nerve-centres. The Histology of Nerve-Cells. The only structures known with certainty to be connected with the central ends of nerve-fibres are nerve-cells, and so many nerve-fibres have FIG. 81.— Nerve-cell from anterior horn of srey matter of spinal cord; a, axis- cylinder process. 2, Cell from posterior horn of spinal cord. been traced into continuity with nerve-cells, that it is fairly certain all arise in this way. The latter may therefore be re- garded as the central organs of the nerve-fibres. 180 THE HUMAN BODY. At 1, Fig. 81, is shown a typical nerve-cell such as may be found in an anterior horn of the gray matter of the spinal cord. It consists of the cell body, or cell protoplasm, in which is a large nucleus containing a nucleolus. From the body of the cell arise several branches,, the great majority of which are granular and divide frequently in a forking or " dichotomous " manner. These are known as the " proto- plasmic " branches of the cell, and possibly serve merely to absorb nourishment for it. One branch, however, a, gives oft' at right angles smaller filaments, but still maintains its in- dividuality and ultimately becomes the axis cylinder of a nerve-fibre. Its side branches probably put it in anatomical continuity with other nerve-fibres and other nerve-cells. Nerve cells from the posterior horn of the grey matter of the spinal cord (2, Fig. 81) also possess numerous granular protoplasmic processes and a nerve-fibre process (#); but the latter, instead of continuing directly into an axis cylinder, breaks up into a network of fine branches which frequently unite with one another and also, no doubt, with fibrils from neighboring cells. It is almost certain that one or more of these fibrils or a bunch of them forms the axis cylinder of a fibre in a dorsal root of a spinal nerve. As we shall learn later, the dorsal roots are concerned in carrying impulses from the skin and other sensitive parts to the spinal cord; the anterior roots in conveying impulses from the nerve-centres to the organs (muscles, glands, etc.) of the Body. Therefore, in general terms, we may speak of the type of nerve-cell 1, Fig. 81, as a motor nerve-cell; and the type of cell 2, Fig. 81, as a sensory nerve-cell. Both varieties of cells are found abundantly in the gray matter of the brain (Fig. 83), along with other forms, of which the pear-shaped cells of Purkinje existing in the cerebellum may be mentioned (Fig/82). In the sympathetic and sporadic ganglia somewhat simpler forms of nerve-cells, having fewer branches, occur. As a rule nerve-cells are comparatively large and have conspicuous nuclei, but in the brain many small ones exist. Neuroglia. In the brain and spinal cord the true nervous elements are intertwined with and supported by connective tissue and minute blood-vessels, but in addition there is found closely twisted around the cells and fibres a peculiar tissue ANATOMY OF THE NERVOUS SYSTEM. 181 made of greatly branched cells (Fig. 83), and named the neuroglia or sus tentacular tissue. Nerve-Centres consist of white and gray nerve-fibres, of nerve-cells, of neuroglia, and of connective tissue and blood-vessels arranged in -^^W^l^&tiM'hln different ways in the differ- ent centres. They are es- sentially collections of nerve- " v \j/ \&M 7*\/$r^n. FIG. 82.— A thin section of the cere- FIG. 83.— Cells from the surface gray mat- bellum showing: pear-shaped cells of ter of a cerebral convolution : p, nerve-cells Purkinje, and numerous other small with axis cylinder processes, o ; ?i, non-ner- nerve-cells. vous neuroglia cells. The method of prepa- ration (Qolgi's) stains the cells an uniform black. cells and nerve-fibres, some of the latter being connected with the cells, while others may merely pass through on their way to or from other centres. As an illustration of the structure of a more complex nerve-centre we may study the spinal cord. Histology of the Spinal Cord. If a thin transverse sec- tion of the spinal cord be examined with a microscope it will be found that enveloping the whole is a delicate layer of connective tissue, the pia mater. Fine bands of it ramify 182 THE HUMAN BODY. through the cord, supporting the nervous elements; some of the coarser of these are represented at 6, 7, and elsewhere in Fig. 84, but from these still finer processes arise, as represented at d and e in Fig. 85. The ultimate finest tissue directly supporting the nervous elements directly, is the neuroglia. In the white columns, the cord (Fig. 85) will be seen to be /IG. 84.— A thin transverse section of half of the spinal cord magnified about 10 diameters. 1, anterior fissure ; 2, posterior fissure ; 3. canalis central is ; 8, pia mater enveloping the cord ; 6, 7, bands of pia mater penetrating the cord and sup- gorting its nerve elements ; 9, a posterior root ; 10, bundles of an anterior root ; a, , c, d, e, groups of nerve cells in the gray matter. mainly made up of medullated nerve-fibres which run longi- tudinally and therefore appear in the transverse section as circles, with a dot in the centre, which is the axis cylinder. At b in Fig. 85 these fibres are represented, the intermediate connective tissue being omitted, while at e this latter alone is represented in order to show more clearly its arrangement. At the levels of the nerve-roots horizontal white fibres are found (9 and 10, Fig. 84, and «,.Fig. 85), running into the gray matter, and others exist at the bottom of the anterior fissure, running from one side of the cord to the other. In ANATOMY OF THE NERVOUS SYSTEM. 183 the gray substance the same supporting network of connec- tive tissue is found, but in it the majority of the nerve-fibres are non-medullated, and at certain points nerve-cells, such as are totally absent in the white substance, are found. One collection of these nerve-cells is seen at c in Fig. 84, and others are represented at a, e,f, and elsewhere. The nerve- fibres in the gray matter are for the most part branches of the axis cylinder processes of these cells (see Fig. 81), and as they unite with one another freely they form a structurally continuous network through the whole gray substance. The fibres of the anterior roots of the spinal nerves enter the gray matter and there most of them soon become continuous with the axis cylinder process of a nerve-cell; the ending of the posterior root-fibres is not quite certain, but they appear to break up and join the gray network, to be by it placed indi- rectly in connection with nerve-cells. In any case the funda- mental fact remains that every nerve-fibre joining the spinal cord is directly or indirectly in continuity with the gray net- work, and so with all the other fibres of all the spinal nerves., FIG. 85.— A small bit of the section represented in Fig, 84 more magnified, a, a bundle of fibres from an anterior root passing tli rough the white substance on its way to the gray. Towards the right of the figure the nerve-fibres of the anterior column have been omitted so as to render more conspicuous the supporting con- nective tissue, d and e. Elsewhere the nerve-fibres alone are represented ; c, envel- oping pia mater. The neuroglia is not indicated. From the sides of the gray substance, fibres continually pass out into the white portion and become medullated ; some of these enter the gray network again at another level and so bring parts of the cord into especially close union, while others pass on into the brain. At the top of the neck, more- over, the gray matter of the cord is continuous with that of 184 THE HUMAN BODY. the medulla oblongata and through it with the rest of the brain, so that nervous disturbances can pass by anatomically continuous paths from one to the other. The Structure of a Spinal Ganglion. When one of these ganglia is cut lengthwise, and the section examined micro- scopically, it is seen that connective tissue forms an envelope for it, and sends ramifying bundles through it. The fibres of the poste- rior root become separated into bundles when they enter a ganglion and unite into a single bunch when they leave it to join the mixed spinal nerve trunk. Between the bundles of nerve-fibres within the gan- glion are groups of nerve- cells, and probably each fibre on its way through the gan- glion is connected with a FIG. 86. — Diagram of a spinal ganglion -M rnr,- cell: uc, its flbrillated process, which ac- Cell. IhlS Connection OC- quiring primitive sheath, ps, and medullary • eOrr,pWV,at r»PPnliir sheath. m«, becomes a fibre which at the c node of Ranvier nr joins a posterior root w«v TVm polla ^TTio- 8fi\ fibre, part of its axis cylinder, c, running WaJ' ± ne C6llS I'H?' °*V centrally in this, and part, d, distaiiy. are pear-shaped, granular, contain a large nucleus and nucleolus, and average -£$• mm. (^l-Q inch) in long diameter. Near its narrow end the cell substance is fibrillated, and a bundle of these fine fibres, ac, passes from it, something like the stalk from a pear. This stalk is an axis cylinder, and has on it small nuclei. A little way from the cell the axis cylinder acquires a primitive sheath, ps, and a little farther on a medullary sheath, ms, so that it becomes a fully formed white nerve-fibre. At a node of Ran- vier (usually that one nearest the cell), nr, this divides, its branches diverging from it at right angles: one branch runs to the posterior root and enters the spinal cord; the other continues through the ganglion as a fibre of the mixed nerve-trunk. The axis cylinders of these branches, c and d, in some cases at least, contain fibrillae not derived from the pear-shaped cell in addition to those which are. Each cell as it lies in the ganglion is gncased in a delicate envelope of ANATOMY OF THE NERVOUS SYSTEM. 185 flattened nucleated cells (not indicated in the figure)., probably belonging to the surrounding connective tissue. Blood-vessels are distributed in the ganglion, the capillaries being especially numerous about the nerve-cells. Most of the cells of sympathetic and other peripheral gan- glia seem to have several branches, no one of which differs essentially from the rest; probably each branch becomes part of the axis cylinder of a different fibre, the cell thus placing several distinct fibres in communication. 186 THE HUMAN BODY. CHAPTER XIII. THE GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. The Properties of the Nervous System. General Con- siderations. If the finger of any one unexpectedly touches a very hot object, pain is felt and the hand is suddenly snatched away; that is to say, sensation is aroused and cer- tain muscles are caused to contract. If, however, the nerves passing from the arm to the spinal cord have been divided, or if they have been rendered incapable of activity by disease, no such results follow. Pain is not then felt on touching the hot body nor does any movement of the limb occur; even more, under such circumstances the strongest effort of the will of the individual is unable to bring about movement of his hand. If, again, the nerves of the limb have uninjured connection with the spinal cord, but parts of the latter, higher up, between the brain and the point of junction of the nerves of the brachial plexus with the cord, are injured, then a sudden contact with the hot body will cause the arm to be snatched away, but no pain or other sensation due to the contact will be felt, nor can the will act upon the muscles of the arm. From the comparison of what happens in such cases (which have been observed over and over again upon wounded or diseased persons) with what occurs in the natural condition of things, several important conclusions may be arrived at: 1. The feeling of pain does not reside in the burnt part it- self; although that may be perfectly normal, no sensation will be aroused by any external force acting upon it, if the nervous cords uniting it with the centres be previously divided. 2. The hot body has originated some change which, when propagated along the nerve-trunks, has excited a condition of the nerve-centres which is accompanied by a sensation, in this particular case a painful one. This is clear from the fact that the loss of sensation immediately follows division of the GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 187 nerves of the limb, but not the injury of any of its other parts; unless of such a character as to cut off the supply of blood, when of course the nerves soon die, with the rest. Even, however, some time after tying the vessels which carry blood to a limb one can observe in experiments upon the lower animals that sensibility is still retained if the nerves be not directly injured. 3. When a nerve in the skin is excited by a burn, or other- wise, it does not directly call forth muscular contractions; for if so, touching the hot body would cause the limb to be moved even when the nerve had been divided high up in the arm, and as a matter of observation and experiment we find that no such result follows if the nerve-fibres have been cut in any part of their course from the burned part to the spinal marrow. It is therefore through the nerve-centres that the change trans- mitted from the excited part of the skin is reflected or sent back, to act upon the muscles. 4. The last deduction makes it probable that nerve-fib? es must pass from the centre to muscles as well as from the skin to the centre. This is confirmed by the fact that if the nerves of .the limb be divided the will is unable to act upon its muscles, showing that these are excited to contract through the nerves. That the nerve-fibres concerned in arousing sensation and muscular contractions are different, is shown also by cases of disease in which the sensibility of the limb is lost while the power of voluntarily moving it remains, and by other cases in which the reverse is seen, objects touching the hand being felt while it cannot be moved by the will. We con- clude then that certain nerve-fibres when stimulated convey something (a nervous impulse) to the centres, and that these when excited may radiate impulses through other nerve-fibres to distant parts, the centre serving as a connecting link be- tween the fibres which carry impulses from without in, and those which convey them from within out. 5. Further we conclude that the spinal cord can act as an intermediary between the fibres carrying -in nervous im- pulses and those carrying them out, but that sensations can- not be aroused by impulses reaching the spinal cord only, nor has the Will its seat there; volition and consciousness are dependent upon states of the brain. This follows from the unconscious movements of the limbs which follow stimula- tion of its skin after such injury to the spinal cord as pre- 188 THE HUMAN BODY. vents the farther transmission of nervous impulses (show- ing that the cord is a reflex centre], and from the absence, in such cases, of sensation in the part whose nerves have been injured, and the loss of the power of voluntarily causing its muscles to contract. 6. Finally we conclude that the spinal cord in addition to being a centre for rt flex actions serves to transmit nervous im- pulses to and from the brain; a fact which is confirmed by the histological observation that in addition to the nerve-cells, which are the characteristic constituents of nerve-centres, it contains the simply conductive nerve-fibres, many of which pass on to the brain. In other words, the spinal cord, besides containing fibres which enter it from and pass from it to peri- pheral parts, contains many which unite it to other centres; and others which connect the various centres in it, as those for the arms and legs, together. This is true not only of the spinal cord, but of the brain (which contains many fibres uniting different centres in it), and probably of all nerve- centres. The Functions of Nerve-Centres and Nerve-Trunks. From what has been stated in the previous paragraphs it is clear that we may distinctly separate the nerve-trunks from the nerve-centres. The fibres serve simply to convey impulses either from without to a centre or in the opposite direction, while the centres conduct and do much more. Some, as the spinal cord, are merely reflex centres and have nothing to do with states of consciousness. A man with }ris spinal cord cut or diseased in the thoracic region will kick violently if the soles of his feet be tickled, but will feel nothing of the tick- ling, and if he did not see his legs would not know that they were moving. Reflex centres moreover do not act, as a rule, indifferently and casually, but rearrange the impulses reach- ing them, so as to produce a protective or in some way advan- tageous result. In other words, these centres, acting in health, commonly co-ordinate the incoming impulses and give rise to outward-going impulses which produce an apparently purposive result. The burnt hand or the tickled foot, in the absence of all consciousness, is snatched away from the irri- tant; and food chewed in the mouth excites nerves there which act on a centre which causes certain cells in the salivary glands to make and pour into the mouth more saliva. In addition to the reflex centres we have others, placed in the GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 189 brain, the excitation of which is accompanied in us by various states of consciousness, as sensations, emotions, and the will; concerning these centres of consciousness our physiological knowledge is still very incomplete; what we know about them is based rather on psychological than physiological observa- tion. The brain also contains a great many important reflex centres, as that for the muscles of swallowing, an act which goes on perfectly without our consciousness at all. In fact if we pay attention to our swallowing we fail to perform it as well as if we let the nervo-muscular apparatus alone, as is illustrated by the difficulty many persons experience on trying to swallow a pill. To complete the statement of the functions of the nerve-centres we must probably add two other groups. The first of these is that of the automatic centres, which are centres excited not directly by nerve-fibres conveying impulses to them, but in other ways. For example the breathing movements go on independently of our consciousness, being dependent on stimulation of a nerve-centre in the brain by the blood which flows through it (see Chap. XXVII); and the beat of the heart is also much dependent (Chap. XVIII) upon nerve-centres, the excitant of which is unknown. The final group of nerve-centres is represented by certain sporadic sympathetic and cerebro-spinal ganglia which are not known to be either reflex, automatic, or conscious in function. They may be called relay and junction centres, since in them prob- ably an impulse entering by one nerve-fibre excites a cell, which by its communicating branches arouses many others, and these then send out impulses by the many nerve-fibres connected with them. By such means a single nerve-fibre can act upon an extended region of the Body. In other cases it seems likely that a feeble nervous impulse reaching an irri- table nerve-cell excites changes in this comparable to those produced in a muscle when it is stimulated; the cell is in fact a store of readily decomposable material which breaks down when stimulated through one branch, with the liberation of energy, the discharge of which takes the form of reinforced nerve impulses sent along other branches or one of them. That nerve-cells are the seats of considerable metabolic changes is indicated by the abundant supply of blood always sent to regions where they are numerous: and that some of their material is used up, or undergoes katabolism, during their activity and is replaced by anabolic processes during 190 THE HUMAN BODY. rest, can be demonstrated histologically. If the sensor}1 nerves of one fore limb of an animal be left at rest and those of the other simultaneously excited for several hours, it will be found, at the end of that time, that the nuclei of many cells of the spinal ganglia of the brachial nerves on the stim- ulated side are shrunken and distorted when compared with those of the other side. But if some hours be suffered to elapse before the animal is killed and the ganglia examined, the nuclei of the cells on both sides will be found equally large and well rounded. In carrier-pigeons after a long flight and in wild sparrows shot at the close of day, the nuclei of the nerve-cells connected with the origin of motor nerve-fibres are found to be shrivelled, and the whole cell frequently dimin- ished in size when compared with specimens taken from birds after a period of rest. In old age the nuclei of many nerve- cells are small and distorted, even after prolonged rest. Nerve-trunks and the white portions of nerve-centres are sparsely supplied with blood and undergo but small and slow nutritive changes in health. Their activity appears to consist in the transmission of some molecular motion not affecting the nutrition and chemical composition of the fibre, and not using up its material. Excitant and Inhibitory Nerves. The great majority of the nerve-fibres of the Body when they convey^n^rvous impulses to a part arouse it to activity; they are exciffrn^ fibres. ' There is, however, in the Body another very impor- tant set which arrest the activity of parts and which are known as inhibitory nerve-fibres. Some of these check the action of central nervous organs, and others the work of peripheral parts. For instance, taking a pinch of snuff will make most persons sneeze; it excites centrally acting fibres in the nose, these excite a centre in the brain, and this in turn sends out impulses by motor fibres which cause various muscles to contract. But if the skin of the upper lip be pinched immediately after taking the snuff, in most cases the reflex act of sneezing, which the Will alone could not pre- vent, will not take place. The afferent impulses conveyed from the skin of the lip have " inhibited " what we may call the "sneezing centre;" and afford us therefore an example of inhibitory fibres checking a centre. On the other hand, the heart is a muscular organ which goes on beating steadily throughout life; but if certain branches of the pneumogastric GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 191 nerve going to it be excited, the beat of the heart will be stopped; it will cease to work and lie in a relaxed resting condition : in this we have an instance of an inhibitory nerve checking the activity of a peripheral organ. Classification of Nerve-Fibres. Nearly all the nerve- fibres of the Body fall into one of two great groups corre- sponding to those which carry impulses to the centres and those which carry them out from the centres. The former are called afferent or centripetal fibres, and the latter efferent or centrifugal. Since the impulses reaching the centres through the afferent fibres frequently cause sensations they are often called sensory fibres ; and as many of those which carry out impulses from the centres excite movements, they are frequently called motor fibres ; but these last names are bad, since even excluding inhibitory nerves, many afferent fibres are not sensory and many efferent are not motor. "We may distinguish as subdivisions of afferent fibres the following groups. 1. Sensory fibres proper, the excitement of which is followed by a sensation when they are connected with their brain-centre, which sensation may or may not give rise to a voluntary movement. 2. Reflex fibres, the excitation of which may be attended with consciousness but gives rise to involuntary efferent impulses. Thus for example light falling on the eye causes not only a sensation, but also a nar- rowing of the pupil, which is entirely independent of the control of the will. No absolute line can, however, be drawn between these fibres and those of the last group: any sudden excitation, as an unexpected noise, will cause an involuntary movement, while the same sound if expected would cause a movement or not according as was willed. 3. Excito motor fibres. The excitation of these when reaching a nerve-centre causes the stimulation of efferent fibres, but without the par- ticipation of consciousness. During fasting, for instance, bile accumulates in the gall-bladder and remains there until some semi-digested food passes from the stomach into the intestine. This is acid and stimulates nerves in the mucous membrane lining the intestine, and these convey an impulse to a centre, which in consequence sends out impulses to the muscular coat of the gall-bladder causing it to contract and expel its con- tents into the intestine: but of all this we are errtirely un- conscious. 4. Centro-inliibitory fibres. Whether these exist as a distinct class is at present doubtful. It may be that 192 THE HUMAN BODY. they are only ordinary sensory or reflex fibres, and that the inhibition is due only to the interference of two impulses reaching a central organ at the same time and impeding or hindering the full production of the normal result of either. In efferent nerve-fibres physiologists also distinguish sev- eral groups. 1. Motor fibres, which are distributed to the muscles and govern their contractions. 2. Vaso-motor fibres. These are not logically separable from other motor fibres; but they are distributed to the muscles of the blood-vessels, and by governing the blood-supply of various parts, indirectly produce such secondary results as entirely overshadow their primary effect as merely producing muscular contractions. 3. Secretory fibres. These are distributed to the cells of the Body which form various liquids used in it, as the saliva and the gastric juice, and arouse them to activity. The salivary glands, for instance, may be made to form saliva by stimulat- ing nerves going to them, and the same is true of the cells which form the sweat poured out upon the surface of the Body. 4. Trophio nerve-fibres. Under this head are included nerve-fibres which hate-^been supposed to govern the nutri- tion of the various tissues, and so to control their healthy life. It has been doubted if any such nerve-fibres exist as a distinct class, and no doubt many of the facts which have been cited to prove their existence are otherwise explicable. For instance, shingles is a disease characterized by an eruption on the skin along the line of certain nerves, oftenest those which run between the ribs; but it may be dependent upon disease of the vaso-motor nerves which control the blood-supply of the part. In other cases diseases ascribed to injury of trophic nerves have been shown to be due to injury of the sensory nerves of the part, which having lost its feeling, is exposed to injuries from which it would otherwise have been protected. There are, however, cases which seem to indicate a direct niv tritive influence of the nervous system on the tissues; as for example the acute bedsores seen in some diseased states of the spinal cord and leading to extensive destruction of the skin in a very few hours; and there is direct experimental evidence to show that stimulation of the branches of the pneumogastric nerve going to the heart tends to restore that organ when ex- hausted, Vhile stimulation of the sympathetic branches has a precisely opposite effect (see Chapter XVIII). There is also no doubt that each nerve fibre depends for the maintenance GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 193 of its nutrition on a nerve-cell since, if divided in its course, the part separated from the cell rapidly degenerates. It might also be urged that secretory nerves are trophic nerves in the true sense of the word, since when excited they cause the secretory cells to live in a special way, and produce substances which when unacted upon by their nerves they do not form. But if we call secretory nerves trophic we must include also under that name all other efferent nerves; the nutritive processes going on in a muscular fibre when at work are different from those in the same fibre when at rest, and the same is true of all other cells the activity of which is governed by nerve-fibres. 5. Peripherally -act ing inhibitory nerves, such as those which slow or stop the beat of the heart. Intercentral Nerve-Fibres. These, which do not convey impulses between peripheral parts and nerve-centres, but connect one centre with another, form a final group in addi- tion to efferent and afferent nerve-fibres. Many of them connect the sporadic and sympathetic ganglia with one an- other and with the cerebro-spinal centre, while others place different parts of this latter in direct communication; as for instance different parts of the spinal cord, the brain and the spinal cord, and the two halves of the brain. The paths taken by some of these commissural fibres will be stated in connec- tion with the physiology of the brain and spinal cord. General Table. We may physiologically classify nerve- fibres as in the following tabular form, which is founded upon the facts above stated. Nerve-fibres. Peripheral. f Suasory. Afferent. Efferent. Excito-motor, Inhibitory. [ Motor. | Vaso-motor. \ Secretory. I Trophic. Inhibitory. Intercentral. Inhibitory. The Electrical Phenomena of Nerves. Under certain conditions electrical currents can be led off from living nerve- 194 THE HUMAN BODY. trunks and studied by aid of a galvanometer: in all respects these currents correspond to those of muscle, except that they are feebler. A perfectly fresh uninjured nerve at rest is isolectric, and so is a completely dead nerve. A dying por- tion of a nerve is negative to a more normal portion, and in consequence, if electrodes be placed, one on the centre and the other on the cut end of a freshly-removed portion of nerve, a current will be found passing through the connecting wire from the central portion of the piece of nerve towards the peripheral. A region of nerve in activity, that is transmit- ting a nervous impulse, is electro-negative to a region at rest, other things being equal; accordingly, an act ion -cur rent or negative variation can be demonstrated on nerves as on mus- cles; the electrical change starting from the point of stimu- lation and travelling along the trunk, to be found at a distant part at a time when it has gone from the place of its first ap- pearance. The account of the, similar phenomena in muscle (Chap. X) may be consulted for a fuller statement. The Stimuli of Nerve-Fibres. Nerve-fibres, like mus- cular fibres, possess no automatic! ty; acted upon by certain external forces or stinmli\ihey propagate a change, which is known as ,a nervous impure, from the point acted jupon to their ends; but they do not generate, nervous impulses when left entirely to themselves. Formally, in the living Body the stimulus acts on a nerve-fibre at one of its ends, being either some change in a nerve-centre with which the fibre is connected (efferent nerves) or some change in an organ at- tached to the outer end of the nerve (afferent fibres). Ex- periment shows, however, that a nerve can be stimulated in any part ot its course; that it is irritable all through its ex- tent. If, for example, the sciatic of a frog be exposed in the thigh and divided, it will be found that electric shocks ap- plied at the point of division to the outer half of the nerve stimulate the motor fibres in it, and cause the muscular fibres of the leg to contract: and similarly such shocks applied to the cut end of the central half irritate the afferent fibres in it, as shown by the signs of feeling exhibited by the animal. In ourselves, too, we often have the opportunity of observing that the sensory fibres can be stimulated in their course at some distance from their ends. A blow at the back of the elbow, at the point commonly known as the "funny bone "or the " crazy bone," compresses the ulnar nerve there against the GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 195 subjacent bone, and in addition to irritating the nerves of the skin at the point struck, starts nervous impulses which make themselves known by severe tingling pain referred to the little and ring fingers to which the ulnar nerve is dis- tributed. This shows not only that the nerve-fibres can be irritated in their course as well as at their ends, but also that sensations do not directly tell us where a nerve-fibre has been excited. No matter where in its course an impulse causing sensation has been started, we irresistibly refer its origin to the peripheral end of the afferent nerve-fibre affected. General and Special Nerve-stimuli. Certain external forces excite all nerve-fibres, and in any part of their course. These are known as general nerve-stimuli ; others act only on the end-organs of nerve-fibres, and often only on one kind of end-organ, and hence cannot be made to excite all nerves: these latter are commonly known as special nerve-stimuli, In reality they are not properly nerve-stimuli at all; but only things which so affect the irritable tissues attached to the ends of certain nerve-fibres as to make these tissues in turn excite the nerves. For example, light itself will not stimulate any nerve, not even the optic: but in the eye it effects changes (perhaps of a, chemical nature) by which nerve-stimuli are produced and these stimulate the optic nerve-fibres. The ends of the nerves in the skin are not accessible to light nor are the proper end organs on which the light acts present there, so light does not lead to the pro- duction of nervous impulses in them: but the optic nerve without its peculiar end-organs would be just as insensible to light as these are. Similarly the aerial vibrations which affect us as sounds do not stimulate directly the fibres of the auditory nerve. They act on terminal organs in the ear, and these then stimulate the fibres of the nerve of hearing, just as they would any other nerve which happened to be con- nected with them. General Nerve Stimuli. Those known are : (1) Electric currents. An electric shock passed through any part of any nerve-fibre powerfully excites it. A steady current passing through a nerve does not stimulate it, but any sudden change in this, whether an increase or a decrease, does. A very gradual change in the amount of electricity passing through a nerve in a unit of time does not stimulate it. (2) Mechanical stimuli. Any sudden pressure or traction, as 196 THE HUMAN BODY. a blow or a pull, will stimulate a nerve-fibre. On the other hand steady pressure, or pressure very slowly increased from a minimum, will not excite the nerve. (3) Thermal stimuli. Any sudden heating or cooling of a nerve, as for instance bringing a hot wire close to it, will stimulate; slow changes of temperature will not. (4) Chemical stimuli. Manv sub- stances which chemically alter the nerve-fibre stimulate before killing it; thus dipping the cut end of a nerve into a strong solution of common salt will excite it; very slow chemical change in a nerve fails to stimulate. In the case of all these general stimuli it will be seen that as one condition of their efficacy they must act with .con- siderable suddenness. On the other hand too transient in- fluences have no eifect. An electric shock sent for only 0.0015 of a second through a nerve does not stimulate it: ap- parently the inertia of the nerve molecules is too great to be overcome by so brief an action. So, also, strong sulphuric acid and some other liquids kill nerves immediately, altering them so rapidly that they die before being stimulated. Special Nerve-stimuli. These as already explained act only on particular nerves, not because one nerve is essen- tially different from another, but because their influence is excited through special end-organs which are attached to some nerves. These stimuli are: (1) Changes occurring in central organs, of whose nature we know next to nothing, but which excite the efferent nerve-fibres connected with them. The remaining special stimuli act on afferent fibres through the sense-organs. They are: (2) Light, which by the interven- tion of organs in the eye excites the optic nerve. (3) Sound, which by the intervention of organs in the ear excites the auditory nerve. (4) Heat, which through end-organs in the skin is able, by very slight changes, to excite certain nerve-fibres: such slight changes of temperature being efficient as would be quite incapable of acting as general nerve-stimuli without the proper end-organs. (5) Chemical agencies, which when extremely feeble and incapable of acting as general stimuli can act as special stimuli through special end-organs in the mouth and nose (as in taste and smell) and probably in other parts of the alimentary tract, where very feeble acids and alkalies seem able to excite cer- tain nerves, and reflexly through them excite movements or render active the cells concerned in making the digestive GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 197 liquids. (6) Mechanical stimuli when so feeble as to be ineffi- cient as general stimuli. Pressure on the skin of the fore- head or of the back of the hand, equal to .002 gram (.03 grain) can be felt through the end-organs of the sensory fibres there, but would be quite incapable of acting as a general stimulus if applied directly to the nerve-fibre. It will be noticed as regards the special stimuli of afferent nerves that many of them are merely less degrees of general stimuli ; the end-organs in skin, mouth, and nose are in fact excited by the same things as nerve-fibres, but they are far more irritable. In the case of the higher senses, seeing and hearing, however, the end-organs seem to differ entirely in property from nerve-fibres, being excited by sonorous and luminous vibrations which, so far as we know, will in no degree of intensity directly excite nerve-fibres. To construct an end -organ capable of recognizing very slight pressures we may imagine that all that would be needed would be to expose directly a very delicate end-branch of the axis cylinder ; and tnis seems in fact to be the case in the nerves of the-transpar- ent exposed part of the eyeball, if not in some other parts of the external integument of the Body. But as axis cylinders are quite unirritable by light or sound a mere exposure of them would be useless in the eye or ear, and in each case we find accordingly a very complex apparatus developed, whose function it is to convert modes of motion which do not excite nerves into others which do. We might compare this apparatus to a fuse with a detonating cap attached ; the stimulus of a blow from a hammer which would not itself ignite the fuse, acting on the detonating material (repre- senting an " end -organ"), causes it to give off a spark, and this in turn ignites the fuse which answers to the nerve-fibre. Specific Nerve-energies. We have already seen that a nervous impulse propagated along a nerve-fibre will give rise to different results according as different nerve-fibres are concerned. Travelling along one fibre it will arouse a sensa- tion, along another a movement, along a third a secretion. In addition we may observe readily that these different results may be produced by the same physical force when it acts upon different nerves. . Radiant energy, for example, falling into the eye causes a sensation of sight, but falling upon the skin one of heat, if any. The different results which follow the stimulation of different nerves do not then depend upon 198 THE HUMAN BODY. differences in the physical forces exciting them. This is still further shown by the fact that different physical forces acting upon the same nerve arouse the same kind of sensa- tion. Light reaching the eye causes a sight sensation, but if the optic nerve be irritated by a blow on the eyeball a sensa- tion of light is felt just as if actual light had stimulated the nerve-ends; and a similar result follows if an electric shock be sent through the eyeball and optic nerve. Different nerves excited by the same stimulus produce different results, and the same nerve excited by different stimuli gives the same result. How are these facts to be explained ? The first explanation which suggests itself is that the various nerves differ in their properties : that electricity ap- plied to a motor nerve causes a muscle to contract, and to the optic nerve a visual sensation, and to the lingual nerve a sensation of taste, because nervous impulses in the motor, optic, and lingual nerves differ from one an- other. This was the view held by the older physiologists; and that supposed peculiarity of a muscular nerve by which its irritation caused a muscular contraction, and that of of the optic nerve in consequence of which its excitation caused a sensation of sight, and so on, they called the specific energy of the nerve. Seeing further that when a pure motor nerve was cut and its peripheral stump pinched the muscles connected with it contracted, but that when its central end was pinched no sensation or other recognizable change fol- lowed, while exactly the reverse was true of a sensory nerve, they believed that afferent nerves differed essentially from efferent nerves, inasmuch as the latter could only propagate impulses centrifu gaily and the former only centripetally. Now, however, we have much reason to believe that this view is wrong, and that all nerve-fibres, though perhaps exhibiting some minor differences, are essentially alike in their physio- logical properties, and can carry nervous impulses either way* The differences observed depend in fact not on any differ- ences in the nerve-fibres, but on the different parts connected with their ends; that is to say, on the different terminal organs excited by the impulses conveyed by the fibre. A motor fibre is one which has at its peripheral end a muscular fibre, and a centrifugally travelling impulse reaching this will cause it to contract: but the cells connected with its central end are not of such a nature as to give rise to sensations GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 199 when centripetally travelling impulses reach them, or to transmit these to other efferent fibres and so cause reflex movements; and therefore when a motor fibre is stimulated in the middle of its course the out ward -going impulse causes a movement, while the centrally travelling impulse, starting at the same time, gives no direct sign of its existence. Simi- larly for a sensory nerve such as the ulnar, already referred to: if it be stimulated at the elbow the centrally travelling impulse will cause a sensation of pain by exciting the brain- centre connected with it, but the outward travelling impulse not reaching muscular fibres or other parts which it can arouse to activity, remains concealed from our notice. In other words, the so-called specific energy of a nerve-fibre de- pends upon the terminal organs on which it can act, and not on any peculiarity of the nerve-fibre itself. proofs that all Nerve-Fibres are Physiologically Alike. (1) Thelnost marked difference between nerve-fibres is obvi- ously that between efferent and afferent, and the microscope fails entirely to show any differences between the two. Some motor and some se!nsory fibres may be bigger or less than others, some may be white and others may be gray; but such differences are secondary, and have no direct relation to the function of a fibre as afferent or efferent. We can recognize no constant difference in structure between the two. (2) The physical properties and chemical composition of motor and sensory nerves agree in all known points. (3) When a nerve, say a motor one, is stimulated half-way between the centre and a muscle, a nervous impulse, as we call it, is propagated to the muscle, which impulse starts at the point stimulated and travels at a definite rate to the muscle, the contraction of which latter gives proof of its arrival. Now starting at the same moment from the same point, and travelling at the same rate, is that change in the elec- trical condition of the nerve which can be detected by a galvanometer, the so-called negative variation or action cur- rent. When a nerve is excited from its end-organ, as for example the optic nerve by light falling into the eyeball, or a motor nerve by a stimulus arising in a centre, an action current exactly like that observed with artificial stimulation travels along it. Since this negative variation always accom- panies a nervous impulse, appearing when it appears and dis- appearing when it disappears, we conclude that it is a change 200 THE HUMAN BODY. in the electrical properties of the nerve dependent on that internal movement of its molecules which constitutes a ner- vous impulse. It is an externally recognizable physical sign, and the only known one, of the existence of the nervous im- pulse while it is travelling along the fibre. If the muscle were cut away from the end of the nerve we could still detect that a nervous impulse had travelled from the point of stimulation to that where the fibres were divided, by tracking the nega- tive variation. If, while stimulating a motor nerve half-way in its course, we examine galvanometrically the portion lying central to the stimulated point we find a well-marked centripe- tally travelling action current; it starts at the same moment as the efferent negative variation and travels in the same manner, but the nervous impulse of which it is a sign produces no more effect than the efferent impulse would after the muscle had been cut away; for it does not reach any muscular fibre, or sen- sory or reflex centre, which it can arouse to activity. Hence it is clear that the motor nerve can conduct impulses equally well in either direction; and similar experiment proves the same thing for pure sensory nerves. While, however, by chemical or electrical stimulation of a motor or a secretory nerve we can get a muscular con- traction or a secretion apparently quite identical with that produced by natural stimulation, we cannot make the same assertion with regard to afferent nerves. It is possible by gentle stimulation of a cutaneous afferent nerve through its end-organs in the skin to excite the centres, so that they in turn give rise to definitely combined reflex muscular con- tractions, producing, even in the absence of all consciousness, an useful movement. But if the skin be removed and the outer end of its afferent nerve stimulated directly, though the centres can be thus excited and caused to send out im- pulses to muscles, the movements which result are random kicks and jerks, very different from the definite, orderly movements which follow suitable stimulation through the skin. And as regards certain nerves of special sense some- thing similar seems to be true. It has indeed been stated that mechanical injury of the optic nerve, as by cutting it during a surgical operation, causes a sensation of light in patients not anaesthized, but this has been denied; and though one positive observation counts for more in such a case than many negative, we must take into account the GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 201 fact that in no other sense-organ has the direct stimulation of the proper nerve-trunk in any other way than through the sense-organ at its outer end, been proved to give rise to true sensations of special sense. Stimulation of the nerves exposed in a wound does not cause a true touch sensation, but a feeling of pain; and similarly irritation of the trunks of the nerves of taste by diseased conditions does not seem to ever cause true taste sensations unless the end-organs in the mouth be also excited. Even if it turn out to be true that a nerve of special sense is only capable of giving rise to feelings belonging to the sphere of that sense when ex- cited through its proper end-organs, that does not prove that its nerve-fibres have any unique faculty distinguishing them in property from other nerve-fibres. It only means that the brain organ, the central nerve-cell mechanism, to be excited by the nerve is highly complex, and only responds with the proper sensation when stimulated in proper strength and proper rhythm, and the sense organs accomplish this. Even the most delicate artificial stimulation that we can apply to a naked nerve-trunk is undoubtedly a crude and gross thing compared with the stimuli arising in the retina when light enters the eye, or in certain skin nerve end- organs when moderate heat falls on them. If we merely wish to get a noise out of a piano it does not matter how we strike it, if we strike hard enough ; and a muscular con- traction or an irregular set of muscular contractions excited by direct stimulation of a nerve-trunk may be compared to such a noise. If we wish for a definite musical chord we must strike through the keyboard in a definite way; and the orderly combined muscular movements and the special sensa- tions which follow stimulation through the proper sense- organs may be compared to such chords. In our bodies the keyboards are different in eye, ear, and skin, and adapted to be set in action by different external physical agencies, and the strings in connection with each keyboard are different and give different results; but the connecting apparatus, the nerve-fibre, lying between the keys in the sense-organs and the strings respectively responding to them in the centres, is essentially the same in all cases. To put the case more definitely: Light outside the eye exists as ethereal vibrations, sound outside the ear as vibra- tions of the air (commonly). Each kind of vibration acts on 202 THE HUMAN BODY. a particular end-organ in eye or ear which is adapted to be acted upon by it, and in turn these end-organs excite the optic and auditory nerve-fibres; these in consequence trans- mit impulses, which reaching different parts of the brain excite them ; the excitement of one of these brain-centres is associated with sonorous and of the other with visual sensa- tions. The nervous impulse in the two cases is quite alike, at least as to quality (though it may differ in quantity and rhythm) and the resulting difference in quality of the sensa- tions cannot depend on it. The quality differences in these cases must be products of the central nervous system. If we had a set of copper wires we might by sending precisely similar electric currents through them produce very different results if different things were interposed in their course. In one case the current might be sent through water and decompose it, doing chemical work; in another, through the coil of an electro-magnet and raise a weight; in a third, through a thin platinum wire and develop light and heat; and so on, the result depending on the terminal organs, as we may call them, of each wire. Or, on the other hand, we might generate the current in each wire differently, in one oy a Darnell's cell, in a second by a thermo-electric machine, iti a third by the rotation of a magnet inside a coil, but the currents in the wires would be essentially the same, as the nervous impulses are in a nerve-fibre. No matter how they have been started, provided their amount is the same, whether they shall produce similar or dissimilar results, de- pends only on whether they are connected with similar or dissimilar end-organs. To sum up : Afferent and efferent nerve-fibres differ in no fundamental physiological property; they are simple trans- mitters, everywhere alike in faculty. We may extend this statement to the subdivisions of each kind, and say that motor, vasomotor and secretory efferent fibres, and tactile, auditory and visual afferent fibres are in all essentials like one another; and that a nervous impulse is alike in every nerve, varying it may be in intensity and in the rate at which others succeed it, in different cases, but the same in kind. Just as all muscles are alike in general physiological proper- ties, and differ in special function according to the parts on which they act, so are all nerve-fibres alike in general physio- logical properties, and differ in special function only because GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 203 they are attached to special things. The special physiology of various nerves will hereafter be considered in connection with the working of various mechanisms in the Body. The Nature of a Nervous Impulse. Since between sense-organs and sensory centres, and these latter and the muscles, nervous impulses are the only means of communi- cation, it is through them that we arrive at our opinions con- cerning the external universe and through them that we are able to act upon it; their ultimate nature is therefore a matter of great interest, but one about which we unfortu- nately know very little. We cannot well imagine it any- thing but a mode of motion of the molecules of the nerve- fibres, but beyond this hypothesis we cannot go far. In many points tl^e phenomena presented by nerve-fibres as transmitters of disturbances are like the phenomena of wires as transmitters of electricity, and when the phenomena of cur- rent electricity were first observed there was a great ten- dency, explaining one unknown by another, to consider ner- vous impulses merely as electrical currents. The increase of our knowledge concerning both nerves and electric currents, however/has made such an hypothesis almost, if not quite, untenable. In the first place nerve-fibres are extremely bad conductors of electricity — so bad that it is impossible to sup- pose them used in the Body for that purpose; and in the second place, merely physical continuity of a nerve-fibre, such as would not interfere with the passage of an electric current, will not suffice for the transmission of a nervous im- pulse. For instance if a damp string be tied around a nerve, or if it be cut and its two moist ends placed in contact, no nervous impulse will be transmitted across the constricted or divided point although an electrical current would pass readily. An electrical shock may be used like many other stimuli to upset the equilibrium of the nerve-molecules and start a nervous impulse, which then travels along the fibre, but is just as different from the stimulus exciting it as a muscular contraction is from the stimulus which calls it forth. Careful study of the action-current give's, perhaps, some information regarding the nature of nervous impulses. That local negativity which causes the current begin& at the stimu- lated point of a nerve at the same time as the nervous impulse and travels along the nerve at the same rate. Hence we con- 204: THE HUMAN BODY. elude that the new internal molecular arrangement in a nerve- fibre which constitutes its active as compared with its resting state, is one which changes also the electrical properties of the fibre. Now it is found that the negative variation travels along the nerve (in the frog) at the rate of 28 metres (92.00 feet) in a second, and takes .0007 second to pass by a given point : accordingly at any one moment it extends over about 18 mm. (0.720 inch) of the nerve-fibre. Moreover, when first reach- ing a point it is very feeble, then rises to a maximum,, and gradually fades away again. Taking it as an indication of what is going on in the nerve, we may assume that the nerv- ous impulse is a progressive molecular change of a wavelike character, rising from a minimum to a maximum, then grad- ually ceasing, and. about 18 millimetres in wave-length. A nervous impulse does not appear to exhaust a fibre when transmitted along it. As a ray of light traversing the ether sets up a transient change in it but does not in any way use it up or leave it less fit to transmit a succeeding ray, so it is with the nervous impulse in its transmission. It is true that when a motor nerve attached to a muscle is continuously stimulated the muscular contractions cease after a certain time, though the muscle still responds to electrical stimula- tion directly applied, and it has been argued that we thus get evidence of the exhaustion of the nerve; but it must be borne in mind that an electrical shock directly applied is un- doubtedly a much more powerful stimulus to the muscle than any nervous impulse, and the muscle may have been so fatigued by its previous work as to have become irresponsive to stimulation through its nerve, though still reacting to the grosser excitation. And we have direct evidence that stimu- lation of a nerve may be continued for a very long time with out causing loss of activity. As an instance, we may take the nerve already mentioned which stops the beat of the heart : when it is stimulated continuously for a few seconds the heart breaks beyond its control and begins to beat again, though the stimulation of the nerve be kept up. This, however, is due to fatigue of the endings of the nerve in the heart, and not of the nerve fibres, as may be proved in this way: the nerve (pneumo-gastric) being carefully exposed in the neck is arti- ficially cooled in one region to below the temperature at which it can conduct a nervous impulse; it is then stimu- lated at a point nearer the head than the cooled portion: the GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 205 resulting impulses being blocked on their way to the heart it goes on beating regularly. After stimulation of the nerve has been continued for several minutes the cooled tract of the nerve is allowed to warm again until it becomes capable of transmitting a nervous impulse; then the heart-beat is found to be promptly stopped or slowed. This shows that if the cardiac endings of the nerve be protected from fatigue, pro- longed stimulation of the nerve-trunk does not interfere with its functional capacity: the stimulation still starts nervous impulses in it, which as soon as they can pass on produce their normal effect on the heart. When long-continued sensations become dulled the explanation is no doubt similar: it is the end-organs, central or peripheral, or both, which are ex- hausted, not the nerve-fibres themselves. It has, however, been observed that when artificial stimulation is long applied to one point on a nerve-trunk that point sometimes becomes unexcitable, though the nerve in general is still quite func- tional and acts perfectly when the point of application of the stimulus is shifted a little: this is especially the case with gray nerve-fibres and white fibres having a thin medullary sheath. The very sparse blood-supply of nerve-trunks is in great contrast to the rich supply of those parts of the nervous system containing nerve-cells and to the abundant supply of muscles, aiid is an evidence that the chemical changes taking place in them during both rest and activity are but small. Seeing that functional activity leads to little or no using up of the conductive substance of a nerve-fibre any more than the transmission of a galvanic current uses up a copper wire, the term irritable is not properly applicable to nerve-fibres. Ir- ritability in its physiological sense we have defined as a con- dition of a living tissue such that a very small extraneous force acting on it may cause it to set free a disproportionately large amount of energy, and in that sense muscle-fibres and nerve-cells are truly irritable, and they both use up their ma- terial when at work and are subject to exhaustion. Nerve- fibres are excitable and conductive, but not really irritable, though on account of their great excitability they are very generally spoken of as irritable. The Rate of Transmission of a Nervous Impulse. This can be measured in several ways. One of the simplest is a modification of the simple nerve-muscle experiment il- 206 THE HUMAN BODY. lustrated in Fig. 62. The muscle M is dissected out with its motor nerve attached, and the stimulus applied to the nerve and not directly to the muscle. First the stimulus is given to the nerve close to the muscle: it is then found that the period of latent excitation, as shown by the greater length of tu, is a very little longer than when the muscle is directly stimulated. Next the stimulus is applied to the nerve, say two inches from the muscle, and it is found that tu is consider- ably longer, the increase in its length being due to the time taken by the nervous impulse in travelling along two inches of nerve. As we know the rate of movement of the surface S, we can readily calculate the amount of the time increase. The rate of travel of the nervous impulse as thus ascertained is almost incomparably slower than that of an electric cur- rent, being 28 metres (92.00 feet) per 1". In the motor nerves of warm-blooded animals the rate of transmission is somewhat faster. Considerable difficulties are met with in making cor- responding measurements on afferent nerves, and the rates obtained by different observers differ widely: probably the impulse travels at about the same speed as in the motor nerves of the same animal. Functions of the Spinal Nerve-Roots. The great ma- jority of the larger nerve-trunks of the Body contain both afferent and efferent nerve-fibres. If one be exposed in its course and divided in a living animal, it will be found that irritating its peripheral stump causes muscular contractions, and pinching its central stump causes signs of sensation, showing that the trunk contained both motor and sensory fibres. If the trunk be followed away from the centre, as it breaks up into smaller and smaller branches, it will be found that the^e too are mixed until very near their endings, where the very finest terminal branches close to the end- organs, whether muscular fibres, secretory cells, or sensory apparatuses, are only afferent or efferent. If the nerve- trunk be one that arises from the spinal cord and be ex- amined progressively back to its origin, it will still be found mixed, up to the point where its fibres separate to enter either a ventral or a dorsal nerve-root. Each of these latter, however, is pure, all the efferent fibres leaving the cord by the ventral or anterior roots, and all the afferent entering it by the posterior or dorsal. This of course could not be learned from examination of the dead nerves, since the best micro- GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 207 scope fails to distinguish an afferent from an efferent fibre, but is readily proved by a simple experiment. If an anterior root be cut and its outer end stimulated, the muscles of the parts to which the trunk which it helps to form is distributed will be made to contract, and the skin will be made to sweat also if the root happen to be one that contains secretory fibres for the sweat-glands. On the other hand, if the cen- tral end of the root (that part of it attached to the cord) be stimulated no result will follow, showing that the root con- tains no sensory, reflex, or excito-motor fibres. With the posterior roots the reverse is the case: if one of them be divided and its outer end stimulated, no observed result fol- lows, showing the absence of all efferent fibres; but stimula- tion of its central end will cause either signs of feeling, or reflex actions, or both. • We might compare a spinal nerve- trunk to a rope made up of green and red threads with at one end all the green threads collected into one skein and the red into another, which would represent the roots. At its/farthest end we may suppose the rope divided into finer cords, each of these containing both red and green threads, down to the very finest branches consisting of only a few threads, and those all of one kind, either red or green, one representing efferent, the other afferent, fibres. The Cranial Nerves. Most of these are mixed also, but with one exception (the fifth pair, the small root of which is efferent and the large gangliated one afferent) they do not present distinct motor and sensory roots, like those of the spinal nerves. At their origin from the brain most of them are purely afferent or purely efferent, and the mixed character which their trunks exhibit is due to cross-branches with neighboring nerves, in which afferent and efferent fibres are interchanged. The olfactory, optic, and auditory nerves re- main, however, purely afferent in all their course, and others, though not quite pure, contain mainly efferent fibres (as the facial) or mainly afferent (as the glosso-pharyngeal). The Intercommunication of Nerve-Centres. From the anatomical arrangement of the nervous system it is clear that it forms one continuous whole. No subdivision of it is isolated from the rest, but nerve-trunks proceeding from the centres in one direction bind them to various tissues and, proceeding in another, to other nerve-centres, which in turn are united with other tissues and other centres. Since the 208 THE HUMAN BODY. physiological character of a nerve-fibre is its conductivity — its power of propagating a disturbance when once its mo- lecular equilibrium has been upset at any one point — it is obvious that through the nervous system any one part of the Body, supplied with nerves, may react on all other parts (with the exception of such as hairs and nails and cartilages, which are not known to possess nerves) and excite changes in them. Pre-eminently the nervous system forms a uniting anatomical and physiological bond through the agency of which unity and order are produced in the activities of differ- ent and distant parts. We may compare it to the Western Union Telegraph, the head office of which in New York would represent the brain and spinal cord, the more impor- tant central offices in other large cities the sympathetic ganglia, and the minor offices in country stations the sporadic ganglia; while the telegraph-wires, directly or indirectly uniting all, would correspond to the nerve-trunks. Just as information started along some outlying wire may be trans- mitted to a central office, and from it to others, and then, according to what happens to it in the centre, be stopped there, or spread in all directions, or in one or two only, so may a nervous disturbance reaching a centre by one nerve- trunk merely excite changes in it or be radiated from it through other trunks more or less widely over the Body and arouse various activities in its other component tissues. In common life the very frequency of this uniting activity of the nervous system is such that we are apt to entirely overlook it. We do not wonder how the sight of pleasant food will make the mouth water and the hand reach out for it; it seems, as we say, "natural," and to need no explanation. But the eye itself can excite no desire, cause the secretion of no saliva, and the movement of no limb. The whole com- plex result depends on the fact that the eye is united by the optic nerve with the brain, and that again by other nerves with saliva-forming cells, and with muscular fibres of the arm; and through these a change excited by light falling into the eye is enabled to produce changes in far-removed organs, and excite desire, secretion, and movement. In cases of disease this action exerted at a distance is more apt to ex- cite our attention: vomiting is a Trery common symptom of certain brain diseases, and most people know that a disordered stomach will produce a headache; while the pain consequent GENERAL PHYSIOLOGY OF THE NERVOUS SYSTEM. 209 upon the hip-disease of children is usually felt, not at the hip- joint, but at the knee. The Degeneration of Nerve-Fibres separated from their Centre. A nerve-fibre may in its course be connected with more than one nerve-cell, but one cell always has a special influence in maintaining its normal structure and functional activity. If cut off from this cell the separated portion undergoes degenerative changes, easily recognized in medul- lated fibres by a breaking up and, later, a disappearance of the medullary sheath. If, for example, the sciatic nerve of a warm-blooded animal be completely cut across, all of the nerve and its branches beyond the point of section will show marked changes in three days or less: the medullary sheath separates into small cuboidal pieces, these in a day or two more round off at their corners and then are gradually ab- sorbed, so/that at the end of ten days or a fortnight they have entirely disappeared. Meantime the nuclei of the internodes multiply and the usually sparse protoplasm around them in- creases, and encroaches upon and causes the absorption of the axis cylinder, so that after some weeks little or no trace of true nervous elements can be found. Some three or four days after making the section the peripheral portion of the nerve ceases to be excitable. If the part of the nerve above the sec- tion be examined, its fibres will be found to have undergone no degeneration except close to the place of section, and it re- mains excitable; pinching it causes pain, and if any muscle branch arising from it be irritated, the muscles contract. If instead of cutting a whole mixed nerve-trunk, such as the sci- atic, we divide only a ventral spinal root (as 5, c, Fig. 71), it is found that all the fibres in that part of the root which is cut off from the spinal cord degenerate and become unirritable, and degenerated fibres can be found in the mixed trunk into which the cut root is continued; while the fibres of the part of the root still attached to the cord do not degenerate. The nutritional integrity of the anterior root-fibres depends therefore on anatomical continuity with the spinal cord, and probably with cells there, of the type shown in Fig. 81. On the other hand, if the dorsal root only be cut across, the por- tion of it attached to the cord degenerates, while that still connected to the spinal ganglion and the fibres beyond the ganglion remain unaltered : the nutritive centres for the dor- sal root-fibres are the cells of the corresponding root-ganglion. 210 THE HUMAN BODY. After complete section of the nerve-trunk supplying a region of the Body that region is for a time paralyzed, but feeling and the power of movement may return to it. It used to be thought that in such cases the divided nerve-fibres grew together again. Such is not the case : all those parts of the fibres which have been cut oif from their centres com- pletely disappear, and when function is restored it is by the formation of new nerve-fibres around outgrowths from the cut ends of those parts of the fibres still united to their cen- tres, whether these be in brain, spinal cord, spinal ganglia, or elsewhere. Nerves, as we have seen, often give fibres to one another by means of uniting branches, as in various plexuses and elsewhere; and when a nerve-branch may contain fibres de- rived from some one of two or more original trunks which have communicating branches, it is often of importance to determine in which original trunk its fibres left the brain or spinal cord. In such cases the determination may often be made by dividing one of the possible sources of origin and after a few days examining the branch for degenerated fibres, which are easily recognized by the microscope. If such are found, then they left the centre in the divided trunk; if not, the branch gets no fibres from that trunk. This method of tracking the nerve-fibres of a given original trunk to their final distribution in one or more of many possible branches is known as the Wallerian method. Instances of its application will be given in later chapters. CHAPTER XIV. THE ANATOMY OF THE HEART AND BLOOD-VESSELS. General Statement. During life the blood is kept flow- ing with great rapidity, through all parts of the Body (except the few non-vascular tissues already mentioned) in definite paths prescribed for it by the heart and blood-vessels. These paths, which under normal circum- stances it never leaves, constitute a con- tinuous set of close^tubes (Fig. 87) beginning at and ending again in the heart, and simple only close to that organ. Elsewhere it is greatly branched, the most numerous and finest branches (I and a) being the capillaries. The heart is essen- tially a bag with muscular walls, internally divided into four chambers (d, g, e, /). Those at one end (d and e) receive blood from vessels opening into them and known as the veins. From there the blood passes on to the remaining chambers (g and/) which have very powerful walls and, for- cibly contracting, drive the blood out into vessels (m and b) which communicate with them and are known as the arteries. The big arteries divide into smaller; these into smaller again (Fig. 88) until the branches become too small to be traced by the unaided eye, and these smallest branches end in the capillaries, through which the blood flows and enters the commencements of the veins ; and these convey it again to the heart. At certain points in the course of the blood-paths valves are placed, which prevent a back-flow. This alternat- ing reception of blood at one end by the heart and its ejec- tion from the other go on during life steadily about seventy times in a minute, and so keep the liquid constantly in motion. 211 sented- THE HUMAN BODY. The vascular system is completely closed except at two points in the neck where lymph- vessels open into the veins; there some lymph is poured in and mixed directly \^th the blood. Accordingly everything which leaves. the blood must- do so by ooiing through the walls of the blood-vessels, and everything which enters it. must do the same, except matters mdu del mvs mvp imv FIG. 88. — The arteries of the hand, showing the communications or anastomose, of different arteries and the fine terminal twigs given off from the larger trunks; these twigs end in the capillaries which would only become visible if magnified, .ff, the radial artery on which the pulse is usually felt at the wrist ; U, the ulnar ar- tery. conveyed in by the lymph at the points above mentioned. This interchange through the walls of the vessels takes place only in the capillaries, which form a sort of irrigation systerh all through the Body. The heart, arteries, and veins are all' merely arrangements for keeping the capillaries full and renewing the blood within them. It is in the capillaries alone that the blood does its ulivsiological workv ANATOMY OF THE I1EA11T AND BLOOD-VESSELS. 213 The Position of the Heart. The heart (h, Fig. 1) lies in the chest immediately above the diaphragm and opposite the low^r two thirds of the breast-bone. It is conical in form with its base or broader end turned upwards and pro- jecting a little on the right of the sternum, while its narrow end or apex, turned downwards, projects to the left of that bone, where it may be felt beating between the cartilages of the fifth and sixth ribs. The position of the organ in the Body is therefore oblique with reference to its long axis. It does not, however, lie on the left side as is so commonly sup- posed but very nearly in the middle line, with the upper part inclined to the right, and the lower (which may be more easily felt beating— hence the common belief) to the left. The Membranes of the Heart. The heart does not lie bare in the chest but is surrounded by a. loose bag composed of connective tissue and called the pericardium. This bag, like the heart, is conical but turned the other way, its broad part being lowest and attached to the upper surface of the diaphragm. Internally it is lined by a smooth serous mem- brane like that lining the abdominal cavity, and a similar layer (the visceral layer of the pericardium) covers the out- side of the heart itselX adhering closely to it. Each of the 3erous layers is covered by a stratum of flat cells, and in the space between them is found a small .quantity of liquid which moistens the contiguous surfaces, and diminishes the friction which would otherwise occur during the movements of the heart. „ *., / Internally the heart is also lined by a .fibroids membrane, covered with a single layer of flattened cells* and called the endocardium. Between the endocardium and- -the -visceral layer of the pericardium the bulk of- the wall of the -heart lies and is made up. mainly of striped muscular tissue (myocar- dium) differing from that of '^he skeletal muscles; but con- nective tissues, blood-vessels, nerve-cells, and nerve-fibres are also abundant in it. Note. — Sometimes the pericardium becomes inflamed, this affection being known as pericarditis. It is extremely apt to occur in acute rheumatism, and great care should be taken never, even for a moment, except under medical advice, to expose a patient to cold during that disease, since any chill is then especially apt to set up pericarditis. In the earlier stages ol pericardiac inflammation the rubbing surfaces on 214 1HE HUMAN BODY. FIG. 89.— Diagram representing a section through the heart from base to apex. the outside of the heart and the inside of the pericardium become roughened, and their friction produces a sound which can be recognized through the stethoscope. In later stages great quantities of liquid may accumulate in the peri- cardium so as to seriously impede the heart's beat. The Cavities of the Heart. On opening the heart (see diagram Fig. 89) it is found to be subdivided by a longi- tudinal partition or sep- tum into completely sepa- rated rigl\t and left halves,- the partition running from about the middle of the base to a point a little on the right of the apex. Each of the chambers on the sides of the septum is again incompletely divided transversely, into a thinner basal portion into which veins open, known as the auricle, and a thicker apical portion from which arteries arise, called the ventricle. The heart thus consists of a right auricle and ventricle and a left auricle and ventricle, each auricle communicating by an aunculo-ventricular orifice with the ventricle on its own side, and there is no direct communication whatever through the septum between the opposite sides of the heart. To get from one side to the other the blood must leave the heart and pass through a set of capillaries, as may readily be seen by tracing the course of the vessels in Fig. 87. The Heart as seen from its Exterior. When the heart is viewed from the side turned towards the sternum (Fig. 90) the two auricles, Aid and As, are seen to be separated by a deep groove from the ventricles, Vd and Vs. A more shallow furrow runs between the ventricles and indicates the position of the internal longitudinal septum. On the dorsal aspect of the heart (Fig. 91) similar furrows may be noted, and on one or other of the two figures the great vessels opening into the cavities of Utes heart may be seen. The pulmonary artery, P, arises from the right ventricle, and very soon divades into the right and left pulmonary arteries, Pd and Ps, which break up into smaller branches and enter ANATOMY OF THE HEART AND BLOOD-VESSELS. 215 the corresponding lungs. Opening into the right auricle are two great veins (see also Fig. 89), cs and ci, known re- spectively as the upper and lower venae cavce, or " hollow " veins; so called by the older anatomists because they are frequently found empty after death. Into the back of the right auricle opens also another vein, Vc, called the coronary \d FIG. 90.— The heart and the great blood-vessel attached to it. seen from the .vanisthe sternum. The left cavities and the vessels connected with them are colored red; the right black. Aid, right auricle; Adx and As, the right and left aariculaf appendages; Vd, right ventricle; Vs, left ventricle; Act, aorta; Ab, inn. -ruinate artery; Cs, left common cjfrotid artery ;"Ssft left subclavian artery; P, i tain trunk of the pulmonary artery, and Pd and Ps, its branches to the right and left lungs; cs, superior vena cava; Adt and A si, the right and left innominate veins; pd and ps, the right and left pulmonary veins; crd and crs, the right and left Coronary arteries. or sinus, which brings back blood that has circulated in tlie wall? of the heart itsfclf. Springing from the left ven- tricle, am1 appearing from beneath the pulmonary artery tae heart is looked; at from the ventral side, is a great ,, th« aorta. Aa. It forms an arch over the base of the heart and then runs down be* ind it at the back -of the chest. Fron< Mio . mvexity of the arch of the aorta several great 216 THE HUMAN BODY. branches are given off, Ssi, Cs, Ab; but before that, close to the heart, the aorta gives off two coronary arteries, branches of which are seen at crd and crs lying in the groove over the partition between the ventricles, and which carry to the sub- stance of the organ that blood which comes back through the FIG. 91. -The heart viewed from its dorsal aspect. Atd, right auricle; ci, in- ferior vena cava; Fc, coronary vein. The remaining letters of reference have vhe same signification as in f ig. 90. coronary sinus. Into the ]eft auricle open two rigM and two left pulmonary veins, ps and pd, which are formt^ by the union of smaller vein^ proceeding1 from the lungs. In the diagram Fig. 89 from which the branches of the great vessels near the heart have been omitted for the .sake of clearness, the connection of the various vessels with the ANATOMY OF THE HEART AND BLOOD - VESSELS. 217 chambers of the heart can be better seen. Opening into the right auricle are the superior and inferior venae cavae (cs and ci) and proceeding from the right ventricle tine pulmonary artery, P. Opening into the left auricle are the right and left pulmonary veins (pel and ps) and springing from the left ventricle the aorta, A. The Interior of the Heart. The communication of each auricle with jits ventricle is also represented in the diagram Fig. 89, and the valves which are present at those points and at the origin of the pulmonary artery and that of the aorta. Interjnally the auricles are for the most part smooth^ but from eacji a hollow pouch, the auricular appendage, pro- jects over th^ base of the corresponding ventricle as seen at Adx and As ,ln Figs. 90 and 91. These pouches have some- what the shape of a dog's ear and have given their name to the whole auricle. Their interior is roughened by muscular- elevations, covered by endocardium, known as the fleshy col- umns (columned car nee). On the inside of the ventricles (Fig. 92) similar fleshy columns are very prominent. The Auriculo-Ventricular Valves. These are known as right and left, or as the tricuspid and mitral valves respec- tively. The mitral valve (Fig. 92) consists of two flaps of the endocardium fixed by their bases to the margins of the auric- ulo-ventricular aperture and with their edges hanging down into the ventricle when the heart is empty. These unattached edges are not however free, but have fixed to them a number of stout connective-tissue cords, the cor dee tendinece, which are fixed below to muscular elevations, the papillary muscles, Mpm and Mpl, on the interior of the ventricle. The cords are long enough to let the valve flaps riae into a horizontal position and so close the opening between auricle and ven- tricle which lies between them, and passes up behind the opened aorta, Sp, represented in the figure. The tricuspid , valve is like the mitral, but with three flaps instead of two. Semilunar Valves. These are six in number: three at the mouth of the aorta, Fig. 92, and three, quite like them, at the mouth of the pulmonary artery. Each is a strong crescentic pouch fixed by its more curved border, and with its free edge turned away from the heart. When the valves are in action these free edges meet across the vessel and pre- vent blood from flowing back into the ventricle. In the middle of the free border of each valve is a little cartilagi- 218 THE HUMAN BODY. nous nodule, the corpus Arantii, and on each side of this the edge of the valve is very thin and when it meets its neighbor turns up against it and so secures the closure. The Arterial System. All the arteries of the Body arise either directly or indirectly from the aorta or pulmonary artery, and the great majority of them from the former vessel. Mpl Mprn FIG. 92.— The left ventricle and the commencement of the aorta laid open. Mpm, Mpl. the papillary muscles. From their upper ends are seen the cordce tendinece proceeding to 'the edges of the flaps of the mitral valve. The opening into the auricle lies between these flaps. At the beginning of the aorta are seen its three pouch-like semilunar valves. The pulmonary artery only carries blood to the lungs, to un- dergo exchanges with the air in them after it has circulated through the Body generally. After making its arch the aorta continues back through the chest, giving off many 'branches on its way. Piercing the AN ATOM Y OF THE HEART AND BLOOD - VESSELS. 219 diaphragm it enters the abdomen and after supplying the parts in and around that cavity with branches, it ends oppo- site the last lumbar vertebra by dividing into the right and left common iliac arteries, which carry blood to the lower limbs. We have then to consider the branches of the arch of the aorta, and those of the descending aorta> which latter is for convenience described by anatomists as consisting of the thoracic aorta, extending from the end of the arch to the., diaphragm, and the abdominal aorta, extending from the diaphragm to the final subdivision of the vessel. Branches of the Arch of the Aorta. From this arise first the coronary arteries (crd and crs, Figs. 90 and 91) which spring close to the heart, just above two of the pouches of the eemilunar valve, and carry blood into the substance of that organ. The remaining branches^ of the arch are three in number, and all arise from its convexity. The first is the innominate artery (AT), Fig. 90), which is very short, imme- diately breaking up into the right subclavian artery, and the right common carotid. Then comes the left common carotid, Cs, and finally flie left subclavian, Ssi. Each subclavian artery runs out to the arm on its own side and after giving off a vertebral artery (which runs up the neck to the head in the vertebral canal of the transverse processes of the cervical vertebrae), crosses the arm-pit and takes there the name of the axillary artery. This contin- ues down the arm as the brachial artery, which, giving off branches on its way, runs to the front of the arm, and just below the elbowT-joint divides into the radial and vlnar ar- teries, the lower ends of which are seen at R and U in Fig. 88. . These supply the forearm and end in the hand by uniting to form an arch, from which branches are given off to the fingers. The common carotid arteries pass out of the chest into the neck, along which they ascend on the sides of the windpipe. Opposite the angle of the lower jaw each divides into an internal arid external carotid artery, right or left as the case may be. The external ends mainly in branches for the face, scalp, and salivary glands, one great subdivision of it with a tortuous course, the temporal artery, being often seen in thin persons beating on the side of the brow. The internal carotid artery enters the skull through an aperture in its base and supplies the brain, which it will be remembered also gets blood through the vertebral arteries. 220 THE HUMAN BODY. Branches of the Thoracic Aorta. These are numerous but small. Some, the intercostal arteries, run out between the ribs and supply the chest-walls; others, the bronchial ar- teries, carry blood to the lungs for their nourishment, that carried to them by the pulmonary arteries being brought there for another purpose; and a few other small branches are given to other neighboring parts. Branches of the Abdominal Aorta. These are both large and numerous, supplying not only the wall of the posterior part of the trunk, but the important organs in the abdominal cavity. The larger are : the cceliac axis which supplies stom- ach, spleen, liver, and pancreas; the superior mesenteric artery, which supplies a great part of the intestine; the renal arteries, one for each kidney; and finally the inferior mes- enteric artery, which supplies the rest of the intestine. Be- sides these the abdominal aorta gives off very many smaller branches. Arteries of the Lower Limbs. Each common iliac di- vides into an internal and external iliac artery. The former mainly ends in branches to parts lying in the pelvis, but the latter passes into the thighs and there takes the name of the femoral artery. At first this lies on the ventral aspect of the limb, but lower down passes to the back of the femur, and above the knee-joint (where it is called the popliteal artery] divides into the anterior and posterior tibial arteries, which supply the leg and foot. The Capillaries. As the arteries are followed from the heart, their branches become smaller and smaller, and finally cannot be traced without the aid of a microscope. Ulti- mately they pass into the capillaries, the walls of which are simpler than those of the arteries, and which form very close networks in nearly all parts of the Body; their immense num- ber compensating for their smaller size.' The average diame- ter of a capillary vessel is .016 mm. (j-gVo inch) so that only two or three blood-corpuscles can pass through it abreast, and in many parts they are so close that a pin's point could not be inserted between two of them. It is while flowing in these delicate tubes that the blood does its nutritive work, the arteries being merely supply-tubes for the capillaries. The Veins. The first veins arise from the capillary net- works in various organs, and like the last arteries are very small. They soon increase in size by union, and so form ANATOMY OF THE HEART AND BLOOD-VESSELS. 221 larger and larger trunks. These in many places lie near or alongside the main artery of the part, but there are many more large veins just beneath the skin than there are large arteries. This is especially the case in the limbs, the main veins of which are superficial, and can in many persons be seen as faint blue marks through the skin. Fig. 94 repre- sents the arm at the front of the elbow-joint after the skin and subcutaneous areolar tissue and fat have been removed. FIG. 93.— A small portion of the capillary network as seen in the frog's web when magnified about 25 diameters, a, a small artery feeding the capillaries; v, v, small veins carrying blood back from the latter. The brachial artery, B, colored red, is seen lying tolerably deep, and accompanied by two small veins (venae comites) which communicate by cross-branches. The great median nerve, 1, a branch of the brachial plexus which supplies several muscles of the forearm and hand, the skin over a great part of the palm and the three inner fingers, is seen alongside the artery. The larger veins of the part are seen 222 THE HUMAN BODY. to form a more superficial network, joined here and there, as for instance at *, by branches from deeper parts. Several small nerve-branches which supply the skin (2, 3, 4) are seen among these veins. It is from the vessel, cep, called the cep FIG. 94.— The superficial veins in front of the elbow- joint. B', tendon of biceps muscle; Bi, brachialis interims muscle;,, Pt, pronator teres muscle; 1, median nerve; 2, 3, 4, nerve-branches to the skin; B, brachial artery, with its small accom- panying veins; cep, cephalic vein; has, basilic vein; m', median vein; *, junction of a deep-lying vein with the cephalic. cephalic vein, just above the point where it crosses the median nerve, that surgeons usually bleed a patient. A great part of the blood of the lower limb is brought back by the long saplienous vein, which can be seen in thin persons running from the inner side of the ankle to the top of the ANATOMY OF THE HEART AND BLOOD-VESSELS. 223 thigh. All the blood which leaves the heart by the aorta, except that flowing through the coronary arteries, is finally collected into the superior and inferior vence cavce (cs and ci, Figs. 90 and 91), and poured into the right auricle. The jugular veins which run down the neck, carrying back the blood which went out along the carotid arteries, unite below with the arm-vein (subdavian) to form on each side an in- nominate vein (Asi and Ade, Fig. 90) and the innominates unite to form the superior cava. The coronary-artery blood after flowing through the capillaries of the. heart itself also returns to this auricle by the coronary veins and sinus. The Pulmonary Circulation. Through this the blood gets back to the left side of the heart and so into the aorta again. The pulmonary artery, dividing into branches for each lung, ends in the capillaries -of those organs'; From these it is collected by the pulmonary veins, which carry it back to the left auricle, whence it passes to the left ventricle to recommence its flow through tho Body gencutlly. The Course of the Blood. From what has been said it is clear that the movement of the blood is a circut"' Start- ing from any one chamber of the heart it will in time return to it; but to clo this it must pass through at least two sets of capillaries; one of these is connected with the aorta and the other with the pulmonary artery, and in its circuit the blood returns to the heart twice. Leaving the left side it returns to the right, and leaving the right it returns to the left: and there is no road for it from one side of the heart to the other except through ;t <;upill;i.^ network. Moreover, it always leaves fro; ricle through an artery, and returns to an auric! * \ein. Then- i - really only one circulation; but it is not un- common to &(.t'ak of two, the flow from the left side of the heart to the right, through the Body generally, being called the systemic, circulation, and from the right to the left, through the lungs, the pulmonary circulation. But since after completing either of these alone the blood is not back at the point from which it started, but is separated from it by the septum of the heart, neither is a "circulation" in the proper sense of the word. Tho Portal Circulation. A certain portion of the blood which leaves the left ventricle of the heart through the aorta has to pass through three sets of capillaries before it can again 224 THE HUMAN BODY. return there. This is the portion which goes through the stomach, spleen, pancreas, and intestines. After traversing the capillaries of those organs it is collected into the portal vein which enters the liver, and breaking up in it into finer and finer branches like an artery, ends in the capillaries of that organ, forming the second set which this blood passes through on its course. From these it is collected by the he- patic veins, which pour it into the inferior vena cava, which carries it to the right auricle, so that it has still to pass through the pulmo- nary capillaries to get back to the left side of the heart. The portal vein is the only one in the human Body which like an artery feeds a capillary net- •work, and the flow from the stomach and intestines through the liver to the vena cava is often spoken of as the portal circulation. Diagram of the Circulation. Since the two halves of the heart are actu- ally completely separated from one another by an impervious partition, although placed in proximity in the Body, we may conveniently represent the course of the blood as in the accom- FIG. 95.-Diaffram of the panying diagram (Fig. 95), in which e the right and left halves of the heart Et -are represented at different points in which fLeal;ePSre°sented ^ the vascular system. Such an arrange- T^ht^ri^Sd V^ridel meilt makeS lfc Clear th^fc the heaH 1S la and iv, left auricle and ven- reallv two pumps working ' .side bv side, tricle; ao, aorta; sc, systemic " , ," capillaries; vc, venae cavae; each engaged in forcing the blood to pa, pulmonary artery; »c, pul- ,, ? ru j- /> ii i £1. monary capillaries; pv, pui- the other, otarting ironi the lelt au- ricle, la, and following the flow, we trace it through the left ventricle' and along the brunches of the aorta into the systemic capillaries, sc', from thence it passes back through the systemic veins, vc. Beaching the right auricle, ra, it is sent into the right ventricle, rv, and thence through the pulmonary artery, pa, to the lung .capilla- ries, pc, from which the pulmonary veins, pv, carry i« to the left auricle, which drives it into the left ventricle, Iv, and this again into the aorta. ANATOMY OF THE HEART AND BLOOD-VESSELS. 225 Arterial and Venous Blood. The blood when flowing in tne pulmonary capillaries gives up carbon dioxide to the air and receives oxygen from it; and since its coloring matter (haemoglobin) forms a scarlet compound with oxygen, it flows to the left auricle through the pulmonary veins of a bright red color. This color it maintains until it reaches the sys- temic capillaries, but in these it loses much oxygen to the surrounding tissues and gains much carbon dioxide from them. But the blood coloring-matter which has lost its oxygen has a dark purple color, and since this unoxidized or "reduced" hemoglobin is now in excess, the blood returns to the heart by the venae cavae of a dark purple-red color. This hue it keeps until it reaches the lungs, when the reduced haemoglo- bin becomes again oxidized. The bright red blood, rich in oxygen and poor in carbon dioxide, .is known as "arterial blood" and the dark red as "venous blood:" and it must be borne in mind that the terms have this peculiar technical meaning, and that the pulmonary veins contain arterial blood, and the pulmonary arteries, , venous blood; the change from arterial to venous taking place in the systemic capillaries, and from venous to arterial in the pulmonary capillaries. The chambers of the heart and the great vessels containing arte- rial blood are shaded red in Figs. 90 and 91. The Structure of the Arteries. A large artery can by careful dissection be separated into three coats : an internal, a middle, and an outer. The internal coat tears readily across the long axis of the artery and consists of an inner lining of flattened nucleated cells, enveloped by a variable number of layers composed of membranes or networks of elastic tissue. The middle coat is made up of alternating layers of elastic fibres and plain muscular tissue; the former running for the most part longitudinally and the latter across the long axis of the vessel. The outer coat is the toughest and strongest because it is mainly made up of white fibrous connective tissue; it contains a considerable amount of elastic tissue also, and gradually shades off into a loose areolar tissue which forms the sheath of the artery, or the tunica adventitia, and packs it between surrounding parts. The smaller arteries have all the elastic elements less developed. The internal coat is consequently thinner, and the middle coat is made up mainly of involuntary muscular fibres. As a result the large arteries are hiorhly elastic, the aorta being physically much like a piece of india-rubber tubing, while the smaller arte- 226 THE HITMAN BODY. ries are highly contractile, in the physiological sense of the word. Structure of the Capillaries. In the smaller arteries the outer and middle coats gradually disappear, and the elastic layers of the inner coat also go. Finally, in the capillaries the lining epithelium alone is left, with a more or less de- veloped layer of connective-tissue corpuscles around it, repre- senting the remnant of the tunica adventitia. These vessels are thus extremely well adapted to allow of nitration or dif- fusion taking place through their thin walls. Structure of the Veins. In these the same three primary coats as in the arteries are found: the inner and middle coats are less developed, while the outer one remains thick, and is made up almost entirely of white fibrous tissue. Hence the venous walls are much thinner than those of the correspond- ing arteries, and the veins collapse when empty while the stouter arteries remain open. But the toughness of their outer coats gives the veins great strength. Except the pulmonary artery and the aorta, which possess the semilunar valves at their cardiac orifices, the arteries pos- sess no valves. Many veins on the contrary have such, formed by semilunar pouches of the inner coat, attached by one margin and having the edge turned towards the heart free. These valves, sometimes single, oftener in pairs, and rarely three at one level, permit blood to flow only towards the heart, for a current in that direction (as in the upper dia- gram, Fig. 96) presses the valve close against the side of the vessel and meets with no obstruction A from it. Should any back-flow be at- c j~ T^ H tempted, however, the current closes up the valve and bars its own passage _ B_ _ as indicated in the lower figure. These valves are most numerous in super- ficial veins and those of muscular parts. the POI>tal and W\™™J Veins. Ustl- end of the vessel.' ally the vein is a little dilated opposite a valve, and hence in parts where the valves are numerous gets a knotted look. On compressing the forearm so as to stop the flow in its subcutaneous veins and cause their dilatation, the points at which valves are placed can be recognized by their swollen appearance. They are most frequently situated where two veins communicate. CHAPTER XV. v^^ THE WORKING OF THE HEART AND BLOOD-VESSELS. The Beat of the Heart. It is possible with some little skill and care to open the chest of a living narcotized ani- mal, such as a rabbit, and see its heart at work, alternately contracting and diminishing the cavities within it, and relax- ing and expanding them. It is then observed that each beat commences at the mouths of the great veins; from there runs over the rest of the auricles, and then over the ventricles; the auricles commencing to dilate the moment the ventricles commence to contract. Having finished their contraction the ventricles also commence to dilate, and so for some time neither they nor the auricles are contracting, but the whole heart is expanding. The contraction of any part of the heart is known as its systole and the relaxation as its diastole, and since the two sides of the heart work synchronously, the au- ricles together and the ventricles together, we may describe a ' whole "cardiac period" or "heart-beat" as made up succes- sively of auricular systole, ventricular systole, and pause. This cycle is repeated about seventy times a minute; and if the whole time occupied by it be subdivided into 100 parts, about 9 of these will be occupied by the auricular systole, about 30 by the ventricular systole, and 61 by the pause: during more than half of life, therefore, the muscle-fibres of the heart are at rest. In the pause the heart if taken be- tween the finger and thumb feels soft and flabby, but during the systole it (especially its ventricular portion) becomes hard and rigid. Change of Form of the Heart. During its systole the heart becomes shorter and rounder, mainly from a change in the shape of the ventricles. ' A cross-section of the heart at the base of these latter during diastole would be elliptical in outline, with its long diameter from right to left; during the systole it is more circular, the long axis of the ellipse becom- ing shortened, while the dorso-ventral diameter remains little 227 228 THE HUMAN BODY. altered. At the same time the length of the ventricles is lessened, the apex of the heart approaching the base and be- coming blunter and rounder. The Cardiac Impulse. The human heart lies with its apex touching the chest-wall between the fifth and sixth ribs on the left side of the breast-bone. At every beat a sort of tap, known as the "cardiac impulse" or "apex beat/' may be felt by the finger at that point. There is, however, no actual " tapping/7 since the heart's apex never leaves the chest-wall. During the diastole the soft ventricles yield to the chest-wall where they touch it, but during the systole they become hard and tense and push it out a little between the ribs, and so cause the apex beat. Since the heart becomes shorter during the ventricular systole, it might be supposed that at that time the apex would move up a little in the chest. This, how- ever, is not the case, the ascent of the apex towards the base of the ventricles being compensated for by a movement of the whole heart in the opposite direction. If water be pumped into an elastic tube, already moderately full, the tube will be distended not only transversely but longitudinally. This is what happens in the aorta : when the left ventricle contracts and pumps blood forcibly into it, the elastic artery is elongated as well as widened, and the lengthening of that limb of its arch attached to the heart pushes the latter down towards the dia- phragm, and compensates for the upward movement of the apex due to the shortening of the ventricles. Hence if the exposed living heart be watched it appears as if during the systole the base of the heart moved towards the tip, rather than the reverse. Events occurring within the Heart during a Cardiac Period. Let us commence at the end of the ventricular systole. At this moment the semilunar valves at the orifices of the aorta and the pulmonary artery are closed, so that no blood can flow back from those vessels. The whole heart, however, is soft and distensible and yields readily to blood flowing into it from the pulmonary veins and the venae cavae; this passes on through the open mitral and tricuspid valves and fills up the dilating ventricles, as well as the auricles. As the ventricles fill, back currents are set up along their walls and these carry up the flaps of the valves so that by the end of the pause they are nearly closed. At this moment the au- ricles contract, and since this contraction commences at and WORKING OF THE HEART AND BLOOD-VESSELS. 229 narrows the mouths of the veins opening into them, and at the same time the blood in those vessels opposes some resist- ance to a back-flow into them, while the still flabby and dilating ventricles oppose much less resistance, the general result is that/the contracting auricles send blood into the ventricles, and not back into the veins. At the same time the increased direct current into the ventricles produces a greater back current on the sides, which, when the auricles cease their contraction and the filled ventricles become tense and press on the blood inside them, completely closes the auriculo- ventricular valves. That this increased filling of the ventri- cles, due to auricular contractions, will close the valves may be seen easily in a sheep's heart. If the auricles be carefully cut away from this so as to expose the mitral and tricuspid valves, and water be then poured from a little height into the ventricles, it will be seen that as these cavities are filled the valve-flaps are floated up and close the orifices. The auricular contraction now ceases and the ventricular commences. The blood in each ventricle is imprisoned be- tween the auriculo- ventricular valves behind and the semi- lunar valves in front. The former cannot yield on account of the cordae tendinese fixed to their edges: the semilunar valves, on the other hand, can open outwards from the ven- tricle and let the blood pass on, but they are kept tightly shut by the pressure of the blood on their other sides, just as the lock-gates of a canal are by the pressure of the water on them. In order to open the canal-gates water is let in or out of the lock until it stands at the same level on each side of them; but of course they might be forced open without this by applying sufficient power to overcome the higher water pressure on one side. It is in this latter way that the semi- lunar valves are opened. The contracting ventricle tightens its grip on the blood inside it and becomes rigid to the touch. As it squeezes harder and harder, at last the pressure on the blood within it becomes greater than the pressure exerted on the other side of the valves by the blood in the arteries, the flaps are forced open and the blood begins to pass out : the ventri- cle continues its contraction until it has obliterated its cavity and completely emptied itself; this total emptying' appears, at least, to occur in the normally beating heart, but in some pathological conditions and under the influence of certain drugs the emptying of the ventricles is incomplete. After 230 THE HUMAN BODY. the systole the ventricle commences to relax and blood imme- diately to flow back towards it from the highly stretched ar- teries. This return current, however, catches the pockets of the semilunar valves, drives them back and closes the valve so as to form an impassable barrier; and so the blood which has been forced out of either ventricle cannot flow directly back into it. Use of the Papillary Muscles. In order that the con- tracting ventricles may not force blood back into the auricles it is essential that the flaps of the mitral and tricnspid valves be maintained in position across the openings which they close, and be not pushed back into the auricles. At the com- mencement of the ventricular systole this is provided for by the cordae tendineae, which are of such a length as to keep the edges of the flaps in apposition, a position which is farther secured by the fact that each set of cordae tendineae (Fig. 92) radiating from a point in the ventricle, is not at- tached around the edges of one flap but on the contiguous edges of two flaps, and so tends to pull them together. But as the contracting ventricles shorten, the cordae tendineae, if directly fixed to their interior, would be slackened and the valve-flaps pushed up into the auricle. The little papillary muscles prevent this. Shortening as the ventricular systole proceeds, they keep the cordae taut and the valves closed. The mechanism is indeed even better working than this. The area of the valve-flaps is greater than is sufficient to stretch across the auriculo-ventricular orifice, so that when their edges are in apposition they form a cone projecting into the ventricle. Towards the ends of the systole the papillary muscles pull this cone down into the ventricular cavity so as to practically obliterate it and force out from it nearly every drop of blood. \ Sounds of the Heart. If the ear be placed on the chest over the region of the heart during life, two distinguishable sounds will be heard during each cardiac cycle. They are known respectively as the first and second sounds of the heart. The first is of lower pitch and lasts longer than the second and sharper sound: vocally their character may be tolerably imitated by the words lubb, dup. The cause of the second sound is the closure, or, as one might say, the"*' click- ing up," of the semilunar -valves, since it occurs at the moment of their closure and ceases if they be hooked back in WORKING OF THE HEART AND BLOOD - VESSELS. 231 a living animal. The origin of the first sound is still uncer- tain: it takes place during the ventricular systole and is probably due to vibrations of the tense ventricular wall at that time. It is not due, at least not entirely, to the auriculo- ventricular valves, since it may still be heard in a beating heart empty of blood, and in which there could be no closure or tension of those valves. In various forms of heart disease these sounds are modified or cloaked by additional " mur- murs" which arise when the cardiac orifices are roughened or narrowed or dilated, or the valves inefficient. By paying attention to the character of the new sound then heard, the exact period in the cardiac cycle at which it occurs, and the region of the chest-wall at which it is heard most distinctly, the physician can often get important information as to its cause. Diagram of the Events of a Cardiac Cycle. In the fol- lowing table the phenomena of the heart's beat are repre- sented with reference to the changes of form which are seen on an exposed working heart. Events in the same vertical column occur simultaneously; on the same horizontal line, from left to right, successively. Auricular Systole. Commence- ment of Ventricular Systole. Ventricular Systole- Cessation of Ven- tricular Systole. Pause. Auricles Ventricles Impulse Contracting and emptying. Dilating and filling. Dilating and filling. Contracting. Apex beat. Dilating and filling. Contracting and emptying. Dilating and filling. Dilaliag. Dilating and filling. Dilating and filling. Auriculo-vrutric ular valves . Semilunar valves Closing. Closed. Closed. Closed. First sound Closed. Open. Opening. Closing. Second Open. Closed. sound. Function of the Auricles. The ventricles have to do the work of pumping the blood through the blood-vessels. Ac- cordingly their walls are far thicker and more muscular than those of the auricles; and the left ventricle, which has to force the blood over the Body generally, is stouter than the right, which has only to send blood around the comparatively short pulmonary circuit. The circulation of the blood is in fact maintained by the ventricles, and we have to inquire what is the use of the auricles. Not unfrequently the heart's 232 THE HUMAN BODY. action is described as if the auricles first filled with blood and then contracted and filled the ventricles; and then the latter contracted and drove the blood into the arteries. From the account given above, however, it will be seen that the events are not accurately so represented, but that during all the pause blood flows on through the auricles into the ventricles, which latter are already nearly full when the auricles con- tract; this contraction merely completing their filling and finishing the closure of the auriculo-ventricular valves. The real use of the auricles is to afford a reservoir into which the veins may empty while the comparatively long-lasting ventricular contraction is taking place: they also largely control the amount of work done by the heart. If the heart consisted of the ventricles only, with valves at the points of entry and exit of the blood, the circulation could be maintained. During diastolo the ventricle would fill from the veins, and during systole empty into the arteries. But in order to accomplish this, during the systole the valves at the point of entry must be closed, or the ventricle would empty itself kito the veins as well as into the arteries; and this closure would necessitate a great loss of time which might be utilized for feeding the pump. This is avoided by the auricles, which are really reservoirs at the end of the venous system, collecting blood when the ventricular pump is at work. When the ventricles relax, the blood entering the auricles flows on into them: but previously, during the -ffo of the cardiac cycle occupied by the ventricular systole, the auricles have accumulated blood, and when they at last con- tract they send on into the ventricles this accumulation. Even were the flow from the veins stopped during the auric- ular contraction this would be of comparatively little conse- quence, since that event occupies so brief a time. But, al- though no doubt somewhat lessened, the emptying of the veins into the heart does not seem to be, in health, stopped while the auricle is contracting. For at that moment the ventricle is relaxing and receives the blood from the auricles under a less pressure than it enters the latter from the veins. The heart in fact consists of a couple of " feed-pumps " — the auricles — and a couple of "force-pumps" — the ventricles; and so wonderfully perfect is the mechanism that the supply to the feed-pumps is never stopped. The auricles are never empty, being supplied all the time of their contraction, which WORKING OF THE HEART AND BLOOD-VESSELS. 233 is never so great as to obliterate their cavities; while the ven- tricles contain no blood at the end of their systole. The auricles also govern to a certain extent the amount of work done by the ventricles. These latter contract with more than sufficient force to completely drive out all the blood contained in them. If the auricles contract more powerfully and empty themselves more completely at any given time, the ventricles will contain more blood at the com- mencement of their systole, and will have pumped out more at its end. Now, as we shall see in Chapter XVIII, the con- traction of the auricles is under the control of the nervous system, and through the auricles the whole work of the heart. In fact the ventricles represent the brute force con- cerned in maintaining the circulation, while the auricles are part of a highly-developed co-ordinating mechanism, by which the rate of the blood-flow is governed according to the needs of the whole Body at the time. The Work Done by the Heart. This can be calculated with approximate correctness. At each systole each ven- tricle sends out the same quantity of blood — a^out 180 grams (6.3 ounces); the pressure se^errfreffl by the blood in the aorta against the semilunar jp^Tves, and which the ventricle has to overcome, is about that which would be exerted on the same surface by a column of mercury 200 millimeters (8 inches) high. The left ventricle therefore drives out, seve-hty times in a minute, 180 grams (6.3 ounces) of blood against this pressure. Since the specific gravity of mercury is 12.5 and that of blood may for practical purposes be taken as 1, the work of each stroke of the ventricle is equivalent to raising 180 grams (6.3 ounces) of blood 200 X 12.5 = 2500 millim. (8.2 feet); or one gram 450 meters (one ounce 51.66 feet); or one kilogram 0.45 meter (one Ib. 3.23 feet). Work is measured by the amount of energy needed to raise a definite weight a given distance against gravity at the earth's surface, the unit, called a kilogr ammeter, being either that necessary to raise one kilogram one meter, or, called a foot-pound, that necessary to raise one pound one foot. Expressed thus the work of the left ventricle in one minute, when the heart's rate is seventy strokes in that time, is 0.45 X 70 — 31 50 kilo- grammeters (3.23 x 70 = 226.1 foot-pounds) ; in one hour it is 31.50 X 60 = 1890 kilogrammeters (226.1 X 60 = 13,566 foot-pounds); and in twenty-four hours 1890 X 24 = 45,360 234 THE HUMAN BODY. kilogrammeters (325,584 foot-pounds). The pressure in the pulmonary artery against which the right ventricle works is about ^ of that in the aorta; hence this ventricle in twenty- four hours will do one third as much work as the left, or 15,120 kilogrammeters (108,528 foot-pounds), and adding this to the amount done by the left, we get as the total work of the ventricles in a day the immense amount of 60,480 kilogrammeters (434,112 foot-pounds). If a man weighing 75 kilograms (165 Ibs.) climbed up a mountain 806 meters (2644 feet) high his skeletal muscles would probably be greatly fatigued at the end of the ascent, and yet in lifting his Body that height they would only have performed the amount of work that the ventricles of the heart do daily without fatigue. The Plow of the Blood Outside the Heart. The_blood leaves the heart intermittently and not in a regular stream, a quantity being forced out at each systole of the ventricles: before it reaches the capillaries, however, this rhythmic movement is transformed into a steady flow, as may readily be seen by examining under the microscope thin transparent parts of various animals, as the wreb of a frog's foot, a mouse's ear, or the tail of a small fish. In consequence of the steadi- ness with which the capillaries supply the veins the flow in these is also unaffected, directly, by each beat of the heart; if a vein be cut the blood wells out uniformly, while a cut artery spurts out not only with much greater force, but in jets which are much more powerful at regular intervals corre- sponding witfi the systoles of the ventricles. The Circulation of the Blood as Seen in the Prog's Web, There is no more fascinating or instructive phenomenon than the circulation of the blood as seen with the microscope in the thin membrane between the toes of a frog's hind lirnb. Upon focusing beneath the epidermis a network of minute arteries, veins, and capillaries, with the blood flowing through them, comes into view (Fig. 91). The arteries, a, are readily recognized by the fact that the flow in them is fastest and from larger to smaller branches. The latter are seen ending in capillaries, which form networks, the channels of which are all nearly equal in size. While in the veins aris- ing from the capillaries the flow is from smaller to larger trunks, and slower than in the arteries, but faster than in the capillaries. WORKING OF THE HEART AND BLOOD - VESSELS. 235 The reason of the slower flow of the capillaries is that their united area is considerably greater than that of the arteries supplying them, so that the same quantity of blood flowing through them in a given time has a wider channel to flow in and moves more slowly. The area of the veins is smaller than that of the capillaries but greater than that of the arteries, and hence the rate of movement in them is also intermediate. Almost always when an artery divides, the area of its branches is greater than that of the main trunk, and so the arterial current becomes slower and slower from the heart onwards. In the veins, on the other hand, the area of a trunk formed by the union of two or more branches is less than that of the branches together, and the flow becomes quicker and quicker towards the heart. But even at the heart the united cross-sections of the veins entering the auri- cles are greater than those of the arteries leaving the ventri- cles, so that, since as much blood returns to the heart in a given time as leaves it, the rate of the current in the pul- monary veins and the verise cava3 is less than in the pulmonary artery and aorta. We may represent the vascular system as a double cone, widening from the ventricles to the capillaries and narrowing from the latter to the auricles. Just as water forced in at a narrow end of this would flow quickest there and slowest at the widest part, so the blood flows quickest in the aorta and slowest in the capillaries, which taken together form a much wider channel. The Axial Current and the Inert Layer,, If a small artery in the frog's web be closely examined it will be seen that the rate of flow is not the same in all parts of it. In the centre is a very rapid current carrying along all the red cor- puscles and known as the axial stream, while near the wall of the vessel the flow is much slower, as indicated by the rate at which the pale blood-corpuscles are carried along in it. This is a purely physical phenomenon. If any liquid be for- cibly driven through a fine tube which it wets, water for in- stance through a glass tube, the outermost layer of the liquid will remain motionless in contact with the tube; the next layer of molecules will move a little, the next faster still; and so on until a rapid current is found in the centre. If solid bodies, as powdered sealing-wax, be suspended in the water, these will all be carried on in the central faster cur- rent or axial stream, just as the red corpuscles are in the 236 THE HUMAN BODY. artery. The white corpuscles, partly because of their less specific gravity, and partly because of their sometimes irregu- lar form, due to amoeboid movements, get frequently pushed out of the axial current, so that many of them are found in the inert layer. Internal Friction. It follows from the above-stated facts that there is no noticeable friction between the blood and the lining of the vessel through which it flows: since the outermost blood-layer in contact with the wall of the vessel is changed only by diffusion. There is great friction between the different concentric layers of the liquid, since each of them is moving at a different rate from that in contact with it on each side. This form of friction is known in hydro- dynamics as "internal friction," and it is of great importance in the circulation of the blood. Internal friction increases very fast as the calibre of the tube through which the liquid flows diminishes: so that with the same rate of flow it is dis- proportionately much greater in a small tube than in a larger one. Hence a given quantity of liquid forced in a minute through one large tube would experience much less resistance from internal friction than if sent in the same time through four or five smaller tubes, the united transverse sections ox which were together equal to that of the single larger one. In the blood-vessels the increased total area, and consequently slower flow, in the smaller channels partly counteracts this increase of internal friction, but only to a comparatively slight extent; so that the internal friction, and consequently the resistance to the blood-flow, is far greater in the capil- laries than in the small arteries, and in the small arteries than in the large ones. Practically we may regard the arteries as tubes ending in a sponge: the united areas of all the channels in the latter might be considerably larger than that of the supplying tubes, but the friction to be overcome in the flow through them would be much greater. The Conversion of the Intermittent into a Continuous Flow. Since the heart sends blood into the 'aorta intermit- tently, we have still to inquire how it is that the flow in the capillaries is continuous. In the larger arteries it is not, since we can feel them dilating as the "pulse," on applying the finger over the radial artery at the wrist, or over the tem- poral artery on the side of the brow. The first explanation which suggests itself is that since WORKING OF THE HEAET AND BLOOD-VESSELS. 237 the capacity of the blood-vessels increases from the heart to the capillaries, an acceleration of the flow during the ven- tricular contraction which might be very manifest in the vessels near the heart would become less and less obvious in the more distant vessels. But if this were so, then when the blood was collected again from the wide capillary sponge into the great veins near the heart, which together are but little bigger than the aorta, we ought to find a pulse, but we do not: the venous pulse which sometimes occurs having quite a different cause, being due to a back-flow from the auricles, or a checking of the on-flow into them, during the cardiac sys- tole. The rhythm of the flow caused by the heart is therefore not merely cloaked in the small arteries and capillaries, but abolished in them. We can, however, readily contrive conditions outside the Body under which an intermittent supply is transformed into a continuous flow. Suppose we have two vessels, A and B (Fig. 97), containing water and con- nected below in two ways: through the tube a on which there is a pump provided with valves so that it can only drive liquid from A to B', and through #, which may be left wide open or narrowed by the clamp c, at will. If the apparatus be left at rest the water will lie at the same level, d, in each vessel. If now we work the pump, at each stroke a certain amount of water will be conveyed from A to B, and as a result of the lowering of the level of liquid in A and its rise in B, there will be immediately a return flow from B to A through the tube 7). A, in these circum- stances, would represent the venous system, from which the heart constantly takes blood to pump it into B, representing the arterial system ; and I would represent the capillary ves- sels through which the return flow takes place; but, so far, we should have as intermittent a flow through the capillaries, b, as through the heart-pump, a. Now imagine 1) to be nar- rowed at one point so as to oppose resistance to the back-flow, while the pump goes on working steadily. The result will be nn accumulation of water in B, and a fall of its level in A. — at. FIG. 97. 238 THE HUMAN BODY. But the more the difference of level in the two vessels in- creases, the greater is the force tending to drive water back through I to A, and more will flow back, under the greater difference of pressure, in a given time, until at last, when the water in B has reached a certain level, d', and that in A has correspondingly fallen to d", the current through b will carry back in one minute just so much water as the pump sends the other way, and this back-flow will be nearly constant; it will not depend directly upon the strokes of the pump, but upon the head of water accumulated in B^ which head of water will, it is true, be slightly increased at each stroke of the pump, but the increase will be very small compared with the whole driving force, and its influence will be inappreciable. We thus gain the idea that an incomplete impediment to the flow from the arteries to the veins (from B to A in the dia- gram), such as is afforded by internal friction in the capil- laries, may bring about conditions which will lead to a steady flow along the latter vessels. But in the arterial system there can be no accumulation of blood at a higher level than that in the veins, such as is sup- posed in the above apparatus; and we must next consider if the "head of water" can be replaced by some other form of driving force. It is in fact replaced by the elasticity of the large arteries. Suppose an elastic bag instead of the vessel B connected with the pump " a" If there be no resistance to the back-flow the current through b will be discontinuous. But if resistance be interposed, then the elastic bag will be- come distended, since the pump sends in a given time more liquid into it than it passes back through b. But the more it- becomes distended the more will the bag squeeze the liquid inside and the faster will it send that back to A, until at last its squeeze is so powerful that each minute or two or five min- utes it sends back into A as much as it receives. Thenceforth the back-flow through b will be practically constant, being im- mediately dependent upon the elastic reaction of the bag, and only indirectly upon the action of the pump which keeps it distended. Such a state of things represents very closely the phenomena occurring in the blood-vessels. The highly elastic large arteries are kept stretched with blood by the heart; and the reaction of their elastic walls, steadily squeezing on the blood in them, forces it continuously through the small arte- ries and capillaries. The steady flow in the latter depends WORKING OF THE HEART AND BLOOD-VESSELS. 239 thus on two factors: first, the elasticity of the large arteries; and, secondly, the resistance to their emptying, dependent upon internal friction in the small arteries and the capillaries, which calls into play the elasticity of the large vessels. Were the capillary resistance or the arterial elasticity absent the blood-flow in the capillaries would be rhythmic. CHAPTER XVI. ARTERIAL PRESSURE. THE PULSE. Weber's Schema. It is clear from the statements made in the last chapter that it is the pressure exerted by the elas- tic arteries upon the blood inside them which keeps up the flow through the capillaries, the heart serving to keep the big arteries tightly filled and so to call the elastic reaction of their walls into play. The whole circulation depends prima- rily, of course, upon the beat of the heart, but this only in- directly governs the capillary flow, and since the latter is the aim of the whole vascular apparatus, it is of great importance to know all about arterial pressure; not only how great it is on the average, but how it is altered in different vessels in various circumstances so as to make the flow through the capillaries of a given part greater or less according to circum- stances; for, as blushing and pallor of the face (which fre- quently occur without any change in the skin elsewhere) prove, the quantity of blood flowing through a given part is not always the same, nor is it always increased or diminished in all parts of the Body at the same time. Most of what we know about arterial pressure has been ascertained by experi- ments made upon the lower animals, from which deductions are then made concerning what happens in man, since An- atomy shows that the circulatory organs are arranged upon the same plan in all the mammalia. A great deal can, how- ever, be learnt by studying the flow of liquids through ordi- nary elastic tubes. Suppose we have a set of such (Fig. 98) supplied at one point with a pump, c, possessing valves of entry and exit which open only in the direction indicated by the arrows, and that the whole system is slightly overfilled with liquid so that its elastic walls are slightly stretched. These will in consequence press upon the liquid inside them and the amount of this pressure will be indicated by the gauges; so long as the pump is at rest it will be the same everywhere (and therefore equal in the gauges on B and A), 240 ARTERIAL PRESSURE. THE PULSE. 241 since liquid in a set of horizontal tubes communicating freely, as these do at D, always distributes itself so that the pressure upon it is everywhere the same. Let the pump c now con- tract once, and then dilate : during the contraction it will empty itself into B and during the dilatation fill itself from A. Consequently the pressure in B, indicated by the gauge x, will rise and that in A will fall. But very rapidly the liquid will redistribute itself from B to A through D, until it again exists everywhere under the same pressure. Every FIG. 98.— Diagram of Weber's Schema. time the pump works there will occur a similar series of phenomena, and there will be a disturbance of equilibrium causing a wave to flow round the tubing; but there will be no steady maintenance of a pressure on the side B greater than that in A. Now let the upper tube D be closed so that the liquid to get from B to A must flow through the narrow lower tubes D', which oppose considerable resistance to its passage on account of their frequent branchings and the great internal friction in them ; then if the pump works fre- quently enough there will be produced and maintained in B a pressure considerably higher than that in A, which may even become negative. If, for example, the pump works 60 times a minute and at .each stroke takes 180 cubic centi- meters of liquid (6 ounces) from A and drives it into B, the quantity sent in at the first stroke will not (on account of the resistance to its flow offered by the small branched tubes), have all got back into A before the next stroke takes place, sending 180 more cubic centimeters (6 oz.) into B. Conse- quently at each stroke B will become more and more dis- tended and A more and more emptied, and the gauge x will 242 THE HUMAN BODY. indicate a much higher pressure than that on A. As B is more stretched, however, it squeezes harder upon its con- tents, until at last a time comes when this squeeze is power- ful enough to force through the small tubes just 180 cubic centimeters (6 oz.) in a second. Then further accumulation in B ceases. The pump sends into it 10,800 cubic centi- meters (360 ounces) in a minute at one end and it squeezes out exactly that amount in the same time from its other end ; and so long as the pump works steadily the pressure in B will not rise, nor that in A fall, any more. But under such circumstances the flow through the small tubes will be nearly constant since it depends upon the difference in pressure pre- vailing between B and A, and only indirectly upon the pump which serves simply to keep the pressure high in B and low in A. At each stroke of the pump it is true there will be a slight increase of pressure in B due to the fresh 180 cub. cent. (6 oz.) forced into it, but this increase will be but a small fraction of the total pressure and so have but an in- significant influence upon the rate of flow through the small connecting tubes. Arterial Pressure. The condition of things just de- scribed represents very closely the phenomena presented in the blood-vascular system, in which the ventricles of the heart, with their auriculo-ventricular and semilunar valves, represent the pump, the smallest arteries and the capillaries the resistance at D', the large arteries the elastic tube B, and the veins the tube A. The ventricles constantly receiving blood through the auricles from the veins, send it into the arteries, which find a difficulty in emptying themselves through the capillaries, and so blood accumulates in them until the elastic reaction of the stretched arteries is able to squeeze in a minute through the capillaries just so much blood as the left ventricle pumps into the aorta, and the right into the pulmonary artery, in the same time. Accordingly in a living animal a pressure-gauge connected with an artery shows a much higher pressure than one connected with a vein, and this persisting difference of pressure, only increased by a small fraction of the whole at each heart-beat, brings about a steady flow from the arteries to the veins. The heart keeps the arteries stretched and the stretched arteries maintain the flow through the capillaries, and the constancy of the current in them depends on two factors: (1) the resistance experi- ARTERIAL PRESSURE. THE PULSE. 243 enced by the blood in its flow from the ventricles to the veins, and (2) the elasticity of the larger arteries which allows the blood to accumulate in them under a high pressure, in consequence of this resistance. The Arterial Pressure. This cannot be directly meas- ured with accuracy in man, but from measurements made on other animals it is calculated that in the human aorta its average is equal to that of a column of mercury 200 milli- meters (8 inches) high. During the systole it rises about 5 millimeters (| inch) above this and during the pause falls the same amount below it. The pressure in the venae cavae on the other hand is often negative, the blood being, to use ordinary language, often " sucked " out of them into the heart, and it rarely rises above 5 millimeters (^ inch) of mercury except under conditions (such as powerful muscular effort accom- panied by holding the breath) which force blood on into the venae cavae and, by impeding the pulmonary circulation, in- terfere with the emptying of the right auricle. Hence to • maintain the flow from the aorta to the vena cava we have an average difference of pressure equal to 200 — 5 — 195 millimeters (7| inches) of mercury, rising to 205 — 5 = 200 mm. (8 inches) during the cardiac systole and falling to 195 — 5 = 190 mm. (7-f inches) during the pause; but the slight alterations, only about -^ of the whole difference of aortic and vena-cava pressures which maintain the blood- flow, are too small to cause appreciable changes in the rate of the current in the capillaries. The pressure on the blood in the pulmonary artery is about £ of that in the aorta. Since the blood flows from the aorta to its branches and from these to the capillaries and thence to the veins, and liquids in a set of continuous tubes flow from points of greater to those of less pressure, it is clear that the blood- pressure must constantly diminish from the aorta to the right auricle; and similarly from the pulmonary artery to the left auricle. At any point, in fact, the pressure is pro- portionate to the resistance in front, and since the farther the blood has gone the less of this, due to impediments at branchings and to internal friction, it has to overcome in finishing its round, the pressure on the blood diminishes as we follow it from the aorta to the venae cavae. In the larger arteries the fall of pressure is gradual and small, since the amount of resistance met with in the flow through them is 244 THE HUMAN BODY. but little. In the small arteries and capillaries the resistance overcome and left behind is (on account of the great internal friction due to their small calibre) very great, and conse- quently the fall of pressure between the medium-sized arteries and the veins is rapid and considerable. Modifications of Arterial Pressure by Changes in the Bate of the Heart's Beat. A little consideration will make it clear that the pressure prevailing at any timu in a given artery depends on two things — the rate at which the vessel is filled, i.e., upon the amount of work done by the heart; and the ease or difficulty with which it is emptied, that is, upon the resistance in front. A third factor has to be taken into account in some cases; namely, that when the muscular coats of the small arteries contract the local capacity of the vascular system is diminished, and has to be compensated for by greater distention elsewhere, and vice versa. This would of itself of course bring about changes in the pressure ex- erted on the contained liquid, but for the present it may be left out of consideration. Returning to the system of elastic tubes with a pump represented in Fig. 98, let us suppose the pump to be driving as before 10,800 cub. cent. (360 oz.) per minute into the tubes B, and that these latter are so dis- tended that they drive out just that quantity in the same time. Under such conditions the pressure at any given point in B will remain constant, apart from the small varia- tions dependent upon each stroke of the pump. Now, how- ever, let the latter, while still sending in 180 cub. cent. (6 oz.) at each stroke, work 80 instead of 60 times a minute and so send in that time 180 X 80 = 14,400 cub. cent. (480 oz.) instead of the former quantity. This will lead to an accumulation in B, since its squeeze is only sufficient, against the resistance opposed to it, to send out 10,800 cub. cent. (360 oz.) in a minute. B consequently will become more stretched and the pressure in it will rise. As this takes place, however, it will press more powerfully on its contents until at last its distention is such that its elastic reaction is able to force out in a minute through the small tubes D, 14,400 cub. cent. (480 oz.) Thenceforth, so long as the pump beats with the same force and at the same rate and the peripheral resistanee remains the same, the mean pressure in B will neither rise nor fall — B sending into A in a minute as much as c takes from it, and we would have a ARTERIAL PRESSURE. THE PULSE. 245 steady condition of things with a higher mean pressure in B than before. On the other hand2 if the pump begins to work more slowly while the resistance remains the same, it is clear that the mean pressure in B must fall. If, for example, the pump works only forty times a minute and so sends in that time 180 X 40 = 7200 cub. cent. (240 oz.) into B, which is so stretched that it is squeezing out 10,800 cub. cent. (360 oz. ), in that time, it is clear that B will gradually empty itself and its walls become less stretched and the pressure in it fall. As this takes place, however, it will force less liquid in a minute through the small tubes, until at last a pressure is reached at which the squeeze of B only sends out 7200 cub. cent. (340 oz.) in a minute ; and then the fall of pressure will cease and a steady one will be maintained, but lower than before. Applying the same reasoning to the vascular system, we see that (the peripheral resistance remaining unaltered), if the heart's force remains the same1 but its rate increases, arterial pressure will rise to a new level, while a slowing of the heart's beat will bring about a fall of pressure. Modifications of Arterial Pressure Dependent on Changes in tha Force of the Heart's Beat. Returning again to Fig. 98 : suppose that, while the rate of the pump remains the same, its power alters so that each time it sends 200 cub. cent. (6.6 oz.) instead of 180 (6 oz.) and so in a minute 12,000 cub. cent (396 oz.) instead of 10,800 (360 oz.) —the quantity which B is stretched enough to squeeze out in that time. Water will in consequence accumulate in B until it becomes stretched enough to squeeze out 12,000 cub. cent. (396 oz.) in a minute, and then a steady pressure at a new and higher level will be maintained. On the other hand if the pump, still beating sixty times a minute, works more feebly so as to send out only 160 cub. cent. (5.6 oz.) at each stroke, then B, squeezing out at first more than it receives in a given time, will gradually empty itself until it only presses hard enough upon its contents to force 160 x 60 — 9600 cub. cent. (336 oz.) out in a minute. Similarly, if while the resistance in the small arteries and capillaries remains the same and the heart's rate unchanged the stroke of the latter alters, so that at each beat it sends 246 THE HUMAN BODY. more blood out than it did previously, then arterial pressure will rise; while if the heart beats more feebly it will fall. Modifications of Arterial Pressure by Changes in the Peripheral Resistance. Let the pump c in Fig. 98 still work steadily sending 10,800 cub. cent. (360 oz.) per minute into B and the resistance increase, it is clear arterial pressure must rise. For B is only stretched enough to squeeze out in a minute the above quantity of liquid against the original re- sistance, and cannot at first send out that quantity against the greater. Liquid will consequently accumulate in it until at last it becomes stretched enough to send out 10,800 cub. cent. (360 cubic oz.) in a minute through the small tubes, in spite of the greater resistance to be overcome. A new mean pressure at a higher level will then be established. If, on the contrary, the resistance diminishes while the pump's work remains the same, then B will at first squeeze out in a minute more than it receives, until finally its elastic pressure is reduced to the point at which its receipts and losses balance, and a new and lower mean pressure will be established in B. Similarly in the vascular system, increase of the peripheral resistance by narrowing of the small arteries will increase arterial pressure in all parts nearer the heart, while dilata- tion of the small arteries will have the contrary effect. Summary. We find then that arterial pressure at any moment is dependent upon — (1) the rate of the heart's beat; (2) the quantity of blood forced into the arteries at each beat; (3) the calibre of the smaller vessels. All of these, and consequently the capillary circulation which depends upon arterial pressure, are under the control of the nervous system (see Chap. XVII.). The Pulse. When the left ventricle contracts it forces a certain amount of blood into the aorta, which is already dis- tended and on account of the resistance in front cannot empty itself as fast as the contracting ventricle fills it. As a consequence its elastic walls yield still more — it enlarges both transversely and longitudinally and if exposed in a living animal can be seen and felt to pulsate, swelling out at each systole of the heart, and shrinking and getting rid of the excess during the pause. A similar phenomenon can be observed in all the other large arteries, for just as the con- tracting ventricle fills the aorta faster than the latter empties (the whole period of diastole and systole being required by ARTERIAL PRESSURE. THE PULSE. 247 the aorta to pass on the blood sent in during systole), so the increased tension in the aorta immediately after the cardiac contraction drives on some of its contents into its branches., and fills these faster than they are emptying, and so causes a dilatation of them also, which only gradually disappears as the aortic tension falls before the next systole. Hence after each beat of the heart there is a sensible dilatation of all the larger arteries, known as the pulse, which becomes less and less marked at points on the smaller branches farther from the heart, but which in health can readily be recognized on any artery large enough to be felt by the finger through the skin, etc. The radial artery near the wrist, for example, will always be felt tense by the finger, since it is kept overfilled by the heart in the way already de- scribed. jfBut after each heart-beat it becomes more rigid and dilates a little, the increased distension and rigidity gradually disappearing as the artery passes on the excess of blood before the next heart-beat. The pulse is then a wave of increased pressure started by the ventricular systole, ra- diating from the semilunar valves over the arterial system, and gradually disappearing in the smaller branches. In the aorta the pulse is most marked, for the resistance there to the transmission onwards of the blood sent in by the heart is greatest, and the elastic tube in which it consequently accu- mulates is shortest, and so the increase of pressure and the dilatation caused are considerable. The aorta, however, gradually squeezes out the excess blood into its branches, and so this becomes distributed over a wider area, and these branches having less resistance in front find less and less diffi- culty in passing it on ; consequently the pulse-wave becomes less and less conspicuous and finally altogether disappears be- fore the capillaries are reached, the excess of liquid in the whole arterial system after a ventricular systole being too small to sensibly raise the mean pressure once it has been widely distributed over the elastic vessels, which is the case by the time the wave has reached the small branches which supply the capillaries. The pulse-wave travels over the arterial system at the rate of about 9 metres (29.5 feet) in a second, commencing at the wrist 0.159 second, and in the posterior tibial artery at the ankle 0.193 second, after the ventricular systole. The blood itself does not of course travel as fast as the pulse-wave, for 24:8 THE HUMAN BODY. that quantity sent into the aorta at each heart- beat does not immediately rush on over the whole arterial system, but by raising the local pressure causes the vessel to squeeze out faster than before some of the blood it already contains, and this entering its branches raises the pressure in them and causes them to more quickly fill their branches and raise the pressure in them; the pulse-wave or wave of increased press- ure is transmitted in this way much faster than any given portion of the blood. How the wave of increased pressure and the liquid travel at different rates may be made clearer perhaps by picturing what would happen if liquid were pumped into one end of an already full elastic tube, closed at the other end. At the closed end of the tube a dilatation and increased tension would be felt immediately after each stroke of the pump, although the liquid pumped in at the other end would have remained about its point of entry; it would cause the pulsation not by flowing along the tube itself, but by giv- ing a push to the liquid already in it. If instead of absolutely closing the distal end of the tube one brought about a state of things more nearly resembling that found in the arteries by allowing it to empty itself against a resistance, say through a narrow opening, the phenomena observed would not be es- sentially altered; the increase of pressure would travel along the distended tube far faster than the liquid itself. The pulse being dependent on the heart's systole, " feeling the pulse" of course primarily gives a convenient means of counting the rate of beat of that organ. To the skilled touch, however, it may tell a great deal more, as for example whether it is a readily compressible or " soft pulse" showing a low ar- terial pressure, or tense and rigid ("a hard pulse") indicative of high arterial pressure, and so on. In adults the normal pulse rate may vary from sixty-five to seventy-five, the most common number being seventy-two. In the same individual it is faster when standing than when sitting, and when sitting than when lying down. Any exercise increases its rate tem- porarily, and so does excitement ; a sick person's pulse should not therefore be felt when he is nervous or excited (as the physician knows when he tries first to get his patient calm and confident), as it is then difficult to draw correct conclu- sions from it. In children the pulse is quicker than in adults, and in old age slower than in middle life. The Bate of the Blood-Flow. As the vascular system ARTERIAL PRESSURE. THE PULSE. 249 becomes more capacious from the aorta to the capillaries the rate of flow in it becomes proportionately slower, and as the total area of the channels diminishes again from the capilla- ries to the venae cavae, so does the rate of flow quicken, just as a river current slackens when it spreads out, and flows faster where it is confined to a narrower channel ; a fact taken advantage of in the construction of Eads' jetties at the mouth of the Mississippi, the object of which is to make the water flow in a narrower channel and so with a more rapid current in that part of the river. Actual measurements as to the rate of flow in the arteries cannot be made on man, but from ex- periments on lower animals it is calculated that in the human carotid the blood flows about 400 millimetres (16 inches) in a second. In the capillaries the current travels only from 0.5 to 0.75 mm. (-fa to -fa inch) in a second. The total time taken by a portion of blood in making a complete circulation has been measured by injecting some easily detected sub- stance into an artery on one side of the body and noting the time which elapses before it can be found in a corresponding vein on the oppos: e side. In dogs this time is 15 seconds, and it is calculated for man at about 23 seconds. Of this total time about half a second is spent in the systemic and another half second in the pulmonary capillaries, as each por- tion of blood on its course from the last artery to the first vein passes through a length of capillary which on the aver- age is 0.5 mm. (^¥ inch). The rate of flow in the great veins is about 100 mm. (4 inche,s) in a second, but is subject to con- siderable variations dependent on the respiratory and other movements of the Body; in the small veins it is much slower. Secondary Causes of the Circulation. x Wh^le the heart's beat is the great driving force of the circulation, certain other things help more or less — viz., gravity, compression of the veins, and aspiration of the thorax. All of them are, how- ever, quite subsidiary; experiment on the dead Body shows that the injection of whipped blood into the aorta under a less force than that exerted by the left ventricle during life is more than sufficient to drive it round and back by the venae cavae. Not infrequently the statement is made in books that, probably, the systemic capillaries have an attractive force for arterial blood and the pulmonary capillaries for venous blood, but there is not the slightest evidence of the correctness of such a supposition, nor any necessity for making it. 250 THE HUMAN BODY. The Influence of Gravity. Under ordinary circum- stances this may be neglected, since in parts of the Body below the level of the heart it will assist the llow in the ar-. teries and impede it equally in the veins, while the reverse is the case in the upper parts of the Body. In certain cases, however, it is well to bear these points in mind. A part "congested" or gorged with blood should if possible be raised so as to make the back-flow in its veins easier; and sometimes when the heart is acting feebly it may be able to drive blood along arteries in which gravity helps, but not otherwise. Ac- cordingly in a tendency to fainting it is best to lie down, and make it easier for the heart to send blood up to the brain, bloodlessness of which is the cause of the loss of consciousness in a fainting-fit. In fact, so long as the breathing continues, the aspiration of the thorax will keep up the venous flow (see below), while, in the circumstances supposed, a slight dimi- nution in the resistance opposed to the arterial flow may be of importance. The head of a person who has fainted should accordingly never be raised until he has undoubtedly recov- ered, a fact rarely borne in mind by spectators, who commonly rush at once to lift any one whom they see fall in the street or elsewhere. The Influence of Transient Compression of the Veins. The valves of the veins being so disposed as to permit only a flow towards the heart, when external pressure empties a vein it assists the circulation. Continuous pressure, as by a tight garter, is of course bad, since it checks all subsequent flow through the vessel; but intermittent pressure, such as is exerted on many veins by muscles in the ordinary move- ments of the Body, acts as a pump to force on the blood in them. The valves of the veins have another use in diminishing the pressure on the lower part of those vessels in many regions. If, for instance, there were no valves in the long saphenous vein of the leg the considerable weight of the column of blood in it, which in the erect position would be about a metre (39 inches) high, would press on the lower part of the vessel. But each set of valves in it carries the weight of the column of blood between it and the next set of valves above, and relieves parts below, and so the weight of the col- umn of blood is distributed and does not all bear on any one point. ARTERIAL PRESSURE. THE PULSE. 251 Aspiration of the Thorax. Whenever a breath is drawn the pressure of the air on the vessels inside the chest is di- minished, while that on the other vessels of the Body is un- affected. In consequence blood tends to flow into the chest. It cannot, however, flow back from the arteries on account of the semilunar valves of the aorta, but it can readily be pressed, or in common language " sucked/' into the great veins close to the heart and into the right auricle of the latter. The details of this action must be omitted until the respiratory mechanism has been considered. All parts of the pulmonary circuit being within the thorax, the respiratory movements do not directly influence it, except in so far as the distention or collapse of the lungs alters the calibre of their vessels. The considerable influence of the respiratory movements upon the venous circulation can be readily observed. In thin persons the jugular vein in the neck can often be seen to empty rapidly and collapse during inspiration, and fill up- in a very noticeable way during expiration, exhibiting a. sort of venous pulse. Every one, too, knows that by making, a violent and prolonged expiration, as exhibited for example' by a child with whooping-cough, the flow in all the veins of the head and neck may be checked, causing them to swell up and hinder the capillary circulation until the person becomes " black in the face/' from the engorgement of the small ves- sels with dark-colored venous blood. In diseases of the tricuspid valve another form of venous, pulse is often seen in the superficial veins of the neck, since at each contraction of the right ventricle some blood is driven back through the right auricle into the veins. Proofs of the Circulation of the Bloo.cL The ancient physiologists believed that the movement of the blood was an ebb and flow, to and from each side of the heart, and out and in by both arteries and veins. They had no idea of a circulation,, but thought pure blood was formed in the lungs and impure in the liver, and that these partially mixed in the heart through minute .pores supposed to exist in the septum. Servetus, who was burnt alive by Calvin in 1553, first stated that there was a continuous passage through the lungs from the pulmonary artery to the pulmonary veins, but the great Englishman Harvey first, in lectures delivered in the College of Phvsicians of London about 1616, demonstrated that the movement of the blood was a continuous circulation as we 252 THE HUMAN BODY. now know it, and so laid the foundation of modern Physi- ology. In his time, however, the capillary vessels had not been discovered, so that although he was quite certain that the blood got somehow from the final branches of the aorta to the radicles of the venous system, he did not exactly know how. The proofs of the course of the circulation are at present quite conclusive, and may be summed up as follows: (1) Blood injected into an artery in the dead Body will return by a vein; but injected into a vein will not pass back by an artery. (2) The anatomical arrangement of the valves of the heart and of the veins shows that the blood can only flow from the heart, through the arteries and back to the heart by the veins. (3) A cut artery spurts from the end next the heart, a cut vein bleeds most from the end farthest from the heart. (4) A portion of a vein when emptied fills only from the end farthest from the heart. This observation can be made on the veins on the back of the hand of any thin per- son, especially if the vessels be first gorged by holding the hand in a dependent position for a few seconds. Select then a vein which runs for an inch or so without branching, place a finger on its distal end, and then empty it up to its next branch (where valves usually exist) by compressing it from below up. The vessel will then be found to remain empty as long as the finger is kept on its lower end, but to fill im- mediately when it is removed; which proves that the valves prevent any filling of the vein from its heart-end backwards. (5) If a bandage be placed around the arm, so as to close the superficial veins, but not tight enough to occlude the deeper- seated arteries, the veins on the distal side of the bandage will become gorged and those on its proximal side empty, showing again that the veins only receive blood from their ends turned towards the capillaries. (6) In the lower animals direct observation with the microscope shows the steady flow of blood from the arteries through the capillaries to the veins, but never in the opposite direction. CHAPTER XVII. THE NERVES OF THE HEART, AND SOME PHYSIOLOGI- CAL PECULIARITIES OF CARDIAC MUSCLE. The Co-ordination of Heart and Arteries. We have hitherto considered the working of the vascular system as if it were a mere mechanical hydraulic apparatus; and such in a certain sense it is, and by so regarding it many of the phe- nomena of the blood-flow can be explained. But life is a constant adjustment to constantly varying conditions, and the higher the organism the more numerous the conditions which influence it and the greater its power of adapting itself to them ; and this adaptability, this continuous self -adjust- ment, is nowhere better exhibited than in the heart and blood-vessels. The object to be attained is the maintenance of an orderly current in the capillaries in accordance with the needs of the whole Body and of each of its organs at the time. This clearly calls for some means -of interaction between heart anu blood-vessels: should the heart beat and the arteries relax or contract, each without reference to the other, no steady capil- lary flow could result. To secure such a flow the work done by the heart and the resistance offered in the vessels must at all times be correlated; so that the heart shall not by too powerful action over-distend or perhaps burst the small arteries, nor the latter contract too much and so, by increasing the peripheral resistance, raise aortic pressure to a great height and increase unduly the work to be done by the left ventricle in forcing open the semilimar valves. Further, the total amount of blood in the Body is not suffi- cient to keep all its organs simultaneously supplied with the amount needful for the full exercise of their activity; in fact the blood-vessels of the spleen, liver, and alimentary canal, if all fully distended, can themselves contain almost the whole blood of the Body, so that by paralyzing their coats in an animal it can be caused to faint, or even be killed, by what has been 253 254 THE HUMAN BODY. called an "internal bleeding," due to the accumulation of so much blood in the vessels of the abdomen that not enough is left over for the supply of the brain and other parts. In the Body, accordingly, we never find all its parts hard at work at the same moment. If when one group of muscles was set at work and needed an extra blood-supply, this should be pro- vided merely by increasing the heart's activity and keeping up a faster blood-flow everywhere throughout the Body, there would be a clear waste — much as if the chandeliers in a house were so arranged that when a larger flame was wanted at one burner it could only be obtained by turn- ing more gas on at all the rest at the same time; besides the big tap at the gas-meter regulating the general supply of the house, local taps at each burner are required which regulate the gas-supply to each flame independently of the others. A corresponding arrangement is found in the Body. Certain nerves control the calibre of the arteries supplying different organs and, when the latter are set at work, cause their arte- ries to dilate and so increase the amount of blood flowing through them, while the general circulation elsewhere re- mains practically unaffected. The resting parts at any mo- ment thus get enough blood to maintain their healthy nutri- tion and the working parts get the larger quantity required to make good used-up material and to wash out wastes : as certain organs come to rest and others are set in activity, the arteries of the former narrow and of the latter dilate; in this way the distribution of the blood in the Body is undergoing constant changes, parts which at one time contain much blood at an- other having but little. In addition, then, to nervous organs regulating the work of the heart and the arteries with refer- ence to one another, we have to consider another set of vascu- lar nerves which govern the local blood-supply of different regions of the Body. How important this is may be illus- trated by considering what happens when the surface of the Body is exposed for some time to cold. The skin normally contains much blood, brought to it in part to be cooled ; but under the supposed conditions the loss of heat would soon be so great as to be harmful did not small arteries of the skin contract, as is indicated by its pallor, and thus lessen the blood-flow through it. This contraction is not chiefly, if at all, due to direct action of the cold on the vessels, but to the stimulation of cutaneous afferent nerves which excite a nerve- NERVES OF THE HEART. CARDIAC MUSCLE. 255 centre from which efferent impulses are in turn sent to the muscular coat of the cutaneous arteries. The blood driven from the skin must find a place elsewhere in the circulatory system, and so internal organs tend to become over-full and at the same time general arterial pressure is raised. This, again through nerves, acts upon the heart, and alters its rate of beat for a time. But in health some internal arteries soon dilate sufficiently to compensate for the constriction of the surface vessels, and arterial pressure and the pulse again be- come normal, though with a less proportion of the total blood flowing through the skin than before: this readjustment is brought about entirely through nerves and nerve-centres placing all the arteries in connection with one another and with the heart, so that they exert a mutual control. If the cold be not too prolonged its cessation is followed by a return of the blood-flow to its original condition, this action being brought about by cardiac and vascular nerve apparatuses. We have to mainly consider in this and the succeeding chapter the nerves which regulate the heart-beat and those which in- fluence the calibre of arteries; but it is necessary iirst to study the muscular tissue of the heart more thoroughly than we have hitherto done. Some Physiological Peculiarities of Cirdiac Muscle. We have already seen that the muscular tissue of the heart, though striped, differs considerably in structure from the tissue of the skeletal muscles: it differs also somewhat in properties, and as the latter differences can be most readily studied on the heart of the frog, which will beat for a long time after excision, it will be best to commence with that. The frog's heart consists of four contractile chambers through which the blood flows successively, as is indicated in the dia- gram, Fig. 99, in which no attempt has been made to indicate the actual appearance of the organ, which is in fact curved on itself somewhat in the form of a capital si (see Z, Fig. 9.9), and this is also the shape of the mammalian heart in an early stage of embryonic development. The main chambers are incompletely separated by constrictions, at some of which valves are placed, and are in order — the venous sinus, A, receiving blood from the systemic veins; the atrium, consist- ing of two auricles, B, C, of which the right is much the larger and is supplied from the sinus, while the left gets blood from the small pulmonary veins, pv, the ventricle, D, sup- 256 THE HUMAN BODY. plied from both auricles and having projecting into it the two flaps of the auriculo-ventricular valve, which are continued from the end of the septum or partition lying between the auricles; the bulbus ar teriosua, E, from which the systemic and pulmonary arte- ries are supplied. To describe the very interesting mechan- ism by which the arterial and venous blood supplied to the single ventricle are kept sep- arate and sent from the arte- rial bulb through different channels would take us be- yond the limits of this book, but it is well worth study in some treatise on comparative physiology. The muscular tissue of the frog's heart consists of cells which are in form somewhat like those of involuntary mus- cle, but they are frequently forked at their ends, and they are obscurely cross - striped like human cardiac muscle (Fig. 123). The main thick- ness of the walls of all the chambers of the heart consists of this muscle, and is known as the myocardium. It com- mences on the ends of the Flo. 99.— Diagram of the frog's heart, ~raof VPITKS npm* whprp thpv A, venous sinus; B, C, right and left au- great Veins liey ricies, together forming the atrium ; p «., -jojn the heart, and is thence pulmonary veins; a, a, constriction be- J tween sinus and atrium; D, ventricle; continued to the roots of the g, 0, constriction between auricles and . .... , ventricles; i, auriculo-ventricular valve; great arteries arising irom the E, arterial bulb; P, pneumogastric or f . ,». , ,-, vagus nerve; S, sympathetic nerve; N, bulb; but it IS thinner at the cardiac nerve containing fibres from both . ,. , . -, r -, vagus and sympathetic. Z shows the COllStriCtlOUS Which 116 De- natural relative positions of the chief , rn-_ fr._ ^o^ ncnrifipa fVian chambers of the heart: d, vena cava; e, tween the main Cavities tnail ?SSflBfcf>/f ^*l" ;le; elsewhere, and there is ar- ranged in rings around the openings. NERVES OF THE HEART. CARDIAC MUSCLE. 257 A single nerve, N, goes to the heart from each side (only that of the right side is represented in the diagram). This nerve is usually spoken of as the cardiac branch of the vagus or pneumogastric, P, but it is partly made up of fibres from the sympathetic nerve, S, which join the pneumogastric close to the skull and run on with its cardiac branch, the two form- ing the apparently single nerve-trunk, N, which runs to the venous sinus, breaking up near it into several twigs. On these twigs and in the plexus which they form in the wall of the sinus are numerous nerve-cells, forming the sinus ganglion or ganglion of Remak. From the sinus nerves run down the walls of the auricles to the auriculo-' ventricular groove, #, and two comparatively large twigs pass down the auricular septum to the region of the valve, i, and there enter a collection of nerve cells which, with other cells lying in the groove, constitute the auricula-ventricular or Bidder's ganglion. From that gan- glion nerves are continued to the wrall of the ventricle, and near its base have nerve-cells mixed with them. A few nerve-cells are also found among the fibres running down the auricular septum : in the apex of the ventricle, however, and in the bulb there are no ganglion-cells, though nerve-fibres are present. We find then a considerable collection of nerve- cells in the walls of the venous sinus, a few cells in the au- ricular septum, a considerable collection at the junction of atrium with ventricle, and a few scattered cells in the neigh- boring portions of the ventricle. The cells of the ganglion of Eemak and some of those in the septum belong to a type differing somewhat from those hitherto described. Each is pear-shaped, and has a conspicuous nucleus with a nucle- olus; from the narrow end of the cell proceeds a branch which ultimately becomes the axis cylinder of a medullated nerve-fibre. Another branch arises by two. or more roots which coil spirally around the straight branch, and finally unite and proceed as a non-medullated fibre. Most of the remaining nerve-cells of the frog's heart are spindle-shaped, and receive a nerve-fibre atrone end and give one off at the other. They are known as bipolar cells. The cardiac nerve, N, Fig. 99, contains both gray and medullated fibres, the latter coming entirely or almost entirely from its vagus root; as the fibres passing on from the sinus ganglion to the gan- glion of Bidder contain very few medullated fibres, it is prob- able that many of the vagus fibres end in the pear-shaped 258 THE HUMAN BODY. cells from which gray fibres are given off to the rest of the heart, mingled with the original gray fibres derived from the sympathetic : in the ventricle and bulb only non-medullated fibres are found. The Beat of the Frog's Heart. When both cardiac nerves are cut in a frog the heart continues its regular rhyth- mic beat, as it does also when carefully removed from the body of the animal: this makes it clear that whatever initi- ates the beat lies in the heart itself, which must therefore be regarded as an automatic organ; but leaves it still uncertain whether the exciting cause of each beat is to be sought in the nervous elements of the heart or in the cardiac muscle itself. Arguing from the analogy of ordinary striped muscle, which is not automatic, one would be inclined to ascribe to the nerve-cells of the isolated heart the origination of nervous impulses for the myocardium, and certain experiments tend to support this view; but cardiac muscle differs considerably from the skeletal muscles in its histology, so it is unsafe to argue from one to the other, and some experiments show that we must ascribe to it, in addition to contractility, a certain amount of automaticity and of conductivity and co-ordinating power. In physiological properties it combines the character- istic properties of fully differentiated nerve-cell and nerve- fibre with those of muscle-fibre. / Each beat of the heart of the frog can be seen to com- mence where the great veins enter the venous sinus, and from there to spread rapidly over the whole sinus; then there is a brief check, and the atrium beats; then another check, fol- lowed by the beat of the ventricle; finally, again after a very short pause, comes the contraction of the arterial bulb : then the series of phenomena is repeated in the same unvarying order as long as. the heart is in good condition and is left to itself. The fact that each cycle of contractions begins at the mouths of the venae caves and the sinus, where nerve-cells are very numerous, and passes on to the ventricle, where they are few, and to the bulb, where there are none, has been taken as an evidence of the origination of each beat through stimuli developed in cardiac nerve-cells; and this opinion gains sup- port from what is usually seen on an excised heart when it is gradually dying. The bulb and ventricle cease to beat first, then the auricles, last the sinus, and this although the ven- tricle may still be contractile and able to give a good beat or NERVES OF THE HEART. CARDIAC MUSCLE. 259 a set of several beats when directly stimulated, as by pricking or by induction shocks. The loss of irritability as the heart dies also usually appears in the same order: when the ventricle and auricle have both ceased to beat, it is frequently possible to excite the auricle by a direct stimulation which is powerless when applied to the ventricle; and when the whole heart has ceased to pulsate the venous sinus will sometimes re- spond to direct stimulation when auricle and ventricle will not. Still further, if the heart be carefully divided at the level aa, Fig. 99, so as to separate the sinus from the rest, the usual result is that the sinus goes on beating, but the rest of the heart lies for a time at rest: soon it begins to beat quite rhythmically, but at a slower rate than the separated sinus. If the cross-section be made at the level gg so as to separate the sinus and auricle from the rest, they go on beating, but the ventricle and bulb usually lie quiescent for a considerable time, and then commence. On account of the anatomical relations of the parts (Z, Fig. 99) it is not possible to com- pletely separate the ventricle from the sinus Of a pert uskm without doing injury to the former; but if separated apex t of the lower third of the ventricle (which con- f?og'Jeheartefo?fthe tains no nerve-cells) be cut off from the rest of the heart along the line oo, this separated jfj portion never begins to beat spontaneously, «uia though the remainder of the heart continues its pulsations. So far the case for the view that the nerve-cells take the in- itiative in the changes which result in a normal beat, and that cardiac muscle is not automatic, is a strong one; but other facts show that it cannot be accepted without modifi- cation. Although the separated apex of the ventricle of the frog, left to itself, does not beat, yet it can be made to beat without the application to it of anything that we are justified in call- ing a stimulus: it does under certain conditions exhibit auto- maticity. If it be tied on the end of a tube divided by a partition (Fig. 100), and some blood or blood-serum be circu- lated through it, in from a and out by b, under a slight press- ure, this bit of ventricle, devoid of nerve-cells, after a time begins to beat rhythmically. It has been suggested that in $ Jan- 260 THE HUMAN BODY. this case the distension of the muscle or some chemical con- stituent of the liquid acts as a stimulus; but in no other muscle do we find blood-supply or mere stretching act as a stimulus, and if they are to be assumed as so acting in this case their action is uniform, while the resulting contractions are interrupted and rhythmic: moreover, they are co-ordi- nated; they are not irregular twitches first of one bundle of the myocardiac fibres and then of another, but duly combined, so as by their mutual action to empty the cavity they surround. The evidence thus obtained as to the possession of some auto- matic and some co-ordinative properties by the frog's cardiac muscle is strengthened by experiments on the hearts of tor- toises and terrapins. In those animals the apical portions of the ventricle are devoid of nerve-cells, yet narrow strips of them hung up and slightly loaded will usually begin to beat after a time. If they do not, all that is necessary is to stimu- late them rhythmically for a short time; then on ceasing the stimulation the rhythmic contractions continue. Here, no doubt, the loading is a favoring condition, but so it is for the activity of ordinary muscles, on which, nevertheless, it does not act as a stimulus. The conclusion to which we are led is that the muscle- cells of the frog's -heart have retained to some extent those automatic and co-ordinating faculties of undifferentiated protoplasm which the more highly evolved fibre of skeletal muscle -has lost. We find in the presence of certain of the nerve- cells of the heart a highly favorable condition for the exhibition of those powers: the nerve-elements perhaps influ- ence the nutrition, perhaps in some other mode affect the molecular structure of the muscle-cells connected with them so as to favor spontaneous contraction, but, like stretching the isolated strip of ventricle, they merely bring about a state of things promoting the exercise of powers inherent in the cardiac muscle tissue itself. The evidence as to the automaticity of the muscle of the mammalian heart is not quite as full as in the case of the frog. In it also there are collections of ganglion-cells where the great veins join the auricles and near the base of the ventri- cles; but there are others in the apical region of the ventricles, so it is not possible to examine an isolated apex free from ganglion-cells as it is in the frog. The musculature of the auricles is prolonged for some little way on the ends of the NERVES OF THE HEART. CARDIAC MUSCLE. 261 vencB cavce and the pulmonary veins, and there each normal beat commences, the contraction spreading rapidly over the whole auricle and thence to the ventricle without the brief in- termediate pause observable in the frog. In the mammal, also, the ventricles if supplied with blood from the auricles go on beating although all nerve and muscular continuity between auricle and ventricle has been destroyed, by passing rigid tubes through the auriculo-ventricular openings and then tying a ligature tight on the outside of the heart along the auriculo- ventricular groove, so as to crush the tissues between the string and the tubes. If the ligatures be so placed as not to impede the flow in the coronary vessels the ventricles beat long and powerfully, but with a rhythm independent of that of the auricles and usually slower. Also when the mammalian heart is dying slowly, as in a suffocated animal, the auricles usually continue to beat after the ventricle has ceased, the small dog's-ear-shaped projection of the auricles (which it may be noted has given its name to the whole auricle) usually being the last portion to come to rest, especially that on the right side, which was accordingly named ultima moriens by the old physiologists. On the whole we are perhaps justified in assuming that the myocardium of the mammal is automatic, like that of the frog, and that in it also the presence and influence of ganglion-cells favor the production of a beat, but do not initiate it. The muscle of the frog's heart is, we have seen, co-ordi- native: the isolated ventricular apex can perform a regular beat. It is probable that this is not the case in the mammal. When a dog's heart is injured the ventricles sometimes cease to give true beats though the muscle bundles constituting them go on contracting, but it is with no combined action such as would empty the ventricle. Irregular and useless contractions travel simultaneously over the myocardium in various directions, so that the whole mass seems trembling. Such a state (known as "fibrillar contraction") is especially apt to follow wounds in the region of the main nerve-trunks running down the ventricles alongside the larger branches of the coronary arteries, and is probably due to the injury of some nervous apparatus concerned in securing the proper co-ordi- nated contractions of the normal beat. In many other regions wounds may be inflicted on the ventricle with con- siderable impunity. 262 TEE HUMAN BODY. The Heart-beat is not a Tetanic Contraction. We have seen that it is possible by rapidly succeeding stimuli to throw the skeletal muscles into a prolonged and apparently contin- uous contraction, and that there is good reason, afforded by the phenomena of " secondary tetanus," for the belief that all normal contractions of the voluntary muscles are compound or tetanic contractions. This is not the case with the heart. It is possible by repeated stimuli to hurry the beat of a frog's heart, but not to fuse two or more beats into a single longer uninterrupted contraction. And as regards the normal beat of the heart, experiments as to secondary tetanus prove the same thing. If the heart of an anaesthetized dog or other mammal be carefully laid bare and the nerve of a nerve- muscle preparation be laid on it, we get for each beat a single twitch of the signal muscle, and not a short tetanus lasting as long as the ventricular contraction, such as must arise were this contraction tetanic. The Ventricular Contraction is always Maximal. It has been pointed out with reference to the skeletal muscles that within limits the extent of a contraction varies with the stimulus used: a feeble stimulus giving a small contraction, a stronger a greater. This is not the case with cardiac mus- cle. A quiescent ventricle or strip of ventricle taken from the heart of a frog or turtle can often be made to contract by stimulation; but provided the stimulus is powerful enough to cause a beat at all, it always causes the fullest contraction the piece of heart is capable of at the time.f Increase of stimulus causes no increase of contraction. There is good reason to believe that in the physiological working of the ventricles of the mammalian heart each completely expels during its contraction all the blood contained in it: the papillary muscles pulling down the flaps of the auriculo- ventricular valves so that they finally form a cone on which the rest of the ventricular boundaries can fit closely so as to obliterate the cavity they enclose. This being so, the quantity of blood driven into the arteries by each contraction of the ventricles depends on the amount in the latter when their beat commences. This amount depends partly upon the quantity of blood returned from the great veins during the preceding diastole and partly upon the force with which the auricles contract, for they, although each contraction is probably maximal for their 'condition at the time being, do NERVES OF THE HEART. CARDIAC MUSCLE. 263 not completely empty themselves at each stroke; they some- times do so more completely and sometimes less. In this manner the auricles can to a great extent control the work done by the ventricles, through influencing the amount of blood in the latter at the commencement of the ventricular systole : more complete relaxation of the auricles during i diastole promotes inflow from the great veins, more extensive contraction during auricular systole more completely fills the ventricles. As we shall see, the force and rate of the auricular beat is much more under the control of nerves reaching the heart from other parts than is that of the ventricles. The auricles are a feed-pump adjusting their work, and through it the work of the whole heart, to the general condition of the Body; the ventricles are a grosser force-pump driving on whatever blood is supplied to them, be it much or be it little. The Extrinsic Nerves of the Mammalian Heart. As in the frog, these come from two sources, at least so far as indi- cated by gross anatomy. Their exact anatomical arrangement differs in various mammals, as the rabbit, dog, and man, and even somewhat in different individuals of these species, but in the main is the same. The pneumogastric gives off from its main stem in the neck several cardiac branches; so do the lower cervical and the upper thoracic ganglia of the sympa- thetic chain. Both sets intermingle, and near the heart end in plexuses containing nerve-cells; from these plexuses nerves are distributed to that organ. In the heart itself, as already stated, are collections of ganglion-cells in the auricles near the ends of the great veins, near the base of the ventricles, and a few cells scattered over the ventricles even in their apical re- gions. The nerve-fibres coming through the pneumogastrics are medullated and consist of a set of small fibres and a group of large: the smaller lose their medulla in ganglion-cells in or near the heart; the larger retain the medullary sheath, and may be traced even over the ventricles, which in this respect differ from that of the frog; the fibres supplied from the sympathetic are non-medullated. Broadly speaking, the nerve-fibres fall into three physiological sets corresponding to the three anatomical varieties: the small medullated fibres are effer- ent and inhibitory — when excited they slow the heart-beat; the large medullated are in part at least afferent, conveying to the central nervous system impulses which originate in the heart; the sympathetic fibres are efferent and excitor, and 264 THE HUMAN BODY. when stimulated quicken or strengthen the heart beat. The afferent fibres will be more conveniently studied in connection with nerves of the blood-vessels (Chap. XVIII). The Cardio-inhibitory Fibres. These, though running in the neck in what seems to be the main pneumogastric trunk, do not leave the skull in that nerve, but in the spinal accessory (XI cranial nerve), which, it will be remembered, arises in part from the brain and in part from the upper por- tion of the spinal cord. That nerve gives off near the brain a small branch which joins the pneumogastric and runs on in it to near the heart. The fibres may be tracked in the pneu- mogastric by their small size, but more satisfactorily by the Wallerian method. It is then found — 1, when the main pneumogastric trunk is divided in the neck all the medullated fibres in it distal to the place of section degenerate; 2, if only the branch joining the spinal accessory to the pneumogastnc be cut, then only some fibres in the pneumogastric stem do- generate, and these fibres are the small medullated set; 3, if the pneumogastric alone be divided above the point where the branch from the spinal accessory joins it, then the large medullated fibres of the cardiac branches of the vagus degen- erate, but the small do not. Hence we conclude that the small fibres come through the accessory. Physiological ex- periment confirms this. Immediately after cutting the main pneumogastric trunk stimulation of its peripheral end checks^ the beat of the heart; but if the stimulation be applied after several days, it has no effect on the heart. If instead of cutting the whole pneumogastric stem we divide only the branch going to it from the accessory, we find similar results: after two or three days (i.e., when the microscope reveals degeneration of the small medullated fibres in the main stem, all the rest being in their normal condition) stim- ulation of it is as absolutely without direct effect on the heart as after complete degeneration of the whole nerve-trunk. In the frog there is no separate spinal accessory nerve; the cardio- inhibitory fibres pass from the brain directly into the pneumo- gastric; but in both frog and mammal their centre lies in a group of nerve-cells of the medulla oblongata known as the cardio-inliibitory centre. The cardiac nerve of the frog consists (Fig. 99) of a pneu- mogastric and a sympathetic portion: if it be stimulated the usual result is that the heart is slowed when the stimulus is NERVES OF THE HEART. CARDIAC MUSCLE. 265 feeble, and is stopped when the stimulus is more powerful; and in this animal it is possible by carefully applied stimula- tion to keep the heart at rest for a considerable time, during which it lies distended and flabby; but nearly always it ulti- mately recommences its beat even though the stimulation of the nerve be continued. During its inhibition the heart is irritable and contractile, for it beats if a direct stimulus be applied to it: the myocardium is therefore not incapable of action; but either some influence normally proceeding from its nerve-cells and promoting its automatic contraction is pre- vented, or the stimulation directly acts on the cardiac muscle and for the time lowers or removes its spontaneity. If the stimulus applied to the cardiac nerve be not strong enough to completely inhibit the heart, it is usually seen that the pulsa- tions are not only fewer, but more feeble; but this is not always the case : the beats may be slower and not less powerful than before, or they may continue with the same rhythm, but be less powerful; in any case the result is to diminish for the time the work done by the heart. In marnmalia the phenomena are essentially the same. If artificial respiration be maintained in an anaesthetized rabbit and its heart laid bare, and then the pneumogastric trunk be divided on one side of the neck and its cardiac end stimu- lated, the heart comes to rest, distended and soft to the touch; or, with more feeble stimulation, the pulsations are slowed; or they may be both slower and feebler, or feebler and not slower; but the amount of blood driven out by the ventricles in a given time is usually much less. When the beat is only weakened it often happens that the effect shows itself much more markedly on the auricles than on the ventricles, though this of course diminishes the work done by the ventricles, as they are then supplied with less blood to pump on; and occa- sionally it may be seen that the auricles miss a beat, giving only one for each two of the ventricles, quite contrary to the case of a dying heart, in which, as we have seen, the auricular beat is more prominent. This illustrates the fact that the auricles are more sensitive to external nervous control than the ven- tricles, and provide, so to speak, the " fine adjustment" of the cardiac apparatus. Wh ether the heart is stopped or slowed or its beats weak- ened, the result must be a fall in arterial pressure, for the stretched arteries go on driving blood through the capillaries 266 THE HUMAN BOD Y. to the veins, while their supply from the heart is cut off or lessened. Hence a pressure-gauge attached to an artery shows readily the influence of stimulation of the cardio-in- hibitory fibres; and in order to avoid the serious operation of opening the thorax to observe the heart directly, it is usual to study indirectly the cardiac effect of stimulation of the pnemogastric by observing its influence on arterial pressure. FIG. 101.— Manometer for recording variations in arterial pressure, ddggg, glass? U-tube partly filled with mercury, o; its limb, gg, is open to the air, and a float bear- ing the light stem e on which is the pen / rests on the mercury: the limb dd is filled above the mercury with magnesium sulphate solution and connected water- tight by tubes and the cannula a with the heart end of a divided artery. The pen writes on a horizontally travelling surface and rises and falls with the mercury on the side gg, a rise indicating increase of arterial pressure, a fall the reverse: the pressure 'in the artery at any moment is indicated by the vertical distance between the top of the mercury in dd and that in gg. due allowance being made for the weight of the magnesium sulphate and some other possible sources of error. For this purpose a small glass tube or cannula, a, filled with solution of magnesium sulphate (to check blood-clotting) is in- troduced into the cardiac end of a divided artery, say the fem- oral, of a living animal, the artery being clamped at a place nearer the heart than the p'oint where the cannula is tied on. NERVES OF THE HEART. CARDIAC MUSCLE. 267 The cannula is (Fig. 101) connected by an inelastic tube, c,oi convenient length, also filled with magnesium sulphate, to one end of a U-shaped glass pressure-gauge or manometer, ddgg, containing mercury. On the top of the mercury in the limb gg of the manometer floats a light stem e carrying a pen which writes on a travelling surface. Above the mercury, o, on the side dd, the tube is filled with magnesium sulphate solution. When the pressure on each side of the manometer is alike the mercury stands at the same level in both limbs, but when it is increased on the side dd by taking the clamp off the artery and throwing in the pressure of the blood the mercury in gg rises, carrying the float and pen with it and draws a line such as that at yz, Fig. 102, on the travelling g FIG. 102. — Tracing: of arterial pressure during vagus inhibition of the heart. To be read from right to left: yzpq, blood pressure-line traced by the manometer pen; o indicates on the tracing the instant at which the nerve was stimulated; p, the instant at which the stimulation ended; ae, line traced by a pen marking half seconds; xg, line of no pressure, that is, level at which the pen would write were there no arterial pressure; the distance between it and the part of the manometer line directly above it multiplied by two gives the actual pressure in mercury in the artery at that moment. The small variations of pressure seen on the curve are due to beats of the heart; they are absent during the inhibition and slow for a short time after it. surface, the small curves (pulse-waves) on which correspond to the slight increases of arterial pressure following each contrac- tion of the left ventricle. The number of these small curves in a given time gives us therefore the pulse-rate. The pneu mo- gastric is meanwhile exposed in the neck and cut across: the object of dividing it is to prevent stimuli travelling to the brain by the afferent fibres in it, as they would act on the nerve- centres and lead to complicated results. The peripheral end of the cut nerve is then stimulated, the excitation commencing at, say, the instant corresponding to the point o on the tracing. 268 THE HUMAN BODY. It is seen that the heart does not stop at once but gives a beat or two and then stops as indicated by the sudden fall of arte- rial pressure and the absence of all pulse-waves from the tracing. ( If the stimulation be stopped at the instant indi- cated by p, the heart does not begin immediately to beat, but when it does, the beats are powerful and soon bring the arte- rial pressure back to its former level, or in many cases to a point above it for some time before the previous pressure and pulse-rate are regained. Such a tracing shows among other things that a certain "latent period" elapses before the stimulation of the inhibitory fibres influences the heart- beat^ and that the influence of the stimulus once established continues a short time after the stimulation is stopped; and that the first beats after cessation of the inhibition are slow and powerful. Of course without any manometer one can detect the effect of cardio-inhibitory stimulus by a finger placed over the -pulse of an animal or by listening to the heart-sounds, but the graphic method above described allows of much more accurate study. It has been stated in a previous paragraph that stimulation of the cardiac nerve usually stops or slows the heart-beat of a frog. The reason for the qualifying term is that sometimes the stimulation quickens the beat. This is due to the fact that the nerve (see Fig. 99) is a mixed one and that the fibres it receives from the sympathetic are directly antago- nistic in action to those derived from the vagus. In most cases when the whole trunk is stimulated the vagus fibres get tlie upper hand, but to be sure of pure cardio-inhibitory results the vagus must be stimulated before the sympathetic branch joins it. Then the action is always inhibitory; and certain other important phenomena may be observed, showing that the vagus contains fibres which tend to throw the heart into a better working state. When an exposed frog's heart is dying and has ceased to beat, or when the ventricle has come to rest though the sinus and auricles still work, it not unfrequently happens that a period of vagus stimulation is followed by a set of beats : or similarly that when the whole heart is beating feebly stimulation of the vagus is after a time followed by more forcible contractions. Hence it has been suggested that the nerve contains fibres which tend to promote the nutrition of the cardiac muscle, fibres which are anabolic and favor constructive chemical processes. Whether these fibres NERVES OF THE HEART. CARDIAC MUSCLE. 269 are the same as the cardio-inhibitory or are a distinct set is still uncertain. In mammals, also, it is frequently noticeable that vagus inhibition of the heart is followed by a period of. unusually powerful pulsation. The Cardio-inhibitory Centre. This consists of nerve- cells lying in the medulla oblongata and giving origin to the cardio-inhibitory fibres. In some animals it seems to be nor- mally always in a state of slight' activity, sending out feeble impulses which exert a slighUfcheck on the rate of pulse. This is the case in the dog, for in that animal division of both pneumogastric nerves in the neck is followed by a quicker heart-beat: in the rabbit, on the other hand, the centre appears usually at rest, as section of the pneumogas- trics in that animal has no effect on the pulse-rate. Whether normally in action or not the centre can readily be excited, especially by afferent impulses reaching it through abdominal nerves. If the intestines of a frog (the brain of which in front of the medulla oblongata has been entirely removed so as to make consciousness impossible) be exposed and sharply struck, the heart stops in diastole; but if both cardiac nerves have been previously divided this result does not follow. The stoppage is clearly then a reflex inhibition through the cardio-inhibitory centre and nerves, and the afferent tract can be readily traced. The afferent impulses from the intestine pass through the mesenteric branches of the sympathetic, for if these be cut no cardiac standstill follows the mechanical stimulation of the intestine, although the vagi be intact. If only the communicating branches from the sympathetic gan- glia to the spinal cord be cut or only the anterior roots of the corresponding spinal nerves, or only the spinal cord above the place of entry of these roots, or only the medulla oblongata destroyed, yet, in each case, the intestinal stimulation causes no stoppage of the heart. When the standstill does result it is therefore reflex, the afferent path being — sensory nerve-end- ings in intestine, mesenteric nerves, sympathetic ganglion, communicating branches, anterior spinal roots, spinal cord to centre in medulla; the efferent fibres are the inhibitory in the vagus. The fainting which in man not infrequently follows a severe blow on the pit of the stomach is due to similar reflex excitation of the cardio-inhibitory centre: and the fainting seen during severe pain and that which certain odors cause in some persons are due to similar stimulation of 270 THE HUMAN BODY. the cardio-inhibitory centre through sensory nerves, and serve to illustrate the many afferent fibres from different regions of the Body which can influence the heart-beat. The cardio-inhibitory centre may also be stimulated directly (as by piercing it with a needle) and stop the heart. But a more interesting instance is its excitation by high arterial pressure. Nearly always a very high pressure in the aorta is accompanied by a slow pulse due to cardio-inhibitory nerve-impulses, for if the vagi be cut under such circum- stances the heart-rate immediately increases. The slower beat, of course, by lessening the work of the heart tends to bring back the high arterial pressure to a more normal level, providing an adjustment of the heart's work to the condition of the arterial system at the time. The brain, enclosed in the rigid skull-cavity, is especially likely to be affected by increased arterial tension, for distension of the intra-cranial arteries must bring about greater pressure on all the other contents of the skull; and the cardio-inhibitory centre is very sensitive to increased pressure. If a small hole be bored through the skull of a dog and a little innocuous fluid in- jected so as to cause pressure on the brain, the beat of the heart is promptly slowed and weakened, but if the pneumo- gastrics have been previously cut the heart-beat is not influenced. In man similar stimulation of the cardio-inhibi- tory centre is shown in apoplexy, which is due to the bursting of some vessel inside the skull and the effusion of blood, which by pressure on the brain causes the unconsciousness and pa- ralysis which characterize the stroke. During such a fit the pulse is almost invariably very slow from the action of the increased pressure on the cardio-inhibitory cells. This is clearly a preservative action, for the resulting lower arterial pressure makes the haemorrhage less, and more likely to come to an end. Among conditions of the blood which stimulate the cardio-inhibitory apparatus may be mentioned deficient oxygenation, which will be referred to again when the phe- nomena of suffocation are described. The Cardio-accelerator or Augmentor Nerves. The influence of these on the heart is to quicken or strengthen its beat or both: but only for a time, their final action being to hasten exhaustion; they are essentially katabolic in their influence on the nutrition of the organ. Both in frog and mammal they pass to the heart from NERVES OF THE HEART. CARDIAC MUSCLE. 271 the sympathetic, taking somewhat different paths in different animals. In the frog their course is shown in Fig. 99; in mammals most of them come from the upper thoracic gan- glion of the sympathetic and the neighboring parts of the main sympathetic chain. If the heart of a frog be exposed and watched while the branch s, Fig. 99, is stimulated its beat is seen to be quickened, especially if the previous rate were slow: and quite similar phenomena may be observed when the corresponding nerves are stimulated in a rabbit or dog. And the beat is not merely made more rapid: it is dis- tinctly more powerful for the time, the heart driving out more blood at each stroke (even though pressure in the aorta may be high) and thus doing increased work. Though the augmentor fibres reach the heart through the sympathetic they have their centre (cardio-accelerator centre) in the medulla oblongata, from which in mammalia they pass down the spinal cord to the anterior roots of the upper tho- racic spinal nerves, to the communicating branches, to the sympathetic ganglia, and thence to the cardiac plexus and the heart. Their centre, like the inhibitory, may be reflexly excited : powerful stimulation of a sensory nerve, after section of the vagi, usually quickens the pulse if the accelerator fibres passing from the thoracic ganglia be intact, but has no effect if these be previously divided. If the vagi are not cut the result is not so certain, as the afferent impulses may also excite the cardio-inhibitory centre and cause a mixed action: but speaking generally afferent impulses which in a conscious animal would cause acute but not extreme pain cause increase of the heart- beat. This by raising general arterial tension would for the time put the animal in good condition to make a vigorous effort, and so is obviously an unconscious adaptation of the organism for the preservation of its safety. While ex- treme pain or extensive injury involving many afferent nerves tends to cause fainting and loss of consciousness, the cardio- inhibitory centre getting the upper hand. The Influence of Temperature Changes and of Calcium Salts on the Heart-beat. If the excised heart of a frog be cooled it beats more slowly; if heated, more quickly; until the temperature approaches the limit at which muscle passes into rigor. The observation is more difficult with mammals, but if the heart of a dog be completely separated from all the rest of the body except the lungs and supplied with blood 272 THE HUMAN BODY. it is possible to keep it alive for some hours, beating regularly and powerfully, and on such a heart it is easy to observe that cooler blood causes slower beat and vice versa. While the quick pulse observed in fevers may therefore be in part due to paralysis of the cardio-inhibitory centre or stimulation of the cardio-accelerator, it is in part at least due solely to the hotter blood circulating through the coronary vessels. Whether the higher temperature in this case acts primarily on the nerve-cells of the heart or on the muscle is not known. If circulation be kept up through a frog's heart by the perf usion method (Fig. 100), the organ may be kept beating for a very long time if the liquid supplied be blood or serum. If only dilute solution (0.75$) of sodium chloride be given, the beat continues for some time, but not so long as if no liquid be circulated ; the salt apparently washes out something which the heart needs. The beat of such a " washed-out " heart may be restored by substituting milk or serum or de- fibrinated blood for the saline solution, or even by adding to the sodium chloride a very little of a soluble calcium salt. Serum, blood, and milk all contain calcium salts, and albu- minous solutions free from calcium (as paraglobulin) do not restore the beat; nor do serum or milk or blood deprived of calcium. Hence the presence of some salt of that metal seems to have a close relation to the functional activity of the heart, as indeed it has to muscular activity in general. CHAPTER XVIII. THE VASO-MOTOR NERVES AND NERVE-CENTRES. The Nerves of the Blood-vessels. The arteries, as already pointed out, possess a muscular coat composed of fibres arranged around them, so that their contraction can narrow the vessels. This coat is most prominent in the smaller vessels, — those of the size which go to supply separate organs, — but disappears again in the smallest branches, which are about to divide into capillaries for the individual tissue elements of an organ. These vascular muscles are under the control of certain special nerves called vaso-motor, and these latter can thus govern the amount of blood reaching any organ at a given time. Most of the vascular nerve-fibres have their origin in the cerebro-spinal centre, though they pass through sympathetic ganglia on their way to the vessels. In a few regions ganglion-cells are found lying close to the arteries, and some of the vaso-motor fibres are probably con- nected with them, but as a rule they end directly in the mus- cular coat. In the heart we had to consider a rhythmically contract- ing organ the force of whose contractions could be increased or diminished by the influence of extrinsic nerves; in the arteries, speaking broadly, we have to deal with muscle in a condition of tonic or constant contraction, which contraction can be increased by impulses coming through excitor or vaso- constrictor nerves, and diminished through the activity of inhibitory or vaso-dilator nerves. The general tonic con- traction of the arterial muscle is, however, much more de- pendent on the vaso-constrictor nerve-fibres than is the beat of the heart on the cardio-excitor nerves. The inhibitory set of vaso-motor nerves have a much less extensive distribu- tion over the arterial system than the constrictor. The Vaso-constrictor Nerves. If the ear of a white rab- bit be held up against the light while the animal is kept quiet and not alarmed, the red central artery can be seen coursing 273 274 THE HUMAN B( >D Y. along the translucent organ, giving off branches which by subdivision become too small to be separately visible, and the whole ear has a pink color and is warm from the abundant blood flowing through it. Attentive observation will show also that the calibre of the main artery is not constant; at somewhat irregular periods of a minute or more it dilates and contracts a little. If the sympathetic trunk have been previously divided on the other side of the neck of the animal, the ear on that side will present a very different appearance. It arteries will be much dilated and the whole ear fuller of blood, redder, and distinctly warmer; the slow alternating variations in arterial diameter also have disappeared. We get thus evidence that the normal mean calibre of the artery is maintained by influ- ences reaching its muscular coat through the cervical sym- pathetic. Stimulation of the upper end of the cut nerve confirms this opinion. It is then seen that the arteries of the corresponding ear gradually contract until even the main vessel can hardly be seen, and in consequence the whole ear becomes pale and cold. After the stimulation is stopped the arteries again slowly dilate until they have regained their full paralytic size, and they usually remain permanently in that condition. Sometimes they regain after some days almost the size of those in the ear on the uninjured side, even when the nerve has not only been cut, but the upper cervical sympathetic ganglion extirpated; this seems to indicate that the arterial muscle has a small automaticity of its own tending to keep it in a moderate state of contraction, but it is less marked than the automaticity of the myocardium. Quite similar phenomena can be observed in transparent parts of other living animals, as in the web of a frog's foot, the arteries of which dilate after section of the sciatic nerve and constrict when the peripheral end of the nerve is stimu- lated. In the case of other parts changes in temperature may be used to detect alterations in the flow of blood. In a dog or cat, for example, a sensitive thermometer placed be- tween the toes indicates a rise of temperature, owing to in- creased flow of warm blood through the skin, after section of the chief nerve of the limb, and a fall of temperature (usu- ally) during stimulation of the peripheral end of the divided nerve. When the vaso-constrictor.nerves cut are those controlling a VASO-MOTOR NERVES AND NERVE-CENTRES. 275 large number of arteries, the dilatation of the latter so much diminishes peripheral resistance to the blood-flow as to lead to a marked fall of general arterial pressure; and, due care being taken to avoid or to allow for concomitant variations in the rate or force of the heart's beat, this gives us another use- ful method of studying the distribution of the nerves con- cerned. For example, the splanchnic nerves are branches which spring from the thoracic portion of the sympathetic chain and pass through the diaphragm to end in the gan- gliated solar plexus from which nerves pass to the arteries of most of the abdominal viscera. When the splanchnic nerves are cut on both sides arterial pressure falls enormously, from say 120 millimetres of mercury in the carotid of a dog to 15 or 20 millimetres, most of the blood of the body lying almost stagnant in the dilated blood-vessels of the abdomen. On the other hand, stimulation of the splanchnic nerves so diminishes the paths open for the circulation of the blood as to enor- mously increase general blood-pressure; especially if the cardio-inhibitory nerves be first divided so that raised blood- pressure inside the skull-chamber may not slow the heart- beat. The skin and the abdominal organs seem to be the pre- dominant localities of distribution of the vaso-constrictor nerves: other parts have them, but not in quantity sufficient to bring about any great general change in the blood-flow. In the abdomen is warmer, in the skin cooler blood: and according to the amount of heat produced in the Body and the temperature of the surrounding medium, the vessels of abdomen and skin contract or relax so as to control the pro- portion of blood sent to the skin to lose heat. The Vaso-constrictor Centre. The constrictor nerves of the arteries do not originate in the sympathetic system. If all the branches of the latter be left intact, the phenomena of paralytic dilatation of the blood-vessels can be fully brought about by dividing the communicating branches between certain spinal nerves and the corresponding sympathetic ganglia, or by dividing the anterior roots of certain spinal nerves. In this way it can be shown that the fibres all proceed from the thoracic and lumbar regions of the spinal cord, but have not their origin in the cord. If it be cut anywhere in the cervical region, all arteries having a constrictor nerve supply are paralyzed, while stimulation of the posterior end 276 THE HUMAN BODY. of the divided cord causes widespread arterial constriction. The main centre for the vaso-constrictors must then lie as far forward as the medulla: and as all the brain in front of the medulla oblongata can be removed without any con- sequent arterial paralysis, the centre must lie in the medulla itself. This centre is often named the vaso-motor centre, but it is better to distinguish it as the vaso-constr ictor from the centre for the dilator efferent nerves. The Control of the Vaso-constrictor Centre. The vaso- constrictor centre is automatic; it maintains a certain amount of activity of its own, independently of any stimuli reaching it through afferent nerve-fibres. Nevertheless, like nearly all automatic nerve-centres, it is under reflex control, so that its activity may be increased or lessened by afferent impulses conveyed to it. Nearly every sensory nerve of the Body is in connection with it; any stimulus giving rise to pain, for example, excites it, and thus constricting the arteries, in- creases the peripheral resistance to the blood-flow and raises arterial pressure. On the other hand, certain fibres conveying impulses from the heart inhibit the centre and dilate the arteries, lower blood-pressure, and diminish the resistance to be overcome by the heart. These afferent fibres, which have been already referred to as the large medullated fibres (p. 263) of the pneumogastric, are known as the depressor fibres, or in certain animals, for example the rabbit, where they are all collected into one branch, as the depressor nerve. If this nerve be divided and its cardiac end stimulated no effect is produced, but if its central end (that still connected with the rest of the pneumogastric trunk and through it with the medulla oblongata) be stimulated, arterial pressure gradually falls; this result being dependent upon a dilatation of the small arteries, and consequent diminution of the peripheral resistance, following an inhibition of the vaso-constrictor centre brought about by the depressor nerve. Through the de- pressor nerve the heart can therefore influence the calibre of the small arteries and, by lowering aortic pressure, diminish its own work if need be. In Fig. 103 is reproduced a tracing of the great but slow fall of blood-pressure which results from stimulation of the depressor fibres. It shows the slow fall of pressure and slightly changed pulse-rate accompanying the slow dilatation of the arteries, and may be compared with the rapid fall and slow pulse brought about (Fig. 102) by excita- VASO-MOTOR NERVES AND NERVE-CENTRES. 277 tion of the cardio-inhibitory nerves. The latent period is also noticeably long and the effect of the stimulus outlasts considerably the time of its application. Blushing. The depressor nerves control a great part of the vaso-constrictor centre (especially that portion of it connected with the splanchnic nerves) and so can bring about dilatation of a large number of arteries — their influence is accordingly called into play when general arterial pressure is to be lowered, but is useless for controlling local blood-supply. This is managed in part by other afferent nerves, each of which inhibits a small part only of the vaso-constrictor centre, gov- erning the arteries of a limited tract of the Body; the dilata- FIG. 103.— Tracing of pressure from femoral artery of a rabbit showing the influ- ence of stimulation of the central end of the depressor nerve; to he read from right to left: a b c d e, tracing of arterial pressure, the small variations indicating heart- beats; op, tracing of seconds pen; s, moment of commencement of stimulation; £, cessation of stimulation; xg, line of no pressure. tion of these increases the amount of blood flowing through the particular region to which they are .distributed, but does not affect the total resistance to the blood-flow sufficiently to influence noticeably the general pressure in the arterial system. In blushing, for example under the influence of an emotion, that part of the vase-motor centre which supplies constrictor nerves to the arteries of the skin of the neck and face, is inhibited by nerve-fibres proceeding from the cerebrum to the medulla oblongata, and the. face and neck consequently be- come full of blood and flush up. Quite similar phenomena occur under other conditions in many parts of the Body, although when not visible on the surface we do not usually call them blushes. The mucous membrane lining the empty stomach is pallid and its arteries contracted, but as soon as food enters the organ it becomes red and full of blood ; the food stimulating afferent nerve-fibres there, which inhibit 278 THE HUMAN BODY. that part of the vaso-motor centre which governs the gastric arteries. Taking Cold. This common disease is not unfrequentlj caused through undue reflex excitement of the vaso-motor centre. Cold acting upon the skin stimulates, through the afferent nerves, the portion of the vaso-motor centre governing the skin arteries, and the latter become contracted, as shown by the pallor of the surface. This has a twofold influence — in the first place, more blood is thrown into internal parts, and in the second, contraction of the arteries over so much of the Body considerably raises the general blood-pressure. Consequently the vessels of internal parts become overgorged or " congested," a condition which readily passes into inflam- mation. The action is of course primarily protective, to prevent too great loss of heat from the Body; but if internal organs be weak or diseased or if the exposure to wet or cold be prolonged, it is apt to be followed by catarrh or inflam- mation of more or less of the respiratory tract causing bron- chitis, or of the intestines causing diarrhoea. In fact the com- mon summer diarrhoea is far more often due to a chill of the surface, causing intestinal catarrh, than to the fruits eaten in that season which are so often blamed for it. The best preventative is to wear, when exposed to great changes of tem- perature, a woollen or at least a cotton garment over the trunk of the Body; linen is so good a conductor of heat that it permits any change in the external temperature to act almost at once upon the surface of the Body. After an unavoidable exposure to cold or wet the thing to be done is of course to restore the cutaneous circulation; for this purpose movement should be persisted in, and a thick dry outer covering put on, until warm and dry underclothing can be obtained. For healthy persons a temporary exposure to cold, as a plunge in a bath, is good, since in them the sudden contrac- tion of the cutaneous arteries soon passes off and is succeeded by a dilatation causing a warm healthy glow on the surface. If the bather remain too long in cold water, however, this reaction passes off and is succeeded by a more persistent chilliness of the surface, which may even last all day. The bath should therefore be left before this occurs, but no abso- lute time can be stated, as the reaction is more marked and lasts longer in strong persons, and in those used to cold bath- ing, than in others. VASO- MOTOR NERVES AND NERVE-CENTRES. 279 Vasodilator Nerves. We have already noticed, in the case of the stomach, one method by which a locally increased blood-supply may be brought about in an organ while it is at work, viz., by inhibition of local vaso- constrictor fibres. Frequently, however, in the Body this is managed in another way; by efferent vaso-dilator nerves which inhibit or paralyze, not the vaso-constrictor centre, but the muscles of the blood-vessels directly. The nerves of the skeletal muscles for example contain two sets of efferent fibres: one motor proper and the other vaso-dilator. When the muscle contracts in a reflex action or under the influence of the will both sets of fibres are excited ; so that when the organ is set at work its arteries are simultaneously dilated and more blood flows through it. But if the animal have previously administered to it such a dose of curare as to just paralyze the true motor-fibres, stimulation of the nerve produces dilatation of the arteries without a corresponding muscular contraction. Quite a similar thing occurs in the salivary glands. Their cells, which form the saliva, are aroused to activity by special nerve-fibres; but the gland-nerve also contains a quite distinct set of vaso-dilator fibres which nor- mally cause a simultaneous dilatation of the gland-artery, though either can be artificially stimulated by itself and produce its effect alone. Through such arrangements the distribution of the blood in the Body at any moment is gov- erned : so that working parts shall have abundance and other parts less, while at the same time the general arterial pressure remains the same on the average; since the expansion of a few small local branches but little influences the total periph- eral resistance in the vascular system. Moreover, commonly when one set of organs is at work with its vessels dilated, others are at rest with their arteries comparatively contracted, and so a general average blood -pressure is maintained. Few persons, for example, feel inclined to do brain-work after a heavy meal: for then a great part of the blood of the whole Body is led off into the dilated vessels of the digestive organs, and the brain gets a smaller supply. On the other hand, when the brain is at work its vessels are dilated and often the whole head flushed : and so excitement or hard thought after a meal is very apt to produce an attack of indigestion, by diverting the blood from the abdominal organs, where it ought to be at that time. Young persons, whose organs have a superabuu- 280 THE HUMAN BODY. dance of energy enabling them to work under unfavorable conditions, are less apt to suffer in such ways than their eld- ers. One sees boys running actively about after eating, when older people feel a desire to sit quiet and ruminate — or even to go to sleep. When the nerve of a limb is cut and its peripheral end is stimulated the usual result is arterial constriction, because the constrictor fibres are more numerous and more powerful than the dilator; a day or two after section, when the nerve has begun to degenerate, stimulation, however, causes dilata- tion, apparently because the constrictor fibres degenerate more quickly: and when the stimuli (as induction shocks) given to the nerve are repeated at only a slow rate the dilator effect frequently overcomes the constrictor. The Vaso-dilator Centre. The vaso-dilator nerves, like the vaso-constrictor, seem to originate primarily in a centre in the rnedullaoblongata. In regard to the arteries in general, they play a much less conspicuous part than their analogues, the cardio-inhibitory fibres, do in regard to the heart. The Vaso-motor Nerves of the Veins. Most veins have a muscular coat, though it is much less developed than in the arteries, and this coat is probably under the control of nerve-fibres. Satisfactory evidence of their existence is still wanting. The Vascular Phenomena of Inflammation. When some transparent portion of an animal (for example the mesentery of a mouse or guinea-pig) is carefully exposed arid studied with a microscope, the normal flow in the small ves- sels may be studied for some time, much as in the web of the frog. If an irritant be applied, the immediate result is a widening of the small arteries and a greater and more rapid flow through them and the capillaries and veins. This seems dependent mainly on a direct paralysis of the arteries, and if the irritant be transient in its influence the congested con- dition soon passes off. If the irritant be more powerful, the vascular dilatation continues and other circulatory changes are seen. The corpuscles, instead of keeping, as is usual in arteries of microscope size, to the central part of the tube (axial current), spread more evenly, and the white cor- puscles especially tend to pass into the layer of liquid in im- mediate contact with the inner coat of the artery, and at the same time to exhibit much more marked amoeboid move- VASO-MOTOR NERVES AND NERVE-CENTRES. 281 merits than they commonly do while travelling in the blood- current. The platelets, also, which are normally confined to the axial currents, now pass towards the sides. If this stage of very early inflammation pass on to the next, it is observed that white corpuscles and platelets both stick to the inside of the vessels. The platelets next adhere together and break down into granular masses, and the white corpuscles thrust amoeboid processes between the lining-cells of the capillaries and smallest veins, and begin to push their way through. By these means a considerable impediment to the blood-flow is caused, and the circulation becomes slower, though all the vessels of the part may be dilated. If the inflammation con- tinue, many white corpuscles pass quite out of the vessels (migration) and enter the neighboring lymph-spaces: the red corpuscles get blocked and squeezed together into a mass in which their individual boundaries are indistinguishable, and some of them may even be squeezed through the walls of the capillaries (diapedesis). Next all blood-flow in the area under observation may be stopped, while more lymph than normal collects in it. From this state recovery may take place; or continued inflammation may lead to destruc- tion of the part. The primary local disturbances in the cir- culation seem due to changes in the inner coats of the vessels of the irritated region; but an extensive continued inflam- mation produces fever and many other secondary general results, partly through the absorption of disease products from the inflamed part and partly through irritation of afferent nerve-fibres which throw various nerve-centres into abnormal action. CHAPTER XIX. THE SECRETORY TISSUES AND ORGANS. Definitions. .In its broad etymological meaning a secre- tion is any substance separated or derived from the blood, so that in a certain sense all the solid tissues of the Body, built up from materials supplied by the blood, are secretions. In practice the name has a more limited application and is given to two classes of substances, distinguished as true or external secretions and internal secretions. Internal secretions are the results of the vital activities of various organs, their by-products, passed out directly into the lymph and blood; and in many cases are simple wastes, sent to the blood-stream for conveyance to other organs which get rid of them: such, for example, is the carbon dioxide formed in every part of the Body. In other cases the by- products of certain organs, after absorption into the blood, have to be further changed in a second organ before elimina- tion, and are probably of use to this second — a part of its pabulum: as an instance we may take leucin (amido-caproic acid), which is formed in many organs and, given by them, to the blood, is carried to the liver, the cells of which convert it (or at least a great part of it) into urea,' to. be subsequently eliminated by the kidneys. A third very important class of internal secretions consists of substances form-ed only in one organ or one pair of organs and yielded by them to the blood which flows through them, the presence of which substances in the blood is essential to the healthy nutrition and the con- tinuance of the life of the Body : in such cases removal or extensive disease of the producing organ results in death. Examples are to be found in substances which the thyroid body and suprarenal capsules produce; they will be consid- ered more fully in Ch&pter XXIII. Excluding such things as cast hairs and epidermic scales, the true or external secretions may be denned as gases or liquids, often of very complex composition, passed out on THE SECRETORY TISSUES AND ORGANS. 283 some free surface of the Body, either that of the general exterior or of some internal cavity, or into recesses commu- nicating with such a surface. The true secretions fall into two classes : one in which the product is of no further use in the Body and is merely separated for removal, as the urine; and one in which the product is intended to be used, for instance as a solvent in the digestion. of food. The former group are sometimes distinguished as excretions and the latter as secre- tion* proper, but there is no real difference between them, the organs and processes concerned being fundamentally alike in each case. A better division is into transudata and secretions, a transudation being a product which contains nothing which did not previously exist in the blood, and only in such quan- tity as might be derivable from it by merely physical processes; while a secretion in addition to transudation elements contains a specific element, due to the special physiological activity of the secretory organ; being either something which does not exist in the blood at all or something which, existing in the blood in small quantity, exists in the secretion in such a high proportion that it must have been actively picked up and conveyed there by the secretory tissues concerned. For in- stance, the gastric juice contains free hydrochloric acid which does not exist in the blood ; and the urine contains so much urea that we must suppose the kidney-cells to have a peculiar power of removing that body from the liquids flowing near them. This subdivision is also justifiable oh histological grounds; wherever there is a secreting surface or recess it is lined by cells, but these cells where transudata are formed (as on the serous membranes) are mere flat scales, with little or no protoplasm remaining in them (Fig. HB), while the cells which line a true secreting organ are cuboidal, spherical, or columnar, and still retain, with their high physiological activ- ity, a good deal of their primitive protoplasm. Organs of Secretion. The simplest form in which a secreting organ occurs (A, Fig. 104) is that of a flat membrane provided with a layer of cells, a, on one side (that on which the secretion is poured out) and with a network of capillary blood-vessels, c, on the other. The dividing membrane, b, is known as the basement membrane and is usually made up of flat, closely fitting connective-tissue corpuscles; supporting it on its deep side is a layer of connective tissue, d, in which the blood-vessels and lymphatics are supported. Such simple forms 284 THE HUMAN BODY. of secreting surfaces are found on the serous membranes, but are not common; in most cases an extended area is required to form the necessary amount of secretion, and if this were attained simply by spreading out plane surfaces, these from their number and extent would be hard to pack conveniently in the Body. Accordingly in most cases, the greater area is attained by folding the secreting surface in various ways so that a large area can be packed in a small bulk, just as a Chinese lantern when shut up occupies much less space than when extended, although its actual surface remains of the same extent. In a few cases the folding takes the form of protrusions into the cavity of the secreting organ as indicated at (7, Fig. 104, and found on some synovial membranes; but much more commonly the surface extension is attained in another way, the basement membrane, covered by its epithe- lium, being pitted in or involuted as at B. Such a secreting organ is known as a gland. Forms of Glands. In some cases the surface involutions are uniform in diameter, or nearly so, throughout (B, Fig. 104). Such glands are known as tubular; examples are found in the lining coat of the stomach (Fig. 113); also in the skin (Fig. 135), where they form the siveat-glands. In other cases the involution swells out at its deeper end and becomes more or less sacculated (E) ; such glands are racemose or acinous. The small glands which form the oily matter poured out on the hairs are of this type. In both kinds the lining cells near the deeper end are commonly different in character from the rest; and around that part of the gland the blood-vessels form a closer network. These deeper cells form the true secreting elements of the gland, and the passage, lined with different cells, leading from them to the surface, and serving merely to carry off the secretion, is known as the gland-duct. When the duct is undivided the gland is simple ; but when, as is more usual, it is branched and each branch has a true secret- ing part at its end, we get a compound gland, tubular (&) or racemose (F, If) as the case may be. In such cases the main duct, into which the rest open, is often of considerable length, ,so that the secretion is poured out at some distance from the main mass of the gland. A fully formed gland, H, thus comes to be a complex structure, consisting primarily of a duct, c, ductules, dd, and secreting recesses, ee. The ducts and ductules are lined witli THE SECRETORY TISSUES AND ORGANS. 285 epithelium which is merely protective and differs in charac- ter from the secreting epithelium which lines the deepest FIG. 104. — Forms of glands. A. a simple secreting: surface ; a. its epithelium ; b, basement membrane ; c, capillnries ; B, a simple tubular gland ; C, a secreting surface increased by protrusions ; E. a simple racemose gland ; D and Gr, com- pound tubular glands ; F, a compound racemose gland. In all but A, B, and C the capillaries are omitted for the sake of clearness. H, halt of a highly developed racemose gland ; c, its main duct. parts. Surrounding each subdivision and binding it to its neighbors is the gland stroma formed of connective tissue, a 286 THE HUMAN BODY. layer of which also commonly envelops the whole gland, as its capsule. Usually on looking at the surface of a large gland it is seen to be separated by partitions of its stroma, coarser than the rest, into lobes, each of which answers to a main division of the primary duct; and the lobes are often similarly divided into smaller parts or lobtiles. In the con- nective tissue between the lobes and lobules blood-vessels penetrate, to end in fine capillary vessels around the terminal recesses. They never penetrate the basement membrane. Lymphatics and nerves take a similar course; there is reason to believe that the nerve-fibres penetrate the basement mem- brane and become directly united with the secreting cells of some glands. The Physical Processes in Secretion. From the struc- ture of a gland it is clear that all matters derived from the blood and poured into its cavity must pass not only through the walls of the capillary blood-vessels, but also, by filtra- tion or dialysis, through the basement membrane and the lining epithelium. By filtration is meant the passage of a fluid under pressure through the coarser mechanical pores of a membrane, as in the ordinary filtering processes of a chemical laboratory ; and the higher the pressure on the liquid to be filtered the greater the amount which, other things being equal, will pass through in a given time. Since in the living Body the liquid pressure in the blood-capillaries is nearly always higher than that outside them, filtration is apt to take place everywhere to a greater or less extent, and will be increased in amount in any region by circum- stances raising blood-pressure there, and diminished by those lowering it. To a certain extent also the nature of the liquid filtered has an influence. True solutions, as those of salt in water, passed through unchanged ; but solutions con- taining substances such as boiled starch or raw egg-albumen, which swell up greatly in water rather than truly dissolve, are altered by filtration ; the filtrate containing less of the imperfectly dissolved body than the unfiltered liquid. The higher the pressure the greater the proportion of such sub- stances which gets through ; and if the pressure is slight the water or other solvent may alone pass, leaving all the rest behind on the filter. Under moderate pressure the blood may thus lose by filtration only such bodies as water and salines ; while an increase 'of arterial pressure may lead to THE SECRETORY TISSUES AND ORGANS. 287 the passage of albumen and fibrinogen. , Under healthy con- ditions, for example, the urine contains no albumen, but any- thing considerably increasing the capillary pressure in the kid- neys will cause it to appear. Dialysis or osmosis has already been considered (p. 42); by it substances pass through the in- termolecular pores of a membrane independently of the press- ure on either side, and for its occurrence two liquids of dif- ferent chemical constitution are required, one on each side of the membrane. At least if diffusion takes place, as is proba- ble, between two exactly similar solutions, the amount and character of the substances passing opposite ways in a given time are exactly equal, so that no change is produced by the dialysis; which practically amounts to the same thing as if none occurred. When a solution is placed on one side of a membrane allowing of dialysis, and pure water on the other, it is found that for every molecule of the dissolved body that passes one way a definite amount of water, called the en- dosmotic equivalent of that body, passes in the opposite direction. Crystalline bodies as a rule (haemoglobin is an exception) have a low endosmotic equivalent or are readily dialyzable; while colloids, such as gum and proteids, have a very high one, so that to get, by dialysis, a small amount of albumen through a membrane, a practically infinite amount of water must pass the other way. Accordingly, if we find such bodies in a secretion we cannot suppose that they have been derived from the blood by mere osmosis. The Chemical Processes of Secretion. As above pointed out certain secretions, called transudata, seem to be products of filtration and dialysis alone, containing only such sub- stances as those which are found in the blood-plasma, more or less altered in relative quantity by the ease or difficulty with which they severally passed through the layers met with on their way to the surface. But in many cases the composition of a secretion cannot be accounted for in this way ; it contains some specific element, either a substance which does not exist in the blood at all and must therefore have been added by the secreting membrane, or some body which, although existing in the blood, does so in such minute proportion, compared with that in which it is found in the secretion, that some special activity of the secreting cells is indicated : some affinity in them for these bodies by which they actively pick them up. 288 THE HUMAN BODY. Each living cell, we have seen, is the seat of constant chemical activity, taking up materials from the medium about it, transforming and utilizing them, and sooner or later restoring their elements, differently combined, to the outer medium. By such means it builds up and maintains its living substance, and obtains energy to carry on its daily .work. While this is true of all cells in the Body, we find certain groups in which chemical metabolism is the promi- nent fact — cells which are specialized for this purpose just as muscular fibre is for contraction or nerve-fibre for con- duction; and certain of these prominently metabolic tissues exist in the true glands and produce or collect the specific elements of their secretions. Their chemical processes are no doubt primarily directed to their own nutritive mainte- nance; they live primarily for themselves, but their nutritive processes are such that the bodies formed in them and sent into the secretion are such as to be useful to the rest of the cells of the community; or the bodies which they specially collect, and in a certain sense feed on, are those the removal of which from the blood is essential for the general good. Their individual nutritive peculiarities are utilized for the welfare of the whole Body. The Mode of Activity of Secretory Cells. If we con- sider the modes of activity of living cells in general, it be- comes clear that secretory cells may produce the specific element of a secretion in either of two ways. They may, as a by-result of their living play of forces, produce chemical changes in the surrounding medium ; or they may build up certain substances in themselves and then set them free as specific elements. Yeast, for example, in a saccharine solu- tion causes the rearrangement into carbon dioxide, alcohol, glycerine and succinic acid, of many atoms of carbon, hydro- gen and oxygen which previously existed as sugar; and a very considerable quantity of sugar may be broken up by the activity of a few living yeast-cells. How the latter act we do not know with certainty, but most likely by picking cer- tain atoms out of the sugar molecule, and leaving the rest to fall down into simpler compounds. On the other hand, we find cells which form and store up in themselves large quantities of substances, which they afterwards liberate; starch, for instance, being formed and laid by in many fruit-cells, and THE SECRETORY TISSUES AND ORGANS. 289 afterwards dissolved and sent in solution to nourish the young plant. Gland-cells might a priori give rise to the specific ele- ments of secretions in either of these ways, and we have to seek in which manner they work. Do they simply act as fer- ments (however that is) upon the surrounding medium; or do they form or collect the bodies characterizing their secretion, first within their own substance, and then liberate them, either disintegrating or not at the same time ? At present there is a large and an increasing mass of evidence in favor of the second view. There is, no doubt, some reason to believe that every living cell can act more or less as a ferment upon certain solutions should they come into contact with it. Not always, of course, as an alcoholic ferment, though even as regards that one fermentative power it seems very generally possessed by vegetable cells, and there is some evidence that alcohol is normally produced in small amount (and presumably by the fermentation of sugar) under the influence of certain of the living tissues of the Human Body. As regards distinctively secretory cells, however, the evidence is all the other way, and in many cases we can see the specific element collecting in the gland-cells before it is set free in the secretion. For example, in the oil-glands of the skin (Chapter XXVIII) we find the secreting cells, at first granular, nucleated, and protoplasmic, gradually under- going changes by which their protoplasm disappears and is replaced by oil-droplets, until finally the whole cell falls to bits and its detritus forms the secretion; the cells being re- placed by new ones constantly formed within the gland. In such cases the secretion is the ultimate product of the cell- life? the result of degenerative changes of old age occurring in it. In other cases, however, the liberation of the specific ele- ment is not attended with the destruction of the secreting cell; as an example we may take the pancreas, which is a large gland lying in the abdomen and forming a secretion used in digestion. Among others, this secretion possesses the power, under certain conditions, of dissolving proteids and converting them into dialyzable peptones (p. 10). This it owes to a specific element known as trypsin, the formation of which, or rather of its forerunner trypsinoyen, within the gland-cells can be traced with the microscope. 290 THE HUMAN BODY. The pancreas, like the majority of the glands connected with the alimentary canal, has an intermittent activity, de- termined by the presence or absence of food in various parts of the digestive tract. If the organ be taken from a recently killed dog which has fasted thirty hours and, after proper preparation, be stained with carmine and examined micro- scopically, we get specimens of what we may call the " rest- ing gland " — a gland which has not been secreting for some time. In these it will be seen that the cells lining the secret- ing recesses present two very distinct zones: an outer, next the basement membrane which combines with the coloring matter and is not granular, and an inner which is granular and does not pick up the carmine. The granules we shall find to be indications of the presence of a trypsin-yielding substance formed in the cells. If another dog be kept fasting until it has a good appetite and be then allowed to eat as much meat as it will, the animal will commonly take so much that the stomach will only be emp- tied at the end of about twenty hours. This period may, so far as the pancreas is concerned, be divided into two. From the time the food enters the stomach and on for about ten hours, the gland secretes abundantly; after that the secretion dwindles, and by the end of the second ten hours has nearly ceased. We have, then, a time during which the pancreas is working hard, followed by a period in which its activity is very little, but during which it is abundantly supplied with food-materials. The pancreas taken from an animal at the end of the first period and prepared for microscopic exami- nation will be found different from that taken from a dog killed at the end of the second digestion period, and also from the resting gland. Towards the end of the period of active work the gland-cells are diminished in size and the proportions of the granular and non-granular zones are quite altered. The latter now occupies most of the cell, while the granular non-staining inner zone is greatly diminished. During the secretion there is, therefore, a growth of the non- granular and a destruction of the granular zone; and the latter process rather exceeding the former, the whole secret- ing cell is diminished in size. During the second digestive period, when secretion is languid, exactly a reverse process takes place. The cells increase in size so as to become larger than those of the resting gland; and this growth is almost THE SECRETORY TISSUES AND ORGANS. 291 entirely due to the granular zone which now occupies most of the cell. These facts suggest that during secretion the granular part of the cells is used up : but that, simultaneously, the deeper non - granular zone, being formed from materials yielded by the blood, gradually renews the granular. Dur- ing active secretion the breaking down of the latter to yield the specific element occurs faster than its regenera- tion; in a later period, however, when the secretion is ceas- ing, the whole cell grows and, especially, the granular zone is formed faster than it is disintegrated; hence the great in- crease of that part of the cell. If this be so, then we ought to find some relationship between the digestive activity of an infusion or extract of the gland and the size of the granular zones of the cells; and it has been shown that such exists; the quantity of trypsin which can be obtained from a pan- creas being proportionate to the size of that portion of its cells. The trypsin, however, does not exist in the cells ready formed, but only a body which yields it under certain cir- cumstances, and called trypsinogen. If a perfectly fresh pancreas be divided into halves and one portion immediately minced and extracted with glyce- rine, while the other is laid aside for twenty-four hours in a warm place and then similarly treated, it will be found that the first glycerine extract has no power of digesting proteids, while the second is very active. In other words, the fresh gland does not contain trypsin, but only something which yields it under some conditions; among others, on being kept. The inactive glycerine extract of the fresh gland is, however, rich in trypsinogen : for if a little acetic acid be added to it, trypsin is formed and the extract becomes powerfully digestive. We may, then, sum up the life of a pancreas-cell in this way. It grows by materials derived from the blood and first laid down in the non-granular zone. This latter, in the ordi- nary course of the cell-life, gives rise to the granular zone; and in this is a store of trypsinogen produced by the active metabolisms of the cell. When the gland secretes, the tryp- sinogen is converted into trypsin and set free in the secre- tion; but in the resting gland this transformation does not occur. During secretory activity, therefore, the chemical 292 THE HUMAN BODY. processes taking place in the cell are different from those at other periods; and we have next to consider how this change in the mode of life of the cells is brought about. Influence of the Nervous System upon Secretion. When the gland is active it is fuller of blood than when at rest: its arteries are dilated and its capillaries gorged so that it gets a brighter pink color; this extra blood-supply might be the primary cause of the altered metabolism. Again, the activity of the pancreas is under the influence of the nervous system, as proved not only by the reflex secretion called forth when food enters the stomach, but also by the fact that electrical stimulation of the medulla oblongata will cause the gland to secrete. The nervous system may, however, only act through the nerves governing the calibre of the gland arteries, and so but indirectly on the secreting cells; while on the other hand it is possible that nerve-fibres act directly upon the gland-cells and, controlling their nutritive pro- cesses, govern the production of the trypsin. To decide be- tween the relative importance of these possible agencies we must pass to the consideration of other glands; since the question can only be decided by experiment upon the lower animals, and the position of the pancreas and the difficulty of getting at its nerves without such severe operations as upset the physiological condition of the animal furnish ob- stacles to its study which have not yet been overcome. In certain other glands, however, we find conclusive evi- dence of a direct action of nerve-fibres upon the secreting elements. When the sciatic nerve of a cat is stimulated electrically, the balls of its feet sweat. Under ordinary cir- cumstances they become at the same time red and full of blood; but that this congestion is a factor of subsidiary im- portance as regards secretion is proved by the facts that stim- ulation of the nerve is still able to excite the gland-cells and cause sweating in a limb which has been amputated ten or fifteen minutes (and in which therefore no circulatory changes can occur) and also by the cold sweats, with a pallid skin, of phthisis and the death-agony. It is, however, with reference to the submaxillary and parotid salivary glands that our in- formation is most precise. When the mouth is empty and the jaws at rest the sali- vary secretion is comparatively little : but a sapid substance placed on the tongue will -cause a copious flow. The phe- THE SECRETORY TISSUES AND ORGANS. 293 nomenon is closely comparable to the production of a reflex muscular contraction. A stimulus acting upon an irritable tissue excites through it certain afferent nerve-fibres; these excite a nerve-centre, which in turn stimulates efferent fibres; going to a muscle in the one case, to a gland in the other. It will be useful to consider again for a moment what occurs in the case of the muscle, taking account only of the efferent fibres and the parts they act upon. When a muscle in the Body is made to contract reflexly, through its nerve, two events occur in it. One is the short- ening of the muscular fibres; the other is the dilatation of the muscular arteries; every muscular nerve contains two sets of fibres, one motor and one vaso-dilator, and normally both act together. In this case, however, it is clear that the activities of both, though correlated, are essentially inde- pendent. The contraction is not due to the greater blood- flow, for not only can an excised muscle entirely deprived of blood be made to contract by stimulating its nerves, but in an animal to which a small dose of curari — the arrow-poison of certain South American Indians — has been given, stimu- lation of the nerve will cause the vascular dilatation but no muscular contraction: the curari paralyzing the motor fibres, but, unless in large doses, leaving the vaso-dilators intact. The muscular fibres themselves are unacted upon by the poi- son, as is proved by their ready contraction when directly stimulated by an electric shock. Now let us return to the salivary glands and see how far the facts are comparable. The main nerve of the sub- maxillary gland is known as the chorda tympani. If it be divided in a narcotized dog, and a tube placed in the gland- duct, no saliva will flow. But on stimulating the peripheral end of the nerve (that end still connected with the gland) an abundant secretion takes place. At the same time there is a great dilatation of the arteries of the organ, much more blood than before flowing through it in a given time: the chorda obviously then contains vaso-dilator fibres. Now in this case it might very well be that the process was different from that in a muscle. It is conceivable that the secretion may be but a filtration due to increased pressure in the gland capillaries, consequent on dilatation of the arteries supplying them. If a greater filtration into the lymph spaces of the gland took place, this liquid might then merely ooze on 294 THE HUMAN BODY. through the secreting cells into the commencing ducts as it passed through, dissolve out and carry on from the cells the specific organic elements of the secretion. Of these, in the submaxillary of the dog at least, mucin is the most im- portant and abundant. That, however, the process is quite different, and that there are in the gland true secretory fibres in addition to the vaso-dilator, just as in the muscle there are true motor fibres, is proved by other experiments. If the flow of liquid from the excited gland were merely the outcome of a filtration dependent on increased blood- pressure in it, then it is clear that the pressure of the secre- tion in the duct could never rise above the pressure in the blood-vessels of the gland. Now it is found, not only that the gland can be made to secrete in a recently decapitated animal, in which of course there is no blood-pressure, but that, when the circulation is going on, the pressure of the secretion in the duct can rise far beyond that in the gland arteries. Obviously, then, the secretion is no question of mere filtration, since a liquid cannot filter against a higher pressure. Finally, the proof that the vascular dilatation is quite a subsidiary phenomenon has been completed by show- ing that we can produce all the increased blood-flow through the gland without getting any secretion — that just as in a muscle nerve we can, by curari, paralyze the motor fibres and leave the vaso-dilators intact, so we can by atropin, the active principle of deadly nightshade, get similar phenomena in the gland. In an atropized animal stimulation of the chorda produces vascular dilatation but not a drop of secretion. Bringing blood to the cells abundantly will not make them drink; we must seek something more in the chorda than the vaso-dilator fibres — some proper secretory fibres; that the atropin acts upon them and not upon the gland-cells is shown, as in the muscle, by the fact that the cells still are capable of activity when stimulated otherwise than through the chorda tympani. For example, by stimulation of the sympathetic fibres going to the gland. So far, then, we seem to have good evidence of a direct action of nerve-fibres upon the gland-cells. But even that is not the whole matter. It is extremely probable, if not cer- tain, that there are two sets of secretory fibres in the gland- nerves: a set which so acts upon the cells as to make them pass on more abundantly the transudation elements of the THE SECRETORY TISSUES AND ORGANS. secretion (the water and mineral salts), and another, quite different, which governs the chemical transformations of the cells so as to make them produce mucin from mucigen pre- viously stored in them, in a way comparable to the production of trypsin from trypsinogen in the active pancreas. These latter fibres may be called " trophic," since they directly con- trol the cell metabolism: while the former may be called " transudatory " fibres. Some of the evidence which leads to thisconclusionis a little complex, but it is worth while to con- sider it briefly. In the first place, on stimulation of the chorda of an unexhausted gland (that is, a gland not over- fatigued by previous work) the following points can be noted : — With increasing strength of the stimulus the quantity of the secretion, that is of the water poured out in a unit of time, increases ; at the same time the mineral salts also in- crease, but more rapidly, so that their percentage in a rap- idly formed secretion is greater than in a more slowly formed, up to a certain limit. The percentage of organic constituents of the secretion also increases up to a limit; but soon ceases to rise, or even falls again, while the water and salts still increase. This of course is readily intelligible; since the water and salts can be derived continually from the blood, while the specific elements, coming from the gland- cells, may be soon exhausted ; and so far the experiment gives no evidence of the existence of distinct nerve-fibres for the salts and water, and for the specific elements: all vary together with the strength of the stimulus applied to the nerve. But under slightly different circumstances their quantities do not run parallel. The proportion of specific elements in the secretion is largely dependent on whether the gland has been previously excited or not. Prior stimula- tion, not carried on of course to exhaustion, largely increases the percentage of organic matters in the secretion produced by a subsequent stimulation; but has no effect whatever on the quantities of water and salts. These are governed en- tirely by the strength of the second stimulation. Here, then, we find that under similar circumstances the transuda- tory and specific elements of the secretion do not vary to- gether; and are therefore probably dependent upon different exciting causes. And the facts might lead us to suspect that there are in the chorda, besides the vaso-dilator, two 396 THE HUMAN BODY. other sets of fibres : one governing the salts and water, and the other the specific elements of the secretion. So far the evidence is, perhaps, not quite conclusive; but experiments upon the parotid gland of the dog put the matter beyond a doubt. The submaxillary gland receives fibres from the sympa- thetic system, as well as the chorda tympani from the cerebro- spinal. Excitation of the sympathetic fibres causes the gland to secrete, but the saliva poured out is different from that following chorda stimulation, which is in the dog abun- dant and comparatively poor in organic constituents, and accompanied by vascular dilatation : while the " sympathetic saliva," as it is called, is less abundant, very rich in inucin, and accompanied by constriction of the gland arteries. According to the above view we might suppose that the chorda contains many trausudatory and few trophic fibres, and the sympathetic many trophic and few transudatory. It might, however, well be objected that the greater rich- ness in organic bodies of the sympathetic saliva was really due to the small quantity of blood reaching the gland, when that nerve was stimulated. This might alter the nutritive phenomena of the cells and cause them to form mucin in unusual abundance, in which case the trophic influence of the nerve would be only indirect. Experiments on the parotid preclude this explanation. That gland, like the sub- maxillary, gets nerve-fibres from two sources: a cerebral and a sympathetic. The latter enter the gland along its artery, while the former, originating from the glosso-pharyngeal, run in a roundabout course to the gland. Stimulation of the cerebral fibres causes an abundant secretion, rich in water and salts, but with hardly any organic constituents. At the same time it produces dilatation of the gland arteries. Stim- ulation of the sympathetic causes contraction of the parotid gland arteries and no secretion at all. Nevertheless it causes great changes in the gland-cells. If it be first stimulated for a while and then the cerebral gland-nerve, the resulting secretion may be ten times as rich in organic bodies as that obtained without previous stimulation of the sympathetic; and a similar phenomenon is observed if the two nerves be stimulated simultaneously. So that the sympathetic nerve, though unable of itself to cause a secretion, brings about great chemical changes in the gland-cells. It is a distinct THE SECRETORY TISSUES AND ORGANS. 297 trophic nerve. This conclusion is confirmed by histology. Sections of the gland after prolonged stimulation of the sym- pathetic show its cells to be quite altered in appearance, and in their tendency to combine with carmine, when compared either with those of the resting gland or of the gland which has been made to secrete by stimulating its glosso-pharyngeal branch alone. We have still to meet the objection that the sympathetic fibres may be only indirectly trophic, .governing the meta- bolism of the cells through contraction of the blood-vessels. If this were so, cutting off or diminishing the blood-supply of the gland in any way ought to have the same result as stimulation of its sympathetic fibres. Experiment shows that such is not the case and reduces us to a direct trophic influ- ence of the nerve. When the arteries are closed and the cere- bral gland-nerve stimulated, it is found that the percentage of organic constituents in the secretion is as low as usual; it re- mains almost exactly the same whether the arteries are open or closed or have been previously open or closed. We must conclude that the peculiar influence of the sympathetic does not depend upon its vaso-constrictor fibres. These observations make it clear that the phenomena of secretion are dependent on very complex conditions, at least in the salivary glands and presumably in others. Primarily dependent upon filtration and dialysis from the blood-vessels and upon the physiological character of the gland-cells, both of these factors are, we find, controlled by the nervous system, such secreting cells being no more automatic than striped muscle; and the facts also give us important evidence of the power of the nervous system to influence cell nutrition directly. In other simpler cases, secretion seems to be a mere direct re- sult of the growth and life of the secreting cell; for example the formation, storage and discharge of fatty matters by the oil-glands of the skin. Summary. By secretion proper is meant the separation of such substances from the blood as are poured out on free surfaces of the Body, whether external or internal. In its simplest form it is merely a physical process dependent on fil- tration and dialysis; for example, the elimination of carbon dioxide from the surfaces of the lungs, and very watery liquid poured out on the surface of the serous membranes. Such secretions are known as transudata, and their amount is only 298 THE HUMAN BODY. indirectly controlled by the nervous system, through the in- fluence of the latter upon the circulation of the blood; they are however dependent on the structure of the cells concerned, so that the characters of the transudata and their quantity are altered when the cells are diseased. After death, too, the process of dialysis through such cells is different from that during life, for the living cell controls to a certain extent the nature and amount of the substances which it will allow to pass through it. The cells lining such surfaces are not, how- ever, secretory tissues in any true sense of the word. In other cases the lining cells are thicker, and more actively concerned in the process; they are then usually spread over the recesses of a much folded membrane, so that the whole is rolled up into a compact organ called a gland, the secre- tion of which may contain only transudation elements (as for example that of the lachrymal glands which form the tears) or may contain a specific element, formed in the gland by its cells, in addition to transudation elements. In both cases the activity of the organ may be influenced by the nervous system, usually in a reflex manner (e.g. the watering of the eyes when the eyeball is touched and the saliva poured into the mouth when food is tasted), but may also be otherwise excited, as for example the flow of tears under the influence of those changes of the central nervous system which are associated with sad emotions, or the water- ing of the mouth at the thought of dainty food. The nerves going to such glands, besides controlling their blood-vessels, act upon the gland-cells; one set governing the amount of transudation of water and salines which shall take place through them, and another (in the case of glands producing secretions with one or more specific elements) controlling the production of these, by starting new chemical processes in the cells by, which a substance built up in them during rest is converted into the specific element, which is soluble in and carried off by the transudation elements. What the specific element of a gland shall be, or whether its secretioii contain any, is dependent on the nature of its special cells; how much transudation and how much specific element shall be secreted at any time is controlled by the nervous system; just as the contractility of a muscle depends on the endow- ments of muscular tissue, and whether it shall rest or con- tract— and if the latter, how powerfully — upon its nerve. CHAPTER XX. , THE INCOME AND EXPENDITURE OF THE BODY. The Material Losses of the Body. All day long while life lasts each of us is losing something from his Body. The air breathed into the lungs becomes in them laden with carbon dioxide and water vapor, which are carried off with it when it is expired. The skin is as constantly giving off moisture, the total quantity in twenty-four hours being con- siderable, even when the amount passed out at any one time is so small as to be evaporated at once and so does not collect as drops of visible perspiration. The kidneys again are con- stantly at work separating water and certain crystalline ni- trogeneous bodies from the blood, along with some mineral salts. The product of kidney activity, however, not being forthwith carried to the surface but to a reservoir, in which it accumulates and which is only emptied at intervals, the ac- tivity of those organs appears at first sight intermittent. If to> these losses we add certain other waste substances passed into- the alimentary canal and got rid of along with the undigested residue of the food, and the loss of hairs and of dried cells from the surface of the skin, it is clear that the total amount of matter daily removed from the Body is considerable. The actual quantity varies with the individual, with the work done, and with the nature of the food eaten; but the follow- ing table (p. 300) gives approximately that of the more im- portant daily material losses of an average man. The living Body thus loses daily in round numbers 4 kilo- grams of matter (9 Ibs.) and, since it is unable to create new matter, this loss must be compensated for from the exterior or the tissues would soon dwindle away altogether; or at least until they were so impaired that life came to an end. After death the losses would be of a different kind, and their quan- tity much more dependent upon surrounding conditions; but except under very unusual circumstances the wasting away would still continue in the dead Body. Moreover, the compo- 299 300 THE HUMAN BODY. >H w s ^ a ft c fc xj - C3 OS 1 OO '• S ^ 55 i O CO Tf i o • o . o o o S pi 0 t-' t-" s fl O 0 10 10 TJH 1O 00 CO CO CO CO "^ 0 , CQ 1 5 <^ o s S ri § 10 10 0 O cb 06 oi CD 0 i CO CO T-H ^ o a* CO a 5-2 I O O O 00 O 00 c §T-H O7 CO* CO 1 CD IO T^ CO Tj< l- i 10 10 10 O 0 10 i cd -^ -^ oi o TH T-H CO CO ^ OS T-H s C5 CO "* ^ : a : 8 j 1 j 0) ^ 03 O * , 3 ^ ,_T « "cu § S'-S. •§• ** 1 ^ B § S^ -§ ! 1 i II I 0 l> P 02 O i INCOME AND EXPENDITURE OF THE BODY. 301 sition of the daily wastes of the living Body is tolerably con- stant; it does not simply lose a quantity. of matter weighing so much, but a certain amount of definite kinds of matter, carbon, nitrogen, oxygen, and so on; and these same sub- stances must be restored to it from outside, in order that life may be continued. To give a stone to one asking for bread might enable him, if he swallowed it, to make up the weight of matter lost in twenty-four hours; but bread would be needed to keep him alive. The Body not only requires a supply of matter from outside, but a supply of certain definite kinds of matter. The Losses of the Body in Energy. The daily expendi- ture of matter by the living Body is not the only one: as continuously it loses in some form or another energy, or the power of doing work; often as mechanical work expended in moving external objects, but even when at rest energy is con- stantly being lost to the Body in the form of heat, by radia- tion and conduction to surrounding objects, by the evaporation of water from the lungs and skin, and by removal in warm excretions. Unless the Body can make energy it must there- fore receive a certain supply of it also from the exterior, or it would very soon cease to carry on any of its vital work ; it would be unable to move and woui/l cool down to the temper- ature of surrounding objects. The discoveries of this century having shown that energy is as inuestructible and uncreatable (see Physics) as matter, we are led to look for the sources of the supply of it to the Body; and finding that the living Body daily receives it and dies when the supply is cut off, we no longer suppose, with the older physiologists, that it works by means of a mysterious vital force existing in or created by it; but that getting energy from the outside it utilizes it for its purposes — for the performance of its nutritive and other living work — and then returns it to the exterior in what the physi- cists know as a degraded state; that is, in a less utilizable condition. While energy like matter is indestructible it is, unlike matter, transmutable; iron is always iron and gold always gold; neither can by any means which we possess be converted into any other form of matter; and so the Body, needing carbon, hydrogen, oxygen, and nitrogen to build it and to cover its daily losses, must be supplied with those very substances. As regards energy this is not the case. While the total amount of it in the universe is constant, its form is 302 THE HUMAN BODY. constantly subject to change — and that one in which it enters the Body need not be that in which it exists while in it, nor that in which it leaves it. Daily losing heat and mechanical work the Body does not need, could not in fact much utilize energy, supplied to it in these forms; but it does need energy of some form and in amount equivalent to that which it loses. The Conservation of Energy. The forms of energy yet discovered are not nearly so numerous as the kinds of matter. Still we all know several of them; such as light, heat, sound, electricity, and mechanical work; and most people nowadays know, that some of these forms are interconvertible, so that directly or indirectly we can turn one into another. In such changes it is found that a definite amount of one kind always disappears to give rise to a certain quantity of the other; or, in other words, that so much of the first form is equivalent to so much of the second. In a steam-engine, heat is pro- duced in the furnace; when the engine is at work all of this energy does not leave it as heat; some goes as mechanical work, and the more work the engine does the greater is the difference between the heat generated in the furnace and that leaving the machine. If, however, we used the work for rub- bing two rough surfaces together we could get the heat back again, and if (which of course is impossible in practice) we could avoid all friction in the moving parts of the machine, the quantity thus restored would be exactly equal to the excess of the heat generated in the furnace over that leaving the engine. Having turned some of the heat into mechanical work we could thus turn the work back into heat again, and find it yield exactly the amount which seemed lost. Or we might use the engine to drive an electro-magnetic machine and so turn part of the heat liberated in its furnace first into mechanical work and that into electricity; and if we chose, to use the latter with the proper apparatus, we could turn more or less of it into light, and so have a great part of the energy which first became conspicuous as heat in the engine furnace, now manifested in the form of light at some distant point. In fact, starting with a given quantity of one kind of energy, we may by proper contrivances turn all or some of it into one or more other forms; and if we collected all the final forms and retransformed them into the first, we should have exactly the amount of it which had disappeared when the other kinds appeared. This law, that eneryv can INCOME AND EXPENDITURE OF THE BODY. 303 form but that its amount is invariable, that it cannot. V>P nrpafpd or destroyed but simply transmuted, is known as the law of tlie Uonservaiion of Energy (see Physics), and, like the inde- structibility of matter, lies at the basis of all scientific con- ceptions of the universe, whether concerned with animate or inanimate objects. Since all forms of energy are interconvertible it is con- venient in comparing amounts of different kinds to express them in terms of some one kind, by saying how much of that standard form the given amount of the kind spoken of would give rise to if completely converted into it. Since the most easily measured form of energy is mechanical work this is commonly taken as the standard form, and the quantities of others are expressed by saying how great a distance against the force of gravity at the earth's surface a given weight could be raised by the energy in question, if it were all spent in lifting the weight. The units of mechanical work being the kilogrammeter or the foot-pound, the mechanical equivalent of any given kind of energy is the number of kilogrammeters or foot-pounds of work its unit quantity would perform if converted into mechanical work and used to raise a weight. FW example the Uhlt quantity oi heaTTs that necessary to raise one kilogram of water one degree centigrade in temper- ature; or sometimes, in books written in English, the quan- tity necessary to warm one pound of water one degree Fahren- heit. When therefore we say that the mechanical equivalent of heat is 423 kilogrammeters we mean that the quantity of heat which would raise one kilogram of water in temperature from 4° C. to 5° C. would, if all turned into mechanical work, be able to raise one kilogram 423 meters against the attraction of the earth; and conversely, that this amount of mechanical work if turned into heat would warm a kilogram of water one degree centigrade. The mechanical equivalent of heat, taking the Fahrenheit thermometric scale and using feet and pounds as measures, is 772 foot-pounds. Potential and Kinetic Energy. At times energy seems to be lost. Ordinarily we only observe it when it is doing work and producing some change in matter:, but sometimes it is at rest, stored away and producing no changes that we recognize and thus seems to have been destroyed. Energy at work is known as kinetic energy; energy at rest, not produc- ing changes in matter, is called potential energy. Suppose a 304 THE HUMAN BODY. stone pulled up by a string and left suspended in the air. We know a certain amount of energy was used to lift it; but while it hangs we have neither heat nor light nor mechanical work to represent it. Still the energy is not lost; we know we have only to cut the string and the weight will fall, and striking something give rise to heat. Or we may wind up a spring and keep it so by a catch. In winding it up a certain amount of energy in the form of mechanical work was used 'to alter the form of the spring. Until the catch is removed this energy remains stored away as potential energy : but we know it is not lost. Once the spring is let loose again it may drive a clock or a watch, and in so doing will perform again just so much work as was spent in coiling it; and when the watch has run down this energy will all have been turned into other forms — mainly heat developed in the friction of the parts of the watch against one another: but partly also in producing movements of the air, a portion of which we ean readily observe in the sound of its ticking. The law of the conservation of energy does not say, then, that either the total potential or the total kinetic energy in the universe is constant in amount: but that the sum of the two is invariable, while constantly undergoing changes from kinetic to potential and vice versa : and from one form of kinetic to another. The Energy of Chemical Affinity. Between every two chemical atoms which are capable of entering into combina- tion there exists a certain amount of potential energy; when they unite this energy is liberated, usually in the form of heat, and once they have combined a certain amount of kinetic energy must be spent to pull them apart again; this being exactly the amount which was liberated when they united. The more stable the compound formed the more kinetic energy appears during its formation, and the more must be spent to break it up again. One may imagine the separated atoms as two balls pushed together by springs, the strength of the spring being proportionate to the degree of their chemical affinity. Once they are let loose and permitted to strike together the potential energy previously represented by the compressed springs disappears, and in its place we have the kinetic energy, represented by the heat developed when the balls strike together. To pull them apart again, against the springs, to their original positions, just so much mechani- cal work must be spent as is the equivalent of that amount INCOME AND EXPENDITURE OF THE BODY. 305 of heat which appeared when they struck; and thus kinetic energy will again become latent in breaking up the compound represented by the two in contact. The energy liberated in chemical combination is the most important source of that used in our machines: and also of that spent by the living Body. The Relation between the Matters Removed from the Body daily and the Energy Spent by it. A working loco- motive is, we know, constantly losing matter to the exterior in the form of ashes and gaseous products of combustion, the latter being mainly carbon dioxide and water vapor. The engine also expends energy, not only in the form of heat radiated to the air, but as mechanical work in drawing the cars against the resistance offered by friction or sometimes, np an incline, by gravity. Now the engine-driver knows that there is a close relationship between the losses of matter and the expenditure of energy, so that he has to stoke his furnace more frequently and allow a greater draft of air through it in going up a gradient than when running on the level. The more work the engine does the more coals and air it needs to make up for its greater waste. If we seek the cause of this relationship between work and waste, the first answer natu- rally is that the engine is a machine the special object of which is to convert heat into mechanical work, and so the more work it has to do the more heat is required for conver- sion, and consequently the more coals must be burnt. This, however, opens the question of the source of the heat — of all that vast amount of kinetic energy which is liberated in the furnace; and to answer this we must consider in what forms matter and energy enter the furnace, since the energy liber- ated there must be carried in somehow from outside. For present purposes coals may be considered as consisting of carbon and hydrogen, both of which substances tend to forcibly combine with oxygen at high temperatures, forming in the one case carbon dioxide and in the other water. The oxygen necessary to form these compounds being supplied by the air entering the furnace, all the potential energy of chemical affinity which existed between the uncombined elements becomes kinetic, and is liberated as heat when the combination takes place. The energy utilized by the engine is therefore supplied to it in the form of potential energy, associated with the uncombined forms of matter which reach 306 THE HUMAN BODY. the furnace. Once the carbon and hydrogen have combined with oxygen they are no longer of any use as liberators of energy; and the compounds formed if retained in the furnace would only clog it and impede farther combustion; they are therefore got rid of as wastes through the smoke-stack. The •engine, in short, receives uncombined elements associated with potential energy; and loses combined elements (which have lost the energy previously associated with them) and kinetic energy: it, so to speak, separates the energy from the matter with which it was connected, utilizes it, and gets rid of the exhausted matter. The amount of kinetic energy liberated during such chemical combinations is very great: a kilogram of carbon uniting with oxygen to form carbon dioxide sets free 8080 units of heat, or calories. During the combination of oxygen and hydrogen to form water even more energy is liberated, one kilogram of hydrogen when completely burnt liberating more than thirty-four thousand of the same units. The mechanical equivalent of this can be calculated if it is remembered that one heat unit = 423 kilogrammeters. Turning now to the living Body we find that its income and expenditure agree very closely with those of the steam- engine. It receives from the exterior substances capable of entering into chemical union; these combine in it and liber- ate energy; and it loses kinetic energy and the products of combination. From the outside it takes oxygen through the lungs, and oxidizable substances (in the form of foods) through the alimentary canal; these combine under the con- ditions prevailing in the living cells just as the carbon and oxygen, which will not unite at ordinary temperatures, com- bine under the conditions existing in the furnace of the engine; the energy liberated is employed in the work of the Body, while the useless products of combination are got rid of. To explain, then, the fact that our Bodies go on working we have no need to invoke some special mysterious power resident in them and capable of creating energy, a vital force having no relation with other natural forces, such as the older physiologists used to imagine. The Body needs and gets a supply of energy from the exterior just as the steam- engine does, food and air being to one what coals and air are to t-he other; each is a machine in which energy is liberated by chemical combinations and then used for special work; INCOME AND EXPENDITURE OF THE BODY. 307 the character of which depends upon the peculiarities of mechanism which utilizes it in each case, and not upon any peculiarity in the energy utilized or in its source. The Body is, however, a far more economical machine than any steam- engine; of all the energy liberated in the latter only a small fraction, about one eighth, is usefully employed, while our Bodies can utilize for the performance of muscular work alone one fifth of the whole energy supplied to them; leaving out of account altogether the nutritive and other work carried on in them, and the heat lost from them. The Conditions of Oxidation in the Living Body. Al- though the general principles applied in the Body and the steam-engine for getting utilizable energy are the same, in minor points obvious differences are found between the two. In the first place the coals of an engine are oxidized only at a very high temperature, one which would be instantly fatal to our Bodies, which, although warm when compared with the bulk of inanimate objects, are very slow fires when com- pared with a furnace. Chemistry and physics, however, teach us that this difference is quite unimportant so far as concerns the amount of energy liberated. If magnesium wire be ignited in the air it will become white-hot, flame, and leave at the end of a few seconds only a certain amount of incombustible rust or magnesia, which consists of the metal combined with oxygen. The heat and light evolved in the process represent of course the energy which, in a potential form, was associated with the magnesium and oxygen before their combination. We can, however, oxidize the metal in a different way, attended with no evolution of light and no very perceptible rise of temperature. If, for instance, we leave it in wet air it will become gradually turned into mag- nesia without having ever been hot to the touch or luminous to the eye. The process will, however, take days or weeks; and while in this slow oxidation just as much energy is liber- ated as in the former case, it now all takes the form of heat; and instead of being liberated in a short time is spread over a much longer one, as the gradual chemical combination takes place. The slowly oxidizing magnesium is, therefore, at no moment noticeably hot, since it loses its heat to sur- rounding objects as fast as it is generated. The oxidations occurring in our Bodies are of this slow kind. An ounce of arrowroot oxidized in a fire, and in the Human Body, would 308 THE HUMAN BODY. liberate exactly as much energy in one case as the other, but the oxidation would take place in a few minutes and at a high temperature in the former, and slowly, at a lower tem- perature, in the latter. In the second place, the engine dif- fers from the living Body in the fact that the oxidations in it all take place in a small area, the furnace, and so the tem- perature there becomes very high; while in our Bodies the oxidations take place all over, in each of the living cells; there is no one furnace or hearth where all the energy is lib- erated for the whole and transferred thence in one form or another to distant parts : and this is another reason why no one part of the Body attains a very high temperature. The Fuel of the Body. This is clearly different from that of an ordinary engine: no one could live by eating coals. This difference, again, is subsidiary; a gas-engine requires different fuel from an ordinary locomotive; and the Body re- quires a somewhat different one from either. It needs, as foods, substances which can, in the first place, be absorbed from the alimentary canal and carried to the various tissues; and, in the second, can be oxidized at a low temperature in the blood or tissues, or can be converted by the living cells into compounds which can be so oxidized. With some trivial exceptions, all substances which fulfil these conditions are complex chemical compounds, and to understand their utili- zation in the Body we must extend a little the statements above made as to the liberation of energy in chemical com- binations. The general law maybe stated thus: Energy is liberated whenever chemical union takes place: and whenever more stable compounds are formed from less stable ones, in which the constituent atoms were less firmly held together. Of the liberation by simple combination we have already seen an instance in the oxidation of carbon in a furnace; but the union need not be an oxidation. Every one knows how hot quicklime becomes when it is slaked; the water combining strongly with the lime, and energy being liberated in the form of heat during the process. Of the liberation of energy by the breaking down of a complex compound, in which the atoms are only feebly united, into simpler and stabler ones, we get an example in alcoholic fermentation. During that process grape-sugar is broken down into more stable com- pounds, mainly carbon dioxide and alcohol, while oxygen is at the same time taken up. To pull apart the carbon, hydro- INCOME AND EXPENDITURE OF THE BODY. 309 gen, and oxygen of the sugar molecule requires a certain expenditure of kinetic energy: but in the simultaneous for- mation of the new and stabler compounds a greater amount of energy is set free, and the difference appears as heat, so that the brewer frequently has to cool his vats with ice. It is by processes like this latter, rather than by direct combinations, that most of the kinetic energy of the Body is obtained; the complex proteids and fats and starches and sugar taken as food being broken down (usually with concomitant oxida- tion) into simpler and more stable compounds. Oxidation by Successive Steps. In the furnace of an engine the oxidation takes place completely at once. The carbon and hydrogen leaving it, if it is well managed, are each in the state of their most stable oxygen compound. But this need not be so: we might first oxidize the carbon so as to form carbon monoxide, CO, and get a certain amount of heat; and then oxidize the carbon monoxide farther so as to form carbon dioxide, C02, and get more heat. If we add together the amounts of heat liberated in each stage, the sum will be exactly the quantity which would have been obtained if the carbon had been completely burnt to the state of car- bon dioxide at first. Every one who has studied chemistry will think of many similar cases. As the process is impor- tant physiologically, we may take another example, say the oxidation of alcohol. This may be burnt completely and di- rectly, giving rise to carbon dioxide and water — C2H60 + 06 = 2C02 + 3H20 1 Alcohol. 6 Oxygen. 2 Carbon dioxide. 3 Water. But instead of this we can oxidize the alcohol by stages, get- ting at each stage only a comparatively small amount of heat evolved. By combining it first with one atom of oxygen, we get aldehyde and water — C,H60 -h 0 = C2H40 + H,0 1 Alcohol. 1 Oxygen. 1 Aldehyde. 1 Water. Then we add an atom of oxygen to the aldehyde and get acetic acid (vinegar)— C2H40 + 0 - C2H40, 1 Aldehyde. 1 Oxygen. 1 Acetic acid. 310 THE HUMAN BODY. And finally we may oxidize the acetic acid so as to get carbon dioxide and water — We get, in both cases, from one molecule of alcohol, two of carbon dioxide and three of water; and six atoms of oxy- gen are taken up. In each stage of the gradual oxidation a certain amount of heat is evolved; and the sum of these is exactly the amount which would have been evolved by burn- ing the alcohol completely at once. The food taken into the Body is for the most part oxi- dized in this gradual manner; the products of imperfect combustion in one set of cells being carried off and more completely oxidized in another set, until the final products, no longer capable of further oxidation in the Body, are car- ried to the lungs, or kidneys, or skin, and got rid of. A great object of physiology is to trace all intermediate compounds between the food which enters and the waste products which leave; to find out just how far chemical degradation is carried in each organ, and what substances are thus formed in vari- ous parts : but at present this part of the science is very im- perfect. The Utilization of Energy in the Human Body. In the steam-engine energy is liberated as heat; some of the heat is used to evaporate water and expand the resulting steam ; and then the steam to drive a piston. But in the living Body it is very probable (indeed almost certain) that a great part of the energy liberated by chemical transformations does not first take the form of heat; though some of it does. This, again, does not affect the general principle: the source of energy is essentially the same in both cases; it is merely the form which it takes that is different. In a galvanic cell energy is liberated during the union of zinc and sulphuric acid, and we may so arrange matters as to get this energy as heat; but on the other hand we may lead much of it off, as a galvanic current, and use it to drive a magneto-electric machine before it has taken the form of heat at all. In fact, that heat may be used to do mechanical work we must reduce some of it to a lower temperature: an engine needs a con- denser of some kind as well as a furnace; and, other things being equal, the cooler the condenser the greater the proper- INCOME AND EXPENDITURE OF THE BODY. 311 tion of the whole heat liberated in the furnace which can be used to do work. Now in a muscle there is no condenser; its temperature is uniform throughout. So when it contracts and lifts a weight, the energy employed must be liberated in some other form than heat — some form which the muscular fibre can use without a condenser. Summary. The living Body is continually losing mat- ter and expending energy. So long as we regard it as work- ing by virtue of some vital force, the power of generating which it has inherited, the waste is difficult to account for, since it is far more than we can imagine as due merely to wear and tear of the working parts. When, however, we con- sider the nature of the income of the Body, and of its ex- penditure, from a chemico-physical point of view, we get the clue to the puzzle. The Body does not waste because it works, but works because it wastes. The working power is obtained by chemical changes occurring in it, associated with the liberation of energy which the living cells utilize; and the products of these chemical changes, being no longer available as sources of energy, are passed out. The chemical changes concerned are mainly the breaking down of complex and unstable chemical compounds into simpler and more stable ones, with concomitant oxidation. Accordingly the material losses of the Body are highly or completely oxidized, tolerably simple, chemical compounds; and its material in- come is mainly nncombined oxygen and oxidizable substances, the former obtained through the lungs, the latter through the alimentary canal. In energy, its income is the potential energy of uncombined or feebly combined elements, which are capable of combining or of forming more stable com- pounds; and its final expenditure is kinetic energy almost entirely in the form of mechanical work and heat. Given oxygen, all oxidizable bodies will not serve to keep the Body alive and working, but only those which (1) are capable of absorption from the alimentary canal and (2) those which are oxidizable at the temperature of the Body under the influ- ence of protoplasm. Just as carbon and oxygen will not unite in the furnace of an engine unless the fire be lighted by the application of a match but, when once started, the heat evolved at one point will serve to bring about the conditions of combination through the rest of the mass, so the oxida- tions of the Body only occur under special conditions; and 312 THE HUMAN BODY. these are transmitted from parent to offspring. Every new Human Being starts as a portion of protoplasm separated from a parent and affording the conditions for those chemi- cal combinations which supply to living matter its working power: this serves, like the energy of the burning part of a fire to start similar 'processes in other portions of matter. At present we know nothing in physiology answering to the match which lights a furnace: those manifestations of energy which we call life are handed down from generation to gen- eration, as the sacred fire in the temple of Vesta from one watcher to another. Science may at some time teach us how to bring the chemical constituents of protoplasm into that combination in which they possess the faculty of starting oxidations under those conditions which characterize life; then we shall have learnt to strike the vital match. For the present we must be content to study the properties of that form of matter which possesses living faculties; since there is no satisfactory proof that it has ever been produced, within our experience, apart from the influence of matter already living. How the vital spark first originated, how molecules of carbon, hydrogen, nitrogen and oxygen first united with water and salts to form protoplasm, we have no scientific data to ground a positive opinion upon, and such as we may have must rest upon other grounds. CHAPTER XXj. FOODS. Foods as Tissue-formers. Hitherto we have considered foods merely as source of energy, but they are also required to build up the substance of the Body. From birth to man- hood we increase in bulk and weight, and that not merely by accumulating water and such substances, but by forming more bone, more muscle, more brain, and so on, from materials which are not necessarily bone or muscle or nerve-tissue. Alongside of the processes by which complex substances are broken down and oxidized and energy liberated, constructive processes take place by which new complex bodies are formed from simpler substances taken as food. A great part of the energy liberated in the Body is in fact utilized first for this purpose, since to construct complex unstable molecules, like those of protoplasm, from the simpler compounds taken into the Body, needs an expenditure of kinetic energy. Even after full growth, when the Body ceases to gain weight, the same synthetic processes go on; the living tissues are steadily broken down and constantly reconstructed, as we see illus- trated by the condition of a man who has been starved for some time, and who loses not only his power of doing work and of maintaining his bodily temperature but also a great part of his living tissues. If again fed properly he soon makes new fat and new muscle and regains his original mass. Another illustration of the continuance of constructive powers during the whole of life is afforded by the growth of the muscles when exercised properly. Since the tissues, on ultimate analysis, yield mainly car- bon, hydrogen, nitrogen and oxygen, it might be supposed a priori that a supply of these elements in the uncombined state would serve as material for the constructive forces of the Body to work with. Experience, however, teaches us that this is not the case, but that the animal body requires, for the most part, highly complex compounds for the con- 314 THE HUMAN BODY. struction of new tissue elements. All the active tissues yield on analysis large quantities of proteids which, as pointed out in Chapter I, enter always into the structure of protoplasm. Now, so far as we know at present,* the animal body is unable to build up proteids from simpler compounds of nitrogen, although when given one variety of them it can convert that one into others, and combine them with other things to form protoplasm. Hence proteids are an essential article of diet, in order to replace the proteid of the living cells which is daily broken down and eliminated in the form of urea and other waste substances. Even albuminoids (p. 10), although so nearly allied to proteids, will not serve to replace them entirely in a diet; a man fed abundantly on gelatine, fats, and starches would starve as certainly, though not so quickly, as if he got no nitrogenous food at all: his tissue waste would not be made good, and he would at last be no more able to utilize the energy-yielding materials supplied to him than a worn-out steam-engine could employ the heat of a fire in its furnace. So, too, the animal is unable to take the carbon for the construction of its tissues, from such simple compounds as carbon dioxide.* Its constructive power is limited to *he utilization of the carbon contained in more complex and less stable compounds, such as proteids, fats or sugars. Nearly all the tissue-forming foods must therefore consist of complex substances, and of these a part must be proteids, since the Body can utilize nitrogen for tissue formation only when supplied with it in that form.* The bodies thus taken in are sooner or later broken down into simpler ones and eliminated; some at once in order to yield energy, others only after having first been built up into part of a living cell. The partial exceptions afforded by such losses to the Body as milk for suckling the young, or the albuminous and fatty bodies stored for the same purpose in the egg of a bird, are only apparent; the chemical degradation is only postponed, taking place in the body of the offspring instead of that of the parent. In all cases animals are thus, essentially, proteid consumers or wasters, and breakers down of complex bodies; the carbon, hydrogen, and nitrogen which they take as foods in the form of complex unstable bodies, ultimately leaving * There is some reason to believe tliat some few of the lower animals which contain chlorophyl can manufacture proteids and utilize carbon dioxide. FOODS. 315 them in the simpler compounds, carbon dioxide, water, and urea; which are incapable of either yielding energy or build- ing tissue for any other animal and so of serving it as food. The question immediately suggests itself — How, since animals are constantly breaking up these complex bodies and cannot again build them, is the supply kept up ? For example, the supply of proteids. substances which cannot be made arti- ficially by any process which we know, and yet are necessary foods for all animals, and daily destroyed by them. The Food of Plants. As regards our own Bodies the question at the end of the last paragraph might perhaps be answered by saying that we get our proteids from the flesh of the other animals which we eat. But, then, we have to account for the possession of them by those animals; since they cannot make them from urea and carbon dioxide and water any more than we can. The animals eaten get them, in fact, from plants which are the great proteid formers of the world, so that the most carnivorous animal really depends for its most essential foods upon the vegetable kingdom ; the fox that devours a hare in the long-run lives on the proteids of the herbs that the hare had previously eaten. All animals are thus, in a certain sense, parasites; they only do half of their own nutritive work, just the final stages, leaving all the rest to the vegetable kingdom and using the products of its labor ; and plants are able to meet this demand because they can live on the simple compounds of carbon, hydrogen, and nitrogen eliminated by animals, building up out of them new complex substances \vhich animals can use as food. A green plant, supplied with ammonium salts, carbon dioxide, water, and some minerals, will grow and build up large quantities of proteids, fats, starches, and similar things; it will pull the stable compounds eliminated by animals to pieces, and build them up into complex unstable bodies, capable of yielding energy when again broken down. However, to do such work, to break up stable combinations and make from them less stable, needs a supply of kinetic energy which disappears in the process, being stored away as potential energy in the new compound ; and we may ask whence it is that the plant gets the supply of energy which it thus utilizes for chemical con- struction, since its simple and highly oxidized foods can yield it none. It has been proved that for this purpose the green plant uses the energy of sunlight : those of its cells which con- 316 THE HUMAN BODY. tain the substance called chloropUyl (leaf green) have the power of utilizing energy in the form of light for the performance of chemical work, just as a steam-engine can utilize heat for the performance of mechanical work. Exposed to light, and re- ceiving carbon dioxide from the air, and water and ammonia (which is produced by the decomposition of urea) and other simple nitrogen compounds from the soil, the plant builds them up again, with the elimination of oxygen, into complex bodies like those which animals broke down with fixation of oxygen. Some of the bodies thus formed it uses for its own growth and the formation of new protoplasm, just as an animal does; but in sunlight it forms more than it uses, and the excess stored up in its tissues is used by animals. In the long- run, then, all the energy spent by our Bodies comes through millions of miles of space from the sun; but to seek the source of its supply there would take us far out of the domain of Physiology. Non-oxidizable Foods. Besides our oxidizable foods, a large number of necessary food-materials are not oxidizable, or at least are not oxidized in the Body. Typical instances are afforded by water and common salt. The use of these is in great part physical : the water, for instance, dissolves ma- terials in the alimentary canal, and carries the solutions through the walls of the digestive tube into the blood and lymph vessels, so that they can be carried from part to part ; and it permits interchanges to go on by diffusion. The salines also influence the solubility and chemical interchanges of other things present with them. Serum albumen, the chief proteid of the blood, for example, is insoluble in pure water, but dissolves readily if a small quantity of neutral salts is present. Besides such uses the non-oxidizable foods have probably others, in what we may call machinery formation. In the salts which give their hardness to the bones and teeth, we have an example of such an employment of them : and to a less extent the same may be true of other tissues. The Body, in fact, is not a mere store of potential energy, but something more — it is a machine for the disposal of it in cer- tain ways; and, wherever practicable, it is clearly advanta- geous to have the purely energy-expending parts made of non-oxidizable matters, and so protected from change and the necessity of frequent renewal. The Body is a self -build- ing and self-repairing machine, and the material for this FOODS. 317 building and repair must be supplied in the food, as well as the fuels, or oxidizable foods, which yield the energy the machine expends; and while experience shows us that even for machinery construction oxidizable matters are largely needed, it is nevertheless a gain to replace them by non-oxi- dizable substances when possible; just as if practicable it would be advantageous to construct an engine out of mate- rials which would not rust, although other conditions deter- mine the use of iron for the greater part of it. Definition of Foods. Foods may be defined as substances which, when taken into the alimentary canal, are absorbed from it, and then serve either to supply material for the growth of the Body, or for the replacement of matter which has been removed from it, either after oxidation or without having been oxidized. Foods to replace matters which have been oxidized must be themselves oxidizable; they are force- generators, but may be and generally are also tissue-formers; and are nearly always complex organic substances derived from other animals or from plants. Foods to replace matters not oxidized in the Body are force-regulators, and are for the most part tolerably simple inorganic compounds. Among the force-regulators we must, however, include certain organic foods which, although oxidized in the Body and serving as liberators of energy, yet produce effects totally dispropor- tionate to the energy they set free, and for which effects they are taken. In other words, their influence as stimuli in excit- ing certain tissues to liberate energy, or as inhibitory agents checking the activity of parts, is more marked than their direct action as force -generators. As examples, we may take condiments: mustard and pepper are not of much use as sources of energy, although they no doubt yield some; we take them for their stimulating effect on the mouth and other parts of the alimentary canal, by which they promote an increased flow of the digestive secretions or an increased appetite for food. Thein and caffein, the active principles of tea and coffee, are taken for their stimulating effect on the nervous system, rather than for the amount of energy yielded by their own oxidation. Conditions which a Pood must Fulfil. (1) A food must contain the elements which it is to replace in the Body: but that alone is not sufficient. The elements leaving the Body being usually derived from the breaking down of com- 318 THE HUMAN BODY. plex substances in it, the food must contain them either in the form of such complex substances, or in forms which the Body can build up into them, Free nitrogen and hydrogen are no use as foods, since they are neither oxidizable under the conditions prevailing in the Body (and consequently can- not yield it energy), nor are they capable of construction by it into its tissues. (2) Food after it has been swallowed is still in a strict sense outside the Body; the alimentary canal is merely a tube running through it, and so long as food lies there it does not form any part of the Body proper. Hence foods must be capable of absorption from the alimentary canal; either directly, or after they have been changed by the processes of digestion. Carbon, for example, is useless as food, not merely because the Body could not build it up into its own tissues, but because it cannot be absorbed from the alimentary canal. (3) Neither the substance itself nor any of the products of its transformation in the Body must be injurious to the structure or activity of any organ. If so it is a poison, not a food. Alimentary Principles. The articles which in common language we call foods are, in most cases, mixtures of several foodstuffs, with substances which are not foods at all. Bread, for example, contains water, salts, gluten (a proteid), some fats, much starch, and a little sugar; all true foodstuffs: but mixed with these is a quantity of cellulose (the chief chemical constituent of the walls which surround vegetable cells), and this is not a food since it is incapable of absorption from the alimentary canal. Chemical examination of all the common articles of diet shows that the actual number of important foodstuffs is but small: they are repeated in various propor- tions in the different things we eat, mixed with small quan- tities of different flavoring substances, and so give us a pleas- ing variety in our meals; but the essential substances are much the same in the fare of the workman and in the " delicacies of the season." These primary foodstuffs, which are found repeated in so many different foods, are known as " alimentary principles" ; and the physiological value of any article of diet depends on them far more than on the traces of flavoring matters which cause certain things to be espe- cially sought after and so raise their market value. The alimentary principles may be conveniently classified into FOODS. 319 proteids, albuminoids, hydrocarbons, carbohydrates, and inor- ganic bodies. Proteid or Albuminous Alimentary Principles. Of the nitrogenous foodstuffs the most important are proteids: they form an essential part of all diets, and are obtained both from animals and plants. The most common and abundant are myosin and syntonin, which exist in the lean of all meats; egg albumen; casein, found in milk and cheese; gluten and vege- table casein from various plants. Gelatinoid or Albuminoid Alimentary Principles. These also contain nitrogen, but cannot replace the proteids entirely as foods; though a man can get on with less proteids when he has some albuminoids in addition. The most important is gelatin, which is yielded by the white fibrous tissue of animals when cooked. On the whole the gelatinoids are not foods of high value, and the calf's-foot jelly and such compounds, often given to invalids, have not nearly the nutritive value they are commonly supposed to possess. Hydrocarbons (Fats and Oils). The most important are stearin, palmatin, and olein, which exist in various propor- tions in animal fats and vegetable oils; the more fluid contain- ing more olein. Butter contains also a little of a fat named butyrin. Fats are compounds of glycerine and fatty acids, and any such substance which is fusible at the temperature of the Body will serve as a food. The stearin of beef and mutton fats is not by itself fusible at the body temperature, but is mixed in those foods with so much olein as to be melted in the alimentary canal. Beeswax, on the other hand, is a fatty body which will not melt in the intestines and so passes on unabsorbed; although from its composition it would be useful as a food could it be digested. A distinction is some- times made between fats proper (the adipose tissue of ani- mals consisting of fatty compounds inclosed in albuminous cell-walls) and oils, or fatty bodies which are not so organized. Carbohydrates. These are mainly of vegetable origin. The most important are starch, found in nearly all vegetable foods ; dextrin ; gums ; grape-sugar, called also dextrose or glucose (into which starch is converted during digestion) ; and cane-sugar. Sugar of milk and glycogen are alimentary prin- ciples of this group, derived from animals. All of them, like the fats, consist of carbon, hydrogen and oxygen; but the per- 320 THE HUMAN BODY. centage of oxygen in them is much higher, there being one atom of oxygen for every two of hydrogen in their molecule. Inorganic Foods. Water; common salt; and the chlo- rides, phosphates, and sulphates of potassium, magnesium and calcium. More or less of these bodies, or the materials for their formation, exists in all ordinary articles of diet, so that we do not swallow them in a separate form. Phosphates, for example, exist in nearly all animal and vegetable foods; while other foods, as casein, contain phosphorus in combina- tions which in the Body yield it up to be oxidized to form phosphoric acid. The same is true of sulphates, which are partially swallowed as such in various articles of diet, and are partly formed in the Body by the oxidation of the sulphur of various proteids. Calcium salts are abundant in bread, and are also found in many drinking-waters. Water and table- salt form exceptions to the rule that inorganic bodies are eaten imperceptibly along with other things, since the Body loses more of each daily than is usually supplied in that way. It has, however, been maintained that salt, as such, is an unnecessary luxury; and there seems some evidence that certain savage tribes live without more than they get in the meat and vegetables they eat. Such tribes are, however, said to suffer especially from intestinal parasites; and there is no doubt that to civilized man the absence of salt is a great privation. Calcium seems to be an essential constituent of all living cells and in some way closely connected with the manifestation of their activity. As previously mentioned the heart of a frog after thorough irrigation with dilute solution of sodium chloride ceases to beat, but resumes its pulsations when a minute trace of calcium chloride is added to the solution; and while ordinary serum restores the beat of such a washed- out heart, serum from which all its calcium has been removed does not. Moreover if defibrinated blood to which a little more sodium oxalate than is sufficient to precipitate all its calcium has been added, be circulated through the vessels of a muscle, the latter loses, its contractility, apparently because the slight excess of oxalate precipitates the calcium of the muscle-fibres; for the contractility may be restored by sup- plying some dissolved calcium chloride. Nerves treated simi- larly lose their irritability"; and the eggs of some aquatic FOODS. 321 animals will not develop normally in water from which all calcium salts have been removed. Mixed Poods. These, as already pointed out, include nearly all common articles of diet; they contain more than one alimentary principle. Among them we find great differ- ences; some being rich in proteids, others in starch, others in fats, and so on. The formation of a scientific dietary depends on a knowledge of these characteristics. The foods eaten by man are, however, so varied that we cannot do more than consider the most important. Flesh. This, whether derived from bird, beast, or fish, consists essentially of the same things — muscular fibres, connective tissue and tendons, fats, blood-vessels, and nerves. It contains several proteids, especially rnyosin; gelatin-yield- ing matters in the white fibrous tissue; stearin, palmatin, and olein as representatives of the fats; and a small amount of carbohydrates in the form of glycogen and grape-sugar, or some chemically allied substances. Flesh also contains much water and a considerable number of salines, the most important and abundant being potassium phosphate. Osmazome is a crystalline nitrogenous body which gives much of its taste to flesh; and small quantities of various similar substances exist in different kinds of meat. There is also more or less yellow elastic tissue in flesh ; it is indigestible and useless as food. When meat is cooked its white fibrous tissue is turned into gelatin, and the whole mass becomes thus softer and more easily disintegrated by the teeth. When boiled some of the proteid matters of the meat pass out into the broth, and there in part coagulate and form the scum : this loss may be prevented in great part by putting the raw meat at once into boiling water which coagulates the surface albumen be- fore it dissolves out, and this keeps in the rest, while the subsequent cooking is continued slowly. In any case the myosin, being insoluble in water, remains behind in the boiled meat. In baking or roasting, all the solid parts of the flesh are preserved and certain agreeably flavored bodies are produced, as to the nature of which little is known. Eggs. These contain a large amount of egg albumen and, in the yolk, another proteid, known as vitellin. Also fats, and a substance known as lecithin, which is important as containing a considerable quantity of phosphorus. Leci- 322 THE HUMAN BODY. thin, or rather a substance yielding it, is an important con- stituent of the nervous tissues. Milk contains a proteid, caseinogen; several fats in the butter; a carbohydrate, milk-sugar; much water; and salts, especially potassium and calcium phosphates. Butter consists mainly of the same fats as those in beef and mutton; but has in it about one per cent of a special fat, butyrin. In the milk it is disseminated in the form of minute globules which, for the most part, float up to the top when the milk is let stand and then form the cream. In this each fat-droplet is sur- rounded by a pellicle of albuminous matter; by churning, these pellicles are broken up and the fat-droplets then run to- gether to form the butter. Caseinogen is insoluble in water; in milk it is dissolved by the alkaline salts present. When milk is kept, its sugar ferments and gives rise to lactic acid, which neutralizes the alkali and precipitates the caseinogen as curds. In cheese-making the caseinogen is acted upon by a ferment (rennin) present in the extract of stomach used, and converted into tyrein which is precipitated : this clotting does not take place unless a calcium salt be present. Tyrein, which forms the main bulk of a true cheese, is different from the curd precipitated from milk by acids; cheese made from the latter does not " ripen.'' Caseinogen is frequently called casein, which name should be given to the tyrein formed from caseinogen by ferment action. Vegetable Foods. Of these wheat affords the best. In 1000 parts it contains 135 of proteids, 568 of starch, 46 of dextrin (a carbohydrate), 49 of grape-sugar, 19 of fats, and 32 of cellulose, the remainder being water and salts. The proteid of wheat is mainly gluten, which when moistened with water forms a tenacious mass, and this it is to which wheaten bread owes its superiority. When the dough is made yeast is added to it, and produces a fermentation by which, among other things, carbon dioxide gas is produced. This gas, imprisoned in the tenacious dough, and expanded during baking, forms cavities in it and causes it to "rise" and make "light bread," which is not only more pleasant to eat but more digestible than heavy. Other cereals may con- tain a larger percentage of starch, but none have so much gluten as wheat; when bread is made from them the carbon dioxide gas escapes so readily from the less tenacious dough that it does not expand the mass properly. Corn contains in FOODS. 323 1000 parts, 79 of proteids, 637 of starch, and from 50 to 87 of fats; much more than any other kind of grain. Rice is poor in proteids (5G parts in 1000) but very rich in starch (823 parts in 1000). Peas and leans are rich in proteids (from 220 to 260 parts in 1000), and contain about half their weight of starch. Potatoes are a poor food. They contain a great deal of water and cellulose, and only about 13 parts of proteids and 154 of starch in 1000. Other fresh vegetables, as carrots, turnips, and cabbages, are valuable mainly for the salts they contain ; their weight is mainly duQ to water, and they contain but little starch, proteids, or fats. Fruits, like most fresh vegetables, are mainly valuable for their saline constituents, the other foodstuffs in them being only present in small proportion. Some fruit or vegetable is, however, a necessary article of diet ; as shown by the scurvy which used to prevail among sailors before fresh or canned vegetables and lime-juice were supplied to them. The Cooking of Vegetables. This is of more importance even than the cooking of flesh, since in most the main ali- mentary principle is starch, and raw starch is difficult of digestion. In plants starch is nearly always stored up in the form of solid granules, which consist of alternating layers of starch cellulose and starch yranulose. The digestive fluids turn the starch into sugars which are soluble and can be absorbed from the alimentary canal, while starch itself can- not. These fluids act slowly and imperfectly on raw starch, and then only on the granulose; but when boiled, the starch granules swell up, and become more readily converted into sugars, and the starch cellulose is so altered that it too un- dergoes that change. When starch is roasted it is in part turned into a substance known as soluble starch which is read- ily dissolved in the alimentary canal. There is, therefore, a scientific foundation for the common belief that the crust of a loaf is more digestible than the crumb, and toast than ordi- nary bread. Alcohol. There are perhaps no common articles of diet concerning which more contradictory statements have been made than alcoholic drinks. This depends upon their pe- culiar position: according to circumstances alcohol may be a poison or be useful; when useful it may be regarded either as a force-regulator or a force-generator. It is sometimes a valuable medicine, but it does no good to the healthy body. 324 THE HUMAN BODY. If not more than two ounces (which would be contained in about four ounces of whiskey or two quarts of lager-beer) are taken in the twenty-four hours, they are completely oxidized in the Body and excreted as water and carbon dioxide. In this oxidation energy is of course liberated and can be util- ized. Commonly, however, alcohol is not taken for this pur- pose but as a force-regulator, for its influence on the nervous system or digestive organs, and it is in this capacity that it becomes dangerous. For not only may it be taken in quan- tities so great that it is not at all oxidized in the Body but is passed through it as alcohol, or even that it acts as a narcotic poison instead of a stimulant, but when taken in what is called moderation there can be no doubt that the constant " whipping up " of the flagging organs, if continued, must be dangerous to their integrity. Hence the daily use of alcohol merely in such quantities as to produce slight exhilaration or to facilitate work is by no means safe; though in disease when the system wants rousing to make some special effort, the physician cannot dispense with it or some other similarly acting substance. In fact, as a force-generator alcohol may be advantageously replaced by other foods in nearly all cases; and there is no evidence that it helps in the construction of the working tissues, though its excessive use often leads to an abnormal accumulation of fat. Its proper use is as a " whip," and one has no more right to use it to the healthy Body than the lash to overdrive a willing horse. The physician is the proper person to determine whether it is wanted under any given circumstances. If alcohol is used as a daily article of diet it should be borne in mind that when concentrated it may chemically alter the proteids of the cells of the stomach with which it comes in contact, in the same sort of way, though of course to a much less degree, as it shrivels and dries up an animal pre- served in it. Dilute alcoholic drinks, such as claret and beer, are therefore far less baneful than whiskey or brandy, and these are, so far as direct action on the stomach is con- cerned, worse the less they are diluted. For the same reason alcoholic drinks are far more injurious on an empty stomach than after a meal. When the stomach is full the liquor is diluted, is more slowly absorbed, and, moreover, is largely used up in coagulating the proteids of the food instead of those of the gastric lining membrane. The old "three FOODS. 325 bottle " men who drank their port-wine after a heavy dinner, got off far more safely than the modern tippler who is taking '•'nips" all day long, although the latter may imbibe a smaller quantity of alcohol in the twenty-four hours. By far the best way, however, is to avoid alcohol altogether in health. If the facts lead us to conclude that under some conditions it may be to a certain extent a food, it is a dangerous one: even in what we may call "physiological " quantities, or such amounts as can be totally oxidized in the Body. The Advantage of a Mixed Diet. The necessary quan- tity of daily food depends upon that of the material daily lost from the Body, and this varies both in kind and amount with the energy expended and the organs most used. In children a certain excess beyond this is required to furnish materials for growth. Although it is impossible to lay down with per- fect accuracy how much daily food any individual requires, still the average quantity may be derived from the table of daily losses given on page 300, which shows that a healthy man needs daily in assimilable forms about 274 grams (4220 grains) of carbon and 19 grams (292 grains) of nitrogen. The daily loss of hydrogen, which is very great (352 grams or 5428 grains), is for the most part made good by water which has been drunk and, so to speak, merely filtered through the Body, after having assisted in the solution and transference through it of other substances. About 300 grams (4620 grains) of water containing 33.3 grams (513 grains) of hy- drogen are, however, formed in the Body by oxidation, and the hydrogen for this purpose must be supplied in the form of some oxidizable foodstuff, whether proteid, fat, or carbo- hydrate. The oxygen eliminated is mainly received from the air through the lungs, but some is taken in combination in the food. Since proteid foods contain carbon, nitrogen and hydro- gen, life may be kept up on them alone, with the necessary salts, water and oxygen; but such a form of feeding would be anything but economical. Ordinary proteids contain in 100 parts (p. 9) about 52 of carbon and 15 of nitrogen, so a man fed on them alone would get about 3| parts of carbon for every 1 of nitrogen. His daily losses are not in this ratio, but about that of 274 grams (4220 grains) of carbon to 20 grams (308 grains) of nitrogen, or as 13.7 to 1; and so to get enough carbon from proteids far more than the necessary 326 THE HUMAN BODY. amount of nitrogen must be taken. Of dry proteids 52? grams (8116 grains) would yield the necessary carbon, but would contain 79 grams (1217 grains) of nitrogen; or four times more than is required to cover the necessary daily losses of that element. Fed on a purely proteid diet a man would, therefore, have to digest a vast quantity to get enough carbon, and in eating and absorbing it, as well as in getting rid of the extra nitrogen which is useless to him, a great deal of unnecessary labo,r would be thrown upon the various or- gans of his Body. Similarly, if a man were to live on bread alone he would burden his organs with much useless work. For bread contains but little nitrogen in proportion to its carbon, and so, to get enough of the former, far more carbo- naceous substances than could be utilized would have to be eaten, digested and eliminated daily. Accordingly, we find that mankind in general employ a mixed diet when they can get it, using richly proteid sub- stances to supply the nitrogen needed, but deriving the car- bon mainly from non-nitrogenous foods of the fatty or carbo- hydrate groups, and so avoiding excess of either. For instance, lean beef contains about \ of its weight of dry proteid, which contains 15 per cent of nitrogen. Consequently the 133 grams (2048 grains) of proteid which would be found in 532 grams (1 Ib. 3 oz.) of lean meat would supply all the nitrogen needed to compensate for a day's losses. But the proteid contains 52 per cent of carbon, so the amount of it in the above weight of fatless meat would be 69 grams (1062 grains) of carbon, leaving 205 grams (3157 grains) to be got either from fats or carbohydrates. The necessary amount would be contained in about 256 grams (3942 grains) of ordinary fats or 460 grams (7084 grains) of starch; hence either of these, with the above quantity of lean meat, would form a far better diet, both for the purse and the system, than the meat alone. As already pointed out, nearly all common foods contain several foodstuffs. Good butcher's meat, for example, con- tains nearly half its dry weight of fat; and bread, besides proteids, contains starch, fats and sugar. In none of them, however, are the foodstuffs mixed in the physiologically best proportions, and the practice of employing several of them at each meal, or different ones at different meals, during the day, is thus not only agreeable to the palate but in a high degree advantageous to the Body. The strict vegetarians who do FOODS. 327 not employ even such substances as eggs, cheese and milk, but confine themselves to a purely vegetable diet (such as is always poor in proteids), daily take far more carbon than they require, and are to be congratulated on their excellent diges- tions which are able to stand the strain. Those who use eggs, cheese, etc., can of course get on very well, since such sub- stances are extremely rich in proteids, and supply the nitro- gen needed without the necessity of swallowing the vast bulk of food which must be eaten in order to get it from plants directly. CHAPTER XXII. THE ALIMENTARY CANAL AND ITS APPENDAGES. General Arrangement. The alimentary canal is essen- tially a tube running through the Body (Fig. 2) and lined by a vascular membrane, most of which is specially adapted for absorption; it communicates with the exterior at three points (the nose, the mouth, and the anal aperture), at which the lining mucous membrane is continuous with the general outer integument. Supporting the absorbent membrane are layers which strengthen the tube, and are in part muscular and, by their contractions, serve to pass materials along it from one end to the other. In the walls of the canal are numerous blood and lymphatic vessels which carry off the matters ab- sorbed from its cavity; and there also exist in connection with it numerous glands, whose function it is to pour into it various secretions which exert a solvent influence on such foodstuffs as would otherwise escape absorption. Some of these glands are minute and imbedded in the walls of the alimentary tube it- self, but others (such as the salivary glands) are larger and lie away from the main channel, into which their products are carried by ducts of various lengths. The alimentary tube is not uniform but presents several dilatations on its course; nor is it straight, since, being much longer than the Body, a large part of it is packed away by being coiled up in the abdominal cavity. Subdivisions of the Alimentary Canal. The mouth- opening leads into a chamber containing the teeth and tongue, the mouth-chamber or buccal cavity. This is suc- ceeded by the pharynx or throat-cavity, which narrows at the top of the neck into the gullet or oesophagus; this runs down through the thorax and, passing through the dia- phragm, dilates in the upper part of the abdominal cavity into the stomach. Beyond the stomach the channel again narrows to form a long and greatly coiled tube, the small intestine, which terminates -by opening into the large intes- 328 THE ALIMENTARY CANAL AND ITS APPENDAGES. 329 tine, much shorter although wider than the small, and ter- minating by an opening on the exterior. The Mouth - cavity (Fig. 105) is bounded in front and on the sides by the lips and cheeks, below by the tongue, k, and above by the palate ; which latter consists of an an- terior part, I, supported by bone and called the hard pal- ate, and a posterior, /, con- taining no bone, and called the soft palate. The two can readily be distinguished by ap- plying the tip of the tongue to the roof of the mouth and drawing it backwards. The hard palate forms the parti- tion between the mouth and nose. The soft palate arches down over the back of the mouth, hanging like a cur- tain between it and the pharynx, FIG. 105.— The mouth, nose and pha- i i -IT j.i rynx. with the commencement of the as Can be Seen by holding the gullet and larynx, as i exposed by mouth open in front of looking-glass. From the mid- dle of its free border a conical process, the uvula, hangs down. The Teeth. Immediately within the cheeks and lips are two semicircles, formed by the borders of the upper and lower jaw-bones, which are covered by the gums, except at intervals along their edges where they contain sockets in which the teeth are implanted. During life two sets of teeth are developed; the first or milk set appears soon after birth and is shed during childhood, when the second or permanent set appears. The teeth differ in minor points from one another, but in each three parts are distinguishable; one, seen in the mouth and called the crown of the tooth ; a second, imbedded in the jaw-bone and called the root or fang; and between the two, a section, a little to the left of the me- & dian plane of the head, a, vertebral column ; 6, gullet : c, windpipe ; d, larynx ; e, epiglottis ; f. soft palate ; g, opening of Eustachian tube ; fc, tongue ; I, hard palate ; m, the sphe- noid bone on the base of the skull ; n, the fore part of the cranial cavity; <>. p, q, the tubinate bones of the out- er side of the left nostril-chamber. 330 THE HUMAN BODY. embraced by the edge of the gum, is a narrowed portion, the neck or cervix. From differences in their forms and uses the teeth are divided into incisors, canines., bicuspids and molars, arranged in a definite order in each jaw. Beginning at the middle line we meet in each half of each jaw with, successively, two incisors, one canine, and two molars in the milk set; making twenty altogether in the two jaws. The teeth of the permanent set are thirty-two in number, eight in each half of each jaw, viz. — beginning at the middle line- two incisors, one canine, two bicuspids, and three molars. The bicuspids, or premolars, of the permanent set replace the milk molars, while the permanent molars are new teeth added on as the jaw grows, and not substituting any of the milk- teeth. The hindmost permanent molars are often called the wisdom-teeth. Characters of Individual Teeth. The incisors (Fig. 106) are adapted for cutting the food. Their crowns are chisel- shaped and have sharp horizontal cutting edges, which be- come worn away by use so that they are bevelled off behind in the upper row, and in the opposite direction in the lower. Each has a single long fang. The canines (Fig. 107) are somewhat larger than the incisors. Their crowns are thick and somewhat conical, having a central point or cusp on the cutting edge. In dogs, cats and other carnivora the canines are very large and adapted for seizing and holding prey. The bicuspids or premolars (Fig. 108) are rather shorter than FIG. 106. FIG. 1 FIG. 108. FIG. 109. FIG. 106.— An incisor tooth. FIG. 107.— A canine or eye tooth. FIG. 108.— A bicuspid tooth seen from its outer side; the inner cusp is, accord- ingly, not visible. FIG. 109.— A molar tooth. i*E. the canines and their crowns are somewhat cuboidal^Each has two cusps, an outer towards the cheek, and an inner on the side turned towards the interior of the mouth. The fang THE ALIMENTARY CANAL AND ITS APPENDAGES. 331 is compressed laterally, and has usually a groove partially subdividing it into two. At its tip the separation is often complete. The molar teeth or grinders (Fig. 109) have large crowns with broad surfaces, on which are four or five project- ing tubercles, which roughen them and make them better adapted to crush the food. Each has usually several fangs. The mil fc -teeth only differ in subsidiary points from those of the same names in the permanent set. The Structure of a Tooth. If a tooth be broken open, a cavity extending through both crown and fang will be found in it. This is filled during life with a soft vascular pulp, and hence is known as the "pulp-cavity" (<", Fig. 110). The hard parts of the tooth disposed around the pulp-cavity consist of three different tissues. Of these one immediately surrounds the cavity and makes up most of the bulk of the tooth; it is dentine (2, Fig. 110); covering the dentine on the crown is the enamel (1, Fig. 110) and, on the fang, the cement (3, Fig. 110). The pulp-cavity opens below by a narrow aperture at the tip of the fang, or at the tip of each if the tooth have more than one. The pulp consists mainly of connective tissue, but its surface next the dentine is covered by a layer of columnar cells. Through the opening on the fang blood-vessels and nerves enter the pulp. The dentine (ivory) yields on analysis the same materials as bone but is somewhat harder, earthy matters constituting 72 per cent of it as against CG per cent in bone. Under the microscope it is recognized by the fine dentinal tiibules which, radiating from the pulp-cavity, perforate it through- out, finally ending in minute branches which open into irregular cavities, the interglobular spaces, which lie just beneath the enamel or cement. At their widest ends, close to the pulp-cavity, the dentinal tubules are only about 0.005 millimeter (T-Vo °^ an inch) in diameter. The cement is much like bone in structure and composition, possessing lacunae and canaliculi, but rarely any Haversian canals. It is thickest at the tip of the fang and thins away towards the cervix. Enamel is the hardest tissue in the Body, yielding on analysis only from two per cent to three per cent of organic matter, the rest being mainly calcium phosphate and carbonate. Its histological elements are minute hexagonal prisms, closely packed, and set on vertically to the surface of 332 THE HUMAN BODY. the subjacent dentine. It is thickest over the free end of the crown, until worn away by use. Covering the enamel in FIG. 110. — Section through a premolar tooth of the cat still imbedded in its socket. 1, enamel; 2, dentine; 3, cement ; 4, the gum ; 5, the bone of the lower jaw ; c, the pulp-cavity. unworn teeth is a thin structureless horny layer, the enamel cuticle. The Tongue (Fig. Ill) is a muscular organ covered by mucous membrane, extremely mobile, and endowed not only with a delicate tactile sensibility but with the terminal organs of the special sense .of taste; it is attached by its root to the hyoid bone. On its upper surface are numerous small THE ALIMENTARY CANAL AND ITS APPENDAGES. 333 eminences or papilla, such as are found more highly devel- oped on the tongue of a cat, where they may he readily felt. On the human tongue there are three forms of papillae, the circumvallate, i\\Q fungi form, and the filiform. The circum- vallate papillae, 1 and 2, the largest and least numerous, are from seven to twelve in number and lie near the root of the tongue arranged in the form of a V with its open angle turned Fm. 111.— The upper surface of the tongue with part of the pillars of the fauces and the tonsils. 1, 2, circumvallate papillae ; 3, fungiform papillae ; 4, filiform papillae ; 6, mucous glands ; 7, tonfeils ; 8, tip of epiglottis. forwards. Each is an elevation of the mucous membrane, covered by epithelium, and surrounded by a trench. On the sides of these papillae, imbedded in the epithelium, are many small oval bodies richly supplied with nerves and sup- 334 THE HUMAN BODY. posed to be concerned in the sense of taste, and hence called the taste-buds (Chap. XXXV). The fungiform papillcB, 3, are rounded elevations attached by somewhat narrowed stalks, and found all over the middle and fore part of the upper surface of the tongue. They are easily recognized on the living tongue by their bright red color. ^\^Q filiform papillae, most numerous and smallest, are scattered all over the dorsum of the tongue except near its base. Each is a conical emi- nence covered by a thick horny layer of epithelium. It is these papillae which are so highly developed on the tongues of Carnivora, and serve them to scrape bones clean of even such tough structures as ligaments. In health the surface of the tongue is moist, covered by little " fur," and in childhood of a red color. In adult life the natural color of the tongue is less red, except around the edges and tip; a bright-red glistening tongue being then, usually a symptom of disease. When the digestive organs are deranged the tongue is commonly covered with a thick yellowish coat, composed of a little mucus, some cells of epithelium shed from the surface, and numerous microscopic organisms known as bacteria; and there is frequently a " bad taste in the mouth." The whole alimentary mucous mem- brane is in close physiological relationship; and any thing' disordering the stomach is likely to produce a "furred tongue." The Salivary Glands. The saliva, which is poured into the mouth and which, mixed with the secretion 'of minute glands imbedded in its lining membrane, moistens it, • is secreted by three pairs of glands, the parotid, the submaxil- lary and the suUingual. The parotid glands lie in front of the ear behind the rarnus of the lower jaw; each sends its secretion into the mouth by a tube known as 8 tenon's duct, which crosses the cheek and opens opposite the second upper molar tooth. In the disease known as mumps * the parotid glands are inflamed and enlarged. The subm axillary glands lie between the halves_of the lower |aw-bope, near its angles, and their ducts open beneath the tongue near the middle line. The sublingual glands lie beneath the floor of the month, covered by its mucous membrane, between the back part of the tongue and the lower jaw-bone. Each has many ducts * Parotitis, in technical language. THE ALIMENTARY CANAL AND ITS APPENDAGES. 335 (8 to 20), some of which join the submaxillary duct, while the rest open separately in the floor of the mouth. The Fauces is the name given to the aperture which can be seen at the back of the mouth below the soft palate (Fig. 105), and leading into the pharynx. It is bounded above by the soft palate and uvula, below by the root of the tongue, and on the sides by muscular elevations covered by mucous membrane, which reach from the soft palate to the tongue. These elevations are the pillars of the fauces. Each bifur- cates below, and in the hollow between its divisions lies a tonsil (7, Fig. Ill), a soft rounded body about the size of an almond, and containing numerous minute glands which form mucus. The tonsils not unfrequently become enlarged during a cold or sore throat, and then pressing on the Eustachiau tube (Chap. XXXIV), which leads from the pharynx to the mid- dle ear, keep it closed and produce partial deafness. The Pharynx or Throat-cavity (Fig. 105). This por- tion of the alimentary canal may be described as a conical bag with its broad end turned upwards towards the base of the skull, and its narrow end downwards and passing into the gullet. Its front is imperfect, presenting openings which lead into the nose, the mouth, and (through the larynx and windpipe) the lungs. Except during swallowing or speech the soft palate hangs down between the mouth and pharynx; during deglutition it is raised into a horizontal position and separates an upper or respiratory portion of the pharynx from the rest. Through this upper part, therefore, air alone passes, entering it from the posterior ends of the two nostril- chambers; while through the lower portion both food and air pass, one on its way to the gullet, b, Fig. 105, the other through the larynx, d, to the windpipe, c\ when a morsel of food " goes the wrong way " it takes the latter course. Opening into the upper portion of the pharynx on each side is an Eustachian tube, g: so that the apertures leading out of it are seven in number; the two posterior nares, the two Eustachian tubes, the fauces, the opening of the larynx, and that of the gullet. At the root of the tongue, over the opening of the larynx, is a plate of cartilage, the epiglottis, e, which can be seen if the mouth is widely opened and the back of the tongue pressed down by some such thing as the handle of a spoon. During swallowing the epiglottis 336 THE HUMAN BODY. is pressed down like a lid over the air-tube and helps to keep food or saliva from entering it. In structure the pharynx consists essentially of a bag of connective tissue lined by mucous membrane, and having muscles in its walls which drive the food on. The (Esophagus or Gullet is a tube commencing at the lower termination of the pharynx and which, passing on through the neck and chest, ends below the diaphragm by joining the stomach. In the neck it lies close behind the windpipe. It consists of three coats — a mucous membrane within; next, a submucous coat of areolar connective tissue; and, outside, a muscular coat made up of two layers, an inner with transversely and an outer with longitudinally arranged fibres. In and beneath its mucous membrane are numerous small mucous glands whose ducts open into the tube. v The Stomach (Fig. 112) is a somewhat conical bag placed transversely in the upper part of the abdominal cavity. Its larger end is turned to the left and lies close beneath the diaphragm; opening into its upper border, through the cardiac orifice at a, is the gullet d. The narrower right end is con- tinuous at c with the small intestine; the aperture be- tween the two is the pyloric OTlfice. The pyloric end of the stomach lies lower in the abdomen than the cardiac, the pylorus and d, the lesser curvature. an(j jg separated from the diaphragm by the liver (see Fig. 1). The concave border be- tween the two orifices is known as the small curvature, and the convex as the great curvature, of the stomach. From the latter hangs down a fold of peritoneum (ne, Fig. 1) as the great omentum. It is spread over the rest of the abdominal contents like an apron. After middle life much fat frequently accumulates in the omentum, so that it is largely responsible for the " fair round belly with good capon lin'd." The protrusion b to the left side of the cardiac orifice, Fig. 112, is the fund us or great cul de sac. The size of the stomach varies greatly "with the amount of food in it; THE ALIMENTARY CANAL AND ITS APPENDAGES. 337 just after a moderate meal it is about ten inches long, by five wide at its broadest part. Structure of the Stomach. This organ has four coats, known successively from without in as the serous, the mus- cular, the submucous, and the mucous. The swous coat is formed by a reflection of the peritoneum, a double fold of which slings the stomach : after separating to envelop it the two layers again unite and, hanging down beyond it, form the great omentum. The muscular coat t (Fig. 59) consists of unstriped muscular tissue arranged in three layers: an outer, longitudinal, most developed about the curvatures; a circu- lar, evenly spread over the whole organ, except around the pyloric orifice where it forms a thick ring; and an inner, oblique and very incomplete, radiating from the cardiac orifice. The submucous coat is made up of lax areolar tissue and binds loosFlTTlie mucous coat to the muscular. The mucous coat is a moist pink membrane which is inelastic, and rar^e-etttrtrfli to line the stomach evenly when it is fully dis- tended. Accordingly, when the organ is empty and shrunken, this coat is thrown into folds, which disappear when the organ is distended. During digestion the arteries supplying the stomach become dilated and, its capillaries being gorged, its mucous membrane is then much redder than during hunger. The blood-vessels of the stomach run to it between the folds of peritoneum which sling it. After giving off a few branches to the outer layers, most of the arteries break up into small branches in the submucous coat, from which twigs proceed to supply the close capillary network of the mucous membrane. The nerves of the stomach are chiefly derived from the Tmeumoffastrica. In the lower part of the thorax these nerves consist mainly of nonmedullated. fibres, and lie on the sides_ of the gullet, across which they interchangej^bres by means of several branches. On entering the'abdomen the left pneu- mogastric passes to the ventral side of the..^JQinacfa., in which ft ends: the right supplies the dorsal side of the stomach, but a considerable portion of it passes on to enter the solarjrtexus, which lies behind the stomach and ^contains several large ganglia. The sympathetic also supplies gastric nerves which mainly go to the blood-vessels. In the muscular coat of the stomach are many nerve-cells. Histology of the Gastric Mucous Membrane. Examina- 338 THE HUMAN BODY. lion of the inner surface of the stomach with a hand lens shows it to be covered with minute shallow pits. Into these open the mouths of minute tubes, the gastric glands, wliich are closely packed side by side in the mucous membrane; something like the cells of a honeycomb, except that each is open at one end. Between them lie a small amount of con- nective tissue, a close network *f lymph-channels, and capil- lary blood-vessels. The connective tissue is of a peculiar variety closely packed with lymph-cells and will be more mi- nutely described later (Chap. XXIII). The whole surface of the mucous membrane is lined by a single layer of columnar mucus-making epithelium cells (Fig. 113). These dip down and line the necks of the tubular glands. The deeper portions of the glands are lined by a layer of shorter and somewhat cuboidal cells, the central or chief cells. In speci- mens taken from a healthy animal killed during digestion these cells are large and do not stain deeply with carmine. Similar specimens taken from an animal an hour or two FIG. 113. — A thin section through the gastric mucous alter a good meal has been swallowed membrane, perpendicular to its , .? 7 . ,. ,, , , , surface, magnified about 25 di- SllOW tllC CniCJ Cells Shrunken and anieters. a, a simple gastric , • • -i i rni ,1 gland ; 6, a compound gastric staining more deeply. They, thus, store up during rest a material which they get rid »f when the gastric juice is being secreted. This material 5s, in part, pepsinogen, which during activity of the gland is changed, giving rise among other things to pepsin, the chief enzyme of gastric juice. The deeply staining protoplasmic portion of the cell which is left behind, forms and stores more pepsinogen during the next period during which the stomach is not digesting. In the pyloric end of the stomach only the chief jlells line the glands, but elsewhere there is found out- side them, in most of the glands, an incomplete layer of larger tvtl cells (d, Fig. 113). These are sometimes called the txinitic cells, from the belief that they are especially con- cerned in secreting the acid of the gastric juice. The glands frequently branch at their deeper ends. The Pylorus. If the stomach be opened it is seen that the mucous membrane projects in a fold around the pyloric vc ; °' retif°rm THE ALIMENTARY CANAL AND ITS APPENDAGES, 339 orifice and narrows it. This is due to a thick ring of the circular muscular layer there developed, and forming around the orifice a sphincter muscle, which, by its contraction, keeps the passage to the small intestine closed except when portions of food are to be passed on from the stomach to succeeding divisions of the alimentary canal. Since the cardiac end of the stomach lies immediately be- neath the diaphragm, which has the heart on its upper side, its over-distension, due to indigestion or flatulence, may im- pede the action of the thoracic organs, and cause feelings of oppression in the chest, or palpitation of the heart. The Small Intestine (Fig. 1*20), commencing at the py- lorus, ends, after many windings, in the large. It is about six meters (twenty feet) long, and about five centimeters (two inches) wide at its gastric end, narrowing to about two thirds of that width at its lower portion. Externally there are no lines of subdivision on the small intestine, but anatomists arbitrarily describe it as consisting of three parts; the first twelve inches being the duodenum, D, the succeeding two fifths of the remainder the jejunum, J, and the rest the ileum, I. Like the stomach, the small intestine possesses four coats 3 a serous, a muscular, a submucous, and a mucous. The! serous coat is formed by a dup'licature of the peritoneum, but presents nothing answering to the great omentum; this double fold, slinging the intestine as the small omenturn slings the stomach, is named the mesentery. The muscular coat is composed of plain muscular tissue arranged in two strata, an outer longitudinal, and an inner transverse or cir- cular. The submucous coat is like that of the stomach; con- sisting of loose areolar tissue, binding* together the mucous and muscular coats, and forming a bed in which the blood and lymphatic vessels (which reach the intestine in the fold of the mesentery) break up into minute branches before en- tering the mucous membrane. The Mucous Coat oFthe Small Intestine. This is pink, soft and extremely vascular. It does not present temporary or effaceable folds like those of the stomach, but is, through- out a great portion of its length, raised up into permanent transverse folds in the form of crescentic ridges, each of which runs transversely for a greater or less way round the tube (Fig. 114). These folds are the valvulce connivences. 340 THE HUMAN BODY. They are first found about two inches from the pylorus, and are most thickly set and largest in the upper half of the jejunum, in the lower half of which they become gradually less conspicuous; and they finally disappear altogether about the middle of the ileum. The folds serve greatly to increase the surface of the mucous membrane both for absorption and secretion, and they also delay the food somewhat in its pas- sage, since it must collect in the hollows between them, and so be longer exposed to the action of the digestive liquids. Examined closely with the eye or, better, with aid of a lens, the mucous membrane of the small intestine is seen to be not smooth but shaggy, being covered everywhere (both over the valvulae conniventes and between them) with closely packed minute processes, standing up somewhat like the4' pile "on velvet, and known as the villi. Each villas is from 0.5 to 0.7 millimeter (-fa to fa inch) in length; some are conical and rounded, but the majority are compressed at the base in one diameter (Fig. 115). In structure a villus is somewhat com- plex. Covering it is a single layer of columnar epithelial cells, the exposed ends of the majority having a peculiar bright striated border and being probably of great importance in ab- sorption. Mixed with these cells are others in which most of the cell has become filled with a clear mass which does not stain readily with reagents; the deep narrow end of the cell stains easily and contains the nucleus. From time to time the clear substance (mucigen) is converted into mucus and dis- charged into the intestine, leaving behind only the nucleus and the protoplasm around it. These reconstruct the cell and form more mucigen. These mucus-forming cells are named goblet* cells, from their shape. Beneath the epithelium the villus may FIG. 114.— A portion of the small intestine opened to show the valvulae, conniventes. be regarded as made up of a framework of connective tissue, mainly of the adenoid variety (Chap. XXIII), supporting the THE ALIMENTARY CANAL AND ITS APPENDAGES. 341 more essential constituents. Near the surface is an incomplete layer of plain muscular tissue, continuous below with a mus- cular stratum forming the deepest layer of the mucous mem- brane and named the muscularis mucosce. In the centre is an offshoot of the lymphatic system; sometimes in the form of a single vessel with a closed dilated end, and sometimes as a net- work formed by two main vessels with cross-branches. During digestion these lymphatics are filled with a milky-white liquid absorbed from the intestines, and they are accordingly called the lacteals. They communicate with larger branches in the submucous coat, which end in trunks that pass out through the mesentery to join the main lymphatic system. Finally, in each villus, outside the lacteals and beneath the muscular layer of the villus, is a close network of blood-vessels. Opening on the surface of the small intestine, between the bases of the villi, are small glands, the crypts of Lieber- kiilin. Each is a simple unbranched tube lined by a layer of columnar cells some of which have a striated free border, though less marked than that on the corresponding cells of FIG. 115.— Villi of the small intestine: magnified about 80 diameters. In the right-hand figure the lacteals, a, 6, c, are filled with white injection ; d, blood-ves- sels. In the left-hand figure the lacteals alone are represented, filled with a dark injection. The epithelium covering the villi, and their muscular fibres, are omitted. the villi, and others are goblet-cells. The crypts of Lieber- kdhn are closely packed, side by side, like the glands of the stomach. In the duodenum are found other minute glands, the glands of B runner. They lie in the submucous coat 342 THE HUMAN BODY. • and send their ducts through the mucous membrane to open on its inner side. The Large Intestine (Fig. 120), forming the final por- tion of the alimentary canal, is about 1.5 meters (5 feet) long, and varies in diameter from about G to 4 centimeters (2^ to 1£ inches). Anatomists describe it as consisting of the ccecum with the vermiform appendix., the colon, and the rectum. The small intestine does not open into the com- mencement of the large but into its side, some distance from its closed upper end, and the ca3cum, CO, is that part of the large intestine which extends beyond the communication. From it projects the vermiform appendix, a narrow tube not thicker than a cedar pencil, and about 10 centimeters (4 inches) long. The colon commences on the right side of the abdominal cavity where the small intestine communicates with the large, runs up for some way on that side (ascending colon, AC), then crosses the middle line (transverse colon, TO) below the stomach, and turns down (descending colon, DC) on the left side and there makes an S-shaped bend known as the sigmoid flexure, SF; from this the rectum, R, the terminal straight portion of the intestine, proceeds to the anal opening, by which the alimentary canal communi- cates with the exterior. In structure the large intestine presents the same coats as the small. The external stratum of the muscular coat is not, however, developed uniformly around it, except on the rectum, but occurs in three bands separated by intervals in which it is wanting. These bands being shorter than the rest of the tube cause it to be puck- ered, or sacculated, between them. The mucous coat pos- sesses no villi or valvula3 conniventes, but is usually thrown into effaceable folds, like those of the stomach but smaller. It contains numerous closely set glands much like the crypts of Lieberkiihn of the small intestine. The Ileo-colic Valve. Where the small intestine joins the large there is a valve, formed by two flaps of the mucous membrane sloping down into the colon, and so disposed as to allow matters to pass readily from the ileum into the large intestine but not the other way. The Nerves of the Intestines. These, like those of the heart with which we shall later have to compare them physiologically, are intrinsic and extrinsic. The former are connected with small ganglia found abundantly on the THE ALIMENTARY CANAL AND ITS APPENDAGES. 343 plexus of Auerbach which lies between the two muscular coats, and the plexus of Meissner found in the submucous coat. The extrinsic fibres proceed immediately from the gangliated solar plexus already referred to and from a similar mesenter ic plexus which lies lower in the abdomen; except a few branches to the longitudinal muscular coat of the rectum which pass directly from some of the sacral spinal nerves. Some of the fibres distributed from the solar plexus are those running from the brain in the right pneumogastric, and probably also from the left, having crossed over to the left in branches joining the two. Others reach the solar plexus by means of the splanchnics and other nerves pro- ceed ing from the thoracic parts of the two sympathetic chains. These are partly vaso-constrictor fibres (Chap. XVIII.), but in part go to the muscular coats of the intestine. They may be traced back through the communicating branches from sympathetic ganglia to the corresponding spinal nerves and thence by the ventral nerve-roots into the spinal cord. The fibres passing to the intestines from the mesenteric plexus reach that plexus from the posterior thoracic and anterior lumbar sympathetic ganglia, and can also be tracked by experiment to the spinal cord. The Liver. Besides the secretions formed by the glands imbedded in its walls, the small intestine receives those of two large glands, the liver and the pancreas, which lie in the abdominal cavity. The ducts of both open by a common aperture into the duodenum about 10 centimeters (4 inches) from the pylorus. The liver is the largest gland in the Body, weighing from 1400 to 1700 grams (50 to 64 ounces). It is situated in the upper part of the abdominal cavity (le, U'9 Fig. 1), rather more on the right than on the left side and immediately below the diaphragm, into the concavity of which its upper surface fits, and reaches across the middle line above the pyloru; end of the stomach. It is of dark reddish-brown color, and of a soft friable texture. A deep fissure incom- pletely divides the organ into right and left lobes, of which the risrht is much the larger; on its under surface (Fig. 116) shallower grooves mark off several minor lobes. Its upper surface is smooth and convex. The vessels carrying blood to the liver are the portal vein, Vp, and the hepatic artery; both enter it at a fissure (the portal fissure) on its under side, 344 THE HUMAN BODY. and there also a duct passes out from each half of the organ. The ducts unite to form the hepatic duct, Dli, which meets at an acute angle, the cystic duct, DC, proceeding from the gall-bladder, Vf, a pear-shaped sac in which the bile, or gall, formed by the liver, accumulates when food is not being digested in the intestine. The common bile-duct, Dck, Lv FIG. 116.— The under surface of the liver, d, rigrht, and s, left lobe; Vh. hepatic vein; Vp< porta.l vein; Vc. vena cava "inferior; Dc/i, 'common bile-duct; DC, cystic duct; Dh, hepatic duct; Vf, gall-bladder. formed by the union of the hepatic and cystic ducts, opens into the duodenum. The blood which enters the liver by the portal vein and hepatic artery passes out by the hepatic veins, Vh, which leave the posterior border of the organ close to the vertebral column, and there open into the inferior vena cava just before it passes up through the diaphragm. The Structure of the Liver. On closely examining the surface of the liver, it will be seen to be marked out into small angular areas from one to two millimeters (^ to TV inch) in diameter. These are the outer sides of the super- ficial layer of a vast number of minute polygonal masses, or lobules, of which the liver is built up; similar areas are seen on the surface of any section made through the organ. Each lobule (Fig. 117) consists of a number of hepatic cells supported by a close, network of capillaries; and is separated from neighboring lobules by connective tissue, THE ALIMENTARY CANAL AND ITS APPENDAGES. 345 larger blood-vessels, and branches of the hepatic duct. The hepatic cells are the proper tissue elements of the liver, all the rest being subsidiary arrangements for their nutrition and protection. Each is polygonal, nucleated and very granular, and has a diameter of about .025 millimeter (ToVo^ of an inch). In each lobule they are arranged in rows or strings, which form a network, in the meshes of which the blood-capillaries run. Covering the surface of the liver is a layer of the peritoneum, beneath which is a dense FIG. 117.— A lobule of the liver, magnified, showing the hepatic cells radiately arranged around the central imralobulur vein, and the lobular capillaries inter- laced with them. connective-tissue layer, forming the capsule of Glisson. At the portal fissure offsets from this capsule run in, and line canals, the portal canals, which are tunnelled through the organ. These, becoming smaller and smaller as they branch, finally become indistinguishable close to the ultimate lobules. From their walls and from the external capsule, connective-tissue partitions radiate in all directions through the liver and, support its other parts. In each portal canal lie three vessels — a branch of the portal vein, a branch of the hepatic artery, and a branch of the hepatic duct; the division of the portal vein being much the largest of the three. These vessels break up as the portal canals do, and all end in minute branches around the lobules. The blood carried in by the portal vein (which has already circulated through the capillaries of the stomach, spleen, intestines and 346 THE HUMAN BODY. pancreas) is thus conveyed to a fine vascular interlobular plexus around the Hver-lobnies, from which it flows on through the capillaries (lobular plexus] of the lobules them- selves. These (Fig. 117) unite in the centre of the lobule to form a small intralobular vein, which carries the blood out and pours it into one of the branches of origin of the hepatic vein, called the sublobular vein. Each of the latter has many lobules emptying blood into it, and if dissected out with them (Fig. 118) would look something like a branch of a tree with apples attached to it by short stalks, represented FIG. 118.— A small portion of the liver, injected, and magnified about twenty diameters. The blood-vessels are represented white; the large vessel is a sub- lobular vein, receiving the intralobular veins, which in turn are derived from the capillaries of the lobules. by the intralobular veins. The blood is finally carried, as already pointed out, by the hepatic veins into the inferior vena cava. The hepatic artery, a direct offshoot of the coeliac axis, ends mainly in Glisson's capsule and the walls of the blood-vessels and bile-ducts, but some of its blood reaches the lobular plexuses; it all finally leaves the liver by the hepatic veins. The bile-ducts can be readily traced to, the periphery of the lobules, and there communicate with a network of extremely minute commencing bile ducts, ramifying in the lobule between the hepatic cells composing it. The Pancreas or Sweetbread. This is an elongated soft organ of a pinkish yellow color, lying along the great curvature of the stomach. Its right end is the larger, and is embraced by the duodenum (Fig. 119), which there THE ALIMENTARY CANAL AND ITS APPENDAGES. 347 makes a curve to the left. A duct traverses the gland and joins the common bile-duct close to its intestinal opening. The pancreas produces a watery-looking secretion which is of great importance in digestion; the gland also (Chap. XXIII) exerts an important influence on the general nutritional processes of the Body. It is of the compound racemose type. FIG. 119 — The stomacn. pancreas, liver, and duodenum, with part of the rest of the small intestine and the mesenterv; the stomach and liver have been turned up so as to expose the pancreas. V. stomach : D, D'. "D". duodenum ; L, spleen ; P. pancreas: R. rigrht kidney : T. jejunum"; Vf, 'gfell-Bladderr'/i, hepatic duct: c. cystic duct ; ch. common bile-duct: 1. aorta; 2. an artery (left coronary) of the stomach; 3. hepatic artery: 4. splenic artery; 5. superior rnesenteric artery; 6, superior mesenteric vein; 7, splenic vein; Fp, portal vein. The Blood-vessels of Alimentary Canal, Liver, Spleen and Pancreas The portal vein ( Vp. Fig. 119) has already 348 THE HUMAN BODY. been referred to as differing from all other veins in that it not only receives blood from a system of capillaries but ends in a second set of capillaries, which lie in the liver. The quantity of blood brought to supply the hepatic capillaries by the hepatic artery is in fact much less than that brought by the portal vein. The stomach, the intestines, the pancreas and the spleen are supplied with arterial blood from three great branches of the aorta. The most anterior of these, the cceliac axis, springs from the aorta close beneath the diaphragm and divides into the hepatic artery, splenic artery, and arteries for the stomach; some of these divisions may be seen in Fig. 119. The pancreas is supplied partly from the hepatic, partly from the splenic artery. The two other branches (superior and inferior mes- enteric artery) are given oif from the aorta lower down in the abdominal cavity; the former (5, Fig. 119) supplies the small intestine and half of the large, the FIG. 120.— Diagram of abdominal part of latter the remainder of the alimentary canal. C, the cardiac, and P, ,„, -, , -, the pyloric end of the stomach; A the large. Ihe blood paSSing duodenum; J, I. t,he convolutions of the , -, T, ,1 o*.f/-»-mnei small intestine: cc, the caecum with the through all these arteries vermiform appendix; AC. ascending, TO, Vi^orimoa vcmrm« in thp transverse, and DC, descending colon; R, 06001868 VCllOUS 6 the rectum. capillaries of the organs they supply, and is gathered into corresponding veins (Fig. 119) which unite near the liver to form the portal vein. The further course of the blood carried to the liver (partly .arterial from the hepatic artery, partly venous from the portal system) has been described already (p. 345), CHAPTER XXIII. THE LYMPHATIC SYSTEM AND THE DUCTLESS GLANDS. The Lymphatics or Absorbents are very widely distrib- uted in the Body. Most organs, as has been pointed out (p. 63), possess a sort of internal skeleton made up of connective tissue, which consists mainly of bundles of fibres, united together and covered-in by a " cement" sub- stance. In this substance are found numerous cavities, usu- ally branched, and communicating with one another by their branches. They frequently contain connective-tissue cor- puscles, which, however, do not completely fill them; and they thus, with their branches, form a set of intercommuni- cating channels known as the " lymph-canaliculi" because they are filled with lymph. As the connective tissues accom- pany blood-vessels wherever the latter run, the canaliculi, which are frequently relatively large around the blood-capil- laries, take up the liquid which transudes through their walls, and this transudation liquid is the origin of the lymph. Even where blood-vessels and connective tissue do not pene- trate, as in bone between the Haversian canals, lymph-canal- iculi penetrate, being connected with the cavities in which the bone-corpuscles lie; and in the deeper layers of the epidermis the cells are covered with prickle-like projections and unite by the tips of these so as to leave minute channels which apparently are lymph-canaliculi. These very minute channels, with no definite lining cells, but mere crevices be- tween tissue elements, or tubes hollowed out in the matrix of connective tissue, bone and (possibly) cartilage, constitute the origin of the lymphatic system. The transudation liquid which enters them from the blood-vessels is rapidly altered by interchange with the neighboring tissues, losing certain materials and gathering others; and as the substances taken and the waste and other products returned vary very much in different organs, the lymph leaving them must differ also. Nevertheless it retains certain common features, histological 349 350 THE HUMAN BODY. and chemical (pp. 49, 62), which justify us in speaking of it in general as the lymph. The lymphatic vessels collect this lymph or at least such part of it as does not pass back locally by diffusion into the blood, and pour it into the veins. The Structure of Lymph-vessels. The smallest lymph- vessels proper are the lymph -capillaries; tubes rather wider than the blood-capillaries, but like them having a wall con- sisting of a single layer of flattened epithelium cells. The cells have, however, a wavy margin and are not as a rule much longer in one diameter than another, in both of which respects they differ from the cells of the corresponding blood-vessels. In some regions, as in many glands, the lymph-capillaries are much dilated and form irregular lymph lacunce, everywhere bounded by their peculiar wavy cells, lying in the interstices of organs; and sometimes they form tubes around small blood- vessels, as in the brain (perivascular lympJt-channel). In some places they commence by blind ends as in the lacteal vessels of the villi of the small intestine (Fig. 115) which are lymph-capillaries; but usually they branch and join to form networks. Lymph from the canaliculi enters them (whether by passing through their boundary cells or through clefts left between these is not certain) and is passed on to larger vessels which much resemble veins of corresponding size, having the same three coats, and being abundantly provided with valves. The Thoracic Duct. The lymph-vessels proceeding from the capillaries in various organs become larger and fewer by joining together, and all end finally in two main trunks which open into the venous system on the sides of the neck, at the point of junction of the jugular and subclavian veins. The trunk on the right side is much smaller than the other and is known as the " right lymphatic duel." It collects lymph from the right side of the thorax, from the right side of the head and neck, and the right arm. The lymph from all the rest of the Body is collected into the thoracic duct. It com- mences at the upper part of the abdominal cavity in a dilated reservoir (the receptaculum cht/li), into which the lacteals from the intestines, and the lymphatics of the rest of the lower part of the Body, open. From thence the thoracic duct, receiving tributaries on its course, runs up the thorax alongside of the aorta and, passing on into the neck, ends on the left side at the point already indicated; receiving on its way the main stems from the left arm and the left side of the LYMPHATIC SYSTEM AND DUCT/LESS GLANDS. 351 head and neck. The thoracic duct, thus, brings back to the blood much more lymph than the right lymphatic duct. The Serous Cavities. These are great dependencies of the lymphatic system and may be regarded as large lacunae. Each of them (peritoneal, plenral, arachnoidal and pericar- diac) is lined by a definite epithelioid layer of close-fitting polygonal cells. At certain points, however, openings or stomata occur, surrounded by a ring of smaller cells, and leading into tubes which open into subjacent lymphatic vessels. The liquid moistening these cavities is, then, really lymph: in some dropsical diseases it collects in great excess in them. Lymphoid or Adenoid Tissue is the name given to cer- tain aggregations of slightly differentiated cells (leucocytes) supported by a peculiar form of tissue and found in con- nection with the lymphatic system in many parts of the body. The cells much resemble white blood--corpuscles, though their nuclei usually have a more distinct network, and they are capable of executing amoeboid movements. Many of them ultimately are carried by the lymph into the blood to be- come pale corpuscles, and from the blood some again pass back into the lymph by migrating through the walls of the blood-capillaries. By amoeboid movement these lymph- corpuscles can take up foreign particles into themselves and creep with the absorbed material along lymph-canaliculi and lymph-capillaries. Lymphoid tissue is extensively devel- oped in the mucous membrane of a great part of the ali- mentary canal. The deepest layer of the mucous membrane of stomach and intestines, lying next to the submucous coat is the mus- cular is mucosce, a thin layer of unstriped muscular tissue quite distinct from the proper muscular coats of those viscera. Above it and forming the main bulk of the mucous membrane lying between the glands (o, Fig. 112) and, in the small intestine, the main mass of the villi, is a delicate connective tissue con- sisting of very fine fibres which originated by the branch- ing of cells; in many places the nuclei of these cells have quite disappeared, and the original central part of the cell is only recognizable as the place from which the branches spread : such tissue is reticular connective tissue. Its meshes contain many leucocytes, and the mixture of reticular tissue with these cells constitutes adenoid or lymphoid tissue. At numerous spots, 352 THE HUMAN BODY. especially in the small intestine, the cells are peculiarly abun- dant, forming local aggregations of about the size of the head of a small pin: these are named dosed or solitary follicles. A minute artery enters each and gives rise to a capillary net- work in it, from which the blood is carried off by a small vein. The follicle lies in, or rather projects into, a lymph-lacunae which closely invests it, and is in direct communication with other lymphatic vessels of the neighborhood. The central leucocytes of the follicle are smaller than the outer, and their nuclei are often found in various stages of karyokinesis. Each follicle must therefore be regarded as a seat of forma- tion of new leucocytes, new-made ones being pushed to the outside, growing, and finally being cast out into the sur- rounding lymph-lacuna, to be carried away in the lymph- current. Near the lower part of the ileurn large numbers of solitary follicles are closely collected side by side at intervals along the part of the bowel opposite to that at which the mesentery joins it: these aggregations are known as Peyer's patches; and are easily recognizable by the unaided eye, as villi are absent from the part of the mucous membrane opposite them, and they also cause a bulging, visible on the outside of the intes- tine. They disappear after middle life. The Lymphatic Glands are essentially Peyer's patches more complicated in structure by the fact that the constitu- ent follicles are more closely united and are gathered into roundish masses instead of being spread out in a single layer. They are found in various regions on the course of lymphatic vessels; especially in the mesentery, groin and neck. In the latter position they often inflame and give rise to abscesses, especially in tuberculous persons; and still more often enlarge, harden and become more or less tender, so as to attract at- tention to them. In common parlance it is then frequently said that the person's " kernels have come down/' or that he has " waxing kernels." Each lymphatic gland is enveloped in a connective-tissue capsule, partitions of which incomplete- ly divide it into chambers in which the lymphoid tissue lies. The partitions are more complete in the outer parts of the gland (cor.tical portion), which accordingly looks different from the central portion (medulla) in sections. In the lym- phoid tissue are contained many leucocytes in process of division. " Afferent " lymphatic vessels open into the pe- LYMPHATIC SYSTEM AND DUCTLESS GLANDS. 353 riphery of the gland, and efferent vessels arise in its centre. Hence the lymph in its flow traverses the cellular gland sub- stance, and in its course picks up extra corpuscles which it carries on to the blood. In the lymphoid tissue there is a close network of blood-capillaries. It is clear that these organs are not true glands, in the proper sense of the word: they are sometimes called lymphatic ganglia, but that sug- gests a connection with nerve-centres; a good name for them is lymphatic nodes. In Fig. 12| is given a diagrammatic rep- resentation of a lymphatic node. tr Fm. 121 —Diagram of cross-section of a lymphatic gland : al, afferent lymphatic vessels; el, efferent lymphatic vessel; tr. one of the connective-tissue bands sub- dividing: the gland ; C, cortical portion: M. medullary portion. The leucocytes are represented only in a part of the right half of the figure, where they are seen, Ih. to lie closely packed in the centre of a gland-chamber, while towards the walls of the chamber, 7.9, where they are naturally less closely packed, they have been washed away, as often happens in preparing a specimen, leaving the reticular sup- porting tissue conspicuous. The Movement of the Lymph. This is no doubt some- what irregular in the commencing vessels, but, on the whole, sets on to the larger trunks and through them to the veins. In many animals (as the frog) at points where the lymphatics communicate with the veins, there are found regularly con- tractile "lymph-hearts" which beat with a rhythm independ- ent of that of the blood-h'eart, and pump the lymph into a vein. In the human Body, however, there are no such hearts, and the flow of the lymph is dependent on less definite arrangements. It seems to be maintained mainly by three things. (1) The pressure on the blood-plasma in the capil- laries is greater than that in the great veins of the neck; hence any plasma filtered through the capillary-walls will be 354 THE HUMAN BODY. under a pressure which will tend to make it flow to the ve- nous termination of the thoracic or the right lymphatic duct. (2) On account of the numerous valves in the lymphatic vessels (which all only allow the lymph to flow past them to larger trunks) any movement compressing a lymph-vessel will cause an onward flow of its contents. The influence thus exerted is very important. If a tube be put in a large lym- phatic, say at the top of the leg of an animal, it will be seen that the lymph only flows out very slowly while the animal is quiet; but as soon as it moves the leg the flow is greatly accelerated. (3) During each inspiration the pressure on the thoracic duct is less than that in the lymphatics in parts of the Body outside the thorax (see Chap. XXV). Accord- ingly, at that time, lymph is pressed, or, in common phrase, is "sucked," into the thoracic duct. During the succeeding expiration the pressure on the thoracic duct becomes greater again, and some of its contents are pressed out; but on account of the valves of the vessels which unite to form, the duct, they can only go towards the veins of the neck. During digestion, moreover, contractions of the villi press on the lymph or chyle within them and force it on; and in certain parts of the Body gravity, of course, aids the flow, though it will impede it in others. The Ductless G-lands— Spleen, Thyroid, Thymus, Pit- uitary Body, Suprarenals. — There are in the Body several organs of such considerable size and so constantly present in vertebrate animals that a priori they would seem to be of functional importance. Until quite recently, however, the functions of nearly all of them were quite problematical, al- though it has long been known that pathological changes in some of them were associated with grave conditions of general disease. Even yet their physiology is very incompletely known. When we speak of a true gland we mean an organ that forms some definite secretion which it pours out in a separate form, but the organs we are about to consider have no secret- ing recesses and no ducts: nevertheless some of them un- doubtedly make, and pass into the lymph and blood, substances of great importance to the healthy working of the Body. Some true glands indeed do this, quite apart from the manu- facture of what is usually spoken of as their secretion. Why so large an organ as the liver should be set apart for the for- mation of so comparatively unimportant a digestive fluid as LYMPHATIC SYSTEM AND DUCTLESS GLANDS. 355 the bile was long a puzzle. We now know that the chief use of the liver is connected with the storage and formation of car- bohydrate materials (see Chap. XXIX), and that, quite apart from the use of bile in digestion or the elimination of part of the bile as waste, the liver exerts an essential influence on the whole normal nutritional processes of the Body. Again, in the pancreas we have an organ which forms a very important digestive secretion, and it might well be that this was its sole use in the economy. But when the pancreas is carefully re- moved from an animal great nutritional disturbances follow, as shown, among other things, by diabetes, i.e., the presence of sugar in the urine. Since the pancreatic secretion poured into the intestine by the gland duct has much to do with the digestion of starch and its conversion into sugar, it might be supposed that mere digestive disturbances due to its absence led to the diabetic and general changes. But this is not so. If a piece of living pancreas be transplanted from one animal to beneath the skin of another, and left until it has grown there, the pancreas of the second animal may be removed without causing diabetes. Moreover it is possible by inject- ing melted paraffin into the pancreatic duct of an animal not only to prevent the gland secretion from reaching the intes- tine, but to cause atrophy of the true gland-cells. Yet animals so treated do not become diabetic. It is then clear that there is some material necessary to health and quite distinct from pancreatic juice formed by pancreatic tissue and taken up from it by the circulating liquids. Scattered through the pancreas, and quite distinct from its proper gland tissue? are peculiar patches of cells very richly supplied with blood- vessels. Probably these cells are concerned in the antidiabetic function of the gland; but whether through special cells or not, the organ has an important internal secretion to blood and lymph, in addition to its external secretion to its duct. This fact may have a very wide bearing: it may be that all organs, or many organs, in addition to their more ob- vious functions, do, as the result of the chemical processes taking place in them, manufacture substances a supply of which, to lymph or blood, is required for the life or health of distant parts of the Body. The waste of one organ before its final conversion into carbon dioxide, water, or urea, for elimi- nation from the system, may be a necessary food of another. It is, for example, quite possible that the kreatin formed in 356 THE HUMAN BODY. muscles and passed from them to the circulating fluid is essential to the general health of the Body. There are, how- ever, so many muscles that the removal of some of them, as when a limb is amputated, does not cut off the kreatin supply, and so disease does not result. When, on the other hand, an organ is unique, as the thyroid, or exists only in a single pair, as the suprarenals, then removal or extensive disease, by de- priving the system of the peculiar internal secretion of the organ concerned or, possibly, from the accumulation within the blood of substances which it is the function of the missing part to absorb and destroy, may, often in fact does, lead to widespread nutritional changes, resulting in death. The Spleen. This is an organ situated at the left end of the stomach (//, Fig. J-H1)) and is about 110 grains (G oz. ) in weight. Its size is, however, very variable; it enlarges dur- ing digestion and shrinks after it until the next meal. In many fevers, especially in those of malarial nature, it also becomes enlarged, frequently to a very great extent, and this enlargement may become permanent, constituting the so- called " ague-cake." In color the spleen is dark red, but if cut across numerous white spots of about 1 mm. (^ inch) diameter are seen scattered over the surface of the section : it is very richly supplied with blood which is carried away by the splenic vein (7, Fig. 119) and poured into the portal vein. The spleen possesses on its exterior a connective-tissue capsule very rich in elastic fibres and giving off numerous bands (trabeculcB] which branch and interlace throughout the organ forming a spongy mass, in the spaces of which is contained a soft red pulp of peculiar structure. The arteries of the organ by frequent branching are reduced to almost capillary size, and these terminal twigs enter into the pulp, and there, los- ing all coats but the lining epithelium, assume the structure of capillaries. The cells forming the walls of these ca- pillaries next separate from one another so as to leave clefts between them, and at the same time become irregu- larly branched and, joining by their branches, form a sup- porting framework or reticulum through the pulp, into which latter the blood is poured freely through the spaces between the cells. The main mass of the splenic pulp con- sists of red blood-corpuscles, some normal in appearance, some appearing partly broken down; mixed with these are some white corpuscles, arid some larger colorless amreboid LYMPHATIC SYSTEM AND DUCTLESS GLANDS. 357 cells in which are often found one or more red corpuscles which have apparently been swallowed by them. There are also many pigmented granules, some free and some within amosboid cells; they are apparently the debris of red corpus- cles which have been broken down. In early life the splenic pulp also contains granular colorless cells within which red corpuscles are seen in the process of development. The whole histological structure of the adult pulp suggests that in it many red blood-corpuscles are finally destroyed, setting free haemoglobin and other coloring matters derived from it. This breaking down of haemoglobin must also give rise to proteids and substances derived from the chemical degradation of proteids, and the spleen is extremely rich in nitrogenous crystallhie^^ubatances. The increase in size of the spleen during Tngestion, when the veins of the alimentary canal are pouring great quantities of blood laden with absorbed mat- .ters into the portal system, suggests that the spleen supplies things to the liver at that time which, are of importance to it. There is reason to believe that the main coloring matter of the bile (bilirubvii) is derived from the haemoglobin of red corpuscles which have completed their life-period and been destroyed, and it may be that the spleen takes the first steps in the preparation of bilirubin for its elimination from the Body as a waste product. There still is, however, much doubt as to the real function of the spleen; it almost certainly plays an important part in the proteid metabolisms of the Body. Though so large an organ it is not essential; animals from whom it has been completely removed can live a long time in good health. The red marrow of spongy bone greatly re- sembles the splenic pulp in histological characters and may have similar functions and be able to entirely take the place of the spleen when the organ has been excised. The white spots seen on the cut surface of a spleen are sections of masses of adenoid tissue attached to the smaller splenic arteries and named MalpigMan corpuscles; they resemble the elosed fol- licles of the intestine in structure. The Thyroid Body or Gland. This organ lies in the neck on the sides of the windpipe and consists usually of a right and a left lobe united by a narrow isthmus across the front of the air-tube. It is about thirty grams (two ounces) in weight; in the disease known as goitre it is greatly en- larged and its structure altered. The thyroid is dark red in 358 THE HUMAN BODY. color and very vascular, richly supplied with nerves, and is subdivided by connective tissue into cavities or alveoli, the largest of which are just visible to the unaided eye. Each alveolus is lined by a single layer of cuboidal cells, and filled by a glairy fluid which appears to contain mucin. The very abundant blood-supply of the thyroid suggests that it is the seat of important metabolic or chemical changes, and observation and experiment confirm this. Extensive disease of the thyroid leads to great changes in the general nutrition of the Body, ending in the condition named myxodosma; muciginous liquid collects in the connective tis- sues, nervous and muscular activity are much impaired, tremors and convulsions occur, and finally a semi idiotic con- dition (cretinism) comes on and is followed by death if all the gland be diseased. Quite similar symptoms follow the com- plete removal of the thyroid body from animals, or from man for tumors; but if even a small part of healthy gland-tissue be left behind the symptoms do not occur. Moreover, if a portion of living thyroid from one animal be grafted beneath the skin of another, the thyroid of the latter can be com- pletely removed without influencing the general health. It would seem then that the gland is the place of formation of some substance essential to the healthy working of the Body, but that under ordinary conditions of life the whole organ is not required to produce the necessary minimum of this substance. This view is strengthened by the fact that in patients with thyroid disease and in animals deprived of the organ the symptoms of myxodoema may be relieved or removed by adding raw thyroid tissue to the food, or by subcutaneous injection of the expressed juice of a fresh gland. When in- jected into a healthy animal extract of thyroid causes arterial dilatation, and a lowering of blood pressure. The Thymus. This is a temporary organ of unknown function. It has its greatest size in proportion to the whole weight of the Body a short time before birth. After birth it grows in absolute weight for some time, but then begins to dwindle away and has usually completely disappeared by the twelfth or fourteenth year. It lies in front of the wind- pipe in the lower part of the neck and the upper part of the thorax, and is the "neck" sweetbread of the butcher as dis- tinguished from the true sweetbread or pancreas. The LYMPHATIC SYSTEM AND DUCTLESS GLANDS. 359 thymus essentially consists of adenoid tissue, and is well sup- plied with blood-vessels and lymphatics. The Pituitary Body (Fig. 75) is in part an offshoot of the brain, and probably that portion of it is, like the pineal body, a remnant of a once functionally important ancestral organ. The anterior lobe of the pituitary body, however, is derived in development from the pharynx, of which it is an embryonic outgrowth. This part of it somewhat resembles the thyroid in structure. Complete removal of the pituitary body in the case of cats and dogs causes a lowering of temperature, mus- cular twitchings and spasms, difficulty in breathing, general lassitude, and death within a fortnight. These symptoms improve when extract of the gland is injected. The.prgan has therefore been supposed to form an internal secretion use- ful in maintaining the nutrition of the muscular and nervous systems. Disease of the pituitary body in man has been found to be associated with the curious condition named acromegaly, in which there is hypertrophy of the bones of the limbs and face, and of parts of the skin and mucous membranes. In- jection of the extract of the gland causes, in a normal animal, a more powerful but not quicker heart-beat, and constriction of the arteries. The Suprarenal Capsules or Adrenals are a pair of small organs, weighing together about 12 grams (f oz.) placed one on the top of each kidney. They have, however, no inti- mate connection with the kidneys, and in many animals are placed at some distance from them. Each consists of a denser less colored external cortex, and a central deep yellow-brown softer medulla. The cortex is subdivided into chambers by connective tissue, and the chambers are filled by closely packed, polygonal nucleated cells. Similar cells are found in the medulla, which is, moreover, closely connected with the sympathetic system and is richly supplied with nerves. It was noticed some fifty years ago by a physician named Addisonthat certain obscure diseased conditions characterized by great debility and by the appearance of bronzed patches on the skin, and leading to death, were found on post-mortem examination to be accompanied by disease of the adrenals. The disease has hence been named Addison's disease. When the suprarenal capsules are completely removed from animals a similar fatal diseased condition results, death taking place in warm-blooded animals within two or three days, and be- 360 THE HUMAN BODY. ing preceded by muscular weakness, dilatation of the arteries, mental feebleness and general prostration. The exact role played in the organism by these small but essential organs is still unknown, but they form substances which have a pro- found effect on the nerves of the heart and blood-vessels. A very minute portion of the watery or alcoholic extract of a suprarenal capsule when injected into avein of an animal causes a very slow heart-beat, or even complete inhibition of the auricles. If the cardio-inhibitory nerves have first been cut, on the other hand, the injection causes a great increase in the rate of heart- beat and a great increase of its force, espe- cially that of the auricles. The small arteries become greatly contracted, and this combined with the powerful heart-beats leads to a very great increase of arterial pressure. The arterial constriction is not due to stimulation of the vaso-con stricter centre, but to a direct action on the muscular coats of the arteries: it is very transient. The skeletal muscles are also affected, the period of a simple muscular contraction being greatly prolonged, and this effect lasts much longer than the changes produced in the organs of circulation. The active material exists only in the medulla of the adrenal, is efficient in extremely minute doses, is dialyzable, and its efficacy is not impaired by short boiling. It would appear then that the suprarenals are constantly forming and passing into the blood minute quantities of a substance which is of great importance for the maintenance of the " tone " of the muscles, especially of the cardiac and arterial muscles. Whether in addition they also remove noxious substances from the blood, the accumulation of which after their removal is one cause of the death which results, is still undecided. The blood of such animals acts as a poison to other animals, and this has been supposed to be due to the presence in it of a specific poison which the adrenals normally pick up and destroy: but it is clear that the blood of an ani- mal dying from extensive malnutrition produced in any way would be quite abnormal, ana might well be poisonous to other animals. The same remark may be made as to the poisonous character of the blood of animals dying as a result of removal of the thyroid: there is no satisfactory evidence that it is due to the accumulation of any one special toxic substance which it is a function of the thyroid to remove: still, it maybe. The symptoms produced by its injection are quite different from those produced by injection of thyroid extract CHAPTER XXIV. DIGESTION. The Object of Digestion. Of the various foodstuffs swal- lowed, some are already in solution and ready to dialyze at once into the lymphatics and blood-vessels of the alimentary canal; others, such as a lump of sugar, though not dissolved when put into the mouth, are readily soluble in the liquids found in the alimentary canal, and need no further digestion. In the case of many most important foodstuffs, however, special chemical changes have to be wrought, either with the object of converting insoluble bodies into soluble, or non- dialyzable into dialyzable, or both. The different_secretions poured into the alimentary tube act in various ways upon different foodstuffs, and at last get them into a state in which they can pass into the circulating medium and be carried to all parts of the Body. The Saliva. The first solvent that the food meets with is the saliva, which, as found in the mouth, is a mixture of pure saliva, formed in paroticlr-subm axillary, and sublingual glands, with the mucus secreted by small glands of the buccal mucous membrane. This mixed saliva is a colorless, cloudy, feebly alkaline liquid, "ropy" from the mucin present in 4t, arid usually containing air-bubbles. Pure saliva, as obtained by putting a fine tube in the duct of one of the salivary glands, is more fluid and contains no imprisoned air. Usually but little saliva is secreted ; the presence of food in the mouth, especially highly flavored or acid food, leads to a more abundant flow : the mere chewing of a tasteless inert substance will, however, excite some secretion. The secre- tion thus brought about is reflex: the afferent fibres running to the brain in the glossopharyngeal and lingual nerves, and exciting there the centre from which the efferent secretory nerve-fibres for the glands arise. The centre may be excited in other ways: as by nausea, or through the nerves of eye or nose when the sight or smell of desirable food makes " the mouth water." 361 362 THE HUMAN BODY. The uses of the saliva are for the most part physical and mechanical. It keeps the mouth moist and allows us to speak with comfort; most young orators know the distress occa- sioned by the suppression of the salivary secretion through nervousness, and the imperfect efficacy under such circum- stances of the traditional glass of water placed beside public speakers. The saliva, also, enables us to swallow dry food ; such a thing as a cracker when chewed would give rise merely to a heap of dust, impossible to swallow, were not the mouth cavity kept moist. This fact used to be taken advantage of in the East Indian rice ordeal for the detection of criminals. The guilty person, believing firmly that he cannot swallow the parched rice given him, and fearful of detection, is apt to have the nerve-centres of his salivary glands inhibited or paralyzed by terror, and does actually become unable to swal- low the rice; while in those with clear consciences the nerv- ous system excites the usual reflex secretion, and the dry food gives rise to no difficulty in its deglutition. The saliva, also, dissolves such bodies as salt and sugar, when they are taken into* the mouth in solid form, and enables us to taste them; undissolved substances are not tasted, a fact which any one can verify for himself by wiping his tongue dry and placing a fragment of sugar upon it. No sweetness will be felt until a little moisture has exuded and dissolved part of the sugar. In addition to such actions the saliva, however, exerts a chemical one on an important foodstuff. Starch (although it swells up greatly in hot water) is insoluble, and could not be absorbed from the alimentary canal. The saliva contains an enzyme, ptyalin, which has the power of turning starch into soluble substances. Until recently the chief product was- believed to be grape sugar (glucose)', but it is now ascertained that it is maltose, belonging to the cane-sugar chemical series. In the small intestine the maltose is changed into glucose and absorbed ; so the chemical action of ptyalin upon starch is at most but a preparatory one. In effecting the change the ptyalin is not altered; a very small amount of it can convert a vast amount of starch, and does not seem to have its activity im- paired in the process. The starch is made to combine with the elements of one or more molecules of water, and the ptyalin is unchanged. This faculty of ptyalin is known as q/niiilolytic : and since DIGESTION. 363 it is associated with the taking up of a molecule of water is a hydrolytic action. Ptyalin is a typical enzyme ; it differs from the true ferments, such as yeast, in the fact that it is not a living organism, and does not multiply during the oc- currence of the change which it sets up; its activity belongs to the obscure chemical category of contact actions. In order that the ptyalin may act upon starch certain conditions are essential. Water must be present, and the liquid must be neutral or feebly alkaline; acids retard, or if stronger, entirely stop the process. The change takes place most quickly at about the temperature of the human- Body, and is greatly checked by cold. Boiling the saliva destroys its ptyalin and renders it quite incapable of converting starch. Cooked starch is changed more rapidly and completely than raw. Saliva has another important but indirect influence in promoting digestion. Weak alkalies stimulate the mucous membrane of the stomach and cause it to pour forth more gastric juice. Hence the efficacy of a little carbonate of soda, taken before meals, in some forms of dyspepsia. The saliva by its alkalinity exerts such an action ; and this is one reason why food should be well chewed before being swallowed; for then its taste, and the movements of the jaws, cause the secretion of more saliva. Deglutition. A mouthful of solid food is broken up " the teeth, and rolled about the mouth by the tongue, untij6 is thoroughly mixed with saliva and made into a soft pa& mass. The muscles of the cheeks keep this from gettii between them and the gums; persons with facial paralysL have, from time to time, to press out with the finger food which has collected outside the gums, where it can neither be chewed nor swallowed. The mass is finally sent on from the mouth to the stomach by the process of deglutition, which is described as occurring in three stages. The first stage in- cludes the passage from the mouth into the pharynx. The food being collected into a heap on the tongue, the tip of that organ is placed against the front of the hard palate, and then the rest of the tongue is raised from before back, so as to press the food mass between it and the palate, and drive it back through the fauces. This portion of the act of swallow- ing is voluntary, or at least is under the control of the will, although it commonly takes place unconsciously. The second 364 . THE HUMAN BODY. - ' stage of deglutition is that in which the food passes through • the pharynx; it is the most rapid part of its progress, since , the pharynx has to be emptied quickly so as to clear the .opening of the air-passages for breathing purposes. The •food mass, passing back over the root of the tongue, pushes -down the epiglottis; at the same time the larynx (or voice- 'box at the top of the windpipe) is raised, so as to meet it, •and thus the passage to the lungs is closed ; muscles around 'the aperture probably also contract and narrow the opening. •The raising of the larynx can be readily felt by placing the finger on the large cartilage forming "Adam's apple" in the neck, and then swallowing something. The soft palate is at the same time raised and stretched horizontally across the pharynx, thus cutting off communication with its upper, or respiratory portion, leading to the nostrils and Eustachian tubes. Finally, the isthmus of the fauces is closed as soon as the food has passed through, by the contraction of the mus- cles on its sides and the elevation of the root of the tongue. All passages out of the pharynx except the gullet are thus blocked, and when the pharyngeal muscles contract the food can be squeezed only into the oesophagus. The muscular movements concerned in this part of deglutition are all re- flexly excited; food coming in contact with the mucous mem- brane of the pharynx stimulates afferent nerve-fibres in it; jpse excite the centre of deglutition which is placed in the dulla oblong ata, and from it efferent nerve-fibres proceed , the muscles concerned and (under the co-ordinating influ- ice of the centre) cause them to contract in proper sequence, rhe pharyngeal muscles, although of the striped variety, are but little under the control of the will; it is extremely diffi- cult to go through the movements of swallowing without something (if only a little saliva) to swallow and thus excise the movements reflexly. Many persons, after having got the mouth completely empty cannot perform the movements of the second stage of deglutition at all. On account of the re- flex nature of the contractions of the pharynx, any food which has once entered it must be swallowed: the isthmus of the fauces is a sort of Rubicon; food that has passed it must continue its course to the stomach, although the swallower learnt immediately that he was taking poison. The third stage of deglutition is that in which the food is passing along the gullet, and is comparatively slow. Even liquid substances •DIGESTION: 365 do not fall or flow down this tube, but have their passage controlled by its muscular coats, which grip the successive portions swallowed and pass them on. Hence the possibility of performing the apparently wonderful feat of drinking a glass of water while standing upon the head, often exhibited by jugglers; the onlookers forget that the same thing is^done every day by horses, and other animals, which drink with the pharyngeal end of the gullet lower than the stomach. The movements of the oesophagus are of the kind known as ver- micular or peristaltic. Its circular muscular fibres contract behind the morsel and narrow the passage there; and the con- striction then travels along to the stpmacjh, pushing the food in front of it. Simultaneously tire longitudinal fibres, at the point where the food-mass is at any moment and immediately in front of that, contracting, shorten and widen the passage. The Gastric Juice. — The food having entered the stom- ach is subjected to the auction of the gastric juice, which is a thin, colorless or pale yellow liquid, of a strongly acid reac- tion. It contains as specific elements free hydrochloric acid (about .2 per cent), and an enzyme called pepsin which, in acid liquids, has the power of converting the ordinary non-' dialyzable proteids which we eat, into closely allied bodies, some of which are dialyzable and named peptones. It also dissolves solid proteids, changing them similarly. Dilute acids will by themselves produce the same changes in the, course of several days, but in the presence of pepsin and at the temperature of the Body the conversion is far more rapid. In neutral or alkaline media the pepsin is inactive; and cold checks its activity. Boiling destroys it. In addi- tion to pepsin, gastric juice contains another enzyme (rennin) which coagulates the casein ogen of milk, as illustrated by the use of "rennet," prepared from the mucous membrane of the calf s digestive stomach, in cheese-making. The acid of the natural gastric juice would, it is true, precipitate the casein, but such precipitate is quite different from the true tyre'm, and neutralized gastric juice still possesses this power; moreover, boiled gastric juice loses the milk-clotting property, and a very little normal juice can coagulate a great quantity of milk. The curdled condition of the milk regurgitated by infants is, therefore, not any sign of a disordered state of the stomach, as nurses commonly suppose. It is proper for milk 366 THE HUMAN BODY. to undergo this change, before the pepsin and acid of the gastric juice digest it. The most important change effected by the gastric juice is that of the proteids. This may be studied either on natu- ral juice obtained from the stomach of an animal through an opening (gastric fistula) or on an artificial juice prepared by extracting the mucous membrane of a fresh stomach with glycerine, and 'adding a large quantity of dilute (0.2$) hydro- chloric acid. If blood-fibrin or boiled white of egg be placed in such a mixtttre and kept at a temperature of about 38° C. | (100° F.) these bodies swell, become transparent, and soon dissolve ; and all other solid proteids undergo similar changes. If the solution be now neutralized a small white precipitate of parapeptone (which is probably only ordinary acid albu- min) is obtained. The filtrate from this gives no precipitate on boiling, but an abundant one of albumose on the addition of ammonium sulphate. The filtrate from this precipitate yields an abundant precipitate of peptone when alcohol is added. Peptone is dialyzable, though not so easily as saline bodies, and in this differs from albumose and parapeptone and all other proteids. The parapeptone is probably a bye- product due to the action of the acid of the juice alone: the albumose and peptone are true products of peptic digestion of proteids, due to their breaking up with concomitant hy- dration, the peptone being the more finished or complete digestive product. If instead of solid proteids we use solu- tion of white of egg or of serum albumin, the earlier stages of the process cannot be followed by the eye, but the final prod- ucts are the same: the original proteid disappears, giving origin to some parapeptone, to albumose, and to peptone; and prolonged artificial peptic digestion causes no further breaking up of the albumose or peptone. Peptone is very soluble in water, and its solutions are not coagulated by boiling. A very small amount of pepsin can, if some acid be added from time to time, convert a very large amount of proteid: it is de- stroyed by boiling. Gastric Digestion. The process of swallowing is contin- uous, but in the stomacli the onward progress of the food is stayed for some time. The pyloric sphincter, remaining con- tracted, closes the aperture leading into the intestine, and the irregularly disposed muscular layers of the stomach keep its semi-liquid contents in constant movement, maintaining a DIGESTION. 367 sort of churning by which all portions are brought into con- tact with the mucous membrane, and thoroughly mixed with the secretion of its glands. The gelatin-yielding connective tissue of meats is dissolved away, and the proteid-containing fibres, left loose, are dissolved and changed. The albuminous walls of the fat-cells are dissolved and their oily contents set free; but the gastric juice does not act upon the latter. Cer- tain mineral salts (as phosphate of lime, of which there is always some in bread) which are insoluble in water but solu- ble in dilute acids, are also dissolved in the stomach. On the other hand, the gastric juice has itself no action upon starch, and since ptyalin does not act at all, or only imper- fectly, in an acid medium, the activity of the saliva in con- verting starch is stayed in the stomach. By the solution of the white fibrous connective tissue, that disintegration of ani- mal foods commenced by the teeth, is carried much farther in the stomach, and the food-mass, mixed with much gastric secretion, becomes reduced to the consistency of a thick soup, usually of a grayish color. In this state it is called cliyme. Chyme contains, after an ordinary meal, much peptone, though some of this has been already dialyzed into the gastric mucous membrane and carried off along with other dissolved dialyz- able bodies, such as salts and sugar. The albumose, fats, and starch still remain in the chyme. After the food has re- mained in the stomach some time (one and a half to two hours) the chyme begins to be passed on into the intestine in successive portions. The pyloric sphincter relaxes at in- tervals, and the rest of the stomach, contracting at the same moment, injects a quantity of chyme into the duodenum; this is repeated frequently, the larger undigested fragments being at first unable to pass the orifice. At the end of about three or four hours after a meal the stomach is again quite emptied, the pyloric sphincter finally relaxing to a greater extent and allowing any larger indigestible masses, which the gastric juice cannot break down, to be driven into the in- testine. The Chyle. When the chyme passes into the duodenum it finds preparation made for it. The pancreas is in reflex connection with the stomach, and its nerves cause it to qom- mence secreting as soon as food enters the latter; hence a quantity of its secretion is already accumulated in the intes- tine when food enters. The gall-bladder is distended with 368 THE HUMAN BODY. bile, secreted since the* last meal; this passing down the hepatic duct has been turned back up the cystic duct (Dc, Fig. 115) on account of the closure of the common bile-duct. The acid chyme, stimulating"' nerve-endings in the duodenal mucous membrane, causes reflex contraction of the muscular coat of the gall-bladder, and a relaxation of the orifice of the common bile-duct; and so a gush of bile is poured out on the chyme. From this time on, both liver and pancreas continue secreting actively for some hours, and pour their products into the intestine. The glands of Brunner and the crypts of Lieberkiilm are also set at work, but concerning their physiology we know very little. All of these secretions are alkaline, and they suffice very soon to more than neutralize the acidity of the gastric juice^and to convert the acid chyme into alkaline chyle, which, after an ordinary meal, will con- tain a great variety of things: mucus derived from the ali- mentary canal; ptyalin from the saliva; pepsin from the stomach; water, partly swallowed and partly derived from the salivary and other secretions; the peculiar constituents of the b^e and pancreatic juice and of the intestinal secretions; some™! digested proteids; unchanged starch; oils from the fats eaten; peptones formed in the stomach but not yet ab- sorbed; albumose; parapeptone; possibly salines and sugar which have also escaped absorption in the stomach; and in- digestible substances taken with the food. The Pancreatic Secretion is clear, watery, alkaline, and much like saliva in appearance. The Germans call the pan- creas the "abdominal salivary gland." In digestive prop- erties, however, the pancreatic secretion is far more impor- tant than the saliva, or even the gastric juice. Starch it changes as the saliva does, but converts it into maltose more quickly : and it acts also on proteids and fats. It is by far the most important of all the digestive secretions. All proteids not already converted into peptone or albumose are acted upon by the pancreatic juice even more ener- getically than in the stomach, being not only converted into peptone, but in part further broken up, if the digestion (arti- ficial) be prolonged, and converted into crystallizable nitrog- enous bodies which, unlike peptone, retain no proteid-like characters: the chief of these are leucin and tyrosin, the former allied chemically to the fatty acids, the other to bodies of the aromatic series. In normal digestion, however, it is DIGESTION. 369 probable that but little of the proteid is broken up beyond the peptone stage, and all of it never is; an album ose is formed as an intermediate product. The enzyme concerned is trypsin ; it is active only in an alkaline or neutral medium, and before dissolving solid proteids does not cause them to swell and become transparent as pepsin does. Like the other digestive ferments, it is most active at about the temperature of the Body, and is destroyed by boiling. On fats the pan- creatic secretion has a double action. To a certain extent it breaks them up, with hyd ration, into free fatty acids and glycerin; for example— (C'CHH0)' 1 °3 + 3H'° = 3(°18Hs H 1 °) + °3H6 1 Stearin + 3 Water = 3 Stearic acid + 1 Glycerine. The fatty acid then combines with some of the alkali present to make a soap, which being soluble in water is capable of absorption. Glycerin, also, is soluble in water and dialyz- able. The greater part of the fats are not, however, so broken up, but are simply mechanically separated into which remain suspended in the chyle and give it color, just as the cream -drops are suspended in milk, or the olive-oil in mayonnaise sauce. This is effected by the help of a quantity of albumin which exists dissolved in the pancreatic secretion. In the stomach, the animal £its eaten have lost their cell-walls, and have become melted by the temperature to which they were exposed. Hence their oily part floats free in the chyme when it enters the duodenum. If oil be shaken up with water, the two cannot be got to mix; immediately the shaking ceases, the oil floats up to the top; but if some raw egg be added, a creamy mixture is readily formed, in which the oil remains for a long time evenly suspended in the watery menstruem. The reason of this is that each oil- droplet becomes surrounded by a delicate pellicle of albumin, and is thus prevented from fusing with its neighbors to make large drops, which would soon float to the top. Such a mix- ture is called an emulsion, and the albumin of the pancreatic secretion emulsifies the oils in the chyle, which becomes , white (for the same reason as milk is that color) because the innumerable tiny oil-drops floating in it reflect all the light which falls on its surface. In brief, the pancreatic secretion converts starch into 370 THE HUMAN BODY. maltose ; dissolves proteids (if necessary) and converts them into peptones; emulsifies fats, and, to a certain extent, breaks them up into glycerin and fatty acids; the latter are then saponified by the alkalies present. The Bile. — Human bile when quite fresh is a golden brown liquid; it becomes green when kept. As formed in the liver it contains hardly any mucin, but if it make any stay in the gall-bladder it acquires much from the lining mem- brane of that bag, and becomes slimy and " ropy." It is alkaline in reaction and, besides coloring matters (the more important of which, bilirubin, is probably a waste product derived from haemoglobin), contains mineral salts and water, and the sodium salts of two nitrogenized acids, taurocliolic and glycliocholic, the former predominating in human bile. Pettenkofer's Bile Test. If a small fragment of cane sugar be added to some bile, and then a large quantity of strong, sulphuric acid, a brilliant purple color is developed, by cer- tain products of the decomposition of the bile acids; the physician can by this test, in disease, detect their presence in the urine or other secretions of the Body. Gmetin's Bile Test. Whe bile-coloring matters, treated with yellow nitric acid, go through a series of oxidations, accompanied with changes of color from yellow-brown to green, then to blue/ violet, purple, red, and dirty yellow. Bile has no digestive action upon starch or proteids./ji It does not break up fats, but to a limited extent emulsifies them, though far less perfectly than the pancreatic secretion. It is even doubtful whether this action is exerted in the in- testines at all. In many animals, as in man, the bile and pancreatic ducts open together into the duodenum, so that, on killing a dog during digestion and finding emulsified fats in the chyle, it is impossible to say whether or no the bile had a share in the process. In the rabbit, however, the pan- creatic duct opens into the intestine about a foot farther from the stomach than the bile-duct, and it is found that if a rabbit be killed after being fed with oil, no milky chyle is found down to the point where the pancreatic duct opens. In this animal, therefore, the bile alone does not emulsify fats, and, since the bile is pretty much the same in it and other mammals, it probably does not emulsify fats in them either. From the inertness of bile with respect to most food- stuffs it has been doubted whether it be of any digestive use at DIGESTION. 371 all, and whether it should not be regarded merely as an excre- tion, poured into the alimentary canal to be got rid of. But there are many reasons against such a view. In the first place, the entry of the bile into the upper end of the small intestine where it has to traverse a course of more than twenty feet before getting out of the Body, instead of its being sent into the rectum, close to the final opening of the alimentary canal, makes it probable that it has some function to fulfil in the intestine. Moreover, a great part of the bile, including prac- tically all the bile salts, poured into the intestines is again absorbed from them ; this seems to show that part of the bile is secreted for some other purpose than mere elimination from the Body. One subsidiary use is to assist, by its alka- linity, in overcoming the acidity of the chyme, and so to allow the trypsin of the pancreatic secretion to act upon pro- teids. Constipation is, also, apt to occur in cases where the bile-duct is temporarily stopped, so that bile probably helps to excite the contractions of the muscular coats of the intestine;* under similar circumstances putrefactive decompositions are apt to occur in the intestinal contents. Apart from such sec- ondary influences,however, the bile probably has some influence in promoting the absorption of fats. If one end of a capillary glass tube, moistened with water, be dipped in oil, the latter will not ascend in it, or but a short way; but if the tube be moist- ened with bile, instead of water, the oil will ascend higher in it. So, too, oil passes through a plug of porous clay kept moist with bile, under a much lower pressure than through one wet with water. Hence bile, by soaking the epithelial cells lining the intestine, may facilitate the passage into the villi of oily substances. At any rate, experiment shows that if the bile be prevented from entering the intestine of a dog, the animal eats an enormous amount of food compared with that amount which it needed previously; and that of this food a great proportion of the fatty parts passes out of the alimen- tary canal unabsorbed. There is no doubt, therefore, that the bile somehow aids in the absorption of fats, but exactly how is uncertain. Its possible action in exciting the muscles of the villi to contract will be referred to presently. The Intestinal Secretions or Succus Entericus. These consist of the secretions of the glands of Brunner and the crypts of Lieberkiihn. It is difficult to obtain them pure; in- deed the product of Brunner's glands has never been obtained 372 THE HUMAN BODY. unmixed. That of the crypts of Lieberkiihn is watery and alkaline, and poured out more abundantly during digestion than at other times. It has no special action on starches, most proteids, or on fats; but is said to dissolve blood fibrin and convert it into peptone, and it changes maltose into grape sugar; so that this cane sugar is turned into a grape sugar before being absorbed. Mucus is also formed and poured out abundantly by the epithelium cells of the intes- tinal lining membrane. It is more especially secreted during fasting, and by its stickiness collects debris and keeps the mucous membrane clean. Intestinal Digestion. Having considered separately the actions of the secretions which the food meets with in the small intestine we may now consider their combined effect. The neutralization of the chyme, followed by its conver- sion into alkaline chyle, will prevent any further action of the pepsin on proteids, but will allow the ptyalin of the saliva (the activity of which was stopped by the acidity of the gastric juice) to recommence its action upon starch. More- over, in the stomach there is produced, alongside of the albu- mose and true peptone, the parapeptone, which agrees very closely with syntonin in its properties, and this passes into the duodenum in the chyme. As soon as the bile meets the chyme it precipitates the parapeptone, and this carries down with it any peptones which, having escaped absorption in the stomach, may be present; it also precipitates the pep- sin. In consequence, one finds in an animal killed during digestion, a granular precipitate over the villi, and in the folds between the valvulge conniventes of the duodenum. This is redissolved by the pancreatic secretion, which also changes into peptone the proteids (usually a considerable pro- portion of those eaten at a meal) which have passed through the stomach unchanged, or as albumose or parapeptone. The conversion of starch into maltose will go on very rapidly under the influence of the pancreatic secretion. Fats will be split up and saponified to a certain extent, but a far larger pro- portion will be emulsified and give the chyle a whitish appear- ance. Later cane sugar, which may have escaped absorption in the stomach, and maltose will be converted into grape sugar and absorbed, along with such salines as may, also, have hith- erto escaped. Elastic tissue from animal substances eaten, DIGESTION. 373 cellulose from plants, and mucin from the secretions of the alimentary tract, will all remain unchanged. Absorption from the Small Intestine. The chyme leav- ing the stomach is a semi-liquid mass which, mixed in the duodenum with considerable quantities of pancreatic secre- tion and bile, is further diluted. Thenceforth it gets the intestinal secretion added to it, but the absorption more than counterbalancing the addition of liquid, the food- mass becomes more and more solid as it approaches the ileo- colic valve. At the same time it becomes poorer in nutritive constituents, these being gradually removed from it in "its progress; most dialyze through the epithelium into the sub- jacent blood and lymphatic vessels, and are carried off. Those passing into the blood capillaries are taken by the por- tal vein to the liver; while those entering the lacteals are carried into the left jugular vein by the thoracic duct. As to which foodstuffs go one road and which the other, there is still much doubt; sugars probably go by the portal system, while the fats, mainly, if not entirely, go through the lacteals. How the fats are absorbed is not clear, since oils will not dia- lyze through membranes, such as that lining the intestine, moistened with watery liquids. Most of them, nevertheless, get into the lacteals as oils and not as soluble soaps; for one finds these vessels, in a digesting animal, filled with white milky chyle; while at other periods their contents are watery and colorless like the lymph elsewhere in the Body. The little fat-drops of the emulsion formed in the intestine, go through the epithelial cells and not between them, for during digestion these cells are loaded with oil-droplets; as their free ends are striated and probably devoid of any definite cell- wall, it is possible that the intestinal movements squeeze Lrops into them, but the cells may play a more active part. yThe \triation of the border is due to closely-set rods which fiown to be able to change their form, and it is possible 'they actively seize oil-droplets and other minute solid particles. The cell passes the fat to its deeper end thence, out into the subjacent lymphoid tissue. It is probable that here certain amoeboid cells of the adenoid tissue pick it up, and carry it into the central lacteal of a villus, where they break up and set it free. In the villus there are all the anatomical arrangements for a mechanism which shall actively suck substances into it. Each is more or less 374 THE HUMAN ItODY. elastic, and moreover, its capillary network when filled with blood will distend it. If its plain muscular layer contracts and compresses it, causing its central lacteal to empty into vessels lying deeper in the intestinal wall, the villas will actively expand again so soon as its muscles relax. In so doing it cannot fill its lacteals from the deeper vessels on account of the valves in the latter, and, accordingly, must tend to draw into itself materials from the intestines; much like a sponge re-expanding in water, after having been squeezed dry. The liquid thus sucked up may draw oil-drops with it, into the free ends of the cells and between them ; and by repetitions of the process it is possible that considerable quantities of liquid, with suspended oil-drops, might be car- ried into the epithelial cells covering a villus. The bile moistening the surface of the villus may facilitate the passage of oil, and it is also said to stimulate the contractions of the villi; if so, its efficacy in promoting the absorption of fats will be explained, in spite of its chemical inertness with re- spect to those bodies. There is also reason to believe that a good deal of the emulsified fat is also directly picked up by amoeboid corpuscles, which push their way between the epithelial cells and thrusting processes into the intestine, pick up oil-droplets, and then travel back and convey their load to the lacteal. The path taken by peptones is uncertain. They seem to be very rapidly converted into proteids (? serum albumin) after absorption as they cannot be found, or only traces of them, in the thoracic duct or the portal vein blood of a digesting animal. Moreover, peptones directly injected into the blood are poisonous. Probably they are seized upon formed by the cells of the lymphoid tissue. Digestion in the Large Intestine. The contractions of the small intestine drive on its continually diminishing con- tents until they reach the ileo-colic valve, through which they are ultimately pressed. As a rule, when the mass enters the large intestine its nutritive portions have been almost entirely absorbed, and it consists merely of some water, with the indigestible portion of the food and of the secretions of the alimentary canal. It contains cellulose, elastic tissue, mucin, and somewhat-altered bile pigments; some fat if a large quantity has been eaten; and some starch, if raw vege- tables have formed part of -the diet. In its progress through DIGESTION. 375 the large intestine it loses more water, and the digestion of starch and the absorption of fats is continued. Finally the residue, with some excretory matters added to it in the large intestine, collects in the sigmoid flexure of the colon and in the rectum, and is sent out of the Body from the latter. The Digestion of an Ordinary Meal. We may best sum up the facts stated in this chapter by considering the diges- tion of a common meal; say a breakfast consisting of bread and butter, beefsteak, potatoes and milk. Many of these substances contain several alimentary principles, and, since these are digested in different ways and in different parts of the alimentary tract, the first thing to be done is to consider what are the proximate constituents of each. We thus sepa- rate the materials of the breakfast as in table on next page. From such a meal we may first separate the elastin, cellu- lose, and calcium sulphate, as indigestible and passed out of the Body in the same state and in the same quantity as they entered it. Then come the salines which need no special digestion, and, taken either in solution or dissolved in the saliva or gastric juice, are absorbed from the mouth, stomach, and intestines without further change. Cane and grape sugars experience the same lot, except that any cane sugar or maltose reaching the intestines before absorption is changed into grape sugar by the succus entericus. Calcium phosphate will be dissolved by the free acid in the stomach, yielding calcium chloride, which will be absorbed there or in the intestine. Starch will be partially converted into maltose ng mastication and deglutition, and it is possible that e of this sugar may be absorbed from the stomach. great part of the starch will, however, be passed on into the intestine unchanged, since the action of saliva is suspended in the stomach; and its conversion will be com- pleted by the pancreatic secretion, and perhaps by the ptyalin, though this is probably destroyed in the stomach by the gastric juice; but in any case the starch will only have been changed to maltose, and will need further digestive treatment. '-/The various proteids will be partially dissolved in the stomach and converted into peptone, which will in part be absorbed there; the residue, with the undigested proteids, will be passed on to the intestines. There the bile will precipitate the peptones and parapeptones and, with the pancreatic secretion, render the chyme alkaline, and so stop the activity 376 HUMAN BODY. is .2 • ' CC •*— Q "cc 3 hi "~ ^ 1 O "^ ^ W O 3 5 s« .S M 2 a ^s O ^ a 13 0) O O o> n- " ^ 1 5 s3® .3 _ tf> a& £• S ^» « 1 § ^ e§ fl ^g ".£ *§ S ^ 4» ^ '-2 'S H 0 C u '1 a § ?-s « i ^§ cd 1 I -2 r5 ^WC3 a>>« 3 ^^ 3 ^ PH S ^2 ^} OH ^^ ^Q ^ r^ Q^ CT* o +=• "o *^ g g "3 &jS II III 1 i *' Is* H O 02 CP ^ g'tS ij 'S 1 "3 5 § si o O C cr 1 i g ^ fj S 2* 02 - 03 S £ 35 02 CD PH 1 D| o O I i A .d J S S 5 cS 3 CO O2 "o « £ S ^ ^3 n^ ^J S +5 ^ «i 1? |S PH^O p ^ J C ^3 ^ A? g- 1 ll O^ O ^ 51"1 Q 0 IjJ £ .=,8 S 8| 5 A O 03 -H | Common salt and others. 1 S 1 1 1 | c! 11§1 g ° eS 03 g ° d ^ "o 2 s ^ |§ ^a Common salt and others, especially phosphates. 1 1 5 -§ S | S £ III 1 : ^ : B B fl tn .2 .2 1 3 CO +* *S o .S d o «j d o rrt C^ 4) 0 •cj o5 ^ *^ ® J^ " ^ O "S o pq W J ° 1 r3 DIGESTION. 377 of the gastric pepsin. The pancreatic secretion will, how- ever, redissolve the precipitated peptone, and the unchanged proteids and parapeptone and the albumose, and turn the three last into peptone, breaking up part of this into leucin and tyrosin ; these will be absorbed as they pass along the small intestine; a small quantity perhaps passing into the large intestine, to be taken up there. The fats will remain unchanged until they enter the small intestine, except that the proteid cell-walls of the adipose tissue of the beefsteak will be dissolved away. In the small intestine some of these little oil masses will be in part saponified, but most will be emulsified and taken up into the lacteals in that condition. Gelatin, from the white fibrous tissue of the beefsteak, will undergo changes in the stomach and intestine, and be dis- solved and absorbed. The substances leaving the alimentary canal after such a meal would be, primarily, the indigestible cellulose and elastin, and some water. But there might also be some uriab- sorbed fats, starch, and salts. To these would be added, in the alimentary canal, mucin, some of the ferments of the di- gestive secretions, some slightly altered bile pigments, and other bodies excreted by the large intestine. Dyspepsia is the common name of a number of diseased conditions attended with loss of appetite or troublesome digestion. Being often unattended with acute pain, and if it kills at all doing so very slowly, it is pre-eminently suited for treatment by domestic quackery. In reality, however, the immediate cause of the symptoms, and the treatment called for, may vary widely; and their detection and the choice of the proper remedial agents often call for more than ordinary medical skill. A few of the more common forms of dyspepsia may be mentioned here, with their proximate causes, not in order to enable people to undertake the rash experiment of dosing themselves, but to show how wide a chance there is for any unskilled treatment to miss its end, and do more harm than good. Appetite is primarily due to a condition of the mucous membrane of the stomach which, in health, comes on after a short fast, and stimulates.its sensory nerves; and loss of appe- tite may be due to either of several causes. The stomach may be apathetic and lack its' normal sensibility, so that the empty condition does not act, as it normally does, as a sum*- 378 THE HUMAN BODY. cient excitant. When food is taken it is a further stimulus and may be enough ; in such cases " appetite comes with eat- ing." A bitter before a meal is useful as an appetizer to patients of this sort. On the other hand,, the stomach may be too sensitive, and a voracious appetite be felt before a, meal, which is replaced by nausea, or even vomiting, as soon as a few mouthfuls have been swallowed; the extra stimulus of the food then overstimulates the too irritable stomach, just as a draught of mustard and warm water will a healthy one. The proper treatment in such cases is a soothing one. When food is taken it ought to stimulate the sensory gastric nerves, so as to excite the reflex centres for the secretory nerves, and for the dilatation of the blood-vessels of the organ; if it does not, the gastric juice will be imperfectly secreted. In such cases one may stimulate the secretory nerves by weak alkalies, as certain mineral waters or a little carbonate of soda, before meals; or give drugs, as strychnine, which increase the irritability of reflex nerve-centres. The vascular dilatation may be helped by warm drinks, and this is probably the rationale of the glass of hot water after eating which has often been found useful; the usual small cup of hot coffee after dinner is a more agreeable form of the same aid to digestion. In states of general debility, when the stomach is too feeble to secrete under any stimulation, the administration of weak acids and artificially prepared pepsin is needed, to supply gastric juice from outside, until the im- proved digestion strengthens the stomach up to the point of being able to do its own work. Enough has probably been said to show that dyspepsia is not a disease, but a symptom accompanying many pathologi- cal conditions, requiring special knowledge for their treat- ment. From its nature — depriving the Body of its proper nourishment — it tends to intensify itself, and so should never be neglected; a stitch in time saves nine. The Movements of the Intestines. When the abdomen of a living anaesthetized animal is opened, especially during digestion, contractions are seen slowly travelling along the bowels, which have in consequence somewhat the appearance of a writhing mass of worms, hence the name vermicular often given to these movements: they are also called peri- staltic. On observing a portion of the gut a narrowing due to contraction of its circular muscular coat will be seen to DIGESTION. 379 pass slowly along it, normally in a direction towards the rectum; these contractions push before them part of the con- tents of the intestine. The simultaneous contractions of the outer longitudinal layer of the muscular coat are not so marked or so easily directly observable. If the bowels be entirely removed from the body of the animal the movements go on for some time, so they are obviously not directly de- pendent on extrinsic nerves. They are probably primarily due to a slight automaticity of the muscle itself, which as in the case of the heart (Chap. XVII) is favored by distension, but they may be due to nerve impulses arising in the cells of the plexus of Auerbach. As in the case of the heart these move- ments are under control of extrinsic nerve-fibres, originating in the cerebro-spinal centre, and these fibres are excitor and depressor. Exactly contrary to that which we find in the case of the heart, the fibres reaching the intestines through the pneumogastrics are excitor, causing more powerful con- tractions, and the fibres coming from the sympathetic through the splanchnics (where they are mixed with but quite dis- tinct from the vaso-constrictor fibres) are inhibitory. Stimu- lation of the splanchnic nerves will bring actively contract- ing intestines to rest. The influence of the central nervous system on the motions of the bowel is shown by the contrac- tions caused by fright or other strong emotions, illustrated by the Hebrew phrase "bowels moved with compassion." Deficiency of arterial blood excites powerful intestinal con- tractions. The various purgative medicines act in very differ- ent ways ; some directly on the intestinal neuro-muscular apparatus; some on the extrinsic nerve centres concerned; some (as Epsom salts) mainly by causing a great secretion of liquid into the bowel and so distending it. CHAPTER XXV. THE RESPIRATORY MECHANISM. . 3J Definitions. Tttie blood as it flows from the right ventri- cle of the heart, through the lungs, to the left auricle, loses carbon dioxide and gains oxygen. In the systemic-- circula- tion exactly the reverse changes take place, oxygen leaving the blood to supply the living tissues; and carbon dioxide, gen- erated in them, passing back into the blood capillaries. The oxygen loss and carbon dioxide gain are associated with a change in the color of the blood from bright scarlet to purple red, or from arterial to venous; and the opposite changes in the lungs restore to the dark blood its bright tint. The whole set of processes through which blood becomes venous in the systemic circulation and arterial in the pulmonary — in other words the processes concerned in the gaseous reception, distribution and elimination of the Body — constitute the function of respiration ; so much of this as is concerned in the interchanges between the blood and air being known as external respiration / while the interchanges occurring in the systemic capillaries, and the processes in general by which oxygen is fixed and carbon dioxide formed by the liv- ing tissues, are known as internal respiration. When the term respiration is used alone, without any limiting adjective, the external respiration only, is commonly meant. Respiratory Organs. The blood being kept poor in oxy- gen and rich in carbon dioxide by the action of the living tissues, a certain amount of gaseous interchange will nearly always take place when it comes into close proximity to the .surrounding medium: whether this be the atmosphere itself .or water containing air in solution. When an animal is .small there are often no special organs for its external res- piration, its general surface being sufficient (especially in aquatic animals with a moist skin) to permit of all the gas- •eous exchange that is necessary. In the simplest creatures, .indeed, there is even no blood, the cell or cells composing 380 THE EE8PIRATORT MECHANISM. 381 them taking up for themselves from their environment the oxygen which they need, and passing out into it their car- bon dioxide waste; in other words, there is no differen- tiation of the external and internal respirations. When, however, an animal is larger many of its cells are so far from a free surface that they cannot transact this give-and-take with the surrounding medium directly, and the blood, or some liquid representing it in this respect, serves as a mid- dleman between the living tissues and the external oxygen; and then one usually finds special respiratory organs devel- oped, to which the blood is brought to make good its oxygen loss and get rid of its excess of carbon dioxide. In aquatic animals such organs take commonly the form of gills; these are protrusions of the body over which a constant current of water, containing oxygen in solution, is kept up; and in which blood capillaries form a close network immediately be- neath the surface. In air-breathing animals a different ar- rangement is usually found. In some, as frogs, it is true, the skin is always moist and serves as an important respiratory organ, large quantities of venous blood being sent to it for aeration. But for the occurrence of the necessary gaseous diffusion, the skin must be kept very moist, and this, in a terrestrial animal, necessitates a great amount of secretion by the cutaneous glands to compensate for evaporation; accord- ingly in most land animals the air is carried into the body through tubes with narrow external orifices and so the drying up of the breathing surfaces is greatly diminished; just as water in a bottle with a narrow neck will evaporate much more slowly than the same amount exposed in an open dish. In insects (as bees, butterflies, and beetles) the air is carried by tubes which split up into extremely fine branches and ramify all through the body, even down to the individual tissue ele- ments, which thus carry on their gaseous exchanges without the intervention of blood. But in the great majority of air-breathing animals the arrangement is different; the air- tubes leading from the exterior of the body do not subdivide into branches which ramify all through it, but open into one or more large sacs to which the venous blood is brought, and in whose walls it flows through a close capillary network. Such respiratory sacs are called lungs, and it is a highly de- yeloped form of them which is employed in the Human Body. The Air-Passages and Lungs. In our own Bodies some 382 THE HUMAN BODY. small amount of respiration is carried on in the alimentary canal, the air swallowed with food or saliva undergoing gaseous ex- changes with the blood in the gas- tric and intestinal mucous mem- branes. The amount of oxygen thus obtained by the blood is however very trivial, as is that absorbed through the skin, cov- ered as it is by its dry horny non- vascular epidermis. All the really essential gaseous interchanges be- tween the Body and the atmos- phere take place in the lungs, two large sacs (lu, Fig. 1) lying in the thoracic cavity, one on each side of the heart. To these sacs the air is conveyed through a series of passages. Entering the pharynx through the nostrils or mouth, it passes out of this by the open- ing leading into the larynx, or voice-box (a, Fig. 122), lying in the upper part of the neck (the communication of the two is seen in Fig. 107) ;' from the larynx passes back the trachea or windpipe, b, which, after entering the chest cavity, divides into the right and left bronchi, d, e. Each bronchus divides up into smaller and smaller branches, called bronchial tubes, within the lung on its own side; and the smallest bronchial tubes end in sacculated dilatations, the infundibula of the lungs, the sacculations (Fig. 124) being the alveoli; the word " cell " being here used in its prim- itive sense of a small cavity, and not in its later technical significa- tion of a morphological unit of the Body. On the walls of the air-cells the pulmonary capillaries ramify, and it is in them that the interchanges of thje external res- piration take place. Structure of the Trachea and Bronchi. The windpipe may readily be felt in the middle line of the neck, a little below Vis. 122. — The lungs and air- passnges seen from the front. On the left of the figure the pulmo- nary tissue lias been dissected away to show the ramifications of the bronchial tubes, a, larynx ; 6, trachea ; d, right bronchus. The left bronchus is seen entering the root of its lung. FIG. 123.— A small bronchial tube, a, dividing into its terminal branch- es, c ; these have pouched or saccu- lated walls and end in the saccu- lated infundibula, b. THE RESPIRATORY MECHANISM. 383 Adam's apple, as a rigid cylindrical mass. It consists funda- mentally of a fibrous tube in which cartilages are imbedded, so as to keep it from collapsing; and is lined internally by a mucous membrane covered by several layers of epithelium cells, of which the superficial is ciliated. The elastic car- tilages imbedded in its walls are imperfect rings, each some- what the shape of a horse shoe, and the deficient part of each ring being turned backwards, it comes to pass that the deeper or dorsal side of the windpipe has no hard parts in it. Against this side the gullet lies, and the absence there of the cartilages no doubt facilitates swallowing. The bronchi re- semble the windpipe in structure. The Structure of the Lungs. These consist of the bron- chial tubes and their terminal dilatations; numerous blood- vessels, nerves and lymphatics; and an abundance of connec- tive tissue, rich in elastic fibres, binding all together. The bronchial tubes ramify in a tree-like manner (Fig. 122). In structure the larger ones resemble the trachea, except that the cartilage rings are not regularly arranged so as to have their open parts all turned one way. As the tubes become smaller their constituents thin away; the cartilages become less frequent and finally disappear; the epithelium is re- duced to a single layer of cells which, though still ciliated, are much shorter than the columnar superficial cell-layer of the larger tubes. The terminal alveoli (a, a, Fig. 124), and the air-cells, ft, which open into them, have walls composed mainly of elastic tissue and lined by a single layer of flat, non-ciliated epithelium, immediately beneath which is a very close network of capillary blood-vessels. The air entering by the bronchial tube is thus only separated from the blood by the thin capillary wail and the thin epithelium, both of which are moist, and well adapted ,.~ . FIG. 124.— Two infuudibula of the to permit gaSeOUS diffusion. lung: much magnified 6, 6. the air- m, -TV, -™ -i i • cells, or hollow protrusions of the The Pleura. Each lung IS alveolus, opening into its central covered, except at one point, by ™' an elastic serous membrane which adheres tightly to it and 384 THE HI MAN BODY. c_/^ is called the pleura ; that point at which the pleura is wanting is called the root of the lung and is on its median side; it is there that its bronchus, blood-vessels and nerves enter it. At the root of the lung the pleura turns back and lines the inside of the chest cavity, as represented by the dotted line in the diagram Fig. 3. The part of the pleura attached to each lung is its visceral, and that attached to the chest-wall its parietal layer. Each pleura thus forms a closed sac surrounding a pleural cavity, in which, during health, there are found a few drops of lymph, keeping its surfaces moist. This lessens friction between the two layers during the movements of the chest-walls and the lungs; for although, to insure distinctness, the visceral and parietal layers of the pleura are represented in the diagram as not in contact, that is not the natural condition of things; the lungs are in life distended so that the visceral pleura rubs against the parietal, and the pleural cavity is practically obliterated. This is due to the pressure of the atmosphere exerted through the air-passages on the interior of the lungs. The lungs are extremely elastic and distensible, and when the chest cavity is perforated each shrivels up just as an indian-rubber blad- der does when its neck is opened; the reason being that then the air presses on the outside of each with as much force as it does on the inside. These two pressures neutralizing one another, there is nothing to overcome the tendency of the lungs to collapse. So long as the chest-walls are whole, how- ever, the lungs remain distended. The pleural sac is air-tight and contains no air, and the pressure of the air around the Body is borne by the rigid walls of the chest and prevented from reaching the lungs; consequently no atmospheric pres- sure is exerted on their outside. On their interior, however, the atmosphere presses with its full weight, equal to about 90 centigrams on a square centimeter (14.5 Ibs. on the square inch), and this is far more than sufficient to dis- tend the lungs so as to make them com- pletely fill all the parts of the thoracic cav- ity not occupied by other organs. Suppose ' me mngs'Khl^ho- bJ a cork through which two tubes pass, rax. one of which, £, leads into an elastic bag, d, and the other, c, provided with a stop-cock, opens freely THE RESPIRATORY MECHANISM. 385 below into the bottle. When the stop-cock, c, is open the air will enter the bottle and press there on the out- side of the bag, as well as on its inside through b. The bag will therefore collapse, as the lungs do when the chest -cavity is opened. But if some air be sucked out through c the pres- sure of that remaining in the bottle will diminish, and of that inside thebag will be unchanged, and the bag will thus be blown up, because the atmospheric pressure on its interior will not be balanced by that on its exterior. At last, when all the air is sucked out of the bottle and the stop-cock on c closed, the bag, if sufficiently distensible, will be expanded so as to com- pletely fill the bottle and press against its inside, and the state of things will then answer to that naturally found in the chest. If the bottle were now increased in size without letting air into it, the bag would expand still more, so as to fill it, and in so doing would receive air from outside through 6; and if the bottle then returned to its original size, its walls would press on the bag and cause it to shrink and expel some of its air through b. Exactly the same must of course happen, under similar circumstances, in the chest, the windpipe answering to the tube b through which air enters or leaves the elastic sac. The Respiratory Movements. The air taken into the lungs soon becomes laden in them with carbon dioxide, and at the same time loses much of its oxygen; these interchanges take place mainly in the deep recesses of the alveoli, far from the exterior and only communicating with it through a long tract of narrow tubes. The alveolar air, thus become unfit to any longer convert venous blood into arterial, could only very slowly be renewed by gaseous diffusion with the atmos- phere through the long air-passages — not nearly fast enough for the requirements of the Body, as one learns by the sensa- tion of suffocation which follows holding the breath for a short time with mouth and larynx open. Consequently co- operating with the lungs is a respiratory mechanism, by which the air within them is periodically mixed with fresh air taken from the outside, and also the air in the alveoli is stirred up so as to bring fresh layers of it in contact with the walls of the air-cells. This mixing is brought about by the breathing movements, consisting of regularly alternating in- spirations^ during which the chest cavity is enlarged and fresh air enters the lungs, and expirations, in which the cav- 386 THE HUMAN BODY. ity is diminished and air expelled from the lungs. When the chest is enlarged the air the lungs contain immediately dis- tends them so as to fill the larger space ; in so doing it be- comes rarefied and less dense than the external air; and since gases flow from points of greater to those of less pressure, some outside air at once flows in by the air-passages and enters the lungs. In expiration the reverse takes place. The chest cavity, diminishing, presses on the lungs and makes the air inside them denser than the external air, and so some passes out until an equilibrium of pressure is restored. The chest, in fact, acts very much like a bellows. When the bel- lows are opened air enters in consequence of the rarefaction of that in the interior, which is expanding to fill the larger space; and when the bellows Fi«. 126.-D5agramto illustrate the en- are cl°Sed again & is expelled. try of air to the lungs when the thoracic To make the bellows Quite cavity enlarges. like the lungs we must, how- ever, as in Fig. 126, have only one opening in them, that of the nozzle, for both the entry and exit of the air; and this opening should lead, not directly into the bellows cavity, but into an elastic bag lying in it, and tied to the inner end of the nozzle-pipe. This sac would represent the lungs and the space between its outside and the inside of the bellows, the pleural cavities. We have next to see how the expansion and contraction of the chest cavity are brought about. The Structure of the Thorax. The thoracic cavity has a conical form determined by the shape of its skeleton (Fig. 127), its narrower end being turned upwards. Dorsally, ven- trally, and on the sides, it is supported by the rigid frame- work afforded by the thoracic vertebrae, the breast-bone, and the ribs. Between and over these lie muscles, and the whole is covered in, air-tight, by the skin externally, and the parietal layers of the pleurae inside. Above, its aperture is closed by muscles and by various organs passing between the thorax and the neck; and below it is bounded by the dia- phragm, which forms a movable bottom to the, otherwise, tolerably rigid box. In inspiration this box is increased in all its diameters — dorso-ventrally, laterally, and from above down. THE RESPIRATORY MSCSANI8M, 381 The Vertical Enlargement of the Thorax. This is brought about by the contraction of the diaphragm which (Figs. 1 and 128) is a thin muscular sheet, with a fibrous membrane, serving as a tendon, in its centre. In rest, the diaphragm is dome-shaped, its concavity being turned towards the abdomen. From the tendon on the crown of the dome striped muscular fibres radiate, downwards and outwards, to all sides; and are fixed by their inferior ends to the lower ribs, the breast-bone, and the vertebral column. In expiration the lower lateral portions of the diaphragm lie close against the chest-walls, no lung intervening between them. In in- spiration the muscular fibres, shortening, flatten the dome FIG. 127.— The skeleton of the thorax, a, g, vertebral column; 6, first rib; c, clavicle; d, third rib; i, glenoid fossa. and enlarge the thoracic cavity at the expense of the ab- dominal ; and at the same time its lateral portions are pulled away from the chest-walls, leaving a space into which the lower ends of the lungs expand. The contraction of the diaphragm thus increases greatly the size of the thorax cham- ber by adding to its lowest and widest part. The Dorso-Ventral Enlargement of the Thorax. The ribs on the whole slope downwards from the vertebral column to the breast-bone, the slope being most marked in the lower ones. During inspiration the breast-bone 388 THE HUMAN BOD7 and the sternal ends of the ribs attached to it are raised, and so the distance between the sternum and the vertebral a Ql FIG. 128.— The diaphragm seen from below. column is increased. That this must be so will readily be seen on considering the diagram Fig. 129, where db repre- sents the vertebral column, c and d two ribs, and st the sternum. The continu- jl \sf ous lines represent the natural position of the ribs at rest in expiration, and the dotted lines the position in inspiration. It is clear that when their lower ends are raised, so as to make the bars lie in a more horizontal plane, the sternum is pushed away from the spine, and so the chest cavity is increased dorso-ventrally. The inspirator? elevation of the ribs is FIG. 129.— Diagram illus- . f - tratiug the dorso-ventrai mainly due to the action of the scalene increase in the diameter of , . 7 . . , , _ rri, the thorax when the ribs and external intercostal muscles. The scalene muscles, three on each side, arise from the cervical vertebras, and are inserted into the upper ribs. The external intercostals (Fig. 113, A) lie between the ribs and extend from the vertebral column to the costal carti- lages; their fibres slope downwards and forwards. During an inspiration the scalenes contract and fix the upper ribs firmly; then the external intercostals shorten and each raises the rib below it. The muscle, in fact, tends to pull together the pair of ribs between which it lies, but as the upper one of these is held tight by the scalenes and other muscles above, THE RESPIRATORY MECHANISM. 389 the result is that the lower rib is pulled up, and not the upper down. In this way the lower ribs are raised much more than the upper, for the whole external intercostal muscles on each side may be regarded as one great muscle with many bellies, each bell)'' separated from the next by a tendon, represented by the rib. When the whole muscular sheet is fixed above and contracts, it is clear that its lower end will be raised more than any intermediate point, since there is a greater length of contracting muscle above it. The elevation of the ribs tends to diminish the vertical diameter of the chest; this is B FIG. 130. — Portions of four ribs of a dog with the muscles between them, a, a, ventral ends of the ribs, joining at c the rib cartilages, 6, which are fixed to carti- laginous portions, d. of the sternum. A, external intercostal muscle, ceasing be- tween the rib cartilages, where the internal intercostal, B. is seen. Between the middle two ribs the external fntercostal muscle has been dissected away, so as to display the internal which was covered by it. more than compensated for by the simultaneous descent of the diaphragm. The Lateral Enlargement of the Chest is mainly due to the diaphragm, which, when it contracts, adds to the lowest and widest part of the conical chest cavity. Some small widening is, however, brought about by a rotation of some of the middle ribs which, as they are raised, roll round a little at their vertebral articulations and twist their cartilages. Each rib is curved and. if the bones be examined in their natural position in a skeleton, it will be seen that the most 390 THE HUMAN BODY. curved part lies below the level of a straight line drawn from the vertebral to the sternal attachment of the bone. By the rotation of the rib, during inspiration, this curved part is raised and turned out, and the chest widened. The mech- anism can be understood by clasping the hands opposite the lower end of the sternum and a few inches in front of it, with the elbows bent and pointing downwards. Each arm will then answer, in an exaggerated way, to a curved rib, and the clasped hands to the breast-bone. If the hands be sim- ply raised a few inches by movement at the shoulder-joints only, they will be separated farther from the front of the Body, and rib elevation and the consequent dorso-ventral en- largement of the cavity surrounded will be represented. But if, simultaneously, the arms be rotated at the shoulder-joints so as to raise the elbows and turn them out a little, it will be seen that the space surrounded by the two arms is consider- ably increased from side to side, as the chest cavity is in in- spiration by the similar elevation of the most curved part or '*' angle " of the middle ribs. Expiration. To produce an inspiration requires consid- erable muscular effort. The ribs and sternum have to be raised; the elastic rib cartilages bent and somewhat twisted; the abdominal viscera pushed down ; and the abdominal wall pushed out to make room for them. In expiration, on the contrary, but little, if any, muscular effort is needed. As soon as the muscles which have raised the ribs and sternum relax, these tend to return to their natural unconstrained position, and the rib cartilages, also, to untwist themselves and bring the ribs back to their position of rest; the elastic abdominal wall presses the contained viscera against the under side of the diaphragm, and pushes that up again as soon as its muscular fibres cease contracting. By these means the chest cavity is restored to its original capacity and the air sent out of the lungs, rather by the elasticity of the parts which were stretched or twisted in inspiration, than by any special expiratory muscles. Forced Respiration. When a very deep breath is drawn or expelled, or when there is some impediment to the entry or exit of the air, a great many muscles take part in produc- ing the respiratory movements; and expiration then becomes, in part, an actively muscular act. The main expiratory mus- cles are the internal intercastals which lie beneath the exter- THE RESPIRATORY MECHANISM. 391 nal between each pair of ribs (Fig. 130 B}, and have an oppo- site direction, their fibres running upwards and forwards. In forced expiration the lower ribs are fixed or pulled down by muscles running in the abdominal wall from the pelvis to them and to the breast-bone. The internal intercostals, con- tracting, pull down the upper ribs and the sternum, and so diminish the thoracic cavity dorso-ventrally. At the same time, the contracted abdominal muscles press the walls of that cavity against the viscera within it, and pushing these up forcibly against the diaphragm make it very convex towards the chest, and so diminish the latter in its vertical diameter. In very violent expiration many other muscles may co-operate, tending to fix points on which those muscles which can directly diminish the thoracic cavity, pull. In violent inspiration, also, many extra muscles are called into play. The neck is held rigid to give the scalenes a firm at- tachment; the shoulder-joint is held fixed and muscles going from it to the chest-wall, and commonly serving to move the arm, are then used to elevate the ribs; the head is held firm on the vertebral column by the muscles going between the two, and then other muscles, which pass from the collar-bone and sternum to the skull, are used to pull up the former. The muscles which are thus called into play in labored but not in quiet breathing are called extraordinary muscles of respiration. The Respiratory Sounds. The entry and exit of air are accompanied by respiratory sounds or murmurs, which can be heard on applying the ear to the chest wall. The character of these sounds is different and characteristic over the trachea, the larger bronchial tubes, and portions of lung from which large bronchial tubes are absent. They are vari- ously modified in pulmonary affections, and hence the value of auscultation of the lungs in assisting the physician to form a diagnosis. The Capacity of the Lungs. Since the chest cavity never even approximately collapses, the lungs are never com- pletely emptied of air: the space they have to occupy is larger in inspiration than during expiration, but is always considerable, so that after a forced expiration they still con- tain a large amount of air which can only be expelled from them by opening the pleural cavities; then they entirely col- lapse, just as the bag in Fig. 125 would if the bottle inclosing 392 THE HUMAN BODY. it were broken. The capacity of the chest, and therefore of the lungs, varies much in different individuals, but in a man of medium height there remain in the lungs after the most violent possible expiration, about 1640 cub. cent. (100 cub. inches) of air, called the residual air. After an ordinary expiration there will be in addition to this about as much more supplemental air ; the residual and supplemental to- gether forming the stationary air, which remains in the chest during quiet breathing. In an ordinary inspiration 500 cub. cent. (30 cub. inches) of tidal air are taken in, and about the same amount is expelled in natural expiration. By a forced inspiration about 1600 cub. cent. (98 cub. inches) of complemental air can be added to the tidal air. After a forced, inspiration therefore the chest will contain 1640 -f- 1640 -f- 500 -f 1600 = 5380 cubic centimeters (328 cubic inches) of air. The amount which can be taken in by the most violent possible inspiration after the strongest possible expiration, that is, the supplemental, tidal, and complemental air together, is known as the vital capacity. For a healthy man 1.7 meters (5 feet 8 inches) high it is about 3700 cub. cent. (225 cub. inches) and increases 60 cub. cent, for each additional centimeter of stature; or about 9 cubic inches for each inch of height. The Quantity of Air Breathed Daily. Knowing the quantity of air taken in at each breath and expelled again (after more or less thorough admixture with the stationary air) we have only to know, in addition, the rate at which the breathing movements occur, to be able to calculate how much air passes through the lungs in twenty-four hours. The average number of respirations in a minute is found by counting on persons sitting quietly, and not knowing that their breathing rate is under observation, to be fifteen in a minute. In each respiration half a liter (30 cubic inches) of air is concerned; therefore 0.5 X 15 X 60 X 24 = 10,800 liters (375 cubic feet) is the quantity of air breathed under ordinary circumstances by each person in a day. Hygienic Remarks. Since the diaphragm when it con- tracts pushes down the abdominal viscera beneath it, these have to make room for themselves by pushing out the soft front of the abdomen which, accordingly, protrudes when the diaphragm descends. Hence breathing by the diaphragm, being indicated on the exter.ior by movements of the abdo- THE RESPIRATORY MECHANISM. 393 men, is often called " abdominal respiration," as distinguished from breathing by the ribs, called " costal " or " chest breath- ing." In both sexes the diaphragmatic breathing is the most important, but, as a rule, men and children use the ribs less than adult women. Since both abdomen and chest alter- nately expand and contract in healthy breathing, anything which impedes their free movement is to be avoided; and the tight lacing which used to be thought elegant a few years back, and is still indulged in by some who think a distorted form beautiful, seriously impedes one of the most important functions of the Body, leading, if nothing worse, to shortness of breath and an incapacity for muscular exertion. In ex- treme cases of tight lacing some organs are often directly injured, weals of fibrous tissue being, for example, not unfre- quently found developed on the liver, from the pressure of the lower ribs forced against it by a tight corset. The Aspiration of the Thorax. As already pointed out, the external air cannot press directly upon the contents of the thoracic cavity, on account of the rigid framework which supports its walls; it still, however, presses on them indi- rectly through the lungs. Pushing on the interior of these with a pressure equal to that exerted on the same area by a column of mercury 760 mm. (30 inches) high, it distends them and forces them against the inside of the chest-walls, the heart, the great thoracic blood-vessels, the thoracic-duct, and the other contents of the chest-cavity. This pressure is not equal to that of the external air, since some of the total air-pressure on the inside of the lungs is used up in overcom- ing their elasticity, and it is only the residue which pushes them against the things outside them. In expiration this residue is equal to that exerted by a column of mercury 754 mm. (29.8 inches) high. On most parts of the Body the at- mospheric pressure acts, however, with full force. Pressing on a limb it pushes the skin against the soft parts beneath, and these compress the blood and lymph vessels among them; and the yielding abdominal walls do not, like the rigid tho- racic walls, carry the atmospheric pressure themselves, but transmit it to the contents of the cavity. It thus comes to pass that the blood and lymph in most parts of the Body are under a higher atmospheric pressure than they are exposed to in the chest, and consequently these liquids tend to flow into the thorax, until the extra distention of the vessels in 394 THE HUMAN BODY. which they there accumulate compensates for the less exter- nal pressure to which those vessels are exposed. An equilib- rium would thus very soon be brought about were it not for the respiratory movements, in consequence of which the intra-thoracic pressure is alternately increased and dimin- ished, and the thorax comes to act as a sort of suction-pump on the contents of the vessels of the Body outside it; thus the respiratory movements influence the circulation of the blood and the flow of the lymph. Influence of the Respiratory Movements upon the Cir- culation. Suppose the chest in a condition of normal expira- tion and the external pressure on the blood in the blood-ves- sels within it and in the heart, to have come, in the manner pointed out in the last paragraph, into equilibrium with the atmospheric pressure exerted on the blood-vessels of the neck and abdomen. If an inspiration now occurs, the chest cavity being enlarged the pressure on all of its contents will be di- minished. In consequence, air enters the lungs from the windpipe, and blood enters the venae cavae and the right au- ricle of the heart. Thus not only the lungs, but the right side of the heart, and the intra-thoracic portions of the sys- temic veins leading to it, are expanded during an inspiration; but the lungs being much the most distensible take far the greatest part in filling up the increased space. The left side of the heart is not much influenced as it is filled from the pulmonary veins; and the whole vessels of the lesser circula- tion lying within the chest, and being all affected in the same way at the same time, the blood-flow in them is not di- rectly influenced by the aspiration of the thorax. Distention of the lungs seems, however, to diminish the capacity of their vessels, and so to a certain extent the flow is influenced; as the lungs expand blood is forced out of their vessels into the left auricle, and when they again contract their vessels fill up from the right ventricle. The pressure on the thoracic aorta being diminished in inspiration, blood tends to flow back into it from the abdominal portion of the vessel, but cannot enter the heart on account of the semilunar valves; and the back-flow does not in any case equal the onflow due to the beat of the heart; so what happens in the aorta is but a slight slowing of the current. The general result of all this is that the circulation is considerably assisted. When the next expiration occurs, and the pressure in the thorax again THE RESPIRATORY MECHANISM. 395 rises, air and blood both tend to be expelled from the cavity. The aorta thus regains what it lost during inspiration; the pressure on it is increased and it empties itself faster into its abdominal portion. The semilunar valves having prevented any regurgitation into the heart, there is neither gain nor loss so far as it is, concerned. With the systemic intra-tho- racic veins, however, this is not the case; the extra blood en- tering them has already in great part gone on beyond the tricuspid valve, and cannot flow back during expiration ; and the pressure in the auricle being constantly kept low by its emptying into the ventricle, the increased pressure on the venae cavae tends rather to send blood on into the heart, than back into the extra-thoracic veins. Moreover, whatever blood tends to take the latter course cannot do it effectually since, although the venae cavae themselves contain no valves, the more distant veins which open into them do. Conse- quently, whatever extra blood has, to use the common phrase, been '* sucked" into the intra-thoracic venae cavae in inspira- tion and has not been sent already on into the right ventricle before expiration occurs, is, on account of the venous valves, imprisoned in the cavae under an increased pressure during expiration; and this tends to make it flow faster into the au- ricle during the diastole of the latter. How much the alter- nating respiratory movements assist the venous flow is shown by the dilation of the veins of the head and neck which oc- curs when a person is holding his breath ; and the blackness for the face, from distention of the veins and stagnation of the capillary flow, which occurs during a prolonged fit of coughing, which is a series of expiratory efforts without any inspirations. On the whole the influence of the respiratory movements on the blood-flow is such as to favor it in inspiration and to impede it during expiration. This influence very often shows itself on tracings of arterial pressure taken as described in Chap. XVIII. Such tracings usually show in addition to the pulse waves, slower and greater rises and falls of pressure which have the same rhythm as the respiration. In general, the rise of pressure in these respiratory waves of blood-pres- sure is synchronous with inspiration and the fall with expira-- tion, but not exactly. The changes manifest themselves on the blood-pressure curve a little later than the commencement of the thoracic movement which leads to them; the rise be- 396 THE HUMAN BODY. ginning a little after the beginning of inspiration, the fall a little later than the commencement of expiration. In still another way the aspiration of the thorax assists the heart. The heart and lungs are both distensible, though in different degrees, and each is stretched in the chest some- what beyond its natural size; the one by the atmospheric pressure directly, the other by that pressure indirectly ex- erted through the blood exposed to it in the extra-thoracic veiiis. Supposing, therefore, the heart suddenly to shrink, it would leave more space in the chest to be filled by the lungs; these must accordingly, at each cardiac systole, expand a lit- tle to fill the extra room, just as they do when the space around them is otherwise enlarged, as during an inspiration. The elasticity of the lungs, however, causes them to resist this distention and oppose the cardiac systole. The matter may be made clear by an arrangement like that in Fig. 131. A is an air-tight vessel with a tube, e, provided with a stop- cock, leading from it; b is a highly distensible elastic bag in free communication through d with the exterior; and c, representing the heart, is a less extensible sac, from which a tube leads and dips under water in the vessel B. If air be pumped out through e both bags will dilate, b filling with air, and c with water driven up by atmos- pheric pressure. Ultimately, if suffi- ciently extensible, they would fill the whole space, the thinner- walled, b, occu- pying most of it. If then the stop-cock be cl°Sed> thingS WJU. remain in ^quilib- rium, each baff striving to collapse and r FIG. 131.-Diagram il- lustrating the influence of aspiration of the thorax on the circulation of the so exerting a pull on the other, lor it o blood. , T shrinks c must expand and vice versa. If c suddenly shrink, as the heart does in its systole, b will dilate; but as soon as the systole of c ceases, b will shrink again and pull c out to its previous size. In the same way, after the cardiac systole, when the heart-walls relax, the lungs pull them out again and dilate the organ. The contracting heart thus expends some of its work in overcoming the elas- ticity of the lungs, which opposes their expansion to fill the space left by the smaller heart; but during the diastole of the heart this work is utilized to pull out its walls again, and THE RESPIRATORY MECHANISM. 397 draw blood into it. Since the normal heart has muscular power, and to spare, for its systole, this arrangement, by which some of the work then spent is stored away to assist the diastole, which cannot be directly performed by cardiac muscles, is of service to it on the whole. It is a physiological though not a mechanical advantage; no work power is gained, but what there is, is better distributed. Influence of the Respiration on the Lymph-Flow. During inspiration, when intra-thoracic pressure is lowered, lymph is pressed into the thoracic duct from the abdominal lymphatics. In expiration, when thoracic pressure rises again, the extra lymph cannot flow back on account of the valves in the lymphatic vessels, and it is consequently driven on to the cervical ending of the thoracic duct. The breath- ing movements thus pump the lymph on. CHAPTER XXVI. THE CHEMISTRY OF RESPIRATION. Nature of the Problems. The study of the respiratory process from a chemical standpoint has for its object to dis- cover what are, in kind and extent, the interchanges between the air in the lungs and the blood in the pulmonary capilla- ries; and the nature and amount of the corresponding gaseous •changes between the living tissues, and the blood in the sys- temic capillaries. Neglecting some oxygen used up otherwise than in forming carbon dioxide, and some carbon dioxide elim- inated by other organs than the lungs, these processes in the long-run balance, the blood losing as much carbon dioxide gas in the lungs as it gains elsewhere, and gaining as much oxygen in the lungs as it loses in the systemic capillaries. To compre- hend the matter it is necessary to know the physical and chemical conditions of these gases in the lungs, in the blood, and in the tissues generally; for only so can we understand how it is that in different localities of the Body such exactly contrary pro- cesses occur. So far as the problems connected with the •external respiration are concerned our knowledge is tolerably •complete; but as regards the internal respiration, taking place all through the Body, much has yet to be learnt; we know that a muscle at work gives more carbon dioxide to the blood than one at rest and takes more oxygen from it, but how much of the one it gives and of the other it takes is only known approximately; as are the conditions under which this greater interchange during the activity of the muscular tissue is effected: and concerning nearly all the other issues we know even less than about muscle. In fact, as regards the Body as a whole, it is compara- tively easy to find how great its gaseous interchanges with the air are during work and rest, waking and sleeping, THE CHEMISTRY OF RESPIRATION. 399 while fasting or digesting, and so on ; but when it comes to be decided what organs are concerned in each case in pro- ducing the greater or less exchange, and how much of the whole is due to each of them, the question is one far more difficult to settle and still very far from completely answered. The Changes Produced in Air by being once Breathed. These are fourfold — changes in its temperature, in its mois- ture, in its chemical composition, and its volume. The air taken into the lungs is nearly always cooler than that expired, which has a temperature of about 36° 0. (97° F.). The temperature of a room is usually less than 21° C. (70° F.). The warmer the inspired air the less, of course, the heat which is lost to the Body in the breathing process; its average amount is calculated as about equal to 50 calories in twenty-four hours; a calorie being as much heat as will raise the temperature of one kilogram (2.2 Ibs.) of water one degree centigrade (1.8° F.). The inspired air always contains more or less water vapor, but is rarely saturated; that is, rarely contains so much but it can take up more without showing it as mist ; the warmer air is, the more water vapor it requires to saturate it. The expired air is nearly saturated for the temperature at which it leaves the Body, as is readily shown by the water deposited when it is slightly cooled, as when a mirror is breathed upon; or by the clouds seen issuing from the nostrils on a frosty day, these being due to the fact that the air, as soon as it is cooled, cannot hold all the water vapor which it took up when warmed in the Body. Air, therefore, when breathed once, gains water vapor and carries it off from the lungs; the actual amount being subject to variation with the tempera- ture and saturation of the inspired air: the cooler and drier that is, the more water will it gain when breathed. On an average the amount thus carried off in twenty-four hours is about 255 grams (9 ounces). To evaporate this water in the lungs an amount of heat is required, which disappears for this purpose in the Body, to reappear again outside it when the water vapor condenses. The amount of heat taken off in this way during the day is about 148 calories. The total daily loss of heat from the Body through the lungs is therefore 198 calories, 50 in warming the inspired air and 148 in the evaporation of water. The most important changes brought about in the 400 THE HUMAN BOD 7 breathed air are those in its chemical composition. .Pure air when completely dried consists in each 100 parts of — By Volume. By Weight. Oxygen 20.8 23 Nitrogen 79.2 77 Ordinary atmospheric air contains in addition 4 volumes of carbon dioxide in 10,000, or 0.04 in 100, a quantity which, for practical purposes, may be neglected. When breathed once, such air gains rather more than 4 volumes in 100 of carbon dioxide, and loses rather more than 5 of oxygen. More accurately, 100 volumes of expired air after drying give 98.9 volumes, which consist of — Oxygen 15.4 Nitrogen 79.2 Carbon dioxide 4.3 The expired air also contains volatile organic substances in quantities too minute for chemical analysis, but readily detected by the nose upon coming into a close room in which a number of persons have been collected. Since 10,800 litres (375 cubic feet) of air are breathed in twenty-four hours and lose 5.4 per cent of oxygen, the total quantity of this gas taken up in the lungs daily is 10,800 X 5.4 ~ 100 = 583.2 litres (20.4 cubic feet). One litre of oxygen measured at 0° C. (32° F.) and under a pressure equal to one atmosphere, weighs 1.43 grams, so the total weight of oxygen taken up by the lungs daily is 583.2 X 1.43 = 833.9 grams. Or, using inches and grains as standards, 44.5 cubic inches of oxygen at the above temperature and pressure weigh almost exactly 16 grains, so the 20.4 cubic feet ab- sorbed in the lungs daily weigh 20.4 X 1728 -f- 44.5 X 16 = 12,818 grains. The amount of carbon dioxide excreted from the lungs being 4.3 per cent of the volume of the air breathed daily, is 10,800 X 4.3 -^ 100 = 464.4 litres (16.25 cubic feet) measured at the normal temperature and pressure. This volume weighs 910 grams, or 14,105 grains. If the expired air be measured as it leaves the Body its bulk will be found greater than that of the inspired air, since it not only has water vapor added to it, but is expanded in consequence of its higher temperature. If, however, it be dried and reduced to the same temperature as the inspired THE CHEMISTRY OF RESPIRATION. 401 air its volume will be found diminished, since it has lost 5.4 volumes per cent of oxygen and gained only 4.3 of carbon dioxide. In round numbers, 100 volumes of dry inspired air at zero, give 99 volumes of dry expired air measured at the same temperature and pressure. Ventilation. Since at every breath some oxygen is taken from the air and some carbon dioxide given to it, were the atmosphere around a living man not renewed he would, at last, be unable to get from the air the oxygen he required; he would die of oxygen starvation or be suffocated, as such a mode of death is called, as surely, though not quite so fast, as if he were put under the receiver of an air-pump and all the air around him removed. Hence the necessity of ventilation to supply fresh air in place of that breathed, and clearly the amount of fresh air requisite must be determined by the number of persons collected in a room; the supply which would be ample for one person would be insufficient for two. Moreover fires, gas, and oil lamps, all use up the oxygen of the air and give carbon dioxide to it, and hence calculation must be made for them in arranging for the ventilation of a building in which they are to be employed. In order that air be unwholesome to breathe, it is by no means necessary that it have lost so much of its oxygen as to make it difficult for the Body to get what it wants of that gas. The evil results of insufficient air-supply are rarely, if ever, due to that cause even in the worst-ventilated room for, as we shall see hereafter, the blood is able to take what oxygen it wants from air containing comparatively little of that gas. The headache and drowsiness which come on from sitting in a badly ventilated room, and the want of energy and general ill-health which result from permanently living in such, are dependent on a slow poisoning of the Body by the reabsorption of the things eliminated from the lungs in previous expirations. What these are is not accurately known; they doubtless belong to those volatile bodies men- tioned above, as carried off in minute quantities in each breath; since observation shows that the air becomes injuri- ous long before the amount of carbon dioxide in it is suffi- cient to do any harm. Breathing air containing one or two per cent of that gas produced by ordinary chemical methods does no particular injury, but breathing air containing one per cent of it produced by respiration is decidedly injurious, 402 THE HUMAN BODY. because of the other things sent out of the lungs at the same time. Carbon dioxide itself, at least in any such percentage as is commonly found in a room, is not poisonous, as used to be believed, but, since it is tolerably easily estimated in air, while the actually injurious substances evolved in breathing are not, the purity or foulness of the air in a room is usually determined by finding the percentage of carbon dioxide in it: it must be borne in mind that to mean much this carbon dioxide must have been produced by breathing; the amount of it found is in itself no guide to the quantity of really important injurious substances present. Of course when a great deal of carbon dioxide is present the air is irrespirable : as for example sometimes at the bottom of wells or brewing-vats. In one minute .5 X 15 = 7.5 liters (0.254 cubic feet) of air are breathed and this is vitiated with carbon dioxide to the extent of rather more than four per cent; mixed with three times its volume of external air, it would give thirty liters (a little over one cubic foot) vitiated to the extent of one per cent, and such air is not respirable for any length of time with safety. The result of breathing it for an evening is headache and general malaise; of breath- ing it for weeks or months a lowered tone of the whole Body —less power of work, physical or mental, and less power of resisting disease; the ill effects may not show themselves at once, and may accordingly be overlooked, or considered scien- tific fancies, by the careless; but they are nevertheless there ready to manifest themselves. In order to have air to breathe in a fairly pure state every man should get for his own allowance at least 23,000 liters of space to begin with (about 800 cubic feet) and the arrangements for ventilation should, at the very least, renew this at the rate of 30 litres (one cubic foot) per minute. The nose is, however, the best guide, and it is found that at least five times this supply of fresh air is necessary to keep free from odor a small room inhabited by one adult. In the more recently constructed hospitals, as a result of experience, twice the above minimum cubic space is allowed for each bed in a ward, and the re- placement of the old air at a far more rapid rate is also provided for. Ventilation does not necessarily imply draughts of cold air, as is too often supposed. In warming by indirect radia- THE CHEMISTRY OF RESPIRATION. 403 tion it may readily be secured by arranging, in addition to the registers from which the warmed air reaches the room, proper openings at the opposite side, by which the old air may pass off to make room for the fresh. An open fire in a room will always keep up a current of air through it, and is the healthiest, though nojb the most economical, method of warming an apartment. Stoves in a room, unless constantly supplied with fresh air from without, dry its air to an unwholesome extent. If no appliance for providing this supply exists in a room, it can usually be got, without a draught, by fixing a board about four inches wide under the lower sash and shutting the win- dow down on it. Fresh air then comes in by the opening between the two sashes and in a current directed upwards, which gradually diffuses itself over the room without being felt as a draught at any one point. In the method of heating by direct radiation, the apparatus employed provides of itself no means of drawing fresh air into a room, as the draught up the chimney of an open fireplace or of a stove does; and therefore special inlet and outlet openings are very necessary. Since few doors and windows, fortunately, fit quite tight, fresh air gets even into closed rooms, in tolerable abundance for one or two inhabitants, if there be outlets for the air already in them. Changes undergone by the Blood in 'the Lungs. These are the exact reverse of those undergone by the breathed air — what the air gains the blood loses, and vice versa. Con- 'sequently, the blood loses heat, and water, and carbon dioxide in the pulmonary capillaries; and gains oxygen. These gains and losses are accompanied by a change of color from the dark purple which the blood exhibits in the pulmonary artery, to the bright scarlet it possesses in the pulmonary veins. The dependence of this color change upon the access of fresh air to the lungs while the blood is flowing through them, can be readily demonstrated. If a rabbit be rendered unconscious by chloroform, and its chest be opened, after a pair of bellows has been connected with its windpipe, it is seen that, so long as the bellows are worked to keep up arti- ficial respiration, the blood in the right side of the heart (as seen through the thin auricle) and that in the pulmonary artery, is dark colored, while that in the pulmonary veins 404 THE HUMAN BODY. and the left auricle is bright red. Let, however, the artificial respiration be stopped for a few seconds and, consequently, the renewal of the air in the lungs (since an animal cannot breathe for itself when its chest is opened), and very soon the blood returns to the left auricle as dark as it left the right. In a very short time symptoms of suffocation show them- selves and the animal dies, unless the bellows be again set at work. The Blood Gases. If fresh blood be rapidly exposed to as complete a vacuum as can be obtained, it gives off certain gases, known as the gases of the Mood. These are the same in kind, but differ in proportion, in venous and arterial blood; there being more carbon dioxide and less oxygen ob- tainable from the venous blood going to the lungs by the pulmonary artery, than from the arterial blood coming back to the heart by the pulmonary veins. The gases given off by venous and arterial blood, measured under the normal pres- sure and at the normal temperature, amount to from 58 to 62 volumes for every 100 volumes of blood, and in the two cases are about as follows — Venous Blood. Arterial Blood. Oxygen 10 20 Carbon dioxide 46 40 Nitrogen 2 2 It is important to bear in mind that while arterial blood contains some carbon dioxide that can be removed by the air-pump, venous blood also contains some oxygen removable in the same way; so that the difference between the two is only one of degree. When an animal is killed by suffocation, however, the last trace of oxygen which can be yielded up in a vacuum disappears from the blood before the heart ceases to beat. All the blood of such an animal is what might be called suffocation blood, and has a far darker color than ordinary venous blood. The Cause of the Bright Color of Arterial Blood. The color of the blood depends on its red corpuscles, since pure blood plasma or blood serum is colorless, or at most a very faint straw yellow. Hence the color change which the blood experiences in circulating through the lungs must be due to some change in its red corpuscles. Now, minute solid bodies suspended in a liquid reflect more light when they are more dense, other things being equal; and the first thing that sug- THE CHEMISTRY OF RESPIRATION. 405 gests itself as the cause of the change in color of the blood is that its red corpuscles have shrunk in the pulmonary circula- tion, and so reflect more light and give the blood a brighter look. This idea gains some support from the fact that, as seen under the microscope, the red blood corpuscles of some animals, as the frog, do expand somewhat when exposed to carbon dioxide gas and shrink up a little in oxygen. But that this is not the chief cause of the color change is readily proved. By diluting blood with water the coloring matter of the red corpuscles can be made to pass out of them and go into solution in the plasma, and it is found that such a solution, in which there can be no question as to the reflect- ing powers of colored solid bodies suspended in it, is brighter red when supplied with oxygen than when deprived of that gas. This suggests that the coloring matter or hcemoglobin of the red corpuscles combines with oxygen to form a scarlet compound, and when deprived of that gas has a darker and more purple color; and other experiments confirm this. Haemoglobin combined with oxygen is known as oxyhcemo- globin, and it is on its predominance that the color of arterial blood depends. Haemoglobin uncombined with oxygen, sometimes named reduced hmmoglolin, predominates in venous blood, and is the only kind found in the blood of a suffocated mammal. The Laws Governing the Absorption of Gases by a Liquid. In order to understand the condition of the gases in the blood liquid it is necessary to recall the general laws in accordance with which liquids absorb gases. They are as follows : 1. A given volume of a liquid at a definite temperature if it absorbs any of a gas to which it is exposed, and yet does not combine chemically with it, takes up a definite volume of the gas. If the gas be compressed the liquid will still, at the same temperature, take up the same volume as before, but now it takes up a greater weight; and a weight exactly as much greater as the pressure is greater, since one volume of a gas under any pressure contains exactly twice as much of the gas by weight as the same volume under half the pres- sure; and so on. A liter or a quart of water, for example, exposed to the air will dissolve a certain amount of oxygen. If the air (and therefore the oxygen in it) be compressed to one fourth its bulk then the water will dissolve exactly the 406 THE HUMAN BODY. same volume of oxygen as before, but this volume of the- compressed gas will contain exactly four times as much oxygen as did the same volume of the gas under the original pressure; and if, now, the pressure be again diminished the oxygen will be given off exactly in proportion as its pressure on the surface of the water decreases. Finally, when a com- plete vacuum is formed above the surface of the water, it will be found that the latter has given off all its dissolved oxygen. This law, that the quantity of a gas dissolved by a liquid varies directly as the pressure of that gas on the surface of the liquid is known as Dalton's law. 2. The amount of a gas dissolved by a liquid depends, not on the total pressure exerted by all the gases pressing on its surface, but on the fraction of the total pressure which is exerted by the particular gas in question. For example, the average atmospheric pressure is equal to that of a column of mercury 760 mm. (30 inches) high. But 100 volumes of air contain approximately 80 volumes of nitrogen and 20 of oxygen : therefore -J of the total pressure is due to oxygen and f to nitrogen : and the amount of oxygen absorbed by water is just the same as if all the nitrogen were removed from the air and its total pressure therefore reduced to -J- of 760 mm. (30 inches) of mercury; that is, to 152 mm. (6 inches) of mercury pressure. It is only the fraction of the total pressure exerted by the oxygen itself which affects the quantity absorbed by water at any given temperature. So, too, of all the atmospheric pressure ^ is due to nitrogen, and all the oxygen might be removed from the air without affect- ing the quantity of nitrogen which would be absorbed from it by a given volume of water. The atmospheric pressure would then be f of 760 mm. of mercury, or 608 mm. (24 inches), but it would all be due to nitrogen gas — and be exactly equal to the fraction of the total pressure due to that gas before the oxygen was removed from the air. When several gases are mixed together the fraction of the total pres- sure exerted by each one is known as the partial pressure of that gas; and it is this partial pressure which determines the amount of each individual gas dissolved by a liquid. If a liquid exposed to the air for some time had taken up all the oxygen and nitrogen it could at the partial pressures of those gases in the air, and were then put in an atmosphere in which the oxygen had all been replaced by nitrogen, it THE CHEMISTRY OF RESPIRATION. 407 would now give off all its oxygen, since, although the total gaseous pressure on it was the saihe, no part of it was any longer due to oxygen; and at the same time it would take up one fifth more nitrogen, since the whole gaseous pressure on its surface was now due to that gas, while before only four fifths of the total was exerted by it. If, on the contrary, the liquid were exposed to pure hydrogen under a pressure of one atmosphere it would give off all its previously dissolved oxygen and nitrogen, since none of the pressure on its surface would now be due to those gases; and would take up as much hydrogen as corresponded to a pressure of that gas equal to 760 mm. of mercury (30 inches). 3. A liquid may be such as to combine chemically with a gas. Then the amount of the gas absorbed is independent of the partial pressure of the gas on the surface of the liquid. The quantity absorbed will depend upon how much the liquid can combine with. Or, a liquid may partly be com- posed of things which simply dissolve a gas and partly of things which chemically combine with it. Then the amount of the gas taken up under a given partial pressure will de- pend on two things; a certain portion, that merely dissolved, will vary with the pressure of the gas in question; but an- other portion, that chemically combined, will remain the same under different pressures. The amount of this second portion depends only on the amount of the substance in the liquid which can chemically combine with it, and is totally independent of the partial pressure of the gas. 4. Bodies are known which chemically combine with certain gases when the partial pressure of these is consider- able, forming compounds which break up, or dissociate, liberating the gas, when its partial pressure falls below a certain limit. Oxygen forms such a compound with heemo- globin. 5. A membrane, moistened by a liquid in which a gas is soluble, does not essentially alter the laws of absorption, by a liquid on one side of it of a gas present on its other side, whether the absorption be due to mere solution or to chem- ical combinations or to both. The Absorption of Oxygen by the Blood. Applying the physical and chemical facts stated in the preceding paragraph to the blood, we find that the blood contains (1) plasma, which simply dissolves oxygen, and (2) JicKrm.oglobin> 408 THE HUMAN BODY. which combines with it under some partial pressures of that gas, but gives it up under lower. Blood plasma or, what comes to the same thing, fresh' serum, exposed to the air, takes up no more oxygen than so much water: about 0.56 volumes of the gas for every 100 of the liquid, at a temperature of 20° 0. At the temperature of the Body the volume absorbed would be still less. This quantity obeys Dalton's law. If fresh whipped blood be employed, the quantity of oxy- gen taken up is much greater; this extra quantity must be taken up by the red corpuscles (in possessing which whipped blood alone differs from blood serum) and it does not obey Dalton's law. If the partial pressure of oxygen on the sur- face of the whipped blood be doubled, only as much more oxygen will be taken up as corresponds to that dissolved in the serum ; and if the partial pressure of oxygen on its sur- face be reduced to one half, only a very small amount of oxygen (one half of that dissolved by the serum) will be given off. All the much larger quantity taken up by the red corpus- cles will be unaffected and must therefore be chemically com- bined with something in them. Since 90 per cent of their dry weight is haemoglobin, and this body when prepared pure is found capable of combining with oxygen, there is no doubt that it is the haemoglobin in the circulating blood which carries around most of its oxygen. The red corpuscles are so many little packages in which oxygen is stowed away. The compound formed between oxygen and haemoglobin is, however, a very feeble one; the two easily separate, and always do so when the oxygen pressure in the liquid or gas to which the oxyhaemoglobin is exposed falls below 25 mil- limeters of mercury. Hence, in an air-pump, the blood only gives off some of its small portion of merely dissolved oxygen, until the pressure falls to about -J- of an atmosphere, that is to -3$o. z= 125 mm. (5 inches) of mercury, of which total pressure one fifth (25 millimeters or 1 inch) is due to the oxygen present. As soon as this limit is passed the haemo- globin gives up its oxygen with a rush. Consequences of the Peculiar Way in which the Oxy- gen of the Blood is Held. The first, and most important, is that the blood can take up far more oxygen in the lungs than would otherwise be possible. Since blood serum ex- posed to pure oxygen takes up only 3 volumes for 100, blood THE CHEMISTRY OF RESPIRATION. 409 exposed to the air would take up one fifth only of that amount at ordinary temperatures, and still less at the temperature of the Body, were it not for its haemoglobin. In the lungs even less would be taken up, since the air in the air-cells of those organs is poorer in oxygen than the external air; and conse- quently the partial pressure of that gas in it is lower. The tidal air taken in at each breath serves merely to renew directly the air in the big bronchi; the deeper we examine the pulmonary air the less oxygen and more carbon dioxide would be found ; in the layers farthest from the exterior and only renewed by diffusion with the air of the large bronchi, it is estimated that the oxygen only exists in such quantity that its partial pressure is equal to 130 millimeters of mer- cury, instead of 152 as in ordinary air. In the second place, on account of the way in which haemoglobin combines with oxygen, the quantity of that gas taken up by the blood is independent of such variations of its partial pressure in the atmosphere as we are subjected to in daily life. At the top of a high mountain, for example, the atmospheric pressure is greatly diminished, but still mountaineers can breath freely and get all the oxygen they want; the distress felt for a time by persons unused to living in high altitudes is due mainly to circulatory disturbances resulting from the low atmospheric pressure. So long as the partial pressure of that gas in the lung air-cells is above 25 millimeters of mercury, the amount of it taken up by the blood depends on how much haemoglobin there is in that liquid and not on how much oxygen there is in the air. So, too, breathing pure oxygen under a pressure of one atmosphere, or air compressed to one half or a fourth its normal bulk, does not increase the quantity of oxygen absorbed by the blood, apart from the small extra quantity dissolved by the plasma. The widespread state- ments as to the exhilaration caused by breathing pure oxygen are erroneous, being founded on experiments made with im- pure gas. The General Oxygen Interchanges in the Blood. Sup- pose we have a quantity of arterial blood in the aorta. This, fresh from the lungs, will have its haemoglobin almost fully combined with oxygen and in the state of oxyhsemoglobin. In the blood plasma some more oxygen will be dissolved, viz., so much as answers to a pressure of that gas equal to 130 mm. (5.2 inches) of mercury, which is the partial pressure of 410 THE HUMAN BODY. oxygen in the pulmonary air-cells. This tension of the gas in the plasma will be more than sufficient to keep the haemo- globin from giving off its oxygen. Suppose the blood now enters the capillaries of a muscle. In the liquid i»oistening this organ the oxygen tension is almost nil, since the tissue elements are steadily taking -the gas up from the lymph around them. Consequently, through the capillary walls, the plasma will give off oxygen until the tension of that gas in it falls below 25 millimeters of mercury. Immediately some of the oxyhaemoglobin is decomposed, and the oxygen liberated is dissolved in the plasma, and from there next passed on to the lymph outside; and so the tension in the plasma is once more lowered and more oxyhaemoglobin decom- posed. This goes on so long as the blood is in the capillaries of the muscle, or at any rate so long as the muscular fibres keep on taking oxygen from the lymph bathing them; if they cease to do so of course the tension of that gas in the lymph will soon come to equal that in the plasma: the latter will therefore cease to yield oxygen to the former; and so maintain its tension (by the oxygen received from the last decomposed oxyhaemoglobin) at a point which will prevent the liberation of any more oxygen from such red corpuscles as have not yet given all of theirs up. The blood will now go on as ordinary venous blood into the veins of the muscle and so back to the lungs. It will consist of (1) plasma with oxygen dissolved in it at a tension of about 25 millimeters (1 inch) of mercury. (2) A number of red corpuscles con- taining reduced haemoglobin. (3) A number of red corpus- cles containing oxyhaemoglobin. Or perhaps all of the- red corpuscles will contain some reduced and some oxidized haemoglobin. The relative proportion of reduced and un- reduced haemoglobin will depend on how active the muscle had been; if it worked while the blood flowed through it, it will have used up more oxygen, and the blood leaving it will con- sequently be more venous, than if it rested. This venous blood, returning to the heart, is sent on to the pulmonary capillaries. Here, the partial pressure of oxygen in the air- cells being 130 mm. (5.2 inches) and that in the blood plasma much less, oxygen will be taken up by the latter, and the tension of that gas in the plasma tend to be raised above the limit at which haemoglobin combines with it. Hence, as fast as the plasma gets oxygen those red corpuscles which THE CHEMISTRY OF RESPIRATION. 411 •contain any reduced haemoglobin rob it, and so its oxygen tension is kept down below that in the air-cells until all the haemoglobin is satisfied. Then the oxygen tension of the plasma rises to that of the gas in the air-cells; no more oxygen is absorbed, and the blood returns to the left auricle of the heart in the same condition, so far as oxygen is con- cerned, as when we commenced to follow it. The Carbon Dioxide of the Blood. The same general laws apply to this as to the blood oxygen. The gas is partly merely dissolved and partly in a loose chemical combination much like that of oxygen with haemoglobin, but the body with which it combines probably exists in the plasma more than in the red corpuscles; what it may be is not certainly known. Besides this, some more carbon dioxide is stably combined and is only given off on the addition of a stronger acid. The partial pressure of carbon dioxide in the pulmo- nary air-cells is about 40 mm. (1.6 inches) of mercury. There- fore the tension of that gas in the pulmonary capillaries must be more than this. On the other hand its tension in arterial blood must be less than that in the lymph around the tissues; otherwise it could not enter the blood in the systemic circulation, which it does, as proved by the fact that 100 vols. of venous blood give off 46 of this gas, and 100 vols. of arterial only 40. The nitrogen dissolved in the blood is, so far as we know, quite unimportant. Internal Respiration. As to the amount of oxygen used by each tissue and the quantity of carbon dioxide produced by it we know but little; the following points seem, however, tolerably certain: 1. The amount of carbon dioxide produced in an organ in a given time bears no constant ratio to the amount of oxygen taken up by it simultaneously. This is certainly true of muscle, for experiment shows that muscular work if really severe leads to an elimination of carbon dioxide containing more oxygen than the total oxygen taken up from the lungs at the same time. The balance is of course made up in subsequent periods of rest, when more free oxygen is taken up than is eliminated in combination during the same time. Moreover, a frog's muscle excised from the body and put in an atmosphere containing no oxygen and made there •to contract, will evolve with each contraction considerable 412 THE HUMAN BODY. quantities of carbon dioxide— although from the conditions of the experiment it can receive from outside no uncombined oxygen, and other experiments show that it contains none. Hence the living muscular fibre must contain a substance which is decomposed during activity and yields carbon dioxide as one product of decomposition ; and this quite in- dependent of any simultaneous direct oxidation. 2. What is true of muscle is probably true of most of the tissues. During rest they take up oxygen and fix it in the form of complex compounds, bodies which, like nitro-glycer- ine, are readily decomposed into simpler, and in such decom- positions liberate energy which is used by the working tissue. One product of the decomposition is the highly oxidized carbon dioxide, and this is eliminated; other products are less oxidized, and possibly are not eliminated but built up again, with fresh oxygen taken from the blood and fresh carbon from the food, into the decomposable substance. 3. During the day a man gives off from his lungs more oxygen in carbon dioxide, than he takes up by the same organs from the air. During the night the reverse is the case. This, however, has nothing to do with the alternating periods of light and darkness, as it has in the case, of a green plant, which in the light evolves more oxygen than it con- sumes, and in the dark the contrary. It depends, rather, on the fact that during the day more muscular effort is exerted than at night, and the meals are then taken and digested. The activity of the muscles and the digestive glands is de- pendent on processes which give rise to a large production of carbon dioxide and, during the night, when both are at rest, more oxygen is taken up than is contained in the carbon dioxide eliminated. If a man works and takes his meals at night, and sleeps in the day, the usual ratios of his gaseous exchanges with the exterior are entirely reversed. 4. The amount of work that a man's organs do, is not dependent on the amount of oxygen supplied to them, but the amount of oxygen used by him depends on how much he uses his organs. The quantity of oxygen supplied must of course always be, at least, that required to prevent suffoca- tion; but an excess above this limit will not make the tissues work. Just as a man must have a certain amount of food to keep him alive, so he must have a certain amount of oxygen; but as extra food will not make his tissues or Jiim THE CHEMISTRY OF RESPIRATION. 413 (who is physiologically the sum of all his tissues) work, apart from some stimulus to exertion, so it is with oxygen. Highly arterialized blood, or an abnormal amount of blood, flowing through an organ will nof arouse it to activity; the working organ, muscle, or gland, for example, usually gets enough more blood to supply its extra needs — just as a healthy man who works will have a better appetite than an idle one; but as taking more food by an idle man will not of itself make him more energetic, so neither will sending more arterial blood through an organ excite it to activity. 5. The preceding statement is confirmed by experiments which show that an animal uses no more oxygen in an hour when made to breathe that gas in a pure state, than when allowed to breathe ordinary air. In other words, the amount of oxygen an animal uses (provided it gets the minimum necessary for health) is dependent only on how much it uses its tissues. These (the rest in most cases subject to a certain amount of control from the nervous) determine their own activity, and this, in turn, how much oxygen shall be used in the systemic circulation and restored in the pulmonary. In other words, the physiological work of an animal, which of course is largely dependent upon how external forces act upon it, determines how much oxygen it uses daily; and not the supply of oxygen how much its tissue activity shall be, unless the supply sinks below* the starvation limit. CHAPTER XXVII. THE NERVOUS FACTORS OF THE RESPIRATORY MECHANISM. ASPHYXIA. The Respiratory Centre. The respiratory movements are to a certain extent under the control of the will; we can breathe faster or slower, shallower or more deeply, as we wish, and can also " hold the breath " for some time — but the voluntary control thus exerted is limited in extent; no one can commit suicide by holding his breath. In ordinary quiet breathing the movements are quite involuntary; they go- on perfectly without the least attention on our part, and, not only in sleep, but during the unconsciousness of fainting or of an apoplectic fit. The natural breathing movements are therefore either reflex or automatic. The muscles concerned in producing the changes in the chest which lead to the entry or exit of air are of the ordinary striped kind; and these, as we have seen, only contract in the Body under the influence of the nerves going to them; the nerves of the diaphragm are the two phrenic nerves, one for each side of it ; the external intercostal muscles are supplied by certain branches of the thoracic spinal nerves, called the intercostal nerves. If the phrenic nerves be cut the diaphragm ceases its contractions, and a similar paralysis of the external intercostals follows section of the intercostal nerves. Since the inspiratory muscles only act when stimulated by nervous impulses reaching them, we have next to seek where these impulses originate; and experiment shows that it is in the medulla oblongata. All the brain of a cat or a rabbit in front of the medulla can be removed, and it will still go on breathing; and children are sometimes born with the medulla oblongata only, the rest of the brain being un- developed, and yet they breathe for a time. If, on the other hand, the spinal cord be divided immediately below the medulla of an animal, all breathing movements of the 414 TEE RESPIRATORY MECHANISM. 415 chest cease at once. We conclude, therefore, that the nerv- ous impulses calling forth contractions of the respiratory muscles arise in the medulla oblongata, and travel down the spinal cord and thence out along the phrenic and intercostal nerves. This is confirmed by the fact that if the spinal cord be cut across below the origin of the fourth pair of cervical spinal nerves (from which the phrenics mainly arise) but above the first thoracic spinal nerves, the respiratory move- ments of the diaphragm continue, but those of the intercostal muscles cease; this phenomenon has sometimes been observed on men so stabbed in the back as to divide the spinal cord in the region indicated. - Finally, that the nervous impulses ex- citing the inspiratory muscles originate in the medulla, is proved by the fact that if a small portion of that organ, the so-called vital point, be destroyed, all the respiratory move- ments cease at once and forever, although all the rest of the brain and spinal cord may be left uninjured. This part of the medulla is known as the respiratory centre. The im- pulses proceeding from it probably do not pass directly to the motor nerve-fibres concerned, but first to subsidiary centres in the cord, from which properly co-ordinated impulses are sent to the muscles concerned. Occasionally in young animals, especially after a small dose of strychnia has been administered, a few respiratory movements are seen after •section of the cord high up in the neck. But the broad general fact remains, that in. the normal working of the Body the spinal respiratory centres only send out respiration-caus- ing impulses when excited by impulses descending to them from the main respiratory centre in the medulla. In the above statements, attention has been chiefly con- fined to the diaphragm and the intercostal muscles; but what is said of them is true of the respiratory innervation of all other breathing muscles, whether expiratory or inspira- tory, normal or extraordinary. Is the Respiratory Centre Reflex? Since this centre goes on working independently of the will, we have next to inquire is it a reflex centre or not ? are the efferent discharges it sends along the respiratory nerves due to afferent impulses reaching it by centripetal nerve-fibres ? or does it originate efferent nervous impulses independently of excitation through afferent nerves? We knew, in the first place, that the respiratory centre is 416 THE HUMAN BODY. largely under reflex control; a dash of cold water on the skin, the irritation of the nasal mucous membrane by snuff, or of the larynx by a foreign body, will each cause a modifi- cation in the respiratory movements — a long indrawn breath, a sneeze, or a cough. But, although thus very subject to influences reaching it by afferent nerves, the respiratory centre seems essentially independent of such. In many ani- mals, as rabbits (and in some men), marked breathing move- ments take place in the nostrils, which dilate during inspira- tion ; and when the spinal cord of a rabbit is cut close to the medulla, thus cutting off all afferent nervous impulses to the respiratory centre except such as may reach it through cranial nerves, the respiratory movements of the nostrils still con- tinue until death. The movements of the ribs and dia- phragm of course cease, and so the animal dies very soon unless artificial respiration be maintained. Moreover, if after cutting the spinal cord as above described, the chief sensory cranial nerves be divided, so as to cut off the respira- tory centre from almost all possible afferent nervous im- pulses, the regular breathing movements of the nostrils con- tinue. It is, therefore, nearly certain that the activity of the respiratory centre, however much it may be capable of modi- fication through sensory nerves, is essentially independent of them ; in other words the normal respiratory movements are not reflex. What it is that Excites the Respiratory Centre. The thing that, above all others, influences the respiratory centre is the greater or less venosity of the blood flowing through it. If this blood be very rich in oxygen and comparatively poor in carbon dioxide the respiratory centre acts but feebly, and the respirations are shallow. If, on the other hand, this blood be highly venous the respiratory movements are more rapid than normal, and are forced, the extraordinary muscles of respiration being called into play; this state of violent labored respiration, due to deficient aeration of the blood is called dyspnma. Normal quiet breathing is eupnosa. If active artificial respiration be kept up on an animal for a short time, it is found, on its cessation, that the creature (dog or rabbit) makes no attempt to breathe for a period which may extend to one and a half minutes. TMs breath- less condition, in which an animal with no hindrance opposed to its breathing makes no respiratory movement is apncea. THE RESPIRATORY MECHANISM. 417 Apnoea used to be ascribed solely to an overloading of the blood with oxygen, but the haemoglobin of the blood leaving the lungs is normally so nearly saturated with that gas that this explanation is not sufficient. The apnceic state is in part due no doubt to the high percentage of oxygen in the air-cells of the lungs, brought about by the active artificial ventilation. The blood, as it flows through the lungs, is thus able to supply itself with oxygen for some time without any renewal of the air within them. But even this is not the whole matter, for an animal made apnceic will often continue so after its arterial blood has become distinctly venous in color; and an animal may, if its pneumogastric nerves be intact, be rendered apnceic for a short time by rapid insuffla- tion of its lungs with an indifferent gas. In fact, there is evidence that distention of the lungs tends to inhibit the sending out of impulses to the inspiratory muscles, the afferent fibres exerting this inhibitory action on the centre taking their course in the pulmonary branches of the pneu- mogastric; and this inhibition plays a part in the production of apnoea. It should be noted that by apncea physicians usually mean only extreme dyspnoea. How venous blood causes great excitation of the respira- tory centre is not certainly known. We may make the following provisional hypothesis: the chemical changes occurring in the respiratory centre produce a substance which stimulates its nerve-cells; when the. blood is richly oxygenated this substance is oxidized as fast as it is formed, and the centre is not excited ; but when the blood is poor in oxygen, the stimulating body accumulates and the respiratory discharges become powerful. Under normal circumstances the oxygen is not kept up to the point of entirely removing this exciting substance, and 'the centre is stimulated so as to produce the natural breathing movements. That the stimu- lant acts upon the respiratory centre itself, and not upon other organs of the Body and through their sensory nerves upon the medulla, is proved by experiments which show that the circulation of venous blood through the trunk and limbs of an animal, while its respiratory centre is supplied with arterial blood, does not produce dyspnoea. Why are the Respiratory Discharges Rhythmic ? Every complete respiratory act consists of an inspiration, an expira- tion and a pause; and then follows the inspiration of the 418 THE HUMAN BODY. next act. In natural quiet breathing there is no essential difference between the expiration and the pause. The in- spiration is the only active part; the expiration and the pause are dependent on muscular inactivity and, there- fore, on the cessation of the discharge of nervous impulses from the respiratory centre. But then, we may ask, if in accordance with the hypothesis made in the last paragraph, the respiratory centre is constantly being excited, why is it not always discharging ? why does it only send out nervous impulses at intervals? This question, which is essentially the same as that why the heart beats rhythmically, belongs to the higher regions of Physiology and can only at present be hypothetically answered. Let us consider, for a moment, ordinary mechanical circumstances under which a steady supply is turned into an intermittent discharge. Suppose a tube closed water-tight below by a hinged bottom, which is kept shut by a spring. If a steady stream of water is poured into the tube from above, the water will rise until its weight is able to overcome the pressure of the spring, and the bottom will then be forced down and some water flow out. The spring will then press the bottom up again, and the water accumulate until its weight again forces open the bottom of the tube, and there is another outrush; and so on. By opposing a certain resistance to the exit we could thus turn a steady inflow into a rhythmic outflow. Or, take the case of a tube with one end immersed in water and a steady stream of air blown into its other end. The air will emerge from the immersed end, not in a steady current, but in a series of bubbles. Its pressure in the tube must rise until it is able to overcome the cohesive force of the water, and then a bubble bursts forth; after this the air has again to get up the requisite pressure in the tube before another bubble is ejected; and so the continuous supply is trans- formed into an intermittent delivery. Physiologists sup- pose something of the same kind to occur in the respiratory centre. Its nerve-cells are always, under usual circum- tances, being excited; but, to discharge a nervous impulse along the efferent respiratory nerves, they have to overcome a certain resistance. The nervous impulses have to accumu- late, or " gain a head," before they travel out from the centre, and, after their discharge, time is required to attain once more the necessary level of irruption before a fresh in- THE RESPIRATORY MECHANISM. 419 nervation is sent to the muscles. This method of account- ing for the respiratory rhythm is known as the " resistance theory." If not altogether satisfactory it is at least far preferable to the older mode of considering the question solved by assuming a rhythmic character or property of the respiratory centre. It gives a definite hypothesis, which accords with what is known of general natural laws outside of the Body, and the validity of which can be subjected to experiment: and so serves very well to show how scientific differs from pre-scientific, or mediaeval, physiology. The latter was content with observing things in the Body and considered it explained a phenomenon when it gave it a name. Now we call a phenomenon explained, when we have found to what general category of natural laws it can be reduced as a special example; and this reducing a special case to a particular manifestation of some one or more general properties of matter already known is, of course, all that we ever mean when we say we explain anything. We explain the fall of an apple and the rise of the tides by referring them to the class of general results of the law of gravitation; but the why of the law of gravitation we do not know at all; it is merely a fact which we have found out. So with regard to Physiology; we are working scientifically when we try to reduce the activities of the living Body to- special instances of mechanical, physical, or chemical laws otherwise known to us, and unscientifically when we lose sight of that aim. Certain vital phenomena, as those of blood-pressure, we can thus explain, as much as we can ex- plain anything; others, as the rhythm of the respiratory movements, we can provisionally explain, although not yet certain that our explanation is the right one; and still others, as the phenomena of consciousness, we cannot explain at all, and possibly never shall, by referring them to general properties of matter, since they may be associated only with that particular kind of matter called protoplasm, and per- haps only with some varieties of it. The Relation of the Pneumogastric Nerves to the Re- spiratory Centre. We have next to consider if any phenom- ena presented by the living Body give support to the resist- ance theory of the respiratory rhythm. A very important collateral prop to it is given by the relation of the pneu mo- gastric nerves to the rate and force of the respiratory move- 420 THE HUMAN BODY. ments. These nerves give branches to the larynx, the wind- pipe, and the lungs, and might therefore be suspected to have something to do with breathing. Indeed at one time it was maintained that the breathing movements were purely reflex, the afferent fibres running in the pneumogastrics from the lungs to the respiratory centre. That the vagi are not concerned in influencing the respiratory muscles directly is shown by the fact that all of these muscles (except certain small ones in the larynx) contract as usual in breathing after both pneumogastric nerves have been divided. Still, the section of both nerve's has a considerable influence on the respiratory movements; they become slower and deeper. We may understand this by supposing that the resistance to the discharges of the respiratory centre is liable to variation. It may be increased, and then the discharges will be fewer and larger; or diminished, and then they will be more fre- quent but each one less powerful. If the spring, in the illustration used in the preceding paragraph, be made stronger, while the inflow of water to the tube remains the same, the outflows will be less frequent but each one greater; and vice versa. The effect of section of the pneumogastric trunk may, therefore, be explained if we suppose that, normally, it carries up, from its lung branches, nervous impulses which diminish the resistance to the discharges of the respiratory centre ; when the nerves are cut these helping impulses are lost to the centre, and its impulses must gather more head before they break out, but will be greater when they do. This view is confirmed by the fact that stimulation of the central ends of the divided pneumogastrics, if weak, brings back the respirations to their normal rate and force; if stronger makes them more rapid and shallower; and when stronger still, abolishes the respiratory rhythm altogether, with the inspiratory muscles in a steady state of feeble con- traction. That is to say, the resistance to the discharges of the centre being entirely taken away (which is equivalent to the total removal of the spring in our example), the centre sends out uninterrupted and non -rhythmic stimuli to the inspiratory muscles. The pneumogastric nerve gives two branches to the larynx; known respectively as the superior and inferior (re- current) laryngeal nerves; the action of these on the respira- tory centre is opposite to that of the fibres from the lungs THE RESPIRATORY MECHANISM. 421 coming up in the main pneumogastric trunk. If the supe- rior laryngeal branch be divided and its central end stimu- lated, the respirations become less frequent but each one more powerful; hence this nerve appears to contain fibres which increase the resistance to inspiratory discharges from the respiratory centre. The same, but to a less degree, is true of the inferior laryngeal branch. Both are inhibitory fibres so far as inspiration is concerned; whereas the main vagus stem when its central end is electrically stimulated is acceler- ator or augmentor. The Expiratory Centre. Hitherto we have considered breathing as due to the rhythmically alternating activity and rest of an inspiratory centre — and such is the case in normal quiet breathing, in which the expirations are passive. But in dyspnoea expiration is a muscular act, and so there must be a section of the respiratory centre controlling the expira- tory muscles, and we may regard the whole centre as consist- ing really of two; an inspiratory and expiratory. The latter part of the respiratory centre, however, is less irritable than the inspiratory part, and hence when the blood is in a normal state of aeration never gets stimulated up to the discharging point. In dyspncea the stimulus becomes sufficient to cause it also to discharge, but only after the more irritable inspira- tory centre; hence the expiration follows the inspiration. This alternation of activity is, moreover, promoted by the fact that the pneumogastric nerve-fibres coming up from the lungs are of two kinds. The predominant sort are the accelerator set already referred to, which favor discharge of the inspiratory centre, and perhaps also increase the resist- ance to the expiratory discharge. This set is excited when the lungs diminish in bulk, as in expiration; and when the whole nerve is stimulated electrically they usually get the better of the other set, which carry up to the medulla im- pulses which inhibit inspiratory discharges. This set is stimulated by expansion of -the lungs, even in quiet breath- ing: and they play a part in producing the phenomenon of apncea. When the distention of the lungs is con- siderable these fibres not only check inspiration but favor expiratory movements. Hence, every expansion of the lungs (inspiration) tends to promote an expiration, and every col- lapse of the lungs (expiration) tends to produce an inspira- 422 THE HUMAN BODY. tion; and so, through the pneumogastric nerves, the respira- tory mechanism is largely self -regulating. Asphyxia. Asphyxia is death from suffocation, or want of oxygen by the tissues. It may be brought about in various ways; as by strangulation, which prevents the entry of air into the lungs; or by exposure in an atmosphere con- taining no oxygen; or by putting an animal in a vacuum; or by making it breathe air containing a gas which has a stronger affinity for haemoglobin than oxygen has, and which, therefore, turns the oxygen out of the red corpuscles and takes its place. The gases which do the latter are very in- teresting since they serve to prove conclusively that the Body can only live by the oxygen carried round by the haemoglobin of the red corpuscles; that amount dissolved in the blood plasma being insufficient for its needs. Of such gases carbon monoxide is the most important and best studied; in the fre- quent French mode of committing suicide by stopping up all the ventilation holes of a room and burning charcoal in it, it is poisoning by carbon monoxide which causes death. The Relations of Carbon Monoxide to Haemoglobin. If aerated whipped blood, or a solution of oxyhyaemoglobin, be exposed to a gaseous mixture containing carbon monoxide, the liquid will absorb the latter gas and give off oxygen. The amount of carbon monoxide taken up will (apart from a small amount dissolved in the plasma) be independent of the partial pressure of that gas in the gaseous mixture to which the blood is exposed ; the quantity absorbed depends on the quantity of haemoglobin in the liquid, and is replaced by an equal volume of oxygen liberated. This equivalence of volume, of itself, proves that the phenomenon is due to the chemical replacement of oxygen in some compound, by the carbon monoxide; for if the carbon monoxide were merely dissolved in the liquid in proportion to its partial pressure on the surface, it would turn out no oxygen; the quantity of dissolved gases held by a liquid being dependent only on the partial pressure of each individual gas on its surface, and unaffected by that of all others. During the taking up of carbon monoxide the blood changes color in a way that can be recognized by a practised eye; it becomes cherry-red in- stead of scarlet. This shows that some new chemical com- pound has been formed in it; examination with the spectro- scope confirms this, and shows the color change to be due to THE RESPIRATORY MECHANISM. 423 the formation of carbon-monoxide haemoglobin which has a different color from oxyhaemoglobin. A dilute solution of reduced haemoglobin absorbs all the rays of light in one region about the green of the solar spectrum, and so pro- duces there a dark band; a thin layer of the blood of an asphyxiated animal does the same. Dilute solution of oxy- haemoglobin absorbs the rays in two narrow regions of the solar spectrum at the • confines of the yellow and green, and arterial blood does the same. Dilute solution of carbon- monoxide haemoglobin, or blood which has been exposed to this gas, also absorbs the light in two narrow bands of the >.olar spectrum; but these are a little nearer the blue end of the spectrum than the absorption bands of oxyhaemoglobin. Pure blood serum saturated with oxygen gas or with carbon monoxide does not specially absorb any part of the spectrum; therefore the absorptions when haemoglobin is present must be due to chemical compounds of those gases with that body. Since carbon-monoxide haemoglobin has a bright-red color, we find, in the Bodies of persons poisoned by that gae, the blood all through the Body cherry-red; the tissues being unable to take carbon monoxide from haemoglobin in the systemic circulation. Hence the curious fact that, while death is really due to asphyxia, the blood is almost the color of arterial blood, instead of very dark purple, as in ordinary cases of death by suffocation. Experiments with animals show that in poisoning by carbon monoxide persistent ex- posure of the blood to oxygen, by means of artificial respira- tion, will cause the poisonous gas to be slowly replaced again by oxygen; hence if the heart has not yet quite stopped beating, artificial respiration, kept up patiently, should be employed in the case of poisoning by carbon monoxide unless transfusion of blood be possible. The Phenomena of Asphyxia. As soon as the oxygen in the blood falls below the normal amount the breathing becomes hurried and deeper, and the extraordinary muscles of respiration are called into activity. The dyspnoea be- comes more and more marked, and this is especially the case with the expirations which, almost or quite passively per- formed in natural breathing, become violently muscular. At last nearly all the muscles in the Body are set at work; the rhythmic character of the respiratory acts is lost, and general convulsions occur, but, on the whole, the contractions of the 424 THE HUMAN BODY. expiratory muscles are more violent than those of the inspira- tory. Thus undue want of oxygen at first merely brings about an increased activity of the respiratory centre, and especially of its expiratory division which is not excited in normal breathing. Then it stimulates other portions (the convulsive centre) of the medulla oblongata also, and gives rise to violent and irregular muscular spasms. That the convulsions are due to excitation of nerve-centres in the medulla (and not, as might be supposed, to poisoning of the muscles or of the fore parts of the brain by the extremely venous blood) is shown of the facts (1) that they do not occur in the trunk' of an animal when the spinal cord has been divided in the neck so as to cut off the muscles from the medulla; and (2) that they still occur if (the spinal cord remaining undivided) all the parts of the brain in front of the medulla have been removed. The violent excitation of the nerve-centres soon exhausts them, and all, the more readily since their oxygen supply (which they like all other tissues need in order to continue their activity) is cut off. The convulsions therefore gradu- ally cease, and the animal becomes calm again, save for an occasional act of breathing when the oxygen want becomes so great as to lead to efficient stimulation even of the dying respiratory centre: these final movements are inspirations and, becoming less and. less frequent, at last cease, and the animal appears dead. Its heart, however, though gorged with extremely dark venous blood still makes some slow feeble pulsations. So long as it beats artificial respiration can restore the animal, but once the heart has finally stopped restoration is impossible. There are thus three distinguish- able stages in death from asphyxia. (1) The stage of dyspnoea. (2) The stage of convulsions. (3) The stage of exhaustion; the convulsions having ceased but there being from time to time an inspiration. The end of the third stage occurs in a mammal about five minutes after the oxygen supply has been totally cut off. If the asphyxia be due to deficiency, and not absolute want of oxygen, of course all the stages take longer. Circulatory Changes in Asphyxia. During death by suffocation characteristic changes occur in the working of the heart and blood-vessels. The heart at first beats quicker, but very soon, before the end of the dyspnoeic stage, more THE RESPIRATORY MECHANISM. 425 slowly, though, at first, more powerfully. This slowing is due to the fact that the unusual want of oxygen leads to stimulation of the cardio-inhibitory centre in the medulla and this, through the pneumogastric nerves, slows the heart's beat. Soon, however, the want of oxygen affects the heart itself and it begins to beat more feebly, and also more slowly, from exhaustion, until its final stoppage. Dur- ing the second and third stages the heart and the venae cavae become greatly overfilled with blood, because the violent muscular contractions facilitate the flow of blood to the heart, while its beats become too feeble to send it out again. The overfilling is most marked on the right side of the heart which receives the venous blood from the Body generally. During the first and second stages of asphyxia arterial pressure rises in a marked degree. This is due to excita- tion of the vaso-motor centre by the venous blood, and the consequent constriction of the muscular coats of the arteries and increase of the peripheral resistance. In the third stage the blood-pressure falls very rapidly, because the feebly acting heart then fails to keep the arteries tense, even although their diminished calibre greatly slows the rate at which they empty themselves into the capillaries. Another medullary centre unduly excited during asphyxia is that from which proceed the nerve-fibres governing those muscular fibres of the eye which enlarge the pupil. During suffocation, therefore, the pupils become widely dilated. At the same time all reflex irritability is lost, and touching the eyeball causes no wink; the reflex centres all over the Body being rendered, through want of oxygen, incapable of activity. The same is true of the higher nerve-centres; un- consciousness comes on during the convulsive stage, which, horrible as it looks, is unattended with suffering. Modified Respiratory Movements. Sighing is a deep long-drawn inspiration followed by a shorter but correspond- ingly large expiration. Yawning is similar, but the air is mainly taken in by the mouth instead of the nose, and the lower jaw is drawn down in a characteristic manner. Hic- cough depends upon a sudden contraction of the diaphragm, while the aperture of the larynx closes; the entering air, drawn through the narrowing opening, causes the peculiar sound. Coughing consists of a full inspiration followed by a violent and rapid expiration, during the first part of which 426 THE HUMAN BODY. the laryngeal opening is kept closed ; being afterwards sud- denly opened, the air issues forth with a rush, tending to carry out with it anything lodged in the windpipe or larynx. Sneezing is much like coughing, except that, while in a cough the isthmus of the fauces is held open and the air mainly passes out through the mouth, in sneezing the fauces are closed and the blast is driven through the nostrils. It is t commonly excited by irritation of the nasal mucous mem- brane, but in many persons a sudden bright light falling into the eye will produce a sneeze. Laugh ing consists of a series of short expirations following a single inspiration; the larynx is open all the time, and the vocal cords (Chap. XXXVII.) are set in vibration. Crying is, physiologically, much like laughing and, as we all know, one often passes into the other. The accompanying contractions of ,the face muscles giving expression to the countenance are, however, different in the two. All these modified respiratory acts are essentially reflex and they serve to show to what a great extent the discharges of the respiratory centre can be modified by afferent nerve impulses; but, with the exception of hiccough, they are to a certain extent, like natural breathing, under the control of the will. Most of them, too, can be imitated more or less perfectly by voluntary muscular movements; though a good stage sneeze or cough is rare. CHAPTER XXVIII. THE KIDNEYS AND SKIN. General Arrangement of the Urinary Organs. These consist of (1) the kidneys, the glands which secrete the urine; (2) the ureters or ducts of the "kidneys, which carry their secretion to (3) the urinary bladder, a reservoir in which it accumulates and from which it is expelled from time to time through (4) an exit tube, the urethra. The general arrangement of these parts, as seen from behind, is represented in Fig. 132. The two kidneys, R, lie in the dorsal part of the lumbar region of the abdominal cavity, one on each side of the middle line. Each is a solid mass, with a convex outer and a concave inner border, and its upper end a little larger than the lower. From the ab- dominal aorta, A, a renal artery, Ar, enters the inner border of each kidney, to break up within it into finer branches, ultimately ending in capillaries. The blood is collected from these into the renal veins, Vr, one of which leaves each kid- ney and opens into the inferior vena cava, Vc. From the concave border of each kidney proceeds also the ureter, U, a slender tube from 28 to 34 cm. (11 to 13.5 inches) long, opening below into the bladder, Vu, on its dorsal aspect, and near its lower end. From the bladder proceeds the urethra, at ffrt. The channel of each ureter passes very obliquely through the wall of the bladder to open into it; accordingly if the pressure inside the latter organ rises above that of the liquid in the ureter, the walls of the oblique passage are pressed together and it is closed. Usually the bladder, which has a thick coat of unstriped muscular tissue lined by a mucous membrane, is relaxed, and the urine flows readily into it from the ureters. While urine is collecting, the be- ginning of the urethra is kept closed, in part at least, by bands of elastic tissue around it: some of the muscles which surround the commencement of the urethra assist, being kept in reflex contraction ; it is found that in a dog the urinary 427 428 2 HE HUMAN BODY. bladder can retain liquid under considerably higher pressure when the spinal cord is intact than after destruction of its Ua Fio. 132.— The renal organs, viewed from behind. R, right kidney; A, aorta; Ar, right renal artery; Fc, inferior vena cava; Vr, right renal vein; £7, right ureter; Fw, bladder; C7a, commencement of urethra. lumbar portion. The contraction of these urethra-con- stricting muscles can be reinforced voluntarily. When some amount of urine has accumulated in the bladder, it contracts THE KIDNEYS AND SKIN. 429 and presses on its contents; the ureters being closed in the way above indicated, the elastic fibres closing the urethral exit are overcome, and the urethral muscles simultaneously relaxing, the liquid is forced out. Naked Eye Structure of the Kidneys. These organs have externally a red-brown color, which can be seen through the transparent capsule of peritoneum which envelops them. When a section is carried through a kidney from its outer to its inner border (Fig. 133) it is seen that a deep fissure, the hilus, leads into the latter. In the hilus the ureter widens out to form the pelvis, D, which breaks up again into a number of smaller divisions, the cups or calices. The cut surface of the kidney proper is seen to consist of two distinct parts; an outer or cortical portion, and an inner or medul- lary. The medullary portion is less red and more glistening to the eye, is finely striated in a radial direction, and does not consist of one continuous mass but of a number of conical portions, the pyramids of Malpighi, 2', each of which is separated from its neighbors by an inward prolongation, *, of the cortical substance: this, however, does not reach to the inner end of the pyramid, which projects, as the papilla, into a calyx of the ureter. At its outer end each pyramid sepa- rates into smaller portions, the pyramids of Ferrein, 2", separated by thin layers of cortex and gradually spreading everywhere into the latter. The cortical substance is redder and more granular looking and less shiny than the medullary, and forms everywhere the outer layer of the organ next its capsule, besides dipping in between the pyramids in the way described. The renal artery divides in the hilus into branches (5) which run into the kidney between the pyramids, giving off a few twigs to the latter and ending finally in a much richer vascular network in the cortex. The branches of the renal vein have a similar course. The Minute Structure of the Kidney. The kidneys are compound tubular glands, composed essentially of branched microscopic urimferous tubules, lined by epithe- lium. Each tubule commences at a small opening on a papilla and from thence has a very complex course to its other extremity: usually about twenty open, side by side, on one papilla, where they have a diameter of about 0.125 mm. (5Jo i»ch). Running from this place into the pyramid 430 THE HUMAN BODY. each tubule divides several times. At first the branches are smaller than the main tube; but as soon as they have come down to about 0.04 mm. (vfa inch) this diminution in size ceases, and division continuing while the tubules retain the same diameter, the pyramid thus gets, in part, its conical form. Ultimately each branch runs out of the pyramid somewhere, either from its base or side, into the cortex and there dilates FIG. 133. — Section through the right Kidney trom its outer to its inner border. I, cortex; 2, medulla: 2', pyramid of Malpiglii; , the pelvis of the kidney; U, ureter; C, a calyx. and is twisted. It then narrows and doubles back into one of the pyramids of Ferrein and runs as a straight tube towards the papilla, but before reaching it makes a loop (loop of Henle], and turns back again as a straight tube towards the base of the pyramid, where it once more enters the cortex, dilates and becomes contorted, and then ends in a spherical capsule, THE KIDNEYS AND SKIN. 431 containing a tuft of small blood-vessels. Or, followed the other way, each tubule commences in the cortex with a globular dilatation, the Malpigliian capsule. From this it continues as a convoluted tubule in the cortex; this passes into a pyramid of Ferrein, becomes straight, and runs to near a pyramid of Malpighi as the descending limb of a loop of Henle. Turning at the loop, it continues as its ascending limb, and this passes out again into the cortex and becomes the convoluted junctional tubule, which passes as a straight collecting tubule into a pyramid of Ferrein, where it joins others to form an excretory tubule; the excretory tubules run into the main pyramid and unite to form the discharging tubules which open on the papilla. Throughout its course the tubule is lined by a single layer of epithelium cells differ- ing in character in its different sections: they are flat and clear in the capsules, and very granular in both the convo- luted parts, where their appearance suggests that they are not mere lining cells but cells with active work to do; they are non-granular and flat in the descending limb of the loop of Henle, clear and columnar in most of the ascending, and in both are probably only protective; in the collecting and discharging tubules they are somewhat cuboidal in form and have no active secretory function. All the tubes are bound together by a sparse amount of connective tissue and by blood-vessels to form the gland. The lymph spaces are large and numerous, especially about the convoluted portions of the tubules. The Blood-flow through the Kidney. The amount of blood brought to the kidney is large relatively to the size of the organ and enters under a very high pressure almost direct from the aorta, and leaves under a very low, into the inferior cava (Fig. 132). The final twigs of the renal artery in the cortex, giving off a few branches which end in a capillary network around the convoluted tubules and in the pyramids, are continued as the afferent vessels of Malpighian capsules, the walls of which are doubled in before them (Fig. 134); there each breaks up into a little knot of capillary vessels called the glomerulus, from which ultimately an efferent vessel proceeds. Where the wall of the glomerulus, w, Fig. 134, is doubled in before the blood-vessels, its lining cells continue as a covering, c, to the latter, closely adhering to the vascular walls. A space, A, is left between the epithelial cells of the 432 THE HUMAN BODY. outside of the capsule and those involuted on the vessels, as there would be in the interior of a rubber ball one side of which was pushed in so as to nearly meet the other; this cleft, into which any liquid transuded from the vessels must enter, opens by a narrow neck, d, into the commencement of the first contorted part of an uriniferous tubule. The effer- ent vein, carrying blood away from the glomerulus, breaks up into a close capillary network around the neighboring tubules of the cortex. From these capillaries the blood is collected into the renal vein. Most of the blood flowing through the kidney thus goes through two sets of capil- laries; one found in the capsules, and the second formed by the breaking up of their efferent veins. The capillary network in the pyra- mids is much less close than that in the cortex, which gives reason to suspect that most of the secretory work of the kidneys is done in the FIG. 134.— Diagram showing a capsules arid convoluted tubules. nanSdnffe^ The pyramidal blood flows only through one set of capillaries, there **™S no glomeruli in the kidney vein e issues; c, involuted epithe- rnprlnlla Hum covering: the vascular tuft; " for the sake of distinctness it is The Renal Secretion. The represented as a general wrapping for the whole tuft, but in nature amount of this carried off from the it forms a close investment . around each vessel of the glo- Body in 24 hours IS SU Dject to CO11- merulus; A. space in capsule into . , , , ... , . ,, which liquid transuded from siderable variation, being especially ng diminished by anything which pro- : motes perspiration, and increased "£££ by conditions, as cold to the sur- brane- face, which diminish the skin ex- cretion. Its average daily quantity varies from 1200 to 1750 cub. cent. (40 to 60 fluid ounces). The urine is a clear amber-colored liquid, of a slightly acid reaction; its specific gravity is about 1022, being higher when the total quantity excreted is small than when it is greater, since the amount of solids dissolved in it remains nearly the same in health; the changes in its bulk being dependent mainly on changes in the amount of water separated from the blood by the kidneys. THE KIDNEYS AND SKIN. 433 Normal urine consists, in 1000 parts, of about 960 water and 40 solids. The latter are mainly crystalline nitrogenous bodies (urea and uric acid], but small quantities of pigments and of non-nitrogenous organic bodies are also present, and a considerable quantity of mineral salts. The following table gives approximately, in the first column, the average compo- sition of the urine excreted in twenty-four hours expressed im grams; in the second column the same expressed in grains. The third column gives the composition of 1000 parts of urine. Urine in 24 hours. 1500 grams. 23,250 grains. In 1000 parts. Water 1428 00 22 134.00 952 00 Solids 72.00 1116.00 4800 The solids consist of — Urea 33 00 511 50 22.00 Uric acid 0 50 7 75 0.33 Hippuric acid 0 40 6.20 0.27 Kreiitinin \ 00 15 50 0.67 Pigments and fats . . .... 10 00 155 00 0.66 Sulphuric acid 2 00 31 00 1.33 Phosphoric acid 3.00 46.50 200 Chlorine 7 00 108 50 4.67 Ammonia 0 75 12 00 0.50 Potassium. . . 2.50 38 75 1.67 Sodium 11.00 170.50 7.33 Calcium . ... 0 25 3 80 0.17 Magnesium 0 20 3.00 0.13 71.60 1110.00 47.73 The urine, however, even in health is subject to consid- erable variation in composition; not only as regards the amount of water in it, but also in respect to its solid con- stituents; the latter are especially modified by the quantity and nature of the food taken. The Crystalline Nitrogenous Constituents of the Urine are of great interest as they represent the final result of the breaking down in the Body of albuminous and gelatinaginous substances, whether due to tissue waste or to the destruction in the bodily liquids of proteids and albuminoids existing in them in solution. Their chemical relationships tend to cast some light on the structure of an albumen molecule and on the metabolisms it undergoes in the living organism. 434 THE HUMAN BODY. Urea (N2H4CO) is the chief nitrogenous waste product of the human Body and is related to the ammonia group, being readily converted into ammonium carbonate by hydra- tion, a change which occurs under the influence of some living ferments when stale urine becomes alkaline and ac- quires its well-known offensive ammoniacal odor — N2H4CO + 2H20 = (NH4)2C03. On another side urea is allied to the cyanogen group of sub- stances, being isomeric with ammonium cyanate, which is converted into it by simple heating. Uric acid (C5H4N403) is present in but small quantity in normal human urine, but is the chief nitrogenous excretion of birds and reptiles. Its molecular structure is more com- plex than that of urea, and when it is decomposed by various methods urea is very frequently one of the products. It is a less complete product of proteid degradation than urea. Some of its decompositions indicate relations to oxalic acid and to amido-acetic acid (glycin), and through this latter to the ammonias and the fatty acids series. In human urine uric acid exists chiefly in the form of salts of potassium and sodium; these are less soluble in cold than in warm water, and are sometimes deposited as a flocculent precipitate when originally clear urine is left to cool. The precipitate dis- appears on reheating the liquid. Hippuric acid (C7H602) is scanty in normal human urine but abundant in the urine of herbivora. Chemically it is related to the aromatic series, being formed when benzoic acid and glycin are made to unite with dehydration; and it is broken up into those substances when boiled with mineral acids. Certain aromatic bodies allied to benzoic acid are found in hay and similar foods and account for the large amount of hippu rates in herbivorous urine. But proteids when broken up by putrefaction also yield bodies of the ben- zoic group, and the hippu ric acid of human urine probably has its origin in the liberation of benzoic residues in metabolic activities of some of the living cells of the Body; these residues being then combined with glycin to form hippu ric acid. That glycin is formed in the Body is shown by the j fact that benzoic acid given in food reappears in human urine I as hippuric acid, having been somewhere united to a glycin residue. THE KIDNEYS AND SKIN. 435 Kreatinin (C4H7N,0) is closely allied tokreatin (C4H9N302), of which it is a simple dehydration product. Kreatin is a normal constituent of muscle (0.2-0.3$), being, indeed, most conveniently prepared from Liebig's extract; it is also known that kreatin introduced into the Body is converted into kreatinin; for if given in the food it causes an equivalent increase of the kreatinin excreted in the urine. Kreatin formed in the muscles has accordingly been supposed to be a source of the kreatinin of the urine, but this does not appear to be the case, as all kreatinin disappears from the urine during starvation. The kreatinin of normal urine probably has its source in the kreatin of flesh eaten as food. The Urinary Pigments are still very imperfectly known, but appear in part to be derived from uro-bilin, which, as we have seen (Chap. XXIV), is itself probably a derivative of haemoglobin. Of the inorganic salts sodium chloride is by far the most abundant, but the phosphates deserve notice because the acidity of normal fresh urine is dependent on the presence of acid sodium phosphate. In various diseases abnormal substances are found in the urine: the more important are albumens in albuminuria or Bright's disease; grape sugar or glucose in diabetes; bile salts ; bile pigments. The Secretory Actions of Different Parts of an Urinif- erous Tubule. — The microscopic structure of the kidneys is such as to suggest that in those organs we have to do with two essentially distinct secretory apparatuses : one represented by the glomeruli, with their capillaries separated only by a single layer of flat epithelial cells from the cavity of the capsule and especially adapted for filtration and dialysis; the other represented by the contorted portions of the tubules, with their large granular cells, which clearly have some more active part to play than that of a mere passive transudation membrane. And we find in the urine substances which like the water and mineral salts may easily be accounted for by mere physical processes, and others, urea especially, which are present in such proportion as must be due to some active physiological work of the kidney, whether a merely selective activity of its cells or a constructive one. More direct evi- dence does, in fact, justify us in saying that in general the glomeruli are transudation organs, the contorted portions of 436 THE HUMAN BODY. the tubuli secretory organs, while the loops of Henle and the collecting and discharging tubules are merely passive channels for the gathering and transmission of liquid. Even in the glomeruli, however, the renal cells provide something more than a merely passive physical membrane for dialysis and filtration : to a certain extent they control the passage of substances through them; while they are in health no serum albumen or paraglobulin passes through them into the urine, though egg albumen injected into the blood of a living mammal does. But when they are altered in disease or even by a temporary stoppage of their blood -supply, then they allow the normal blood proteids to transude: if the blood- supply of a kidney be cut off for some minutes by clamping the renal artery, then the urine secreted for some time after the clamp is removed is albuminous. The structure of the glomerular epithelium and its rela- tion to the blood-vessels are such as to make it almost certain that when albumen appears in the urine it enters through them and not through other parts of the tubule; but in some amphibia we get direct evidence of the entry of substances other than salts and water into the renal secretion by the path of the Malpighian capsules. In amphibia the blood carried to the kidney, like that supplying the mammalian liver, has two sources, one venous and one arterial ; the arterial supply comes from the renal arteries, the venous from the veins of the leg by the reniportal vein. Both, bloods leave the organ by the renal veins, but their distribution in it is in great part distinct; the arteries supply the glomeruli, the reniportal vein the tubules of the cortex, though mixed there with blood from the efferent vessels of the glomeruli. In some small amphibia it is, in fact, possible to observe the circulation in the living kidney and to see that all blood-flow in the glomer- uli ceases when the renal arteries are tied, though it con- tinues elsewhere throughout the organ. When sugar or peptone is injected into the blood of such an animal those substances appear in the urine; but if the renal arteries be pre- viously tied they do not. It is true that under those circum- stances all secretion of urine usually ceases, but it may be excited by administering certain drugs, and then is found to be free from sugar and peptone. Grape-sugar when present in the blood of mammals beyond a certain small percentage passes out in the urine; and the same is true of peptone: THE KIDNEYS AND SKIN. 487 indeed, the absence of peptone (or of all but the merest traces of it) from healthy human urine is one of the main reasons for believing that peptone absorbed from the alimentary canal is converted at once by the lymphoid tissues of the mucous membrane into the proper proteids of the blood plasma. When sugar appears in the urine either in disease or, as some- times happens temporarily, in health, after a meal rich in starchy substances we have from the results of experiment on amphibia reason to believe that its path of excretion is through the glomeruli. In hcvmoglobinuria, a condition in which haemoglobin is found in solution in urine (not in blood- corpuscles, for in that case it may have come from ruptured vessels anywhere in the renal apparatus), the haemoglobin also passes out through the Malpighian bodies: for when some laky blood (Chap. IV) is injected into the vessels of an animal and the secretion of urine at the same time made slow, col- lections of haemoglobin may be found in the cavities of the capsules. While, however, we have evidence that the epithe- lium of the capsule has a certain selective power and is the special seat of transmission of particular, especially abnormal, urinary constituents, yet on the whole the glomeruli provide a merely physical apparatus. Through them most of the bulk of the urine passes out, and, flushing the more active portions of the tubules on its course to the pelvis of the kid- ney, picks up from them the more specific urinary con- stituents. Urea is the most important and most abundant of the characteristic ingredients of urine, and it has a very marked influence on kidney activity, the injection of some of it into blood causing a greatly increased secretion of urine, in which the injected urea is quickly passed out. Judging from ex- periments on amphibia, urea is not excreted or at any rate not chiefly excreted by the glomeruli. On tying the renal arte- ries of one of these animals urinary secretion ceases, there being then no blood-pressure in the glomeruli to cause the transudation of liquid; but if some urea be now injected into the blood the ephithelial cells of other parts of the tubules are stimulated to secrete, and urine rich in urea is formed; but in these circumstances it cannot come from the Malpighian bodies. It would seem then that urea is a special stimulant to some cells of the tubules, and that an excess of it in the blood can stir them up to its elimination along 438 THE HUMAN BODY. with some water, quite independently of any formation of transudation urine. In mammalia we cannot separate the glomerular secretion from the tubular as in amphibia; and the diuresis which administration of urea causes in them is in part due to increased glomerular activity, as urea dilates the kidney vessels and causes more blood flow through the glomeruli, which causes the transudation of more water through them; but the simultaneous increase of urea is almost certainly due to special activity of the other parts of the tubules. The proteids and albuminoids of food may while within the organism have been built up into tissue or may have remained in solution in the liquids; but in either case they are sooner or later broken up and oxidized, the main final products being carbon dioxide, water, and urea. But this breaking down may and does occur in many stages and by different modes in the various tissues; and there is no doubt that most of the intermediate processes in the chemical degradation of albuminous compounds take place outside the kidneys. It was, however, at one time believed that the urea itself was a kidney product : that the penultimate ni- trogenous products of proteid degradation were brought to the kidneys, and that there the final formation of urea took place. But if this were so there could not be less urea in the blood leaving the kidneys by their veins than in that brought to them by the renal arteries; yet such is the case. And further, if urea be made in the kidneys it ought not to accumulate in the blood of animals from whom both kidneys have been removed, as it is now known to do, though not the immediate cause of the symptoms of so-called urcemic poisoning seen in persons with extensive kidney disease. So far, then, as urea is concerned the cells of the kidney tubules are not its producers; they have a special affinity for it and pick it up from the lymph of the kidney, which in turn gets it from the blood. The cells then pass it on with some water, and no doubt other things, into the tubules which they line. That it is the epithelial cells of the contorted portions of the tubules which especially exer- cise this selective power is, so far as urea is concerned, a presumption based on their histological characters, but there is evidence that these cells have a special selective power for some other substances circulating in the blood. . THE KIDNEYS AND SKIN. 439 A blue substance known as sodium sulphindogate after in- jection, in solution, into a vein of an animal is excreted in the bile and urine. If the animal be killed during the excretion no traces of this body can under normal circum- stances be detected in any special part of the kidney; it is in fact washed away by the urine as fast as the cells pick it up and pass it into the tubuli. But if the blood-pressure of the animal be made so low (as by cutting the main vaso- constrictor nerves) as to bring the renal secretion to a stand, and the animal be killed some time after injection of the indigotate, the glomeruli and most of the tubules are found free of the blue, which lies only in the contorted portions, just where the cells which gathered it from the circulating liquid had passed it out. Though the renal epithelium does not make urea it has constructive powers as regards some other urinary constit- uents. As already stated, benzoic acid taken with the food leaves the Body as hippuric acid, having been combined with glycin. If blood containing benzoic acid and glycin be artificially circulated through a perfectly fresh still living kidney, the renal vein blood will contain hippuric acid. Even if no glycin be provided in the blood injected through the renal artery the returning blood will still yield hippuric acid. So living kidney cells can not only perform the synthesis, with dehydration, necessary to form hippuric acid, but can also form and supply the required glycin. The process is closely dependent on the vitality of the cells; the experiment fails if the organ be not perfectly fresh and unin- jured, and if the blood supplied be not properly arterialized. The Influence of Renal Blood-flow on the Amount of Urine Secreted. From the structure of the glomeruli and the fact that most of the water of the urine is derived from them it is a priori probable that anything tending to increase the pressure of blood in them will increase the bulk of urine secreted, and anything diminishing that pressure decrease the urine. This is confirmed by experiment. The kidney is supplied with both vaso-constrictor and vaso-dilator nerves which reach it mainly through the solar plexus, though both sets come ultimately from the spinal cord. When the spinal cord is cut in the neck region of a dog the kidney vessels as well as those of the rest of its body dilate and blood-pressure everywhere is very low. Under these 440 THE HUMAN BODY. circumstances the secretion of urine is suppressed. If the lower end of the cut cord be stimulated the vessels all over the body of the animal contract, and blood-pressure every- where becomes very high. But the kidney vessels being constricted with the rest allow very little blood to enter the glomeruli in spite of the high aortic pressure, and little or no urine is secreted. If, however, the vasoconstrictor nerves of the kidney be cut before the stimulation of the cord, we get a dilatation of the kidney vessels with a con- striction of vessels elsewhere, and abundant blood flows through the glomeruli under high pressure : the whole kidney swells and abundant urine is formed. When the skin vessels contract on exposure to cold, more blood flows through internal organs, the kidneys included, and the blood- pressure in these is if anything increased, the expansion of internal arteries not at the most more than counterbalancing the constriction of the cutaneous. Hence the greater secre- tion of urine in cold weather. Injection of a little water into a vein of an animal causes a very transient constriction of the kidney vessels followed by a dilatation; and general blood-pressure not being at the same time lowered, pressure in the renal glomeruli is high and the secretion of urine increased. Urea introduced into the blood acts in a similar way, but more markedly , so that this substance causes diuresis not merely, as we have seen, by stimulating the cells of the tubuli, but also by exciting the vaso-dilator nerves of the glomerular arteries. Solution of sodium acetate or even of common salt injected into the veins causes very marked local vascular dilatation in the kidney, and hence great flow through the organ under high pressure and a marked in- crease in the quantity of urine excreted. Even if the nerves going to the kidney be first cut, the above results follow, these salts appearing to act directly on a local renal vaso- dilator mechanism. They may of course also, like urea, directly stimulate the cells of the contorted tubules, but this is not proved. The increased secretion of urine after drink- ing much water is probably produced by the dilution of the blood by the liquid absorbed by the alimentary canal, essen- tially in the same manner as the extra secretion caused by direct injection of water into the blood-vessels. That the central nervous system may influence the renal secretion is well known, fear, for example, stimulating it. Probably THE KIDNEYS AND SKIN. 441 such influence is mainly due to vaso-motor changes — either paralysis of the renal vaso-constrictor nerves or stimulation of the vaso-dilator. Such changes would account for the phenomenon, and there is no evidence of the existence of true secretory nerves acting directly on the cells of the organ as certain fibres of the chorda tympani (Chap. XIX) do on the cells of the submaxillary gland. The Skin, which covers the whole exterior of the Body, consists everywhere of two distinct layers ; an outer, the cuti- cle or epidermis, and a deeper, the dermis, cutis vera, or corium. A blister is due to the accumulation of liquid be- tween these two layers. The hairs and nails are excessively developed parts of the epidermis. The Epidermis, Fig. 135, consists of cells, arranged in many layers, and united by a small amount of cementing substance. The deepest layer, d, is composed of elongated or columnar cells, set on with their long axes perpendicular to the corium beneath. To it succeed several layers of round- ish cells, b, the deepest of which, prickle cells, are covered by minute processes (not indicated in the figure) which do not interlock but join end to end so as to leave narrow spaces between the cells ; in more external layers the cells become more and more flattened in a plane parallel to the surface. The outermost epidermic stratum is composed of many layers of extremely flattened cells from which the nuclei (conspicu- ous in the deeper layers) have disappeared. These super- ficial cells are dead and are constantly being shed from the surface of the Body, while their place is taken by new cells, formed in the deeper layers, and pushed up to the surface and flattened in their progress. The change in the form of the cells as they travel outwards is accompanied by chemical changes, and they finally constitute a semitransparent dry horny stratum, a, distinct from the deeper, more opaque and softer Mfilpiffhiftn or mucous layer, b and d, of the epider- mis. The cells of this latter, in spite of their name, are not muceginous; they are soluble in acetic acid; those of the horny stratum not. The rolls of material which are peeled off the skin in the "shampooing^ of the Turkish bath, or by rubbing with a rough towel after an ordinary warm bath, are the dead outer scales of the horny stratum of the epidermis. 442 THE HUMAN BODY. In dark races the color of the skin depends mainly on minute pigment granules lying in the cells of the deeper part of the Malpighian layer. No blood or lymphatic vessels enter the epidermis, which is entirely nourished by matters derived from the subjacent x— a FIG. 135.— A section through the epidermis, somewhat diagrammatic, highly magnified. Below is seen a papilla of the dermis, with its artery, /, and veins, gg ; a, the horny layer of the epidermis ; b, the rete mucosum or Malpighian layer; d, the layer of columnar epidermic cells in immediate contact with the dermis ; h, the duct of a sweat-gland. corium. Fine nerve-fibres run into it and end there among the cells. The Corium, Cutis Vera, or True Skin, Fig. 136, consists fundamentally of a close feltwork of elastic and white fibrous tissue, which, becoming wider meshed below, passes gradually into the subcutaneous areolar tissue (Chap. VIII) which attaches the skin loosely to parts beneath. In tanning it is the THE KIDNEYS AND SKIN. 443 cutis vera which is turned into leather, its white fibrous tissue forming an insoluble and tough compound with the tannin of the oak-bark employed. Wherever there are hairs, bun- dles of plain muscular tissue are found in the corium ; it contains also a close capillary network and numerous lym- phatics and nerves. In shaving, so long as the razor keeps in the epidermis there is no bleeding; but a deeper cut shows at once the vascularity of the true skin. The outer surface of the corium is almost everywhere raised into minute elevations, called the papilla, on which a h m f •so FIG. 186. — A section through the skin and subcutaneous areolar tissue, ft, horny stratum, and m, deeper more opaque layer of the epidermis ; d, dermis; passing below into sc, loose areolar tissue, with fat, /, in its meshes : above, dermic papillae are seen, projecting into the epidermis which is moulded on them, a, opening of a sweat-gland ; gl, the muscular work, and to some heat : the proteid muscular fibre being broken first into a highly nitrogenous part (urea, or some body well on the road to become urea) and a non-nitro- genized richly hydrocarbonous part; and this latter was then oxidized and gave rise to heat. Several facts may be urged against this view: (1) Men in tropical climates live mainly on non-proteid foods, yet their chief needs are not heat pro- duction, but tissue formation and muscular work : according to Liebig's view their diet should be mainly nitrogenous. (2) Carnivorous animals live on a diet very rich in proteids, nevertheless develop plenty of animal heat, and that without doing the excessive muscular work which, on Liebig's theory, must first be gone through in order to break up the proteids, with the production of a non-azotized part which could then be oxidized for heat-production. (3) Great muscular work can be done on a diet poor in proteids; beasts of burden are for the most part herbivorous. (4) Further, we know exactly how much energy can be liberated by the oxidation of pro- teids to that stage which occurs in the Body; and it is pos- sible to estimate with considerable accuracy the amount of urea and uric acid excreted in a given time; from their sum the amount of proteid oxidized arid the amount of energy liberated in that oxidation can be calculated; if this be done it is found that, nearly always, the muscular work done* dur- ing the same period represents far more energy expended than could be yielded by the proteids broken down. The Source of the Energy Expended in Muscular Work. This important question, which was postponed in the chap- ters dealing with the physiology of the muscular tissues, needs now consideration. It may be put thus : Does a muscle-fibre work by the oxidation of its proteids, i.e. by breaking them down into compounds which are then re- moved from it and conveyed out of the Body ? or does it work by the energy liberated by the oxidation of carbon and hydrogen compounds only ? The problem may be attacked in two ways : first, by examining the excretions of a man, or other animal, during work and rest; second, by examining directly the chemical changes produced in a muscle when it contracts. Both methods point to the same conclusion, viz., that proteid oxidation is not the source of the mechanical energy expended by the Body. NUTRITION. 455 One gram (15.5 grains) of pure albumen when completely burnt liberates, as heat, an amount of energy equal to 2117 kilogrammeters (15,270 foot-pounds). But in the Body pro- teids are not fully oxidized ; part of their carbon is, to form carbon dioxide, and part of the hydrogen, to form water; but some carbon and hydrogen pass out, combined with ni- trogen and oxygen, in the incompletely oxidized state of urea. Therefore all of the energy theoretically obtainable is not de- rived from proteids in the Body: from the above full amount for each gram of proteid we must take the quantity carried off in the urea, which will be the amount liberated when that urea is completely oxidized. Each gram (15.5 grains) of proteid oxidized in the Body gives £ of a gram (5.14 grains) of urea ; since one gram of urea liberates, on oxidation, energy amounting to 934 kilogrammeters (6740 foot-pounds), each gram of proteid oxidized, so far as is possible in the Body, will yield during the process 2117 — *f * = 1805.7 kilo- grammeters (13,037 foot-pounds) of energy. Knowing that urea carries off practically all the nitrogen of proteids broken up in the Body, and contains 46.6 per cent of nitrogen, while proteids contain 16 per cent, it is easy to find that each gram of urea represents the decomposition of about 2.80 grams of proteid and, therefore, the liberation of 5060.00 kilogram- meters (36,533.0 foot-pounds) of energy. If, therefore, we know how much urea a man excretes during a given time, and how much mechanical work he does during the same time, we can readily discover if the latter could possibly have been done by the energy set free by proteid decomposition. Let us take a special case. Tick and Wislecenus, two Ger- man observers, climbed the Faulhorn mountain, which is 1956 meters (about 6415 feet) high. Fick weighed 66 kilo- grams and, therefore, in lifting his Body alone, did during the ascent 129,096 kilogrammeters (932,073 foot-pounds) of work. Wislecenus, who weighed 76 kilograms, did similarly 148,656 kilogrammeters (1,073,296 foot-pounds) of work. But during the ascent, and for five hours afterwards, Fick secreted urine containing urea answering only to 37.17 grams of proteid, and Wislecenus urea answering to 37 grams. Since each gram of proteid broken up in the Body liberates 1805.7 kilogrammeters (13,037 foot-pounds) of energy, the amount that Fick could possibly have obtained from such a source is 1805.7 X 37.17 = 67,117 kilogrammeters (484,584 456 THE HUMAN BODY. foot-pounds), and Wislecenus 1805.7 X 37 = 66,810 kilo- grammeters. If to the muscular work done in actually rais- ing their bodies, we add that done simultaneously by the heart and the respiratory muscles, and in such movements of the limbs as were not actually concerned in lifting the Aveight, we should have, at least, to double the above total muscular work done ; and the amount of energy liberated meanwhile by proteid oxidation, becomes utterly inadequate for its execution. ^ It is thus clear that muscular work is not wholly done at the expense of the oxidation of muscle pro- teid; and it is very probable that none is so done under ordi- nary circumstances, for the urea excretion during rest is about as great as that during work, if the diet remain the same :\f the work be very severe, as in long-distance walking- matches, the urea quantity is sometimes temporarily raised, but this increase, which no doubt represents an abnormal wear and tear of muscle-fibre, is probably independent of the liberation of energy in the form in which a muscle can use it, more likely taking the form of heat ; and is, moreover, com- pensated for afterwards by a diminished urea excretion. Thus, hourly, before the ascent Fick and Wislecenus each excreted on the average about 4 grams (62 grains) of urea ; during the ascent between 7 and 8 grams (108-124 grains) ; but during the subsequent 16 hours, when any urea formed in the work would certainly have reached the urine, only an average of about 3 grams (46.5 grains) per hour. It may still be objected, however, that a good deal of the muscle work may be done by the energy of oxidized muscle proteid ; that the amount of this oxidation occurring in a muscle during rest or ordinary work is pretty constant and simply takes different forms in the two cases, much as a steam-engine with its furnace in full blast will burn as much coal when resting as when working, but in the former case lose all the generated energy in the form of heat, and in the latter partly as mechanical work. Thus the smallness of in- crease in urea excretion as a consequence of muscular activity could be explained, while still a good deal of utilizable energy might come from proteid degradation. But if this were so, then the working Body should eliminate no more carbon dioxide than the resting; the amount of chemical changes in its muscles being by hypothesis the same, the carbon dioxide eliminated should not be increased. Experiment, however, NUTRITION. 457 shows that it is, and that to a very large extent, even when the work done is quite moderate and falls within the limits which could be performed by the normal proteid degradation of the Body. Quite easy muscular work doubles the carbon dioxide excreted in twenty-four hours, and in a short period of very hard work it may rise to five times the amount elimi- nated during rest. Since the urea is not increased, or but slightly increased, at the same time, this carbon dioxide can- not be due to increased proteid metamorphosis; and it there- fore indicates that a muscle works by the oxidation of car- bonaceous non-nitrogenous compounds. Since all the carbon compounds oxidized in the Body contain hydrogen this element is also no doubt oxidized during muscular work; but the estimation of the amount so used is difficult and has not been satisfactorily made, because the Body contains so much water ready formed that a large quantity is always ready for increased evaporation from the lungs and skin, whenever the respirations are quickened, as they are by exercise. It, thus, is very difficult to say how much of the extra water eliminated from the Body during work is due merely to this cause and how much to increased hydrogen oxidation. The conclusion we are led to is, then, that a muscle works by the oxidation mainly, if not entirely, of carbon and hydrogen';, and that the proteid constituents of the living muscle .substance are essentially the machinery determining in what way the energy shall be spent: they may and do suffer some wear and tear, but this bears no direct proportion to the work done; as a steam-engine may rust, so muscle proteid may and does oxidize, but not to supply the organ with energy for use. This conclusion, arrived at by a study of the excretions of the whole Body, is confirmed by the re- sults obtained by the chemical study of a single muscle. A fresh frog's muscle (which agrees in all essential points with a man's) contains practically no carbon dioxide, yet made to work in a vacuum gives off that gas, and more the more it works. Some carbon dioxide is therefore formed in the working muscle. If the muscle, after contracting as long as it can be made to do so, be thrown into death rigor it gives off more carbon dioxide; and if taken perfectly fresh and sent into rigor mortis without contracting, it gives off carbon dioxide also, in amount equal to the sum of that 458 THE HUMAN BODY. which it would have given off in two stages, if first worked and then sent into rigor. The muscle must, therefore, con- tain a certain store of a carbon-dioxide-yielding body, and the decomposition of this is associated with the occurrence both of muscular activity and death stiffening. Similar things are true of the acid simultaneously developed; the muscle when it works produces some sarcolactic acid, and when thrown into rigor mortis still more. No increase of urea or kreatin or any similar product of nitrogenous de- composition is found in a worked muscle when compared with a rested one, but the total carbohydrates are rather less in the former. These facts make it clear that muscular work is not done at the expense of proteid oxidation; and we have already seen (Chap. XXVI) that the oxygen a muscle uses in contracting is not taken up by it at the time it is used, since a muscle containing no oxygen will still contract in a vacuum and form carbon dioxide. It is probable that the chemical phenomena occurring in contraction and rigor are essentially the same; the death stiffening results when they occur to an extreme degree. Provisionally one may explain the facts as follows: A muscle in the Body takes up from the blood, oxygen, proteids, and non-nitrogenous (carbohydrate or fatty) substances. These it builds up into a highly complex and very unstable compound, comparable, for example, to nitro- glycerine. When the muscle is stimulated this falls down into simpler substances in which stronger affinities are satis- fied; among these are carbon dioxide and sarcolactic acid and a proteid (myosinogen). The energy liberated is thus in- dependent of any simultaneous taking up of oxygen; the amount possible depends only on how much of the decom- posable body existed in the muscle. Under natural condi- tions the carbon dioxide is carried off in the blood and per- haps the sarcolactic acid also, the latter to be elsewhere oxidized further to form water and more carbon dioxide. The myosinogen remains in the muscle-fibre and is combined with more oxygen, and with compounds of carbon and hydrogen taken from the blood, and built up into the unstable energy- yielding body again; no increased quantity of nitrogenous material, under ordinary circumstances, leaves the working muscle. If, however, the blood-supply be deficient, myosin forms from myosinogen and clots (Chap. IX) before this restitution takes place, and cannot be directly rebuilt into NUTRITION. 459 living muscle material; in excessive work the same thing partially occurs, decomposition occurring faster than recom- position; clotted myosin is then broken up into simpler bodies as kreatin, and these are somewhere turned into urea and excreted. In rigor mortis all the myosinogen passes into clotted myosin and causes the rigidity. A working muscle takes up more oxygen from the blood than a resting one, as is shown by a comparison of the gases of the venous blood of the two; this oxygen assumption is not necessarily pro- portionate to the carbon-dioxide elimination at the same time.; for the latter depends on the breaking down of a material already accumulated in the muscle during rest, and this breaking down may occur faster than the reconstruction. We are thus enabled, also, to understand how, during exercise, the carbon dioxide evolved from the lungs may contain more oxygen than that taken up at the same time; for it is largely oxygen previously stored during rest which then appears in the carbon dioxide of the expired air. The kreatin which can always be found even in muscles suddenly killed after long rest, represents the breaking down of proteid in the chemical processes of the living fibres, in their vital meta- bolisms, which are not necessarily similar to the special chemical changes associated with a contraction. Are any Foods Respiratory in Liebig's Sense of the Term ? We find, then, that Liebig's classification of foods cannot be accepted in an absolute sense. There is no doubt that the substance broken down in muscular contraction is proper living muscular tissue; and if this (its proteid con- stituent being retained) be reconstructed from foods con- taining no nitrogen (whether carbohydrates or fats) then the term plastic or tissue-forming cannot be restricted to the proteids of the diet. We must rather conclude that any alimentary principle containing carbon may be used to re- place the oxidized carbon, and any containing hydrogen to replace the oxidized hydrogen, of a tissue; and so even non- proteid foods may be plastic. A certain proportion of the foods digested may perhaps be oxidized to yield energy, before they ever form part of a tissue; and so correspond pretty much to Liebig's respiratory foods; but no hard and fast line can be drawn, making all proteid foods plastic and all oxidizable non-proteid foods respiratory. Luxus Consumption. Not only, as above pointed out, 460 THE HUMAN BODY. may non-nitrogenous foods be plastic but, on the other hand, it is certain that if any foods are oxidized at once before being organized into a tissue, proteids are under certain circumstances; namely, when they are contained in excess in a diet. If an animal be starved it is found that its non- nitrogenous tissues go first; an insufficiently fed animal loses its fat first, and if it ultimately dies of starvation is found to have lost 97 per cent of its adipose tissue and only about 30 per cent of its proteid-rich muscular tissue, and almost none of its brain and spinal cord; all of course reckoned by their dry weight. It is thus clear that the proteids of the tissues resist oxidation much better than fat does. But, on the other hand, if a well-fed animal be given a very rich proteid diet all the nitrogen of its food reappears in its urine, and that when it is laying up fat; so that then we get a state of things in which proteids are broken up more easily than fats. This indicates that proteid in the Body may exist under two conditions ; one, when it forms part of a living tissue and is protected to a great extent from oxidation, and another, in which it is oxidized with readiness and is presumably in a different condition from the first, being not yet built up into part of a living cell. The use of proteids for direct oxidation is known as luxus consumption ; how far it occurs under ordinary circumstances will be considered presently. The main point now to be borne in mind is that while all organic non-nitrogenous foods cannot be called respiratory, neither can proteids under all circumstances be called plastic, in Liebig's sense. The Antecedents of Urea. In the long-run the pro- genitors of the urea excreted from the Body are the proteids taken in the food; but it remains still to be considered what intermediate steps these take before the excretion of their nitrogen in the urine. In seeking antecedents of urea one naturally turns first to the muscles, which form by far the largest mass of pro- teid tissues in the Body. Analysis shows that they always yield kreatin, the quantity of this in muscles being practically unaffected by work, and from 0.2 to 0.3 per cent of the dry weight of the muscle. Since it is readily soluble and dialyz- able, and therefore fitted to pass rapidly out of the muscles into the blood stream, it is a fair conclusion that a good deal of it is formed in the muscles daily and carried off from them. NUTRITION. 461 Kreatin, too, exists in the brain, and probably there and else- where in the nervous system is produced by chemical degra- dation of protoplasm; the spleen also contains a good deal of kreatin, and so do many glands. This substance would therefore seem to be constantly produced in considerable quantities by the protoplasmic tissues generally; and since it belongs to a group of nitrogenous compounds which the Body is unable to utilize for reconstruction into proteids, it must be carried off somehow. The urine, however, contains no kreatin and but little of its immediate derivative, krea- tinin, and what kreatinin it does contain depends mainly on the feeding, since its amount varies with the diet and it disappears during starvation. Kreatin can readily be chem- ically broken up with hyd ration, yielding urea and sarkosin; and sarkosin in turn can be decomposed so as to yield its nitrogen in the form of urea. Hence there are no great chemical difficulties in regarding kreatin as the main im- mediate source of the urea of normal urine. There are some reasons for thinking that kreatin is not the form of the actual nitrogen waste in living muscle but a post-mortem product from that waste; but that is not of importance in- the present connection. Whatever the original form of the' waste substance be, if it be not kreatin it is certainly very easily converted into it. The formation of the final product,, urea, does not occur in the muscles. They never contain urea; and very little of it, if any, can be extracted from the; brain. Where the kreatin is finally changed into urea is doubt- ful. We have seen (Chap. XXVIII) that it is not formed in the kidneys but merely separated by them from the blood. A good deal of urea is found in the liver, which suggests some part played by that organ in urea formation. Further, in certain cases of hepatic disease (acute yellow atrophy) in which the liver cells are profoundly changed, the urea of the urine is greatly diminished and a quite different substance, leucin, takes its place; and this favors the view that the liver has much to do with the final elaboration of urea. It may also be noted in this connection that, quite apart from kreatin as a source of urea, there may be another in leucin, for leucin is very widely distributed through the Body, and when proteids are decomposed by various chemical methods leucin is very constant among the products. It is therefore a possible form 462 THE HUMAN BODY. for the primary nitrogen waste of many tissues. Chemically leucin is an ammonium derivative, being the amide of caproic (a fatty) acid. "While the urea resulting from further changes in the kreatin, leucin, or similar substances formed in the tissues, is a measure of the wear and tear of their protoplasm, part of the urea excreted has probably a different source; being due to the oxidation of proteids as energy liberators or respira- tory foods, before they have ever formed a tissue. When abundant proteid food is taken the urea excretion is largely increased and that very rapidly, within a couple of hours for example, and before we can well suppose the proteids eaten to have been built up into tissues, and these in turn broken down; in fact there need be, and usually is, under such cir- cumstances no sign of any special activity of any group of tissues, such as one would expect to see if the urea always came from the breaking down of formed histological ele- ments. This urea is thus indicative of a utilization of pro- teids for other than plastic purposes; and the same fact is indicated by the storage of carbon and elimination of all the nitrogen of the food when a diet very rich in proteid alimentary principles is taken. This luxus consumption may be compared to the paying out of gold by a merchant instead of greenbacks when he has an abundance of both. Only the gold can be used for certain purposes, as settling foreign debts, but any quantity above that needed for such a purpose is harder to store than the paper money, and not so con- venient to handle; so it is paid out in preference to the paper money, which is really somewhat less valuable, as available at par only for the settlement of domestic debts. Similarly, only proteids can be used for certain final stages of tissue building, but an excess of them is more difficult to store than fats or carbohydrates, and so is eliminated in pref- erence to them. In artificial pancreatic digestions, when long carried on, two bodies, called leucin and tyrosin, are produced from proteids. It is found that when leucin is given to an ani- mal in its food, it reappears in the urine as urea; so the Body can turn leucin into that substance. Hence a possible source of some of the luxv.s-consumption urea is leucin produced dur- ing intestinal digestion; and this is very likely turned into urea in ^the liver. Mammalia rapidly die when the liver is NUTRITION. 463 removed, but some birds survive for a time. In them it has been found that the uric acid (which in avian urine has the predominance which urea takes in mammalian) excreted is diminished after extirpation of the liver; and also that leucin which when given to the normal bird reappears in the urine as uric acid, in the bird from which the liver has been removed is excreted unaltered. Circulating and Fixed Proteid. When an animal is fed on food deficient in proteids, or containing none of them at all, its urea excretion falls very rapidly during the first day or two, but then much more slowly until death: there is thus indicated a double source of urea, apart resulting from tissue wear and tear, and always present; and a part resulting from the breaking down of proteids not built up into tissue, and ceasing when the amount of this proteid in the Body (in the blood for example) falls below a certain limit as a result of the starvation. As the nitrogen-starved Body wastes, its bulk of proteid tissues is slowly reduced and the urea result- ing from their degradation diminishes also. How well pro- teid built up into a tissue resists removal is shown by the tacts already mentioned as to the relative losses of the pro- teid-rich and proteid-poor tissues during starvation. On the other hand, if an animal be taken while starving and losing weight and have a small amount of flesh given it, it will continue to lose weight, and more urea than before will appear in the urine; increased proteid diet increases the proteid metamorphosis, and the animal still loses, though less rapidly than it did. A little more proteid still increases proteid metamorphosis in its body and its urea elimination, and so on for some time; but each increment of proteid in the food increases the nitrogenous metamorphosis in propor- tion to itself somewhat less than the preceding one did, until,, finally, a point is reached at which the nitrogen egesta and ingesta balance: in a dog this occurs when the animal gets daily -^ its weight of lean meat, along with the necessary water. More flesh if then given is at first stored up and the animal increases in weight; but very soon the greater wear and tear of the larger mass of tissues shows itself as increased urea excretion, and again the egesta and ingesta balance, and the animal comes to a new weight equilibrium at the higher level. More meat now causes a repetition of the phenomenon: at first increase of tissue, and nitrogen storage; and then a 464 THE HUMAN BODY. cessation of the gain in weight, and an excretion in twenty- four hours of all the nitrogen taken. And so on, until the animal refuses to eat a larger quantity. These facts seem, very clearly, to show that proteids can- not be built up quickly into tissues. Meat given to the starving animal has its proteids, at first, used up mainly in luxits consumption — while a little is stored as tissue, though at first not enough to counterbalance the daily tissue waste. When a good deal more proteid is given than answers to the nitrogen excretion during starvation, the animal builds up as much into living tissue as it breaks down in the vital processes of these, the rest going in luxus consumption ; it thus neither gains nor loses. Still more proteid if now given does not all appear in the urine at once; some is used to build up new tissue, but only slowly; then, after some daysr the increased metabolism of the increased mass of living tissues balances the excess of nitrogen in the diet, and equi- librium is again attained. But, all through, it seems clear that the tissue formation is slow and gradual; and so it be- comes additionally probable that the increased urea excretion soon after a meal is not due to rapidly increased tissue forma- tion and degradation, but to a more direct proteid destruction. The more stable proteid, that which breaks down slowly in starvation and is rebuilt slowly when food is given, has been distinguished as fixed or tissue albumen from the less stable portion, which from the belief that it mainly exists in the liquids of the Body has been named circulating albumen Feeding experiments further show the important fact that the gelatinous or albuminoid foods cannot be converted into fixed proteid; for its formation true albumens are required. The tissues of an animal deprived of all proteid food -stuffs waste, no matter how much albuminoids be given :. but given some of the latter the Body can build tissues and maintain their integrity with less true proteid than would otherwise be necessary, so the gelatin-yielding foods are by no means without nutritive value. The Storage Tissues. Every healthy cell of the Body contains at any moment some little excess of material laid' by in itself, above what is required for its immediate neces- sities. The capacity of contracting, and the concomitant evolution of carbon dioxide, exhibited by an excised muscle in a vacuum, seem to show that even oxygen, of which NUTRITION. 465 warm-blooded animals have but a small reserve, may "be stored up in the living tissues in such forms that they can utilize it, even when the air-pump fails to extract any from them. But in addition to the supplies for immediate spend- ing, contained in all the cells, we find special food reserves in the Body, on which any of the tissues can call at need. These, especially the oxygen and proteid reserves, are found for most part in the blood. Special oxygen storage is, however, rendered unnecessary by the fact that the Body can, except under very unusual circumstances, get more from the air at any time, so the quantity of this substance laid by is only small; hence death from asphyxia follows very rapidly when the air-passages are stopped; while, on account of the re- serves laid up, death from other forms of starvation is a much slower occurrence. Proteids, also, we have learnt from the study of muscle, are probably but little concerned in energy-production in the tissues. Speaking broadly, the work of the Body is carried on by the oxidation of carbon and hydrogen, and we find in the Body, in correspondence with this fact, two great storehouses of fatty and carbo- hydrate foods, which serve to supply the materials for the performance of work and the maintenance of the bodily temperature in the intervals between meals, and during longer periods of starvation. One such store, that of car- bohydrate material, is found in the liver-cells; the other, or fatty reserve, is laid by in the adipose tissue and to a cer- tain extent in oil droplets found in other cells, and sometimes in blood and lymph. That such substances are true reserves, not for any special local purpose but for the use of the Body generally, is shown by the way they disappear in starvation; the liver reserve in a few days, and the fat somewhat later and more slowly, but very largely before any of the other tissues has been seriously affected. By using these accumu- lated matters the Body can work and keep warm during several days of more or less deficient feeding; and the fatter an animal is at the beginning of a starvation period the longer will it live; which would not be the case could not its fat be utilized by the working tissues. Hibernating animals prove the same thing; bears, before their winter sle p, are very fat, and at the end of it commonly very thin; while their muscular and nervous systems are not noticeably diminished in mass. During the whole winter, then, the 466 THE HUMAN BODY. energy needed to keep the heart and respiratory muscles at work, and to maintain the temperature of the body, must have been obtained from the oxidation of the fat reserve with which the animal started. Glycogen. The size of the liver was long a stumbling- block to physiologists: it was difficult to understand why so large an organ should be developed for the mere secretion of some bile, a not very important digestive liquid. But even centuries ago some glimmering of the truth was guessed, and the liver was believed to be concerned in the elaboration of nutritive blood, which was distinguished from the blood, charged with vital spirits, which came from the lungs and the left side of the heart. Harvey's discovery of the real course of the circulation, and Lavoisier's interpretation of the meaning of respiration, upset these crude doctrines; and for long the germ of truth which they contained was lost to view in the glare of the new light. We have now learned, on a new basis of actual experiment, that the liver is very largely concerned in the nutritive processes of the Body : its relation to proteid metabolism and urea formation has already been considered, and we have now to study its activity in regard to the formation, and storage, and trans- mission of a carbohydrate substance, glycogen. If a liver be cut up two or three hours after removal from the body of a healthy well-fed animal, and thoroughly ex- tracted with water, it will yield much grape-sugar. If, on the other hand, a perfectly fresh liver be heated rapidly to the tem- perature of boiling water, and be then pounded up and ex- tracted, it will yield a milky solution, containing little grape- sugar, but much glycogen; a substance which chemically has the same empirical formula as starch (C6H100B), and in other ways is closely allied to that body. The salivary and pancreatic secretions rapidly convert it into the sugar maltose, as they do starch. The transformation of glycogen into glucose (grape-sugar) which occurs in the liver after death and prob- ably also during life is then quite different from that brought about by the digestive enzymes; and in fact no enzyme has been extracted from fresh liver. The change is apparently not a fermentative one, but one dependent on some vital metabolic activity of the liver-cells, which activity is greatly accelerated during their period of dying: hence the need of killing them rapidly by boiling, if any considerable amount of NUTRITION. 467 glycogen is to be obtained from the organ. Pure glycogen is a white amorphous inodorous powder, readily soluble in water, forming an .opalescent milky solution; insoluble in alcohol, and giving with iodine a red coloration which dis- appears on heating and reappears on cooling again. About four per cent of glycogen can be obtained from the liver of a well- nourished animal (dog or rabbit). This for the human liver, which weighs about 1500 grams (53 oz.), would give about 60 grams (2.1 oz.) of glycogen at any one moment. The quantity actually formed daily is, how- ever, much in excess of that, since glycogen is constantly being removed from the liver and carried elsewhere, while a fresh supply is formed in the organ. Its quantity is subject, also, to considerable fluctuations; being greatest about two hours after a good meal, and falling from that time until the next digestion period commences, when it begins to rise until it again attains its maximum. If a warm-blooded animal be starved glycogen disappears from its liver in the course of four or five days. We are, thus, led to believe that glycogen is being constantly used up, and that its mainte- nance in normal quantity depends on food supply. The accumulation and disappearance of glycogen can be demonstrated histologically. The liver is essentially a com- pound tubular gland, but its structure is obscured by the fact that the hepatic cells are very large in proportion to the tubules wnich they surround, so that these are reduced to in^re ductules, formed by the apposition of grooves on the adjacent sides of two cells; and by the fact that cells and ductules form an irregular network interlaced with the capil- laries of the lobule (Chap. XXII), which capillaries are far larger than the interlobular bile-ducts. When properly pre- pared hepatic cells, taken from a healthy well-fed animal, are examined, the side of the cell nearest the bile-ductule is seen to be granular, and it also picks up readily most of the ordinary protoplasmic stains. * The rest of the cell contains few granules and does not stain with carmine, but it does stain red with iodine. It is in fact mainly filled with glyco- gen, and if this be dissolved out by digestion with saliva there is left a loose protoplasmic network. If sections from the liver of a starved animal be compared with those from a well-fed, the liver-cells are seen to be considerably smaller, to be granular throughout, and to stain everywhere with carmine 468 THE HUMAN BODY. and not at all with iodine: they contain no glycogen and may be compared with the cells of the pancreas in a late stage of digestion (Chap. XIX). In the liver we have to deal with cells of twofold function; the granular portion of each especially concerned with bile secretion, and the larger portion of the cell with the making of glycogen. In a salivary gland we have cells whose sole apparent function is the formation of secretion to be poured into the gland ducts; in the thyroid and suprarenal bodies we find cells forming special materials which are passed into blood or lymph. The hepatic cells do both, and it should be borne in mind that possibly all gland-cells do. In fact it has already been pointed out that the pancreas has still an- other function than the formation of pancreatic juice. As regards the liver-cells, we naturally ask whether the two processes, bile-making and glycogen-rnaking, are distinct and independent activities, or whether bile and glycogen are simultaneous products of a single metabolic activity, as soap and glycerine are of the chemical process of soap-making : but to this question it is not possible yet to give a satisfactory answer. The Source and Destination of Liver Glycogen. All foods are not equally efficacious in keeping up the stock of glycogen in the liver; fats by themselves are useless; proteids by themselves give a little; by far the most is formed on a diet rich in starch and sugar ; so it would seem tliat glyco- gen is mainly formed from carbohydrate materials absorbed from the alimentary canal and carried to the hepatic cells by the portal vein. The chief of these materials is probably glucose, since, although saliva and the amylolytic ferment of the pancreas convert starch into maltose (CiaHMOn + H20), of the cane-sugar group, the intestinal secretion rapidly con- verts this into grape-sugar or glucose. This is taken up by the liver-cells, modified by them and stored as glycogen; and by their further activity from time to time reconverted into glucose and passed into the blood according to the needs of the Body in general. The cells then do distinctly chemical work on the carbohydrate material: possibly, indeed even probably, they build that supplied into their own living sub- stance and then by partial breaking down of this, deposit some of it for a time as glycogen: and by further living activity turn this into glucose and send it on to the blood, when the NUTRITION. 469 sugar in that liquid falls below a certain percentage. That the chief part of the glycogen found in the normal liver has its ultimate source in carbohydrate foods is shown by several facts. (1) Sugar if it exist in the blood in above a certain small percentage, passes out by the kidneys and appears in the urine, constituting the characteristic symptom of the disease called diabetes. In health, however, even after a meal very rich in carbohydrates, sugar rarely appears in the urine, and then but temporarily; so that the large quantity of it absorbed from the alimentary canal within a brief time under such cir- cumstances, must be stopped somewhere before it reaches the general blood-current. (2) Glucose injected into one of the general veins of an animal, if in any quantity, soon appears in the urine; but the same amount injected into the portal vein, or one of its radicles, causes no diabetes, but an accumu- lation of glycogen in the liver. We may therefore conclude that the sugar absorbed from the alimentary canal is taken by the portal vein to the liver, and there converted into glycogen and stayed for a time ; and later slowly passed on into the hepatic veins during the intervals between meals. Thus in spite of the intervals which elapse between meals the carbohydrate content of the blood is kept pretty constant: during digestion it is not suffered to rise very high, nor dur- ing ordinary periods of fasting to fall very much below the average. In what form glycogen leaves the liver is not certain ; it might be dissolved out and carried off as such, or previously turned again into glucose and sent on in that form ; since the fresh liver-cells are capable of changing glycogen into glucose the latter view is the more probable. Analyses of portal and hepatic bloods, made with the view of determining whether more sugar was carried out of the liver during fasting than into it, are conflicting; and considering the great amount of blood which flows through the liver in twenty-four hours, a very slight increase of sugar (falling within the limits of error of the difficult quantitative determination of that sub- stance in the blood) in the hepatic vein would represent a large total amount during the whole day. The main fact, however, remains that somehow this carbohydrate reserve in the liver is steadily carried off to be used elsewhere: and animal glycogen thus answers pretty much to vegetable starch, which, made in the green leaves, is dissolved and carried away 470 THE HUMAN BODY. by the sap currents to distant and not green parts (as the grains of corn or tubers of a potato, which cannot make starch for themselves) and in them is again laid down in the form of solid starch grains, which are subsequently dissolved and used for the growth of the germinating seed or potato. Eeasons have been given in an early part of this chapter for believing that the carbohydrate leaving the liver is not oxidized in the blood, but only after it has passed out of that into the organ- ized tissue. Among these the muscles at least seem to get some, since a fresh muscle always contains glycogen, and even to retain it in normal amount after an animal has been starved for some time; the muscle-fibres then, so to speak, drawing on the balance with their banker (the liver) so long as there is any. When a muscle contracts, this glycogen disappears and some glucose appears, but not an amount equivalent to the glycogen used up; so that the working muscle, it is probable, uses this substance, among others, for its repair after each contraction. How it is that the glycogen, which is so rapidly converted into grape-sugar by the dying liver, escapes such rapid con- version during life has not been satisfactorily answered. It may be that the metabolisms of the dying hepatic cell include processes which are an exaggeration of those occurring dur- ing normal life; in some such way as the production of myo- sin in dying muscle is apparently an exaggeration of chemical changes occurring in norma^contracting muscle: or the gly- cogen in the living cell may not exist free, but combined with other portions of the cell substance so as to be pro- tected ; while, after death, post-mortem changes may rapidly liberate it in a condition to be acted upon. Diabetes. The study of this disease throws some light upon the history of glycogen. Two distinct varieties of it are known; one in which sugar appears in the urine only when the patient takes carbohydrate foods; the other in which it is still excreted when he takes no such foods, and mnst therefore form sugar in his Body from substances not at all chemically allied to it. The more probable source of the sugar in the latter case is proteids; since some glycogen is found in the livers of animals fed 011 proteids only, while fats by themselves give none of it. It seems that the proteid molecule, in some complex way, is split up in the liver into a highly nitrogenized part (urea or an antecedent of urea) and NUTRITION. 471 a nonazotized part, giycogen. On this view the more severe form of diabetes would be due to an increased activity of a normal proteid-decomposing function of the hepatic cells; and sometimes the urea and sugar in the urine of diabetics rise and fall together, thus seeming to indicate a community of origin. Diabetes dependent on carbohydrate food might be produced in several ways. The liver-cells might cease to stop the sugar and, letting it all pass on into the general cir- culation, suffer it to rise to such a percentage in the blood after a meal, that it attained the proportion in which the kidneys pass it out; or the tissues might cease to use their natural amount of sugar, and this, sent on steadily out of the liver, at last rise in the blood to the point of excretion. Or the liver might transform (into glucose) and pass on its giy- cogen faster than the other tissues used it, and so diabetes might arise; but this would only be temporary, lasting until the liver stock was used up by the rapid conversion. Arti- ficially we can, in fact, produce diabetes in several of these ways; curari poisoning, for example, paralyzing the motor nerves, makes the skeletal muscles lie completely at rest, and so diminishes the giycogen consumption of the Body and pro- duces diabetes. Carbon-monoxide poisoning produces dia- betes also, .presumably by checking bodily oxidation. Fi- nally, pricking a certain spot in the medulla oblongata causes a temporary diabetes. This might conceivably be due to the fact that the operation injures that part of the vaso-motor centre which controls the muscular coat of the hepatic artery, and this artery, then dilating, carries so much blood through the liver that an excess of giycogen is carried off by the hepatic veins; and in favor of this opinion is the fact that if the splanchnic nerves be cut the whole arteries of the ab- dominal viscera dilate no diabetes follows. This has been explained as due to the fact that so many vessels are dilated that a great part of the blood of the Body accumulates in them, and there is in consequence no noticeably increased flow through the liver. Others, however, maintain that the "piqiire " diabetes (as that due to pricking the medulla is called) is due to irritation of trophic nerve-fibres originating there, and governing the rate at which the liver-cells produce giycogen or convert it into glucose. This latter view, though perhaps the less commonly accepted, is probably the more correct. The hepatic cells do not merely hold back 472 THE HUMAN BODY. glucose carried through the liver so that it is there to be washed out by a greater blood-flow, but they feed on sugar and proteids and make glycogen; and this is later converted into glucose and carried off. Glycogen, except for its dis- charge into the blood instead of a gland duct, would then be comparable to the materials stored in the cells of the salivary and some other glands (Chap. XIX); and the transforma- tion of such bodies into the specific element of a secretion we have already seen to be directly under the control of the nervous system, and almost entirely or quite independent of the simultaneous blood-flow. The History of Fats. While glycogen forms a reserve store of material which is subject to rapid alterations, deter- mined by meal-times, the fats are much more stable; their periods of fluctuation are regulated by days, weeks, or months of good or bad nutrition, and during starvation they are not so readily, or at least so rapidly, called upon as the hepatic glycogen. If we carry on the simile by which we compared the reserve in each cell to pocket-money, the glycogen would answer somewhat to a balance on the right side with a man's banker; while the fat would represent assets or securities not so rapidly realizable; as capital in business, or the cargoes afloat in the argosies of Antonio, the " Merchant of Venice." Fat, in fact, is slowly laid down in fat-cells and surrounded in these by a cell-wall, and, being itself insoluble in blood plasma or lymph, it must undergo chemical changes, which no doubt require some time, before it can be taken into the blood and carried off to other parts. When adipose tissue is developing it is seen that undif- ferentiated cells in the connective tissues (especially areolar) show minute oil-drops in their protoplasm; these increase in size and ultimately fuse together and form one larger oil-droplet, while most of the original protoplasm disappears. The oily matter would thus seem due to a chemical meta- morphosis of the cell protoplasm, during which it gives rise to a non-azotized fatty residue which remains behind, and *a highly nitrogenous part which is carried off. In many parts of the Body protoplasmic masses are subject to a similar but less complete metamorphosis; fatty degeneration of the heart, for example, is a more or less extensive replacement of the proper substance of its muscular fibres by fat-droplets; and the cream of milk and the oily matter of the sebaceous secre NUTRITION. 473 tion are due to a similar fatty degeneration in gland-cells. Moreover, careful feeding experiments undoubtedly show that fat can come from proteids; when an animal is very richly supplied with these all the nitrogen taken in them reappears in its excretions, but all the carbon does not; it is in part stored in the Body: and, since such feeding produces but little glycogen, this carbon can only be stored as fat. While there is, then, no doubt that some fat may have a proteid origin, it is not certain that all has such. During digestion a great deal of fat is ordinarily absorbed, in a chemically unchanged state, from the alimentary canal; it is merely emulsified and carried off in minute drops by the chyle to be poured into the blood; and this fat might conceiveably be directly deposited, as such, in adipose tissue. There are, however, good reasons for supposing that all the fat in the Body is manufactured. The fat of a man, of a dog, and of a cat varies in the proportions of palmatin, stearin, margarin, and olein in it; and varies in just the same way if all be fed on the same kind of food, which could not be the case if the fat eaten were simply deposited unchanged. Moreover, if an animal be fed on a diet containing one kind of fat only, say olein, but a very slightly increased percentage of that particular fatty substance is found in its adipose tissue, which goes to show that if fats come from fats eaten, these latter are first pulled to bits by the living cells and built up again into the forms normal to the animal; so that, even with fatty food, the fats stored up seem to be in most part manu- factured in the Body. In still another way it is proved that fats can be con- structed in the Body. In animals fed for slaughter, the total fat stored up in them during the process is greatly in excess of that taken with their food during the same time. For example, a fattening pig may store up nearly five hundred parts of fat for every hundred in its food, and this fat must be made from proteids or carbohydrates. Whether it can come from the latter is still perhaps an open question ; for, while all fattening foods are rich in starch or similar bodies, there are considerable chemical difficulties in supposing an origin of fats from such; and it is on the whole more probable that they simply act by sparing from use fats simultaneously formed or stored in the body, and which would have other- wise been called upon. They make glycogen, and this 474 THE HUMAN BODY. shelters the fats. Liebig, indeed, in a very celebrated dis- cussion, maintained that fats were formed from carbohydrates He showed that a cow gave out more butter in its milk than it received fats in its food; and Huber, the blind naturalist, showed that bees still made wax (a fatty body) for a time when fed on pure sugar; and indefinitely when fed on honey. Consequently, for a long time, an origin of fats from carbo- hydrates was supposed to be proved; but their possible origin from proteids (a possibility now shown to be a certainty) was neglected, and the validity of the above proofs of their carbo- hydrate origin is thus upset. The cow may have made its butter from proteids; the bees, fed on sugar, their wax for a time from proteids already in their bodies; and, indefinitely, when fed on honey, from the proteids in that substance. Moreover, animals (ducks) fed on abundant rice, which con- tains much carbohydrate but very little proteid or fat, remain lean; while if some fat be added they lay up fat. Persons who fatten cattle for the butcher find that the foods useful for the purpose all contain proteids, carbohy- drates, and fats, and that rapid fattening is only obtained with foods containing a good deal of fat; as oilcake, milk, or Indian corn. Taking all the facts into account we shall probably not be wrong in concluding that nearly all the bodily fat is manufactured either from fats or proteids; from fats easier than from anything else, but when much proteid is eaten some is made from it also. Carbohydrates alone do not fatten; the animal body cannot make its pal- matin, etc., out of them. Nevertheless they are, indirectly, important fattening foods when given with others, since, being oxidized instead of it, they protect the fat formed. Dietetics. That "one man's meat may be another man's poison" is a familiar saying, and one that, no doubt, ex presses a certain amount of truth; but the difference probably depends on the varying digestive powers of individuals rather than on peculiarities in their laws of cell nutrition : we all need about the same amount of proteids, fats, and carbohydrates for each kilogram of body weight; but all of us cannot digest the same varieties of them equally well : it is also a matter of common experience that some foods have peculiar, almost poisonous, effects on certain persons. Some people are made ill by mutton, which the majority digest better than beef. NUTRITION. 475 The proper diet must necessarily vary, at least as to amount, with the work done; whether it should vary in kind with the nature of the work is not so certain. Provided a man gets enough proteids to balance those lost in the wear and tear of his tissues, it probably matters little whether he gets for oxidation and the liberation of energy either fats or carbohydrates, or even excess of proteids themselves; any one of the three will allow him to work either his brain or his muscles, and to maintain his temperature. Proteids, how- ever, are wasteful foods for mere energy-yielding purposes: in the first place, they are more costly than the others; secondly, they are incompletely oxidized in the Body; and, thirdly, it is probably more laborious to the system to get rid of urea than of the carbon dioxide $nd water, which alone are yielded by the oxidation of fats and carbohydrates. Be- tween fats and carbohydrates similar considerations lead to a use of the latter when practicable: starch is more easily utilized in the Body than fats, as shown by the manner in which it protects the latter from oxidation; and a given weight of starch fully oxidized in the Body will liberate about one half as much energy as the same amount of butter, while it costs considerably less than half the money. Also, starch is more easily digested than fats by most persons: children especially are apt to be fond of starchy or saccharine foods and to loathe fats; and the appetite in ouch cases is a good guide. As a rule the people of the United States differ very markedly from the English in their love of sweet foods of all kinds; whether this is correlated with their char- acteristic activity, calling for some food that can be rapidly used, is an interesting question. It is certain that no general rules for the best dietary for all persons can be formulated, but on broad principles the best diet is that which contains just the amount of pro- teid necessary for tissue repair, and so much carbohydrates as can be well digested; the balance needed, if any, being made up by fats and platinoids. Such a food would be the cheapest; that is, the supplying of it would call for less of the time and energy of the nation using it, and leave more work to spare for other pursuits than food production — for all the arts which make life agreeable and worth living, and which elevate civilized man above the merely material life of the savage whose time is devoted to catching and eating. 476 THE HUMAN BODY. We have high authority for saying that man does not live by bread alone; in other words, his highest development is impossible when he is totally absorbed in " keeping body and soul together/' and the more labor that can be spared from getting enough food the better chance has he, if he use his leisure rightly, of becoming a more worthy man. While there is, thus, a theoretically best diet, it is nevertheless impossible to say what that is for each individual; but what the general experience is may be approximately gathered by taking an average of the dietaries of a number of public institutions in which the health of many people is main- tained as economically as possible. Such an examination made by Moleschott gives us as its result a diet containing daily — . • Proteids 30 grams or 465 grains Fats 84 " or 1,300 " Carbohydrates 404 " or 6,262 " Salts 30 " or 465 Water 2800 " or 43,400 " People in easy circumstances take as a rule more proteids and fats and less amyloids; and this selection, when a choice is possible, probably indicates that such a diet is the better one : the proteids in the above table seem especially deficient. Experimenting on himself the physiologist Ranke found that when he was in good health, neither gaining nor losing weight, and excreting daily as much nitrogen as he took in food, he maintained this condition of equilibrium on a diet containing Proteids 100 grams ( 1550 grains) Fats 100 " ( 1550 " ) Carbohydrates 240 " ( 3720 " ) Salts 25 " ( 437 " ) Water 2600 " (40,400 " ) Other experimenters have since arrived at very similar re- suits; and such a diet is probably about the normal for per- sons of our race living in a temperate climate. CHAPTEE XXX. THE PRODUCTION AND REGULATION OF THE HEAT OF THE BODY. Cold- and Warm-blooded Animals. All animals, so long as they are alive, are the seat of chemical changes by which heat is liberated; hence all tend to be somewhat warmer than their ordinary surroundings, though the differ- ence may not be noticeable unless the heat production is considerable. A frog or a fish is a little hotter than the air or water m which it lives, but not much; the little heat that it produces is lost, by radiation or conduction, almost at once. Hence such animals have no proper temperature of their own; on a warm day they are warm, on a cold day cold, and are accordingly known as changeable-temperatured (poikilo-tlier- mous) or, in ordinary language, " cold-blooded " animals. Man and other mammals, as well as birds, on the contrary, are the seat of very active chemical changes by which much heat is produced, and so maintain a tolerably uniform tem- perature of their own, much as a fire does whether it be burn- ing in a warm or a cold room; the heat production during any given time balancing the loss, a normal body temperature is maintained, and usually one considerably higher than that of the medium in which they live; such animals are com- monly named " warm-blooded. " This name, however, does not properly express the facts; a lizard basking in the sun on a warm summer's day may be quite as hot as a man usu- ally is; but on the cold day the lizard becomes cold, while the average temperature of the healthy Human Body is, within a degree, the same in winter or summer; within the arctic circle or on the equator. Hence it is better to call such animals " homothermous " or of uniform temperature. Moderate warmth accelerates protoplasmic activity; com- pare a frog dormant in the winter with the same animal ac- tive in the warm months: what is true of the whole frog is true of each of its living cells. Its muscles contract more 477 478 THE HUMAN BODY, rapidly when warmed, and the white corpuscles of its blood when heated up to the temperature of the Human Body are seen (with the microscope) to exhibit much more active amoe- boid movements than they do at the temperature of frog's blood. In summer a frog or other cold-blooded animal uses much more oxygen and evolves much more carbon dioxide than in winter, as shown not only by direct measurements of its gaseous exchanges, but by the fact that in winter a frog can live a long time after its lungs have been removed (being able to breathe sufficiently through its moist skin), while in warm weather it dies of asphyxia very soon after the same loss. The warmer weather puts its tissues in a more active state; and so the amount of work the animal does, and there- fore the amount of oxygen it needs, depend to a great extent upon the temperature of the medium in which it is living. With the warm-blooded animal the reverse is the case. Within very wide limits of exposure to heat or cold it maintains its temperature at that at which its tissues live best ; accordingly in cold weather it uses more oxygen and sets free more carbon dioxide because it needs a more active internal combustion to compensate for its greater loss of heat to the exterior. And it does not become warmer in warm weather, partly because its oxidations ore less than in cold (other things being equal), and partly because of physiological arrangements by which it loses heat faster from its body. In fact the living tissues of a man may be compared to hothouse plants, living in an arti- ficially maintained temperature; but they differ from the plants in the fact that they themselves are the seats of the combustions by which the temperature is kept up. Since, within wide limits, the Human Body retains the same temper- ature no matter whether it be in cold or warm surroundings, it is clear that it must possess an accurate arrangement for heat regulation ; either by controlling the production of heat in it, or the loss of heat from it, or both. The Temperature of the Body. The parts of the Body are all either in contact with one another directly or, if not, at least indirectly through the blood, which, flowing from part to part, carries heat from warmer to colder regions. Thus, although at one time one group of muscles may espe- cially work, liberating heat, and at other times another, or the muscles may be at rest and the glands the seat of active oxidation, the temperature of the whole Body is kept pretty much the same. The skin, however, which is in direct con- THE HEAT OF THE BODY. 479 tact with external bodies, usually colder than itself, is cooler than the internal organs; its temperature in health is from 36° to 37° C. (96.8-98.5° F.), being warmer in more protected parts, as the hollow of the armpit. In internal organs, as the liver and brain, the temperature is higher; about 43° C. (107° F.) in health. In the lungs there is a certain quantity of heat liberated when oxygen combines with haemoglobin, but this is more than counterbalanced by loss of the heat carried out by the expired air and that used up in evaporating the water carried out in the breath, so the blood returned to the heart by the pulmonary veins is slightly colder than that carried from the right side of the heart to the lungs. The Sources of Animal Heat. Apart from heat received from its surroundings in hot food and drink the sources of heat in the Body are twofold — direct and indirect. Heat is directly produced wherever oxidation is taking place; and, since almost invariably the chemically degrading or katabolic processes going on in a living organ exceed the anabolic, the living tissues at rest produce heat as one result of the chemical changes supplying them with energy for the maintenance of their vitality: and whenever an organ is active and its chemi- cal metamorphoses are increased it becomes hotter: a secret- ing gland or a contracting muscle is warmer than a resting one, and the venous blood leaving noticeably warmer than •the arterial supplied to it. Indirectly, heat is developed within the Body by the transformation of other forms of en- ergy: mainly mechanical work, but also of electricity. All movements of parts of the Body which do not move it in space or move external objects, are transformed into heat within it; arid the energy they represent is lost in that form. Every cardiac contraction sets the blood in movement, and this motion is for the most part turned into heat within the Body by friction within the blood-vessels. The same trans- formation of energy occurs with respect to the movements of the alimentary canal, except in so far as they expel matters from the Body; and every muscle in contracting has part of the mechanical energy expended by it turned into heat by friction against neighboring parts. Similarly the movements of cilia and of amoeboid cells are for the most part converted in the Body into heat. The muscles and nerves are also the seats of manifestations of electricity, which, though small in amount, for the most part do not leave the Body in that form tout are first converted into heat. 480 THE HUMAN BODY. The Energy Lost by the Body in Twenty-four Hours Practically speaking, the Body only loses energy in two forms; as heat and mechanical work: by applying conduct- ors to different parts of its surface small amounts of elec- tricity can be carried off, but the amount is quite trivial in comparison with the total daily energy expenditure. During complete rest, that is, when no more work is done than that necessary for the maintenance of life, nearly all the loss takes the form of heat. The absolute amount of this will vary with the surrounding temperature and other conditions, but on an average a man loses, during a day of rest, 2700 calories; that is enough to raise 2700 kilograms (5940 Ibs.) of water from 0° to 1° C. (from 32° to 33 8° F.); otherwise expressed, this amount of heat would boil 27 kilos (59.4 Ibs.) of ice-cold water. This does not quite represent all the energy lost by the Body in that time: since a small proportion is lost aa mechanical work in moving the clothes and air by the respir- atory movements, and even by the beat of the heart, which rings to a focus on the points a and b. of the retina, rays of light diverging from ,-1 and B respectively. the physical action of these media or, in other words, of the eye as an optical instrument, is known as the dioptrics of the eye. The Appendages of the Eye. The eyeball itself con- sists of the retina and refracting media, together with sup- porting and nutritive structures and other accessory appa- ratuses, as, for example, some controlling the light-converg- ing power of the media, and others ^regulating the size of the aperture (pupil] by which light enters. Outside the ball lie muscles which bring about its movements, and other parts serving to protect it. Each orbit is a pyramidal cavity occupied by connective tissue, muscles, blood-vessels and nerves, and in great part by fat, which forms a soft cushion on which the back of the eye- ball lies and rolls during its movements. The contents of 506 THE HUMAN BODY. the orbit being for the most part incompressible, the eye can- not be drawn into its socket. It simply rotates there, as the head of the femur does in the acetabulum. When the orbital blood-vessels are gorged, however, the eyeball may protrude (as in strangulation) ; and when these vessels empty it recedes somewhat, as is commonly seen after death. The front of the eye is exposed for the purpose of allowing light to reach it, but can be covered up by the eyelids, which are folds of integument, movable by muscles and strengthened by plates of fibro-cartilage. At the edge of each eyelid the skin which covers its outside is turned in, and becomes con- tinuous with a mucous membrane, the conjunctiva, which lines the inside of each lid, and also covers all the front of the eyeball as a closely adherent layer. The upper eyelid is larger and more mobile than the lower, and when the eye is closed covers all its transparent part. Ifc has a special muscle to raise it, the levator palpebrm superioris. The eyes are closed by a flat circular muscle, the orbicularis palpebrarum which, lying on and around the lids, immediately beneath the skin, surrounds the aperture between them. At their outer and inner angles (canthi) the eyelids are united, and the apparent size of the eye depends upon the interval between the canthi, the eyeball itself being nearly of the same size in all persons. Near the inner can- thus the line of the edge of each eyelid changes its direction and becomes more horizontal. At this point is found a small eminence, the lachrymal papilla, on each lid. For most of their extent the inner surfaces of the eyelids are in contact with the outside of the eyeball, but near their inner ends a red vertical fold of conjunctiva, the semilunar fold (plica seniilunaris] intervenes. This is a representative of the third eyelid, or nictitating membrane, found largely developed in many animals, as birds, in which it can be drawn all over the exposed part of the eyeball. At the inner or nasal corner is a reddish elevation, the caruncula laclirymalis, caused by a collection of sebaceous glands imbedded in the semilunar fold. Opening along the edge of each eyelid are from twenty to thirty minute compound sebaceous glands, named the Meibomian follicles. Their secretion is sometimes ab- normally abundant, and then appears as a yellowish matter along the edges of the eyelids, which olten dries in the night and causes the lids to be glued together in the morning. \ THE EYE AS AN OPTICAL INSTRUMENT. 507 The eyelashes are short curved hairs, arranged in one or two rows along each lid where the skin joins the conjunctiva. The Lachrymal Apparatus consists of the tear-gland in each orbit, the ducts which carry its secretion to the upper eye- lid, and the canals by which the tears, unless when excessive, are carried off from the front of the eye without running down over the face. The lachrymal or tear gland, about the size of an almond, lies in the upper and outer part of the orbit, near the front end. It is a compound racemose gland, from which twelve or fourteen ducts run and open in a row at the outer corner of the upper eyelid. The secretion there poured out, is spread evenly over the exposed part of the eye by the movements of winking, and keeps it moist; finally the tear is drained off by two lachrymal canals, one of which opens by a small pore (punctum lachrymalis) on each lachrymal papilla. The aperture of the lower canal can be readily seen by ex- amining the corresponding papilla by the aid of a looking- glass. The canals run inwards and open into the lachrymal sac, which lies just outside the nose, in a hollow where the lachrymal and superior maxillary bones (L and Ms, Fig. 30) meet. From the sac the nasal duct .proceeds to open into the nose-charnber, below the inferior turbinate bone and within the nostril. Tears are constantly being secreted, but ordinarily in such quantity as to be drained off into the nose, from which they flow into the pharynx and are swallowed. When the lachrymal ducts are stopped up, however, their continual presence makes itself unpleasantly felt, and may need the aid of a surgeon to clear the passage. In weeping the secretion is increased, and then not only more of it enters the nose, but some flows down the cheeks. The frequent swallowing movements of a crying child, sometimes spoken of as " gulp- ing down his passion/7 are due to the need of swallowing the extra tears which reach the pharynx. The Muscles of the Eye (Fig. 141). The eyeball is spheroidal in form and attached behind to the optic nerve, n, somewhat as a cherry might be to a thick stalk. On its ex- terior are inserted the tendons of six muscles, four straight :and two oblique. The straight muscles lie, one (superior rectus), s, above, one (inferior rectus) below, one (external rectus), a, outside, and one (internal rectus), i, inside the •eyeball. Each arises behind from the bony margin of the 508 THE HUMAN BODY. foramen through which the optic nerve enters the orbit. In the figure, which represents the orbits opened from above, the superior rectns of the right side has been removed. The superior oblique or pulley (trocUlear) muscle, t, arises behind near the straight muscles and forms anteriorly a tendon, u, which passes through a fibre-cartilaginous ring, or pulley, placed at the notcli in the frontal bone where it bounds superiorly the front end of the orbit. The tendon then turns FIG. 141.— The eyeballs and their muscles as seen when the roof of the orbit has been removed and ilie fat in the cavity has been partly cleared away. On the right side the superior rectus muscle has been cut away, a, external rectus ; s, superior rectus ; i, internal rectus; /. superior oblique. back and is inserted into the eyeball between the upper and outer recti muscles. The inferior oblique muscle does not arise, like the rest, at the back of the orbit, but near its front at the inner side, close to the lachrymal sac. It passes thence outwards and backwards beneath the eyeball to be inserted into its outer and posterior part. The inner, upper, and lower straight muscles, the inferior oblique, and the elevator of the upper lid are supplied by branches of the third cranial nerve. The sixth cranial nerve goes to the outer rectus; and the fourth to the superior oblique. The eye may be moved from side to side; up or down; obliquely, that is neither truly vertically nor horizontally, but partly both ; or, finally, it may be rotated on its antero- posterior axis. The oblique movements are always accom- THE EYE AS AN OPTICAL INSTRUMENT. 509 panied by a slight amount of rotation. When the glance is turned to the left, the left external rectus and the right in- ternal contract, and vice versa; when up, both superior recti; when down, both the inferior. The superior oblique muscle acting alone will roll the front of the eye downwards and outwards with a certain amount of rotation; the inferior oblique does the reverse. In oblique movements two of the recti are concerned, an upper or lower with an inner or outer; at the same time one of the oblique also always con- tracts. Movements of rotation rarely, if ever, occur alone. The natural combined movements of the eyes by which both are directed simultaneously towards the same point de- pends on the accurate adjustment of all its nervo-muscular apparatus. When the co-ordination is deficient the person is said to squint. A left external squint would be caused by paralysis of the inner rectus of that eye, for then, after the eyeball had been turned out by the external rectus, it would not be brought back again to its median position. A left internal squint would be caused, similarly, by paralysis of the left external rectus; and probably by disease of the sixth cranial nerve or its brain-centres. Dropping of the upper eyelid (ptosis) indicates paralysis of its special elevator muscle and is often a serious symptom, pointing to disease of the brain -parts from which it is innervated. The Globe of the Eye is on the whole spherical, but consists of segments of two spheres (see Fig. 142), a portion of a sphere of smaller radius forming its anterior transparent part and being set on to the front of its posterior segment, which is part of a larger sphere. From before back it measures about 22,5 millimeters (^ inch), and from side to side about 25 millimeters (1 inch). Except when looking at near objects, the antero-posterior axes of the eyeballs are nearly parallel, though the optic nerves diverge considerably (Fig. 141); each nerve joins its- eyeball, not at the centre, but about 2.5 mm. (^ inch) on the nasal side of the posterior end of its antero-posterior axis. In general terms'the eyeball may be described as consisting o± three coats and three refracting media. The outer coat, 1 and 3, Fig. 142, consists of the sclerotic and the cornea, the latter oeing transparent and situated in front; the iormei is opaque and white and covers the back and sides of the globe and part of the front, where it is seen 510 THE HUMAN BODY. between the eyelids as the ivliite of the eye. Both are tough and strong, being composed of dense connective tissue. The white of the eye and the cornea are covered by a thin layer of the conjunctiva, 4 and 5. Behind the proper connective- tissue layer, 3, of the cornea is a thin structureless membrane, FIG. 142. — The left eyeball in horizontal section from before back. 1, sclerotic; 2, junction of sclerotic and cornea; 3, cornea: 4. 5, conjunctiva; 6, posterior elastic layer of cornea; 7. ciliary muscle; 10, choroid; 11, 13, ciliary processes; 14, iris; 15, retina; 16, optic nerve; IT, artery entering retina in optic nerve; 18, fovea centralis; 19, region where sensory part of retina ends; 22, suspensory ligament; 23 is placed in the canal of Petit and the line from 25 points to it; 24, the anterior part of the hyaloid membrane; 26, 27, 28 are placed on the lens; 28 points to the line of attachment around it of the suspensory ligament; 29, vitreous humor; 30, anterior chamber of aqueous humor; 31, posterior chamber of aqueous humor. 6, lined inside by a single layer of epithelial cells; it is the membrane of Descemet, or the posterior elastic layer. The second coat consists of the choroid, 9, 10, the ciliary processes, 11, 13, and the iris, 14. The choroid is made up of blood-vessels supported by loose connective tissue containing numerous corpuscles, which in its inner layers .are richly rilled with dark-brown or black pigment granules. Towards the front of the eyeball, where it begins to diminish in diameter, the choroid is thrown into plaits, the ciliary processes, 11, 13. Beyond these it continues as the iris, which forms the colored part of the eye seen through the cornea; and in the centre of the iris is a circular aperture, THE EYE AS AN OPTICAL INSTRUMENT. 511 the pupil : so its second coat does not, like the outer one, completely envelop the eyeball. In the iris is a ring of plain muscular tissue encircling the aperture of the pupil : when its fibres contract they narrow the pupil. Radial fibres can be found passing from the ring to the outer edge of the iris, and they have been supposed to be muscular and concerned in dilating the pupil. They are probably merely elastic and, being stretched when the circular muscle contracts, by mere physical elasticity dilate the pupil when the muscle relaxes. The circular or sphincter muscle appears to be normally in a state of tonic contraction; this is increased by impulses travelling in fibres of the third cranial nerve and is diminished or inhibited by impulses travelling along fibres of the sympathetic, which, however, have their origin in the medulla oblongata and run down the spinal cord to the lower part of the neck, where they pass out in anterior spinal nerve-roots to reach the sympathetic. The pigment in the iris is yellow, or of lighter -or darker brown, according to the color of the eye, and more or less abundant according as the eye is black, brown, or gray. In blue eyes the pigment is confined to the deeper layers, and modified in tint by light absorption in the anterior colorless strata through which the light passes. The third coat of the eye, the retina, 15, is its essential portion, being the part in which the light produces those changes that give rise to impulses in the optic nerve. It is a still less complete envelope than the second tunic, extend- ing forwards only as far as the commencement of the ciliary processes, at least in its typical form. It is extremely soft and delicate; and, when fresh, transparent. Usually when an eye is opened the retina is colorless; but when the eye has been cut open in faint yellow light and the exposed retina quickly examined in white light it is seen to be purple. The coloring substance (visual purple) very rapidly bleaches when a dead eye is exposed to daylight. On front or inner surface of the human retina two special areas can be distinguished in a fresh eye. One is the point of entry of the optic nerve, 16, the fibres of which, penetrating the sclerotic and choroid, spread out in the retina. At this place the retina is whiter than elsewhere and presents an elevation, the optic mound. The other peculiar region is the yellow spot (macula luted], 18, which lies nearly at the posterior end of the axis of the eye- 512 THE HUMAN BODY. ball and therefore outside the optic mound; in its centre the retina is thinner than elsewhere and so a pit (fovea cen- tralis), 18, is formed. This appears black, the thinned retina there allowing the choroid to be seen through it more clearly than elsewhere. In Fig. 143 is represented the left retina as seen from the front, the elliptical darker patch about the centre indicating the yellow spot, and the white circle on one side, the optic mound. The vessels of the retina arise from an artery (17, Fig. 142) which runs in with the optic nerve and from which branches diverge as shown in Fig. 143. The Optic Nerves, Commissure, and Tracts. The optic nerves converge to meet in the optic commissure (m, Fig. 141), from which the optic tracts pass to the region of the mid brain. They terminate mainly in the anterior corpora quadrigemina (Chap. XII) and in masses of gray nerve matter lying to the outer sides and in front of these, and known as the corpora geniculata. At the commissure (m, Fig. 141) many fibres cross the middle line, so that fibres from each optic nerve are found in both optic tracts. In general, fibres from the right (that is, the outer or temporal) side of the right retina and the right (i.e. nasal) side of the left retina pass on to the brain in the right optic tract; and similarly for the left sides of the two retinas. Catting the right optic nerve, therefore, causes total blindness of the right eye, but cutting of the right optic tract blindness of the right half of each retina (hemianopia). It will later be seen that rays of light cross in' the eye so that objects to the left in space form images on the right sides of the retinas; and vice versa (Figs. 153, 154). Consequently section or extensive disease of the right optic tract causes left hemianopia; that is, blindness to objects on the left of the line of vision. The incomplete crossing of the optic nerve-fibres in man is correlated with the fact that his eyes are so placed that part of the field of vision is common to both. In mammals whose eyes are so laterally placed that at any given moment the objects seen by the two eyes are quite different, the cross- ing at the commissure is complete; when the eyes are placed so that some oojects can be seen simultaneously by the two eyes, some fibres cross, and a greater number cross the larger, the common part of the visual fields. Even in man more of the fibres cross than go direct to the same side of the brain. THE EYE AS AN OPTICAL INSTRUMENT. 513 The Microscopic Structure of the Retina. A simpli- fied stratum, continuous with the proper retina, and formed of a layer of nucleated columnar cells, is continued over the ciliary processes; elsewhere the membrane has a very com- plex structure, and a section taken, except at the yellow spot or the optic mound, shows ten layers, partly sensory appa- ratuses and nerve-tissues, and partly accessory structures. Beginning (Fig. 144) on the front side we find, first, the internal limiting membrane, 1, a thin structureless layer. Next comes the nerve-fibre, layer, 2, formed by radiating fibres of the optic nerve; third, the nerve-cell layer, 3; fourth, FIG. 143. — The right retina as it would be seen if the front part of tho eyeball with the lens and vitreous humor were removed. the inner molecular layer, 4, consisting partly of very fine nerve-fibrils, and largely of connective tissue; fifth, the inner nuclear layer, 5, composed of nucleated cells, with a small amount of protoplasm at each end, and a nucleolus. These cells, or at any rate the majority of them, have an inner process running to the inner molecular layer and an outer running to, 6, the outer molecular layvr, which is thinner than the inner. Then comes, seventh, the rod and cone fibre layer, 7, or outer nuclear layer; composed of thick and thin fibres in each of which is a conspicuous nucleus with a nucleolus. Next is the thin external limiting mem- brane, 8, perforated by apertures through which the rods and cones, 9, of the ninth layer join the fibres of the seventh. Outside of all, next the choroid, is the pigmentary layer, 10; 514 THE HUMAN BODY. the cells of this layer send processes between the rods and cones. The processes contain dark pigment and in eyes which have been exposed to bright light reach a long way, sometimes even as far as the external limiting membrane. If, however, the animal have been kept in the dark for some 10 FIG. 144.— A section through the retina from its anterior or inner surface, 1, in contact with the hyaloid membrane, to its outer, 10, in contact with the chqroicl. 1, internal limiting membrane; 2, nerve-fibre layer; 3, nerve-cell layer; 4, inner molecular layer: 5, inner nuclear layer; 6, outer molecular layer; 7, rod and cone fibres or outer nuclear layer; 8, external limiting membrane; 9, rod and cone layer; 10, pigment-cell layer. time before its eye is removed, the processes of the pigment- cells are short and extend only a short distance between the outer ends of the rods. In addition, certain fibres run verti- cally through the retina from the inner to the outer limiting membrane; they are known as the radial fibres of Mutter THE EYE AS AN OPTICAL INSTRUMENT. 515 and give off lateral branches, which are especially numerous in the molecular layers. Like the limiting membranes they are merely supporting tissues. On account ol the way in which the supporting and essen- tial parts are interwoven in the retina it is not easy to track the latter through it. There is, however (Chap. XXXIII), good evidence that light first acts upon the rod and cone layer, traversing all the thickness of inner strata of the retina to reach it, before starting those changes which result in visual sensations; and it is therefore probable that the rods and cones are in direct continuity with the optic nerve-fibres. The limiting membranes, with the fibres of Miiller and their branches, are undoubtedly merely accessory and supporting. Each rod and cone consists of an outer and an inner seg- ment. The outer segments of both tend to split up trans- versely into disks and are very similar, except that those of the rods are longer than those of the cones and do not taper as the latter do. Moreover, the visual purple is entirely con- fined to the outer segments of the rods, the cones containing none of it. The inner segments of the cones are swollen, while those of the rods are narrow and nearly cylindrical. Over most of the retina the rods are longer and much more numerous than the cones, but near the ciliary processes they cease before the cones do; and in the yellow spot elongated cones alone are found. In this region the whole retina is modified; at its margin all the layers are thickened but especially the nerve-cell layer, which becomes six or seven thick, while elsewhere the cells are found in but one or two strata. Most of the fibres run obliquely, reaching in to become continuous with the cones of the central pit, which are long, slender, and very closely packed. In the fovea itself all the layers, except that ot the cones, thin away, and thus the depres- sion is produced. The fovea is the seat of most acute vision; when we look at an object we always turn our eyes so that the light proceeding from it shall be focussed on the two foveae. Where the optic nerve enters, all the layers but the nerve- fibre layer (which is there very thick), and the internal limit- ing membrane, are absent. The blood-vessels of the retina lie almost entirely in the nerve-fibre and nerve-cell layers. The Refracting Media of the Eye are, in succession from before back, the cornea, the aqueous humor, the crystalline lens, and the vitreous humor. 516 THE HUMAN BODY. The aqueous humor fills the space between the front of the lens, 28, and the back of the cornea. This space is in- completely divided by the iris into an anterior chamber, 30, and a posterior, 31 (Fig. 142). Chemically, the aqueous humor consists of water holding- in solution a small amount of solid matters, mainly common salt. The crystalline lens ( 28, 26, 27) is colorless, transparent, and biconvex, with its anterior surface less curved than the posterior. It is surrounded by a capsule, and the inner edge of the iris lies in contact with it in front. In consistence it is soft, but its central layers are rather more dense than the outer. The vitreous humor is a soft jelly enveloped in a thin capsule, the hyaloid membrane* In front, this membrane splits into two layers, one of which, 22, passes on to be fixed to the lens a little in front of its edge. This layer is known as the suspensory ligament of the lens; its line of attachment around that organ is not straight but sinuous as represented by the curved line between 28 and 26 in Fig. 142. The space between the two layers into which the hyaloid splits is the canal of Petit. The vitreous humor consists mainly of water and contains some salts, a little albumin, and some mucin. It is divided up, by delicate membranes, into compartments in which its more liquid portions are imprisoned. The Ciliary Muscle. Running around the eyeball where the cornea joins the sclerotic is a lymph-vessel called the canal of Schlemm; it is seen in section at 8 in Fig. 142. Lying on the inner side of this canal, just where the iris and the ciliary processes meet, there is some plain muscular tissue, imbedded mainly in the middle coat of the eyeball arid form- ing the ciliary muscle, which consists of a radial and a circular portion (Fig. 149). The radial part is much the larger, and arises in front from the inner surface of the scler- otic; the fibres pass back, spreading out as they go, and are inserted into the front of the choroid opposite the ciliary processes. The circular part of the muscle lies around the outer rim of the iris. The contraction of the ciliary muscle tends to pull forward (radial fibres) and press inward (circu- lar fibres) the front part of the choroid, to which the back part of the suspensory ligament of the lens is closely at- tached. When this occurs the tension exerted on the margin of the lens by its ligament is diminished. The Properties of Light. Before proceeding to the THE EYE AS AN OPTICAL INSTRUMENT. 517 study of the eye as an optical instrument, it is necessary to recall briefly certain properties of light. Light is considered as a form of movement of the particles of an hypothetical medium, or ether, the vibrations being in planes at right angles to the line of 'propagation of the light. When a stone is thrown into a pond a series of circular waves travel from that point in a horizontal direction over the water, while the particles of water themselves move up and down, and cause the surface inequalities which we see as the waves. Somewhat similarly, light-waves spread out from a luminous point, but in the same medium travel equally in all directions so that the point is surrounded by shells of spherical waves, instead of rings of circular waves travelling in one plane only, as those on the surface of the water. Starting from a luminous point light would travel in all directions along the radii of a sphere of which the point is the centre; the light propagated along one such radius is called a ray, and in each ray the ethereal particles swing from side to side in a plane perpendicular to the direction of the ray. Taking a particle on any ray it would swing aside a certain distance from it, then back to it again, and across for a certain distance on the other side; and then back to its original position on the line of the ray. Such a movement is an oscillation, and takes a certain time; in lights of certain kinds the periods of oscillation are all the same, no matter how great the extent or amplitude of the oscillation; just as a given pendulum will always complete its swing in the same time no matter whether its swings be great or small. Light composed of rays in which the periods of oscillation arc all equal is called mono chromatic or simple light, while light made of a mixture of oscillations of different periods is called mixed or compound light. If monochromatic light is steadily emitted from a point, we come at definite distances along a ray, to particles in the same phase of oscillation, say at their greatest distance from their position of rest; just as in the concentric waves seen on the water after throwing in a stone we would along any radius meet, at intervals, with water raised most above its horizontal plane as the crest of a wave, or depressed most below it as the hollow of a wave. The distance along the ray from crest to crest is called a wave-length and is always the same in any given simple light; but it is different in simple 518 THE HUMAN BODY. lights of different colors; the briefer the time of an oscillation the less the wave-length. When light falls on a polished surface separating two transparent media, as air and glass, part of it is reflected or turned back into the first medium; part goes on into the second medium, and is commonly deviated from its original course or refracted. The original ray falling on the surface is the incident ray. Let A B (Fig. 145) be the surface of separation; a x the incident ray; and C D the perpendicular or normal to the surface at the point of inci- dence : a x C will then be the angle of incidence. Then the reflected ray makes an angle of reflection with the normal which is equal to the angle of incidence; and the reflected ray lies in the same plane as the incident ray and the nor- mal to the surface at x. The refracted ray lies also in the same plane as the normal and equal to the angle a x c. foQ indent ray, but does not continue in its original direction, x /; if the medium below A B be more refractive than that above it, the refracted ray is bent, as x d, nearer to the normal, and making with it an angle of refraction, D xd, smaller than the angle of inci- dence, a x C. If, on the contrary, the second medium is less refracting than the first, the refracted ray x g is bent away from the normal, and makes an angle of refraction, D x g, greater than the angle of incidence. The ratio of the sine of the angle of incidence to that of the angle of refraction is always the same for the same two media with light of the same wave-length. When the first medium is air the ratio of the sine of the angle of refraction to that of the angle of in- cidence is called the refractive index of the second medium. The greater this refractive index the more is the refracted ray deviated from its original course. Rays which fall per- pendicularly on the surface of separation of two media pass on without refraction. D FIG. M 45.— Diagram illustrating the refraction of light. A B, surface of separation between two transparent media; C D, the perpendicular to the surface at the point of incidence, #; a x, incident ray; x d, refracted ray, if the second medium be denser than the first ; x we refer all stimulations of it to that cause, unless we have special reason to know the contrary. As already pointed out pressure on the eyeball causes a luminous sensation (phosphene), which suggests itself to us as dependent on a luminous body situated in space where such an object must be in order to excite the same part of the retina. Since all rays of light penetrating the eye, except in the line of its long axis, cross that axis, if we press the outer side of the eyeball we get a visual sensation referred to a luminous body on the nasal side; if we press below we see the luminous patch above, and so on. Of course different rays entering the eye take different paths through it, but on general optical principles, which cannot here be detailed, we may trace all oblique rays through the organ by assuming that they meet and leave the optic axis at what are known as the nodal points of the system; these (Jck* ', Fig. 154) lie near together in the lens. If we want to find where rays of light from A will meet the retina (the eye being properly accommodated for seeing an object at that distance) we draw a line from A to Jc (the first nodal point) and then another, parallel to the first, from Tc' (the second nodal point) to the retina. The nodal points of the eye lie so near together that for practical purposes we may treat them as one (k, Fig. 155), placed near the back of the lens. By manifold experience we have learnt that a luminous body (A, Fig. 155) which we see, always lies on the prolongation of the line joining the excited part of the retina, 530 THE EYE AS A SENSORY APPARATUS. 531 a, and the nodal point Jc. Hence any excitation of that part of the retina makes us think of a luminous body somewhere on the line a A, and, similarly, any excitation of b, of a body B FIG. 154. — Diagram illustrating the points at which incident rays meet the retina. xx, optic axi£ ; fc, first nodal point; fc', second nodal point; 6, point where the im- age of B would be formed, were the eye properly accommodated for it ; a, the retinal point where the image of A would be formed. on the line b B or its prolongation. It is only other conflict- ing experiences, as that with the eyes closed external bodies do not excite visual sensations, and the constant connection • • FIG. 155.- Diagrammatic section through the eyeball, xx, optic axis ; k, nodal point. of the pressure felt on the eyelid with the visual sensation, that enable us when we press the eyeball to conclude that, in spite of what we seem to see, the luminous sensation is not due to objective light from outside the eye. The Idio-Retinal Light.— The eyelids are not by any means perfectly opaque ; in ordinary daylight they still allow a considerable quantity of light to penetrate the eye, as any one may observe by passing his hand in front of the closed eyes. But even in a dark room with the eyes completely covered up so that no objective light can enter them, there is still experienced a small amount of visual sensation due to 532 THE HUMAN BODY. internal causes. The field of vision is not absolutely dark but slightly luminous, with brighter fleeting patches travers- ing it. These are especially noticeable, for example, in try- ing to see and grope one's way with the eyes open up a per- fectly dark staircase. Then the luminous patches attract special attention because they are apt to be taken for the signs of objective realities; they become very manifest when any sudden jar of the Body, due for example to knocking against something, occurs; and have no doubt given rise to many ghost stories. These visual sensations felt in the ab- sense of all external stimulation of the eyes, may for conveni- ence be spoken of as due to the idio-retinal light. The Excitation of the Visual Apparatus by Light. — Light only excites the retina when it reaches its nerve end organs, the rods and cones. The proofs of this are several. FIG. 156. 1. Light does not arouse visual sensations tvhen it falls directly on the fibres of the optic nerve. Where this nerve enters there is a retinal part possessing only nerve-fibres, and this part is blind. Close the left eye and look steadily with the right at the cross in Fig. 156, holding the book verti- cally in front of the face, and moving it to and fro. It will be found that at about 25 centimeters (10 inches) off the white circle disappears ; but when the page is nearer or farther, it is seen. During the experiment the gaze must be kept fixed on the cross. There is thus in the field of vision a Uind spot, and it is easy k> show by measurement that it lies where the optic nerve enters. When the right eye is fixed on the cross, it is so directed that rays from this fall on the yellow spot (y, Fig. 157). The rays from the circle then cross the visual axis at the nodal point, n, and meet the retina at o. If the distance of the nodal point of the eye from the paper be/, and from THE ETE AS A SENSORY APPARATUS. 533 the retina (which is 15mm.) be F, then the distance, on the paper, of the cross from the circle will be to the distance of y from o as/ is to F. Meas- urements made in this way show that the circle disappears when its image is thrown on the entry of the optic nerve, which lies to the nasal side of the yellow spot. 2. The above experiment having shown that light does not act directly on the optic nerve- fibres any more than it does on any other nerve- fibres, we have next to see in what part of the retina those changes do first occur which form the link between light and nervous impulses. They occur in the outer part of the retina, in the rods and cones. This is proved by what is called Purkinje's experiment. Take a candle in- to a dark room and look at a surface not covered with any special pattern, say a whitewashed wall or a plain window-shade. Hold the candle to the side of one eye and close to it, but so far back that no light enters the pupil from it; that is so far back that the flame just can- not be seen, but so that a strong light is thrown on the white of the eye as far back as possible. Then move the candle a little to and fro. The surface looked at will appear luminous with reddish-yellow light, and on it will be seen dark branch- ing lines which are the shadows of the retinal vessels. Now in order that these shadows may be seen the parts on which the light acts must be behind the vessels, that is in the outer layers of the retina since the blood vessels lie in its inner strata. The experiment may be more satisfactorily performed by getting another person to focus with a lens the light of the candle as a bright spot as far back as possible on the white of the observer's eye. If the light be kept steady the vascular shadows soon dis- appear ; in order to continue to see them the candle must be kept moving. The explanation of this fact may readily be made clear by fixing the eyes for ten or fifteen seconds on the dot of an"i" somewhere about the middle of this page : at first the distinction between the slightly luminous black letters and the highly luminous white page is very obvious ; in other words, the different sensations arising from the strongly and the feebly excited areas of the retina. But if 534 THE HUMAN BODY. the glance do not be allowed to wander, very soon the letters become indistinct and at last disappear altogether ; the whole page looks uniformly grayish. The reason of this is that the powerful stimulation of the retina by the light reflected from the white part of the page soon fatigues the part of the visual apparatus it acts upon ; and as this fatigue progresses the stimulus produces less and less effect. The parts of the retina, on the other hand, which receive light only from the black letters are but little stimulated and retain much of their original excitability, so that, at last, the feebler excitation act- ing upon these more irritable parts produces as much sensa- tion as the stronger stimulus acting upon the fatigued parts; and the letters become indistinguishable. To see them con- tinuously we must keep shifting the eyes so that the parts of the visual apparatus are alternately fatigued and rested, and the general irritability of the whole is kept about the same. So, in Purkinje's experiment, if the position of the shadows remain the same, the shaded part of the retina soon becomes more irritable than the more excited unshaded parts, and its relative increase of irritability makes up for the less light falling on it, so that the shadows cease to be perceived. It is for this reason that we do not see the retinal vessels under ordi- nary circumstances. When light, as usual, enters the eye from front through the pupil the shadows always fall on the same parts of the retina, and these parts are thus kept suffi- ciently more excitable than the rest to make up for the less light reaching them through the vessels. To see the latter we must throw the light into the eye in an unusual direction, not through the pupil but laterally through the sclerotic. If v, Fig. 158, be the section of a retinal vessel, ordinarily its shadow will fall at some point on a line prolonged through it from the centre of the pupil. If a candle flame be held opposite b it illuminates that part of the sclerotic and from there light radiates and illu- mines the interior of the eye. The resulting sensation we refer to light entering the eye in the usual manner through the pupil, and accordingly see the surface we look at as if it were illuminated. The shadow of v, is now cast on an unusual spot c, and we see it as if at the THE E7E AS A SENSORY APPARATUS. 535 point d on the wall, on the prolongation of the line joining the nodal point, k, of the eye with c. If the candle be moved so as to illuminate the point V of the sclerotic, the shadow of v will be cast on c' and will accordingly seern on the wall to move from d to d' . It is clear that if we know how far b is from b', how far the wall is from the eye, and how far the nodal point is from the retina (15 mm. or 0.6 incJa}, and measure the distance on the wall from d to d', we c^f calcu- late how far c is from c' : and then how far the vessel throwing the shadow must be in front of the retinal parts perceiving it. fin this way it is found that the part seeing the shadow, that is the layer on which light acts, is just abouJMs far be- hind the retinal vessels as the main vascular trumts of the retina are in front of the rod and cone layer. It is, there- fore, in that layer that the light initiates those changes which give rise to nervous impulses ; which is further made obvious by the fact that the seat of most acute vision iaihefovea cen- tral is, where only this layer and the cone-fibres diverging from it are present. When we want to see anything dis- tinctly we always turn our eyes so that its image shall fall on the centres of the yellow spots.J The Vision Purple. How light acts in the retina so as to produce nerve stimuli is still uncertain. Recent observations show that it produces chemical changes in the rod and cone layer, and seemed at first to indicate that its action was to produce 'substances which were chemical excitants of nerve- fibres ; but although there can be little doubt that these chemical changes play some important part in vision, what their role may be is at present quite obscure. If a perfectly fresh retina be excised rapidly, its outer layers will be found of a rich purple color. In daylight this rapidly bleaches, but in the dark persists even when putrefaction has set in. In pure yellow light it also remains unbleached a long time, but in other lights disappears at different rates. If a rabbit's eye be fixed immovably and exposed so that an image of a window is focused on the same part of its retina for some time, and then the eye be rapildy excised in the dark and placed in solution of potash alum, a colorless image of the window is found on the retina, surrounded by the visual purple of the rest which is, through the alum, fixed or rendered incapable of change by light. Photographs, or optograms, are thus ob- tained which differ from the photographer's in that he uses 536 THE HUMAN BODY. light to produce chemical changes which give rise to colored bodies, while here the reverse is the case. If the eye be not rapidly excised and £ut in the alum after its exposure, the optogram will disappear ; the vision purple being rapidly re- generated at the bleached part. This reproduction of it is due mainly to the cells of the pigmentary layer of the retina, which in living eyes exposed to light thrust long processes betwee^he rods and cones. Portions of frogs' retinas raised from this, bleach more rapidly than those left in contact with it, but become soon purple again if let fall back upon the pigment-cells. Experiments show, however, that animals (frogs) exited for a long time to a bright light may have their retinW completely bleached and still see very well; they can still unerringly catch flies that come within their reach ; and they can also distinguish colors, or at least some colors, as green. Moreover, the vision purple is only found in the outer segments of the rods ; there is none in the cones, and yet these alone exist in the yellow spot of the human eye, which is the seat of most acute vision; and animals, such as snakes, which have only cones in the retina, possess no vision purple and nevertheless see very well. It may be that other bodies exist in the retina which are also chemically changed by light, but the changes of which are not accompanied by alterations in color which we can see; and, in the absence of the vision purple, seeing might be carried on by means of these, which may be less quickly destroyed by light and so still persist in the bleached retinas of the frogs above mentioned. For the present, however, the question of the part, if any, played in vision by such bodies must be left an open one : and the possibility that the rods and cones form an apparatus which directly converts ethereal vibrations into nerve stimuli without any intervening chemi- cal process must be borne in mind. The Intensity of Visual Sensations. Light considered as a form of energy may vary in quantity ; physiologically, also, we distinguish quantitative differences in light as degrees of brightness, but the connection between the intensity of the sensation excited and the quantity of energy represented by the stimulating light is not a direct one. In the first place, "" some rays excite our visual apparatus more powerfully than others : a given amount of energy in the form of yellow light, for example, causes more powerful visual sensations than the THE EYE AS A SENSORY APPARATUS. 537 same quantity of energy in the form of violet light; and ultra- violet rays only become visible, and then very faintly, when all others are suppressed; but if they be passed through some fluorescent substance (see Physics), such as an acid solution of quinine sulphate, which, without altering the amount of energy, turns it into ethereal oscillations of a longer period, then the light becomes readibly perceptible. ^ Even with light-rays of the same oscillation periot^ur sen- sation is not proportional to the amount of energy in th^ light; to the amount of heat, for example, to which it would give rise if all transformed into it. If objective- light increase gradually in amount our sensation increases also, £|| to a limit beyond which it does not go, no matter how strong the light becomes; but the increase of sensation takes place far more slowly than that of the light, in accordance with the psycho- physical law already mentioned. If we call the amount of light given out by a single candle a, then that emitted by two candles will be 2a; and so on. If the amount of sensation excited by the single candle be A, then that due to two can- dles will not be 2 A, and that by three will be far less than 3 A. If a white surface, P, Fig 159, be illuminated by a candle at c and another elsewhere, and a rod, a, be placed so as to in- tercept the light from c, but not - Q that from the other candle, we see clearly a shadow, since our eyes recognize the difference in luminos- £5 ity of this part of the paper, reflect- ing light from one candle only, from that of the rest which is illuminated by two: that is wo can tell the sensation due to the stimulus ah-om that due to the stimulus 2 a.) If now a bright lamp be brought in and placed alongside, and its light be physically equal to that of 10 candles, we cease to perceive the shadows. We find the sensation aroused by objective light = 12« (due to the lamp and two candles) cannot be told from that due to light = llaj although the difference of objective light is still la as before. Most persons must have observed illustrations of this. Sitting in a room with three lights not unfrequently some object so intercepts the light from two as to cast on the wall two shadows which partly overlap. Where the shadows overlap the wall gets light only from the third candle; around that, where each shadow is separate, it is illuminated by this 538 THE HUMAN BODY. and one other candle; and the wall in the neighborhood of the shadows by all three. Objectively, therefore, the differ- ence between the deep shadow and half shadow is that between the light of one candle and that of two. The differ- ence between the half shadows and the wall around is that between the light of two and three candles. But as .a matter of sensation the difference between the half shadow and the full s^low seems much greater than that between the half shadow and the rest of the wall; in other words the difference, a, between a and 2a, is a more efficient stimulus than the same difference, a, between 2a and 3«. When the total stim^bs increases the same absolute difference is less felt or mlP be entirely unperceived. An example of this which every one will recognize is afforded by the invisibility of the stars in daytime. On the other hand, as the total stimulus increases or de- creases the same fractional difference of the whole is per- ceived with the same ease; i.e., excites the same amount of sensation. In reading a book by lamplight we perceive clearly the difference between the amount of light reflected from the black letters and the white page. If we call the total lamplight reflected by the blank parts 10« and that by the letters 2#, we may say we perceive with a certain distinct- ness a luminous difference equal to one fifth of the whole. If we now take the book into the daylight the total light re- flected from the letters and the imprinted part of the page increases, but in the same proportion. Say the one now is 50a and the other 10#; although the absolute difference be- tween the two is now 40& instead of 8a we do not see the letters any more plainly than before. The smallest difference in luminous intensity which we can perceive is about T^ of the whole, for all the range of lights we use in carrying on our ordinary occupations. For strong lights the smallest per- ceptible fraction is considerably greater; finally we reach a limit where no increase in brightness is felt. For weak illumination the sensation is more nearly proportioned to the total differences of the objective light. Thus in a dark room an object reflecting all the little light that reaches it appears almost twice as bright as one reflecting only half; in a stronger light it would so appear. Bright objects in general obscurity thus appear unnaturally bright when compared with things about them, and indeed often look self-luminous. THE EYE AS A SENSORY APPARATUS. 539 A cat's eyes, for example, are said to "shine in the dark"; and painters to produce moonlight effects always make the bright parts of a picture relatively brighter, when compared with things about them, than would be the case if a sunny scene were to be represented ; by a relatively excessive use of white pigment they produce the relatively great brightness of those things which are seen at all in the general obscurity of a moonlight landscape. The Duration of Luminous Sensations.— This is greater than that of the stimulus, a fact taken advantage of in mak- ing fireworks : an ascending rocket produces the sensation of a trail of light extending far behind the position of the bright part of the rocket itself at the moment, because the sensation aroused by it in a lower part of its course still persists. So, shooting stars appear to have luminous tails behind them. By rotating rapidly before the eye a disk with alternate white and black sectors we get for each point of the retina on which a part of its image falls, alternating stimulation (due to the passage of white sector) and rest (when a black sector is passing). If the rotation be rapid enough the sensation aroused is that of a uniform gray, such as would be produced if the white and black were mixed and spread evenly over the disk. In each revolution the eye gets as much light as if that were the case, and is unable to distinguish that this light is made up of separate portions reaching it at intervals : the stimulation due to each lasts until the next begins and so all are fused together. If, while looking at the flame, one turns out suddenly the gas in a room containing no other light, the image of the flame persists a short time after the flame itself is extinguished. The Localizing Power of the Retina. — As already pointed out a necessary condition of seeing definite objects, as distin- guished from the power of recognizing differences of light and darkness, is that all light entering the eye from one point of an object shall be focused on one point of the retina. This, however, would not be of any use had we not the faculty of distinguishing the stimulation of one part of the retina from that of another part. This power the visual apparatus possesses in a very high degree; while with the skin we can- not distinguish from one, two points touching it less than 1 mm. (-£s inch) apart, with our eyes we can distinguish two points whose retinal images are not more than .004 mm. 540 THE HUMAN BODY. (.00016 inch) apart. The distance between the retinal images of two points is determined by the "visual angle " under which they are seen; this angle is that included between lines drawn from them to the nodal point of the eye. If a and b (Fig. 160) are luminous points, the image of a wiU b& formed at a' on the prolongation of the line a n joining a with the node, n. Similarly the image of b will be formed at b'. If a and b still remaining the same distance apart, be moved nearer the eye to c and d, then the visual angle under which they are seen will be greater and their retinal images will be farther apart, at c' and d'. If a and b are the highest and lowest parts of an object, the distance between their retinal images will then depend, clearly, not only on the size of the object, but on its distance from the eye; to know the discriminating power of the retina we must therefore measure the visual angle in each case. In the fovea centralis two objects seen under a visual angle of 50 to 70 seconds can be distinguished from one another; this gives for the distance between the retinal images that above mentioned, and corre- sponds pretty accurately to the diameter of a cone in that part of the retina. We may conclude, therefore, that when two images fall on the same cone or on two contiguous cones they are not discriminated; but that if one or more unstimu- lated cones intervene between the stimulated, the points may be perceived as distinct. The diameter of a rod or cone, in fact, marks the anatomical limit up to which we can by prac- tice raise our acuteness of visual discrimination; and in the yellow spot which we constantly use all our lives in looking at things which we want to see distinctly, we have educated the visual apparatus up to about its highest power. Else- where on the retina our discriminating power is much less and diminishes as the distance from the yellow spot increases. This is partly due, no doubt, to a less sensibility of those reti- nal regions, such as, by other facts, is proved to exist, but in part, no doubt is also due to a want of practice. The more THE EYE AS A SENSORY APPARATUS. 541 peripheral the retinal region the less we have used it for such purposes. It is probable, therefore, that outlying portions of the retina are capable of education to a higher discriminating power, just as we shall find the skin to be for tactile stimuli. While we can tell the stimulation of an upper part of the retina from a lower, or a right region from a left, it must be borne in mind that we have no direct knowledge of which is upper or lower or right or left in the ocular image. All our visual sensations tell us is that they are aroused at different points, and nothing at all about the actual positions of these on the ratina. There is no other eye behind the retina look- ing at it to see the inversion of the image formed on it. Suppose I am looking at a pane in a second-story window of a distant house: its image will then fall on the fovea cen- tralis ; the line joining this with the pane is called the. visual axis. The image of the roof will be formed on a part of the retina below the fovea, and that of the front door above it. I distinguish that the images of all these fall on different parts of the retina in certain relative positions, and have learnt, by the experience of all my life, that when the image of any- thing arouses the sensation due to excitation of part of the retina below the fovea the object is above my visual axis, and vice versa ; similarly with right and left. Consequently 1 in- terpret the stimulation of lower retinal regions as meaning high objects, and of right retinal regions as meaning left ob- jects, and never get confused by the inverted retinal image about which directly I know nothing. A new-born child, even supposing it could use its muscles perfectly, could not, except by mere chance, reach towards an object which it saw; it would grasp at random, not yet having learnt that to reach an object exciting a part of the retina above the fovea needed movement of the hand towards a position in space below the visual axis ; but very soon it learns that things near its brow, that is up, excite certain visual sensations, and objects below its eyes others, and similarly with regard to right and left; in time it learns to interpret retinal stimuli so as to localize accurately the direction, with reference to its eyes, of outer objects, and never thenceforth gets puzzled by retinal inver- sion. Color Vision. — Sunlight reflected from snow gives us a sensation which we call white. The same light sent through a prism and reflected from a white surface excites in us, mo 542 THE HUMAN BODY. white sensation but a number of color sensations, gradating insensibly from red to violet, through orange, yellow, green, blue-green, blue, and indigo. The prism separates from one another light-rays of different periods of oscillation and each ray excites in us a colored visual sensation, while all mixed together, as in sunlight, they arouse the entirely different sensation of white. If the light fall on a piece of black velvet we get still another sensation, that of black; in this case the light-rays are so absorbed that but few are reflected to the eye and the visual apparatus is left at rest. Physically black represents nothing: it is a mere zero — the absence of ethereal vibrations; but, in consciousness, it is as definite a sensation as white, red, or any other color. We do not feel blackness or darkness except over the region of the possible visual field of our eyes. In a perfectly dark room we only feel the darkness in front of our eyes, and in the light there is no such sensation associated with the back of our heads or the palms of our hands, though through these we get no visual sensations. It is obvious, therefore, that the sensation of blackness is not due to the mere absence of luminous stimuli, but to the unexcited state of the retinas, which are alone capable of being excited by such stimuli when present. This fact is a very remarkable one, and is not paralleled in any other sense. Physically, complete stillness is to the ear what darkness is to the eye; but silence impresses itself on us as the absence of sensation, while darkness causes a definite feeling of " blackness." Young's Theory of Color Vision. — Our color sensations insensibly fade into one another; starting with black we can insensibly pass through lighter and lighter shades of gray to white: or beginning with green through darker and darker shades of it to black or through lighter and lighter to white: or beginning with red we can by imperceptible steps pass to orange, from that to yellow and so on to the end of the solar spectrum: and from the violet, through purple and carmine, we may get back again to red. Black and white appear to be fundamental color sensations mixed up with all the rest: we never imagine a color but as light or dark, that is as more or less near white or black; and it is found that as the light thrown on any given colored surface weakens, the shade be- comes deeper until it passes into black; and if the illumina- tion be increased, the color becomes "lighter" until it passes THL EYE AS A SENSORY APPARATUS. 543 into white. Of all the colors of the spectrum yellow most easily passes into white with strong illumination. Black and white, with the grays which are mixtures of the two, thus seem to stand apart from all the rest as the fundamental visual sensations, and the others alone are in common par- lance named " colors." It has even been suggested that the power of differentiating them in sensation has only lately been acquired by man, and a certain amount of evidence has been adduced from passages in the Iliad to prove that the Greeks in Homer's time confused together colors that are very different to most modern eyes; at any rate there seems to be no doubt that the color sense can be greatly improved by practice; women whose mode of dress causes them to pay more attention to the matter, have, as a general rule, a more acute color sense than men. Leaving aside black, white, gray, and the various browns (which are only dark tints of other colors), we may enumer- ate our color sensations as red, orange, yellow, green, blue, violet, or purple; between each there are, however, numerous transition shades, as yellow-green, blue-green, etc., so that the number which shall have definite names given to them is to a large extent arbitrary. Of the above, all but purple are found in the spectrum given when sunlight is separated by a prism into its rays of different refrangibility; rays of a cer- tain wave-length or period of oscillation cause in us the feel- ing red; others yellow, and so on; for convenience we may speak of these as red, yellow, blue, etc., rays; all together, in about equal proportions, they arouse the sensation of white. A remarkable fact is that most color feelings can be aroused in several ways. White, for example, not only by the above general mixture, but red and blue-green rays, or orange and blue, or yellow and violet, taken in pairs in certain propor- tions, and acting simultaneously or in very rapid succession on the same part of the retina, cause the sensation of white: snch colors are called complementary to one another. The mixture may be made in several ways; as, for example, by causing the red and blue-green parts of the spectrum to overlap, or by painting red and blue-green sectors on a disk and rotating it rapidly; they cannot be made, however, by mixing pigments, since what happens in such cases is a very complex phenomenon. Painters, for example, are accustomed to produce green by mixing blue and yellow paints, and some 544 THE HUMAN BODY. may be inclined to ridicule the statement that yellow and blue when mixed give white. When, however, we mix the pigments we do not combine the sensations of the same name, which is the matter in question. Blue paint is blue because it absorbs all the rays of the sunlight except the blue and some of the green; yellow is yellow because it absorbs all but the yellow and some of the green, and when blue and yellow are mixed the blue absorbs all the distinctive part of the yellow and the yellow does the same for the blue; and so only the green is left over to reflect light to the eye, and the mixture has that color. Grass-green has no complementary color in in the solar spectrum; but with purple, which is made by mixing red and blue, it gives white. Several other colors taken three together, give also the sensation of white. If then we call the light-rays which arouse in us the sensation red, «, those giving us the sensation orange #, yellow c, and so on, we find that we get the sensation white with a, b, c, d, e, f, and g all together; or with b and e, or with c and/*, or with #, d, and e ; our sensation white has no determinate re- lation to ethereal oscillations of a given period, and the same is true for several other colors; yellow feeling, for example, may be excited by ethereal vibrations of one given wave- length (spectral yellow), or by a light containing only such waves as taken separately cause the sensations red and grass- green; in other words a physical light in which there are no waves of the " yellow " length may cause in us the sensation yellow, which is only one more instance of the general fact that our sensations, as such, give us no direct information as to the nature of external forces; they are but signs which we have to interpret. The doctrine of specific nerve energies makes it highly improbable that our different color sensa- tions can all be due to different modes of excitation of exactly the same nerve-fibres; a fibre which when excited alone gives us the sensation red will always give us that feeling when so excited. The simplest method of explaining our color sensations would therefore be to assume that for each there exists in the retina a set of nerve-fibres with appropriate terminal organs, each excitable by its own proper stimu- lus. But we can distinguish so innumerable and so finely graded colors, that, on such a supposition, there must be an almost infinite number of different end organs in the retina, and it is more reasonable to suppose that there are a limited THE EYE AS A SENSORY APPARATUS. 545 number of primary color sensations, and that the rest are due to combinations of these. That a compound color sensation may be very different from its components when these are, regarded apart, is clearly shown by the sensation white aroused either by what we may call red and blue-green, or green and purple, stimuli acting together; or of yellow due to grass-green and red. To account for our various color sen- sations we may, therefore, assume a much smaller number of primary sensations than the total number of color sensations we experience; all can in fact be explained by assuming any three primary color sensations which together give white, and regarding all the rest as due to mixtures of these in various proportions; there may be more than three, but three will account for all the phenomena, black being a sensation expe- rienced when all visual stimuli are absent. This is known as Young's theory of color vision, and is that at present most commonly accepted. The selection of the three primary sen- sations is decided by the phenomena of color-blindness, which show that if this theory of color vision be correct red must be one of the primary color sensations: if so, then green and violet must be the other two. The theory further assumes that all kinds of light stimulating the end appa- ratuses give rise to all three sensations, but not necessarily in the same proportion. When all are equally aroused the sen- sation is white or some shade of gray when the red and green are tolerably powerfully excited and the violet little, the sen- sation is yellow; when the green powerfully and the red and violet little, the sensation is green, and so on. In this way we can also explain the fact that all colored surfaces when intensely illuminated pass into white. A red light, for ex- ample, excites the primary red sensation most, but green and violet a little; as the light becomes stronger a limit is reached beyond which the red sensation cannot go, but the green and violet go on increasing with the intensity of the light, until they too reach their limits; and all three primary sensations being then equally aroused, the sensation white is produced. Color Blindness. Some persons fail to distinguish colors which are to others quite different; when such a deficiency is well marked it is known as "colorblindness," and, assuming Young's theory to be correct, it may be explained by an ab- sence of one or more of the three primary color sensations; 546 THE HUMAN BODY. observation of color-blind persons thus helps in deciding which these are. The most common form is red color blind- ness; persons afflicted with it confuse reds and greens. .Red to the normal eye is red because it excites red sensation much, green some, and violet less; and a white page white, because it excites red, green, and violet sensations about equally. In a person without red sensation a red object would arouse only some green and violet sensation and so would be indistinguishable from a bluish green; in practice it is found that many persons confound these colors. Cases of green and violet color blindness are also met with, but they are much rarer than the red color blindness or " Daltonism." The detection of color blindness is often a matter of considerable importance, especially in sailors and railroad officials, since the two colors most commonly confounded, red and green, are those used in maritime and railroad signals. Persons attach such different names to colors that a decision as to color blindness cannot be safely arrived at by simply showing a color and asking its name. The best plan is to^ take a heap of worsted of all tints, select one, say a red, and tell the man to put alongside it all those of the same color, whether of a lighter or a darker shade; if red blind he will select not only the reds but the greens, especially the paler tints. About one man in eight is more or less red blind. The defect is much rarer in women. Fatigue of the Retina. The nervous visual apparatus is easily fatigued. Usually we do not observe this because its restoration is also rapid, and in ordinary life our eyes, when open, are never at rest; we move them to and fro, so that parts of the retina receive light alternately from brighter and darker objects and are alternately excited and rested. How constant and habitual the movement of the eyes is can be readily observed by trying to fix for a short time a small spot without deviating the glance; to do so for even a few seconds is impossible without practice. If any small object is steadily " fixed " for twenty or thirty seconds it will be found that the whole field of vision becomes grayish and obscure, because the parts of the retina receiving most light get fatigued, and arouse no more sensation than those less fatigued and stimu- lated by light from less illuminated objects. Or look steadily at a black object, say a blot on a white page, for twenty seconds, and then turn the eye on a white wall; the latter THE E7E AS A SENSORY APPARATUS. 547 will seem dark gray, with a white patch on it; an effect due to the greater excitability of the retinal parts previously rested by the black, when compared with the sensation aroused elsewhere by light from the white wall acting on the previously stimulated parts of the visual surface. All persons will recall many instances of such phenomena, which are es- pecially noticeable soon after rising in the morning. Similar things may be noticed with colors; after looking at a red patch the eye turned on a white wall sees a blue-green patch; the elements causing red sensations having been fatigued, the white, mixed light from the wall now excites on that region of the retina only the other primary color sensations. The blending of colors so as to secure their greatest effect depends on this fact; red and green go well together because each rests the parts of the visual apparatus most excited by the other, and so each appears bright and vivid as the eye wan- ders to and fro; while red and orange together, each exciting and exhausting mainly the same visual elements, render dull, r or in popular phrase " kill," one another. Contrasts. If a well-defined black surface be looked at on a larger white one the parts of the latter close to the black look whiter than the rest, and the parts of the black near the white blacker than the rest; so, also, if a green patch be looked at on a red surface each color is heightened near where they meet. This phenomenon is largely due to fatigue and deficient fixation : the retinal parts not excited and fatigued by the black or the green are brought by a movement of the organ so as to receive light from the white or red surface; phenomena due to this cause are known as those of successive contrast. Even in the case of perfect fixation, however, some- thing of the same kind is seen; black looks blacker near white and green greener near red when the eye has not moved in the least from one to the other. A small piece of light gray paper put on a sheet of red, which latter is then covered accurately with a sheet of semi-transparent tissue- paper, assumes the complementary color of the red, i.e., IOOKS bluish green ; and gray on a green sheet under similar cir- cumstances looks pink. Such phenomena are known as those of simultaneous contrast, and are explained on psychological grounds by those who accept Young's theory of color vision. Just as a medium-sized man looks short beside a tall one, so, it is said, a black surface looks blacker near a white one, or a 548 THE HUMAN BODY. gray (slightly luminous white) surface, which feebly excites red, green, and violet sensations, looks deficient in red (and so bluish green) near a deeper red surface. There are, however, certain phenomena of simultaneous contrast which cannot be satisfactorily so explained, and these have led to other theories of color vision, the most important of which is that described in the next paragraph. Hering's Theory of Vision. Contrasts can be seen with the eyes closed and covered. If we look a short time at a bright object and then rapidly exclude light from the eye, we see for a moment a positive after-image of the object, e.g.f a window with its frame and panes after a glance at it and then closing the eyes. In these positive after-images the bright and dark parts of the object which was looked at retain their original relationship; they depend on the persistence of retinal excitement after the cessation of the stimulus and usually soon disappear. If an object be looked at steadily for some time, say twenty seconds, and the eyes be then closed, a negative after-image is seen. In this the lights and shades of the object looked at are reversed. Frequently a positive after-image becomes negative before disappearing. The negative images are explained commonly by fatigue; when the eye is closed some light still enters through the lids and ex- cites less those parts of the retina previously exhausted by prolonged looking at the brighter parts of the field of vision; or, when all light is rigorously excluded, the self stimula- tion of the visual apparatus itself, causing the idio-retinal light, affects less the exhausted portions, and so a negative image is produced. If we fix steadily for thirty seconds a point between two white squares about 4 mm. (£ inch) apart on a large black sheet, and then close and cover our eyes, we get a negative after-image in which are seen two dark squares on a brighter surface; this surface is brighter close around the negative after-image of each square, and brightest of all between them. This luminous boundary is called the corona, and is explained usually as an effect of simultaneous contrast; the dark after-image of the square it is said makes us mentally err in judgment and think the clear surface close to it brighter than elsewhere; and it is brightest between the two dark squares, just as a middle-sized man between two tall ones looks shorter than if alongside one only. If, however, the after-image be watched it will often THE EYE AS A SENSORY APPARATUS. 549 be noticed not only that the light band between the squares is intensely white, much more so than the normal idio-retinal light, but, as the image fades away, often the two dark after- images of the squares disappear entirely with all of the corona, except that part between them which is still seen as a bright band on a uniform grayish field. Here there is no contrast to produce the error of judgment, and from this and other experiments Hering concludes that light acting on one part of the retina produces inverse changes in all the rest, and that this has an important part in producing the phe- nomena of contrasts. Similar phenomena may be observed with colored objects; in their negative after-images each tint is represented by its complementary, as black is by white in colorless vision. Endeavoring to exclude such loose general explanations as " errors of judgment," Hering proposes a theory of vision •which can only be briefly stated here. We may put all our colorless sensations in a continuous series, passing through grays from the deepest black to the brightest white; some- where half-way between will be a neutral gray which is as black as it is white. We may do something similar with our color sensations; as in gray we see black and white so in purple we see red and blue, and all colors containing red and blue may be put in a series of which one end is pure red, the other pure blue. So with red and yellow, blue and green, yellow and green. If we call to mind the whole solar spec- trum from yellow to blue, through the yellow-greens, green, and blue -greens, we get a series in which all but the ter- minals have this in common that they contain some green. Green itself forms, however, a special point; it differs from all tints on one side of it in containing no yellow, and from all on the other in containing no blue. In ordinary language this is recognized : we give it a definite name of its own and call it green. Its simplicity compared with the doubleness of its immediate neighbors entitles it to a distinct place in the color-sensation series. There are three other color sensa- tions which like green are simple and must have specific names of their own; they are red, blue, and yellow. Green may be pure green or yellow-green or blue-green, but never yellow and bluish at once, or reddish. Red may be pure or yellowish or bluish, but never greenish. Red and green are thus mutually exclusive; yellow and blue stand in a similar 550 THE HUMAN BODY. relationship. All other color sensations, as orange, suggest two of the above, and may be described as mixtures of them; but they themselves stand out as fundamental color sensa- tions. Moreover, it follows from the above, that more than two simple color sensations are never combined in a com- pound color sensation. Since red always excludes green, and yellow blue, we may call them anti-colors (the complementary colors of Young's theory), and are led to suspect that in the visual organ there must occur, in the production of each, processes which pre- vent the simultaneous production of the other, since there is no a priori reason in the nature of things why we should not see red and green simultaneously, as well as red and yellow. Along with our color sensations there is always some color- less from the black- white series; which we recognize in speak- ing of lighter and darker shades of the same color. Hering assumes, then, in the retina or some part of the- nervous visual apparatus, three substances answering to the black-white, red-green, and yellow-blue sensational series, the construction of each substance being attended with one sen- sation of its pair, and its destruction with the other. Thus, when construction of the black-white substance exceeds de- struction, we get a blackish-gray sensation; when the pro- cesses are equal the neutral gray; when destruction exceeds construction a light-gray, and so on. In the other color series similar things would occur; when construction of red- green substance exceeded destruction in any point of the retina we would get, say, a red feeling; if so, then excess of destruction would give green sensation. The intensity of any given simple sensation would depend on the ratio of the difference between the construction and destruction of the corresponding substance, to the sum of all the constructions and destructions of visual substances going on in that part of the visual apparatus : in this way anabolic and katabolic nutritive processes would be the material basis of visual sen- sations. The intensity of a mixed color sensation would be the sum of the intensities of its factors, and its tint and shade dependent on the relative proportion of these factors. When the construction and destruction of the red-green sub- stance are equal no color sensation is aroused by it; and we get gray, due to those simultaneously occurring changes in the black- white substance which are always present, but were THE EYE AS A SENSORY APPARATUS. 551 previously more or less cloaked by the results of the changes in the red-green substance. Ked and green in certain pro- portions cause then a white or gray sensation, not because they supplement one another, as on Young's theory, but be- cause they mutually cancel; and so for other complementary colors. Moreover, according to Hering, destruction of a visual sub- stance going on in one region of the retina promotes con- struction and accumulation of that substance elsewhere, but especially in the neighborhood of the excited spot. Hence, when a white square on a black ground is looked at. destruc- tion of the black-white substance overbalances construction in the place, on which the image of the square falls, but around this construction occurs in a high degree. When the eyes are shut, this latter retinal region, with its great accumu- lation of decomposable material, is highly irritable and, under the internal stimuli causing the idio-retinal light, breaks down comparatively fast, causing the corona, which may be intensely luminous; for with the closed eye the total constructive and destructive processes in the visual apparatus are small, and so the excess of destruction in the coronal region bears a large ratio to the sum of the whole processes. The student must apply this theory for himself to the other phenomena of contrasts and negative images, as also to the gradual disappearance of differences between light and dark objects when looked at for a time with steady fixation; the general key being the principle that anything leading to the accumulation of a visual substance increases its decomposi- tions under given stimulation, and vice versa. The main value of Bering's theory is that it attempts to account physiologically for phenomena previously indefinitely ex- plained psychologically by such terms as "errors of judg- ment," which really leave the whole matter where it was, since if (as we must believe) mind is a function of brain, the errors of judgment have still to be accounted for on physio- ' logical grounds, as due to conditions of the nervous system. The three visual substances, the anabolisms and katabol- isms of which according to Hering give rise to color sensa- tions, need not necessarily be in the retina itself: they may be in the central nerve portions of the visual apparatus, being excited through different nerve fibres excited by dif- ferent lights falling on the retina. 552 THE HUMAN BODY. There are difficulties in the way of the full acceptance of either the Young (often called the Young-Helmholtz) theory or the theory of Hering, and the whole doctrine of color vision is still in a very unsettled state. Visual Perceptions. The sensations which light excites in us we interpret as indications of the existence, form, and position of external objects. The conceptions which we arrive at in this way are known as visual perceptions. The full treatment of perceptions belongs to the domain of Psychology, but Physiology is concerned with the conditions under which they are produced. The Visual Perception of Distance. With one eye our perception of distance is very imperfect, as illustrated by the common trick of holding a ring suspended by a string in front of a person's face, and telling him to shut one eye and pass a rod from one side through the ring. If a pen -holder be held erect before one eye, while the other is closed, and an attempt be made to touch it with a finger moved across towards it, an error will nearly always be made. (If the finger be moved straight on towards the pen it will be touched because with one eye we can estimate direction accu- rately and have only to go on moving the finger in the proper direction till it meets the object.) In such cases we get the only clue from the amount of effort needed to " accommo- date" the eye to see the object distinctly. When we use both eyes our perception of distance is much better; when we look at an object with two eyes the visual axes are con- verged on it, and the nearer the object the greater the con- vergence. We have a pretty accurate knowledge of the degree of muscular effort required to converge the eyes on all tolerably near points. When objects are farther off, their apparent size, and the modifications of their retinal images brought about by aerial perspective, come in to help. The relative distance of objects is easiest determined by moving the eyes; all stationary objects then appear displaced in the opposite direction (as for example when we look out of the window of a railway car) and those nearest most rapidly; from the different apparent rates of movement we can tell which are farther and nearer. We so inseparably and uncon- sciously bind up perceptions of distance with the sensations aroused by objects looked at, that we seem to see distance; it seems at first thought as definite a sensation as color. TEE EYE AS A SENSORY APPARATUS. 553 That it is not is shown by cases of persons born blind, who have had sight restored later in life by surgical operations. Such persons have at first no visual perceptions of distance: all objects seem spread out on a flat surface in contact with the eyes, and they only learn gradually to interpret their sensations so as to form judgments about distances, as the rest of us did unconsciously in childhood before we thought about such things. The Visual Perception of Size. The dimensions of the retinal image determine primarily the sensations on which conclusions as to size are based; and the larger the visual angle the larger the retinal image : since the visual angle de- pends on the distance of an object the correct perception of size depends largely upon a correct perception of distance; having formed a judgment, conscious or unconscious, as to that, we conclude as to size from the extent of the retinal region affected. Most people have been surprised now and then to find that what appeared a large bird in the clouds was only a small insect close to the eye; the large apparent size being due to the previous incorrect judgment as to the distance of the object. The presence of an object of toler- ably well-known height, as a man, also assists in forming conceptions (by comparison) as to size; artists for this pur- pose frequently introduce human figures to assist in giving an idea of the size of other objects represented. The Visual Perception of a Third Dimension of Space. This is very imperfect with one eye; still we can thus arrive at conclusions from the distribution of light and shade on an object, and from that amount of knowledge as to the relative distance of different points which is attainable monocularly; the different visual angles under which objects are seen also assist us in concluding that objects are farther and nearer, and so are not spread out on a plane before the eye, but occupy depth also. Painters depend mainly on devices of these kinds for representing solid bodies, and objects spread over the visual field in the third dimension of space. Single Vision with Two Eyes. When we look at a flat object with both eyes we get a similar retinal image in each. Under ordinary circumstances we see, however, not two ob- jects but one. In the habitual use of the eyes we move them so that the images of the object looked at fall on the two yellow spots. A point to the left of this object forms its 554 THE HUMAN BODY. image on the inner (right) side of the left eye and the outer (right) side of the right. An object vertically above that looked at would form an image straight below the yellow spot of each eye; an object to the left and above, its image to the inner side and below in the left eye and to the outer side and below in the right eye; and so on. We have learned that similar simultaneous excitations of these corresponding points mean single objects, and so interpret our sensations. This at least is the theory of the experi- ential or empirical school of psychologists, though others be- lieve we have a sort of intuition on the subject. When the eyes do not work together, as in the muscular incoordination of one stage of intoxication, then they are not turned so that images of the same objects fall on corresponding retinal points, and the person sees double. When a squint comes on, as from paralysis of the external rectus of one eye, the sufferer at first sees double for the same reason, but after a time he makes new associations of corresponding retinal points, and this is in favor of the empirical theory. When a given object is looked at, lines drawn from it through the nodal points reach the fovea centralis in each eye. Lines so drawn at the same time from a more distant object diverge less and meet each retina on the inner side of its fovea; but as above pointed out the corresponding points for each retinal region on the inside of the left eye, are on the outside of the right, and vice versa. Hence the more distant object is seen double. So, also, is a nearer object, be- cause the more diverging lines drawn from it through the nodal points lie outside of the fovea in each eye. Most people go through life unobservant of this fact; we only pay attention to what we are looking at, and nearly always this makes its images on the two foveae. That the fact is as above stated may, however, be readily observed. Hold one finger a short way from the face and the other a little farther off; looking at one, observe the other without moving the eyes; it will be seen double. For every given position of the eyes there is a surface in space, all objects on which produce images on corresponding points of the two retinas: this sur- face is called the horopter for that position of the eyes: all objects in it are seen single; all others in the visual field, double. The Perception of Solidity. When a solid object is THE EYE AS A SENSORY APPARATUS. 555 looked at the two retinal images are different. If a truncated pyramid be held in front of one eye its image will be that represented at P, Fig. 161. If, however, it be held midway FIG. 161. between the eyes, and looked at with both, then the left-eye image will be that in the middle of the figure, and the right- eye image that to the right. The small surface, bdca, in one answers to the large surface, V df c' a', in the other. This may be readily observed by holding a small cube in front of the nose and alternately looking at it with each eye. In such cases, then, the retinal images do not correspond, and yet we combine them in consciousness so as to see one solid object. This is known as stereoscopic vision, and the illusion of the common stereoscope depends on it. Two photographs are taken of the same object from two different points of view, one as it appears when seen from the left, and the other when seen from the right. These are then mounted for the stereoscope so that each is looked at by its proper eye, and the object appears in distinct relief, as if, instead of flat pictures, solid objects, occupying three dimensions of space, were looked at. Of course in many stereoscopic views the dis- tribution of light and shade, etc., assist, but these are quite unessential, as may be readily observed by copying the draw- ings of Fig. 161 and mounting them on a card the size of a stereoscopic slide, and placing it in the instrument. A solid pyramid standing out into space will be distinctly perceived ; if the pictures be reversed the pyramid appears hollow. The pictures must not be too different, or their combination to give the idea of a single solid body will not take place. Many persons, indeed, fail entirely to get the illusion with ordinary stereoscopic slides. The phenomena of stereoscopic vision militate strongly against the view that there are any anatom- ically prearranged corresponding points in the two retinas. The Perception of Shine. When we look at a rippled 556 THE HUMAN BODY. lake in the moonlight, we get the perception of a "shiny " or brilliant surface. The moonlight is reflected from the waves to the eyes in a number of bright points: these are not ex- actly the same for both eyes, since the lines of light-reflection from the surface of the water to each are different, The perception of brilliancy seems largely to depend on this slight non-agreement of the light and dark points on the two retinas. A rapid change of luminous points, to and fro be- tween neighboring points on one retina, seems also to pro- duce it. CHAPTER XXXIV. THE EAK AND HEARING. The External Ear. The auditory organ in man consists of three portions, known respectively as the external ear, the middle ear or tympanum, and the internal ear or labyrinth; the latter contains the end organs of the auditory nerve. The external ear consists of the expansion seen on the ex- terior of the head, called the concha, M, Fig. 162, and a pas- sage leading in from it, the external auditory meatus, 6r. FIG. 162. — Semidiagrammatic section through the right ear (Czermak). M, concha; (?, external auditory meatus ; T, tympanic membrane ; P, tympanic cavity ; o, oval foramen ; r, round foramen ; R, pharyngeal opening of Eusta- chian tube ; V, vestibule ; B, a semicircular canal ; S, the cochlea ; Vt, scala ves- tibuli ; Pt, scala tympani ; A, auditory nerve. This passage is closed at its inner end by the tympanic or drum membrane, T. It is lined by skin, through which numerous small glands, secreting the wax of the ear, open. The Tympanum (P, Fig. 162) is an irregular cavity in the temporal bone, closed externally by the drum membrane* 557 558 THE HUMAN BODY. From its inner side the EustacMan tube (R) proceeds to the pharynx, and the mucous membrane of that cavity is con- tinued up the tube to line the tympanum; the proper tym- panic membrane composed of connective tissue is therefore covered by mucous membrane on its inner, as it is by very thin skin on its outer, side. In the bony inner wall of the tympanum are two small apertures, the oval and round fora- mens, o and r, which lead into the labyrinth. During life the round aperture is closed by the lining mucous membrane, and the oval in another way, to be described presently. The tym- panic membrane, T, stretched across the outer side of the tympanum, forms a shallow funnel with its concavity out- wards. It is pressed by the external air on its exterior, and by air entering the tympanic cavity through the Eustachian tube on its inner side. If the tympanum were closed the pressures on the inner and outer sides of the drum membrane would not be always equal when barometric pressure varied, and the membrane would be bulged in or out according as the external or internal pressure on it were the greater. On the other hand, were the Eustachian tube always open the sounds of our own voices would be loud and disconcerting, so it is usually closed; but every time we swallow it is opened, and thus the air-pressure in the cavity is kept equal to that in the external auditory meatus. By holding the nose, keep- ing the mouth shut, and forcibly expiring, air may be forced under pressure into the tympanum, and will be held in part imprisoned there until the next act of swallowing. On making a balloon ascent or going rapidly down a deep mine, the sudden and great change of aerial pressure outside fre- quently causes painful tension of the drum membrane, which may be greatly alleviated by frequent swallowing movements. The Auditory Ossicles. Three small bones lie in the tympanum forming a chain from the drum membrane to the oval foramen. The external bone (Fig. 163) is the malleus or hammer; the middle one, the incus or anvil; and the internal, the stapes or stirrup. The malleus, M, has an upper enlargement or head, which carries on its inner side an articular surface for the incus; below the head is a constriction, the neck, and below this two processes com- plete the bone; one, the long or slender process, is im- bedded in a ligament which reaches from it to the front wall of the tympanum; the other process, the handle, THE EAR AND HEARING. 559 reaches down between the mucous membrane lining the inside of the drum membrane and the membrane proper, and is firmly attached to the latter near its centre and keeps Mcp the membrane dragged in there so as to give it its peculiar MC concave form, as seen from the outside. The incus has a MI^ body and two processes, and is 4 much like a molar tooth with ~f~ two fangs. On its body is an articular hollow to receive the Mm head of the malleus; its short FlG i63.-The auditory ossicles of the v»vnr>pc<3 ( 77) \ io tiffnnliorl Kirlirra right ear. seen from the front. M, mal- piocess (Jo) is attached byiiga- le*s . j incus . s stapes . Mcp^ head of mpnf fn HIP h«oV \vnll nf flip the malleus ; Me, neck of ditto; Af J, long ment to tne Dack wall oi tne process. ^nl, handle ;jc, body,X short, tympanum; the long process and art of the cortex direct, having no connection with the thalamus and passing ventral to the internal capsule. Most of the fibres of the fillet, we have seen, end in the red nucleus or corpora quadrigemina: fibres arising in these gray masses connect them with the thalamus and through it with the cortex. Besides fibres connecting the cortex with other parts are many which unite different cortical areas directly. A vast number (Ca, Fig. 177) cross the middle line in the corpus callosum and are believed to join corresponding parts of the two hemispheres. Others pass over in the small white an- terior commissure and unite the two olfactory lobes and portions of the temporal lobes. The posterior commissure unites mainly the optic thalami and the front ends of the THE PHYSIOLOGY OF THE BRAIN. 621 tegmenta. The soft commissure is mainly gray matter. Finally a large number of associational fibres, as, unite different parts of the cortical substance of the same hemi- sphere. The different gray masses on the same side of the forebrain are also united by fibres. They are either so scattered among others that they cannot be tracked out along special tracts of degeneration; or, as is possible, resemble some of the com- FI — i FIG 178.— Diagram to illustrate cerebral distribution of the fibres proceeding from the tegmentum. For description see text. missural fibres uniting upper and lower regions of gray matter in the spinal cord in having nutritive, centres at each end, and therefore not degenerating on either side of a section. In any case very little is known as to their numbers or paths : their existence is indicated by the dotted lines in Figs. 177, 178. Omitting the associational and the cross commissure fibres and those uniting the corpora striata and optic thalami,. 622 THE HUMAN BODY. it may be said in general that the systems of fibres represented in Fig. 177 are all almost certainly concerned in conveying impulses from the cortex, and those in Fig. 178 in the trans- mission of afferent impulses. It will be noted that both affer- ent and efferent fibres are abundant in the internal capsule ; and that the corpus striatum and pes are more especially con- nected with efferent and the tegmentum and thalamus with afferent impulses. It can hardly be necessary to add that each line in the diagrams represents hundreds of thousands of nerve-fibres. The Functions of the Cerebral Cortex. That this part of the nervous system is in close association with the intellect and with the initiation of voluntary movements seems beyond doubt: but it may have other functions quite apart from any states of consciousness ; and intelligence and every volition may not entirely depend on it. The experiments made in recent years on the lower animals tend to the conclusion that some will and some intellect may remain in animals all or almost all of whose gray cerebral surfaces have been removed ; the more complete loss of those powers described by earlier workers being due to the fact that the animals were not kept alive long enough after the operation. It has been observed that a dog whose cerebral cortex (as verified by subsequent post-mortem examination) had been nearly completely removed did learn after some months to walk about to all appearance voluntarily, and to find and eat his food ; he even learned not to take the food of other dogs after he had been severely bitten several times for so doing. But more complex perceptions were lost : before the operation, for example, he was greatly terrified by seeing a man fantastically dressed, but afterwards no such appearance aroused in him so complex a conception as that of a strange or dangerous object. He also never recovered the trick of "giving paw," which had previously been taught him. But on the whole a person casually observing him would not have thought him very different from any other dog, ex- cept perhaps that he was rather stupid : put into a low open box, for example, he would not jump out of it when called, though he easily could do so and clearly desired to. Such simple and fundamental perceptions and volitions as remained in this and some similar cases probably have their seats in the optic thalami and corpora striata, and indeed embryology shows that the corpora striatum is morphologically a part of the THE PHYSIOLOGY OF THE BRAIN. 623 cerebral cortex : it is therefore probable that in man some of the lower and simpler mental faculties are associated also with those parts. There are, however, great and obvious chances of error in arguing from the actions of the lower animals as to their mental state : and these are increased by the compara- tively small proportion the cerebral cortex bears to the whole cerebro-spinal centre in these animals when compared with its ratio in man, showing its less importance in the management of their actions. Hence the most useful observations are those made of late years on apes and monkeys and on men suffering from local brain disease. By utilizing these it has been possible to map out certain areas of the brain surface as having special, though possibly not absolutely unshared association, with volitional movement and with groups of sensations and sensory interpretations. In addition to facts obtained by removal or local disease of parts of the brain we have others obtained by electrical stimulation of certain parts of the cortex, which although quite insensible to cut- ting or mechanical irritation does in some places respond to application of the interrupted or constant electric current. The more important results obtained are indicated in a general way in Figs. 179 and 180, representing respectively the outer and inner surfaces of the right cerebral hemisphere; these diagrams should be compared with the more detailed figures in Chapter XI. The shaded area beginning on the top of the brain and extending down the sides of the fissure of Rolando or central fissure, Ro, and beyond its ventral end is the motor area of the cortex. It also extends to the inner side of the hemi- sphere, as shown in Fig. 179. Electric stimulation of dif- ferent parts of this area causes movements of leg, arm, or face as indicated. Removal of the region marked " arm " in the monkey causes motor paralysis and some loss of sensi- bility in the arm on the opposite side of the body. It is also followed by degenerations extending from the re- moved region of cortex through the internal capsule to some pyramidal fibres in the pes and thence back through the pyramids to the crossed pyramidal and direct pyram- idal tracts in the cord as far as the cervical enlarge- ment. Localized disease of this area in man is followed by paralysis of voluntary movements of the opposite «'irm and by similar degenerations. Similar statements are true 624 THE HUMAN BODY. for the areas marked leg, foot, and face, except that the re- sulting degeneration would extend in the one case to the lumbar enlargement of the cord, in the other to the nucleus of the vn nerve in the medulla. Moreover, each of these areas can be mapped out into smaller ones, giving origin to a more limited movement when stimulated and a more limited paralysis and tract of degeneration when removed. Thus areas especially associated with the eyelids, with the muscles of the angle of the mouth, with the flexor muscles of Pa Fv FIG. 179.— Diagram of outer surface of left cerebral hemisphere to illustrate the localization of functions. The motor area is shaded in vertical and transverse lines: .Vj/, fissure of Sylvius; an, angular gyrus or convolution; Ro, fissure of Rolando; Fv, frontal lobe; Pa, parietal lobe; Te, temporal lobe. Only a very few of the more important fissures are indicated. Compare with Fig. 180. the wrist, all have their definite places in the general face or arm region. So definite are the positions of these areas that in cases of localized paralysis, diagnosed as due to lesions of the cerebral cortex, surgeons now have no hesitation in open- ing the skull in order if possible to remove the cause of trouble, as a small tumor: they know precisely in what spot they will find it. Although the localization is therefore tolerably precise, yet the limits of neighboring areas are not as sharp cut as the boundaries of neighboring countries on a map: as shown in Fig. 179, the arm area in its lower part overlaps part of the face area; and the minor areas within the main ones also overlap one another at their margins. The general interpretation put upon the above facts, and one which seems justified, is that in making definitely willed THE PHYSIOLOGY OF THE BRAIN. 625 movements the cortical area connected through the pyram- idal tract with the muscles concerned is the place from which efferent impulses start throwing into action lower centres which more immediately co-ordinate the muscles: these lower centres in mid brain, cerebellum, medulla or cord may of course be thrown into reflex action by afferent im- pulses having no connection with the cortex, and to the eye the resulting movement would be exactly the same as a willed one. In another person, and still more in a dog or monkey, we must often be in doubt whether an action is or is not intentional; and as already pointed out, many move- ments of our own which were at one time even painfully in- tentional become quite unconscious after* practice and are carried out by lower centres. It is also to be borne in mind that the cortical area from which the efferent processes of a willed movement make their start is in connection by as- sociational and other commissural fibres with many other regions of the cortex, and with fibres from the optic thalamus which may bring nerve impulses exciting it, and it is also in connection with the whole gray cortical network, so that the brain antecedents or excitants leading to a given movement, either alone or in combination with others, may be very different, and may be associated or not with concomitant sensations or emotions. Take such a movement as clenching the fist. On a corpse this might be brought about by pulling on the flexor tendons of the digits, but in an imperfect way; or, again in a very imperfect manner by stimulation of the motor nerves of the flexor muscles in the arm of a living person. If, however, we knew exactly the proper sensory fibres in spinal nerve-roots to stimulate and could thus act on the centre co-ordinating the proper muscles, there is no doubt we could bring about reflexly, and apart from all consciousness, a quite normal clenching movement. Next suppose a person struggling for breath : as his extraordinary muscles of respiration come into play his fists are clenched; here impulses from the medulla oblongata travel down the cord and throw the " clenching " spinal centre into activity along with many other muscles, and co-ordinating them all so as to give as good a pull as pos- sible to ail muscles which can help an inspiration. In a higher but still not volitional stage, more groups of muscles are concerned, and centres of co-ordination in the pons and 626 THE HUMAN BODY. cerebellum come into action also; take a man preparing for a high jump: as he crouches and puts himself in bal/nce for the spring he clenches his fists, quite unconsciously of course. Here the immediate clenching centre is thrown into activity along with the muscles of breathing, and of all parts of the trunk and limbs. Each subsidiary peripheral centre plays its part and the instreaming afferent impulses from the skin of the feet, from the fibres of the muscular sense, from the semicir- cular canals, from the eyes, are all concerned (without the person's perception of them) in throwing the motor mechanisms of midbrain, cerebellum, medulla, and cord into harmonious activity, so that when the jump is actually willed it shall be accomplished. But that in this case the volition plays a very secondary part is obvious; it merely acts on an apparatus all ready to discharge in a given way when a suitable additional nerve impulse reaches it. A runner all tense for the start of a hundred-yard race can hardly be said to start voluntarily when he hears the signal; the case is comparable more to the self-balancing of a pigeon deprived of its cerebral hemi- spheres, when its perch is tilted. Next, suppose I clench my fist "involuntarily," as we commonly say, when I see some- thing that arouses my indignation; here clearly a mental element is in play, but not a volitional one, and so far as the movement is concerned probably the motor area of the cortex has little or nothing to do with it: it is more in accord with what is seen on animals to suppose that such simple emotions and their characteristic movements may be carried out by nerve apparatuses lying no higher than the thalami and -corpora striata. If, however, I strike a man with the intention to punish him, there can be little doubt that the "clenching" centre is excited by fibres from the cortex and passing down in the pyramidal tract. But this cortical area may in turn be thrown into activity and may have its ten- dency to discharge modified in many ways. My anger may be the culminating result of many long past received and interpreted and remembered sensations, and whether I shall give the blow or restrain myself also be dependent on many antecedents of experience. Again, I clench my hand to knock doAvn a madman, as the only immediate method of preventing him from committing a murder: here the same motor cortical area no doubt would be thrown in action as when the blow was struck in anger, but it is clear that the THE PHYSIOLOGY OF THE BRAIN. 627 antecedent nerve processes arousing its activity would be quite different in the two cases; and they would yet again be different if I clenched the fist in order to explain to a child the meaning of the word clench. We see then that the im- mediate motor centres may be excited in various ways and in various combinations quite apart from the cortex of the cere- brum and by fibres not connected with the pyramidal tracts; and that when excited from the cortical area of the cere- brum through fibres of the pyramidal tract, that area itself may be excited or controlled in its activity by a vast number of other parts of the cortex, and by non-cortical parts of the nervous system. The motor area cannot properly be spoken of as the seat of volition : an act of willing is the final out- come of changes in other and often numerous other regions of the cortex, the resultant of whose material processes is a discharge of efferent impulses from some region of the motor area. The permanent effects of local lesions of the Rolandic region differ with the development of the brain. In dogs removal of the left brain region connected with the fore paw causes only temporary motor paralysis of the limb on the other side; after a time the animal learns to walk again as well as before: then removal of the corresponding area on the right side of the brain is followed by paralysis of both fore limbs. This has been supposed to show that the centre on the right side had taken up the duty of control for both sides after that on the left had been removed. However that may be, the second paralysis is also only temporary, disappearing in some weeks or months; and as has been already stated, even after removal of all the motor area the animal occasion- ally learns in the course of time to walk nearly as well as ever. This must be due to lower centres (corpora striata ?), and the question is whether the movements in such cases are truly volitional, for definite acts of willing a movement prob- ably play a very small part in a dog's life: most of its move- ments are the immediate efferent expression of afferent im- pulses and true volitions have but a small part in them. In the lower monkeys definite motor effects of removal of part of the cortical motor area are also temporary, but last longer than in dogs; and in the anthropoid apes the same is the case in a greater degree, and according to some experimenters certain delicate combined movements are permanently lost 628 THE HUMAN BODY. .after destruction of the motor area. These facts are correl- .ated with the relatively larger size of the cortical motor area .and of the pyramidal tracts in monkeys as compared with dogs, and the anthropoid apes as compared with other monkeys. The larger and more highly organized the brain area the greater the part it plays in the life-work of the animal and more noticeable are the results of its absence. In man local paralysis due to local cortical lesion is often only temporary: this may be due to disappearance of the disease; or to the primary paralysis being only a " shock " effect, and not due to actual disease of the motor centre, for it is well known that in animals injury to one region of the brain will often for a considerable time inhibit the activity of other parts: or it may be due to the hemisphere of the opposite side assuming con- trol. Different observers attribute very various values to these three possible factors. \ In this connection reference may be made to cases of what is called aphasia, which in its fully de- veloped state is a loss of the power to apply words to express ideas. The power of speech may, of course, be lost through disease of the larynx or paralysis of the nerves or muscles of the voice organs, but such a condition is not true aphasia: the aphasic person can often articulate perfectly well, but he can- not attach a meaning to his spoken word : in some cases he can write words with meaning, though he cannot say them; in other cases (agr aphid) the power of using written words to express ideas is also lost, though the person can write, and his general conduct shows that he is still guided by .his intelli- gence; he knows quite well what he wants to say, but he can- not set the proper motor apparatus in action to utter the word : if he speaks, the word has no connection with that in his mind, and as soon as he hears himself speaking it he often knows that the word he uses is quite wrong. We find in such cases the power to understand words, and to form ideas of words, and to utter words, but some link between the origin of the idea and the discharge of the motor impulses willed to express it is out of gear. It is as if an injured reflex centre should give a wrong or inco-ordinate efferent response to an afferent impulse. Aphasia is almost invariably connected with disease of the area marked SP in Fig. 179 and known as the third or lower frontal convolution, and the pathological change is on the left side of the brain only. The area, as will be seen, is closely associated with the face area and the tongue THE PHYSIOLOGY OF THE BRAIN. 629 and partly overlaps them, or rather is intermixed with them ; as pointed out above, the lesion is not one of motor speech cen- tres, but of the connection between these and other cerebral areas in which have occurred changes accompanied by the desire of verbal expression; something wrong probably in the gray network. Very rarely aphasia has been known to follow disease or injury of the corresponding convolution on the right side; so that in it we have an example of a very definite nexus between a limited area of the cortex and the expres- sion of will through movements. Cases of recovery from aphasia have occurred, but are extremely rare. In the ex- ceptional cases it has been supposed that the right side of the brain takes up the duty of connecting the material changes in the gray network which accompany the origination of an idea in one or more cortical areas, with the other changes which result in speech. This view gains some support from the fact that in certain cases of recovery due to left-side dis- ease, subsequent disease in the third right frontal convolution has been followed by a fresh aphasia. But however that may be we have in aphasic persons definite evidence of the limita- tion of definite function to a very limited area or areas of the cerebral cortex. Much less is known as to other regions of the cortex than of the motor area: most of them do not respond to electrical stimulation at all, and those areas that do, only show it by movements lacking in precision. We are reduced, therefore, to observation on animals from whom certain cortical parts have been removed, and to observations on diseased persons. Certain broad regions have in this way been mapped out as connected with certain main groups of sensations (Figs. 179, 180), probably rather with the combining and interpreting of sensations, with their ideation, than with the mere raw sensation itself. The latter is probably more dependent on the lower brain centres; in most cases it is secondary changes in these which lead to impulses which are passed on to excite the cortical sensory areas. There is considerable evidence that removal or extensive injury of the left occipital lobe causes blindness of the left half of each retina, and vice versa. Also, that stimulation of this region of the brain may cause movements of the eyes and eyelids which have been described as such as an animal would make if it thought it saw something, though obviously 630 THE HUMAN BODY. that must be a very uncertain deduction. Also, the optic tract of each side has through the anterior corpus quadri- geminum and some other gray masses a close connection with the cortex of the occipital lobe. Probably, therefore, that region has some close 'connection with vision. There is also some evidence that the angular gyrus (an, Fig. 179) has con- nection with sight. The sense of smell has been supposed especially connected with the uncinate gyrus of median side of the temporal lobe (un, Fig. 180), and the sense of taste with a neighboring Ro FIG. 180.— Diagram of inner surface of left cerebral hemisphere to illustrate cerebral localization. Sq, fissure of Sylvius; Ro, fissure of Rolando; Fr, frontal lobe; Of, occipital lobe: Te, temporal Jobe; C.cZ, corpus callosum; ZZ7, third ven- tricle. Compare with Fig. 179. area, but the evidence is unsatisfactory; and the same may be said of the reasons which led to designation of the region of the temporal lobe close behind the fissure of Sylvius with hearing. The region marked on the diagram as that of cutaneous sensations has also a doubtful claim : there is some reason to believe that the motor area of the cortex has con- nection with the muscular sense; also to some extent with tactile feelings. Tactile and temperature impulses cross the middle line somewhere on their path from the skin to the brain. An apoplectic effusion in one cerebral hemisphere causes loss of sensation and of voluntary movement on the other side of the Body. The frontal lobes are quite irresponsive to excitation, and considerable parts of them have been removed without ap- THE PHYSIOLOGY OF THE BRAIN. 631 parent diminution of motor or sensory faculty. By a sort of process of exclusion, the rest of the cortex being allotted (though on unsatisfactory evidence) to motion and sensation the frontal regions have been supposed to have special con- nection with the higher intellectual faculties. Mental Habits. Movements which are commonly exe- cuted together tend to become so associated that it is difficult to perform one alone; many persons, e.g., cannot close one eye and keep the other open. From frequent use, the paths of conduction between the co-ordinating centres for both groups of muscles have become so easy that a volitional im- pulse reaching one centre spreads to the other and excites both. This association of movements, dependent on the modification of brain structure by use, finds an interesting parallel in the psychological phenomenon known as the asso- ciation of ideas; and all education is largely based on the fact that the more often brain regions have acted together the more readily, until finally almost indissolubly, do they so act. If we always train up the child to associate feelings of disgust with wrong actions and of approbation with right, when he is old he will find it very hard to do otherwise: such an organic nexus will have been established that the activity of the one set of centres will lead to an excitation of that which habit has always associated with it. The higher nerve- centres are throughout eminently plastic; it is that which marks them out for a far higher utility and greater adaptation to the varying experiences of individual life than the more fixed and machine-like lower centres: every thought leaves in them its trace for good or ill; and the moral truism that the more often we yield to temptation — the more often an evil solicitation, sensory or otherwise, has resulted in a wrong act — the harder it is to resist the repetition of it, has its par- allel (and we can hardly doubt its physical antecedent) in the marking out of a path of easier conduction from perceptive to volitional centres in the brain. The knowledge that every weak yielding degrades our brain structure and leaves its trail in that organ through which man is the " paragon of animals/' while every resistance makes less close the bond between the thought and the act for all future time, ought surely to "give us pause :" on the other hand, every right action helps to establish a " path of least resistance," and makes its sub- sequent performance easier. 632 THE HUMAN BODY. The brain, like the muscles, is improved and strengthened by exercise and injured -by overwork or idleness; and just as a man may specially develop one set of muscles and neglect the rest until they degenerate, so he may do with his brain; developing one set of intellectual faculties and leaving the rest to lie fallow until, at last, he almost loses the power of using them at all. The fierceness of the battle of life nowa- days especially tends to produce such lopsided mental de- velopments; how often does" one meet the business man, so absorbed in money-getting that he has lost all power of ap- preciating any but the lower sensual pleasures; the intel- lectual joys of art, science, and literature have no charm for him; he is a mere money-making machine. One, also, not unfrequently meets the scientific man with no appreciation of art or literature; and literary men utterly incapable of sympathy with science. A good collegiate education in early life, on a broad basis of mathematics, languages, and the natural sciences, is a great security against such imperfect mental growth; one danger in American life is the tendency to put lads in a technical college, or to start them in business before they have attained any broad general education. An- other danger, no doubt, is the opposite one of making the training too broad; a man who knows one or two literatures fairly well, and who has mastered the elements of mathemat- ics and of one of the observational or experimental sciences, is likely to have a better and more utilizable brain than he who has a smattering of half a dozen languages and a con- fused idea of all the " ologies." The habits of mental sloven- liness, the illogical thinking, and the incapacity to know when a thing really is mastered and understood, which one so often finds as the results of such an education, are far worse than the narrowness apt to follow the opposite error, which is often associated with the power of accurate logical thought. Those who are deprived of the advantages of a general colle- giate education may now, more easily than at any previous period, cultivate mental breadth by reading some of the many excellent general reviews and magazines, and the readable but exact popular expositions now available on nearly all subjects, which are such a feature of our age. Associating, out of working hours, with those whose special pursuits are different from our own is almost necessary to those who would avoid such an asymmetrical development as almost amounts to intellectual deformity. CHAPTER XXXVIII. VOICE AND SPEECH. Voice consists of sounds produced by the vibrations of two elastic bands, the true vocal cords, placed in the larynx, an upper modified portion of the passage which leads from the pharynx to the lungs. When the vocal cords are put in a cer- tain position, air driven past them sets them in periodic vibra- tion, and they emit a musical note; the lungs and respiratory muscles are, therefore, accessory parts of the vocal apparatus : the strength of the blast produced by them determines the loudness of the voice. The larynx itself is the essential voice- organ: its size primarily determines the pitch of the voice, which is lower the longer the vocal cords; and, hence, shrill in children, and usually higher pitched in women than in men: the male larynx grows rapidly at commencing man- hood, causing the change commonly known as the " breaking of the voice." Every voice, while its general pitch is de- pendent on the length of the vocal cords, has, however, a certain range, within limits which determine whether it shall be soprano, mezzo-soprano, alto, tenor, baritone, or bass. This variety is produced by muscles within the larynx which alter the tension of the vocal cords. Those characters of voice which we express by such phrases as harsh, sweet, or sympathetic, depend on the structure of the vocal cords of the individual; cords which in vibrating emit only harmonic partial tones (Chap. XXXV) are pleasant; while those in which inharmonic partials are conspicuous are disagreeable. The vocal cords alone would produce but feeble sounds; those that they emit are strengthened by sympathetic reso- nance of the air in the pharynx and mouth, the action of which may be compared to that of the sounding-board of a violin. By movements of throat, soft palate, tongue, cheeks, and lips the sounds emitted from the larynx are altered or 634 THE HUMAN BODY. supplemented in various ways, and converted into articulate language or speech. The Larynx lies in front of the neck, beneath the hyoid bone and above the windpipe; in many persons it is promi- nent, causing the projection known as "Adam's apple." It consists of a framework of cartilages, partly joined by true synovial joints and partly bound together by membranes; •Ci It^-^BP^** FIG. 181.— The more important cartilages of the larynx from behind, t, thy- roid; Cs, its superior, and Ci. its inferior, horn of the right side; #*, cricoid carti- lage; t, arytenoid cartilage; Pv, the corner to which the posterior end of a vocal cord is attached; Pm, corner on which the muscles which approximate or sepa- rate the vocal cords are inserted; co, cartilage of Santorini. muscles are added which move the cartilages with reference to one another; and the whole is lined by a mucous mem- brane. The cartilages of the larynx (Fig. 181) are nine in. num- ber; three single and median, and three pairs. The largest (t) is called the thyroid, and consists of two halves which meet at an angle in front, but separate behind so as to inclose a V-shaped space, in which most of the remaining cartilages lie. The epiglottis (not represented in the figure) is fixed to the top of the thyroid cartilage and overhangs the entry from the pharynx to the larynx; it may be seen, covered by mucous membrane, projecting at the base of the tongue, if the latter be pushed down while the mouth is held open in front of a mirror; and is, similarly covered, represented, as seen from behind, at a in Fig. 182. The cricoid, the last VOICE AND SPEECH. 635 of the unpaired cartilages, lias the shape of a signet-ring; its broad part („,„,, Fig. 181) is on the posterior side and lies at the lower part of the opening between the halves of the thyroid; in front and on the sides it is narrow, and a space, occupied by the crico-tJiyroid membrane, intervenes between its upper border and the lower edge of the thyroid cartilage. The angles of the latter are produced above and below into projecting horns (Cs and Ci, Fig. 181), and the lower horn on each side forms a joint with the cricoid. The thyroid can be rotated on an axis, passing through the joints on each side, and rolled down so that its lower front edge shall come nearer the cricoid cartilage, the membrane there intervening being folded. The arytenoids (f,Fig. 181) are the largest of the paired cartilages; they are seated on the upper edge of the posterior wide portion of the cricoid, and form true joints with it. Each is pyramidal with a triangular base, and has on its tip a small nodule (co, Fig. 181), the cartilage of Santorini. From the tip of each arytenoid cartilage the aryteno-epiglottidean fold of mucous membrane (10, Fig. 182) extends to the epiglottis; the cartilage of Santorini causes a projection (8, Fig. 182) in this; and a little farther on (9) is a similar eminence on each side, caused by the remaining pair of cartilages, known as the cuneiform, or cartilages of Wrisberg. The Vocal Cords are bands of elastic tissue which reach from the inner angle (Pv, Fig. 181) of the base of each aryte- noid cartilage to the angle on the inside of the thyroid where the sides of the V unite; they thus meet in front but are separated at their other ends. The cords are not, however, bare strings, like those of a harp, but covered over with the lining mucous membrane of the larynx, a slit, called the glottis (c, Fig. 182), being left between them. It is the pro- jecting cushions formed by them on each side of this slit which, are set in vibration during phonation. Above each vocal cord is a depression, the ventricle of the larynx (bf, Fig. 182); this is bounded above by a somewhat prominent edge, the false vocal cord. Over most of the interior of the larynx its mucous membrane is thick and covered by ciliated epithelium, and has many mucous glands imbedded in it. Over the vocal cords, however, it is represented only by a thin layer of flat non-ciliated cells, and contains no glands. In quiet breathing, and after death, the free inner edges of the 636 THE HUMAN BODY. vocal cords are thick and rounded, and seem very unsuitable for being readily set in vibration. They are also tolerably widely separated behind, the arytenoid cartilages, to which their posterior ends are attached, being separated. Air under 11 11 FIG. 182.— The larynx viewed from its pharyngeal opening. The back wall of the pharynx has been divided and its edges (11) turned aside. 1, body of hyoid; 2, its small, and 3, its great, horns; 4, upper and lower horns of thyroid cartilage; 5, mucous membrane of front of pharynx, covering the back of the cricoid carti- lage; 6. upper end of gullet; 7, windpipe, lying in front of the gullet; 8, eminence caused by cartilage of Santorini; 9, eminence caused by cartilage of Wrisberg; both lie in, 10, the aryteno-epiglottidean. fold of mucous membrane, surrounding the opening (aditus larynyis) from pharynx to larynx, a, projecting tip of epi- glottis; c, the glottis, the lines leading from the letter point to the free vibratory edges of the vocal cords. 6', the ventricles of the larynx: their upper edges, mark- ing them off from the eminences fe, are the false vocal cords. these conditions passes through without producing voice. If they are watched with the laryngoscope during phonation, it is seen that the cords approximate behind so as to narrow the glottis; at the same time they become more tense, and their inner edges project more sharply and form a better-defined margin to the glottis, and their vibrations can be seen. These changes are brought about by the delicately co- VOICE AND SPEECB. 637 ordinated activity of a number of small muscles, which move the cartilages to which the cords are fixed. The Muscles of the Larynx. In describing the direc- tion and action of these it is convenient to use the words front or anterior and back or posterior with reference to the larynx itself (that is, as equivalant to ventral and dorsal) and not with reference to the head, as usual. The base of each arytenoid cartilage is triangular and fits on a surface of the cricoid, on which it can slip to and fro to some extent, the ligaments of the joint being lax. One corner of the tri- angular base is directed inwards and forwards (i.e. towards the thyroid) and is called the vocal process (Pv, Fig. 181), as to it the vocal cords are fixed. The outer posterior angle (Pm, Fig, 181) has several muscles inserted on it and is called the muscular process. If it be pulled back and towards the middle line the arytenoid cartilage will rotate on its vertical axis, and roll its vocal processes forwards and out- wards, and so widen the glottis; the reverse will happen if the muscular process be drawn forwards. The muscle pro- ducing the former movement is the posterior crico-arytenoid (Cap, Fig. 183); it arises from the back of the cricoid carti- lage, and narrows to its insertion into the muscular process of the arytenoid on the same side. The opponent of this muscle is the lateral crico-arytenoid, which arises from the side of the cricoid cartilage, on its inner surface, and passes upwards and backwards to the muscular process. The pos- terior crico-arytenoid s, working alone, pull inwards and down- wards the muscular processes, turn upwards and outwards the vocal processes, and separate the posterior ends of the vocal cords. The lateral crico-thyroid, working alone, pulls downwards and forwards the muscular process, and rotates inwards and upwards the vocal process, and narrows the glottis; it is the chief agent in producing the approximation of the cords necessary for the production of voice. When both pairs of muscles act together, however, each neutralizes the tendency of the other to rotate the arytenoid cartilage; the downward part of the pull of each is, thus, alone left, and this causes the arytenoid to slip downwards and outwards, off the eminence on the cricoid with which it articulates, as far as the loose capsular ligament of the joint will allow. The arytenoid cartilages are thus moved apart and the glottis greatly widened and brought^ into its state in deep quiet 638 THE HUMAN BODY. breathing. Other muscles approximate the arytenoid carti- lages after the cartilages have been separated. The most im- portant is the transverse arytenoid (A, Fig. 183), which runs across from one arytenoid cartilage to the other. Another is the oblique arytenoid (Taep), which runs across the middle line from the base of one arytenoid to the tip of the other; FIG. 183.— The larynx seen from behind and dissected so as to display some of its muscles. The mucous membrane of the front of the pharynx (5, Fig. 157) has been dissected away, so as to display the laryngeal muscles beneath it. Part of the left half of tne thyroid cartilage has been cut away, co, cartilage of San- tor iui; c«, cartilage of Wrisberg. thence certain fibres continue in the aryteno-epiglottidean fold (10, Fig. 182) to the base of the epiglottis; this, with its fellow, embraces the whole entry to the larynx; when they contract they bend inwards the tips of the arytenoid car- tilages, approximate the edges of the aryteno-epiglottidean fold, and draw down the epiglottis, and so close the passage from the pharynx to the larynx. When the epiglottis has been removed, food and drink rarely enter the larynx in swallowing, the folds of mucous membrane being so brought together as to effectually close the aperture between them. Increased tension of the vocal cords is produced by the crico-tliyroid muscles, one of which lies on each side of the larynx, over the crico- thyroid membrane. Their action may VOICE AND SPEECH. be understood by help of the diagram, Fig. 184, in which t represents the thyroid cartilage, c the cricoid, a an arytenoid, and vc a vocal cord. The muscle passes obliquely backwards and upwards from about d near the front end of \a } vc c, to t, about /, near the pivot (which represents the joint between the cricoid cartilage and the inferior horn of the thyroid). When the muscle contracts it pulls together the anterior ends of t and c; either by depressing the thyroid (as rep- resented by the dotted lines) or by raising the front end of the cricoid; and thus stretches the vocal cord, if the ary- tenoid cartilages be held from slipping forwards. The an- tagonist of the crico-thyroid is the tltyro-arytenoid muscle; it lies, on each side, imbedded in the fold of elastic tissue forming the vocal cord, and passes from the inside of the angle of the thyroid cartilage in front, to the anterior angle and front surface of the arytenoid behind. If the latter be held firm, the muscle raises the thyroid cartilage from the position into which the crico-thyroid pulls it down, and so slackens the vocal cords. If the thyroid be held fixed by the crico-thyroid muscle, the thyro-arytenoid will help to approxi- mate the vocal cords, rotating inwards the vocal processes of the arytenoids. The lengthening of the vocal cords when the thyroid cartilage is depressed tends to lower their pitch; the in- creased tension, however, more than compensates for this and raises it. There seems, however, still another method by which high notes are produced. Beginning at the bot- tom of his register, a singer can go on up the scale some dis- tance without a break; but, then, to reach his higher notes, must pause, rearrange his larynx, and begin again. What happens is that, at first, the^vocal processes are turned in, so as to approximate but not to meet; the whole length of each edge of the glottis then vibrates, and its tension is increased, and the pitch of the note raised, by increasing contraction of the crico-thyroid. At last this attains its limit and a new method has to be adopted. The vocal processes are more rolled in, until they touch. This produces a node (see 640 THE HUMAN BODY. Physics) at that point and shortens the length of vocal cord which vibrates. The shorter string emits a higher note; so the crico- thyroid is relaxed, and then again gradually tight- ened as the notes sung are raised in pitch from the new starting-point. To pass easily and imperceptibly from one such arrangement of the larynx to another is a great art in singing. There is some reason to believe that a second node may, for still higher notes, be produced at a more anterior point on the vocal cords. The method of production of falsetto notes is uncertain; during their emission the free border of the vocal cords alone vibrates. The range of the human voice is about three octaves, from e (80 vib. per 1") on the unaccented octave, in male voices, to c on the thrice-accented octave (1024 vib. per 1"), in female. Great singers of course go beyond this range; basses have been known to take a on the great octave (55 yib. per 1") ; and Nilsson in " II Flauto Magico " used to take /on the fourth accented octave (1408 vib. per 1"). Mozart heard at Parma, in 1770, an Italian songstress whose voice had the extraordinary range from g in the first accented octave (198 vib. per 1") to c on the fifth accented octave (2112 vib. per 1"). An ordinary good bass voice has a com- pass from /(88 vib. per 1") to d" (297 vib. per 1"); and a soprano from bf (248 vib. per 1") to g"' (792). Vowels are, primarily, compound musical tones produced in the larvnx. Accompanying the primary partial of each, which determines its pitch when said or sung, are a number of upper partials, the first five or six being recognizable in good full voices. Certain of these upper partials are rein- forced in the mouth to produce one vowel, and others for other vowels; so that the various vowel sounds are really musical notes differing from one another in timbre. The mouth and throat cavities form an air-chamber above the larynx, and this has a note of its own which varies with its size and form, as may be observed by opening the mouth ! widely, with the lips retracted and the cheeks tense; then I gradually closing it and protruding the lips, meanwhile tap- \ ping the cheek. As the mouth changes its form the note produced changes, tending in general to pass from a higher to a lower pitch and suggesting to the ear at the same time a ; change from the sound of a (father) through 6 (more) to 06 j VOICE AND SPEECH. 641 (moor). When the mouth and throat chambers are so ar- ranged that the air in them has a vibratory rate in unison with any partial in the laryngeal tone, it will be set in sym- pathetic vibration, that partial will be strengthened, and the vowel characterized by it uttered. As the mouth alters its form, although the same note be still sung, the vowel changes. In the above series (a, 6, 06) the tongue is depressed and the cavity forms one chamber; for a this has a wide mouth open- ing; for 6 it is narrowed; for 56 still more narrowed, and the lips protruded so as to increase the length of the resonance chamber. The partial tones reinforced in each case are, ac- cording to Helmholtz — In other cases the mouth and throat cavity is partially sub- divided, by elevating the tongue, into a wide posterior and a narrow anterior part, each of which has its own note; and the vowels thus produced owe their character to two rein- forced partials. This is the case with the series a (man), e (there), and i (machine), the tones reinforced by resonance in the mouth being — The usual I of English, as in spire, is not a true simple vowel but a diphthong, consisting of a (pad) followed by e (feet), as may be observed by trying to sing a sustained note to the sound T; it will then be seen that it begins as a and ends as ee. A simple vowel can be maintained pure as long as the breath holds out. In uttering true vowel sounds the soft palate is raised so as to cut off the air in the nose, which, thus, does not take part in the sympathetic resonance. For some other sounds (the semi-vowels or resonants) the initial step is, as in the case of the true vowels, the production of a laryngeal tone; 642 THE HUMAN BODY. but the soft palate is not raised, and the mouth exit is more or less closed by the lips or the tongue; hence the blast partly issues through the nose, and the air there takes part in the vibrations and gives them a special character; this is the case with D), n, and ng. Consonants are sounds produced not mainly by the vocal cords, but by modifications of the expiratory blast on its way through the mouth. The current may be interrupted and the sound changed by the lips (labials); or, at or near the teeth, by the tip of the tongue (dentals); or, in the throat, by the root of the tongue and the soft palate (gutturals). Con- sonants are also characterized by the kind of movement which gives rise to them. In explosives an interruption to the passage of the air-current is suddenly interposed or re- moved (P, T, B, D, K, G). Other consonants are continuous (as F, S, R), and may be subdivided into — (1) aspirates, char- acterized by the sound produced by a rush of air through a narrow passage, as when the lips are approximated (F), or the .teeth (S), or the tongue is brought near the palate (Sh), or its tip against the two rows of teeth, they not being quite in contact (Th). For L the tongue is put against the hard palate and the air escapes on its sides. For Ch (as. in the proper Scotch pronunciation of loch) the passage between the back of the tongue and the soft palate is narrowed. To many of the above pure consonants answer others, in whose production true vocalization (i.e. a laryngeal tone) takes a part. F with some voice becomes V; S becomes Z, Th soft (tee^) becomes Th hard; and Ch becomes Gh. (2) reso- nant s; these have been referred to above. (3) vibratories (the different forms of R). which are due to vibrations of parts bounding a constriction put in the course of the air- current. Ordinary R is due to vibrations of the tip of the tongue held near the hard palate; and guttural R to vibra- tions of the uvula and parts of the pharynx. The consonants may physiologically be classified as in the following table (Foster) : Explosives. Labials, without voice P. " with voice B. Dentals, without voice T. " with voice D. Gutturals, without voice . . . K. " with voice G (hard). VOICE AND SPEECH. 643 Aspirates. Labials, without voice F. " with voice V. Dentals, without voice S, L, Sh, Th (hard). " with voice Z, Zh (azure), Th (soft). Gutturals, without voice. . .Ch (loch). " with voice Ch. Resonants. Labial M. Dental N. Guttural NG-. Vibratories. Labial — not used in European languages. Dental .R (common). Guttural R (guttural). H is a laryngeal sound : the vocal cords are separated for its production, yet not so far as in quiet breathing. The air- current then produces a friction sound but not a true note, as it passes the glottis; and this is again modified when the current strikes the wall of the pharynx. Simple sudden closure of the glottis, attended with no sound, is also a speech element, though we do not indicate it with a special letter, since it is always understood when a word begins with a vowel, and only rarely is used at other times. The Greeks had a special sign for it, ', the soft breathing; and another, \ the hard breathing, answering somewhat to our h and indi- cating'that the larynx was to be held open, so as to give a friction sound, but not voice. In whispering there is no true voice; the latter implies true tones, and these are only produced by periodic vibra- tions; whispering is a noise. To produce it the glottis is considerably narrowed but the cords are not so stretched as to produce a sharply defined edge on them, and the air driven past is then thrown into irregular vibrations. Such vibra- tions as coincide in period with the air in the mouth and throat are always present in sufficient number to characterize the vowels; and the consonants are produced in the ordinary way, though the distinction between such letters as P and B, F and V, remains imperfect. CHAPTER XXXIX. REPRODUCTION. Reproduction in General. In all cases reproduction consists, essentially, in the separation of a portion of living matter from a parent; the separated part bearing with it, or inheriting, certain tendencies to repeat, with more or less variation, the life history of its progenitor. In the more simple cases a parent merely divides into two or more pieces, each resembling itself except in size; these then grow and repeat the process; as, for instance, in the case of Amoeba and our own white blood corpuscles (pp. 23, 44). Such a process may be summed up in two words as discontinuous growth; the mass, instead of increasing in size without segmentation, divides as it grows, and so forms independent living beings. In some tolerably complex multicellular animals we find essentially the same thing; at times certain cells of the fresh- water Polype multiply by simple division in the manner above described, but there is a certain concert between them: they build up a tube projecting from the side of the parent,. a mouth-opening forms at the distal end of this, tentacles sprout out around it, and only when thus completely built up and equipped is the young Hydra set loose on its own career. How closely such a mode of multiplication is allied to mere growth is shown by other polypes in which the young, thus formed, remain permanently attached to the parent stem, so that a compound animal results. This mode of reproduction (known as gemmation or budding) may be compared to the method in which many of the ancient Greek colonies were founded; carefully organized and prepared at home, they were sent out with a due proportion of artificers of various kinds; so that the new commonwealth had from its first sep- aration a considerable division of employments in it, and was, on a small scale, a repetition of the parent community. In the great majority of animals, however (even those which at times multiply by budding),'a different mode of reproduction 644 REPRODUCTION. 645 occurs, one more like that by which our western lands were settled and gradually built up into Territories and States. The new individual in the political world began with little differentiation; it consisted of units, separated from older and highly organized societies, and these units at first did pretty much everything, each man for himself, with more or less efficiency. As growth took place development also occurred; persons assumed different duties and performed different work until, finally, a fully organized State was formed. Similarly, the body of one of the higher animals is, at an early stage of life, merely a collection of undiiferentiated cells, each capable of multiplication by division, and more or less retaining all its original protoplasmic properties; and with no specific individual endowment or function. The mass (Chap. III.) then slowly differentiates into the various tissues, each with a predominant character and duty; at the same time the majority of the cells lose their primitive powers of reproduction, though exactly how completely is a problem not yet sufficiently studied. In adult Vertebrates it seems certain that the white blood corpuscles multiply by division: and in some cases (in the newts or tritons, for example) a limb is reproduced after amputation. But exactly what cells take part in such restorative processes is uncertain; we do not know if the^ old bone corpuscles left form new bones, old muscle-fibres new muscles, and so on; though it is probable that the little-differentiated leucocytes build up most of the new limb. In Mammals no such restoration occurs; an am- putated leg may heal at the stump but does not form again. In the healing processes the connective tissues play the main part, as we might expect; their cellular elements being but little modified from their primitive state (p. 102) can still multiply and develop. New blood capillaries, however, sprout out from the sides of old, and new epidermis seems only to be formed by the multiplication of epidermic cells; hence the practice, frequently adopted by surgeons, of transplanting little bits of skin to points on the surface of an extensive burn or ulcer. In blood capillaries and epidermis the de- parture from the primary undifferentiated cell is but slight; and, as regards the cuticle, one of the permanent physiologi- cal characters of the cells of the rete mucosum is their multi- plication throughout the whole of life; that is a main physio- logical characteristic of the tissue: the same is very probably 646 THE HUMAN BODY. true of the protoplasmic cells forming the walls of the capil- laries. When a highly differentiated tissue is replaced in the body of mammals after breaking down or removal, it is usually by the activity of special cells set apart for that pur- pose, or by repair or outgrowth of the cells affected and not by their division. The red blood corpuscles are constantly being broken down and replaced, but the new ones are not formed by the division of already fully formed corpuscles but by certain special licematoblastic cells retained throughout life in the red marrow of bone and perhaps in the spleen. The nervous tissues are highly differentiated and a nerve is often regenerated after division, but this is by outgrowth of the ends of axis cylinders still attached to their cells and by secondary formation of a medullary sheath around these, and not by division or multiplication of already existing fibres. A striped muscle when cut across is healed by the formation of a band of connective tissue; after a very long time it is said that true muscular fibres may be found in the cicatrix, but their origin is not known; it is probably not from pre- viously developed muscle fibres. On the other hand, the less differentiated unstriated muscle has been observed to be re- paired in some cases after injury by true karyokinetic division of previously formed muscle cells. Although many gland- cells in the performance of their physiological work are par- tially broken down and lost in their secretion, and then repaired by the 'residue of the cell, multiplication by division of fully differentiated gland-cells does not appear to occur, if we except such organs as the testes, the secretion of which consists essentially of cells. An excised portion of a salivary or parotid gland is never regenerated : the wound is repaired by connective tissues. We find, then, as we ascend in the animal scale a diminish- ing reproductive power in the tissues generally: with the increasing division of physiological labor, with the changes that fit pre-eminently for one work, there is a loss of other faculties, and this one among them. The more specialized a tissue the less the reproductive power of its elements, and the most differentiated tissues are either not reproduced at all after injury, or only by the specialization of amoeboid cells, and not by a progenitive activity of survivors of the same kind as those destroyed. In none of the higher animals, therefore, do we find multiplication by simple division, or by budding : no one REPRODUCTION. 647 cell, and no group of cells used for the physiological mainte- nance, of the individual, can build up a new complete living being; but the continuance of the race is specially provided for by setting apart certain cells which shall have this one property — cells whose duty is to the species and not to any one representative of it — an essentially altruistic element in the otherwise egoistic whole. Sexual Reproduction. In some cases, especially among insects, the specialized reproductive cells can develop, each for itself, under suitable conditions, and give rise to new indi- viduals; such a mode of reproduction is called parthenogenesis: but in the majority of cases, and always in the higher animals, this is not so; the fusion of two cells, or of products of two cells, is a necessary preliminary to development. Commonly the coalescing cells differ considerably in size and form, and one takes a more direct share in the developmental processes; this is the egg-cell or ovum; the other is the sperm-cell or spermatozoon. The fusion of the two is known as fertiliza- tion. Animals producing both ova and spermatozoa are hermaphrodite; those bearing ova only, female; and those spermatozoa only, male : hermaphrodiBsm is not found in Vertebrates, except in rare and doubtful cases of monstrosity. Accessory Reproductive Organs. The organ in which ova are produced is known as the ovary, that forming sperma- tozoa, as the testis or testicle; but in different groups of animals many additional accessory parts may be developed. Thus, in all but the very lowest Mammalia, the offspring is nourished for a considerable portion of its early life within the body of its mother, a special cavity, the uterus or womb, being pro- vided for this purpose: the womb communicates with the exterior by a passage, the vagina; and two tubes, the oviducts or Fallopian tubes, convey the eggs to it from the ovaries. In addition, mammary glands provide milk for the nourish- ment of the young in the first months after birth. In the male mammal we find as accessory reproductive organs, vasa defer entia which convey from the testes the seminal fluid con- taining spermatozoa; vesiculce seminales (not present in all Mammalia) , glands whose secretion is mixed with that of the testes or is expelled after it in the sexual act ; a prostate gland, whose secretion is added to the semen; and an erectile organ, the penis, by which the fertilizing liquid is conveyed into the vagina of the female. 648 THE HUMAN BODY. The Male Reproductive Organs. The testes in man are paired tubular glands, which lie in a pouch of skin called the scrotum. This pouch is subdivided internally by a partition into right and left chambers, in each of which a testicle lies. The chambers are lined inside by a serous membrane, the tunica vaginalis, and this doubles back (like the pleura round the lung) and covers the exterior of the gland. Between the external and reflected layers of the tunica vaginalis is a space containing a small quantity of lymph. The testicles develop in the abdominal cavity, and only later (though commonly before birth) descend into the scrotum, passing through apertures in the muscles, etc. , of the abdom- inal wall, and then sliding down over the front of the pubes, beneath the skin. 'The cavity of the tunica vaginalis at first is a mere offshoot of the peritoneal cavity, and its serous mem- brane is originally a part of the peritoneum. In the early years of life the passage along which the testis passes usually becomefe nearly closed up, and the communication between the peri- toneal cavity and that of the tunica vaginalis is also obliterated. Traces of this passage can, however, readily be observed in male infants; if the skin inside the thigh be tickled a muscle lying beneath the skin of the scrotum is made to contract reflexly, and the testis is jerked up some way towards the abdomen and quite out of the scrotum. Sometimes \he passage remains per- manently opeii and a cpil of intestine may descend along it and enter the scrotum, constituting an inguinal hernia or rupture. A hydrocele is an excessive accumulation of liquid in the serous cavity of the tunica vaginalis. Beneath its covering of serous mem- brane each testis has a proper fibrous tunic of its own. This forms a thick mass on the posterior side of the gland, from which partitions or septa (i, Fig. 185) radiate, subdividing the gland into many chambers. In each chamber lie several greatly coiled seminiferous tubules, a, a, averaging in length 0.68 metre (27 inches) and in diameter only 0.14 mm. (T^_ inch) . Their total number in each gh nd is about 800. FIG. 185.— Diagram of a Vertical section through the testis. a, a, tubuli semini- feri; b, vasa recta: d, vasa efferentia endii^g in the coni vasculosi; e, e, epidi- dyiriis. &, vas deferens. EEPROD UCTION. 649 Near the posterior side of the testis the tubules unite to form about 20 vasa recta (#), and these pass out of the gland at its upper end, as the vasa efferentia (d), which become coiled up into conical masses, the coni vasculosi; these, when unrolled, are tubes from 15 to 20 cm. (6-8 inches) in length; they taper somewhat from their commencements at the vasa efferentia, where they are 0.5 mm. (-£$ inch) in diameter, to the other end where they terminate in the epididymis (e, e, Fig. 185). The latter is a narrow mass, slightly longer than the testicle, which lies along the posterior side of that organ, near the lower end of which it passes (g) into the vas defer ens , h. If the epididymis be carefully unravelled it is found to consist of a tube about 6 metres (20 feet) in length, and varying in diam- eter from 0.35 to 0.25 mm. (T^ to -fa inch). The vas deferens (A, Fig. 185) commences at the lower part of the epididymis as a coiled tube, but it soon ceases to be convoluted and passes up beneath the skin covering the inner part of the groin, till it gets above the pelvis and then, passing through the abdominal walls, turns inwards, backwards, and downwards, to the under side of the urinary bladder, where it joins the duct of the seminal vesicle; it is about 0.6 meters (2 feet) in length and 2.5 mm. (fa inch) in diameter. Its lining epithelium is ciliated. The vesiculcB seminales, two in number, are membranous receptacles which lie, one on each side, beneath the bladder, between it and the rectum. They are commonly about 5 cm. (3 inches) long and a little more than a centimetre wide (or about 0.5 inch) at their broadest part. The narrowed end of each enters the vas deferens on its own- side, the tube formed by the union being the ejaculatory duct, which, after a course of about an inch, enters the urethra near the neck of the bladder. In some animals the vesiculce seminales form a liquid Avhieh IP added to the secretion of the testis. In man they appear to be merely reservoirs in which the semen collects. The prostate gland is a dense body, about the size of a large chestnut, which surrounds the commencement of the urethra; the ejaculatory ducts pass through it. It is largely made up of fibrous and unstriped muscular tissues, but con- tains also a number of small secreting saccules whose ducts open into the urethra. The prostatic secretion though small in amount would appear to be of importance: at least the gland remains undeveloped in persons who have been castrated 650 THE HUMAN BODY. in childhood ; and atrophies after removal of the testicles later in life. The male urethra leads from the bladder to the end of the penis, where it terminates in an opening, tlie meatus urinarius. It is described by anatomists as made up of three portions, the prostatic, the membranous, and the spongy. The first is surrounded by the prostate gland and receives the ejaculatory ducts. On its posterior wall, close to the bladder, is an eleva- tion containing erectile tissues (see below) and supposed to be dilated during sexual congress, so as to cut off the passage to the urinary receptacle. On this crest is an opening leading into a small recess, the utricle, which is of interest, since the study of its embryology shows it to be an undeveloped male uterus. The succeeding membranous portion of the urethra is about 1.8 cm. (f inch) long; the spongy portion lies in the penis. The penis is composed mainly of erectile tissue, i.e., tissues so arranged as to inclose cavities which can be distended by blood. Covered outside by the skin, internally it is made up of three elongated cylindrical masses, two of which, the corpora cavernosa, lie on its anterior side; the third, the corpus spongi- osum, surrounds the urethra and lies on the posterior side of the organ for most of its length; it, however, alone forms the terminal dilatation, or glans, of the penis. Each corpus cavernosiun is closely united to its fellow in the middle line and extends from the pubic bones, to which it is attached behind, to the glans penis in front. It is enveloped in a dense connective-tissue capsule from which numerous bars, contain- ing white fibrous, elastic, and unstriped muscular tissues, radiate and intersect in all directions, dividing its interior into many irregular chambers called venous sinuses. Into these blood is conveyed partly through open capillaries, partly directly by the open ends of small arteries ; this blood is car- ried off by veins proceeding from the sinuses. The arteries of the penis are supplied with vaso-dilator nerves, the nervi erigentes, derived from the sacral plexus. Under certain conditions these are stimulated and, the arteries expanding, blood is poured into the venous sinuses faster than the veins drain it off ; the latter are probably also at the same time compressed where they leave the penis by the contraction of certain muscles passing over them. Simul- taneously the involuntary muscular tissue of the bars ran if y- REPRODUCTION. 651 ing through the erectile masses relaxes. As a result the whole organ becomes distended and finally rigid and erect. The co-ordinating centre of erection lies in the lumbar region of the spinal cord, and may be excited reflexly by mechanical stimu- lation of the penis, or under the influence of nervous impulses originating in the brain and associated with sexual emotions. The corpus spongiosum resembles the corpora cavernosa in essential structure and function. The skin of the penis is thin and forms a simple layer for some distance; towards the end of the organ it separates and forms a fold, the foreskin or prepuce, which doubles back, and, becoming soft, moist, red, and very vascular, covers the glands to the meatus urinarius, where it becomes continuous with the mucous membrane of the urethra; in it, near the projecting posterior rim of the glans, are imbedded many sebaceous glands. It possesses nerve end organs (genital corpuscles) which much resemble end bulbs in structure. The Seminal Fluid. The essential elements of the tes- ticular secretion are much modified cells, the spermatozoa, which are passed out with some albuminous liquid. The spermatozoa (Fig. 186) are motile bodies about 0.04 m.m. (-g-J^ inch) in length. They have a flattened clear body or head and a long vibratile tail or cilium ; the portion of the tail nearest to the head is thicker than the rest, and is known as the neck. The mode of development of a spermatozoon shows that the head is a cell-nu- cleus and the neck and tail a modified cell- hnrlv 'n s'tle view, a, DC1y- head; 6, neck; c. On cross-section a seminiferous tubule pre- tail- sents externally a well-marked basement membrane, upon which are borne several layers of cells; the lumen or bore of the tubule is in great part occupied by the tails of sper- matozoa projecting from some of the lining cells. The outer cells, those next the basement membrane, are arranged in a single layer, and are usually found in one or other stage of active karyokinetic division (p. 19). The result of the divi- sion is an outer cell, which remains next the basement mem- brane to repeat the process, and an inner, which is the mother - cell of spermatozoa. The latter cell by repeated mitotic divi- sion give rise to a number of cells lying side by side and each having a relatively large nucleus and small cell-body. These ** 3 -T .< 652 THE HUMAN BODY. cells elongate, the nucleus remaining near the deeper end and the protoplasm extending towards the lumen of the tubule, into which it ultimately projects. Such cells are sperma- toUasts, and lie in bunches side by side and several rows deep. Interlaced among them are other granular supporting cells of the epithelium, which are probably concerned with the nutrition of the essential cells. The final step by which the spermatoblast is converted into a spermatozoon is a kary- okinetic division into two unequal cells: a part of the nu- cleus with a little of the protoplasm separates and appears to have no further function; the remaining part of the nucleus (male pronucleus] remains as the head of the spermatozoon and the cell protoplasm develops into the neck and tail. The spermatozoa appear frequently to be cast off before their development is completed : at least many spermato- blasts which have not gone through the final stages are found in the vasa recta, and even in the vas deferens. Probably the secretion normally collects in the vesiculse seminales, and there undergoes its final elaboration. The Reproductive Organs of the Female. Each ovary (0, Fig. 187) is a dense oval mass about 3.25 cm. (1.5 inches) in length, 2 cm. (0.75 inch) in width, and 1.27 cm. (0.5 inch) in thickness; it weighs from 4 to 7 grams (60-100 grains). The organs lie in the pelvic cavity enveloped in a fold of peritoneum (the broad ligament), and receive blood-vessels and nerves along one border. From time to time ova reach the surface, burst through the enveloping peritoneum, and are received by the wide fringed aperture, j#, of the oviduct or Fallopian tube, od. This tube narrows towards its inner end, where it communicates with the uterus, and is lined by a mucous membrane, covered by ciliated epithelium; plain muscular tissue is also developed in its wall. The uterus (u, c, Fig. 187) is a hollow organ, with relatively thick mus- cular walls (left unshaded in the figure); it contains the foetus during pregnancy and expels it at birth; it lies in the pelvis between the Trrhrary bladder and~fhe"rectum (Fig. 188); the Fallopian tubes open into its anterior corners. It is free above, but its lower end is attached to and projects into the vagina. In the fully developed virgin state the organ rs somewhat pear-shaped, but flattened from before back; about 7.5 cm. (3 inches) in length, 5 cm. (2 inches) in breadth at its upper widest part, and 2.5 cm. (1 inch) in thickness; it REPRODUCTION. 655 The vulva is a general term for all the portions of the female generative organs visible from the exterior. Over the front of the pelvis the skin is elevated by adipose tissue beneath it, and forms the mom Veneris. From this two folds of skin (I, Fig. 188), the labia major a, extend downwards and backwards on each side of a median cleft, beyond which they again unite. On separating the labia majora a shallow genito-urinary sinus, into which the urethra and vagina open, is exposed. * At the upper portion of this sinus lies the clitoris, a small and very sensitive erectile organ, resembling a miniature penis in struc- ture, except that it has no corpus spongiosum and is not traversed by the urethra. From the clitoris descend two folds of mucous membrane, the nymphce or labia internet, between which is the vestibule, a recess containing, above, the opening of the short female urethra, and, below, the aperture of the vagina, which is in the virgin more or less closed by a thin duplicature of mucous membrane, the hymen. FIG. 189.— k section of a Mammalian ovary, considerably magnified. 1, outer capsule of ovarv 2 3 3', atroma; 4, blood-vessels; 5, rudimentary Graaflan fol- licles: 678 follicles bejdnninff to Pnlargp and mature, and receding: from the sur- face; 9 a nearly ripe follicle which is extending towards the surface preparatory to discharging the ovum; «, membrana granules*: b. discus proifgernfl: c, ovum, with d. ^prminal vesicle, and e. eprminal snot. The general cavity of thf follicle (in which 9 is printed) is filled with lymph-like, transudation liquid during life. Microscopic Structure of the Ovary. The main mass of the .ovary consists of a dense connective-tissue stroma, con- ta'ninof unstriped muscle, blood-vessels, and nerves; it is covered externally by a peculiar germinal epithelium, and con- tains imbedded in it many minute cavities, the Graafian folH- r7/x, in which omlie. If a thin section of an ovary be examined the microscope many hundreds of small Graafian follicles, 656 THE HUMAN BODY. each about 0.25 mm. (TJ¥ incli) in diameter, will be found imbedded in it near the surface. These are lin^d by cells, and each contains a single ovum. In a woman Sf child-bearing age there will be found also, deeper in, larger follicles (7, 8, 9, Fig. 189), their cavities being distended, during life, by liquid ; in these the essential structure may be more readily made out. Each has an external fibrous coat constituted by a dense and vascular layer of the ovarian stroma; within this •come several layers of lining cells (9, &, Fig. 189) constituting the membrana granulosa. At one point, #, the cells of this layer are heaped up, forming the discus proligerus, which projects into the liquid filling the cavity of the follicle. Buried .among the cells of the discus proligerus the ovum, c, lies. The Mammalian Ovum. As the Graafian follicles enlarge the ova grow but not proportionately, so that they occupy relatively less of the cavities of the larger follicles: the cells of the discus proligerus probably elaborate food for the egg cell from material derived from the blood-vessels which form a •close network around most of each enlarging Graafian follicle and transude crude nutritive matter into the liquid filling most of the follicle. The fully formed ovum (Fig. 19Q) is about 0.2 mm. (yi-o inch) in diameter: it has a well- marked outer coat or sac, a, the zona radiata, zona pellucida or vitelline membrane, surrounding a very granu- lar cell-body or viteiius, b, in which is a conspicuous nucleus, c, here named the germinal vesicle and possessing FIG. 190.— A human ovum; a nucleolus or germinal spot. The •somewhat diagrammatic, a, ..... zona peiiucida; b, viteiius; c, zona pellucida exhibits distinct radial germinal vesicle, with distinct . reticuium of karyopiasm and markings which probably are due to flue tubes traversing it. The main bulk of the viteiius or yelk consists of highly refracting spheroidal particles of nutritive matter (deutoplasm) imbedded in and concealing a true protoplasmic reticuium. In the eggs of birds and reptiles the deutoplasm is in very large amount and forms nearly all of the yelk, the protoplasm being for the most part aggregated around the germinal vesicle at a small area on one side of the yelk. It is in this area that new cell-formation occurs and the embryo is built up, the rest of the yelk being gradually absorbed by it: such eggs are known as mesoblastic REPROD UCTION. 657 or partly-dividing eggs. In all the higher mammalia the dentoplasm is relatively sparse and tolerably evenly mingled with the protoplasm, and the whole fertilized ovum divides to form the first cells of the embryo: such eggs are named holoblastic. The Maturation of the Ovum. From time to time, usually at intervals of about four weeks, in a woman of child- bearing age, certain ova after attaining the size and struc- ture described in the preceding paragraph undergo further changes by which the egg-cell is rendered capable of fertiliza tion. These phenomena, known as the maturation of the ovum, result in separation of small parts of the nucleus or germinal vesicle and cell protoplasm from the rest. They are essentially typical cases of indirect cell division (p. 19). The cell-body shrinks a little so as to not quite fill the zona pellu- cida, and the germinal vesicle approaches one side. Meanwhile the nuclear membrane and karyoplasm form the chromatic loop and this divides into the usual two sets of Vs. One set of these, with part of the nuclear plasm, now separates with a little of the cell protoplasm to form a small cell, the first polar globule or directive corpuscle (c, Fig 191). The much larger cell result ing from the division and represent- ing the remainder of the vitellus and nucleus now repeats the process, and gives rise to the second polar globule. In Fig. 191 the first polar globule is shown at c. as already * FIG. 191. -An ovum about to Separated, and the nucleus, d. IS form the second polai globule. , . . ,. a, zona pellucida ; b. space filled dividing, preparatory to the iorma- with liquid and left by the shrfok- , • » ,i -i" -i • , • age of the vitellus: c, first polar tlOIl OI the Second directive COr- globule; d, nucleus of ovum divid- puscle. The stage of karyokmesis is more advanced than those repre- sented m Fig. 10. The two polar of the nuclear spindle, globules lie for a time (Fig. 192) within the zona pellucida in the space left by the shrinkage of the vitellus, but take no part in the formation of the embryo and soon disappear. The rest of the original ovum is now mature and ready for fertili- zation; its nucleus is known as the female pronucleus, fn, Fig. 192. It passes towards the centre of the ovum and forms 658 THE HUMAN BODY. the usual recticulum of karyoplasm found in normal resting nuclei (Fig. 8). Ovulation. From puberty, during the whole child-bearing period of life, certain comparatively very large Graafian follicles may nearly always be found either close to the surface of the ovary or projecting on its exterior. These, by accumulation of liquid within them, have become distended to a diameter of about 4 mm. (-J- inch) ; finally, the thinned projecting por- tion of the wall of the follicle, which differs from the rest in containing few blood-vessels, gives way and the ovum is dis- charged, surrounded by some cells of the discus proligerus. The emptied follicle becomes filled up with a reddish-yellow mass of cells, and constitutes the corpus luteum, which recedes again to the interior of the ovary and disappears in three or four weeks, unless pregnancy occur; in that case the corpus luteum increases for a time, and persists during the greater part of the gestation period. Menstruation. Ovulation occurs during the sexual life of a healthy woman at intervals of about four weeks, and is attended with important changes in other portions of the gen- erative apparatus. The ovaries and Fallopian tubes become congested, and the fimbrias of the latter are erected and come into contact with the ovary so as to receive any ova discharged. Whether the fimbrise embrace the ovary and catch the ovum, or merely touch it at various points and the ova are swept along them by their cilia to the cavity to the oviduct, is not certain. Having entered the Fallopian tube the egg slowly passes on to the uterus, probably moved by the cilia lining the oviduct ; its descent probably takes about four or five days; if not fertil- ized, it dies and is passed out. In the womb important changes occur at or just before the periods of ovulation; its mucous membrane becomes swollen and soft, and minute hemorrhages occur in its substance. The superficial layers of the uterine mucous membrane are broken down, and discharged along with more or less blood, constituting; the menses, or monthly sick- ness, which commonly lasts from three to five days. During this time the vaginal secretion is also increased, and, mixed with the blood discharged, more or less alters its color and usually destroys its coagulating power. Except during pregnancy and while suckling, menstruation occurs at the above intervals, from puberty up to about the forty-fifth year; the periods then become irregular, and finally the discharges cease ; this REPRODUCTION. 659 is an indication that ovulatioii has come to an end, and that the sexual life of the woman is completed. This time, the climacteric or ' ' turn of life, " is a critical one ; various local disorders are apt to supervene, and even mental derangement. Hygiene of Menstruation. During menstruation there is apt to be more or less general discomfort and nervous irrita- bility; the woman is not quite herself, and those responsible for her happiness ought to watch and tend her with special solicitude, forbearance, and tenderness, and protect her from anxiety and agitation. Any strong emotion, especially of a disagreeable character, is apt to check the flow, and this is always liable to be followed by serious consequences. A sudden chill often has the same eff ect ; hence a menstruating woman ought always to be warmly clad, and take more than usual care to avoid draughts or getting wet. At these periods, also, the uterus is enlarged and heavy, and being (as may be seen in Fig. 188) but slightly supported, and that near its lower end, it is especially apt to be displaced or distorted; it may tilt forwards or sideways (versions of the uterus], or be bent where the neck and body of the organ meet (flexion). Hence violent exercise at this time should be avoided, though there is no reason why a properly clad woman should not take her usual daily walk. The absence of the menstrual flow (amenorrhcea) is normal during pregnancy and while suckling; and in some rare cases it never occurs throughout life, even in healthy women capa- ble of child-bearing. Usually, however, the non-appearance of the menses at the proper periods is a serious symptom, and one which calls for prompt measures. In all such cases it cannot be too strongly impressed upon women that the most dangerous thing to do is to take drugs tending to induce the discharge, except under skilled advice; to excite the flow, in many cases, as for example occlusion of the os uteri, or in general debility (when its absence is a conservative effort of the system), may have the most disastrous results. Fertilization. As the ovum descends the Fallopian tube the changes of menstruation are taking place in the uterus. Fertilization usually takes place in a Fallopian tube. The spermatozoa are carried along partly, perhaps, by the contrac- tions cf the muscular walls of the female cavities, but mainly by thei~ own activity. Occasionally the ovum is fertilized 660 THE HUMAN BODY. before reaching the Fallopian tube and fails to enter it, giving rise to an extra-uterine pregnancy. The actual process of the fertilization of the ovum has only been observed in the lower animals, but there is no doubt that the phenomena are the same in all essentials in all cases. Some of the spermatozoa penetrate the zona pellucida and the head of one of them enters the ovum, when it grows and forms the male pronucleus (mn, Fig. 192). This travels towards the nucleus of the matured ovum or female pronucleus, fn, and in each pro- nucleus a karyoplastic filament forms and breaks up into a set of V's; in the pronuclei repre- sented in Fig. 192 this has not yet taken place, the karyoplasm being still arranged in a retic- ulum. The tail of the sperma- tozoon (which represents, it will i^ rmnmce of, on circulation and on /flow of lymph, 394. /Respiratory sounds, 391. jr Reticular membrane, 563. Reticulum of cells, 19. Retiform (adenoid) connective tis- sue, 103. Retina, 511, 514. Rhythmic movements, 417. Ribs, 72. Rib cartilage, 72. Rice, 323. Right lymphatic duct, 350. Rigor mortis, 123, 457. Rods and cones, 513, 532. Rolando, fissure of, 623. Round foramen, 558. Running, 152. Sacculus, 561. Sacral plexus, 166. Sacral vertebrae, 69. Sacrum, 69. Saliva, uses of, 361. Salivary glands, 363. Salivary glands, nerves of, 293. Salivin (ptyalin), 362.- Santorini, cartilages of, 635. Sarcolactic acid, 13, 123. Sarcolemma, 118. Sarcoinere, 119. Sarcoplasm, 120. Sarcous element, 120. Sarcosome, 120. Sarcostyle, 119. Scalae of cochlea, 561. Scalene muscles, 388. Scapula, 77. Sciatic nerve, 166. Sclerotic, 509. Sebaceous glands, 446. Secondary (acquired) reflexes, 613. Secretion, 282. Secretion, cutaneous, 447. Secretion, renal, 432. Secretory nerves, 292. Secretory tissues, 32, 283. Sections of Body, 6. Segmentation of ovum, 29.. * Segmentation-of skeleton, 67. Semicircular canals, 560, 563, 574, 615. Semilunar valves, 217. Sensation, 488; color, 541; com- mon, 490, 585; intensity of, 499; of equilibrium, 614; of hunger, 587; special, 490; of thirst, 587; pain, 585; peripheral reference of, 491, 501; qualities of, 491. Sense-organs, 493. Sense, muscular, 591; of hearing, 557; of pain, 585; of sight, 530; of smell, 587; of taste, 589; of temperature, 582; of touch, 576. Sensory illusions, 502. Serous or lymph canaliculi, 103, 351. Serous cavities, 351. Serous membranes, 5. Serum, 51, 59. Serum albumin, 9, 59. Shin-bone, 79. Shine, 555. Shingles, 192. Short sight, 525. Shoulder-blade, 77. Shoulder-girdle, 77. Sighing, 425. Sight, sense of, 530. Sight, hygiene of, 525. Sigmoid flexure, 342. Single vision, 553. Size, perception of, 553. INDEX. 683 Skeleton, 63 ; appendicular, 77 ; axial, 64, 67 ; of face, 75 ; of skull. 72; peculiarities of human, 83; of thorax, 386. Skin, 5, 441; glands of, 446; hy- giene of, 448; nerve endings iu, 576 Skull, 72. Small intestine, 339. Smell, 587. Sneezing, 426. Solar plexus, 176. Solar spectrum, 519. Solidity, visual perception of, 554. Soluble ferments, 11. Sounds, 564. Sounds of the heart, 230. Sounds, respiratory, 391. Source of animal heat, 479. Source of fats, 472. Source of glycogen, 468. Source of muscular work, 454. Source of urea, 460. Sources of energy to Body, 304. Special senses, 490. Specific elements, 283. Specific nerve energies, 197. Spectacles, 526. Speech, 633. Spermatozoa, 651. Sphenoid bone, 75. Spherical aberration, 527. Spinal column, 71. Spinal cord, 161, 594 ; conduction in, 594 ; functions of, 187, 594, 600 ; histology of, 181 ; mem- branes of, 160; psychical activi- ties of, 607. Spinal access9ry nerve, 174. Spinal marrow, see Spinal cord. Spinal nerves. 163. Spinal nerve-roots, 163, 206. Spleen, 356. Spongioplasm, 19. Spontaneity, "25. Sporadic ganglia, 176. Sprains, 97. Squinting, 509. Stages of life, 670. Stapedius muscle, 559. Stapes, 558. Starch, 323; digestion of , 362, 367. Starvation, proteid, 463. Stationary air, 392. Stearin, 12. Stereoscopic vision, 555. Sternum, 73. Stimuli, muscular, 128 ; nervous, 194. Stimulus, 24. Stirrup-bone, 558. Stomach, 122, 336. Stomata, lymphatic, 351. Storage tissues, 33, 464. Strabismus (squinting), 509. Structure of bone, 85. Strychnine poisoning, 602. Subclavian artery, 219. Subcutaneous areolar tissue, 442. Sublingual gland, 336. Submaxillary gland, 293, 334. Succus entericus, 371. Sudoriparous glands, 446. Superior laryngeal nerve, 420. Superior maxillary nerve, 174. Superior mesenteric artery, 220. Supination, 96. Supplemental air, 392. Supporting tissues, 32, 105. Supra-renal capsules, 359. Sutures, 92. Swallowing, 363. Sweat, 446. Sweat-glands, 446. Sweat-glands, nerves of, 292. Sweetbread, 290, 346, 358. Sympathetic nervous system, A5, 160, 175. Sympathetic resonance, 569. Sympathetic resonance in ear, 573. Synovial membranes, '93. Syntonin, 125. System, alimentary, 328 ; circula- tory, 211; muscular, 116, 127; nervous, 158, 186 ; osseous, 63 ; respiratory, 380 ; renal, 427. Systemic circulation, 223. Systems, anatomical, 39. Tactile organs, 576. Taking cold, 278. Tarsus, 79. Taste, 589. Taste-buds. 589. Taurocholic acid, 12. Tear-glands, 507. Tectorial membrane, 563. Teeth, 329. Teeth, structure of, 331. Tegmentum, 616 Temperature of Body, 478. Temperature, bodily, regulation of, 482. Temperature, influence of, on pulse rate, 271. Temperature sense, 582. Temperatures, local, 484. Temporal artery, 219. 684 INDEX. Temporal bone, 75. Tendons, 113. Tension of blood gases, 407. Tensor tyinpani muscle, 559. Testis, 648. Tests for proteids, 10. Tetanus, 133, 140. Thalarnencephalon, 171, 618. Theory, resistance, 419. Theory of color vision, 542, 548. Thermogenic nerves, 484. Thigh-bone, 78. Thirst, 587. Thoracic duct, 350. Thoracic vertebrae, 66. Thorax, aspiration of, 251, 393 ; contents of, 5.; movements of, in respiration, 385 ; skeleton of, 387. Throat, 335. Thyroid body, 357. Thyroid cartilage, 634. Thyroid foramen, 78. Thymus, 358. Tibia, 79. Timbre, 564. Tissues, 1 ; adenoid, 103; adipose; 107 ; areolar, 100 ; assimilative, 32; automatic, 34; bony, 87; car- tilaginous, 100; classification of, 31; conductive, 35; connective, 63, 100; contractile, 35, 117; co- ordinating, 34, 594; elastic, 102; eliminative, 32; excretory, 32; ir- ritable, 33; jelly-like connective, 103, lymphoid; 49; metabolic, 33, 288 ; motor, 35, 121 ; muscular, 35, 127; nervous^ 176; nutritive, 32 ; plain '"muscular, 123, 142 ; protective, 36; receptive, 32; re- productive, 36; respiratory, 33; retiform or adenoid, 103 ; socre- tory, 32, 283 ; storage, 33, 464 ; supporting, 32; undifferentiated, 32 ; white fibrous, 100. Tissue-forming foods, 314, 452. Tone, sensations of, 564, 568. Tone color (timbre), 564. Tongue, 332. Tonsil, 335. Touch-organs, 576. Touch, sensations of, 578. Trachea, 382. Tracts of degeneration in spinal cord, 596. Training, 157. Transudata, 283. Trigeminal nerve, 173. Trophic nerves, 192, 295. Trypsin, 289, 369. Tunica adventitia, 225. Turbinate bones, 76. Tympanic bones, 557, 571. Tympanic membrane, 557, 571. Tyrein, 10. Tyrosin, 368, 462. Ulna, 77. Ulnar artery, 219. Undifferentiated tissues, 32. Upper maxilla, 75. Urea, 11, 434, 460. Ureter, 427. Uric acid, 11, 434. Urinary organs, 427. Urine, 432. Uterus, 652. Utilization of energy in Body, 310. Utriculus, 561. Uvula, 329. Vagus nerve, Valve, ileoco Valves, auriculo-ventricular, 217 ; of veins, 226; semilunar, 217. Valvulae conniventes, 339. Vaso- constrictor centre, 276. Vaso-dilator centre, 280. Vaso-dilator nerves, 273, 279, 293. Vaso-motor nerves, 273, 280. Vegetable foods, 322. Veins, 220, 226; cephalic, 222; coronary, 215; hepatic, 345; in- nominate, 223; jugular, 223; long saphenous, 222; portal, 224, 345; pulmonary, 216. Velum interposituin, 169. Vena cava, 215. ""- Venous blood, 225. Ventilation, 401. Ventral cavity, 3, 6, Ventricles of brain, 168; of larynx. 635. Vermicular (peristaltic) move- ments, 365, 378. Vermiform appendix, 342. Vertebra?, 64; cervical, 68; coccy- geal, 70; dorsal or thoracic, 66; lumbar, 69; sacral, 69. Vertebral artery, 219. Vertebral column, 3, 64, 71. Vertebral foramen, 68. Vertebrata, 3. Vestibule, 560, 561, 574. Vibrations, analysis of, 568; com- position of, 567; pendular, 565; sonorous, 564. Villi of intestine, 341. INDEX. 685 Vision, color, 541. Vision, purple, 511, 535. Vision, stereoscopic, 555, Visual axis, 541. Visual contrasts, 547. Visual perceptions, 551. Visual sensations, 530, 536; dura- tion of, 539; intensity of, 536. Vital capacity, 392. Vitreous humor, 516. Vocal chords, 635. Vocal chords, false, 635. Voice, 633. Voluntary movements, 622. Vorner, 75. Vowels, 640. Walking, 151. Wallerian method, 210, 596. Wandering cells, 103. Warm-blooded animals, 477. Water, constituent, 27. Water, percentage of, in body, 13. Weber's law, 499. Weber's schema, 240. Weissman's theory of heredity, 661. Wheat, 323. Whipped blood, 52. Whispering, 643. White blood-corpuscles. 17, 47, 60. White fibrous tissue, 101. Windpipe, 382. Work, muscular, 135. Wrisberg, cartilage of, 635. Wrist, 77. Xantho-proteic test, 9. Yawning, 425. Yellow spot, 511 Young's theory of color vision, 542. Zoological position of man, 2. THIS BOOK IS DUE ON THE LAST DATE STAMPED BELOW AN INITIAL FINE OF 25 CENTS WILL BE ASSESSED FOR FAILURE TO RETURN THIS BOOK ON THE DATE DUE. THE PENALTY WILL INCREASE TO 5O CENTS ON THE FOURTH DAY AND TO $1.OO ON THE SEVENTH DAY OVERDUE. DEC 16 1937 B 1938 06 I I «* N13 UNIVERSITY OF CALIFORNIA LIBRARY