THAT structure by which
the blood or nourishing
fluid of the body is,
from time to time,
brought into such prox-
imity to the air as to
have its vital properties
renewed, constitutes a
respiratory apparatus.
There is an infinite va-
riety of form observed
in the organs of respira-
tion in different classes
of animals. In one class
the respiration is effec-
ted by the direct con-
tact of the atmosphere
itself, whilst in others it
is effected by means of
water holding air mecha-
nically suspended in it.
In some of the very
lowest forms of animal
life, respiration seems to
be carried on by the
whole surface of the
body; in insects the air
is admitted by holes in
the sides of the animal, communicating with tubes which ramify
through its whole body; in fishes, the breathing is accomplished
by the well-known organs called gills, in which the blood circu-
lates freely, and is exposed to the air which is held suspended
in the water in which the animal swims. In their highest and
most perfect condition, as in man and quadrupeds, the respira-
tory organs assume the form of lungs; that is, the light spongy
bodies made up of an immense series of tubes and cells, into
which the air enters freely that we minutely described in our
last number.

FIGURE 5.-THE NATURAL FORMATION OF THE
FEMALE CHEST.

Supposing our readers to be acquainted with the construction of the organs of respiration, we proceed to give a short account of the fluid inspired, the results it effects whilst permeating through the lungs, its character when expired, and the physiology of the respiratory function.

The atmosphere in which we live, chemically considered, consists essentially of two gases, 'oxygen and nitrogen, or as it was formerly called, azote; the proportions being, in a hundred

FIGURE 6.-THE CHEST DISTORTED BY MODERN ART.

PRICE ONE PENNY.

parts, about twenty of the former, and eighty of the latter. The nature of these gases we need not further comment upon in relation to our present subject, than to state that oxygen alone is capable of effecting that alteration in the blood which constitutes its change from the venous to the arterial condition. Air, therefore, to be respirable,- that is, to be

able to carry on correctly and easily the function of respiration, -must contain a certain proportion of oxygen. Hence an animal cannot live in an atmosphere of nitrogen,hot because the nitrogen is poisonous or exerts any deleterious influence on the body,

but simply because it is incapable of producing, when introduced into the lungs, the necessary alteration of venous to arterial blood. We would explain our opinion of nitrogen in a few words :-it is only hurtful because it excludes that which is beneficial. The atmosphere likewise contains a small proportion of another gas, carbonic acid gas, which, however, is regarded as rather an admixture than an essential component of the atmosphere, being present only in the proportion of about one part in a hundred of air. This gas, however, plays a very important office in the function of respiration; for, as we shall find immediately, it is uniformly produced by the act of breathing. It may be noticed that, chemically, this gas differs from oxygen and nitrogen-which are simple or ultimate elements-in being a compound gas, made up of carbon and oxygen. It, moreover, differs from other gases in its action on animals; for whilst oxygen supports life by maintaining respiration, and nitrogen proves fatal only by excluding oxygen, carbonic acid, on the contrary, when breathed, is a positive poison, proving fatal by

F

a narcotic action; that is, producing the same degree of insensibility that opium does. It is this gas that is vaguely known by miners and others as the "choke-damp."

Having thus stated the nature and composition of the air which we breathe, let us now briefly observe the changes produced on the air by the act of respiration. If we confine an animal in a limited bulk of air, it goes on breathing naturally for a while, but very soon respiration becomes oppressed, then is arrested altogether, and the animal dies. If we now analyse this air, we find that the oxygen has nearly or entirely disappeared; that the nitrogen remains almost unaltered in quantity; that a considerable portion of watery vapour has been exhaled; and lastly, above all, that the place of the oxygen is supplied by nearly an equal bulk of carbonic acid. It is very easy to show, by a simple experiment, that carbonic acid is given off during the act of breathing; thus, if we place a little clear lime-water in a glass, and propel the breath through it by means of a small glass tube, it will become turbid and present the appearance of milk and water, in consequence of the formation of the carbonate of lime, which is an insoluble compound of lime and carbonic acid.

The decision of the point as to whether the quantity of oxygen consumed, and the amount of carbonic acid expelled during respiration are the same, is of very great importance in determining the manner in which this carbonic acid is formed. The quantity of oxygen consumed by an adult, according to Lavoisier and the late Sir H. Davy, is thirty-two cubic inches in a minute, which gives for twenty-four hours 46,037 inches; and, according to Thompson, the quantity of carbonic acid that passes out of the lungs in the same time is about 40,000 cubic inches,-probably it is a little less; and this quantity of carbonic acid represents twelve ounces of solid carbon.

Briefly, we may state that in the respiration of atmospheric air the oxygen disappears, is absorbed, and conveyed into the circulation; and that it is replaced by exhaled carbonic acid, which proceeds, wholly or in part, from that which is contained in the mass of the blood. In fact, we inhale oxygen-we give out carbon.

To confine, however, the office of the lungs to the mere removal of redundant carbon from venous blood, is to take a limited view of its operation, and to underrate the utility and necessity of the complex and astonishing mechanism by which so simple an object could be accomplished. To the process of respiration the construction of the chief parts of the animal system are subservient. If we are inattentive to our respiration, we find the degree of alteration that the air undergoes in our lungs, by a feeling which inclines us to renew it; if the breathing is suspended for many seconds, there is anxiety and fear, and, as it were, an instinctive warning of the importance of respiration. If respiration be suspended, so is life.

We know the important and extensive agency of oxygen in creation can we doubt in the laboratory of the body, where chemical changes are incessantly taking place, that oxygen is less constantly in demand? And is it not probable that the medium of supply of oxygen to all these parts is that obvious one which, in order to receive the supply, presents the blood, in a thousand currents, to the oxygen contained in the air we breathe, and that its absorption is promoted by the two most efficacious means-motion, and an extensive surface?

tion.

The function of respiration consists of inspiration and expira

During inspiration, or the act of" drawing in the breath," the intercostal muscles (A, fig. 3) raise and draw out the ribs, and the diaphragm (B, fig. 3) descends; at the same time the muscles of the abdomen are protruded forwards, and the viscera

contained in its cavity are pushed downwards. The result of these movements is, that the cavity of the chest is enlarged in every direction, so as to permit the perfect distension of the lungs.

Expiration is the respiratory motion which alternates with that of inspiration; the capacity of the chest is now diminished by converse motions of the same organs,—that is, by the descent of the ribs and the ascent of the diaphragm. The substance of the lungs, from its elasticity, recovers its former dimensions, and expels the additional volume of air just admitted; and the respiratory muscles follow the shrinking substance of the lungs, offering from their relaxation no resistance to the atmosphere pressing on the surface of the chest or abdomen.

Thus respiration is produced; thus, from the hour of our birth to the latest moment of our existence, the lungs are continually expanding to admit the atmospheric air, or contracting to expel it. This alternation in an adult perfectly at rest occurs about twenty times in a minute, or about one inspiration to every three beats of the pulse, which gives a total of 28,800 inspirations in twenty-four hours.

The mean quantity of air that enters the lungs at each inspiration is forty cubic inches, and the ordinary quantity of air contained in the lungs is 280. Thus, supposing twenty inspirations in a minute, the quantity of air that would enter and pass out in this time would be 800 inches, which make 48,000 in the hour, and in twenty-four hours is 1,152,000 cubic inches. Now it must be evident that, unless a due amount of atmospheric air be admitted into the chest, the working of our machinery must be imperfect; if it requires a chest of the capacity of the healthy girl our artist has depicted on the other side, to contain the lungs when inflated with 280 cubic inches of atmospheric air, how is it possible that health can be maintained when the thorax is narrowed to the limit of her emaciated, sickly companion, whose chest-cabined, cribbed, and confined by stays -cannot admit the half of this amount of air to be received into the lungs?

We would appeal to the good sense and best feelings of woman, and ask her why she attempts to alter or to mend the work of our great Creator. He has made the human frame so perfect, with such complete unity of design, and such adaptation of means to an end, that it is wonderful that in ignorance, or led by perverted notions, we should dare any vain attempts to improve it. Women should know that a contracted waist is as opposed to beauty of form as is the spider or wasp, which it resembles; let them observe the paintings and sculptures of antiquity-let them see the beauty of form and harmony of symmetrical proportion displayed in the females of Turkey, of Georgia, of Otaheite, and other countries where Nature is left to her own unrestrained luxuriance, and then let them cast aside "a pair of stays." This salutary change may be effected as easily as the banishment of "bishops' sleeves" and the introduction of "polka caps."

The diseases induced by this unnatural diminution of the space allotted to the most vital organs of the body are not confined merely to the chest; every other part and organ is also affected, and we have no hesitation in saying that one half of the uterine diseases now so rife, many cases of abortion, piles, and general nervous debility, have their origin in the improper use of stays.

Let us draw a contrast between the rustic female who is guiltless of all knowledge of whalebone, and the belle who is the victim of modern fashion. The former is sprightly, active, and vivacious; her countenance lively, animated, and expressive of good health; her mind buoyant amidst all the troubles and vexations necessarily attendant upon the duties of a mother and a

housewife; she enjoys the blessings of health and the society of her friends; she possesses a calm, serene mind, and is capable of meeting any reverse of fortune with fortitude; she is blessed with healthy offspring, and generally lives to see them grow up and acting for themselves. But the votary of modern fashion, how reversed her condition in after-life! Her corporeal powers at an early period begin to evince decay; her intellectual faculties to manifest imbecility; her mind becomes irascible, and her temper fretful and peevish; she is hysterical and a confirmed dyspeptic. Such women are generally sterile, or at most conceive but a few times. The functions of the uterine organs finally become entirely or so nearly suspended as to render all possibility of future offspring extremely doubtful.

In our next we shall describe and illustrate (two engravings) the anatomy of the heart and the physiology of the circulation

of the blood.

FEVER S.

BY THE EDITOR.
No. III.

LOW NERVOUS FEVER-TYPHUS MITIOR. SYSTEMATIC writers describe mild typhus, or low nervous fever, as being a contagious fever, accompanied by extreme prostration of strength, great disturbance of the mental functions, and inducing diminished sensibility to external impressions and internal

sensations.

Before we proceed further, we beg to express our views as to the contagious character of this type of fever, which are,-that it is only contagious under circumstances favourable to the encroachment of disease. If a person be in excellent health and in good spirits—if he use every means in his power to preserve this condition-he may be exposed to the contact and the emanations from a fever patient, and escape sickness. If, on the other hand, his mind become depressed-if he is fearful, if his body become debilitated in any way, the contagion (if it be contagious) will take effect, and he will become a victim to the complaint.

THE CAUSES.-Low nervous fever more commonly attacks persons of a weak and delicate habit of body, and such as are of extreme sensibility and irritability of constitution. In localities occupied by the ill-fed, the badly clothed, and the intemperate, it is seldom altogether absent; and, when neglected, and as too frequently happens, aggravated by the increase of misery which always attends disease, it speedily runs into putrid fever.

The chief predisposing causes include whatever will diminish the natural strength of the body,-as, poor living, absence of cleanliness, over-crowding and breathing an impure atmosphere, over-exertion of the mind or body, anxiety and all the depressing passions, sedentary habits, profuse evacuations (hence it frequently succeeds exhausting bowel complaints), cold and wet seasons, also all habits of excess or irregularity, especially intemperance. When an individual is liable to these conditions, then will he be prone to receive the disease by contagion; or exposure to cold and wet, or some irregularity in diet, or intemperance in drink, may throw him on a sick-bed.

THE SYMPTOMS are at first slight, and present no feature to alarm the patient or his friends-in fact, they come on so gradually, that they do not greatly differ from a mild and comparatively insignificant fever of any kind operating upon a nervous temperament. He will complain of great languor and lassitude, accompanied by alternate chilliness and heat of the body and flushing of the face; pain in the head, back, and limbs; the tongue will exhibit but little change, the pulse will be somewhat smaller than usual, and only slightly quickened. But as the dis

ease advances, all the symptoms of sensorial debility are more decided and severe. The pain in the head increases to a violent headache, with giddiness, dulness, and confusion of thought; there is great anxiety and depression of the spirits; the stomach loathes sustenance, and every thing nauseates; the respiration is short and laborious; the pulse is frequent, weak, and intermittent. At first the tongue is moist, and covered with a whitish mucus, but soon becomes dry, brown, and tremulous; there is little thirst; the urine is pale and watery; and low, muttering delirium sets in; from which, however, the patient is easily roused, so as to answer questions.

66

About the third or fourth day the heat of the body often becomes very great, rising several degrees above the healthy standard, and the skin gives a peculiar burning pungent sensation to the hand. In some cases it will be covered with a profuse, clammy, debilitating perspiration, often very offensive to the smell, and sometimes, according to Stoll, as sour as the sharpest vinegar." The tongue is dry and brown, or morbidly red; the patient is very drowsy, but his sleep is disturbed by frightful dreams; he is less easily roused, and his answers are given more slowly. The suffused redness of the eyes, and the flushed countenance so void of expression, give a peculiar aspect to the patient which is highly characteristic of the disease.

On the ninth or tenth day the weakness greatly increases; all the limbs tremble, and the tremors soon become convulsive; the patient will make frequent attempts to get out of bed; he will be restless and desponding; and anxious wakefulness will supersede the previous drowsy state. The delirium is now constant towards night, but is of a mild or quiet character, rarely amounting to frensy. The disease often runs on to the twenty-first day, and occasionally to a much longer period. In its progress the pulse becomes intermittent or irregular; the urine is scanty, high-coloured, and of an offensive smell; the bowels are relaxed, and the skin sometimes bathed in a profuse perspiration.

Low nervous fever is seldom marked by that sudden change which can be called a crisis, but gradually becomes more aggravated in its symptoms, until it reaches a fatal termination, or slowly advances to convalescence. The favourable symptoms that announce the latter happy result generally commence by a refreshing natural sleep, succeeded by composure of mind; more steadiness and firmness in the pulse; a moisture breaking out upon the skin; the countenance more hopeful, the tongue florid at the edges; the appearance of scabby eruptions about the mouth; and a returning desire for food, often, indeed, capricious, but without nausea or sickness.

The unfavourable symptoms tell their own tale: they are, extreme debility; continued insensibility, or confusion of intellect; low, muttering delirium; convulsions, and tremulous motion of the tongue and lips; difficulty in swallowing; the patient lying prostrate on his back, and insensibly gliding down to the bottom of the bed; involuntary evacuations; hiccup; small, rapid, and intermittent pulse; the countenance expressing the most acute anguish, and the hands constantly picking the bedclothes, or catching at imaginary objects in the air. These signs denote a fearful climax, but still do not absolutely preclude all hope: the patient may yet recover, but his friends should know and be prepared for the worst result.

THE TREATMENT.-Cleanliness of the body, cleanliness of the sick chamber, thorough ventilation, and the immediate removal of all offensive materials and foul linen, are of the first importance. Without these essential means be insured, all treatment will be of little avail,-the disease will go on, will increase in virulence, and spread infection to all around. The condition of an apartment occupied by a fever patient merits the best atten

tion of physician and nurse. All useless furniture should be removed; carpets should be taken up and curtains taken down; the floor should be sprinkled with boiling vinegar, and saucers containing a solution of chloride of lime placed in the several corners: not any cooking ought to be permitted in the room-in fact, a fire is seldom admissible. The light should be excluded, all noise subdued, and the sick person's attendant should wear list or cloth-soled slippers. Nothing is more distressing to a poor irritable invalid in bed than the creaking of boots and shoes. It should never be forgotten that typhus in every stage and variety is a disease of sensorial debility, and that our only hope of cure depends on economising the nervous power that remains, in subduing all local inflammation with the least possible loss of blood and strength, and opposing the natural tendency of the disease to run into the putrid type of typhus, by such gentle tonics and moderate stimulants as the system will best bear.

At the onset of the fever we must endeavour to lessen whatever appears to have been the moving cause of its attack; if the stomach be overloaded with an indigestible mass, it is necessary to administer an emetic,-as, one or two tea-spoonsful of antimonial wine; and to follow its operation by a saline aperient, or a small dose of castor oil. If the state of the bowels seem to require it-if the action of the liver has, been sluggish for some time previous small and repeated doses of a mild mercurial preparation, as three or four grains of mercury with chalk, may be given every four or six hours, until the evacuations are of a more healthy character, and all pain and tenderness around the liver and upper part of the abdomen be removed; but the mercurial should seldom be allowed to induce salivation. Conjointly with this treatment, some simple fever mixture should be ordered. During the hot stage the surface of the body may be sponged with cold water with safety and advantage. It is necessary always to be on the look-out for any local-inflammation, so that we may check it instantly; if allowed to progress, bleeding and leeching may be absolutely required for immediate relief; but it should be borne in mind that all depletion greatly retards the patient's convalescence, if it do not so prostrate the strength as to render recovery very doubtful. When inflammation is present, small and frequent doses of tartarised antimony, from the eighth to the tenth part of a grain, should be added to each dose of the fever-mixture; the bowels should be moved by the tartrate of potash, sulphate of magnesia, or castor oil; spoon-diet, as arrow-root, barley water, tapioca, &c. only allowed; and the patient should drink plentifully of acidulated beverages.

As the brain suffers more or less in all cases, it is desirable to guard against inflammation, by having the head shaved, and applying cold water, iced water, refrigerating lotions, or a bladder filled with pounded ice, according to the severity of the existing symptoms. Should inflammation of the lungs, or liver, or stomach, or intestines set in, it must be treated according to its peculiar seat, but always with reference to the typhoid character of the disease. With regard to bleeding in such cases, a great authority says: "If the pulse, though rapid, be soft and compressible, the tongue begin early to assume a brown tint, and there be considerable prostration, the loss of blood cannot be sustained."

If the patient is extremely weak, it will be prudent to give him, with great caution, some gentle stimulant-as the aromatic spirit of ammonia, in infusion of cascarilla-or a tea-spoonful of brandy in a little tepid water: some practitioners do not hesitate to give stimulating doses of opium; but we are always too apprehensive of the brain being affected by it, that we should be loth to advise its employment. Towards the close of the

disease, when the debility and prostration is extreme, full doses of stimulants, wine, and brandy may be allowed, and the most nourishing diet that can be got into the stomach ordered; in some cases the administration of strong beef-tea with an egg beat into it, by means of a glyster, is expedient.

When the fever is over, we must not deny the patient food. In some cases the appetite returns immediately and wonderfully, and whenever all urgent symptoms are entirely absent, it may be moderately indulged. "I give them," says Dr. Elliotson, who before the days of mesmerism was an authority,-“I give them light animal food, plain mutton, and good fresh beef, not pork, or veal, or artificial trash." As convalescence proceeds, the returning strength should be encouraged by judicious doses of quinine, the moderate use of good beer-pale ale; removal from the sick room to the drawing room; occasional, but very quiet society; and then, happily, a tender wife or mother and a good cook may be promoted to the direction of the patient, vice Physician, superseded. (To be continued.)

CASE OF SWEATING SICKNESS.

DR. LAWRIE has published in the "Monthly Journal of Medical Science" a case of this disease. The patient was a healthy, active, robust man, aged about sixty, but liable to biliary derangements. An attack of this kind came on apparently from drinking bad porter, and the patient continued poorly during the week; three days afterwards he was seized with pain round the navel, and bilious vomiting on the second night, after which he slept well till about one in the morning, when he awoke bathed in profuse perspiration, the sheets being literally dripping. This perspiration continued till six in the morning, by which time his blankets, pillows, and part of the feather-bed on which he lay, were dripping wet, the sheets in particular appearing as though they had been dipped in a stream of water. At ten on the same morning he had. what his family described as a fit of ague, followed by cramps in his limbs and a return of the intense pain in the abdomen: a large blister was applied over the abdomen. Early in the forenoon he was found very weak and restless; his pulse small and easily compressed; voice husky and choleric; cold perspiration, especially on the head; counte nance sunk; intense thirst and desire for cold water, and a feeling of internal heat. These symptoms were aggravated in the afternoon. The pulse became more and more feeble, and, at last, imperceptible at the wrist; and the other symptoms increased, with the addition of vomiting, purging, and a tendency to delirium and slight stupor. Brandy-and-water, cold water, and beef-tea were given as freely as they could be taken. At nine on the following morning the pulse was little more than perceptible, it was not to be counted at the wrist, but quite distinct in the groin constant restlessness and tossing; no urine. The patient had, in fact, many of the symptoms of a cholera patient in the stage of collapse. In the evening rallying had commenced, but the other symptoms were much the same. On the following morning the rallying was completed, and the patient during the day rose and shaved himself. He had a relapse on the day after, with bilious stools and vomiting of grass-green matter, and was subsequently collapsed. He gradually recovered from this state, however, and though convalescence was protracted by a mild secondary fever, he recovered perfectly in about a month.