A '■ ./ V ■ r' / '• ' ' \ ' '■ ■ f y vy .. / l il']. ',,J ;2, i *3 :v H 3ERTS’ of Medicine. A NEW, ENLARGED EDITION. JUST READY. Recommended as a Text-book at University of Pennsylvania, Long Lsland College Hospital, Yale and Harvard Colleges, Bishop's College, Montreal, University of Michigan, and over twenty other Medical Schools. A HANDBOOK OF THE THEORY AND PRACTICE OF “I 1 system son, J “ It tioners compe Allen, “Af convin Yale l ut id- ti- tal ms dy in take pleasure in mentioning it among the works which may properly be put in the hands of students.”—A. B. Palmer, M.D., Professor of the Practice of Medicine, Ann Arbor University, Michigan. “ I have never met with a work on Practice that seemed to me so well adapted for students. While concise, nothing is omitted that is important to be known.”—Professor J. A. Thacker, Cincinnati. “ I shall include it among the text-books of the College of Physicians and Surgeons, and strongly recommend it to my classes.”—Professor John S. Lynch, Baltimore. “ It is unsurpassed by any work that has fallen into our hands, as a compen- dium for students preparing for examination. It is thoroughly practical, and fully up to the times.”—The Clinic. “ Our opinion of it is one of almost unqualified praise. The style is clear, and the amount of useful and, indeed, indispensable information which it con- tains is marvelous. We heartily recommend it to students, teachers, and prac- titioners.”—Boston Medical and Surgical Journal. “ That Dr. Roberts’ book is admirably fitted to supply the want of a good handbook of medicine, so much felt by every medical student, does not admit of a question.”—Students' Journal and Hospital Gazette. “I have examined it witn some care, P. BLAKISTON, SON A CO., Publishers and Booksellers, 1012 WALNUT STREET, PHILADELPHIA. BYFORD’S Diseases of Women. THIRD ENLARGED EDITION. Recommended as a '1 ext-book at Rush Medical College, Chicago ; Woman's Medical College, Chicago; National Medical College, Washington, D. C., and other Medical Schools. THE PRACTICE OF MEDICINE AND SURGERY, APPLIED TO THE DISEASES AND ACCIDENTS INCIDENT TO WOMEN. By Wm. H. Byford, a.m., m.d., author of “A Treatise on the Chronic Inflammation and Displacement of the Unimpregnated Uterus,” and Pro- fessor of Obstetrics and Diseases of Women and Children in the Chicago Medical College, and in the Woman’s Medi- cal College, Chicago. Third Edition, Revised. In One Volume. Octavo. 164 Illustrations. Price, Cloth, $S.OO; Leather, $6.00. RECOMMENDATIONS. “I have read with pleasure your book on Diseases of Women; it gratifies me to indorse its teachings.”—Prof. H. P. C. Wilson, Jr., Baltimore. “ I am well acquainted with the author, and regard him an excellent practi- tioner and teacher.”—Dr. J. A. Ireland, Professor of Obstetrics and Gynce- cology, Louisville Medical College. “ It is much improved and is still more what it always was, a valuable practi- cal assistant to the practitioner.”—Prof. Henry G. Landis, Starling Medical College, Colu/nbus. “ I find, from its being so well brought up to the present state of the science it treats of, that it is particularly adapted to the requirements of the medical student.”—J:Fred Prioleau, M. D., Professor of Gynecology, Medical College of South Carolina, Charleston. “ The author has presented to the profession a concise and comprehensive treatise on the subject of diseases of females. We congratulate Dr. Byford upon his success, and feel satisfied that the effort will be duly appreciated by those whom the work is intended to instruct. It is one of the best treatises on the subject ever submitted to the American profession, and will early be acknowledged as such. It is well written, and where necessary, is appropri- ately illustrated.”—Medical and Surgical Reporter, Philadelphia. “The present work being particularly of use where questions of etiology and general treatment are concerned. * * * This volume, hence, will commend itself both to those who possess former editions and to those who do not. It cannot fail to be useful to many, and will certainly prove interest- ing to all.”—The American fournal of Obstetrics. “ These important topics are all handled vigorously and practically. The work cannot fail to be in great demand, and to exert a material influence on clinical practice.”—New York Medical fournal. P. BLAKI8TON, SON A CO., Publishers and Booksellers, 1012 WALNUT STREET, PHILADELPHIA. ESSENTIALS OF PATHOLOGY. JUST PUBLISHED. GILLIAM’S The object of this book is to explain to the student, in a plain, practical way, the fundamentals of Pathology, as an introduction to larger books. THE ESSENTIALS OF PATHOLOGY. By D. Tod Gilliam, m.d., Professor of Physiology, Starling Medical College, formerly Professor of General Pathology, Columbus Medical College, Columbus, Ohio. i2mo. 296 pages.. 47 Illustrations. Price, Cloth, $2.00. A Review, by G. A. Piersol, m.d., Demonstrator of Normal Histology in the Medical De- partment of the University of Pennsylvania, at Philadelphia. Published in the Western Medical Reporter, September, 1883. “ Of no study of the medical student of to-day is a clear conception of fundamental prin- ciples more necessary than of pathology ; yet how many are the first-course men who turn the last page of Wagner or Rindfleisch without having thoroughly comprehended a tithe of the broad and important generalizations without a clear perception of which elaborate detail and minutiae are meaningless. With this fact fully appreciated by the author, the little volume before us was conceived; ‘ not intended to supplant more pretentious works by allaying, but rather to lead up to them by kindling, a thirst for pathological investigation.’ * * * “ The pages before us will be found to present an excellent epitome of the generally accepted pathological doctrines, with a keen appreciation of the broader and more comprehensive and logical views of to-day. “ The arrangement of the matter is well adapted to present the subject in a clear and attractive manner. * * * * We recommend every first-course student to make himself thoroughly familiar with the contents of Dr. Gilliam’s book.” From the Southern Clinic. “We will venture to say, that both student and practitioner will be likely to use this in preference to other more pretentious but less valuable works.” RKCOMMENDATION8. CLEVELAND’S Pocket Medical Lexicon The compact size, convenience of arrangement, and the extraneous information which it contains, make it a valuable companion to the student. THE PRONOUNCING POCKET MEDICAL LEXICON, containing the correct Pronunciation and Definition of terms used in Medicine and the Collateral Sciences, with Addenda containing Abbreviations used in Pre- scriptions, and List of Poisons and Their Antidotes. By C. H. Cleve- land, m.d. Thirtieth Edition. Very small 641110. Price, Cloth, Red Edges, 75 cents; Tucks, with Pocket, $1.00. THIRTIETH EDITION. P. BLAKISTON, SON & CO., Medioal Publishers and Booksellers, 1012 WALNUT STREET, PHILADELPHIA. Human Physiology. ENLARGED EDITION. BRUBAKER. ? QUIZ COMPENDS. ? A NEW SERIES OF BOOKS FOR STUDENTS’ USE IN QUIZ-CLASS AND EXAMINATION ROOMS. 8®' These Compends are based on the most popular text-books, and the lectures of prominent professors. 41®=* The Authors have had large experience as Quiz Masters and attaches of colleges, and are well acquainted with the wants of students. 8®“ They are arranged in the most approved form, thorough and concise, with illustrations whenever they can be used to advantage. 4®=“ Can be used by students of any college. 4®“ They contain information nowhere else collected in such a condensed, practical shape. ■8®=“ Size is such that they may be easily carried in the pocket, and the price is low. 4®“They will be found very serviceable to physicians, as remembrancers. LIST OF VOLUMES. No. i. ANATOMY. By Samuel O. L. Potter, m.d. 63 Illustra- tions . Now ready. No. 2. PRACTICE, Parti. By Dan’l E. Hughes, m.d., Demon- strator of Clinical Medicine, Jefferson College, Philadelphia. Now ready. No. 3. PRACTICE, Part II. Same author. Now ready. No. 4. PHYSIOLOGY. By A. P. Brubaker, m.d., Demonstrator of Physiology, Jefferson College, Philadelphia. Now ready. No. 5. OBSTETRICS. By Henry G. Landis, m.d., Professor of Obstetrics and Diseases of Women and Children, Starling Medical College, Columbus, Ohio. Illustrated. Now ready. No. 6. MATERIA MEDICA. By Samuel O. L. Potter, m.d. Now Ready. No. 7. INORGANIC CHEMISTRY. By G. Mason Ward, m.d., Demonstrator of Chemistry, Jefferson College, Philadelphia. Now ready. No. 8. VISCERAL ANATOMY. By Samuel O. L. Potter, m.d. With illustrations. Now ready. No. 9. SURGERY. By Orville Horwitz, b.s., m.d. With nu- merous Illustrations. Now ready. No. 10. ORGANIC CHEMISTRY. Including Medical Chemistry, Urine Analysis and the Analysis of Water, Air and Food. By Henry Leffmann, m.d., Professor of Clinical Chemistry and Hy- giene in the Philadelphia Polyclinic. Others in preparation. Price, each, in Cloth, $1.00. Interleaved Edition, for taking Notes, $1.25. P. BLAKISTON, SON & CO., Publishers, 1012 WALNUT ST., PHILADELPHIA. 4}®“ Complete stock of Medical, Dental, Pharmaceutical and Scientific Books. Catalogues free. ? QUIZ COMPENDS. ? No. 4. A COMPEND OF Human Physiology. ESPECIALLY ADAPTED FOR THE USE OF MEDICAL STUDENTS. BY ALBERT A.M. M.D., Demonstrator of Physiology in the Jefferson Medical College; Member of the Pathological Society. SECOND EDITION, REVISED AND ENLARGED. OF PH YSIOLOGICAI^--'CONSTAJN'y$.v PHILADELPHIA : -y. 'WLA K ISTON, SON & CO., 1012 Walnut Street. 1884. Entered according to Act of Congress, in the year 1884, by P. BLAKISTON, SON & CO., In the Office of the Librarian of Congress, at Washington, D. C. PRESS OF WM. F. FELL & CO., 1220-24 Sansom Street. TO MY FATHER, HENRY BRUBAKER, A.M., M.D., THIS LITTLE VOLUME IS AFFECTIONATELY INSCRIBED. PREFACE. This Compend of Physiology is the outgrowth of the author’s system of examinations in the Quiz room during a number of years, and was written at the request of medical students who desired a compact and convenient arrangement of the fundamental facts of human physiology. As most medical students enter upon the study of physiology before they have acquired a thorough knowledge of anatomy, it was thought desirable that such anatomical details should also be inserted as would be essential to a clear conception of the functions about to be studied. It was believed that it would be practically useful to students during their attendance upon lectures and in reviewing the subject prior to examinations. The fact that during the first year after its publication the first edition has been exhausted, proves that it has met the needs of students. In preparing a second edition the author has carefully revised the en- tire work, and inserted some fifteen pages of additional matter, which it is hoped will still further increase the usefulness of the book. To those teachers of physiology who have kindly noticed and recom- mended the Compend to their students I tender my thanks, and trust that in its improved condition it will continue to merit their approval. 1210 Race Street. May 1st, 1884. ALBERT P. BRUBAKER. TABLE OF CONTENTS. PAGE Introduction 9 Chemical Composition of the Body 10 Structural Composition of the Body 14 Food 17 Digestion 21 Absorption 28 Blood 32 Circulation of Blood 37 Respiration 44 Animal Heat 50 Secretion 52 Mammary Glands 54 Vascular or Ductless Glands 56 Excretion 58 Kidneys 58 Liver 63 Skin 67 Nervous System 70 Spinal Nerves 72 Properties and Functions of Nerves 74 Cranial Nerves 77 Spinal Cord 91 Medulla Oblongata 98 Pons Varolii 101 Crura Cerebri 102 Corpora Quadrigemina 102 Corpora Striata and Optic Thalami 103 VII VIII TABLE OF CONTENTS. PAGE Cerebellum 105 Cerebrum 106 Sympathetic Nervous System in Sense of Touch 114 Sense of Taste 116 Sense of Smell 117 Sense of Sight 118 Sense of Hearing 124 Voice and Speech 128 Reproduction 131 Generative Organs of the Female 131 Generative Organs of the Male •. 134 Development of Accessory Structures 135 Development of the Embryo 140 Table of Physiological Constants 147 Table showing Relation of Weights and Measures of the Metric System to Approximate Weights and Measures OF THE U. S 150 Index 151 COMPEND OF HUMAN PHYSIOLOGY. Physiology, from tpbais, nature, and Xopos, a discourse, in its origi- nal application embraced the study of all natural objects, inorganic as well as organic. In its modern application physiology signifies the study of life; the investigation of the vital phenomena exhibited by all organic bodies, vegetable and animal. It may be divided into— 1. Vegetable physiology, which treats of the phenomena manifested by the several structures of which the plant is composed. 2. Animal physiology, which treats of the phenomena manifested by the organs and tissues of which the animal body is composed. Human Physiology is the study of the functions exhibited by the human body in a state of health. A Function is the action of an organ or tissue. The Functions of the Human Body may be classified into three groups, viz.:— 1. Nutritive functions, which have for their object the preservation of the individual; e. g., digestion, absorption, circulation of the blood, respiration, assimilation, animal heat, secretion and excretion. 2. Animal functions, which bring the individual into conscious relation- ship with external nature; e. g., sensation, motion, language, mental and moral manifestations. 3. Reproductive function, which has for its object the preservation of the species. The facts of human physiology have been determined by means of anatomy, chemistry, pathology, comparative anatomy, vivisection, the application of physics, etc. The Body may be studied from a chemical and structural point of view. 9 10 HUMAN PHYSIOLOGY. CHEMICAL COMPOSITION OF THE HUMAN BODY. composition of the body, in the following proportions:— Of the Sixty-four Chemical Elements, about sixteen enter into the Oxygen 72.00 Hydrogen 9.10 Nitrogen 2.50 Carbon 13.50 O. H. and C. are found in all the tissues and fluids of the body, without exception. O. H. C. and N. found in most of the fluids and all tissues except fat. Sulphur 147 In fibrin, casein, albumen, gelatin; as potas- sium sulpho-cyanide in saliva; as alkaline sulphate in urine and sweat. Phosphorus 1.15 In fibrin and albumen; in brain; as tri-sodium phosphate in blood and saliva, etc. Calcium 1.30 As calcium phosphate in lymph, chyle, blood, saliva, bones and teeth. Sodium 10 As sodium chloride in all fluids and solids of the body, except enamel; as sodium sul- phate and phosphate in blood and muscles. Potassium 026 As potassium chloride in muscles; generally found with sodium as sulphates and phos- phates. Magnesium 001 Generally in association with calcium, as phos- phate, in bones. Chlorine 085 In combination with sodium, potassium and other bases, in all the fluids and solids. Fluorine 08 As calcium fluoride in bones, teeth and urine. Iron 01 In blood globules; as peroxide in muscles. Silicon a trace In blood, bones and hair. Manganesium, a trace Probably in hair, bones and nails. Of the four chief elements which together make up 97 per cent, of the body, O. H. N. are eminently mobile, elastic, and possess great atomic heat. C. H. N. are distinguished for the narrow range and feebleness of their affinities and chemical inertia. C. has the greatest atomic cohesion. O. is noted for the number and intensity of its combinations, and its remark- able display of chemical activity. Chemical Elements do not exist alone in the body, but are combined in characteristic proportions to form compounds, the proximate principles, which are the ultimate compounds to which the fluids and solids can be reduced. CHEMICAL COMPOSITION OF THE HUMAN BODY. 11 Proximate Principles exist in the body under their own form, and can be extracted without losing their distinctive properties. There are about one hundred proximate principles, which are divided into four classes, viz: inorganic, organic, non-nitrogenized, organic nitro- genized, and principles of waste. SUBSTANCE. WHERE FOUND. Oxygen Lungs and blood. Hydrogen Stomach and intestines. Nitrogen Blood and intestines. Carbonic anhydride Expired air of lungs. I. INORGANIC PROXIMATE PRINCIPLES. Carburetted hydrogen Sulphuretted hydrogen Lungs and intestines. Water Found in all solids and fluids. Sodium chloride In all fluids and solids except enamel. Potassium chloride In muscles, liver, saliva, gastric juice, etc. Ammonium chloride Gastric juice, saliva, tears, urine. Calcium chloride Bones, teeth, urine. Calcium carbonate Bones, teeth, cartilage, internal ear, blood. Calcium phosphate Magnesium phosphate Sodium phosphate Potassium phosphate In all fluids and solids of the body. Sodium sulphate Potassium sulphate Universal,except milk,bile and gastric juice. Sodium carbonate Potassium carbonate Blood, bones, lymph, urine, etc. Magnesium carbonate Blood and sebaceous matter. Inorganic principles enter and leave the body under their own form. Water gives elasticity to the tissues and is a general solvent. Sodium chloride regulates osmotic action (exudation and absorption), influences the form and consistence of blood corpuscles. Calcium phosphate gives solidity and resistance to bones. II. ORGANIC NON-NITROGENIZED PRINCIPLES. Palmitin, Stearin, Olein, PATS. c. o. H. Palmitic acid, Stearic acid, Oleic acid, Neutral Fats. - Fatty Acids. The Neutral fats, when combined in proper proportions, constitute a large part of the fatty tissue of the body; they are soluble in ether, chloro- 12 HUMAN PHYSIOLOGY. form and hot alcohol; insoluble in cold alcohol and water, and liquefy at a high temperature; by boiling with a caustic alkali they are decomposed into glycerine and fatty acids. The Fatty acids combined with sodium, potassium and calcium, are found as salts in various fluids of the body, such as blood, chyle, fseces, etc. Phosphorized fats in nervous tissue, butyric acid in milk, propionic acid in sweat, are also constituents of the body. Fat is derived from the food, stored up in the form of vesicles in and around the various anatomical structures and beneath the skin, constituting the adipose tissue; it serves as a non-conductor of heat, and gives round- ness and form to the body. During the process of nutrition fat undergoes oxidation, which is attended by the evolution of heat and the manifestation of muscular and nervous force. SUGARS. C.O. H. Glycogen, or Amyloid substance. Lactose, or Milk sugar. Dextrose, or Grape sugar. Inosite, or Muscle sugar. Dextrine. Sugar is found in many of the tissues and fluids of the body, e. g., liver, placenta, blood, milk, muscles, etc. The varieties of sugar are soluble in water, assume the crystalline form upon evaporation, and are converted into alcohol and carbonic anhydride by fermentation. Sugar is derived from the food, is absorbed into the blood, where it largely disappears, undergoing a transformation into fat; or it is directly oxidized and con- tributes, like the fats, to the production of heat and force. III. ORGANIC NITROGENIZED PRINCIPLES. ALBUMENS. C. O. H. N. S. P. Albumen. Albuminose. Fibrin. Casein. Ostein. Myosin. Protagon. Pepsin. Pancreatin. Salivin. Mucin. Chondrin. Elastin. Keratin. Globulin. The Albuminous compounds are organic in their origin, being derived from the animal and vegetable world; they are taken into the body as food, appropriated by the tissues, and constitute their organic basis; they differ from the non-nitrogenized substances in not being crystalline, but amorphous, in having a more complex but just as definite composition, and containing in addition to C. O. H., nitrogen, with, at times, sulphur and CHEMICAL COMPOSITION OF THE HUMAN BODY. 13 phosphorus. The albumens possess characteristics which distinguish them from all other substances: viz., a molecular mobility, which permits isomeric modifications to take place with great facility. Under favorable conditions they promote chemical changes, by their presence (catalysis) in other substances: e. g., during digestion, salivin and pepsin cause starch and albumen to be transformed into sugar and albuminose respectively. Different albumens possess varying proportions of water, which they lose when subjected to desiccation, becoming solid; but upon exposure to moisture they again absorb water, regaining their original condition—they are hygroscopic. Another property is that of coagulation, which takes place under certain conditions: e. g., the presence of mineral acids, heat, alcohol, etc. After death the albuminous compounds undergo putrefactive changes, giving rise to carburetted and sulphuretted hydrogen and other gases. Albumen exists in the blood, lymph, chyle, constituting the pabulum of the tissues; it is coagulated by heat, mineral acids and alcohol. Peptones are formed in the stomach from the digestion of albuminous principles of the food; they are coagulated by tannic acid, chlorine, acetate of lead, and characterized by great diffusibility, which permits them to pass through animal membranes with facility. Fibrin can be obtained from freshly drawn blood by whipping; it also coagulates spontaneously, and when examined microscopically exhibits a filamentous structure. Casein is the albuminous principle of milk. Ostein constitutes the organic basis of bone, with which are mingled the salts of lime. Myosin is found in muscles, protagon in brain, pepsin, pancreatin and salivin, in the digestive fluids. Mucin, chondrin, elastin, keratin and globulin, are found in mucus, cartilage, elastic tissues, hair, nails, and red corpuscles, respectively. As the properties of the compounds formed by the union of elements are the resultants of the properties of the elements themselves, it follows that the ternary substances, sugars, starches and fats, possess a great inertia and notable instability; while in the more complex albuminous compounds, in which sulphur and phosphorus are united to the four chief elements, molecular mobility, resulting in isomerism, exists in a high degree. As these compounds are unstable, of a great molecular mobility, they are well fitted to take part in the composition of organic bodies, in which there is a continual movement of composition and decomposition. 14 HUMAN PHYSIOLOGY. IV. PRINCIPLES OF WASTE. Urea. Xanthin. Sodium, Creatin. Tyrosin. Potassium, Creatinin. Hippuric Acid. Ammonium, Cholesterin. Calcium Oxalate. Calcium, Urates. These principles, which represent waste, are of organic origin, arising within the body as products of disassimilation or retrograde metamorphosis of the tissues; they are absorbed by the blood, carried to the various excre- tory organs, and by them eliminated from the body. The excrementitious substances will be fully considered under excretion. Proximate Quantity of the Chemical Elements and Proximate Principles of Body Weighing 154 lbs. Oxygen lbs. oz. Hydrogen Nitrogen 3 8 Carbon., 21 Calcium Phosphorus I 12 Sodium, etc 12 154 ti Water lbs. OZ. Albuminoids ... 23 7 Fats ... 12 .. Calcium phosphate - 5 13 Calcium carbonate Calcium fluoride 3 Sodium sulphate, etc... 9 154 „ STRUCTURAL COMPOSITION of THE BODY. The Study of the Structure of the body reveals that it is composed of dissimilar parts, e. g., bones, muscles, nerves, lungs, etc.; while these, again, by closer examination, can be resolved into elementary structures, the tissues, e. g., connective tissue, muscular, nervous, epithelial tissue, etc. Microscopical examination of the tissues shows that they are com- posed of fundamental structural elements, termed cells. Cells are living physiological units; the simplest structural forms capable of manifesting the phenomena of life. Cells vary in their anatomical constitution in the different structures of the body, and may be classed in three groups, viz.: I. Cells possessing a distinct cell wall, cell substance and a nucleus. 2. Cells possessing a cell substance and a nucleus. 3. Cells possessing the cell substance only. They vary in size from the to the of an inch in diameter; when young and free to move in a fluid medium they assume the spherical STRUCTURAL COMPOSITION OF THE BODY. 15 form; but when subjected to pressure, may become flattened, cylindrical, fusiform or stellate. Structure of cells. The cell wall is not an essential structure, as many cells are entirely devoid of it. It is a thin, structureless, transparent membrane, permeable to fluids. The Cell Substance in young cells is a soft, \gscid, albuminous matter, unstable, insoluble in water, and known as protoplasm, bioplasm, sarcode, etc.; in older cells the original cell substance undergoes various trans- formations, and is partly replaced by fat globules, pigment and crystals. The Nucleus is a small vesicular body in the interior of the cell sub- stance, and frequently contains smaller bodies, the micleoli. MANIFESTATIONS OF CELL LIFE. Growth. Cells when newly formed are exceedingly small, but as they approach maturity they increase in size, by the capability which the cells possess of selecting and appropriating new material as food, vitalizing and organizing it. The extent of cell growth varies in different tissues; in some the cells remain exceedingly small, in others they attain considerable size. In many instances the cell substance undergoes transformation into new compounds destined for some ulterior purpose. Reproduction. Like all organic structures cells have a limited period of life; their continual decay and death necessitates a capability of repro- duction. Cells reproduce themselves in the higher animals mainly by fission. This is seen in the white blood corpuscles of the young embryos of animals; the corpuscle here consists of a cell substance and nucleus. When division of the cell is about to take place, the nucleus elongates, the cell substance assumes the oval form, a constriction occurs, which gradually deepens, until the original cell is completely divided and two new cells are formed, each of which soon grows to the size of the parent cell. In cells provided with a cell membrane the process is somewhat different. In the ova of the inferior animals, after fertilization has taken place, a furrow appears on the opposite sides of the cell substance, which deepens until the cell is divided into two equal halves, each containing a nucleus; this process is again repeated until there are four cells, then eight, and so on until the entire cell substance is divided into a mulberry mass of cells, completely occupying the interior of the cell membrane. The whole process of segmentation takes place with great rapidity, occupying not more than a few minutes, in all probability. 16 HUMAN PHYSIOLOGY. Motion. Spontaneous movement lias been observed in many of the cells of the body. It may be studied, for example, in the movements of the spermatozoa, the waving of the cilia covering the cells of the bronchial mucous membrane, the white corpuscles of the blood, etc. By a combination and transformation of these original structural elements, and material derived from them, all the tissues are formed which enter into the structure of the humSn body. CLASSIFICATION OF TISSUES. I. Homogeneous Substance, a more or less solid, albuminous struc- ture, filling the spaces between the cells and fibres of various tissues, e. g., cartilage, bone, dentine, etc. II. Limiting Membrane, a thin, homogeneous membrane, structure- less, composed of coagulated albumen, and often not more than the of an inch in thickness, found lining the blood vessels and lymph- atics, forming the basement membrane of the skin and mucous mem- branes, the posterior layer of the cornea, the capsule of the crystalline lens, etc. III. Simple fibrous or filamentous tissue—the elements of which are real or apparent filaments. (a) Connective or areolar; white fibrous tissue; constituting tendons, ligaments, aponeuroses, periosteum, dura mater, synovial membranes, vas- cular tunics, etc. (b) Yellow elastic tissue, found in the middle coats of arteries, veins, lymphatics, ligamentum nuchse, vocal cords, ligamenta subflava, etc. IV. Compound membranes (membrano-cellular or fibro-cellular tissues), cells aggregated into laminae. (a) Epidermic tissue; (b) epithelial tissue; (c) glandular tissue; (d) cornea. V. Cells containing coloring matter, or pigment cells, e. g., skin, choroid membrane, etc. VI. Cells coalesced or consolidated by internal deposits, e. g., hair, nails, bone, teeth, etc. VII. Cells imbedded in an intercellular substance, e. g., cartilage, crystalline lens, etc. VIII. Cells aggregated in clusters, forming tissues more or less solid, e. g., adipose tissue, lymphatic glands. IX. Cells imbedded in a matrix of capillaries, e. g., gray or vesicular nervous matter. FOOD. 17 X. Cells whose coalesced cavities form tubes containing liquids or secondary solid deposits, e. g., vascular tissue, dentine. XI. Cells free, isolated, or floating—fluid tissue—e. g., red and white blood corpuscles, lymph and chyle corpuscles. A Food may be defined to be any substance capable of playing a part in the nutrition of the body. Food is required for the repair of the waste of the tissues consequent on their functional activity, for the generation of heat and the evolution of force. Hunger and Thirst are sensations which indicate the necessity for taking food; they arise in the tissues at large, and are referred to the stomach and fauces, respectively, through the sympathetic nervous system. Inanition or Starvation results from an insufficiency or absence of food, the physiological effects of which are hunger, intense thirst, intestinal uneasiness, weakness and emaciation; the quantity of carbonic acid exhaled diminishes and the urine is lessened in amount; the volume of the blood diminishes; a fetid odor is exhaled from the body; vertigo, stupor followed by delirium, and at times convulsions, result from a disturbance of the nerve centres; a marked fall of the bodily temperature occurs, from a diminished activity of the nutritive process. Death usually takes place, from exhaustion. During starvation the loss of different tissues, before death occurs, aver- ages or 40 per cent, of their weight. Those tissues which lose more than 40 per cent, are fat, 93.3; blood, 75 ; spleen, 71.4; pancreas,64.1; liver, 52; heart,44.8; intestines, 42.4; muscles, 42.3. Those which lose less than 40 per cent, are the muscular coat of the stomach, 39.7; pharynx and oesophagus, 34.2; skin, 33.3; kidneys, 31.9; respiratory apparatus, 22.2; bones, 16.7; eyes, 10; nervous system, 1.9. The Fat entirely disappears, with the exception of a small quantity which remains in the posterior portion of the orbits and around the kidneys. The Blood diminishes in volume and loses its nutritive properties. The Muscles undergo a marked diminution in volume and become soft and flabby. The Nervous system is last to suffer, not more than two per cent, dis- appearing before death occurs. The appearances presented by the body after death from starvation are those of anaemia and great emaciation; almost total absence of fat; blood- lessness ; a diminution in the volume of the organs; an empty condition FOOD. 18 HUMAN PHYSIOLOGY. of the stomach and bowels, the coats of which are thin and transparent. There is a marked disposition of the body to undergo decomposition, giving rise to a very fetid odor. The duration of life after a complete deprivation of food varies from eight to thirteen days, though life can be maintained much longer if a quantity of water be obtained. The water is more essential under these circumstances than the solid matters, which can be supplied by the organism itself. The different alimentary principles which are appropriated by the system are combined in different proportions in the various articles of food, and are separated from the innutritious substances during the process of digestion. They belong to the organic and inorganic worlds, and may be classified, according to their chemical composition, as follows :— 1. Albuminous group—nitrogenized, C. O. H. N. S. P. PRINCIPLE. WHERE FOUND. Myosin, syntonin Flesh of animals. Vitellin, albumen Yolk of egg, white of egg. Fibrin, globulin Blood contained in meat. Casein Milk, cheese. Gluten Grain of wheat and other cereals. Vegetable albumen Soft growing vegetables. Legumin Peas, beans, lentils, etc. Gelatin Bones. 2. Saccharine group—non-nitrogenized, C. O. H. Cane sugar beet root sugar Sugar cane, beets, etc. Glucose, grape sugar Fruits. Inosite, liver sugar, glycogen Muscles, liver, etc. Lactose or milk sugar Milk. Starch Cereals, tuberous roots and legu - minous plants. CLASSIFICATION OF ALIMENTARY PRINCIPLES. 3. Oleaginous group—non-nitrogenized, C. O. H. Animal fats and oils... Stearin, olein Palmatin, fatty acids.. Found in the adipose tissue of animals, seeds, grains, nuts, fruits, and other vegetable tissues. 4- Inorganic group. Water, sodium and potassium chlorides, sodium, calcium, magnesium and potassium phosphates, calcium carbonate and iron. FOOD. 19 5. Vegetable acid group. Malic, citric, tartaric and other acids, found principally in fruits. 6. Accessory foods. Tea, coffee, alcohol, cocoa, etc. The Albuminous principles enter largely into the composition of the body, and constitute the organic bases of the different tissues; they are mainly required for the growth and repair of the tissues, but when oxidized give rise, to some extent, to the evolution of heat and force. Muscular work, however, does not result from a destruction of the albuminous com- pounds. The oxidation of the carbonaceous compounds, sugars and oils, furnishing the force which is transformed by the muscular system into motor power. When employed exclusively as food for any length of time the albuminous substances are incapable of supporting life. The Saccharine principles are important to the process of nutrition, but the changes which they undergo are not fully understood ; they form but a small proportion of the animal tissues, and by oxidation generate heat and force. Starch undergoes conversion into dextrin and grape sugar. The Oleaginous principles form a large part of the tissues of the body. They are introduced into the system as food, and are formed also from a transformation of saccharine and albuminous matter during the nutritive process; they enter into the composition of nervous and muscular tissue, and are stored up as adipose tissue in the visceral cavities and subcutaneous connective tissue, thus giving roundness to the form and preventing, to some extent, the radiation of heat. While they aid in the reconstruction of tissue, they mainly undergo oxidation, giving rise to the production of heat and the evolution of muscular and nervous force. The Inorganic principles constitute an essential part of all animal tissues, and are introduced with the food. Water is present in all fluids and solids of the body, holding their ingredients in solution, promoting the absorption of new material into the blood and tissues, and the removal of waste ingredients. Sodium chloride is an essential constituent of all tissues, regulating the passage of fluids through animal membranes (endosmosis and exosmosis). Calcium■ phosphate gives solidity to bones and teeth, constituting more than one-half their substance. Iron is a constituent of the coloring matter of the blood. The Vegetable acids are important to nutrition, and tend to prevent the scorbutic diathesis. The Accessory foods also influence the process of nutrition. Tea excites the respiratory function, increasing the evolution of carbonic acid. Coffee is a stimulant to the nervous system; increases the force of the heart’s action, increases the arterial tension and retards waste. 20 HUMAN PHYSIOLOGY. Alcohol, when introduced into the system in small quantities, under- goes oxidation and contributes to the production of force, and is thus far a food. It excites the gastric glands to increased secretion, improves the digestion, accelerates the action of the heart and stimulates the activities of the nervous centres. In zymotic diseases, and all cases of depression of the vital powers, it is most useful as a restorative agent. When taken in excessive quantities, it is eliminated by the lungs and kidneys. The metamorphosis of the tissues is retarded, the elimination of urea and carbonic acid is lessened, the temperature lowered, the mus- cular powers impaired and the resistance to depressing external influences diminished. When taken through a long period of time, alcohol impairs digestion, produces gastric catarrh, disorders the secreting power of the hepatic cells. It also diminishes the muscular power and destroys the structure and composition of the cells of the brain and spinal cord. The connective tissue of the body increases in amount, and subsequently con- tracting, gives rise to sclerosis. A proper combination of different alimentary principles is essential for healthy nutrition; no one class being capable of maintaining life for any definite length of time. The Albuminous food in excess promotes the arthritic diathesis, mani- festing itself as gout, gravel, etc. The Oleaginous food in excess gives rise to the bilious diathesis, while a deficiency of it promotes the scrofulous. The Farinaceous food, when long continued in excess, favors the rheu- matic diathesis by the development of lactic acid. The Alimentary Principles are not introduced into the body as such, but are combined in proper proportions to form compound substances, termed foods, e. g., bread, milk, eggs, meat, etc., the nutritive value of each depending upon the extent to which these principles exist. WATER. ALBUMEN. STARCH. SUGAR. FATS. Bread 37 8.1 47-4 3-6 1.6 2-3 Milk 86 4.1 5-2 3-9 0.8 Eggs 14.0 10.5 1.5 Meat 54 27.6 15-45 2-95 Potatoes 75 2.1 18.8 3-2 0.2 0.7 Corn H 11.1 64.7 0.4 8.1 1.7 Oatmeal i5 12.6 58.4 5-4 5-6 3 Turnips 9i 1.2 5-i 2.1 6 Carrots 83 i-3 8.4 6.1 0.2 1.0 Rice 6-3 79.1 0.4 0.7 °-5 PERCENTAGE COMPOSITION OF DIFFERENT FOODS. DIGESTION. 21 The Amount of food required in 24 hours has been estimated at about pounds, comprising meat, 16 oz.; bread, 19 oz.; fat, oz.; water, 52 fluid oz. In the excreta of the body the normal proportion of nitrogen to carbon is I to 15. To maintain this relation, a proper proportion of nitrogenized to carbonaceous food should be observed in diet. The proportion in the excreta would be— On a meat diet nitrogen i to carbon 3 On a bread diet “ 1 “ 30 On a mixed diet “ 2 “ 33 Or “ 1 “ 16 The amount of nitrogen and carbon necessary to compensate for the loss would be contained in 16 oz. of meat and 2 lbs. of bread; as, however, usually 3 oz. of oil are consumed in 24 hours, only 19 oz. of bread are required. COMPARISON OF INGESTA AND EGESTA IN 24 HOURS FOOD, DRINK, AIR. OZ. Albumen 4.23 Starch 11.63 Fats 3.17 Salts 1.13 Water (6 pints) 93.00 Oxygen 26.24 Breath EXCRETIONS. OZ. carbonic acid' watery vapor 43-4° Perspiration carbonic acid watery vapor ► 23.62 Urine 66.31 Solid excreta 6.07 Total 139-4° Total 139-4° DIGESTION. Digestion is a physical and chemical process, by which the food is changed by the action of solvent fluids into a form capable of being absorbed into the blood. The Digestive Apparatus consists of the alimentary canal and its appendages, viz: teeth, salivary, gastric and intestinal glands, liver and pancreas. Digestion may be divided into seven stages; prehension, mastication, insalivation, deglutition, gastric and intestinal digestion and defecation. Prehension, the act of conveying food into the mouth, is accomplished by the hands, lips and teeth. 22 HUMAN PHYSIOLOGY. Mastication is the trituration of the food, and is accomplished by the teeth and lower jaw, under the influence of muscular contraction. When thoroughly divided, the food presents a greater surface for the solvent action of the digestive fluids, thus aiding the general process of digestion. The Teeth are thirty-two in number, sixteen in each jaw, and divided into four incisors or cutting teeth, two canines, four bicuspids, and six molars or grinding teeth; each tooth consists of a crown covered by enamel, a neck, and a root surrounded by the crusta petrosa, and imbedded in the alveolar process; a section through a tooth shows that its substance is made up of dentine, in the centre of which is the pulp cavity, containing blood vessels and nerves. The lo7ver jaw is capable of making a downward and an upward, a lateral and an antero-posterior movement, dependent upon the construc- tion of the temporo-maxillary articulation. The jaw is depressed by the contraction of the digastric, genio hyoid, mylo-hyoid and platysma myoides muscles; elevated by the temporal, masseter and internal pterygoid muscles; moved laterally by the alternate contrac- tion of the external pterygoid muscles; moved anteriorly by the pterygoid and posteriorly by the united actions of the genio-hyoid, mylo-hyoid and posterior fibres of the temporal muscle. The food is kept between the teeth by the intrinsic and extrinsic mus- cles of the tongue from within, and the orbicularis oris and buccinator muscles from without. The Movements of Mastication are called forth by reflex action through the medulla oblongata, induced by the presence of food in the mouth. NERVOUS CIRCLE OF MASTICATION. AFFERENT OR EXCITOR NERVES. 1. Lingual branch of 5th pair. 2. Glosso-pharyngeal. EFFERENT OR MOTOR. 1. 3d branch of 5th pair. 2. Hypo-glossal. 3. Facial. Insalivation is the incorporation of the food with the saliva secreted by the parotid, sub-?naxillary and sub-lingual glands; the parotid saliva, thin and watery, is poured into the mouth through Steno’s duct; the sub- maxillary and sub-lingual salivas, thick and viscid, are poured into the mouth through Wharton’s and Bartholini’s ducts. Saliva is an opalescent, slightly viscid, alkaline fluid, having a specific gravity of 1.005. Microscopical examination reveals the presence of salivary corpuscles and epithelial cells. Chemically it is composed of DIGESTION. 23 water, proteid matter, a ferment (ptyalin) and inorganic salts. The amount secreted in 24 hours is about 2J4 lbs. Its function is twofold:— 1. Physical.—Softens and moistens the food; glues it together, and facilitates swallowing. 2. Chemical.—Converts starch into grape sugar. This action is due to the presence of the organic ferment, ptyalin. The change consists in the assumption of a molecule of water. Starch. c6h10o8 + h2 o = c6h12o6 Water. Grape sugar. NERVOUS CIRCLE OF INSALIVATION. 1. Lingual Branch of 5th pair. 2. Glosso-pharyngeal. AFFERENT OR EXCITOR NERVES. EFFERENT OR MOTOR NERVES. 1. Auriculo-temporal branch of 5th pair, for parotid gland. 2. Chorda tympani, for sub-maxil- lary and sub-lingual glands. The centres regulating the secretion are two, viz.: The medulla oblon- gata and the sub-maxillary ganglion of the sympathetic; the latter acting antagonistically to the former. Impressions excited by the food in the mouth reach the medulla oblongata through the afferent nerves; motor impulses are there generated which pass outward through the efferent nerves. Stimulation of the auriculo-temporal branch increases the flow of saliva from the parotid gland; division arrests it. Stimulation of the chorda tympani is followed by a dilation of the blood vessels of the sub-maxillary glands, increased flow of blood (thus act- ing as a vaso dilator nerve) and an abundant discharge of a thin saliva; division of the nerve arrests the secretion. Stimulation of the cervical sympathetic is followed by a contraction of the blood vessels, diminishing the flow of blood (thus acting as a vaso- constrictor nerve) and a diminution of the secretion, which now becomes thick and viscid; division of the sympathetic does not, however, com- pletely dilate the vessels. There is evidence of the existence of a local vaso-motor mechanism, which is inhibited by the chorda tympani; exalted by the sympathetic. Deglutition is the act of transferring food from the mouth into the stomach, and may be divided into three stages:— 1. The passage of the bolus from the mouth into the pharynx. 2. From the pharynx into the oesophagus. 3. From the oesophagus into the stomach. 24 HUMAN PHYSIOLOGY. In the ist stage, which is entirely voluntary, the mouth is closed and respiration momentarily suspended; the tongue, placed against the roof of the mouth, arches upward and backward, and forces the bolus into the fauces. In the 2d stage, which is entirely reflex, the palate is made tense and directed upward and backward by the levatores-palati and tensores-palati muscles; the bolus is grasped by the superior constrictor muscle of the pharynx and rapidly forced into the oesophagus. The food is prevented from entering the posterior nares by the uvula and the closure of the posterior half-arches (the palato-pharyngei muscles); from entering the larynx by its ascent under the base of the tongue and the action of the epiglottis. In the jd stage the longitudinal and circular muscular fibres, contract- ing from above downward, strip the bolus into the stomach. [For nervous mechanism of Deglutition see Medulla Oblongata.] Gastric Digestion. The stomach is a dilatation of the alimentary canal, 13 inches long, 5 inches deep, having a capacity of about 5 pints; there can be distinguished a cardiac and pyloric orifice, a greater and lesser curvature, a greater and lesser pouch. It possesses three coats:— 1. Serous, a reflection of the peritoneum. 2. Muscular, the fibres of which are arranged longitudinally, trans- versely and obliquely. 3. Mucous, thrown into folds, forming the rugae; imbedded in the mucous coat are immense numbers of mucous and true gastric glands ; the former, found in the pyloric portion, are lined by columnar epithelium throughout their depth; the latter, the true peptic cells, are found in the cardiac end, and mainly contain oval, spherical cells, which are granular and nucleated. During the intervals of digestion the mucous membrane of the stomach is pale and covered with a layer of mucus. Upon the introduction of food the blood vessels dilate and become filled with blood, and the mucous membrane becomes red. At the same time small drops of a fluid, the gastric juice, begin to exude upon its surface, which gradually run together and trickle down the sides of the stomach. The Gastric Juice is a secretion of the true peptic cells, and when obtained from the stomach through a fistulous opening, is a clear, straw-colored fluid, decidedly acid, with a specific gravity of 1.005 to I.OIO. DIGESTION. 25 COMPOSITION OF GASTRIC JUICE. Water 975.00 Pepsin 15.00 Hydrochloric acid 4.78 Inorganic salts 5.22 1000.00 The water forms the large part of the fluid, and holds in solution the other ingredients. It results from a transudation from the blood vessels under the increased blood supply. Of the inorganic salts the chlorides of sodium and potassium are the most abundant. Pepsin is the organic nitrogenized ferment of the gastric juice, and is formed, during the intervals of digestion, by the peptic cells. In the pres- ence of a small per cent, of an acid, it acquires the property of converting the albumen of the food into albuminose or peptones. Hydrochloric acid is present in small quantity, and gives the juice its acidity. In all probability, its production is due to the activity of the peptic cells. These two characteristic ingredients of the gastric juice exist in a state of combination as hydrochloro-peptic acid, and the presence of both is absolutely essential for the complete digestion of the food. When the food enters the stomach it is subjected to the peristaltic action of the muscular coat, and thoroughly incorporated with the gastric juice. This fluid pos- sesses the property of attacking the connective tissues of the food, disin- tegrating it and dissolving out the alimentary principles. The Principal Action of the gastric juice, however, is to transform the different albuminous principles of the food into peptones or albuminose. Before digestion they are insoluble in water and incapable of being absorbed. After digestion they become soluble and are readily absorbed. Peptones differ from the albumins in being— 1. Diffusible, passing rapidly through the mucous membrane and walls of the blood vessels. 2. Non-coagulable by heat, nitric or acetic acids; but are readily precipitated by tannic acid. 3. Soluble in water and saline solutions. 4. Assimilable by the blood; when injected into it they do not reappear in the urine. Gastric juice exerts no influence either upon grape sugar, cane sugar, starch or fat. 26 HUMAN PHYSIOLOGY. Gastric Digestion occupies on the average from 3 to 5 hours, but varies in duration according to the nature and quantity of the food, exercise, temperature, etc. The Amount of gastric juice secreted in 24 hours varies, under normal conditions, from 8 to 14 pounds. Movements of the Stomach. As soon as digestion commences, the cardiac and pyloric orifices are closed; the walls of the stomach contract upon the food, and a peristaltic action begins, which carries the food along the greater and lesser curvatures, and thoroughly incorporates it with the gastric juice. As soon as any portion of the food is digested it passes through'the pylorus into the intestine. Intestinal Digestion. The intestine is about 20 feet long, inches in diameter, and possesses three coats:— 1. Serous (peritoneal). 2. Muscular, the fibres of which are arranged longitudinally and trans- versely. 3. Mucous, thrown into folds, forming the valvulce conniventes. This stage of digestion is probably the most complex and important; here the different alimentary principles are further elaborated and prepared for absorption into the blood by being acted upon by the intestinal juices pancreatic juice and bile. Throughout the mucous coat are imbedded the intestinal follicles, the glands of Brunner and Lieberkiihn. They secrete the true intestinal juice, which is an alkaline, viscid fluid, composed of water, organic matter and salts. Its function is to convert starch into glucose, and assist in the digestion of the albuminoids. The Pancreatic Juice is secreted by the pancreas, a flattened gland about six inches long, running transversely across the posterior wall of the abdomen, behind the stomach; its duct opens into the duodenum. The Pancreatic fluid is transparent, colorless, strongly alkaline and viscid, having a specific gravity of 1.040. COMPOSITION OF PANCREATIC JUICE. Water 900.76 Pancreatin 90.44 Inorganic salts 8.80 1000.00 The Pancreatin is the most important constituent, and gives to the fluid its digestive power. It is coagulated by heat, nitric acid and alcohol. DIGESTION. 27 The Functions of the pancreatic fluid are: 1. To transform starch and cane sugar into glucose. 2. To emulsify the oils and fats, and split them up into fatty acids and glycerine. 3. To convert albuminoid sub- stances into peptones. The Emulsification of the fats seems to be the principal office of the pancreatic juice, for disease of the pancreas, preventing the discharge of its secretion into the intestine, is attended by an abundant discharge of fat from the bowels. The total quantity of this fluid secreted in 24 hours has not been accu- rately determined; varies from one to two pounds. The Bile has an important influence in the elaboration of the food and its preparation for absorption. It is a golden-brown, viscid fluid, having a neutral or slighly alkaline reaction and a specific gravity of 1.020. Water 859.2 COMPOSITION OF BILE. Sodium glycocholate Sodium taurocholate ... gi-4 Fat 9.2 Cholesterine 2.6 Mucus and coloring matter 29.8 Salts 7.8 1000.00 The Biliary salts are characteristic ingredients, and are formed in the liver by the process of secretion, from materials furnished by the blood. They probably aid digestion. Cholesterine is a product of waste taken up by the blood from the nervous tissues and excreted by the liver. The Coloring matters which give the tints to the bile are biliverdin and bilirubin, and are probably derived from the coloring matter of the blood. The Bile is both a secretion and an excretion; it is constantly being formed and discharged by the hepatic ducts into the gall bladder, in which it is stored up, during the intervals of digestion. As soon as food enters the intestines, it is poured out abundantly by the contraction of the walls of the gall bladder. The Amount secreted in 24 hours is about pounds. Functions of the Bile. (1) It assists in the emulsification of the fats and promotes their absorption. (2) It tends to prevent putrefactive changes in the food. (3) Stimulates the secretions of the intestinal glands, and excites the normal peristaltic movements of the bowels. 28 HUMAN PHYSIOLOGY. The digested food, the chyme, is a grayish, pultaceous mass, but as it passes through the intestines it becomes yellow, from admixture with the bile. It is propelled onward by vermicular motion; by the contraction of the circular and longitudinal muscular fibres. As the digested food passes through the intestines the nutritious matters are absorbed into the blood, and the residue enters the large intestine. The Faeces consist chiefly of indigestible matters, excretin, stercorin and salts; varying in amount from 4 to 7 oz. in 24 hours. Defecation is the voluntary act of extruding the faeces from the body; accomplished by a relaxation of the sphincter muscle, the contraction of the walls of the rectum, assisted by the abdominal muscles. The Gases contained in the stomach and small intestine are oxygen, nitrogen, hydrogen, and carbonic acid. In the large intestine, carbonic acid, sulphuretted and carburetted hydrogen. They are introduced with the food, and also developed by chemical changes in the alimentary canal. They distend the intestines, aid capillary circulation, and tend to prevent pressure. Absorption has for its object the introduction of new materials into the blood, and takes place mainly from the alimentary tract; but also to some extent from the skin, respiratory surface and closed cavities of the body. The Agents of Absorption are the veins and lymphatics. As a result of the process of digestion the different alimentary substances are converted into forms which are capable of being absorbed into the blood, e. g., albuminose, glucose and fatty emulsion, water and inorganic matters undergoing no change, being already in a condition to be absorbed and to play a part in the nutritive process. The blood vessels which are most active as absorbents, are the gastric, superior and inferior mesenteric veins. They arise in the coats of the alimentary canal, and as they converge, unite with the splenic vein to form the portal vein, which enters the liver. As the digested mass of food, the chyme, passes through the alimentary canal a large portion of it disappears; the veins absorb water, albutninose, glucose, and inorganic salts, and convey them directly into the liver; the blood of the portal vein being especially rich in these substances. At times, after the ingestion of large quantities of oleaginous food, the blood vessels take up, in addition, a certain quantity of fatty matter; but this is not usually the case; the fats being absorbed by special vessels, the lymphatics or lacteals. ABSORPTION. ABSORPTION. 29 General Anatomy of the Lymphatic System. The lymphatics constitute a system of minute, delicate, transparent vessels, which, having their origin at the periphery of the body, pass forward toward the centre and empty into the veins at the base of the neck, by means of the thoracic duct. In their course they pass through small ovoid bodies, the lymphatic glands. Origin of Lymphatics. The lymphatic vessels commence by a fine capillary plexus, or in irregular lymph spaces, distributed over the surface and throughout the interior of the various tissues of the body. The lymphatics of the small intestine, the lacteals, arise within the villous processes which cover its inner surface throughout its entire extent. Each villus is formed by an elevation of the mucous membrane, covered externally by a laver of columnar epithelial cells; in the interior are found numerous blood vessels, non-striated muscular fibres, and the beginnings of the lacteal vessels. The structure of the larger vessels resembles that of the veins, consisting of three coats— i. External, composed of fibrous tissue and muscular fibres, arranged longitudinally. 2. Middle, consisting of white fibrous and yellow elastic tissue, non-striated muscular fibres, arranged transversely. 3. Internal, composed of an elastic membrane, lined by epithelial cells. Throughout their course are found numerous semi-lunar valves, looking toward the larger vessels, formed by a folding of the inner coat and strengthened by connective tissue. Lymphatic Glands consist of an external fibrous covering, from the inner surface of which partitions of fibrous tissue, the trabeculae, pass into the substance of the gland, forming a stroma or network, in the meshes of which are found the true lymph corpuscles. The lymphatics which enter the gland are called the afferent vessels; those which leave it, the efferent vessels. The Thoracic Duct is the general trunk of the lymphatic system, into which the vessels of the lower extremities, of the abdominal organs, of the left side of the head and left arm empty their contents. It is about twenty inches in length, arises in the abdomen, opposite the third lumbar verte- bra, by a dilatation, the receptaculum chyli; ascends along the vertebral column to the seventh cervical vertebra, and terminates in the venous system at the junction of the internal jugular and subclavian veins on the left side. The lymphatics of the right side of the head, of the right arm and the right side of the thorax, terminate in the right thoracic duct, about 30 HUMAN PHYSIOLOGY. one inch in length, which joins the venous system at the junction of the internal jugular and subclavian on the right side. Lymph is a clear, transparent fluid, slightly alkaline, having a saline taste and a specific gravity of 1.022. It is found in the lymphatic vessels throughout the body. Lymph contains a number of corpuscles (the leucocytes') resembling the white corpuscles of the blood, which increase in number as it passes through the lymphatic glands. They are about of an inch in diam- eter and somewhat granular; they are discharged into the blood, but their function is obscure. When withdrawn from the vessels lymph undergoes spontaneous coagulation, separating into serum and clot, as in the case of the blood. DR. OWEN REES. Water 96.536 Proteids (serum-albumen, fibrin, globulin) 1.320 Extractives (urea, sugar, cholesterine) 1.559 Fatty matter a trace Salts 0.585 100.000 COMPOSITION OF LYMPH. Origin of Lymph. Lymph is undoubtedly a transudation from the capillary blood vessels, occurring during the process of nutrition, and is identical, for the most part, with the liquor sanguinis, or plasma. As new material is constantly exuded, the old is absorbed by the lymphatics, and returned again to the circulation. Excrementitious matters, as urea, cholesterine, etc., are also taken up from the tissues by the lymphatics and emptied into the blood. The total quantity of lymph poured into the thoracic duct in 24 hours has been estimated at 3 lbs. Chyle. As a result of the process of digestion, the oleaginous matters which have been acted upon by the pancreatic juice and bile are trans- formed into a condition of emulsion, forming an opaque, milky fluid, termed chyle, which adheres to the folds of the mucous membrane and villi. * The Molecules of the fat are first absorbed by the epithelial cells upon the surface of the villi, through which they pass and enter the lymphatics. Absorption by the Lacteals. The lacteals, or lymphatics of the small intestine, have their origin in the interior of the villi, from which they emerge and form a lymphatic plexus; the larger branches of which pass ABSORPTION. 31 through the layers of the mesentery, and finally terminate in the thoracic duct. In the intervals of digestion the lacteals contain clear, transparent lymph, and are invisible on account of their small size and delicacy. But during digestion these vessels become filled, from absorption of the chyle, and form a visible network of white vessels ramifying through the mesentery, and converging toward the receptaculum chyli. The lacteal vessels also absorb a small quantity of water, albuminose, glucose and salts. Water 902.37 Albumen 35.16 Fibrin 3.70 Extractives 15.65 Fatty matters 36.01 Salts 7.11 1000.00 COMPOSITION OF CHYLE. The Products of digestion find their way into the general circulation by two routes: — 1. Water, albuminose, glucose and salts, are mainly absorbed by the gastric and mesenteric veins, carried into the liver, through the capillaries of which they pass, and enter the inferior vena cava by the hepatic veins. 2. The Fats are absorbed by the lacteals, emptied into the thoracic duct, and enter the blood at the junction of the internal jugular and subclavian veins. Forces aiding the movements of Lymph and Chyle. 1. Endosmosis. The continued transudation of matter from the capil- laries, and its absorption into the lymphatics by endosmosis, constitutes the main cause, the vis-a-tergo, of the movement of the lymph; it is so con- siderable as to rupture the walls of the vessels if they are ligated. 2. Contraction of the non-striated muscular fibres in the walls of the lymphatic vessels, especially when fully distended, aided by the action of the valves, promotes the onward flow of the fluids. 3. Muscular contraction in all parts of the body, by exerting intermit- tent pressure upon the lymphatic vessels, hastens the current onwards; regurgitation being prevented by the closure of the valves. 4. The Inspiratory movement, by expanding the chest, causes a dilation of the thoracic duct, and a rapid flow of lymph and chyle into it; during expiration it is compressed, and the fluids forcibly expelled into the venous system. 32 HUMAN PHYSIOLOGY. The Blood is a nutritive fluid containing all the elements necessary for the repair of the tissues; it also contains principles of waste absorbed from the tissues, which are conveyed to the various excretory organs and by them eliminated from the body. The total amount of blood in the body is estimated to be about one- eighth of the body weight; from 16 to 18 pounds in an individual of average physical development. The quantity varies during the 24 hours ; the maximum being reached in the afternoon, the minimum in the early morning hours. Blood is a heterogeneous, opaque red fluid, having an alkaline reaction, a saline taste, and a specific gravity of 1.055. The opacity is due to the refraction of the rays of light by the elements of which the blood is composed. The color varies in hue, from a bright scarlet in the arteries to a deep purple in the veins, due to the presence of a coloring matter, hcemoglobin, in different degrees of oxidation. The alkalinity is constant, and depends upon the presence of the tri- sodium phosphate; becomes acid in cholera and sunstroke. The saline taste is due to the amount of sodium chloride present. The specific gravity ranges within the limits of health from 1.045 to 1.075 • The odor of the blood is characteristic, and varies with the animal from which it is drawn, due to the presence of caproic acid. The temperature of the blood ranges from 98° Fahr. at the surface to 107° P’ahr. in the hepatic vein; it loses heat by radiation and evaporation as it approaches the extremities, and as it passes through the lungs. Blood consists of two portions:— 1. The Liquor Sanguinis or Plasma, a transparent, colorless fluid in which are floating— 2. Red and white corpuscles ; these constituting by weight less than one- half, 40 per cent., of the entire amount of blood. BLOOD. COMPOSITION OF PLASMA. dalton. Water 902.00 Albumen 53-°° Paraglobulin 22.00 Fibrinogen 3.00 Fatty matters 2.50 Crystallizable nitrogenous matters 4.00 Other organic matter 5.00 Mineral salts 8.50 1000.00 BLOOD. 33 Water acts as a solvent for the inorganic matters and suspends the corpuscular elements. Albumen is the nutritious principle of the blood; it is absorbed by the tissues to repair their waste, and is transformed into the organic basis characteristic of each structure. Paraglobulin or Jibrinoplastin is a soft amorphous substance precipitated by sodium chloride in excess, or by passing a stream of carbonic acid through dilute serum. Fibrinogen can also be obtained by strongly diluting the serum and passing carbonic acid through it for a long time, when it is precipitated as a viscous deposit. Fatty matters exist in small proportion, except in pathological conditions and after the ingestion of food rich in oleaginous matters; it soon dis- appears, undergoing oxidation, generating heat and force, or is deposited as adipose tissue. Sugar is represented by glucose, a product of the digestion of saccharine matter and starches in the alimentary canal; glycogenic matter is derived from the liver. The Saline constituents aid the process of osmosis, give alkalinity to the blood, promote the absorption of carbonic acid from the tissues into the blood, and hold other substances in solution; the most important are the sodium and potassium chlorides, the calcium and magnesium phos- phates. Excrementitious matters are represented by carbonic acid, urea, creatin, creatinin, urates, oxalates, etc.; they are absorbed from the tissues by the blood and conveyed to the excretory organs, lungs, kidneys, etc. Gases. Oxygen, nitrogen, and carbonic acid exist in varying propor- tions. BLOOD CORPUSCLES. The corpuscular elements of the blood occur under two distinct forms, which from their color are known as the red and white corpuscles. The Red Corpuscles, as they float in a thin layer of the Liquor Sanguinis, are of a pale straw color ; it is only when aggregated in masses that they assume the bright red color. Inform they are circular and biconcave; they have an average diameter of the an inch- In mammals, birds, reptiles, amphibia and fish the corpuscles vary in size and number, gradually becoming larger and less numerous as the scale of animal life is descended, e. g. :— 34 HUMAN PHYSIOLOGY. TABLE SHOWING COMPARATIVE DIAMETER OF RED CORPUSCLES. Mammals. Man, 32^3- Chimpanzee, Ourang, 3^3. Dog, 3BV2- Cat, «W Hog, iihs- Horse, ISW Ox, 52*37 • Birds. Eagle, tbW Owl, T7!S3- Sparrow, 21*w. Swallow, 5x35. Pigeon, rsVs- Turkey, Goose, ihbb- Swan, ib'ss- Reptiles. Turtle, Ti&x. Tortoise, Lizard, tsbs- Viper, tbVj- Amphibia. Frog, nW 1 oad, Tuks- Proteus, Siren, Amphiuma, 3J3. Fish. Perch, 20&5* Carp, 2ihi- Pike, soVff* I7is- In man and the mammals the red corpuscles present neither a nucleus nor a cell wall, and are universally of a small size. They can be readily distinguished from the corpuscles of birds, reptiles and fish, in which they are larger, oval in shape and possess a well defined nucleus. The red corpuscles are exceedingly numerous, amounting to about 5,000,000 in a cubic millimetre of blood. In structure they consist of a firm, elastic, colorless framework, the stroma, in the meshes of which is entangled the coloring matter, the hcemoglobin. Water 688.00 Globulin 282.22 Hsemoglobin 16.75 Fatty matter 2.31 Extractives 2.60 Mineral salts 8.12 1000.00 CHEMICAL COMPOSITION OF RED CORPUSCLES. Hcemoglobin, the coloring matter of the corpuscles, is an albuminous compound, composed of C. O. H. N. S. and iron. It may exist either in an amorphous or crystalline form. When deprived of all its oxygen, except the quantity entering into its intimate composition, the haemoglobin becomes darker in color, somewhat purple in hue, and is known as reduced hcemoglobin. When exposed to the action of oxygen it again absorbs a definite amount and becomes scarlet in color, and is known as oxy-hcemo- globin. The amount of oxygen absorbed is 1.76 c.cm. (xV cubic inch,) for I milligramme grain) of hsemoglobin. It is this substance which gives the color to the venous and arterial blood. As the venous blood passes through the capillaries of the lungs, the reduced hcemoglobin absorbs the oxygen from the pulmonary air and becomes oxy-hcemoglobin, scarlet in color, and the blood becomes arterial. BLOOD. 35 When the arterial blood passes into the systemic capillaries the oxygen is absorbed by the tissues, the haemoglobin becomes reduced, purple in color, and the blood becomes venous. A dilute solution of oxy-hsemo- globin gives two absorption bands between the lines D and E of the solar spectrum. Reduced haemoglobin gives but one absorption band, occupying the space existing between the two bands of the oxy-haemoglobin spectrum. The Function of the red corpuscles is, therefore, to absorb oxygen and carry it to the tissues; the smaller the corpuscles, and the greater the number, the greater is the quantity of oxygen absorbed; and, consequently, all the vital functions of the body become more active. The White Corpuscles are far less numerous than the red, the proportion being, on an average, about I white to 350 or 400 red; they are globular in shape, and measure the twists °f an inch in diameter, and consist of a soft, granular, colorless substance, containing several nuclei. The white corpuscles possess the power of spontaneous movement, alter- nately contracting and expanding, throwing out processes of their substance and quickly withdrawing them, thus changing their shape from moment to moment. These movements resemble those of the amoeba, and for this reason are termed amoeboid. They also possess the capability of moving from place to place. In the interior of the vessels they adhere to the inner surface while the red corpuscles move through the centre of the stream. The white corpuscles are identical with the leucocytes, and are found in milk, lymph, chyle and other fluids. Origin of Corpuscles. The red corpuscles take their origin from the mesoblastic cells in the vascular area of the developing embryo. In the adult they are produced from colorless nucleated corpuscles resembling the white corpuscles. The spleen is the organ in which they are finally destroyed. The white corpuscles originate from the leucocytes of the adenoid tissue, and subsequently give rise to the red corpuscles and partly to new tissues that result from inflammatory action. COAGULATION OF THE BLOOD. When blood is withdrawn from the body and allowed to remain at rest it becomes somewhat thick and viscid in from three to five minutes; this viscidity gradually increases until the entire volume of blood assumes a jelly-like consistence, which occupies from five to fifteen minutes. As soon as coagulation is completed a second process begins, which con- sists in the contraction of the coagulum and the oozing of a clear, straw- colored liquid, the serum, which gradually increases in quantity as the clot 36 HUMAN PHYSIOLOGY. diminishes in size, by contraction, until the separation is completed, which occupies from 12 to 24 hours. The changes in the blood are as follows:— Before coagulation. Liq. Sanguinis or Plasma. Water. Albumen. Fibrin. Salts. Living blood. Consisting of Corpuscles. Red and white. After coagulation. Crassamentum. Clot or coagulum. Containing Fibrin. Corpuscles. Dead blood. Serum. Containing f Water. -j Albumen. [ Salts. The Serum, therefore, differs from the Liquor Sanguinis in not contain- ing fibrin. In from 12 to 24 hours the upper surface of the clot presents a grayish appearance, the buffy coat, which is due to the rapid sinking of the red corpuscles beneath the surface, permitting the fibrin to coagulate without them, which then assumes a grayish-yellow tint. Inasmuch as the white corpuscles possess a lighter specific gravity than the red, they do not sink so rapidly, and becoming entangled in the fibrin, assist in forming the buffy coat. Continued contraction gives a cupped appearance to the surface of the clot. Inflammatory states of the blood produce a marked increase in the buffed and cupped condition, on account of the aggregation of the corpus- cles and their tendency to rapid sinking. Nature of Coagulation. Coagulable fibrin does not pre-exist in the blood, but is formed at the moment blood is withdrawn from the vessels. According to Denis, a liquid substance, plasmine, exists in the blood, which, when withdrawn from the circulation, decomposes into fibrin and 7net-albumen. According to Schmidt, fibrin results from the union of fibrinoplastin (paraglobulin) and fibrinogen, brought about by the presence of a third substance, the fibrin ferment. Conditions Influencing Coagulation. The process is retarded by cold, retention within living vessels, neutral salts in excess, inflammatory conditions of the system, imperfect aeration, exclusion from air, etc. CIRCULATION OF THE BLOOD. 37 It is hastened by a temperature of ioo° F., contact with air, rough sur- faces and rest. Blood coagulates in the body after the arrest of the circulation in the course of 12 to 24 hours; local arrest of the circulation from compression or a ligature will cause coagulation, thus preventing hemorrhages from wounded vessels. The Composition of the Blood varies in different portions of the body. The arterial differs from the venous, in being more coagulable, in containing more oxygen and less carbonic acid, in having a bright scarlet color, from the union of oxygen with haemoglobin; the purple hue of venous blood results from the deoxidation of the coloring matter. The blood of the portal vein differs in constitution, according to different stages of digestive process; during digestion it is richer in water, albumin- ous matter and sugar; occasionally contains fat; corpuscles are dimin- ished, and there is an absence of biliary substances. The blood of the hepatic vein contains a larger proportion of red and white corpuscles; the sugar is augmented, while albumen, fat and fibrin are diminished. Pathological conditions of the Blood. 1. Plethora—increase in the volume or quantity of blood. 2. Ancemia—deficiency of red globules with increase of water. 3. Leucocythemia—increase of white and diminution of red corpuscles. 4. Glycohcemia—excess of sugar in the blood. 5. Urcemia—increase in the amount of urea. 6. Cholestercemia— an excess of cholesterine in the blood. 7. Thrombosis and embolism—clotting of blood in the vessels and dis- semination of coagula. 8. Lipcemia—an excess of fat. 9. Melanamia—pigment in the blood. CIRCULATION OF THE BLOOD. The Object of the Circulation is to distribute nutritious blood to all portions of the system and to carry waste materials to the various elimi- nating organs. The Circulatory Apparatus consists of the heart, arteries, capillaries and veins. The Heart is a hollow, muscular organ, pyramidal in shape, measuring inches in length and weighing from io to 12 oz. in the male, and 8 to 10 oz. in the female. It is invested externally by a closed fibro-serous 38 HUMAN PHYSIOLOGY. sac, the pericardium, containing a small amount of fluid, which prevents friction as the visceral and parietal layers glide over each other, during the movements of the heart and lungs. The heart consists of four cavities, a right auricle and ventricle, and a left auricle and ventricle, completely separated by a vertical partition. The right is the venous side, receiving the blood from the venae cavae, and pro- pelling it through the pulmonary artery into the lungs; the left is the arterial side, receiving the arterial blood from the lungs by the pulmonary veins, and propelling it through the aorta to the system at large. The Auriculo-ventricular orifices are guarded on the right and left sides by the tricuspid and mitral valves respectively, while they are so arranged as to permit the flow of blood in the forward direction only; the orifices of the pulmonary artery and aorta are guarded by the semi-lunar valves. The Endocardium is a delicate, shining membrane, lining the interior of the heart, and continuous with the lining membrane of the blood vessels. The walls of the left ventricle are nearly half an inch in diameter, being two or three times thicker than the walls of the right; the force of its contraction being much greater. The Function of the Heart is to propel the blood to all portions of the vascular system; accomplished by successive alternate contractions and relaxations of its muscular walls, constituting the systole and diastole. Course of the blood through the Heart. The venous blood re- turned to the heart by the superior and inferior vense cavse is emptied, during the diastole, into the right auricle, on the contraction of which it is forced through the right auriculo-ventricular opening into the right ventricle and distends it. Upon contraction of the ventricle the blood is propelled through the pulmonary artery into the lungs, where it undergoes aeration and is changed in color. The arterial blood is now collected by the pulmonary veins and poured into the left auricle; thence it passes into the left ventricle, which becomes fully distended. Upon the contraction of the ventricle, the blood is pro- pelled into the aorta, and by it distributed to the system at large, to be again returned to the heart by the veins. Regurgitation from the ventricles into the auricles during the systole is prevented by the closure of the tricuspid and mitral valves; regurgitation from the pulmonary artery and aorta into the ventricles during the diastole is prevented by the closure of the semi-lunar valves. Movements of the Heart. At each revolution, during the systole, the heart hardens and becomes shortened in its long diameter; its apex is CIRCULATION OF THE BLOOD. 39 raised up, rotated on its axis from left to right and thrown forward against the walls of the chest. The impulse of the heart, observed about two inches below the nipple, and one inch to the sternal side, between the fifth and sixth ribs, is caused mainly by the apex of the heart striking against the chest walls, assisted by the distention of the great vessels about the base of the heart. Sounds of the Heart. If the ear be placed over the cardiac region two distinct sounds are heard during each revolution of the heart, closely following each other and which differ in character. The sound coinciding with the systole in point of time, the first sound, is long and dull, and caused by the closure and vibration of the auriculo-ven- tricular valves, the contraction of the walls of the ventricles and the apex beat; the second sound, occurring during the diastole, is short and sharp, and caused by the closure of the semi-lunar valves. The capacity of the left ventricle when fully distended is estimated at from four to seven ounces. The frequency of the heart’s action varies at different periods of life, but in the adult male it beats about 72 times per minute. It is influenced by age, exercise, posture, digestion, etc. Age. Before birth the number of pulsations per minute averages 140 During the first year it diminishes to 128 During the third year diminishes to 95 From the eighth to the fourteenth years averages 84 In adult life the average is 72 Exercise and digestion increase the frequency of the heart’s action. Posture influences the number of pulsations per minute ; in the male, standing, the average is 81; sitting, 71; lying, 66; independent, for the most part, of muscular effort. The Rhythmical movements of the heart are dependent upon, 1. An inherent irritability of the muscular fibres, which manifests itself as long as the nutrition is maintained. 2. The continuous flow of blood through its cavities distending them and stimulating the endocardium. The force exerted by the left ventricle at each contraction has been estimated at 52 pounds. If a tube be inserted into the aorta the pressure there will be sufficient to support a column of blood nine feet or a column of mercury six inches in height, the weight in either case being about four pounds. The estimation of the force which the heart is required to exert to support this column of blood, is arrived at by multiply- ing the pressure in the aorta (4 pounds) by the area of the internal surface 40 HUMAN PHYSIOLOGY. of the left ventricle (about 13 inches). Each inch of the ventricle being capable of supporting a downward pressure of 4 pounds. Work done by the Heart. The work done by the heart is esti- mated by multiplying the amount of blood sent out from the right and left ventricles at each contraction, by the pressure in the pulmonary artery and aorta respectively, e. g., when the right ventricle contracts it forces out one quarter pound of blood, and in so doing must overcome a pressure in the pulmonary artery sufficient to support a column of blood three feet in height; that is, must exert energy sufficient to raise lb 3 feet or X 3 or fb one foot. When the left ventricle contracts it sends out lb of blood, and in so doing the left ventricle must overcome pressure in the aorta sufficient to support a column of blood nine feet in height; that is, must exert energy sufficient to raise lb 9 feet, or X 9 or 2)4' lbs one foot. Work done is estimated by the amount of energy required to raise a definite weight a definite height, the unit, the foot pound, being that required to raise one pound one foot. The heart, therefore, at each systole exerts energy sufficient to raise 3 foot pounds, and as it contracts 72 times per minute it would raise in that time 3 X 72 or 216 foot pounds; and in one hour 216 X 60 or 12,960 foot pounds; and in 24 hours 12,960 X 24 or 311,040 foot pounds or 138.5 foot tons. Influence of the Nervous System upon the Heart. When the heart of a frog is removed from the body it continues to beat for a variable length of time, depending upon the nature of the conditions sur- rounding it. The heart of warm-blooded animals continues to beat but for a very short time. The cause of the continued pulsations of the frog heart is the presence of nervous ganglia in its substance. These ganglia have not been shown to exist in the mammalian heart, but there is reason to believe that the nervous mechanism is fundamentally the same. The ganglia of the heart are three in number, one situated at the open- ing of the inferior vena cava (the ganglion of Remak), a second situated in the auriculo-ventricular septum (the ganglion of Bidder), and a third situated in the inter-auricular septum (the ganglion of Ludwig). The first two are motor in function and excite the pulsations of the heart; the third is inhibitory in function and retards the action of the heart. The actions of these ganglia, though for the most part automatic, are modified by impressions coming through nerves from the medulla oblongata. When the inhibitory centre is stimulated by muscarin, the heart is arrested in diastole; when atropia is applied, the heart recommences to beat, because atropia paralyzes the inhibitory centre. ARTERIES. 41 The nerves modifying the action of the heart are the Pneumogastric (Vagus) and the Accelerator nerves. The Pneumogastric nerve after emerging from the medulla receives motor fibres from the spinal accessory nerve. It then passes downward, giving off branches, some of which terminate in the inhibitory ganglion. Stimulation of the vagus by increasing the activity of the inhibitory centre arrests the heart in diastole with its cavities full of blood; but as the stimu- lation is only temporary, after a few seconds the heart recommences to beat; at first the pulsations are weak and feeble, but soon regain their original vigor. After the administration of atropia in sufficient doses to destroy the termination of the pneumogastric, stimulation of its trunk has no effect upon the heart. The inhibitory fibres in the vagus are constantly in action, for division of the nerve on both sides is always followed by an increase in the frequency of the heart’s pulsations. The Accelerator fibres arise in the medulla, pass down the cord, emerge in the cervical region, pass to the last cervical and first dorsal ganglia of the sympathetic, and thence to the heart. Stimulation of these fibres causes an increased frequency of the heart’s pulsations, but they are diminished in force. The Arteries are a series of branching tubes conveying blood to all portions of the body. They are composed of three coats— 1. External, formed of areolar and elastic tissue. 2. Middle, contains both elastic and muscular fibres, arranged trans- versely to the long axis of the artery. The elastic tissue is more abundant in the larger vessels, the muscular in the smaller. 3. Internal, composed of a thin homogeneous membrane, covered with a layer of elongated endothelial cells. The arteries possess both elasticity and contractility. The Property of Elasticity allows the arteries already full to accommo- date themselves to the incoming amount of blood, and to convert the intermittent acceleration of blood in the large vessels into a steady and continuous stream in the capillaries. The Contractility of the smaller vessels equalizes the current of blood, regulates the amount going to each part, and promotes the onward flow of blood. Blood Pressure. Under the influence of the ventricular systole, the recoil of the elastic walls of the arteries, and the resistance offered by the capillaries, the blood is constantly being subjected to a certain amount of ARTERIES. 42 HUMAN PHYSIOLOGY. pressure. If a large artery of an animal be divided, and a glass tube of the same calibre be inserted into its orifice, the blood will rise to a height of about nine feet; or if it be connected with a mercurial manometer, the mercury will rise to a height of six inches. This height will be a measure of the pressure in the vessel. The absolute quantity of mercury sustained by an artery can be arrived at by multiplying the height of the column by the area of a transverse section of that artery. The pressure of the blood is greatest in the large arteries, but gradually decreases toward the capillaries. The blood pressure is increased or diminished by influences acting upon the heart or upon the peripheral resistance of the capillaries, viz.:— If, while the force of the heart remains the same, the number of pulsa- tions per minute increases, thus increasing the volume of blood in the arteries, the pressure rises. If the rate remains the same, but the force increases, the pressure again rises. Causes that increase the peripheral resistance by contracting the arterioles, e. g., vaso-motor nerves, cold, etc., produce an increase of the pressure. On the other hand, influences which diminish either the volume of the blood, or the number of pulsations, or the force of the heart, or the peripheral resistance, lower the pressure. The Pulse is the sudden distention of the artery in a transverse and longitudinal direction, due to the injection of a volume of blood into the arteries at the time of the ventricular systole. As the vessels are already full of blood, they must expand in order to accommodate themselves to the incoming volume of blood. The blood pressure is thus increased, and the pressure originating at the ventricle -excites a pulse waste, which passes from the heart toward the capillaries at the rate of about twenty-nine feet per second. It is this wave that is appreciated by the finger. The Velocity with which the blood flows in the arteries diminishes from the heart to the capillaries, owing to an increase of the united sec- tional area of the vessels, and increases in rapidity from the capillaries toward the heart. It moves most rapidly in the large vessels, and espe- cially under the influence of the ventricular systole. From experiments on animals, it has been estimated to move in the carotid of man at the rate of sixteen inches per second, and in the large veins at the rate of four inches per second. The Calibre of the blood vessels is regulated by the vaso-motor nerves, which have their origin in the gray matter of the medulla oblon- gata. They issue from the spinal cord through the anterior roots of spinal ARTERIES. 43 nerves, pass through the sympathetic ganglia, and ultimately are distributed to the coats of the blood vessels. They exert, at different times, a constrict- ing and dilating action upon the vessels, thus keeping up the arterial tonus. Capillaries. The capillaries constitute a network of vessels of micro- scopic size, which distribute the blood to the inmost recesses of the tissues, inosculating with the arteries on the one hand and the veins on the other ; they branch and communicate in every possible direction. The diameter of a capillary vessel varies from the -rfas to the of an inch; their walls consist of a delicate homogeneous membrane, the TubniS of an inch in thickness, lined by flattened, elongated, endothelial cells, between which, here and there, are observed stomata. It is through the agency of the capillary vessels that the phenomena of nutrition and secretion takes place, for here the blood flows in an equable and continuous current, and is brought into intimate relationship with the tissues, two of the essential conditions for proper nutrition. The rate of movement in the capillary vessels is estimated at one inch in thirty seconds. , In the capillary current the red corpuscles may be seen hurrying down the centre of the stream, while the white corpuscles in the still layer adhere to the walls of the vessel, and at times can be seen to pass through the walls of the vessel by amoeboid movements. The passage of the blood through the capillaries is mainly due to the force of the ventricular systole and the elasticity of the arteries; but it is probably also aided by a power resident in the capillaries themselves, the result of a vital relation between the blood and the tissues. The Veins are the vessels which return the blood to the heart; they have their origin in the venous radicles, and as they approach the heart, converge to form larger trunks, and terminate finally in the venae cavae. They possess three coats— 1. External, made up of areolar tissue. 2. Middle, composed of non-striated muscular fibres, yellow, elastic and fibrous tissue. 3. Internal, an endothelial membrane, similar to that of the arteries. Veins are distinguished by the possession of valves throughout their course, which are arranged in pairs, and formed by a reflection of the in- ternal coat, strengthened by fibrous tissue; they always look toward the heart, and when closed prevent a return of blood in the veins. Valves are most numerous in the veins of the extremities, but are entirely absent in many others. 44 HUMAN PHYSIOLOGY. The onward flow of blood in the veins is mainly due to the action of the heart; but is assisted by the contraction of the voluntary muscles and the force of aspiration. Muscular contraction, which is intermittent, aids the flow of blood in the veins, by compressing them. As regurgitation is prevented by the closure of the valves, the blood is forced onward toward the heart. Rhythmical movements of veins have been observed in some of the lower animals, aiding the onward current of blood. During the movement of inspiration the thorax is enlarged in all its diameters, and the pressure on its contents at once diminishes. Under these circumstances a suction force is exerted upon the great venous trunks, which causes the blood to flow with increased rapidity and volume toward the heart. Venous pressure. As the force of the heart is nearly expended in driving the blood through the capillaries, the pressure in the venous system is not very marked, not amounting in the jugular vein of a dog to more than tV that of the carotid artery. The time required for a complete circulation of the blood throughout the vascular system has been estimated to be from 20 to 30 seconds, while for the entire mass of blood to pass through the heart 58 pulsations would be required, occupying 48 seconds. The Forces keeping the blood in circulation are— 1. Action of the heart. 2. Elasticity of the arteries. 3. Capillary force. 4. Contraction of the voluntary muscles upon the veins. 5. Respiratory movements. RESPIRATION. Respiration is the function by which oxygen is absorbed into the blood and carbonic acid exhaled. The appropriation of the oxygen and the evolution of carbonic acid takes place in the tissues as a part of the general nutritive process; the blood and respiratory apparatus constituting the media by means of which the interchange of gases is accomplished. The Respiratory Apparatus consists of the larynx, trachea and lungs. The Larynx is composed of firm cartilages, united together by liga- ments and muscles; running antero-posteriorly across the upper opening are four ligamentous bands, the two superior or false vocal cords, and the two inferior or true vocal cords, formed by folds of the mucous membrane. RESPIRATION. 45 They are attached anteriorly to the thyroid cartilages and posteriorly to the arytenoid cartilages, and are capable of being separated by the contraction of the posterior crico-arytenoid muscles, so as to admit the passage of air into and from the lungs. The Trachea is a tube from four to five inches in length, three-quarters of an inch in diameter, extending from the cricoid cartilage of the larynx to the third dorsal vertebra, where it divides into the right and left bronchi. It is composed of a series of cartilaginous rings, which extend about two- thirds around its circumference, the posterior third being occupied by fibrous tissue and non-striated muscular fibres which are capable of dimin- ishing its calibre. The trachea is covered externally by a tough, fibro-elastic membrane, and internally by mucous membrane, lined by columnar ciliated epithelial cells. The cilia are always waving from within outward. When the two bronchi enter the lungs they divide and subdivide into numerous and smaller branches, which penetrate the lung in every direction until they finally terminate in the pulmonary lobules. As the bronchial tubes become smaller their walls become thinner; the cartilaginous rings disappear, but are replaced by irregular angular plates of cartilage; when the tube becomes less than the of an inch in di- ameter they wholly disappear, and the fibrous and mucous coats blend together, forming a delicate, elastic membrane, with circular muscular fibres. The Lungs occupy the cavity of the thorax, are conical in shape, of a pink color and a spongy texture. They are composed of a great number of distinct lobules, the pulmonary lobules, connected together by inter- lobular connective tissue. These lobules vary in size, are of an oblong shape, and are composed of the ultimate ramifications of the bronchial tubes, within which are contained the air vesicles or cells. The walls of the air vesicles, exceedingly thin and delicate, are lined internally by a layer of tessellated epithelium, externally covered by elastic fibres, which give the lungs their elasticity and distensibility. The Venous Blood is distributed to the lungs for aeration by the pulmonary artery, the terminal branches of which form a rich plexus of capillary vessels surrounding the air cells; the air and blood are thus brought into intimate relationship, being separated only by the delicate walls of the air cells and capillaries. The Pleura. Each lung is surrounded by a closed serous membrane, the pleura, one layer of which, the visceral, is reflected over the lung, the 46 HUMAN PHYSIOLOGY. other, the parietal, reflected over the wall of the thorax; between the two layers is a small amount of fluid which prevents friction during the play of the lungs in respiration. The lungs are nourished by blood from the bronchial arteries ramifying in the walls of the bronchial' tubes and interlobular connective tissue. Respiratory movements. The movements of respiration are two, and consist of an alternate dilation and contraction of the chest, known as inspiration and expiration. 1. Inspiration is an active process, the result of the expansion of the thorax, whereby air is introduced into the lungs. 2. Expiration is a partially passive process, the result of the recoil of the elastic walls of the thorax, and the recoil of the elastic tissue of the lungs, whereby the carbonic acid is expelled. In Inspiration the chest is enlarged by an increase in all its diameters, viz:— 1. The vertical is increased by the contraction and descent of the diaphragm when it approximates a straight line. 2. The antero-posterior and transverse diameters are increased by the elevation and rotation of the ribs upon their axes. In ordinary tranquil inspiration the muscles which elevate the ribs and thrust the sternum forward, and so increase the diameters of the chest, are the external intercostals, running from above downward and forward, the sternal portion of the internal intercostals and the levatores costarum. In the extraordinary efforts of inspiration certain auxiliary muscles are brought into play, viz: the sterno-mastoid, pectorales, serratus magnus, which increase the capacity of the thorax to its utmost limit. In Expiration the diameters of the chest are all diminished, viz : 1. The vertical, by the ascent of the diaphragm. 2. The antero-posterior, by a depression of the ribs and sternum. In ordinary tranquil expiration the muscles which depress the ribs and sternum, and thus diminish the diameter of the chest, are the internal inter- costals, the infra-costals and the triangularis sterni. In the extraordinary efforts of expiration certain auxiliary muscles are brought into play, viz: the abdominal and sacro-lumbalis muscles, which diminish the capacity of the thorax to its utmost limit. Expiration is aided by the recoil of the elastic tissue of the lungs and ribs and the pressure of the air. Movements of the Glottis. At each inspiration the rima glottidis is dilated by a separation of the vocal cords, produced by the contraction of RESPIRATION. 47 the crico-arytenoid muscles so as to freely admit the passage of air into the lungs; in expiration they fall passively together, but do not interfere with the exit of the air from the chest. Nervous Mechanism of Respiration. The movements of respira- tion are involuntary and reflex, and are under the control of the medulla oblongata. This centre may be stimulated— 1. Directly, by the condition of the blood. An increase of carbonic acid or a diminution of oxygen in the blood causes an acceleration of the respiratory movements; the reverse of these conditions causes a diminution of the respiratory movements. 2. Indirectly, by reflex action. The medulla may be excited to action through the pneumogastric nerve, by the presence of carbonic acid in the lungs irritating its terminal filaments; through the fifth nerve, by irrita- tion of the terminal branches; and through the nerves of general sensibility. In either case this centre reflects motor impulses to the respiratory muscles through the phrenic, intercostals, inferior laryngeal and other nerves. Types of Respiration. The abdominal type is most marked in young children, irrespective of sex; the respiratory movements being effected by the diaphragm and abdominal muscles. In the superior costal type, exhibited by the adult female, the respiratory movements are more marked in the upper part of the chest, from the istto the 7th ribs, permitting the uterus to ascend in the abdomen during preg- nancy without interfering with respiration. In the inferior costal type, manifested by the male, the movements are largely produced by the muscles of the lower portion of the chest, from the 7th rib downward, assisted by the diaphragm. The respiratory movements vary according to age, sleep and exercise, being most frequent in early’life, but averaging 20 per minute in adult life. They are diminished by sleep and increased by exercise. There are about four pulsations of the heart to each respiratory act. During inspiration two sounds are produced; the one, heard in the thorax, in the trachea and larger bronchial tubes, is tubular in character; the other, heard in the substance of the lungs, is vesicular in character. AMOUNT OF AIR EXCHANGED IN RESPIRATION, AND CAPACITY OF LUNGS. The Tidal or breathing volume of air, that which passes in and out of the lungs at each inspiration and expiration, is estimated at from 20 to 30 cubic inches. 48 HUMAN PHYSIOLOGY. The Complemcntal ah- is that amount which can be taken into the lungs by a forced inspiration, in addition to the ordinary tidal volume, and amounts to about no cubic inches. The Reserve air is that which usually remains in the chest after the ordinary efforts of expiration, but which can be expelled by forcible expira- tion. The volume of reserve air is about ioo cubic inches. The Residual air is that portion which remains in the chest and cannot be expelled after the most forcible expiratory efforts, and which amounts, according to Dr. Hutchinson, to about ioo cubic inches. The Vital Capacity of the chest indicates the amount of air that can be forcibly expelled from the lungs after the deepest possible inspiration, and is an index of an individual’s power of breathing in disease and pro- longed severe exercise. The combined amounts of the tidal, the comple- mental and reserve air, 230 cubic inches, represents the vital capacity of an individual 5 feet 7 inches in height. The vital capacity varies chiefly with stature. It is increased 8 cubic inches for every inch in height above this standard, and diminishes 8 cubic inches for each inch below it. The Tidal Volume of air is carried only into the trachea and larger bronchial tubes by the inspiratory movements. It reaches the deeper portions of the lungs in obedience to the law of diffusion of gases, which is inversely proportionate to the square root of their densities. The ciliary action of the columnar cells lining the bronchial tubes also assists in the interchange of the air and carbonic acid. The entire volume of air passing in and out of the thorax in 24 hours is subject to great variation, but is estimated by Dr. Smith at 686,000 cubic inches, or 397 cubic feet. Composition of Air: Oxygen, 20.81 parts; nitrogen, 79.19, forming a mechanical mixture in which exist traces of carbonic acid and watery vapor. The changes in the air effected by respiration are— Loss of oxygen, to the extent of 4.782 per cent. Gain of carbonic acid, to the extent of 4.35 per cent. Increase of watery vapor and organic matter. Elevation of temperature. Increase and at times decrease of nitrogen. Gain of ammonia. The total quantity of oxygen withdrawn from the air and consumed by the body in 24 hours amounts to 18 cubic feet; to obtain this quantity 400 cubic feet of pure air are necessary. RESPIRATION. 49 The quantity of carbonic acid exhaled in 24 hours varies greatly. Dr. Smith computed it at 24.208 cubic inches, containing 7.144 oz. of pure carbon. It is increased by muscular exercise; nitrogenous food ; tea, coffee and rice; age, and by muscular development; decreased by a lowering of temperature; repose; gin and brandy, and a dry condition of the air. Condition of the Gases in the Blood. Oxygen is absorbed from the lungs into the arterial blood by the color- ing matter, hcemoglobin, with which it exists in a state of loose combina- tion, and is disengaged during the process of nutrition. Carbonic acid, arising in the tissues, is absorbed into the blood in conse- quence of its alkalinity; where it exists in a state of simple solution and also in a state of feeble combination with soda and potassa, forming the bicarbonates; it is liberated by pneumic acid in the pulmonary tissue. Nitrogen is simply in solution in the plasma. The amount of watery vapor thrown off from the lungs daily is about one pound, with which is mingled organic matter and ammonia. Changes in the Blood during Respiration. As the blood passes through the lungs it is changed in color, from the dark purple hue of venous blood to the bright scarlet of arterial blood. The heterogeneous composition of venous blood is exchanged for the uniform composition of the arterial. It gains oxygen and loses carbonic acid. Its coagulability is increased. Temperature is diminished. Asphyxia. If the supply of oxygen to the lungs be diminished and the carbonic acid retained in the blood, the normal respiratory movements cease, the condition of asphyxia ensues, which soon terminates in death. The phenomena of asphyxia are, violent spasmodic action of the respira- tory muscles, attended by convulsions of the muscles of the extremities, engorgement of the venous system, lividity of the skin, abolition of sensibility and reflex action, and death. The cause of death is a paralysis of the heart, from over distention by blood. The passage of the blood through the capillaries is prevented by contraction of the smaller arteries from irritation of the vaso-motor centre. The heart is enfeebled by a want of oxygen and inhibited in its action by the inhibitory centres. 50 HUMAN PHYSIOLOGY. ANIMAL HEAT. The Functional Activity of all the organs and tissues of the body is attended by the evolution of heat, which is independent, for the most part, of external conditions. Heat is a necessary condition for the due perform- ance of all vital actions ; though the body constantly loses heat by radia- tion and evaporation, it possesses the capability of renewing it and maintaining it at a fixed standard. The normal temperature of the body in the adult, as shown by means of a delicate thermometer placed in the axilla, ranges from 97.250 Fahr. to 99.50 Fahr., though the mean normal temperature is estimated by Wunderlich at 98.6° Fahr. The temperature varies in different portions of the body, according to the degree to which oxidation takes place; being the highest in the muscles during exercise, in the brain, blood, liver, etc. The conditions which produce variations in the normal tempera- ture of the body are: age, period of the day, exercise, food and drink, climate, season and disease. Age. At birth the temperature of the infant is about i° F. above that of the adult, but in a few hours falls to 95.5° F., to be followed in the course of 24 hours by a rise to the normal or a degree beyond. During childhood the temperature approaches that of the adult; in aged persons the temperature remains about the same, though they are not as capable of resisting the depressing effects of external cold as adults. A diurnal variation of the temperature occurs from 1.8° F. to 3.6° F. (Jiirgensen); the maximum occurring late in the afternoon, from 4 to 9 p. M., the minimum, early in the morning, from x to 7 A. M. Exercise.. The temperature is raised from i° to 2° F. during active con- tractions of the muscular masses, and is probably due to the increased activity of chemical changes ; a rise beyond this point being prevented by its diffusion to the surface, consequent on a more rapid circulation, radia- tion, more rapid breathing, etc. Food and drink. The ingestion of a hearty meal increases the tempera- ture but slightly; an absence of food, as in starvation, produces a marked decrease. Alcoholic drinks, in large amounts, in persons unaccustomed to their use, cause a depression of the temperature amounting from i° to 20 F. Tea causes a slight elevation. External temperature. Long continued exposure to cold, especially if the body is at rest, diminishes the temperature from i° to 20 F., while ex- posure to a great heat slightly increases it. Disease frequently causes a marked variation in the normal temperature ANIMAL HEAT. 51 of the body, rising as high as 107° F. in typhoid fever, and 105° F. in pneu- monia; in cholera it falls as low as 8o° F. Death usually occurs when the heat remains high and persistent, from 1060 to no° F.; the increase of heat in disease is due to excessive production rather than to diminished elimination. The source of heat is to be sought for in the chemical combinations taking place during the general process of nutrition, and the amount of its production is in proportion to the activity of the internal changes. Every contraction of a muscle, every act of secretion, each exhibition of nerve force, is accompanied by a change in the chemical composition of the tissues and an evolution of heat. The reduction of the disintegrated tissues to their simplest form by oxidation ; the combination of the oxygen of the inspired air with the carbon and hydrogen of the blood and tissues, results in the formation of carbonic acid and water and the generation of a large amount of heat. Certain elements of the food, particularly the non-nitrogenized sub- stances, undergo oxidation without taking part in the formation of the tissues, being transformed into carbonic acid and water, and thus increase the sum of heat in the body. Heat-producing Tissues. All the tissues of the body add to the general amount of heat, according to the degree of their activity. But special structures, on account of their mass and the large amount of blood they receive, are particularly to be regarded as heat producers ; e. g. :— 1. During mental activity the brain receives nearly one-fifth of the entire volume of blood, and the venous blood returning from it is charged with waste matters, and its temperature is increased. 2. The muscular tissue, on account of the many chemical changes occurring during active contractions, must be regarded as the chief heat- producing tissue. 3. The secreting glands, during their functional activity, add largely to the amount of heat. Of the entire quantity of heat generated in the body, it is estimated that only a small proportion is utilized, as five-sixths escape by radiation and evaporation, the remaining one-sixth being utilized in keeping the body at the normal temperature standard, 98.6° F., and in the production of muscular force. The body loses heat by radiation and evaporation from the general cuta- neous surface, the respiratory passages and by the urine and faeces. About 75 per cent, of all the heat lost escapes from the skin. In passing through the lungs the temperature of the blood is lowered by about i° Fahr. 52 HUMAN PHYSIOLOGY. The nervous system influences the production of heat in a part, by increasing the amount of blood going through it by its action upon the vaso-motor nerves. Whether there exists a special heat centre has not been satisfactorily determined, though this is probable. The Process of Secretion consists in the separation of materials from the blood, which are either to be again utilized to fulfill some special pur- pose in the economy, or are to be removed from the body as excrementi- tious matter; in the former case they constitute the secretions, in the latter, the excretions. The materials which enter into the composition of the secretions are de- rived from the nutritive principles of the blood, and require special organs, e. g., gastric glands, mammary glands, etc., for their proper elaboration. The materials which compose the excretions pre-exist in the blood, and are the results of the activities of the nutritive process; if retained within the body they exert a deleterious influence upon the composition of the blood. Destruction of a secreting gland abolishes the secretion peculiar to it, and it cannot be formed by any other gland; but among the excreting organs there exists a complementary relation, so that if the function of one organ be interfered with, another performs it, to a certain extent. SECRETION. CLASSIFICATION OF THE SECRETIONS. Serous fluids. Synovial fluid. Aqueous humor of the eye. PERMANENT FLUIDS. Vitreous humor of the eye. Fluid of the labyrinth of the internal ear. Cerebro-spinal fluid. Mucus. Sebaceous matter. Cerumen (external meatus). Meibomian fluid. Milk and colostrum. Tears. Saliva. TRANSITORY FLUIDS. Gastric juice. Pancreatic juice. Secretion from Brunner’s glands. Secretion from Lieberkiihn’s glands. Secretion from follicles of the large intestine. Bile (also an excretion). EXCRETIONS. Perspiration and the secretion of the axillary glands. Urine. Bile (also a secretion). SECRETION. 53 FLUIDS CONTAINING FORMED ANATOMICAL ELEMENTS. Seminal fluid, containing spermatozoids. Fluid of the Graafian follicles. The essential apparatus for secretion is a delicate, homogeneous, structureless membrane, on one side of which, in close contact, is a capillary plexus of blood vessels, and on the other side a layer of cells whose physio- logical function varies in different situations. Secreting organs may be divided into membranes and glands. Serous membranes usually exist as closed sacs, the inner surface of which is covered by pale, nucleated epithelium, containing a small amount of secretion. The serous membranes are the pleura,peritoneum,pericardium, synovial sacs, etc. The serous fluids are of a pale amber color, somewhat viscid, alkaline, coagulable by heat, and resemble the serum of the blood; their amount is but small; the pleural varies from 4 to 7 drachms; the peritoneal from 1 to 4 ounces; the pericardial from 1 to 3 drachms. The synovialfluid is colorless, alkaline, and extremely viscid, from the presence of synovine. The function of serous fluids is to moisten the opposing surfaces, so as to prevent friction during the play of the viscera. The mucous membranes are soft and velvety in character, and line the cavities and passages leading to the exterior of the body, e. g., the gastro- intestinal, pulmonary and genito-urinary. They consist of a primary basement membrane covered with epithelial cells, which, in some situa- tions, are tessellated, in others, columnar. Mucus is a pale, semi-transparent, alkaline fluid, containing epithelial cells and leucocytes. It is composed, chemically, of water, an albumin- ous principle, mucosine, and mineral salts; the principal vari eties are nasal, bronchial, vaginal and urinary. Secreting Glands are formed of the same elements as the secreting membranes; but instead of presenting flat surfaces, are involuted, forming tubules, which may be simple follicles, e. g., mucous, uterine or intestinal; or compound follicles, e. g., gastric glands, mammary glands; or racemose glands, e. g., salivary glands and pancreas. They are composed of a basement membrane, enveloped by a plexus of blood vessels, and are lined by epithelial and true secreting cells, which in different glands possess the capability of elaborating elements characteristic of their secretions. In the production of the secretions two essentially different processes are concerned, viz.:— 54 HUMAN PHYSIOLOGY. 1. Chemical. The formation and elaboration of the characteristic organic ingredients of the secreting fluids, e. g., pepsin, pancreatin, takes place during the intervals of glandular activity, as a part of the general function of nutrition. They are formed by the cells lining the glands, and can often be seen in their interior with the aid of the microscope, e. g., bile in the liver cells, fat in the cells of the mammary gland. 2. Physical. Consisting of a transudation of water and mineral salts from the blood into the interior of the gland. During the intervals of glandular activity, only that amount of blood passes through the gland sufficient for proper nutrition; when the gland begins to secrete, under the influence of an appropriate stimulus, the blood vessels dilate and the quantity of blood becomes greatly increased beyond that flowing through the gland during its repose. Under these conditions a transudation of water and salts takes place, washing out the characteristic ingredients, which are discharged by the gland ducts. The discharge of the secretions is intermittent; they are retained in the glands until they receive the appropriate stimulus, when they pass into the larger ducts by the vis-a-tergo, and are then discharged by the contraction of the muscular walls of the ducts. The activity of glandular secretion is hastened by an increase in the blood pressure and retarded by a diminution. The nervous centres in the medulla oblongata influence secretion, (i) by increasing or diminishing the amount of blood entering a gland; (2) by exerting a direct influence upon the secreting cells themselves, the centres being excited by reflex irritation, mental emotion, etc. The Mammary Glands secrete the milk, and undergo at different periods of life remarkable changes in size and structure. Though rudi- mentary in childhood, they gradually increase in size as the young female approaches puberty. The gland presents, at its convexity, a small prominence of skin, the nipple, surrounded by an areola of a deeper tint. It is covered anteriorly by a layer of adipose tissue and posteriorly by a fibrous structure which attaches it loosely to the pectoralis muscle. During utero-gestation the mammae become large, firm, well-developed and lobulated; the areola becomes darker and the veins more prominent. In the intervals of lactation the glands gradually shrink in size to their original condition, undergo involution, and become non-secreting organs. Structure of the Mammae. The mamma is a conglomerate gland, MAMMARY GLANDS. MILK. 55 consisting of a number of lobes, from 15 to 20 in number, each of which is subdivided into lobules made up of gland vesicles or acini. The ducts which convey the secretion to the exterior, the lactiferous ducts, open by 15 to 20 orifices upon the surface of the nipple, at the base of which they are dilated to form little reservoirs in which the milk collects during the periods of active secretion. The walls of the lacteal duct consist of white, fibrous tissue, and non- striated muscular fibres, lined by short columnar cells, which disappear during active lactation. The ducts measure about the of an inch in diameter; as they pass into the substance of the gland, each duct divides into a number of branches, which are distributed to distinct lobules and terminate in the acini. An acinus is made up of a number of vesicles composed of a homoge- neous membrane, lined by pavement epithelium. The gland vesicles are held together by white, fibrous tissue, which unites the lobules into lobes. MILK Milk has a pale, blue color, is almost inodorous, of a sweetish taste, an alkaline reaction, and a specific gravity varing from 1.025 t0 1.04.6. Examined microscopically it is seen to contain an immense number of globules, measuring the xuihjT! °f an inch in diameter, suspended in a clear fluid; these are the milk globules, formed of a small mass of oily matter covered by a layer of albumen. The quantity of milk secreted by the human female in 24 hours, during the period of lactation, is about two to three pints; the quantity removed by the infant from a full breast at one time being about two ounces. COMPOSITION OF MILK. Water 890.00 Proteids, including casein and serum albumen 35 .oo Fatty matter (butter) 25.00 Sugar (lactose) with extractives 48.00 Salts 2.00 1000.00 Casein is the nutritive principle of milk, and constitutes its most import- ant ingredient. It is held in solution by an alkali, but upon the addition of an acid it undergoes coagulation, passing into a semi-solid form. The presence of lactic acid, resulting from a transformation of milk sugar, causes spontaneous coagulation to take place. The Fatty matter is more or less solid at ordinary temperature, and con- 56 HUMAN PHYSIOLOGY. sists of margarine and oleine; when subjected to the churning process the globules run together and form a coherent mass, the butter. When milk is allowed to stand for a varying length of time the fat glob- ules rise to the surface, forming a layer more or less thick, the crea?n. Milk sugar or lactose is an important ingredient in the food of the young child; it is readily transformed into lactic acid in the presence of nitro- genized ferments. Influences modifying the secretion. During lactation there is a demand for an increased amount of fluid, and if not supplied, the amount of milk secreted is diminished. Good food in sufficient quantity is neces- sary for the proper elaboration of milk, though no particular article influ- ences its production. Mental emotion at times influences the character of the milk, decreasing the amount of its different constituents. Mechanism of Secretion. The water and salts pre-exist in the blood and pass into the gland vesicles by osmosis. The casein, fatty matter and sugar appear only in the mammary gland, but the mechanism of their for- mation is not understood. Colostrum is a yellowish, opaque fluid, formed in the mammary glands towards the latter period of utero-gestation ; it consists of water, albumen, fat, sugar and salts, and acts as a laxative to the newly born infant. VASCULAR OR DUCTLESS GLANDS. The Vascular Glands are regarded as possessing the power of acting upon certain elements of the food and aiding the process of sanguinifi- cation; of modifying the composition of the blood as it flows through their substance, by some act of secretion. The vascular glands are the spleen, suprarenal capsules, thyroid and thymus glands. The Spleen is about 5 inches in length, 6 ounces in weight, of a dark bluish color, and situated in the left hypochondriac region. It is covered externally by a reflection of the peritoneum, beneath which is the proper fibrous coat, composed of areolar and elastic tissue and non-striated muscular fibres. From the inner surface of the fibrous envelope processes or trabeculae are given off, which penetrate the substance of the gland, forming a network, in the meshes of which is contained the spleen pulp. The splenic artery divides into a number of branches, some of which, when they become very minute, pass directly into veins, while others terminate in true capillaries. VASCULAR OR DUCTLESS GLANDS. 57 As the capillary vessels ramify through the substance of the gland their walls frequently disappear and the blood passes from the arteries into the veins through lacuna (Gray). The splenic or Malpighian corpuscles are small bodies, spherical or ovoid in shape, the of an inch in diameter, situated upon the sheaths of the small arteries. They consist of a delicate membrane, containing a semi- fluid substance composed of numerous small cells resembling lymph cor- puscles. The spleen pulp is a dark red, semi fluid substance, of a soft consistence, contained in the meshes of the trabeculae. In it are found numerous corpuscles, like those observed in the Malpighian bodies, blood corpuscles in a natural and altered condition, nuclei and pigment granules. Function of the Spleen. Probably influences the preparation of the albuminous food for nutrition; during digestion the spleen becomes larger, its contents are increased in amount, and after digestion it gradually dimin- ishes in size, returning to the normal condition. The red corpuscles are here disintegrated, after having fulfilled their function in the blood; the splenic venous blood containing relatively a small quantity. The white corpuscles appear to be increased in number, the blood of the splenic vein containing an unusually large proportion. The spleen serves also as a reservoir for blood when the portal circula- tion becomes obstructed. The nervous system controls the enlargement of the spleen; division of the nerve produces dilatation of the vessels, stimulation contracts them. The Supra-renal Capsules are triangular, flattened bodies, situated above the kidney. They are invested by a fibrous capsule sending in trabeculae, forming the framework. The glandular tissue is composed of two portions, a cortical and medullary. The cortical being made up of small cylinders lined by cells and containing an opaque mass, nuclei and granular matter. The medullary consists of a fibrous network containing in the alveoli nucleated protoplasm. The Thyroid gland consists of a fibrous stroma, containing ovoid closed sacs, measuring on the average of a inch, formed of a delicate membrane lined by cells; the contents of the sacs consist of yellowish albuminous fluid. The Thymus gland is most developed in early life and almost disap- pears in the adult. It is divided by processes of fibrous tissue into lobules, and these again into follicles which contain lymphoid corpuscles. The functions of the vascular glands appear to be the more complete 58 HUMAN PHYSIOLOGY. elaboration of the blood necessary for proper nutrition; they are most highly developed during infancy and embryonic life, when growth and development are most active. The Principal Excrementitious Fluids discharged from the body are the urine, perspiration and bile; they hold in solution principles of waste which are generated during the activity of the nutritive process, and are the ultimate forms to which the organic constituents are reduced in the body. They also contain inorganic salts. The Urinary Apparatus consists of the kidneys, ureters and bladder. EXCRETION. KIDNEYS. The Kidneys are the organs for the excretion of urine; they resemble a bean in shape, are from four to five inches in length, two in breadth, and weigh from four to six ounces. They are situated in the lumbar region, one on each side of the verte- bral column, behind the peritoneum, and extend from the nth rib to the crest of the ilium; the anterior surface is convex, the posterior concave, and presents a deep notch, the kilum. The kidney is surrounded by a thick layer of fat, beneath which is the fibrous coat, thin and smooth, composed of dense white fibrous tissue with which are intermingled elastic fibres. It is adherent to the surface of the organ, but can easily be removed by dissection. The Substance of the Kidney is dense, but friable; upon making a longitudinal section, and dividing it, there is presented a cavity, the pelvis, lined by the proper fibrous coat and occupied by the expanded portion of the ureter. The kidney exhibits two structures, viz.:— 1. An external or cortical portion, about *4 of an inch in diameter, of a reddish color, and somewhat granular. 2. An internal or medullary portion, of a dark red color, arranged in the form of pyramids, the bases of which are directed towards the cortical portion, and the apices toward the pelvis, into which they project, and are covered by the calyces. The Cortical portion of the kidney consists of a delicate matrix con- taining an immense number of tubules, having a markedly convoluted appearance, and interlacing in every direction (the tubules of Ferrein). Throughout its structure are numerous ovoid bodies, the Malpighian bodies, which are the flask-like terminations of the convoluted tubules; these tubes KIDNEYS. 59 are composed of a delicate homogeneous membrane lined by nucleated cells. After pursuing a most intricate course in the cortical portion, they become narrower and form loops which dip into the pyramidal portion (Henle’s tubules), returning upon themselves, to finally terminate in the straight tubes of the pyramids. The Malpighian bodies, the dilated extremities of the convoluted tubes, consist of a little sac, which is ovoid in shape, measuring about the of an inch in diameter, and contains a tufted mass of minute blood vessels, over the surface of which is reflected a layer of cells. Medullary Substance. The conical masses, th e. pyramids of Malpi- ghi, consist of a number of straight tubes, which commence at the apex by from io to 20 openings; and as they pass towards the cortical portion, they divide and subdivide at acute angles, until a large mass of tubes is pro- duced. These tubes are on the average about of an inch in diameter, and composed of a thin, but firm, elastic, structureless membrane, lined by polygonal nucleated cells, which reduce the diameter of the lumen of the tube about two-thirds ; these are the straight tubes of Bellini. Blood vessels of the Kidney. The renal artery is of large size and enters the organ at the hilum; it divides into several large branches, which penetrate the substance of the kidney, between the pyramids, at the base of which they form an anastomosing plexus, which completely surrounds them. From this plexus vessels follow the straight tubes.towards the apex, while others entering the cortical portion, divide into small twigs which enter the Malpighian body and form a mass of convoluted vessels, the glomerulus. After circulating through the Malpighian tuft the blood is gathered together by two or three small veins, which again subdivide and form a fine capillary plexus, which envelops the convoluted tubules ; from this plexus the veins converge to form the emulgent vein, which empties into the vena cava. The Nerves of the kidney follow the course of the blood vessels and are derived from the renal plexus. The Ureter is a membranous tube, situated behind the peritoneum, about the diameter of a goose quill, 18 inches in length, and extends from the pelvis of the kidney to the base of the bladder, which it perforates in an oblique direction. It is Composed of 3 coats, fibrous, muscular and mucous. The Bladder is a temporary reservoir for the reception of the urine prior to its expulsion from the body ; when fully distended it is ovoid in shape, and holds about one pint. It is composed of four coats, serous, 60 HUMAN PHYSIOLOGY. muscular, the fibres of which are arranged longitudinally and circularly, areolar and mucous. The orifice of the bladder is controlled by the sphincter vesicce, a muscular band, about half an inch in width. As soon as the urine is formed it passes through the tubuli urini- feri into the pelvis, and from thence through the ureters into the bladder, which it enters at an irregular rate. Shortly after a meal, after the ingestion of large quantities of fluid, and after exercise, the urine flows into the bladder quite rapidly, while it is reduced to a few drops during the intervals of digestion. It is prevented from regurgitating into the ureters on account of the oblique direction they take between the mucous and muscular coats. Nervous Mechanism of Urination. When the urine has passed into the bladder it is there retained by the sphincter .vesicse muscle kept in a state of tonic contraction by the action of a nerve centre in the lumbar region of the spinal cord. This centre can be inhibited and the sphincter relaxed, either reflexly, by impressions coming through sensory nerves from the mucous membrane of the bladder, or directly, by a voluntary impulse descending the spinal cord. When the desire to urinate is experienced, impressions made upon the vesical sensory nerves are carried to the centres governing the sphincter and detrusor urince muscles and to the brain. If now the act of urination is to take place, a voluntary impulse, originating in the brain, passes down the spinal cord and still further inhibits the sphincter vesicse centre, with the effect of relaxing the muscle, and of stimulating the centre governing the detrusor muscle, with the effect of contracting the muscle and expelling the urine. If the act is to be sup- pressed voluntary impulses inhibit the detrusor centre and possibly stimu- late the sphincter centre. Thqgenito-spinal centre controlling these movements is situated in that portion of the spinal cord corresponding to the origin of the 3d, 4th and 5th sacral nerves. URINE. Normal Urine is of a pale yellow or amber color, perfectly transpa- rent, with an aromatic odor, an acid reaction, a specific gravity of 1.020, and a temperature when first discharged of ioo° Fahr. The color varies considerably in health, from a pale yellow to a brown hue, due to the presence of the coloring matter, urobilin or urochrome. The transparency is diminished by the presence of mucus, the calcium and magnesium phosphates and the mixed urates. The reaction is slightly acid, caused by the acid phosphate of sodium. After standing for a short time, an increased acidity is observed, due to an URINE, 61 acid fermentation, from the presence of mucus. The urea is converted into ammonium carbonate, giving rise to a strong ammoniacal odor. The specific gravity varies from 1.010 to 1.025. The quantity of urine excreted in 24 hours is between 40 and 50 fluid ounces, but ranges above and below this standard. The odor is characteristic, and caused by the presence of taurylic and phenylic acids, but is influenced by vegetable foods and other substances eliminated by the kidneys. Water 967. Urea 14.230 COMPOSITION OF URINE. Other nitrogenized crystalline bodies, uric acid, prin- cipally in the form of alkaline urates. Creatin, creatinin, xanthin, hypoxanthin. Hippuric acid, leucin, tyrosin, taurin, cystin, all in small amounts, and not constant. Mucus and pigment. io.63S Salts :— Inorganic, principally sodium and potassium sulphates,' phosphates and chlorides, with magnesium and cal- cium phosphates, traces of silicates and chlorides. Organic; lactates, hippurates, acetates, formates, which appear only occasionally. 8-135 Sugar a trace. Gases (nitrogen and carbonic acid principally). 1000.00 The Average Quantity of the principal constituents excreted in 24 hours is as follows:— Water 52 fluid oz. Urea 512.4 grains. Uric acid 8.5 “ Phosphoric acid 45.0 “ Sulphuric acid 31.11 “ Inorganic salts..., 323-25 “ Lime and magnesia 6.5 “ To Determine the amount of solid matters in any given amount of urine, multiply the last two figures of the specific gravity by the coefficient of Hseser, 2.33; e.g., in 1000 grains of urine having a specific gravity 1.022, there are contained 22 X 2-33 = 51-26 grains of solid matter. 62 HUMAN PHYSIOLOGY. The Elimination of the urinary constituents is accomplished by the two processes of filtration and secretion. 1. By Filtration the water and mineral salts are removed from the blood, and takes place, for the most part, in the Malpighian corpuscles, by the process of osmosis. The amount of these constituents eliminated varies with the pressure of blood in the renal arteries. All of the agen- cies which increase the general blood pressure increase the quantity of urine. Season. In summer, while the capillary vessels of the skin are dilated, and perspiration is abundant, there is a diminished blood pressure, and a consequent diminution in the amount of urine ; in winter the reverse takes place. During sleep the renal excretion is diminished, but increased in the morning hours, and especially after the ingestion of hearty meals. The nervous system influences the secretion of urine. Irritation of the medulla oblongata, a little above the origin of the pneumogastric and auditory nerves, increases the quantity; division of the renal nerves destroys the nutrition of the kidney, and thus interferes with the elimina- tion of the urine. Mental emotion, fear, anxiety, etc., increase the amount secreted. 2. Secretion. While it is established that the Malpighian corpuscles permit the filtration of water and salts, it has also been shown that the renal epithelial cells lining the convoluted tubes are the agencies by which the solid matters, as urea, creatin, etc., are removed from the blood, by a process of true secretion, which is independent of blood pressure and caused by the presence of these ingredients in the blood. Urea is the most important of the organic constituents of the urine. It is a colorless, neutral substance, crystallizing in four-sided prisms, soluble in boiling alcohol and water; when subjected to prolonged boiling it is decomposed, with the production of ammonium carbonate. Urea is not formed in the kidneys, but pre-exists in the blood. The Amount of Urea excreted in 24 hours is estimated at about 500 grains; it is increased during the waking hours, by an animal diet, and by prolonged muscular exertion; diminished during sleep and by non- „nitrogenized food. Source. Urea results from an imperfect oxidation of the albuminous principles of the food, and from a disintegration of the organic constituents of the tissues. Uric acid, or lithic acid, is a constant ingredient of the urine; the LIVER 63 amount excreted daily is about 8 grains; it is increased by nitrogenized, decreased by non-nitrogenized food. It exists in the urine in a free state, and as the urate of soda. It arises from the disassimilation of albuminous compounds, and when secreted in excess is deposited in a crystalline form, as a brown or “ brick-red ” sediment, with the sodium and ammonium urates. Creatin is a colorless, transparent substance, crystallizing in prisms; found in blood, kidneys, and muscular tissue; by boiling in acid solutions it is transformed into Creatinin, which resembles creatin chemically. It is soluble in water and alcohol, and crystallizes in colorless prisms. About 15 grains are excreted daily. The Earthy phosphates are insoluble in water but held in solution in the urine by the acid reaction. If the urine becomes alkaline, they are de- posited copiously, and yet may not be increased in quantity; from 15 to 25 grains are excreted in 24 hours. The sulphates are those of sodium and potassium; they are very soluble and do not appear as a precipitate; the average quantity excreted in 24 hours is about 60 grains. Abnormal ingredients appear in the urine at times, in pathological con- ditions, e. g., sugar, albumen, biliary salts, etc. The Gases of the urine are carbonic acid and nitrogen. The Liver is a highly vascular, conglomerate gland, appended to the alimentary canal, and performs the triple office of (i) excreting bile, (2) elaborating blood and (3) secreting glycogen. It is the largest gland in the body, weighing about pounds; it is situated in the right hypochondriac region, and retained in position by five ligaments, four of which are formed by duplicatures of the peritoneal in- vestment. The proper coat of the liver is a thin but firm fibrous membrane, closely adherent to the surface of the organ, which it penetrates at the transverse fissure, and follows the vessels in their ramifications through its substance, constituting Glisson's capsule. Structure of the Liver. The liver is made up of a large number of small bodies, the lobules, rounded or ovoid in shape, measuring the of an inch in diameter, separated by a space in which are 'situated blood vessels, nerves, hepatic ducts and lymphatics. The lobules are composed of cells, which, when examined microscopi- cally, exhibit a rounded or polygonal shape, and measure, on the average, LIVER. 64 HUMAN PHYSIOLOGY. the xthtT7 °f an inch in diameter; they possess one, and at times two, nuclei; they also contain globules of fat, pigment matter, and animal starch. The cells constitute the secreting structure of the liver, and are the true hepatic cells. The Blood vessels which enter the liver are (i) The portal vein, made up of the gastric, splenic, superior and inferior mesenteric veins ; (2) the hepatic artery, a branch of the cceliac axis ; both of which are invested by a sheath of areolar tissue; the vessels which leave the liver are the hepatic veins, originating in its interior, collecting the blood distributed by the portal vein and hepatic artery, and conducting it to the ascending vena cava. Distribution of Vessels. The portal vein and hepatic artery, upon entering the liver, penetrate its substance, divide into smaller and smaller branches, occupy the spaces between the lobules, completely surrounding and limiting them, and constitute the inter-lobular vessels. The hepatic artery, in its course, gives off branches to the walls of the portal vein and Glisson’s capsule, and finally empties into the small branches of the portal vein in the interlobular spaces. The interlobular vessels form a rich plexus around the lobules, from which branches pass to neighboring lobules and enter their substance, where they form a very fine network of capillary vessels, ramifying over the hepatic cells, and among which the various functions of the liver are performed. The blood is then collected by small veins, converging toward the centre of the lobule, to form the intra-lobular vein, which runs through its long axis and empties into the sub-lobular vein. The hepatic veins are formed by the union of the sub-lobular veins, and carry the blood to the ascending vena cava; their walls are thin and adherent to the substance of the hepatic tissue. The Hepatic Ducts or Bile Capillaries originate within the lobules, in a very fine plexus lying between the hepatic cells; whether the smallest vessels have distinct membranous walls, or whether they originate in the spaces between the cells by open orifices, has not been satisfactorily determined. The Bile Channels empty into the interlobular ducts, which measure about the of an inch in diameter, and are composed of a thin homo- geneous membrane lined by flattened epithelial cells. As the interlobular bile ducts unite to form larger trunks, they receive an external coat of fibrous tissue, which strengthens their walls; they finally unite to form one large duct, the hepatic duct, which joins the cystic LIVER. 65 duct; the union of the two forms the ductus communis choledochus, which is about three inches in length, the size of a goose quill, and opens into the duodenum. The Gall Bladder is a pear-shaped sack, about four inches in length, situated in a fossa on the under surface of the liver. It is a reservoir for the bile, and is capable of holding about one ounce and a half of fluid. It is composed of three coats, (i) serous, a reflection of the peritoneum, (2) fibrous and muscular, (3) mucous. (1) Bile. Mechanism of its Secretion. Bile does not preexist in the blood,but is formed in the interior of the hepatic cells, from materials derived from the venous as well as arterial blood. The secreted bile is tljen taken up by the delicate plexus of vessels, from which it passes into the larger ducts, and finally either empties into the intestine or is regur- gitated backward into the gall bladder, in which it is stored up during the intervals of digestion. Although the secretion of bile is constantly taking place, it is only when the food passes into the intestinal canal that this fluid is discharged abund- antly, under the influence of the contraction of the walls of the gall bladder; it increases in amount during the period of active digestion, from the 2d to the 8th hour, and then gradually diminishes. The Bile is both a secretion and an excretion; it contains new con- stituents which are formed only in the substance of the liver, and are destined to play an important part ultimately in nutrition ; it contains also waste ingredients which are discharged into the intestinal canal and eliminated from the body. The physical properties and functions of bile have been considered under the head of digestion (see page 27). (2) Elaboration of Blood. Besides the capability of secreting bile, the liver possesses the property of so acting upon and modifying the chemical composition of the products of digestion, as they traverse its substance, that they readily assimilate with the blood, and are transformed into mate- rials capable of being converted into the elements of the blood and solid tissues. The albuminose particularly requires the modifying influence of the liver; for if it be removed from the portal vein and introduced into the jugular vein, it is at once removed from the blood by the action of the kidneys. The blood of the hepatic vein differs from the blood of the portal vein, in being richer in blood corpuscles, both red and white; its plasma is 66 HUMAN fHYSIOLOGY. more dense, containing a less percentage of water and a greater amount of solid constituents, but no fibrin; its serum contains less albumen, fat and salts, but its sugar is increased. (3) Glycogenic Function. In addition to the two preceding func- tions, Bernard, in 1848, demonstrated the fact that the liver, during life, normally produces a sugar-forming substance, analogous in its chemical composition to starch, which he termed glycogen ; also that when the liver is removed from the body, and its blood vessels thoroughly washed out, after a few hours, sugar again makes its appearance, in abundance. It can be shown to exist in the blood of the hepatic vein as well as in a decoction of the liver substance, by means of either Trommer’s or Fehling’s tests, even when the blood of the portal vein does not contain a trace of sugar. Origin and Destination of Glycogen. Glycogen appears to be formed de novo in the liver cells, from materials derived from the food, whether the diet be animal or vegetable, though a larger per cent, is formed when the animal is fed on starchy and saccharine, than when fed on animal food. The glucose, which is one of the products of digestion, is absorbed by the blood vessels and carried directly into the liver; as it does not appear in the urine, as it would if injected at once into the general circulation, it is probable that it is detained in the liver, dehydrated and stored up as glycogen. The change is shown by the following formula: Glucose. Water. Glycogen. The glycogen thus formed is stored up in the hepatic cells for the future requirements of the system. When it is carried from the liver it is again transformed into glucose by the agency of a ferment. Glycogen does not undergo oxidation in the blood; this takes place in the tissues, particularly in the muscles, where it generates heat and contributes to the development of muscular force. Glycogen, when obtained from the liver, is an amorphous, starch-like substance, of a white color, tasteless and odorless, and soluble in water; by boiling with dilute acids, or subjected to the action of an animal ferment, it is easily converted into glucose. When an excess of sugar is generated by the liver, it can be found, not only in the blood of the hepatic vein, but also in other portions of the body; under these circumstances it is eliminated by the kidneys, appearing in the urine, constituting the condition of glycosuria. The nervous system influences the production of the glycogenic C6Hi206 h2o — C6H10O5. SKIN. 67 matter; irritation of the medulla oblongata, between the auditory and pneumogastric nerves, is followed by an increase in the production of sugar, and its appearance in the urine, which, however, is only temporary. SKIN. The Skin, the external investment of the body, is a most complex and important structure, serving (i) as a protective covering; (2) an organ for tactile sensibility; (3) an organ for the elimination of excrementitious matters. The Amount of Skin investing the body of a man of average size is about twenty feet, and varies in thickness, in different situations, from the to the of an inch. The skin consists of two principal layers, viz., a deeper portion, the Comum, and a superficial portion, the Epidermis. The Corium, or Cutis Vera, may be subdivided into a reticulated and a papillary layer. The former is composed of white fibrous tissue, non- striated muscular fibres and elastic tissue, interwoven in every direction, forming an areolar network, in the meshes of which are deposited masses of fat, and a structureless amorphous matter; the latter is formed mainly of club-shaped elevations or projections of the amorphous matter, constituting the papillce ; they are most abundant, and well developed, upon the palms of the hands and the soles of the feet; they average the of an inch in length, and may be simple or compound; they are well supplied with nerves, blood vessels and lymphatics. The Epidermis or scarf skin is an extra vascular structure, a product of the true skin, and composed of several layers of cells. It may be divided into two layers, the rete mucosum or the Malpighian layer, and the horny or corneous. The former closely applies itself to the papillary layer of the true skin, and is composed of large, nucleated cells, the lowest layer of which, the “ prickle cells,” contain pigment granules, which give to the skin its vary- ing tints in different individuals and in different races of men; the more superficial cells are large, colorless, and semi-transparent. The latter, the corneous layer, is composed of flattened cells, which, from their exposure to the atmosphere, are hard and horny in texture; it varies in thickness from of an inch on the palms of the hands and feet, to the of an inch in the external auditory canal. 68 HUMAN PHYSIOLOGY. APPENDAGES OF THE SKIN. Hairs are found in almost all portions of the body, and can be divided into (i) long, soft hairs, on the head; (2) short, stiff hairs, along the edges of the eyelids and nostrils; (3) soft, downy hairs, on the general cutane- ous surface. They consist of a root and a shaft, which is oval in shape, and about the of an inch in diameter; it consists of fibrous tissue, covered externally by a layer of imbricated cells, and internally by cells containing granular and pigment material. The Root of the hair is embedded in the hair follicle, formed by a tubular depression of the skin, extending nearly through to the subcutaneous tissue ; its walls are formed by the layers of the corium, covered by epidermic cells. At the bottom of the follicle is a papillary projection of amorphous matter, corresponding to a papilla of the true skin, containing blood vessels and nerves, upon which the hair root rests. The investments of the hair roots are formed of epithelial cells, constituting the internal and external root sheaths. The hair protects the head from the heat of the sun and cold, retains the heat of the body, prevents the entrance of foreign matter into the lungs, nose, ears, etc. The color is due to the pigment matter, which, in old age, becomes more or less whitened. The Sebaceous Glands, imbedded in the true skin, are simple and compound racemose glands, opening, by a common excretory duct, upon the surface of the epidermis or into the hair follicle. They are found in all portions of the body, most abundantly in the face, and are formed by a delicate, structureless membrane, lined by flattened polyhedral cells. The sebaceous glands secrete a peculiar oily matter, the sebum, by which the skin is lubricated and the hairs softened; it is quite abundant in the region of the nose and forehead, which often present a greasy, glistening appear- ance ; it consists of water, mineral salts, fatty globules, and epithelial cells. The Vernix caseosa which frequently covers the surface of the foetus at birth consists of the residue of the sebaceous matters, containing epithelial cells and fatty matters; it seems to keep the skin soft and supple, and guards it from the effects of the long continued action of water. The Sudoriparous Glands excrete the sweat; they consist of a mass or coil of a tubular gland duct, situated in the derma and in the sub- cutaneous tissue; average the -fa of an inch in diameter, and are surrounded by a rich plexus of capillary blood vessels. From this coil the duct passes in a straight direction up through the skin to the epidermis, where it makes SKIN. 69 a few spiral turns and opens obliquely upon the surface. The sweat glands consist of a delicate homogeneous membrane lined by epithelial cells, whose function is to extract from the blood the elements existing in the perspiration. The glands are very abundant all over the cutaneous surface, as many as 3528 to the square inch, according to Erasmus Wilson. The Perspiration is an excrementitious fluid, clear, colorless, almost odorless, slightly acid in reaction, with a specific gravity of 1.003 or 1.004. The total quantity of perspiration excreted daily has been estimated at about two pounds, though the amount varies with the nature of the food and drink, exercise, external temperature, season, etc. The elimination of the sweat is not intermittent, but continuous; but it takes place so gradually that as fast as it is formed it passes off by evaporation as insensible perspiration. Under exposure to great heat and exercise the evaporation is not sufficiently rapid, and it appears as sensible perspiration. COMPOSITION OF SWEAT. Water 995-573 Urea 0.043 Fatty matters 0.014 Alkaline lactates. 0.317 Alkaline sudorates 1.562 Inorganic salts 2.491 1000.000 Urea is a constant ingredient. Carbonic acid is also exhaled from the skin, the amount being about of that from the lungs. Perspiration regulates the temperature, and removes waste matters from the blood; it is so important, that if elimination be prevented death occurs in a short time. The Nervous System influences the secretion of watery vapor by causing a dilatation of the capillary blood vessels around the tubular coil. It is increased by mental emotions; section of the sympathetic fibres in the neck is followed by a copious perspiration; stimulation of the nerves, pro- ducing contraction of the vessels, is followed by an arrestation of the elimination of the sweat. 70 HUMAN PHYSIOLOGY. NERVOUS SYSTEM. The Nervous System co-ordinates all the various organs and tissues of the body, and brings the individual into conscious relationship with external nature by means of sensation, motion, language, mental and moral manifestations. The Nervous Tissue may be divided into two systems, viz: the Cerebro-Spinal and the Sympathetic. (1) The Cerebro-Spinal System occupies the cavities of the cranium and spinal canal, and consists of the brain, the spinal cord, the cranial and spinal nerves. It is the system of animal life, and presides over the func- tions of sensation, motion, etc. (2) The Sympathetic System, situated along each side of the spinal column, consists (1) of a double chain of ganglia, united together by nerve cords, which extends from the base of the cranium to the coccyx; (2) of various ganglia, situated in the head and face, thorax, abdomen, pelvis, etc. All the ganglia are united together by numerous communicating fibres, many of which anastomose with the fibres of the cerebro-spinal system. It is the nervous system of organic life, and governs the functions of nutrition, growth, etc. Nervous Tissue is composed of two kinds of matter, the grey and white, which differ in their color, structure and physiological endowments; the former consists of vesicles or cells which receive and generate nerve force; the latter consists offibres which simply conduct it, either from the periphery to the centre or the reverse. Structure of Grey Matter. The grey matter, found on the surface of the brain in the convolutions, in the interior of the spinal cord, and in the various ganglia of the cerebro-spinal and sympathetic nervous systems, consists of a fine connective tissue stroma, the neuroglia, in the meshes of which are embedded the grey cells or vesicles. The cells are greyish in color, and consist of a delicate investing cap- sule containing a soft, granular, albuminous matter, a nucleus, and some- times a nucleolus. Some of the cells are spherical or oval in shape, while others have an interrupted outline, on account of having one, two, or more processes issuing from them, constituting the uni polar, bi-polar or multi- polar nerve cells. Cells vary in size; the smallest being found in the NERVOUS SYSTEM. 71 brain, the largest in the anterior horns of grey matter of the spinal cord. Some of the cell processes become continuous with the fibres of the white matter, while others anastomose with those of adjoining cells and form a plexus. Structure of the White Matter. The white matter, found for the most part in the interior of the brain, on the surface of the spinal cord, and in almost all of the nerves of the cerebro-spinal and sympathetic systems, consists of minute tubules or fibres, the ultimate nerve filaments, which, in the perfectly fresh condition, are apparently structureless and homogeneous; but when carefully examined after death are seen to consist of three dis- tinct portions, (i) a tubular membrane; (2) the white substance of Schwann; (3) the axis cylinder. The Tubular membrane, investing the nerve filament, is thin, homo- geneous, and lined by large, oval nuclei, and presents, in its course, annular constrictions; it serves to keep the internal parts of the fibre in position, and protects them from injury. The White substance of Schwann, or the medullary layer, is situated immediately within the tubular membrane, and gives to the nerves their peculiar white and glistening appearance. It is composed of oleaginous matter in a more or less fluid condition ; after death it undergoes coagula- tion, giving to the fibre a knotted or varicose appearance. It serves to insulate the axis cylinder, and prevents the diffusion of the nerve force. The Axis cylinder occupies the centre of the medullary substance. In the natural condition it is transparent and invisible, but when treated with proper reagents, it presents itself as a pale, granular, flattened band, albuminous in character, more or less solid, and somewhat elastic. It is composed of a number of minute fibrillge united together to form a single bundle. (Schultze.) Nerve fibres in which these three structural elements coexist are known as the medullated nerve fibres. In the sympathetic system, and in the gray substance of the cerebro-spinal system, many nerves are destitute of a medullary layer, and are known as the non-medullated nerve fibres. Grey or Gelatinous nerve fibres, found principally in the sympathetic system, are grey in color, semi-transparent, flattened, with distinct borders, finely granular, and present oval nuclei. The diameter of the gelatinous fibres is about the an 5 °f the medullated fibres, from to of an inch. Ganglia are small bodies, varying considerably in size, situated on the posterior roots of spinal nerves, on the sensory cranial nerves, alongside 72 HUMAN PHYSIOLOGY. of the vertebral column, forming a connected chain, and in the different viscera They consist of a dense, investing, fibrous membrane, containing in its interior grey or vesicular cells, among which are found white and gelatinous nerve fibres. They may be regarded as independent nerve centres. Structure of Nerves. Nerves are rounded or flattened cords extend- ing from the centres to the periphery; they are surrounded externally by a sheath, the neurilemma, composed of fibrous and elastic tissue forming a stroma, in which blood vessels ramify, from which the nerves derive their nourishment. A Nerve consists of a greater or less number of ultimate nerve filaments, separated into bundles by fibrous septa given off from the neurilemma. The nerve filaments pursue an uninterrupted course, from their origin to their termination; branches pass from one nerve trunk into the sheath of another, but there is no anastomosis or coalescence with adjoining nerve fibres. A Plexus is formed by a number of branches of different nerves inter- lacing in every direction, in the most intricate manner, but from which fibres are again given off to pursue their independent course, e.g., brachial, cervical, lumbar, sacral, cardiac plexuses, etc. SPINAL NERVES. Origin. The spinal nerves are thirty-one in number on each side of the spinal cord, and arise by two roots, an anterior and posterior, from the anterior and posterior aspects of the cord respectively; the pos- terior roots present near their emergence from the cord a small ganglionic enlargement; outside of the spinal canal the two roots unite to form a main trunk, which is ultimately distributed to the skin, muscles and viscera. The Function of the Anterior Roots is to transmit motor impulses from the centres outward to the periphery. Irritation of these roots, from whatever cause, excites convulsive movements in the muscles to which they are distributed; disease or division of these roots induces a condition of paresis or paralysis. The Function of the Posterior Roots is to transmit the impressions made upon the periphery to the centres in the spinal cord, where they excite motor impulses, or to the brain, in which they are translated into conscious sensations. Irritation of these roots gives rise to painful sensa- tions ; division of the roots abolishes all sensation in the parts to which they are distributed. SPINAL NERVES. 73 The ganglion on the posterior root influences the nutrition of the sen- sory nerve; for if the nerve be separated from the ganglion, it undergoes degeneration in the course of a few days, in the direction in which it carries impressions, i. e., from the periphery to the centres; if the nerve be divided between the ganglion and the cord, the central end only undergoes degeneration. The nutrition of the anterior root is governed by nerve cells in the grey matter of the cord; for if these cells undergo atrophy, or if the nerve be divided, it undergoes degeneration outward. Nerve Terminations, (i) Central. Both motor and sensory nerve fibres, as they enter the spinal cord and brain, lose their external invest- ments, and retaining only the axis cylinder, ultimately become connected with the processes of the grey cells. (2) Peripheral. As the nerves approach the tissues to which they are to be distributed, they inosculate freely, forming a plexus from which the ultimate fibres proceed to individual tissues. Motor Nerves. In the voluntary or striped muscles the motor nerves are connected with the contractile substance by means of the “ motorial end plates /” when the nerve enters the muscular fibre the tubular mem- brane blends with the sarcolemma, the medullary layer disappears, and the axis cylinder spreads out into the form of a little plate, granular in character, and containing oval nuclei. In the unstriped or involuntary muscles, the terminal nerve fibres form a plexus on the muscular fibre cells, and become connected with the granular contents of the nuclei. In the glands nerve fibres have been traced to the glandular cells, where they form a branching plexus from which fibres pass into their interior and become connected with their substance, and thus influence secretion. Sensitive Nerves terminate in the skin and mucous membranes, in three distinct modes, e. g., as tactile corpuscles, Pacinian corpuscles, and as end bulbs. The tactile corpuscles are found in the papilla; of the true skin, espe- cially on the palmar surface of the hands and fingers, feet and toes ; they are oblong bodies, measuring about of an inch in length, consisting of a central bulb of homogeneous connective tissue surrounded by elastic fibres and elongated nuclei. The nerve fibre approaches the base of the cor- puscle, makes two or three spiral turns around it, and terminates in loops. They are connected with the sense of touch. The Pacinian corpuscles are found chiefly in the subcutaneous cellular tissue, on the nerves of the hands and feet, the intercostal nerves, the 74 HUMAN PHYSIOLOGY. cutaneous nerves, and in many other situations. They are oval in shape, measure about the of an inch in length on the average, and consist of concentric layers of connective tissue; the nerve fibre penetrates the cor- puscle and terminates in a rounded knob in the central bulb. Their function is unknown. The end bulbs of Krause are formed of a capsule of connective tissue in which the nerve fibre terminates in a coiled mass or bulbous extremity; they exist in the conjunctiva, tongue, glans penis, clitoris, etc. Many sensitive nerves terminate in the papillae at the base of the hair follicle ; but in the skin, mucous membranes, and organs of special sense their mode of termination is not well understood. PROPERTIES AND FUNCTIONS OF NERVES. Classification. Nerves may be divided into two groups, viz:— (1) Afferent or centripetal, as when they convey to the nerve centres the impressions which are made upon their peripheral extremities or parts of their course. They may be sensitive, when they transmit impressions which give rise to sensations; reflective or excitant, when the impression carried to the nerve centre is reflected outward by an efferent nerve and produces motion or some other effect in the part to which the nerve is dis- tributed. (2) Efferent or centrifugal, as when the impulses generated in the centres are transmitted outward to the muscles and various organs. They may be motor, as when they convey impulses to the voluntary and involun- tary muscles; vaso-motor, when they regulate the calibre of the small blood vessels, increasing or diminishing the amount of blood to a part; secretory, when they influence secretion; trophic, when they influence nutrition ; inhibitory, when they conduct impulses which produce a restraining or inhibiting action. The Axis Cylinder is the essential conducting agent, the white substance of Schwann and tubular membrane being probably accessory structures, protecting the axis from injury, and preventing the diffusion of nerve force to adjoining nerves. The properties of sensation and motion reside in different nerve fibres. Motor nerves can be destroyed or paralyzed by the introduction of woorara under the skin, without affecting sensation; the sensibility of nerves can be abolished by the employment of anaesthetics without destroying motion. Irritability. Nerves conduct peripheral impressions to the centres, and motor impulses to the periphery, in virtue of their possessing an ultimate and inherent property, denominated neurility, nervous irritability, or PROPERTIES AND FUNCTIONS OF NERVES. 75 excitability, which is manifested as long as the physical and chemical integ- rity of the nerve is maintained. Nerve degeneration. When nerves are separated from their trophic or nutritive centres, they degenerate progressively in the direction in which they conduct impressions. In motor nerves, from the centre to the pe- riphery ; in sensory nerves, from the periphery to the centres. Nerve force is not identical with electricity. Nerves do not possess the power of generating force, or of originating impulses within themselves, but propagate only the nervous impulses which are called forth by chemi- cal, physical and mechanical stimuli from without, and by volitional acts, normal and pathological conditions from within. * Phenomena of Muscles and Nerves. The muscles are the motor organs of the body and constitute a large per cent, of the body weight. Muscles are of two kinds, striated and non-striated or involuntary. The striated muscles consist of bundles of fibres, the fasciculi, held together by connective tissue. Each muscle fibre is about yz to I inches long, and possesses a delicate homogeneous membrane, the sarcolemma, in the interior of which is contained the contractile substance, which presents a striated appearance. During life this substance is in a fluid condition, but after death undergoes stiffening. The non-striated muscles form membranes which surround cavities, e.g., stomach, arteries, bladder, etc. They are composed of elongated cells without striations and contain in their interior one or more nuclei. Muscular tissue is composed of water, an organic contractile substance, myosin, non-nitrogenized substances, such as glycogen, inosite, fat and inorganic salts. When at rest the muscle is alkaline in reaction, but during and after contraction it becomes acid. Muscles possess the properties of (i) Contractility, which is the capa- bility of shortening themselves in the direction of their long axis, and at the same time becoming thicker and more rigid. (2) Extensibility, by means of which they are lengthened in proportion to weights attached. (3) Elasticity, in virtue of which they return to their original shape when the force applied is removed. The contractility of muscles is called forth mainly by nervous impulses, descending motor nerves, which originate in the central nervous system; but it can also be excited by the electric current, the application of strong acids, heat, or by mechanical means. Phenomena of a Muscular Contraction. When a single induc- tion shock is propagated through a nerve, the muscle to which it is dis- 76 HUMAN PHYSIOLOGY. tributed undergoes a quick pulsation, and speedily returns to its former condition. As is shown by the muscle curve, the contraction, which is at first slow, increases in rapidity to its maximum, gradually relaxes and is again at rest, the entire pulsation not occupying more than the of a second. The muscular contraction does, not instantly follow the induction shock even when the electrodes are placed directly upon the muscular fibres themselves; an appreciable period intervenes before the contraction, during which certain chemical changes are taking place preparatory to the manifestation of force. This is the “latent period,” which has an average duration of the of a second, but varies with the temperature, the strength of the stimulus, the animal, etc. The muscular movements of the body, however, are occasioned by contractions of a much longer duration, depending upon the number (the average, 20) of nervous impulses passing to the muscles in a second. During the muscular contraction the following phenomena are observed, viz: a change in form, a rise in temperature, a consumption of oxygen and an evolution of carbonic acid; the production of a distinct musical sound, a change from an alkaline to an acid reaction, from the development of sarcolactic acid; a disappearance of the natural muscle currents, which undergo a negative variation in the “ latent period,” just after the nervous impulse reaches the termination of the nerve, and before the appearance of the muscular contraction wave. Electrical Properties of Nerves. When a galvanic current is made to flow along a motor nerve from the centre to the periphery, from the positive to the negative pole, it is known as the direct, descending or centrifugal current. When it is made to flow in the reverse direction it is known as the inverse, ascending or centripetal current. The passage of a direct current enfeebles the excitability of a nerve; the passage of the inverse current increases it. The excitability of a nerve may be exhausted by the repeated applications of electricity; when thus exhausted it may be restored by repose, or by the passage of the inverse current if the nerve has been exhausted by the direct current or vice versa. During the actual passage of a feeble constant current in either direction neither pain nor muscular contraction is ordinarily manifested; if the current be very intense the nerve may be disorganized and its excitability destroyed. CRANIAL NERVES. 77 Electrotonus. The passage of a direct galvanic current through a portion of a nerve, excites in the parts beyond the electrodes a condition of electric tension or electrotonus, during which the excitability of the nerve is decreased near the anode or positive pole, and increased near the kathode or negative pole; the increase of excitability in the kathelectro- tonic area, that nearest the muscle, being manifested by a more marked contraction of the muscle than the normal, when the nerve is irritated in this region. The passage of an inverse galvanic current excites the same condition of electrotonus; and the diminution of excitability near the anode, the anelectrotonic area, that now nearest the muscle, being mani- fested by a less marked contraction than the normal when the nerve is stimulated in this region. Between the electrodes is a neutral point where the kathelectrotonic area emerges into the anelectrotonic area. If the current be a strong one the neutral point approaches the kathode; if weak, it approaches the anode. When a nervous impulse passes along a nerve the only appreciable effect is a change in its electrical condition, there being no change in its temperature, chemical composition or physical condition. The natural nerve currents, which are always present in a living nerve as a result of "its nutritive activity, in great part disappear during the passage of an impulse, undergoing a negative variation. The rapidity with which nervous impulses are propagated along a nerve has been estimated at about ioo feet in a second for both motor and sensory nerves, but varies according to the temperature, the degree of excitability, the strength of the stimulus, etc. Law of Contraction. If a feeble galvanic current be applied to a recent and excitable nerve, contraction is produced in the muscles only upon the making of the circuit with both the direct and inverse current. If the current be moderate in intensity the contraction is produced in the muscle both upon the making and breaking of the circuit, with both the direct and inverse currents. If the current be intense, contraction is produced only when the circuit is made with the direct current, and only when it is broken with the inverse current. CRANIAL NERVES. The Cranial Nerves come off from the base of the brain, pass through the foramina in the walls of the cranium, and are distributed to the skin, muscles and organs of sense in the face and head. 78 HUMAN PHYSIOLOGY. According to the classification of Soemmering, there are 12 pairs of nerves, enumerating them from before backward, as follows, viz :— xst Pair, or Olfactory. 7th Pair, or Facial, Portio dura. 2d Pair, or Optic. 8th Pair, or Auditory, Portio mollis. 3d Pair, or Motor oculi communis. 9th Pair, or Glosso-pharyngeal. 4th Pair, or Patheticus, Trochlearis. 10th Pair, or Pneumogastric. 5th Pair, or Trifacial, Trigeminus, nth Pair, or Spinal accessory. 6th Pair, or Abducens. 12th Pair, or Hypoglossal. The Cranial Nerves may also be classified physiologically, according to their function, into three groups: 1. Nerves of special sense. 2. Nerves of motion. 3. Nerves of general sensibility. 1st Pair. Olfactory. Apparent Origin. From the inferior and internal portion of the anterior lobes of the cerebrum by three roots, viz : an external white root, which passes across the fissure of Sylvius to the middle lobe of the cerebrum; an internal white root, from the most posterior part of the anterior lobe; a grey root, from the grey matter in the posterior and inner portion of the inferior surface of the anterior lobe. Deep Origin. Not satisfactorily determined. Distribution. The olfactory nerve, formed by the union of the three roots, passes forward along the under surface of the anterior lobe to the ethmoid bone, where it expands into the olfactory bulb. This bulb con- tains ganglionic cells, is greyish in color and soft in consistence; it gives off from its under surface from 15 to 20 nerve filaments, the true olfactory nerves, which pass through the cribriform plate of the ethmoid bone, and are distributed to the Schneiderian mucous membrane. This membrane extends from the cribriform plate of the ethmoid bone downward, about one inch. Properties. The olfactory nerves give rise to neither motor nor sensory phenomena when stimulated. They carry simply the special impressions of odorous substances. Destruction or injury of the olfactory bulbs is attended by a loss of the sense of smell. Function. Governs the sense of smell. Conducts the impressions which give rise to odorous sensations. 2d Pair. Optic. Apparent Origin. From the anterior portion of the optic commissure. Deep Origin. An external -white root, from the corpus geniculatum externum; an internal white root, from the corpus geniculatum internum CRANIAL NERVES. 79 and the anterior tubercula quadrigemina; a grey root, from the grey matter in the floor of the 3d ventricle. Filaments also come from the optic thalami and cerebral peduncles. Distribution. The two roots unite to form a flattened band, the optic tract, which winds around the crus cerebri to decussate with the nerve of the opposite side, forming the optic chiasm. The decussation of fibres is not complete ; some of the fibres of the left optic tract going to the outer half of the eye of the same side, and to the inner half of the eye of the opposite side; the same holds true for the right optic tract. The optic nerves proper arise from the commissure, pass forward through the optic foramina, and are finally distributed in the retina. Properties. They are insensible to ordinary impressions, and convey only the special impressions of light. Division of one of the nerves is attended by complete blindness in the eye of the corresponding side ; division of the optic tract produces loss of sight in the outer half of the eye of the same side, and in the inner half of the eye of the opposite side. Lesion of the anterior part of the optic chiasm causes blindness in the inner half of the two eyes. Functions. Governs the sense of sight. Receives and conveys to the brain the luminous impressions which give rise to the sensation of sight. The reflex movements of the iris are called forth by the optic nerve. When an excess of light falls upon the retina the impression is carried back to the tubercula quadrigemina, where it is transformed into a motor impulse, which then passes outward through the motor oculi nerve to the contractile fibres of the iris and diminishes the size of the pupil. The absence of light is followed by a dilatation of the pupil. Apparent Origin. From the inner surface of the crura cerebri. Deep Origin. By filaments coming from the lenticular nucleus, corpora quadrigemina, optic thalamus; these filaments converge to form a main trunk, which winds around the crus cerebri, in front of the pons Varolii. Distribution. The nerve then passes forward, and enters the orbit through the sphenoidal fissure, where it divides into a superior branch, distributed to the superior rectus and levatorpalpebrce muscles; an inferior branch sending branches to the internal and inferior recti, and the inferior oblique muscles; filaments also pass into the ciliary or ophthalmic ganglion ; from this ganglion the ciliary nerves arise which enter the eyeball, and are distributed to the circular fibres of the iris and the ciliary muscle. The 3d Pair. Motor Oculi Communis. 80 HUMAN PHYSIOLOGY. 3d nerve also receives filaments from the cavernous plexus of the sympa- thetic and from the 5th nerve. Properties. Irritation of the root of the nerve produces contraction of the pupil, internal strabismus, muscular movements of eye, but no pain. Division of the nerve is followed by ptosis (falling of the upper eyelid), external strabismus, due to the unopposed action of the external rectus muscle; dilatation of the pupil and persistent accommodation of the eye for long distances, from paralysis of the circular fibres of the iris and ciliary muscle; and inability to rotate the eye, slight protrusion and double vision, the images being on the same plane. Function. Governs movements of the eyeball by animating all the muscles except the external rectus and superior oblique, the movements of the iris, elevates the upper lid, influences the accommodation of the eye for distances. Can be called into action by (1) voluntary stimuli, (2) by reflex action through irritation of the optic nerve. 4th Pair. Patheticus. Apparent Origin. From the superior peduncles of the cerebellum. Deep Origin. By fibres terminating in the corpora quadrigemina, lenticular nucleus, valve of Vieussens, and in the substance of the cerebellar peduncles; some filaments pass over the median line and decussate with fibres of the opposite side. Distribution. The nerve enters the orbital cavity through the sphe- noidal fissure, and is distributed to the sziperior oblique muscle; in its course receives filaments from the ophthalmic branch of the 5th pair and the sympathetic. Properties. When the nerve is irritated muscular movements are pro- duced in the superior oblique muscle, and the pupil of the eye is turned downward and outward. Division or paralysis of the nerve renders the eyeball immovable as far as rotation is concerned, and produces double vision. Function. Governs the movements of the eyeball produced by the action of the superior oblique muscles. 6th Pair.* Abducens. Motor Oculi Externus. Apparent Origin. From the groove between the anterior pyramidal body and the pons Varolii, where it arises by two roots. Deep Origin. From the grey matter of the medulla oblongata. * The 6th nerve is considered in connection with the 3d and 4th nerves, since they together constitute the motor apparatus by which the ocular muscles are excited to action. CRANIAL NERVES. 81 Distribution. The nerve then passes into the orbit through the sphe- noidal fissure, and is distributed to the external rectus muscle. Receives filaments from the cervical portion of the sympathetic, through the carotid plexus and spheno-palatine ganglion. Properties. When irritated, the external rectus muscle is thrown into convulsive movements, and the eyeball is turned outward. When divided or paralyzed, this muscle is paralyzed, and internal strabismus is produced. Function. To turn the eyeball outward. Apparent Origin. By two roots from the side of the pons Varolii. Deep Origin. The deep origin of the two roots is the upper part of the floor and anterior wall of the 4th ventricle, by three bundles of fila- ments, one of which anastomoses with the auditory nerve; another passes to the lateral tract of the medulla; while a third, greyish in color, goes to the restiform bodies, and may be traced to the point of the calamus scriptorius. Filaments of origin have been traced to the “trigeminal sensory nucleus,” located on a level with the point of exit of the nerve, and to the posterior grey horns of the cord, as low down as the middle of the neck. Distribution. The large root of the nerve passes obliquely upward and forward to the ganglion of Gasser, which receives filaments of com- munication from the carotid plexus of the sympathetic. It then divides into three branches. 1. Ophthalmic branch, which receives communicating filaments from the sympathetic, and sends sensitive fibres to all the motor nerves of the eyeball. It is distributed to the ciliary ganglion, lachrymal gland, sac and caruncle, conjunctiva, integument of the upper eyelid, forehead, side of head and nose, anterior portion of the scalp, ciliary muscle and iris. 2. Superior maxillary branch, sends branches to the spheno-palatine ganglion, integument of the temple and lower eyelid, side of forehead, nose, cheek and upper lip, teeth of the upper jaw, and alveolar processes. 3. Inferior maxillary branch, which, after receiving in its course fila- ments from the small root and from the facial, is distributed to the sub- maxillary ganglion, the parotid and subdingual glands, external auditory meatus, mucous membrane of the mouth, anterior two-thirds of the tongue (lingual branch), gums, arches of the palate, teeth of the lower jaw, and integument of the lower part of the face, and to the muscles of mastication. The small root passes forward beneath the ganglion of Gasser, through the foramen ovale, and joins the inferior maxillary division of the large 5th Pair. Trifacial. Trigeminal. 82 HUMAN PHYSIOLOGY. root, which then divides into an anterior and posterior branch, the former of which is distributed to the muscles of mastication, viz: temporal, masseter, internal and external pterygoid muscles. Properties. It is the most acutely sensitive nerve in the body, and endows all the parts to which it is distributed with general sensibility. Irritation of the large root, or any of its branches, will give rise to marked evidence of pain; the various forms of neuralgia of the head and face being occasioned by compression, disease, or exposure of some of its terminal branches. Division of the large root within the cranium is followed at once by a complete abolition of all sensibility in the head and face, but is not attended by any loss of motion. The integument, mucous membranes and the eye, may be lacerated, cut or bruised, without the animal exhibiting any evidence of pain. At the same time the lachrymal secretion is diminished, the pupil becomes contracted, the eyeball is protruded, and the sensibility of the tongue is abolished. The reflex movements of deglutition are also somewhat impaired; the impression of the food being unable to reach and excite the nerve centre in the medulla oblongata. Galvanization of the small root produces movements of the muscles of mastication; section of the root causes paralysis of these muscles, and the jaw is drawn to the opposite side, by the action of the opposing muscles. Influence upon the Special Senses. After division of the large root within the cranium, a disturbance in the nutrition of the special senses sooner or later manifests itself. Sight. In the course of 24 hours the eye becomes very vascular and inflamed, the cornea becomes opaque and ulcerates, the humors are dis- charged, and the eye is totally destroyed. Smell. The nasal mucous membrane swells up, becomes fungous, and is liable to bleed on the slightest irritation. The mucus is increased in amount, so as to obstruct the nasal passages; the sense of smell is finally abolished. Hearing. At times the hearing is impaired, from disorders of nutrition in the middle ear and external auditory meatus. Alteration in the nutrition of the special senses is not marked if the sec- tion is made posterior to the ganglion of Gasser, and to the anastomosing filaments of the sympathetic which join the nerve at this point; but if the ganglion be divided, these effects are very noticeable, due to the section of the sympathetic filaments. CRANIAL NERVES. 83 Function. Gives sensibility to all parts of the head and face to which it is distributed; through the small root endows the masticatory muscles with motion; through fibres from the sympathetic governs the nutrition of the special senses. 7th Pair. Portio Dura. Facial Nerve. Apparent Origin. From the groove between the olivary and restiform bodies at the lateral portion of the medulla oblongata, and below the margin of the pons Varolii. Deep Origin. From a nucleus of large cells in the floor of the 4th ventricle, below the nucleus of origin of the 6th pair, with which it is connected. Some filaments are traceable to the lenticular nucleus of the opposite side. Some of the fibres cross the median line and decussate. It is intimately associated with the nerve of Wrisberg at its origin. Distribution. From its origin the facial nerve passes into the internal auditory meatus, and then, in company with the nerve of Wrisberg, enters the aqueduct of Fallopius. The filaments of the nerve of Wrisberg are supplied with a ganglion, of a reddish color, having nerve cells. These filaments unite with those of the root of the facial, to form a common trunk, which emerges at the stylo mastoid foramen. In the aqueduct the facial gives off the following branches, viz:— 1. Large petrosal nerve, which passes forward to the spheno-palatine, or Meckel’s ganglion, and through this to the levator palati and azygos uvulae muscles, which receive motor influence from this source. 2. Small petrosal nerve, passing to the otic ganglion and thence to the tensor-tympani muscle, endowing it with motion. 3. Tympanic branch, giving motion to the stapedius muscle. 4. Chorda tympani nerve, which after entering the posterior part of the tympanic cavity, passes forward between the malleus and incus bones, through the Glasserian fissure, and joins the lingual branch of the 5th nerve. It is then distributed to the mucous membrane of the anterior two-thirds of the tongue and the sub-maxillary glands. After emerging from the stylo-mastoid foramen, the facial nerve sends branches to the muscles of the ear, the occipito-frontalis, the digastric, the palato-glossi, and palato-pharyngei; after which it passes through the parotid gland and divides into the temporo-facial and cervico-facial branches, which are distributed to the superficial muscles of the face, viz: occipito-frontalis, corrugator supercilii, orbicularis palpebrarum, levator labii superioris et alseque nasi, buccinator, levator anguli oris, orbicularis oris, zygomatici, depressor anguli oris, platysma myoides, etc. 84 HUMAN PHYSIOLOGY. Properties. Undoubtedly a motor nerve at its origin, but in its course receives sensitive filaments from the 5th pair and the pneumogastric. Irritation of the nerve, after its emergence from the stylo-mastoid fora- men, produces convulsive movements in all the superficial muscles of the face. Division of the nerve at this point causes paralysis of these muscles on the side of the section, constituting facial paralysis ; the phenomena of which are, a relaxed and immobile condition of the same side of the face; the eyelids remain open, from paralysis of the orbicularis palpebrarum ; the act of winking is abolished; the angle of the mouth droops, and saliva constantly drains away; the face is drawn over to the sound side; the face becomes distorted upon talking or laughing; mastication is interfered with, the food accumulating between the gums and cheek, from paralysis of the buccinator muscle; fluids escape from the mouth in drinking; articulation is impaired, the labial sounds being imperfectly pronounced. Properties of the branches given off in the aqueduct of Fallopius. The Large petrosal, when irritated, throws the levator palati and azygos uvulae muscles into contraction. Paralysis of this nerve, from deep-seated lesions, produces a deviation of the uvula to the sound side, a drooping of the palate, and an inability to elevate it. The Small petrosal influences hearing by animating the tensor tympani muscle; when paralyzed, there occurs partial deafness and an increased sensibility to sonorous impressions. The Tympanic branch animates the stapedius muscle, and influences audition. The Chorda tympani influences the circulation and the secretion of saliva, in the sub-maxillary glands, and governs the sense of taste in the anterior two-thirds of the tongue. Galvanization of the chorda tympani dilates the blood vessels, increases the quantity and rapidity of the stream of blood, and increases the secretion of saliva. Division of the nerve is followed by contraction of the vessels, an arrestation of the secretion, and a diminution of the sense of taste, on the same side. Function. The facial is the nerve of expression, and co-ordinates the muscles employed to delineate the various emotions, influences the sense of taste, deglutition, movements of the uvula and soft palate, the tension of the membrana tympani, and the secretions of the sub-maxillary and parotid glands. Indirectly influences smell, hearing and vision. 8th Pair, Portio Mollis, Auditory Nerve. Apparent Origin. From the upper and lateral portion of the medulla oblongata, just below the margin of the pons Varolii. CRANIAL NERVES. 85 Deep Origin. By two roots frorn the floor of the 4th ventricle, each root consisting of a number of grey filaments, some of which decussate in the median line; the external root has a gangliform enlargement contain- ing fusiform nerve cells. Distribution. The two roots wind around the restiform bodies and enter the internal auditory meatus, and divide into an anterior branch distributed to the cochlea, and a posterior branch distributed to the vesti- bule and semicircular canals. Properties. They are soft in consistence, greyish in color, consisting of axis cylinders with a medullary sheath only; they are not sensible to ordinary impressions, but convey the impression of sound. Function. Governs the sense of hearing. Receives and conducts to the brain the impressions of sound, which give rise to the sensations of hearing. Apparent Origin. Partly from the medulla oblongata and the inferior peduncles of the cerebellum. Deep Origin. From the lower portion of the grey substance in the floor of the 4th ventricle. This nerve has two ganglia; the jugular ganglion includes only a por- tion of the root filaments; the ganglion of Andersch includes all the fibres of the trunk. Distribution. The trunk of the nerve passes downward and forward, receiving near the ganglion of Andersch fibres from the facial and pneumo- gastric nerves. It divides into two large branches, one of which is distributed to the base of the tongue, the other to the pharynx. In its course it sends filaments to the otic ganglion; a tympanic branch which gives sensibility to the mucous membrane of the fenestra rotunda, fenestra ovalis, and Eustachian tube; lingual branches to the base of the tongue; palatal branches to the soft palate, uvula and tonsils; pharyngeal branches to the mucous membrane of the pharynx. Properties. Irritation of the roots at their origin calls forth evidences of pain; it is, therefore, a sensory nerve, but its sensibility is not so acute as that of the tri-facial. Irritation of the trunk after its exit from the cranium produces contraction of the muscles of the palate and pharynx, due to the presence of anastomosing motor fibres. Division of the nerve abolishes sensibility in the structures to which it is distributed, and impairs the sense of taste in the posterior third of the tongue (see Sense of Taste). 9th Pair. Glosso-pharyngeal. 86 HUMAN PHYSIOLOGY. Function. Governs sensibility#of pharynx, presides partly over the sense of taste, and controls reflex movements of deglutition and' vomiting. Apparent Origin. From the lateral sideof the medulla oblongata, just behind the olivary body. Deep Origin. In the grey nuclei in the lower half of the floor of the 4th ventricle, and in the substance of the restiform body. Some filaments are traced along the restiform tract, toward the cerebellum, and others to the median line of the floor of the 4th ventricle, where many of them decussate. This nerve has two ganglia; one in the jugular foramen, called the gan- glion of the root, find another outside of the cranial cavity on the trunk, the ganglion of the trunk. Distribution. The filaments from the root unite to form a single trunk, which leaves the cavity of the cranium* through the jugular foramen, in company with the spinal accessory and glosso-pharyngeal. It soon receives an anastomotic branch from the spinal accessory, and afterward branches from the facial, the hypoglossal and the anterior branches of the two upper cervical nerves. , As the nerve passes down the neck it sends off the following main branches:— 1. Pharyngeal nerves, which assist in forming the pharyngeal plexus, which is distributed to the mucous membrane and muscles of the pharynx, 2. Superior laryngeal nerve, which enters the larynx through the thyro- hyoid membrane, and is distributed to the mucous membrane lining the interior of the larynx, and to the crico thyroid muscle and the inferior constrictor of the pharynx. The “ depressor nerve” found in the rabbit, is formed by the union of two branches, one from the superior laryngeal, the other from the main trunk; it passes downward to be distributed to the heart. 3. Inferior laryngeal, which sends its ultimate branches to all the in- trinsic muscles of the larynx except the crico-thyroid, and to the inferior constrictor of the pharynx. 4. Cardiac branches, given off from the nerve throughout its course, which unite with the sympathetic fibres to form the cardiac plexus, to be distributed to the heart. 5. Pulmonary branches, which form a plexus of nerves and are dis- tributed to the bronchi and their ultimate terminations, the lobules and air cells. 10th Pair. Pneumogastric. Par Vagum. CRANIAL NERVES. 87 From the right pneumogastric nerve branches are distributed to the mucous membrane and muscular coats of the stomach and intestines, to the liver, spleen, kidneys, and supra-renal capsules. Properties. At its origin the pneumogastric nerve is sensory, as shown by direct irritation or galvanization, though its sensibility is not very marked In its course exhibits motor properties, from anastomosis with motor nerves. The Pharyngeal branches assist in giving sensibility to the mucous mem- brane of the pharynx, and influence reflex phenomena of deglutition, through motor fibres which they contain, derived from the spinal accessory. The Superior laryngeal nerve endows the upper portion of the larynx with sensibility ; protects it from the entrance of foreign bodies ; by con- ducting impressions to the medulla, excites the reflex movements of deglu- tition and respiration; through the motor filaments it contains produces contraction of the crico-thyroid muscle. Division of the “ Depressor nervef and galvanization of the central end, retards and even arrests the pulsations of the heart, and by depressing the vaso-motor centre diminishes the pressure of blood in the large vessels, by causing dilatation of the intestinal vessels through the splanchnic nerves. The Inferior laryngeal contains, for the most part, motor fibres from the spinal accessory. When irritated, produces movement in the laryn- geal muscles. When divided, is followed by paralysis of these muscles, except the crico-thyroid, impairment of phonation, and an embarrassment of the respiratory movements of the larynx, and finally death, from suffoca- tion. The Cardiac branches, through filaments derived from the spinal acces- sory, exert a direct inhibitory action upon the heart. Division of the pneumogastrics in the neck increases the frequency of the heart’s action. Galvanization of the peripheral ends diminishes the heart’s pulsation, and, if sufficiently powerful, paralyzes it in disastole. The Pulmonary branches give sensibility to the bronchial mucous mem- brane, and govern the movements of respiration. Division of both pneumogastrics in the neck diminishes the frequency of the respiratory movements, falling as low as 4 to 6 per minute; death usually occurs in from 5 to 8 days. Feeble galvanization of the central ends of the divided nerves accelerates respiration; powerful galvanization retards, and may even arrest, the respiratory movements. The Gastric branches give sensibility to the mucous coat, and through sympathetic filaments, which join the pneumogastrics high up in the neck, 88 HUMAN PHYSIOLOGY. give motion to the muscular coat of the stomach. They influence the secretion of gastric juice, aid the process of digestion and absorption from the stomach. The Hepatic branches, probably through anastomosing sympathetic fila- ments, influence the secretion of bile, and the glycogenic function of the liver; division of the pneumogastrics in the neck produces congestion of the liver, diminishes the density of the bile, and arrests the glycogenic function; galvanization of the central ends exaggerates the glycogenic function, and makes the animal diabetic. The Intestinal branches give sensibility and motion to the small intestines, and when divided, purgatives generally fail to produce purga- tion. Function. A great sensitive nerve which, through anastomotic fila- ments from motor sources, influences deglutition, the action of the heart, the circulatory and respiratory systems, voice, the secretions of the stomach, intestines, and various glandular organs. Apparent Origin. By two sets of filaments :— 1. A bulbar or medullary set, four or five in number, from the lateral or motor tract of the lower half of the medulla oblongata, below the origin of the pneumogastric. 2. A spinal set, from 6 to 8 in number, from the lateral portion of the spinal cord, between the anterior and posterior roots of the upper four or five cervical nerves. Deep Origin. The medullary portion arises in a nucleus in the lower half of the floor of the 4th ventricle, common to the pneumogastric and glosso-pharyngeal nerves. The spinal portion has its origin in an elon- gated nucleus lying along the external surface of the anterior cornua of the spinal cord, extending down to the 5th cervical vertebra. Distribution. From this origin the fibres unite to form a main trunk, which enters the cranial cavity through the foramen magnum, where it is at times joined by fibres from the posterior roots of the two upper cervical nerves, and sends filaments to the ganglion of the root of the pneumo- gastric. After emerging from the cranial cavity through the jugular fora- men, it sends a branch to the pneumogastric, and receives others in return, and also from the 2d, 3d and 4th cervical nerves. It divides into two branches: (1) An internal or anastomotic branch, made up of filaments coming principally from the medulla oblongata, and is distributed to the muscles of the pharynx through the pharyngeal nerves coming from the nth Pair. Spinal Accessory. CRANIAL NERVES. 89 pneumogastric ; to all the muscles of the larynx, except the crico-thyroid, through the inferior laryngeal nerve; to the heart, by filaments which reach it through the pneumogastric nerve. (2) An external branch, which is distributed to the sterno-cleido-mastoid and trapezius muscles; these muscles also receiving filaments from the cervical nerves. Properties. At its origin it is a purely motor nerve, but in its course exhibits some sensibility from anastomosing fibres. Destruction of the medullary root, by tearing it from its attachment by means of forceps, impairs the action of the muscles of deglutition, and destroys the power of producing vocal sounds by paralysis of the laryngeal muscles, without, however, interfering with the respiratory movements of the larynx; these being controlled by other motor nerves. The normal rate of movement of the heart is also impaired by destruction of the medul- lary root. Irritation of the external branch throws the trapezius and sterno-mastoid muscles into convulsive movements, though section of the nerve does not produce complete paralysis, as they are also supplied with motor influence from the cervical nerves. The sterno-mastoid and trapezius muscles per- form movements antagonistic to those of respiration, fixing the head, neck and upper part of the thorax, and delaying the expiratory movement during the acts of pushing, pulling, straining, etc., and in the production of a prolonged vocal sound, as in singing. When the external branch alone is divided, in animals, they experience shortness of breath during exercise, from a want of coordination of the muscles of the limbs and res- piration; and while they can make a vocal sound, it cannot be prolonged. Function. Governs phonation by its influence upon the vocal move- ments of the glottis; influences the movements of deglutition, inhibits the action of the heart and controls certain respiratory movements associated with sustained or prolonged muscular efforts and phonation. 12th Pair. Hypoglossal or Sublingual. Apparent Origin. By two groups of filaments from the medulla ob- longata, in the grooves between the olivary body and the anterior pyramid. Deep Origin. From the hypoglossal nucleus situated deeply in the sub- stance of the medulla, on a level with the lowest portion of the floor of the 4th ventricle; some decussating filaments have been traced to a higher encephalic centre. Distribution. The trunk formed by the union of the root filaments passes out of the cranial cavity through the anterior condyloid foramen, occasionally receiving a filament from the lateral and posterior portion of 90 HUMAN PHYSIOLOGY. the medulla oblongata. After emerging from the cranium, it sends fila- ments to the sympathetic and pneumogastric; it anastomoses with the lingual branch of the 5th pair, and receives and sends filaments to the upper cervical nerves. The nerve is finally distributed to the sterno-hyoid, sterno thyroid, omo hyoid, thyro-hyoid, stylo-glossi, hyo-glossi, genio- hyoid, genio-hyo-glossi, and the intrinsic muscles of the tongue. Properties. A purely motor nerve at its origin, but derives sensibility outside of the cranial cavity, from anastomosis with the cervical, pneumo- gastric and 5th nerves. Irritation of the nerve gives rise to convulsive movements of the tongue and slight evidences of sensibility. Division of the nerve abolishes all movements of the tongue, and inter- feres considerably with the act of deglutition. When the hypoglossal nerve is involved in hemiplegia, the tip of the tongue is directed to the paralyzed side when the tongue is protruded ; due to the unopposed action of the genio-hyo-glossus on the sound side. Articulation is considerably impaired in paralysis of this nerve; great difficulty being experienced in the pronunciation of the consonantal sounds. Mastication is performed with difficulty, from inability to retain the food between the teeth until it is completely triturated. Function. Governs all the movements of the tongue and influences the functions of mastication, deglutition and articulate language. CEREBRO-SPINAL AXIS. The Cerebro-Spinal Axis consists of the spinal cord, medulla oblon- gata, pons Varolii, cerebellum and cerebrum, exclusive of the spinal and cranial nerves. It is contained within the cavities of the cranium and spinal column, and surrounded by three membranes, the dura mater, arachnoid and pia mater, which protect it from injury and supply it with blood vessels. The Brain and Spinal Cord are composed of both white fibres and collections of grey cells, and are therefore to be regarded as conductors of impressions and motor impulses, as well as generators of nerve force. MEMBRANES. The Dura Mater, the most external of the three, is a tough membrane, composed of white fibrous tissue, arranged in bundles, which interlace in every direction. In the cranial cavity it lines the inner surface of the SPINAL CORD. 91 bones, and is attached to the edge of the foramen magnum; sends processes inward, forming the falx cerebri, falx cerebelli, and tentorium cerebelli, supporting and protecting parts of the brain. In the spinal canal it loosely invests the cord, and is separated from the walls of the canal by areolar tissue. The Arachnoid, the middle membrane, is a delicate serous structure which envelopes the brain and cord, forming the visceral layer, and is then reflected to the inner surface of the dura mater, forming the parietal layer. Between the two layers there is a small quantity of fluid which prevents friction by lubricating the two surfaces. The Pia Mater, the most internal of the three, composed of areolar tissue and blood vessels, covers the entire surface of the brain and cord, to which it is closely adherent, dipping down between the convolutions and fissures. It is exceedingly vascular, sending small blood vessels some distance into the brain and cord. The Cerebro-Spinal Fluid occupies the sub-arachnoid space, and the general ventricular cavity of the brain, which communicate by an opening, the foramen of Magendie, in the pia mater, at the lower portion of the 4th ventricle. This fluid is clear, transparent, alkaline, possesses a salt taste and a low specific gravity; it is composed largely of water, traces of albumen, glucose and mineral salts. It is secreted by the pia mater; the quantity is estimated from 2 to 4 fluid oz. The function of the cerebro-spinal fluid is to protect the brain and cord, by preventing concussion from without; by being easily displaced into the spinal canal, prevents undue pressure and insufficiency of blood to the brain. SPINAL CORD. The Spinal Cord varies from 16 to 18 inches in length; is half an inch in thickness, weighs oz., and extends from the atlas to the 2d lumbar vertebra, terminating in the filurn terminate. It is cylindrical in shape, and presents an enlargement in the lower cervical and lower dorsal regions, corresponding to the origin of the nerves which are distributed to the upper and lower extremities. The cord is divided into two lateral halves by the anterior and posterior fissures. It is composed of both white or fibrous and grey or vesicular matter, the former occupying the exterior of the cord, the latter the interior, where it is arranged in the form of two crescents, one in each lateral half, united together by the central mass, the grey commissure; the white matter being united in front by the white commissure. 92 HUMAN PHYSIOLOGY. Structure of the White Matter. The white matter surrounding each lateral half of the cord is made up of nerve fibres, some of which are continuations of the nerves which enter the cord, while others are derived from different sources. It is subdivided into: (i) An Anterior column, comprising that portion between the anterior roots and the anterior fissure, which is again subdivided into two parts : (a) an inner portion, bordering the anterior median fissure, the direct pyramidal tract, or column of Tiirck, containing motor fibres which do not decussate, and which extends as far down as the middle of the dorsal region; (b) an outer portion, sur- rounding the anterior cornua, known as the anterior root zone, composed of short longitudinal fibres which serve to connect together different seg- ments of the spinal cord. (2) A Lateral column, the portion between the anterior and posterior roots, which is divisible into (a) the crossed pyra- midal tract, occupying the posterior portion of the lateral column, and containing all those fibres of the motor tract which have decussated at the medulla oblongata; it is composed of longitudinally running fibres which are connected with the multipolar nerve cells of the anterior cornua; (3) the direct cerebellar tract, situated upon the surface of the lateral column, consisting of longitudinal fibres which terminate in the cerebellum ; it first appears in the lumbar region, and increases as it passes upward; (/j of an inch transversely, of an inch antero-posteriorly; it is held in position by the suspensory ligament, formed by a splitting of the hyaloid tunic, the external layer of which passes in front of the lens, the internal layer behind it. Vision. The eye may be regarded as a camera obscura, in which images of external objects are thrown upon a screen, the retina, by means of a double convex lens. The Essential Conditions for proper vision are: I. Certain refract- ing media, e. g., cornea, aqueous humor, and crystalline lens, by which the rays of light are so disposed as to form an image. 2. A diaphragm, the iris, which, by alternately contracting and dilating, increases or dimin- ishes the amount of light entering the eye. 3. A sensitive surface, to receive the image and transmit the luminous impressions through the optic nerve to the brain. 4. A contractile structure, the ciliary muscle, which can so manipulate the lens as to enable external objects to be seen at near or far distances. The Refracting Apparatus, by which parallel rays of light are brought to a focus on the retina, consists mainly of the crystalline lens, though aided by the cornea and aqueous humor. A ray of light passing through the pupil is refracted and concentrated by the lens at a given point pos- terior to it. For the correct perception of images of external objects, the rays of light must be accurately focused on the retina; in order that this may be accomplished, the lens must have a certain density and a proper curvature of its surfaces. When the lens is too convex, its refracting power is greatly increased, the rays of light are brought to a focus in front of the retina, and the visual perception becomes dim and confused. When it is too flat, the rays are not focused at all, and the resulting perception is the same. The Crystalline lens, therefore, produces a distinct perception of the outline and form of external objects. Action of the Iris. The iris, consisting of contracting and dilating fibres, transmits and regulates the quantity of light passing through its central aperture, the pupil, which is necessary for distinct vision. If the light be too intense or excessive, the circular fibres contract under the stimulus of the 3d pair of nerves, and the aperture is diminished in size; if the quantity of light be insufficient, the dilating fibres contract under the stimulus of the sympathetic, and the pupillary aperture is increased in size. The Retina, which is formed partly by the expansion of the optic nerve, and partly by new nervous structures, is the membrane which 122 HUMAN PHYSIOLOGY. receives the impressions of light. Its posterior surface, which is in con- tact with the choroid, and especially the layer of rods and cones, is the sensitive portion, in which the rays of light produce their effects. The point of most distinct vision is in the macula lutea, and especially in its central depression, the fovea, which corresponds to the central axis of the eye; it is situated about of an inch to the outside of the entrance of the optic nerve. It is at this point that images of external objects are seen most distinctly, while all around it the perceptions are more or less obscure; at the macula all the layers disappear except the layer of rods and cones. Blind Spot. At the point of entrance of the optic nerve is a region in which the rays of light make no impression, owing to the absence of the proper retinal elements; the fibres of the optic nerve being insensible to the action of light. The course which a ray of light takes is as follows: After passing through the cornea, lens, and vitreous humor and the layers of the retina, it is finally arrested by the pigmentary layer of the choroid ; here it excites in the layer of rods and cones some physical or chemical change, which is then transmitted to the fibres of the optic nerve, and thence to the brain, where it is perceived as a sensation of light. The Accommodation of the eye to vision for different distances is accomplished by a change in the convexities of the lens, caused by the action of the ciliary muscle. When the eye is accommodated for vision at far distances, the structures are in a passive condition and the lens is flat- tened ; when it is adjusted for vision at short distances, the convexities of the lens are increased. When the Ciliary muscle contracts and draws the choroid coat forward, the suspensory ligament is relaxed and the lens becomes more convex, in virtue of its own elasticity. Optical Defects. Astigmatistn is a condition of the eye which pre- vents vertical and horizontal lines from being focused at the same time, and is due to a greater curvature of the eye in one direction than another. Spherical aberration is a condition in which there is an indistinctness of an image from the unequal refraction of the rays of light passing through the circumference and the centre of the lens; it is corrected mainly by the iris, which cuts off the marginal rays, and only transmits those passing through the centre. Chromatic aberration, in which the image is surrounded by a colored margin, from the decomposition of the rays of light into their elementary THE SENSE OF SIGHT. 123 parts, is corrected by the different refractive powers of the transparent media in front of the retina. Myopia, or short-sightedness, is caused by an abnormal increase in the antero-posterior diameter of the eyeball; the lens being too far removed from the retina, forms the image in front of it, and the perception becomes dim and blurred. Concave glasses correct this defect, by preventing the rays from converging too soon. Hypermetropic, or long-sightedness, is caused by a shortening of the antero-posterior diameter; the lens consequently focuses the rays of light behind the retina. Convex glasses correct this defect, by converging the rays of light more anteriorly. Presbyopia is a loss of the power of accommodation of the eye to near objects, and usually occurs between the ages of 40 and 60; it is remedied by the use of a convex eye-glass. Accessory Structures. The muscles which move the eyeball are six in number; the superior and inferior recti, the external and internal recti, the superior and inferior oblique muscles. The four recti muscles, arising from the apex of the orbit, pass forward and are inserted into the sides of the sclerotic coat; the superior and inferior muscles rotate the eye around a horizontal axis; the external and internal rotate it around a vertical axis. The Superior oblique muscle, having the same origin, passes forward to the inner and upper angle of the orbital cavity, where its tendon passes through a cartilaginous pulley; it is then reflected backward and inserted into the sclerotic just behind the transverse diameter. Its function is to rotate the eyeball in such a manner as to direct the pupil downward and outward. The Inferior obliqtie muscle arises at the inner angle of the orbit and then passes outward and backward to be inserted into the sclerotic. Its function is to rotate the eyeball and direct the pupil upward and outward. By the associated action of all these muscles, the eyeball is capable of performing all the varied and complex movements necessary for distinct vision. The Eyelids, bordered with short, stiff hairs, shade the eye and protect it from injury. On the posterior surface, just beneath the conjunctiva, are the Meibomian glands, which secrete an oily fluid; it covers the edge of the lids and prevents the tears from flowing over the cheek. The Lachrymal Glands are ovoid in shape and situated at the upper and outer part of the orbital cavity ; they open by from six to eight ducts at the outer portion of the upper lids. 124 HUMAN PHYSIOLOGY. The Tears, secreted by the lachrymal glands, are distributed over the cornea by the lids during the act of winking, and keep it moist and free from dust. The excess of tears passes into the lachrymal ducts, which begin by two minute orifices, one on each lid, at the inner canthus. They conduct the tears into the nasal duct, and so into the nose. THE SENSE OF HEARING. The Organ of Hearing is situated in the petrous portion of the tem- poral bone, and is divided into three portions, viz: the external ear, the middle ear and the internal ear. The External Ear consists of two portions, the pinna or auricle, and the external auditory canal. The former, consisting of cartilage, which is irregularly folded and covered by integument, is united to the side of the head by ligaments and muscles ; the latter, partly cartilaginous and partly bony, is about one and a quarter inches in length ; it runs downward and forward from the concha to the middle ear, and is lined by a reflection of the gene- ral integument, in which is lodged a number of glands, which secrete the cerumen. The function of the external ear is to collect the waves of sound coming from all directions and to transmit them to the membrana tympani. The Middle Ear or Tympanum is an irregularly shaped cavity, narrow from side to side, but long in its vertical and antero-posterior diameters. It is separated from the external ear by the membrana ty?npani, and from the internal ear by a second membrana tympani; it communicates posteriorly with the mastoid cells, anteriorly with the pharynx, through the Eustachian tube. It is lined by mucous membrane, and contains three small bones, forming a connected chain running across its cavity. The Membrana tympani is a thin, delicate, translucent membrane, cir- cular in shape and measuring about two-fifths of an inch in diameter; it is received into a delicate ring of bone, which in the adult becomes consoli- dated with the temporal bone; it is concave externally and situated ob- liquely, inclining at an angle of 45 degrees. The membrane consists of three layers; the outer is formed by a reflec- tion of the integument lining the external auditory canal; the middle is composed of fibrous tissue, and the internal of mucous membrane. The Function of the membrana tympani is to receive and transmit the waves of sound to the chain of bones; it is capable of being made tense THF. SENSE OF HEARING. 125 and lax by the action of the tensor tympani and laxator tympani muscles, so as to vibrate in unison with the waves of sound in the external auditory meatus. When the membrane is relaxed, its vibrations have a greater amplitude, and it appreciates sounds of a low pitch. When it is made tense it vibrates less forcibly and appreciates sounds of a high pitch. The Chain of bones is formed by the malleus, incus and stapes, united together by ligaments. The malleus consists of a head, neck and handle, of which the latter is attached to the inner surface of the membrana tym- pani. The incus, or anvil bone, articulates with the head of the malleus by a capsular joint, and with the stapes by the end of its long process. The stapes resembles a stirrup in shape ; it articulates externally with the long process of the incus, and internally its oval base is applied to the edges of the foramen ovale. The Function of the chain of bones is to transmit the waves of sound across the tympanum to the internal ear; being surrounded by air, and acting as a solid rod, they prevent the vibrations from losing but little in intensity. The Tensor tympani muscle arises mainly from the cartilaginous part of the Eustachian tube ; it then passes backward into the tympanic cavity, where it bends at a right angle around a process of bone, and is inserted into the root of the handle of the malleus. Its function is to draw the handle of the malleus internally, and thus increase the tension of the membrana tympani, so as to make it capable of vibrating with sounds of greater or less intensity; at the same time it tightens the joints of the chain of bones, so that they may the better conduct waves of sound to the internal ear, with but a slight loss of intensity. The Laxator tympani muscle, arising from the spinous process of the sphenoid bone, passes backward through the Glasserian fissure, into the .tympanic cavity, and is inserted into the neck of the malleus. Its function is to draw the handle of the malleus outward, and so relax the membrana tympani, and enables it to receive waves of sound of greater amplitude than when it is tense. The Stapedius muscle, emerging from the cavity of the pyramid of bone projecting from the posterior wall of the tympanum, is inserted into the head of the stapes bone. Its function is to draw the stapes backward, preventing too great movement of the bone, and at the same time relaxing the membrana tympani. The Eustachian tube, by means of which the middle ear communicates with the pharynx, is partly bony and partly cartilaginous in its structure. It is about one and a half inches in length; commencing at its opening in 126 HUMAN PHYSIOLOGY. the pharynx, it passes upward and outward to the spine of the sphenoid bone, where it is slightly contracted; it then gradually dilates as it passes backward into th'e tympanic cavity. It is lined by mucous membrane, which is continued into the middle ear and into the mastoid cells. The Eustachian tube permits the passage of air from the pharynx into the middle ear; in this way the pressure of the air within and without the membrana tympani is equalized, which is one of the essential conditions for the reception of sonorous vibrations. By closing the mouth and nose, and blowing out the cheeks, air can be forced into the middle ear, producing undue pressure, and bulging out of the membrana tympani; by making an effort at swallowing, with the mouth and nose closed, the air in the tympanum can be rarefied and the tympanic membrane will be pressed in. In both such cases the acuteness of hearing is very much diminished. The pharyngeal orifice of the Eustachian tube is opened by the action of certain of the muscles of deglutition, viz: the levator palati, tensor palati, and at times the palato-pharyngei muscles. The Internal Ear, or Labyrinth, is located in the petrous portion of the temporal bone, and consists of an osseous and membranous portion. The Osseous Labyrinth is divisible into three parts, viz: the vestibule, the semi-circular canals, and the cochlea. The Vestibtile is a small, triangular cavity, which communicates with the middle ear by the foramen ovale; in the natural condition it is closed by the base of the stapes bone. The filaments of the auditory nerve enter the vestibule through small foramina in the inner wall, at the fovea hemi- spherica. The Semi-circular canals are three in number; the superior vertical, the inferior vertical and the horizontal, each of which opens into the cavity of the vestibule, by two openings, with the exception of the two vertical,* which at one extremity open by a common orifice. The Cochlea forms the anterior part of the internal ear. It is a gradu- ally tapering canal, about one and a half inches in length, which winds spirally around a central axis, the modiolus, two and a half times. The interior of the cochlea is partly divided into two passages by a thin plate of bone, the lamina osseous spiralis, which projects from the central axis two- thirds across the canal. These passages are termed the scala vestibuli and the scala tympani, from their communication with the vestibule and tym- panum. The scala tympani communicates with the middle ear through the foramen rotundum, which, in the natural condition, is closed by the THE SENSE OF HEARING. 127 second membrana tympani; superiorly they are united by an opening, the helicotrema. The whole interior of the labyrinth, the vestibule, the semi-circular canals, and the scala of the cochlea, contains a clear, limpid fluid, the peri-lymph, secreted by the periosteum lining the osseous walls. The Membranous Labyrinth corresponds to the osseous labyrinth with respect to form, though somewhat smaller in size. The Vestibular portion consists of two small sacs, the utricle and saccule. The Semi-circular canals communicate with the utricle in the same manner as the bony canals communicate with the vestibule. The saccule communicates with the membranous cochlea by the canalis reuniens. In the interior of the utricle and saccule, at the entrance of the auditory nerve, are small masses of carbonate of lime crystals, constituting the otoliths. Their function is unknown. The Membranous cochlea is a closed tube, commencing by a blind extremity at the first turn of the cochlea, and terminating at its apex by a blind extremity also. It is situated between the edge of the osseous lamina spiralis and the outer wall of the bony cochlea, and follows it in its turns around the modiolus. A transverse section of the cochlea shows that it is divided into two portions by the osseous lamina and the basilar membrane : I. The scala vestibuli, bounded by the periosteum and membrane of Reissner. 2. The scala tympani, occupying the inferior portion, and bounded above by the septum, composed of the osseous lamina and the membrana basilaris. The true membranous canal is situated between the membrane of Reiss- ner and the basilar membrane. It is triangular in shape, but is partly divided into a triangular portion and a quadrilateral portion by the tectorial membrane. The Organ of Corti is situated in the quadrilateral portion of the canal, and consists of pillars or rods, of the consistence of cartilage. They are arranged in two rows; one internal, the other external; these rods rest upon the basilar membrane; their bases are separated from each other, but their upper extremities are united, forming an arcade. In the internal row it is estimated there are about 3500, and in the external row about 5200 of these rods. On the inner side of the internal row is a single layer of elongated hair cells; on the outer surface of the external row are three such layers of hair cells. Nothing definite is known as to their function. The Endolymph occupies the interior of the utricle, saccule, membranous 128 HUMAN PHYSIOLOGY. canals, and bathes the structures in the interior of the membranous cochlea, throughout its entire extent. The Auditory Nerve at the bottom of the internal auditory meatus divides into (i) a vestibular branch, which is distributed to the utricle and semi-circular canals; (2) a cochlear branch, which passes into the central axis at its base, and ascends to its apex; as it ascends, fibres are given off, which pass between the plates of the osseous lamina, to be ultimately con- nected with the organ of Corti. The Function of the semi-circular canals appears to be to assist in main- taining the equilibrium of the body; destruction of the vertical canal is followed by an oscillation of the head upward and downward; destruc- tion of the horizontal canal is followed by oscillations from left to right. When the canals are injured on both sides, the animal loses the power of maintaining equilibrium upon making muscular movements. Function of the Cochlea. It is regarded as possessing the power of appreciating the quality of pitch and the shades of different musical tones. The elements of the organ of Corti are analogous, in some respects, to a musical instrument, and are supposed, by Helmholtz, to be tuned so as to vibrate in unison with the different tones conveyed to the internal ear. Summary. The waves of sound are gathered together by the pinna and external auditory meatus, and conveyed to the membrana tympani. This membrane, made tense or lax by the action of the tensor tympani and laxator tympani muscles, is enabled to receive sound waves of either a high or low pitch. The vibrations are conducted across the middle ear by the chain of bones to the foramen ovale, and by the column of air of the tympanum to the foramen rotundum, which is closed by the second membrana tympani; the pressure of the air in the tympanum being regu- lated by the Eustachian tube. The internal ear finally receives the vibrations which excite vibrations successively in the perilymph, the walls of the membranous labyrinth, the endolymph, and, lastly, the terminal filaments of the auditory nerve, by which they are conveyed to the brain. VOICE AND SPEECH The Larynx is the organ of voice. Speech is a modification of voice, and is produced by the teeth and the muscles of the lips and tongue, coordinated in their action by stimuli derived from the cerebrum. The Structures entering into the formation of the larynx are mainly the thyroid, cricoid and arytenoid cartilages; they are so situated and VOICE AND SPEECH. 129 united by means of ligaments and muscles as to form a firm cartilaginous box. The Larynx is covered externally by fibrous tissue and lined inter- nally with mucous membrane. The Vocal Cords are four ligamentous bands, running antero-posteri- orly across the upper portion of the larynx, and are divided into the two superior or false vocal cords, and the two inferior or true vocal cords; they are attached anteriorly to the receding angle of the thyroid cartilages and posteriorly to the anterior part of the base of the arytenoid cartilages. The space between the true vocal cords is the rima glottidis. The Muscles which have a direct action upon the movements of the vocal cords are nine in number, and take their names from their points of origin and insertion, viz : the two crico thyroid, two thyro-arytenoid, two posterior crico-arytenoid, two lateral crico-arytenoid, and one arytenoid muscles. The crico thyroid muscles, by their contraction, render the vocal cords more tense by drawing down the anterior portion of the thyroid cartilage and approximating it to the cricoid, and at the same time tilting the posterior portion of the cricoid and arytenoid cartilages backward. The thyro-arytenoid, by their contraction, relax the vocal cords by draw- ing the arytenoid cartilage forward and the thyroid backward. The posterior crico-arytenoid muscles, by their contraction rotate the arytenoid cartilages outward and thus separate the vocal cords and enlarge the aperture of the glottis. They principally aid the respiratory move- ments during inspiration. The lateral crico-arytenoid muscles are antagonistic to the former, and by their contraction rotate the arytenoid cartilages so as to approximate the vocal cords and constrict the glottis. The aiytenoid muscle assists in the closure of the aperture of the glottis. The itiferior laryngeal nerve animates all the muscles of the larynx, with the exception of the crico thyroid. Movements of the Vocal Cords. During respiration the move- ments of the vocal cords differ from those occurring during the production of voice. At each inspiration, the true vocal cords are widely separated, and the aperture of the glottis is enlarged by the action of the crico-arytenoid muscles, which rotate outward the anterior angle of the base of the aryte- noid cartilages; at each expiration the larynx becomes passive; the elasticity of the vocal cords returns them to their original position, and the air is forced out by the elasticity of the lungs and the walls of the thorax. 130 HUMAN PHYSIOLOGY. Phonation. As soon as phonation is about to be accomplished a marked change in the glottis is noticed with the aid of the laryngoscope. The true vocal cords suddenly become approximated and are made parallel, giving to the glottis the appearance of a narrow slit, the edges of which are capable of vibrating accurately and rapidly; at the same time their tension is much increased. With the vocal cords thus prepared, the expiratory muscles force the column of air into the lungs and trachea through the glottis, throwing the edges of the cords into vibration. The pitch of sounds depends upon the extent to which the vocal cords are made tense and the length of the aperture through which the air passes. In the production of sounds of a high pitch the tension of the vocal cords becomes very marked, and the glottis diminishes in length. When grave sounds, having a low pitch, are emitted from the larynx, the vocal cords are less tense and their vibrations are large and loose. The quality of voice depends upon the length, size and thickness of the cords, and the size, form and construction of the trachea, larynx and the resonant cavities of the pharynx, nose and mouth. The compass of the voice comprehends from two to three octaves. The range is different in the two sexes; the lowest note of the male being about one octave lower than the lowest note of the female; while the highest note of the male is an octave less than the highest of the female. The varieties of voices, e. g., bass, baritone, tenor, contralto, mezzo soprano and soprano, are due to the length of the vocal cords; being longer when the voice has a low pitch, and shorter when it has a high pitch. Speech is the faculty of expressing ideas by means of combination of sounds, in obedience to the dictates of the cerebrum. Articulate sounds may be divided into vowels and consonants. The vowel sounds, a, e, i, o, u, are produced in the larynx by the vocal cords. The consonantal sounds are produced in the air passages above the larynx by an interruption of the current of air by the lips, tongue and teeth ; the consonants may be divided into : (i) mutes, b, d, k,p, t, c, g; (2) dentals, d, j,s, t, z ; (3) nasals, m, n, ng; (4) labials, b,p,f, v, m; (5) gutturals, k, g, c, and g hard; (6) liquids, /, m, n, r. GENERATIVE ORGANS OF THE FEMALE. 131 REPRODUCTION. Reproduction is the function by which the species is preserved, and is accomplished by the organs of generation in the two sexes. GENERATIVE ORGANS OF THE FEMALE. The Generative Organs of the Female consist of the ovaries, Fal- lopian tubes, uterus and vagina. The Ovaries are two small, ovoid, flattened bodies, measuring one inch and a half in length and three-quarters of an inch in width; they are situated in the cavity of the pelvis, and imbedded in the posterior layer of the broad ligament; attached to the uterus by a round ligament, and to the extremities of the Fallopian tubes by the fimbriae. The ovary consists of an external membrane of fibrous tissue, the cortical portion, in which are imbedded the Graafian vesicles, and an internal portion, the stroma, containing blood vessels. The Graafian Vesicles are exceedingly numerous, but situated only in the cortical portion. Although the ovary contains the vesicles from the period of birth, it is only at the period of puberty that they attain their full development. From this time onward to the catamenial period, there is a constant growth and maturation of the Graafian vesicles. They consist of an external investment, composed of fibrous tissue and blood vessels, in the interior of which is a layer of cells, forming the membrana granulosa; at its lower portion there is an accumulation of cells, the proligerous disc, in which the ovum is contained. The cavity of the vesicle contains a slightly-yellowish, alkaline, albuminous fluid. The Ovum is a globular body, measuring about the of an inch in diameter; it consists of an external investing membrane, the vitelline membrane, a central granular substance, the vitellus, or yelk, a nucleus, the germinal vesicle, in the interior of which is imbedded the nucleolus, or germinal spot. The Fallopian Tubes are about four inches in length, and extend outward from the upper angles of the uterus, between the folds of the broad ligaments, and terminate in a fringed extremity, which is attached by one of the fringes to the ovary. They consist of three coats: (i) the external, or peritoneal, (2) middle, or muscular, the fibres of which are arranged in a circular or logitudinal direction, (3) internal, or mucous, 132 HUMAN PHYSIOLOGY. covered with ciliated epithelial cells, which are always waving from the ovary toward the uterus. The Uterus is pyriform in shape, and may be divided into a body and neck; it measures about three inches in length and two inches in breadth in the unimpregnated state. At the lower extremity of the neck is the os externum; at the junction of the neck with the body is a constric- tion, the os internum. The cavity of the uterus is triangular in shape, the walls of which are almost in contact. The walls of the uterus are made up of several layers of non-striated muscular fibres, covered externally by peritoneum, and lined internally by mucous membrane, containing numerous tubular glands, and covered by ciliated epithelial cells. The Vagina is a membranous canal, from five to six inches in length, situated between the rectum and bladder. It extends obliquely upward from the surface, almost to the brim of the pelvis, and embraces at its upper extremity the neck of the uterus. Discharge of the Ovum. As the Graafian vesicle matures, it in- creases in size, from an augmentation of its liquid contents, and approaches the surface of the ovary, where it forms a projection, measuring from one- fourth to one-half an inch in size. The maturation of the vesicle occurs periodically, about every twenty eight days, and is attended by the phe- nomena of menstruation. During this period of active congestion of the reproductive organs the Graafian vesicle ruptures, the ovum and liquid contents escape, and are caught by the fimbriated extremity of the Fallo- pian tube, which has adapted itself to the posterior surface of the ovary. The passage of the ovum through the Fallopian tube into the uterus occu- pies from ten to fourteen days, and is accomplished by muscular contraction and the action of the ciliated epithelium. Menstruation is a periodical discharge of blood from the mucous membrane of the uterus, due to a fatty degeneration of the small blood vessels. Under the pressure of an increased amount of blood in the repro- ductive organs, attending the process of ovulation, the blood vessels rupture, and a hemorrhage takes place into the uterine cavity; thence it passes into the vagina, where it is kept in a fluid condition from admixture with the vaginal mucus. Menstruation lasts from five to six days, and the amount of blood discharged averages about five ounces. Corpus Luteum. For some time anterior to the rupture of a Graa- fian vesicle, it increases in size and becomes vascular; its walls become thickened, from the deposition of a reddish-yellow, glutinous substance, a product of cell growth from the proper coat of the follicle and the membrana GENERATIVE ORGANS OF THE FEMALE. 133 granulosa. After the ovum escapes, there is usually a small effusion of blood into the cavity of the follicle, which soon coagulates, loses its coloring matter, and acquires the characteristics of fibrin, but it takes no part in the formation of the corpus luteum. The walls of the follicle become convo- luted, vascular, and undergo hypertrophy, until they occupy the whole of the follicular cavity. At its period of fullest development, the corpus luteum measures three-fourths of an inch in length and one-half inch in depth. In a few weeks the mass loses its red color, and becomes yellow, constituting the corpus luteum or yellow body. It then begins to retract, and becomes pale; and at the end of two months nothing remains but a small cicatrix upon the surface of the ovary. Such are the changes in the follicle, if the ovum has not been impregnated. The corpus luteum, after impregnation has taken place, undergoes a much slower development, becomes larger, and continues during the entire period of gestation. The differences between the corpus luteum of the unimpregnated and pregnant condition is expressed in the following table by Dalton:— Corpus Luteum of Menstruation. Corpus Luteum of Pregnancy. At the end of three weeks. Three-quarters of an inch in diameter; central clot reddish ; convoluted wall pale. One month. Smaller; convoluted wall bright yellow; clot still reddish. Larger; convoluted wall bright yellow; clot still red- dish. Seven-eighths of an inch in diameter; convoluted wall bright yellow; clot perfectly decolorized. Seven-eighths of an inch in diameter; clot pale and fibrinous; convoluted wall dull yellow. Still as large as at the end of second month; clot fib- brinous; _ convoluted wall paler. Half an inch in diameter; central clot converted into a radiating cicatrix; external wall tolerably thick and convoluted, but without any bright yellow color. Two months. Reduced to the condi- tion of an insignificant cicatrix. Four months. Absent or unnotice- able. Six months. Absent. Nine months. Absent. 134 HUMAN PHYSIOLOGY. GENERATIVE ORGANS OF THE MALE. The Generative Organs of the Male consist of the testicles, vasa deferentia, vesiculae seminales and penis. The Testicles, the essential organs of reproduction in the male, are two oblong glands, about an inch and a half in length, compressed from side to side, and situated in the cavity of the scrotum. The proper coat of the testicle, the tunica albuginea, is a white, fibrous structure, about the 0f an inch in thickness; after enveloping the testicle, it is reflected into its interior at the posterior border, and forms a vertical process, the mediastinum testis, from which septa are given off, dividing the testicle in lobules. The substance of the testicle is made up of the seminiferous tubules, which exist to the number of 840; they are exceedingly convoluted, and when unraveled, are about 30 inches in length. As they pass toward the apices of the lobules they become less convoluted and terminate in from 20 to 30 straight ducts, the vasa recta, which pass upward through the medias- tinum and constitute the rete testis. At the upper part of the mediastinum the tubules unite to form from 9 to 30 small ducts, the vasa efferentia, which become convoluted, and form the globus major of the epididynnis; the continuation of the tubes downward behind the testicle and a second con- volution constitutes the body and globus minor. The seminal tubule consists of a basement membrane lined by granular nucleated epithelium. The Vas Deferens, the excretory duct of the testicle, is about two feet in length, and may be traced upward from the epididymis to the under surface of the base of the bladder, where it unites with the duct of the vesi- cula seminalis, to form the ejaculatory duct. The Vesiculae Seminales are two lobulated, pyriform bodies, about two inches in length, situated on the under surface of the bladder. They have an external fibrous coat, a middle muscular coat, and an in- ternal mucous coat, covered by epithelium, which secretes a mucous fluid. The vesiculae seminales serve as reservoirs, in which the seminal fluid is temporarily stored up. The Ejaculatory Duct, about of an inch in length, opens into the urethra and is formed by the union of the vasa deferentia and the ducts of the vesiculae seminales. The Prostate Gland surrounds the posterior extremity of the urethra, and opens into it by from twenty to thirty openings, the orifices of the pros- DEVELOPMENT OF ACCESSORY STRUCTURES. 135 tatic tubules. The gland secretes a fluid which forms part of the semen, and assists in maintaining the vitality of the spermatozoa. Semen is a complex fluid, made up of the secretions from the testicles, the vesiculse seminales, the prostatic and urethral glands. It is greyish- white in color, mucilaginous in consistence, of a characteristic odor, and somewhat heavier than water. From half a drachm to a drachm is ejaculated at each orgasm. The Spermatozoa are peculiar anatomical elements, developed within the seminal tubules, and possess the power of spontaneous movement. The spermatozoa consist of a conoidal head and a long filamentous tail, which is in continuous and active motion; as long as they remain in the vas deferens they are quiescent, but when free to move in the fluid of the vesiculae seminales, become very active. Origin. The spermatozoa appear at the age of puberty, and are then constantly formed until an advanced age. They are developed from the nuclei of large, round cells, contained in the interior of the seminal tubules, as many as fifteen to twenty developing in a single cell. When the spermatozoa are introduced into the vagina, they pass readily into the uterus and through the Fallopian tubes toward the ovaries, where they remain and retain their vitality for a period of from 8 to io days. Fecundation is the union of the spermatozoa with the ovum during its passage toward the uterus, and usually takes place in the Fallopian tube, just outside of the womb. After floating around the ovum in an active manner, they penetrate the vitelline membrane, pass into the interior of the vitellus, where they lose their vitality, and along with the germinal vesicle entirely disappear. DEVELOPMENT OF ACCESSORY STRUCTURES. Segmentation of the Vitellus. After the disappearance of the spermatozoa and the germinal vesicle there remains a transparent, granular, albuminous substance, in the centre of which a new nucleus soon appears; this constitutes the parent cell, and is the first stage in the development of the new being. Following this, the vitellus undergoes segmentation; a constriction appears on the opposite sides of the vitellus, which gradually deepens, until the yelk is divided into two segments, each of which has a distinct nucleus and nucleolus; these two segments undergo a further division into four, the four into eight, the eight into sixteen, and so on, until the entire 136 HUMAN PHYSIOLOGY. vitelius is divided into a great number of cells, each of which contains a nucleus and nucleolus. The peripheral cells of this “ mulberry mass ” then arrange themselves so as to form a membrane, and as they are subjected to mutual pressure, assume a polyhedral shape, which gives to the membrane a mosaic appear- ance. The central part of the vitelius becomes filled with a clear fluid. A secondary membrane shortly appears within the first, and the two together constitute the external and internal blastodermic membranes. Germinal Area. At about this period there is an accumulation of cells at a certain spot upon the surface of the blastodermic membranes, which marks the position of the future embryo. This spot, at first circular, soon becomes elongated, and forms the primitive trace, around which is a clear space, the area pellucida, which is itself surrounded by a darker region, the area opaca. The primitive trace soon disappears, and the area pellucida becomes guitar-shaped; a new groove, the medullary groove, is now formed, which develops from before backward, and.becomes the neural canal. Blastodermic Membranes. The embryo, at this period, consists of three layers, viz: the external and internal blastodermic membranes, and a middle membrane formed by a genesis of cells from their internal sur- faces. These layers are known as the epiblast, mesoblast and hypoblast. The Epiblast gives rise to the central nervous system, the epidermis of the skin and its appendages, and the primitive kidneys. The Mesoblast gives rise to the dermis, muscles, bones, nerves, blood vessels, sympathetic nervous system, connective tissue, the urinary and reproductive apparatus and the walls of the alimentary canal. The Hypoblast gives rise to the epithelial lining of the alimentary canal and its glandular appendages, the liver and pancreas, and the epithelium of the respiratory tract. Dorsal Laminae. As development advances, the true medullary groove deepens, and there arise two longitudinal elevations of the epiblast, the dorsal lamina, one on either side of the groove, which grow up, arch over and unite so as to form a closed tube, the primitive central nervous system. The Chorda Dorsalis is a cylindrical rod running almost throughout the entire length of the embryo. It is formed by an aggregation of meso- blasdc cells, and situated immediately beneath the medullary groove. Primitive Vertebrae. On either side of the neural canal the cells of the mesoblast undergo a longitudinal thickening, which develops and DEVELOPMENT OF ACCESSORY STRUCTURES. 137 extends around the neural canal and the chorda dorsalis, and forms the arches and bodies of the vertebrae. They become divided transversely into four-sided segments. The Mesoblast now separates into two layers; the external, joining with the epiblast, forms the somatopleure; the internal, joining with the hypo- blast, forms the splanchnopleure ; the space between them constituting the pleuro-peritcmeal cavity. Visceral Laminae. The walls of the pleuro-peritoneal cavity are formed by a downward prolongation of the somatopleure (the visceral lamina;),.which, as they extend around in front, pinch off a portion of the yelk sac (formed by the splanchnopleure), which becomes the primitive alimentary canal; the lower portion, remaining outside of the body cavity, forms the umbilical vesicle, which after a time disappears. Formation of Fcetal Membranes. The Amnion appears shortly after the embryo begins to develop, and is formed by folds of the epiblast and external layer of the mesoblast, rising up in front and behind, and on each side; these amniotic folds gradually extend over the back of the embryo to a certain point, where they coalesce, and enclose a cavity, the amniotic cavity. The membranous partition between the folds disappears, and the outer layer recedes and becomes blended with the vitelline mem- brane, constituting the chorion, the external covering of the embryo. The Allantois. As the amnion develops, there grows out from the posterior portion of the alimentary canal a pouch, or diverticulum, the allantois, which carries blood vessels derived from the intestinal circula- tion. As it gradually enlarges, it becomes more vascular, and inserts itself between the two layers of the amnion, coming into intimate contact with the external layer. Finally, from increased growth, it completely surrounds the embryo, and its edges become fused together. In the bird, the allantois is a respiratory organ, absorbing oxygen and exhaling carbonic acid; it also absorbs nutritious matter from the interior of the egg. Amniotic fluid. The amnion, when first formed, is in close contact with the surface of the ovum; but it soon enlarges, and becomes filled with a clear, transparent fluid, containing albumen, glucose, fatty matters, urea and inorganic salts. It increases in amount up to the latter period of gestation, when it amounts to about two pints. In the space between the amnion and allantois is a gelatinous material, which is encroached upon, and finally disappears as the amnion and allantois come in contact, at about the fifth month. 138 HUMAN PHYSIOLOGY. The Chorion, the external investment of the embryo, is formed by a fusion of the original vitelline membrane, the external layer of the amnion, and the allantois. The external surface now becomes covered with villous processes, which increase in number and size by the continual budding and growth of club-shaped processes from the main stem, and give to the chorion a shaggy appearance. They consist of a homogeneous granular matter, and are penetrated by branches of the blood vessels derived from the aorta. The presence of villous processes in the uterine cavity is proof positive of the previous existence of a foetus. They are characteristic of the chorion, and are found under no other circumstances. At about the end of the second month the villosities begin to atrophy and disappear from the surface of the chorion, with the exception of those situated at the points of entrance of the foetal blood vessels, which occupy about one-third of its surface, where they continue to grow longer, become more vascular, and ultimately assist in the formation of the placenta; the remaining two-thirds of the surface loses its villi and blood vessels, and becomes a simple membrane. The Umbilical Cord connects the foetus with that portion of the chorion which forms the foetal side of the placenta. It is a process of the allantois, and contains two arteries and a vein, which have a more or less spiral direction. It appears at the end of the first month, and gradually increases in length, until at the end of gestation it measures about 20 inches. The cord is also surrounded by a process of the amnion. Development of the Decidual Membrane. The interior of the uterus is lined by a thin, delicate mucous membrane, in which are im- bedded immense numbers of tubules, terminating in blind extremities, the uterine tubules. At each period of menstruation the mucous membrane becomes thickened and vascular, which condition, however, disappears after the usual menstrual discharge. When the ovum becomes fecundated, the mucous membrane takes on an increased growth, becomes more hyper- trophied and vascular, sends up little processes, or elevations from its sur- face, and constitutes the decidua vera. As the ovum passes from the Fallopian tube into the interior of the uterus, the primitive vitelline membrane, covered with villosities, becomes entangled with the processes of the mucous membrane. A portion of the decidua vera then grows up on all sides, and encloses the ovum, forming the decidua reflexa, while the villous processes of the chorion insert them- selves into the uterine tubules, and in the mucous membrane between them. DEVELOPMENT OF ACCESSORY STRUCTURES. 139 As development advances the decidua reflexa increases in size, and at about the end of the fourth month comes in contact with the decidua vera, with which it is ultimately fused. The Placenta. Of all the embryonic structures, the placenta is the most important. It begins to be formed towards the end of the second month, and then increases in size until the end of gestation, when it assumes an oval or rounded shape, and measures from 7 to 9 inches in length, 6 to 8 inches in breadth, and weighs from 15 to 20 ounces. It is most frequently situated at the upper and posterior part of the inner surface of the uterus. The placenta consists of two portions, a foetal and a maternal. The Foetal portion is formed by the villi of the chorion, which, by devel- oping, rapidly increase in size and number. They become branched and penetrate the uterine tubules, which enlarge and receive their many rami- fications. The capillary blood vessels in the interior of the villi also en- large and freely anastomose with each other. The Maternal portion is formed from that part of the hypertrophied and vascular decidual membrane between the ovum and the uterus, the decidua serotina. As the placenta increases in size, the maternal blood vessels around the tubules become more and more numerous, and gradually fuse together, forming great lakes, which constitute sinuses in the walls of the uterus. As the latter period of gestation approaches, the villi extend deeper into the decidua, while the sinuses in the maternal portion become larger and extend further into the chorion. Finally, from excessive development of the blood vessels, the structures between them disappear, and as their walls come in contact, they fuse together, so that, ultimately, the maternal and foetal blood are only separated by a thin layer of a homogeneous substance. When fully formed, the placenta consists principally of blood vessels inter- lacing in every direction. The blood of the mother passes from the ute- rine vessels into the lakes surrounding the villi; the blood from the child flows from the umbilical arteries into the interior of the villi; but there is not at any time an intermingling of blood, the two being separated by a delicate membrane formed by a fusion of the walls of the blood vessels and the walls of the villi and uterine sinuses. The function of the placenta is that of a respiratory organ, permitting the oxygen of the maternal blood to pass by osmosis through the delicate placental membrane into the blood of the foetus; at the same time permit- ting the carbonic acid and other waste products, the result of nutritive changes in the fcetus, to pass into the maternal blood, and so to be carried to the various eliminating organs. 140 HUMAN PHYSIOLOGY. Through the placenta also passes all the nutritious materials of the maternal blood which are essential for the development of the embryo. At about the middle of gestation there develops beneath the decidual membrane a new mucous membrane, destined to perform the functions of the old when it is extruded from the womb, along with the other embryonic structures, during parturition. DEVELOPMENT OF THE EMBRYO. Nervous System. The cerebro-spinal axis is formed within the medullary canal by the development of cells from its inner surfaces, which as they increase fill up the canal, and there remains only the central canal of the cord. The external surface gives rise to the dura mater and pia mater. The neural canal thus formed is a tubular membrane; it termi- nates posteriorly in an oval dilatation, and anteriorly in a bulbous extremity, which soon becomes partially contracted, and forms the anterior, middle and posterior cerebral vesicles, from which are ultimately developed the cerebrum, the corpora quadrigemina, and medulla oblongata, respectively. The anterior vesicle soon subdivides into two secondary vesicles, the larger of which becomes the hemispheres, the smaller, the optic thalami; the posterior vesicle also divides into two; the anterior becoming the cerebellum, the posterior, the pons Varolii and medulla oblongata. About the seventh week the straight chain of cerebral vesicles becomes curved from behind forward and forms three prominent angles. As devel- opment advances, the relative size of the encephalic masses changes. The cerebrum developing more rapidly than the posterior portion of the brain, soon grows backward and arches over the optic thalami and the tubercula quadrigemina; the cerebellum overlaps the medulla oblongata. The surface of the cerebral hemispheres is at first smooth, but at about the fourth month begins to be marked by the future fissures and convolutions. The Eye is formed from a little bud projecting from the side of the anterior vesicle. It is at first hollow but becomes lined with nervous matter, forming the optic nerve and retina ; the remainder of the cavity is occupied by the vitreous body. The anterior portion of the pouch becomes invaginated and receives the crystalline lens, which is a product of the epiblast, as is also the cornea. The iris appears as a circular membrane without a central aperture, about the seventh week; the eyelids are formed between the second and third months. The Internal Ear is developed from the auditory vesicle, budding from the third cerebral vesicle; the membranous vestibule appears first, DEVELOPMENT OF THE EMBRYO. 141 and from it diverticula are given off, which become the semi-circular canals and cochlea. The cavity of the tympanum, the Eustachian tube, and the external auditory canal are the remains of the first branchial cleft; the cavity of this cleft being subdivided into the tympanum and external auditory meatus by the membrana tympani. The Skeleton. The chorda dorsalis, the primitive part of the verte- bral column, is a cartilaginous rod situated beneath the medullary groove. It is a temporary structure, and disappears as the true bony vertebra; develop. On either side are the quadrate masses of the mesoblast, the primitive vertebrae, which send processes upward and around the medul- lary groove, and downward and around the chorda dorsalis, forming in these situations the arches and bodies of the future vertebrae. More externally the outer layer of the mesoblast and epiblast arch downward and forward, forming the ventral laminae, in which develop the muscles and bones of the abdominal walls. The true cranium is an anterior development of the vertebral column, and consists of the occipital, parietal and frontal segments, which corres- pond to the three cerebral vesicles. The base of the cranium consists, at this period, of a cartilaginous rod on either side of the anterior extremity of the chorda dorsalis, in which three centres of ossification appear, the bast-occipital, the basi-sphenoidal, and the pre-sphenoidal. They ultimately develop into the basilar process of the occipital bone and the body of the sphenoid. The entire skeleton is at first either membranous or cartilaginous. At the beginning of the second month centres of ossification appear in the jaws and clavicle; as development advances, the ossific points in all the future bones extend, until ossification is completed. The limbs develop from four little buds projecting from the sides of the embryo, which, as they increase in length, separate into the thigh, leg and foot, and the arm, forearm and hand ; the extremities of the limbs undergo subdivision, to form the fingers and toes. Face and Visceral Arches. In the facial and cervical regions the visceral laminae send up three processes, the visceral arches, separated by clefts, the visceral clefts. The first, or the mandibular arches, unite in the median line to form the lower jaw, and superiorly form the malleus. A process jutting from its base grows forward, unites with the fronto-nasal process growing from above, and forms the upper jaw. When the superior maxillary processes fail to unite, there results the cleft palate deformity; if the integument also 142 HUMAN PHYSIOLOGY. fails to unite, there results the hare-lip deformity. The space above the mandibular arch becomes the mouth. The second arch develops the incus and stapes bones, the styloid process and ligament, and the lesser cornu of the hyoid bone. The cleft between the first and second arches partially closes up, but there remains an open- ing at the side which becomes the Eustachian tube, tympanic cavity, and external auditory meatus. The third arch develops the body and greater cornu of the hyoid bone. Alimentary Canal and its Appendages. The alimentary canal is formed by a pinching off of the yelk sac by the visceral plates as they grow downward and forward. It consists of three distinct portions, the fore gut, the hind gut, and the central part, which communicates for some time with the yelk sac. It is at first a straight tube, closed at both extremities, lying just beneath the vertebral column. The canal gradu- ally increases in length, and becomes more or less convoluted; at its anterior portion two pouches appear, which become the cardiac and pyloric extremities of the stomach. At about the seventh week the inferior extremity of the intestine is brought into communication with the exterior, by an opening, the anus. Anteriorly the mouth and pharynx are formed by an involution of epiblast, which deepens until it communicates with the fore gut. The Liver appears as a slight protrusion from the sides of the alimen- tary canal, about the end of the first month ; it grows very rapidly, attains a large size, and almost fills up the abdominal cavity. The hepatic cells are derived from the intestinal epithelium, the vessels and connective tissue from the mesoblast. The Pancreas is formed by the hypoblastic membrane. It originates in two small ducts budding from the duodenum, which divide and subdivide, and develop the glandular structure. The Lungs are developed from the anterior part of the oesophagus. At first a small bud appears, which, as it lengthens, divides into two branches; secondaiy and tertiary processes are given off these, which form the bron- chial tubes and air cells. The lungs originally extended into the abdomi- nal cavity, but became confined to the thorax by the development of the diaphragm. The Bladder is formed by a dilatation of that portion of the allantois remaining within the abdominal cavity. It is at first pear shaped, and communicates with the intestine, but later becomes separated, and opens exteriorly by the urethra. It is attached to the abdominal walls by a rounded cord, the urachus, the remains of a portion of the allantois. DEVELOPMENT OF THE EMBRYO. 143 Genito-Urinary Apparatus. The Wolffian bodies appear about the thirtieth day, as long hollow tubes running along each side of the primi- tive vertebral column. They are temporary structures, and are sometimes called the primordial kidneys. The Wolffian bodies consist of tubules which run transversely and are lined with epithelium; internally they become invaginated to receive tufts of blood vessels; externally they open into a common excretory duct, the duct of the Wolffian body, which unites with the duct of the opposite body, and empties into the intestinal canal at a point opposite the allantois. On the outer side of the Wolffian body there appears another duct, the duct of Muller, which also opens into the intestine. Behind the Wolffian bodies are developed the structures which become either the ovaries or testicles. In the development of the female, the Wolffian bodies and their ducts disappear; the extremities of the Mullerian ducts dilate and form the fimbriated extremity of the Fallopian tubes, while the lower portions coalesce to form the body of the uterus and vagina, which now separate themselves from the intestine. In the development of the male, the Mullerian ducts atrophy, and the ducts of the Wolffian body ultimately form the epididymis and vas deferens. About the seventh month the testicles begin to descend, and by the ninth month have passed through the abdominal ring into the scrotum. The Kidneys are developed out of the Wolffian bodies. They consist of little pyramidal lobules, composed of tubules which open at the apex into the pelvis. As they pass outward they become convoluted and cup-shaped at their extremities, receive a tuft of blood vessels, and form the Mal- pighian bodies. The ureters are developed from the kidneys, and pass downward to be connected with the bladder. The Circulatory Apparatus assumes three different forms at different periods of life, all having reference to the manner in which the embryo receives nutritious matter and is freed of waste products. The Vitelline circulation appears first and absorbs nutritious material from the vitellus. It is formed by blood vessels which emerge from the body and ramify over a portion of the vitelline membrane, constituting the area vasculosa. The heart, lying in the median line, gives off two arches which unite to form the abdominal aorta, from which two large arteries are given off, passing into the vascular area; the venous blood is returned by veins which enter the heart. These vessels are known as the omphalo- mesenteric arteries and veins. The vitelline circulation is of short dura- 144 HUMAN PHYSIOLOGY. tion in the mammals, as the supply of nutritious matter in the vitellus soon becomes exhausted. The Placental circulation becomes established when the blood vessels in the allantois enter the villous processes of the chorion and come into close relationship with the maternal blood vessels. This circulation lasts during the whole of intra-uterine life, but gives way at birth to the adult circulation, the change being made possible by the development of the circulatory apparatus. The Heart appears as a mass of cells coming off from the anterior por- tion of the intestine; its central part liquefies, and pulsations soon begin. The heart is at first tubular, receiving posteriorly the venous trunks and giving off anteriorly the arterial trunks. It soon becomes twisted upon itself, so that the two extremities lie upon the same plane. The heart now consists of a single auricle and a single ventricle. A septum growing from the apex of the ventricle divides it into two cavities, a right and a left. The auricles also become partly separated by a septum which is perforated by the foramen ovale. The arterial trunk becomes separated by a partition, into two canals, which become, ultimately, the aorta and pulmonary artery. The auricles are separated from the ventri- cles by incomplete septa, through which the blood passes into the ventricles. Arteries. The aorta arises from the cephalic extremity of the heart and divides into two branches which ascend, one on each side of the intestine, and unite posteriorly to form the main aorta; posteriorly to these first aortic arches four others are developed, so that there are five altogether running along the visceral arches. The two anterior soon disappear. The third arch becomes the internal carotid and the external carotid; a part of the fourth arch, on the right side, becomes the subclavian artery, and the remainder atrophies and disappears, but on the left side it enlarges and becomes the permanent aorta; the fifth arch becomes the pulmonary artery on the left side. The communication between the pulmonary artery and the aorta, the ductus arteriosus, disappears at an early period. Veins. The venous system appears first as two short, transverse veins, the canals of Cuvier, formed by the union of the vertebral veins and the cardinal veins, which empty into the auricle. The inferior vena cava is formed as the kidneys develop, by the union of the renal veins, which, in a short time, receive branches from the lower extremities. The sub- clavian veins join the jugular as the upper extremities develop. The heart descends in the thorax, and the canals of Cuvier become oblique; they shortly communicate by a transverse duct, which ultimately becomes the left innominate vein. The left canal of Cuvier atrophies and becomes a DEVELOPMENT OF THE EMBRYO. 145 fibrous cord. A transverse branch now appears, which carries the blood from the left cardinal vein into the right, and becomes the vena azygos minor; the right cardinal vein becomes the vena azygos major. Circulation of Blood in the Foetus. The blood returning from the placenta, after having received oxygen, and been freed from carbonic acid, is carried by the umbilical vein to the under surface of the liver; here a portion of it passes through the ductus venosus into the ascending vena cava, while the remainder flows through the liver, and passes into the vena cava by the hepatic veins. When the blood is emptied into the right auricle, it is directed by the Eustachian valve, through the foramen ovale, into the left auricle, thence into the left ventricle, and so into the aorta to all parts of the system. The venous blood returning from the head and upper extremities is emptied, by the superior vena cava, into the right auricle, from which it passes into the right ventricle, and thence into the pulmonary artery. Owing to the condition of the lung, only a small por- tion flows through the pulmonary capillaries, the greater part passing through the ductus arteriosus, which opens into the aorta at a point below the origin of the carotid and subclavian arteries. The mixed blood now passes down the aorta to supply the lower extremities, but a portion of it is directed, by the hypogastric arteries, to the placenta, to be again oxygenated. At birth, the placental circulation gives way to the circulation of the adult. As soon as the child begins to breathe, the lungs expand, blood flows freely through the pulmonary capillaries, and the ductus arteriosus begins to contract. The foramen ovale closes about the tenth day. The umbilical vein, the ductus venosus, and the hypogastric arteries become impervious in several days, and ultimately form rounded cords. TABLE OF PHYSIOLOGICAL CONSTANTS. Mean height of male, 5 feet inches; of female, 5 feet 2 inches. “ weight “ “ 145 pounds; of female, 121 pounds. Number of chemical elements in the human body ; from 16 to 18. “ “ proximate principles in the human body; about 100. Amount of water in the body weighing 145 pounds; 108 pounds. “ “ solids in the body weighing 145 pounds; 36 pounds. “ “ food required daily; 16 ounces meat, 19 ounces of bread, 2,% ounces of fat, 52 ounces of water. Amount of saliva secreted in 24 hours; about 3*4 lbs. Function of saliva; converts starch into glucose. Active principle of saliva; ptyalin. Amount of gastric juice secreted in 24 hours; from 8 to 14 lbs. Functions of gastric juice; converts albumen into albuminose. Active principles of gastric juice ; pepsin and hydrochloric acid. Duration of digestion ; from 3 to 5 hours. Amount of intestinal juice secreted in 24 hours; about 1 lb. Function of intestinal juice ; converts starch into glucose. Amount of pancreatic juice secreted in 24 hours; about \]/z lbs. Active principles of pancreatic juice; pancreatin and trypsin. Functions: • 1. Emulsifies fats. 2. Converts albumen into albuminose. . 3. “ starch into glucose. Amount of bile poured into the intestines daily; about lbs. 1. Assists in the emulsification of fats. 2. Stimulates the peristaltic movements. 3. Prevents putrefactive changes in the food. 4. Promotes the absorption of the fat. Functions: Amount of blood in the body; from 16 to 18 lbs. Size of red corpuscles; of an inch. “ “ white corpuscles; an inch- Shape of red corpuscles; circular biconcave disks. “ “ white corpuscles ; globular. 147 148 TABLE OF PHYSIOLOGICAL CONSTANTS. Motor nerve to tongue ; hypoglossal or 12th pair. “ “ “ laryngeal muscles; spinal accessory or nth pair. Sensory nerve of the face; trifacial or 5th pair. “ “ “ “ pharynx; glosso-pharyngeal or 9th pair. “ “ “ “ lungs, stomach, etc,; pneumogastric or 10th pair. Length of spinal cord; 16 to 18 inches, weight, ozs. Point of decussation of motor fibres; at the medulla oblongata. “ “ “ “ sensory fibres; throughout the spinal cord. Function of antero-lateral columns of spinal cord; transmit motor impulses from the brain to the muscles. - Functions of the posterior columns; assist in the coordination of muscular movements. Functions of the medulla oblongata ; controls the functions of insaliva- tion, mastication, deglutition, respiration, circulation, etc. Functions of the corpora quadrigemina; physical centres for sight. “ “ “ corpora striata; centres for motion. “ “ “ optic thalami; centres for sensation. “ “ “ cerebellum; centre for the coordination of muscular movements. Function of the cerebrum ; centre for intelligence, reason and will. Centre for articulate language; 3d frontal convolution on left side of cerebrum. Number of coats to the eye; three; 1st, cornea and sclerotic; 2d, choroid ; 3d, retina. Function of iris; regulates the amount of light entering the eye. “ “ crystalline lens ; refracts the rays of light so as to form an image on the retina. Function of retina; receives the impressions of light. “ “ membrana tympani; receives and transmits waves of sound to internal ear. Function of Eustachian tube ; regulates the passage of air into and from the middle ear. Function of semi-circular canals; assist in maintaining the equipoise of the body. Function of the cochlea; appreciates the shades and combinations of musical tones. Size of human ovum; of an inch in diameter. “ “ spermatozoa, twists of an inch in length. Function of the placenta; acts as a respiratory and digestive organ for the foetus. Duration of pregnancy; 280 days. TABLE OF PILYSIOLOGICAL CONSTANTS. 149 Number of red corpuscles in a cubic millimetre of blood (the cubic of an inch); 5,000,000. Function of red corpuscles; to carry oxygen from the lungs to the tissues. Frequency of the heart’s pulsations per minute; 72, on the average. Velocity of the blood movement in the arteries; about 16 inches per second. Length of time required for the blood to make an entire circuit of the vascular system; about 20 seconds. Amount of air passing in and out of the lungs at each respiratory act; from 20 to 30 cubic inches. Amount of air that can be taken into the lungs on a forced inspiration; 110 cubic inches. Amount of reserve air in the lungs after an ordinary expiration; 100 cubic inches. Amount of residual air always remaining in the lungs; about 100 cubic inches. Vital capacity of the lungs; 230 cubic inches. Entire volume of air passing in and out of the lungs in 24 hours; about 400 cubic feet. Composition of the air; nitrogen, 79.19, oxygen, 20.81, per 100 parts. Amount of oxygen absorbed in 24 hours; 18 cubic feet. Amount of carbonic acid exhaled in 24 hours; 14 cubic feet. Temperature of the human body at the surface; F. Amount of urine excreted daily; from 40 to 50 ozs. “ “ urea “ “ 512 grains. Specific gravity of urine; from 1.010 to 1.015. Number of spinal nerves; 31 pairs. “ “ roots of origin; two; 1st, anterior, motor; 2d, posterior, sensory. Rate of transmission of nerve force; about 100 feet per second. Number of cranial nerves ; 12 pairs. ' 1. Olfactory, or 1st pair. 2. Optic, or 2d pair. 3. Auditory, or 8th pair. 4. Chorda tympani for anterior % of tongue. 5. Branches of glosso-pharyngeal or 8th pair, for posterior of tongue. Nerves of special sense. Motor nerves to eyeball and accessory structures; motor oculi, or 3d pair ; pathetic, or 4th pair; abducens, or 6th pair. Motor nerve to facial muscles; portio dura, facial or 7th pair. TABLE SHOWING RELATION OF WEIGHTS AND MEASURES OF THE METRIC SYSTEM TO APPROX- IMATE WEIGHTS AND MEASURES OF THE U. S. One Myriametre = 10,000 metres = 32800. feet. One Kilometre = 1,000 “ = 3280. “ One Hectometre = 100 “ = 328.0 “ One Decametre = 10 “ = 32.80 “ MEASURES OF LENGTH. One Metre r the ten millionth part of a ' quarter of the Meridian of [ the Earth j — 39-368 inches. One Decimetre = the tenth part of one metre = 3.936 “ One Centimetre the one hundredth part of one metre = -393 ( f ) “ One Millimetre the one thousandth part of one metre = -°39 (2V) “ OneMyriagramme= 10,000 grammes = pounds Troy. One Kilogramme = 1,000 “ = “ “ One Hectogramme = ioo “ = ounces “ One Decagramme = 10 “ = drachms “ WEIGHTS. One Gramme = f the weight of a cubic centi-' \ metre of water at 40 C. I5-434 grains. One Centigramme = One Decigramme = the tenth part of one gramme = 1.543 (ij£) “ ' the hundredth part of one 1 gramme J •154(34) “ One Milligramme = r the thousandth part of one k gramme •OI5 ( A) “ MEASURES OF CAPACITY. One Myrialitre 10 cubic Metres or the' measure of 10 Milliers of water 2600. gallons. One Kilolitre 1 cubic Metre or the meas-' ure of I Millier of water 260. “ One Hectolitre 100 cubic Decimetres or the measure of 1 Quintal of water 26. “ 10 cubic Decimetres or' the measure of 1 Myria- gramme of water One Decalitre 1 cubic Decimetre or the measure of 1 Kilogramme of water 2.6 “ One Litre 2.1 pints. One Decilitre 100 cubic Centimetres or the measure of 1 Hecto- gramme of water 3.3 ounces. One Centilitre 10 cubic Centimetres or' the measure of x Deca- gramme of water 1 cubic Centimetre or the 2.7 drachms. One Millilitre measure of 1 gramme of water 16.2 minims. 150 INDEX. PAGE A BDUCENS NERVE 80 Aberration, chromatic 122 spherical 122 Absorption 28 by the lacteals 30 by the blood vessels 31 of oxygen in respiration 48 Accommodation of the eye 122 Adipose tissue, uses of in the body 12 Adult circulation, establishment of at birth. 143 Air, atmospheric, composition of. 48 amount exchanged in respira- tion 47 changes in during respiration.. Albumen, uses of in the body 12 Albuminoid substances 19 Alcohol, action of. 20 Alimentary principles, classification of. 18 albuminous principles 19 saccharine principles 19 oleaginous principles 19 inorganic principles 19 Alimentary canal, development of. 142 Allantois, development and function of. 137 Amnion, formation of. 137 Animal heat 50 Anterior columns of spinal cord 92 Area, germinal 136 Arteries, properties of. 41 Asphyxia 49 Astigmatism 122 Axis, cerebro-spinal 90 cylinder of nerves 71 27 Bladder, urinary 59 Blastodermic membranes 136 Blood 32 composition of plasma 32 coagulation of. 36 coloring matter of. 34 changes in, during respiration. 49 circulation of. 37 rapidity' of flow in arteries 42 rapidity of flow in capillaries... 43 pathological conditions of. 37 corpuscles 33 origin of. 35 pressure 41 Burdach, column of.. 92 PAGE PANALS OF CUVIER 144 Capillary blood vessels 43 Capsule, internal 104 external 103 Caudate nucleus 103 Cells, structure of. 14 ■ -■— manifestations of life by 15 of anterior horns of grey mat- ter 92 Centre for articulate language no Cerebrum 106 fissures and convolutions 107 functions of 109 localization of functions no motor area of no special centres of in Cerebellum 105 forced movements of...... jo6 Cerebral vesicles of embryo 140 Chemical composition of human body 10 elements, proximate quantity of in body 14 Chorda dorsalis 136 tympani nerve, course and function of. 83,84 Chorion 138 Chyle 31 Ciliary muscle 120 Circulation of blood 37 Claustrum 103 Cochlea 126 Columns of spinal cord 92 Corium 67 Corpora Wolffiana 143 quadrigemina 102 Corpus luteum 132 striatum 103 Corti, organ of 104 Cranial nerves 77 Crura cerebri 102 Crystalline lens 120 ■T)ECIDUAL MEMBRANE 138 Decussation of motor and sen- sory fibres 93 Deglutition 23 nervous circle of Development of accessory structures of embryo 135 Digestion 21 Ductus arteriosus 145 venosus 145 151 152 INDEX, T7 AR 124 Electrotonus 76 Embryo, development of. 140 Endolymph 127 Epidermis 67 Epididymis 134 Epiglottis 24 Eustachian tube 125 Excretion 58 Eye 118 refracting apparatus of. 121 blind spot of. 122 paralysis, symptoms of... 84 Fallopian tubes 131 Faeces 28 Fat, uses of in the body 12 Female organs of generation 131 Fissures and convolutions of brain 107 Food 17 percentage composition of. 20 daily amount required 21 albuminous principles of 19 saccharine principles of. 19 oleaginous principles of. 19 inorganic principles of 19 Fovea centralis 122 Galvanic currents, ef- fect on nerves. 76 Ganglia 71 ophthalmic 112 Gasserian 81 spheno-palatine 112 otic 112 sub-maxillary.... 112 semi-lunar T13 Gases of the intestine 28 condition of, in blood 49 Gastric juice 24 action of. 25 Generation, male organs of 134 female organs of. 131 Globules of the blood 33 of the lymph 30 Glomeruli of the kidneys 59 Glosso-pharyngeal nerve 85 Glottis, respiratory movements of. 46 Glycogen 66 Glycogenic function of liver 66 Goll, column of. 92 Graafian follicles 131 Grey matter of nervous system. 70 "LJ AIR 68 -*■ * Haemoglobin 34 Hearing, sense of. 124 Heart 37 valves of, 38 sounds of. 39 influence of pneumogastric nerve upon 41 ganglia of. 40 force exerted by left ventricle...' 39 PAGE Heart, work done by 40 course of blood through 38 influence of nervous system 3b upon 40 Hyaloid membrane 120 Hypermetropia 126 Hypoglossal nerve 89 TNCUS BONE 125 Ingesta and egesta, comparison of in 24 hours 21 Insalivation 22 nervous circle of. 23 Inspiration, movements of thorax in.. 46 Internal capsule 104 results of injury to 104 Intestinal juice 26 Iris 119 action of. 121 Island of Reil 108 excretion of urine by 62 T ABYRINTH OF INTERNAL ear 126 function of cochlea 128 function of semicircular canals 128 Language, articulate, centre for no Larynx 128 Lateral columns of spinal cord 92 Laws of muscular contraction 77 Laxator tympani muscle 125 Lens, crystalline 120 Lime phosphate 19 Liver 63 secretion of bile by 65 glycogenic function of. 66 elaboration of blood 65 cells 63 Localization of functions in cerebrum no Lungs 45 changes in blood while passing through 49 Lymph 30 Lymphatic glands 29 Lymphatic vessels, origin and course of. 29 1WTAMMARY GLANDS 54 Malleus bone 125 Mastication 22 nervous circle of. 22 muscles of. 22 Medulla oblongata 98 properties and functions of. 99 Membrana basilaris 127 Membrana tympani 124 Menstruation 132 Middle ear 124 Milk 55 Motor centres of cerebrum no Muscles, properties of. 75 PAGE Myopia 123 INDEX. 153 TSJERVE, OLFACTORY 78 optic 78 motor oculi 79 pathetic 80 trigeminal 8r abducens 80 facial 83 auditory 84 glosso-pharyngeal 85 pneumogastric 86 spinal accessory 88 hypoglossal 89 • cells, structure of. 70 fibres, terminations of. 73 force, rate of transmission of... 77 roots, function of anterior and posterior 72 Nerves, centrifugal and centripetal.... 74 cranial 77 decussation of motor and sen- sory 93 vaso-motor 100 properties and functions of 74 spinal 72 Nervous system 70 white and grey matter of. 70, 71 cerebro-spinal 70 sympathetic 70 Nucleus caudatus 103 ienticularis 103 QLFACTORY NERVES 78 Ophthalmic ganglion 118 Optic nerves 78 thalamus 103 function of. 104 Organs of Corti 127 Otic ganglion 11 Ovaries 131 Ovum 131 discharge of from the ovary.... 132 Oxygen, absorption of by haemoglobin 49 pACINIAN CORPUSCLES 73 Patheticus nerve 80 Peptones 25 Perilymph 127 Perspiration 69 Petrosal nerves, large and small 83, 84 Phonation 130 Physiology, definition of 9 Placenta, formation and function of... 139 Pneumogastric nerve 86 Pons varolii iox Portal vein 64 Posterior columns of spinal cord 92 functions of. 95 Prehension 21 Presbyopia 126 Pressure of blood in arteries 41 Proximate principles 11 inorganic 11 organic, non-nitrogenized 11 organic, nitrogenized 12 of waste 14 PAGE Proximate quantity of chemical ele- ments in body 14 Ptyalin 23 Pulse 42 Pyramidal tracts 92 DED CORPUSCLES OF blood 34 Reflex movements of spinal cord 96 action, laws of. 96 Reproduction 131 Respiration 44 movements of 46 nervous mechanism of. 47 types of. 47 nervous circle of 101 Retina 120 OALIVA 22 Sebaceous glands. 68 Secretion 52 Semi-circular canals 127 Semen 133 Sight, sense of. 118 Skin 67 -relative sensibility of. 115 appendages of. 68 Smell, sense of. 117 Sounds of heart 39 Spermatozoa 135 Spheno-palatine ganglion 142 Spinal accessory nerve 88 Spinal cord 91 membranes of. 90 structure of white matter 92 structure of grey matter 92 properties of. 94 function of as a conductor 94 as an independent centre 95 decussation of motor and sen- sory fibres 93 reflex action of. 96 special centres of. 97 paralysis, from disease of. 99 nerves, origin of. 93 course of anterior and posterior roots of. 93 Spleen 57 Stapes bone 125 Starvation, phenomena of. 17 Stomach 74 Structural composition of the body.... 14 Submaxillary ganglion 112 Sugar, uses of in the body 12 Supra-renal capsules 57 Sudoriparous glands 68 Sympathetic nervous system m properties and functions of. 113 npASTE, SENSE OF 116 Teeth 22 Tensor tympani muscle 125 Testicles 134 Thoracic duct 29 Thorax, enlargement of in inspiration 46 PACK 154 INDEX. Tissues, classification of. 16 Tongue 116 motor nerve of. 117 sensory nerve of. 117 Touch, sense of. 114 Tiirck column 92 UMBILICAL CORD 138 Urea 62 Uric acid 62 Urine 60 composition of. 61 average quantity of constitu- ents secreted daily 61 Urination, nervous mechanism of.. ... 60 Uterus 132 PAGE yAPOR, WATERY, OF • breath 49 Vascular glands . 56 system, development of. 144 Vaso-motor nerves, origin of. 100 Veins 43 Vesiculse seminales 134 Vision, psychical centre for in physical centre for 103 Vital capacity of lungs 48 Vocal cords 129 Voice 128 TX7ATER, AMOUNT OF IN ®v body 14 Wolffian bodies 143 PAGE CATALOGUE No. 7. A CATALOGUE OF Books for Students; INCLUDING A FULL LIST OF The ? Quiz- Compends ? AND MANY OF THE MOST PROMINENT Students’ Manuals and Text-Books PUBLISHED BY P. BLAKISTON, SON & CO., Medical Booksellers, Imporlers and Publishers, No. 1012 WALNUT STREET, PHILADELPHIA. *#* For sale by all Booksellers, or any book will be sent by mail, postpaid, upon receipt of price. Catalogues of books on all branches of Medicine, Dentistry, Pharmacy, etc., supplied upon application. THE PQUIZ-COMPENDS? A NEW SERIES OF COMPENDS FOR STUDENTS. For Use in the Quiz Class and when Preparing for Examinations. Price of Each, Bound in Cloth, $1.00 Interleaved, $1.25. Based on the most popular text-books, and on the lec- tures of prominent professors, they form a most complete set of manuals, containing information nowhere else collected in such a condensed, practical shape. The authors have had large experience as quiz masters and attaches of colleges, with exceptional opportunities for noting the most recent advances and methods. The arrangement of the subjects, illustrations, types, etc., are all of the most improved form, and the size of the books is such that they may be easily carried in the pocket. No. 1. ANATOMY. (Illustrated.) THIRD REVISED EDITION. A Compend of Human Anatomy. By Samuel O. L. Potter, m.a., m.d., U. S. Army. With 63 Illustrations. “ The work is reliable and complete, and just what the student needs in reviewing the subject for his examinations."—The Physi- cian and Surgeon's Investigator, Buffalo, N. Y. “ To those desiring to post themselves hurriedly for examination, this little book will be useful in refreshing the memory."—New Orleans Medical and Surgical Journal. “ The arrangement is well calculated to facilitate accurate memo- rizing, and the illustrations are clear and good.”—North Carolina Medical Journal. Nos. 2 and 3. PRACTICE. A Compend of the Practice of Medicine, especially adapted to the use of Students. By Dan’l E. Hughes, m.d., Demonstrator of Clinical Medicine in Jefferson Medical College, Philadelphia. In two parts. Part I.—Continued, Eruptive, and Periodical Fevers, Diseases of the Stomach, Intestines, Peritoneum, Biliary Passages, Liver, Kidneys, etc., and General Diseases, etc. Part II.—Diseases of the Respiratory System, Circu- latory System, and Nervous System; Diseases of the Blood, etc. These little books can be regarded as a full set of notes upon the Practice of Medicine, containing the Synonyms, Definitions, Causes, Symptoms, Prognosis, Diagnosis, Treatment, etc., of each disease, and includ- ing a number of new prescriptions. They have been compiled from the lectures of prominent Professors, and reference has been made to the latest writings of Pro- fessors Flint, Da Costa, Reynolds, Bartholow, Roberts and others. “ It is brief and concise, and at the same time possesses an accu- racy not generally found in compends.”—fas. M. French, M.D., Ass’/ to the Prof, of Practice, Medical College of Ohio, Cincinnati. “ The book seems very concise, yet very comprehensive. . . . An unusually superior book.”—Dr. E. T. Bruen, Demonstrator of Clinical Medicine, University of Pennsylvania. “ I have used it considerably in connection with my branches in the Quiz-class of the University of La.”—J. H. Bemiss, New Orleans. “ Dr. Hughes has prepared a very useful little book, and I shall take pleasure in advising my class to use it.”—Dr. George IV. Hall, Professor of Practice, St. Louis College of Physicians and Surgeons. No. 4. PHYSIOLOGY. A Compend of Human Physiology, adapted to the use of Students. By Albert P. Brubaker, m.d., De- monstrator of Physiology in Jefferson Medical College, Philadelphia. “ Dr. Brubaker deserves the hearty thanks of medical students for his Compend of Physiology. He has arranged the fundamental and practical principles of the science in a peculiarly inviting and accessible manner. I have already introduced the work to my class.”—Maurice N. Miller, M.D., Instructor in Practical His- tology, formerly Demonstrator of Physiology, University City of New York. “ ‘ Quiz-Compend' No. 4 is fully up to the high standard estab- lished by its predecessors of the same series.”—Medical Bulletin, Philadelphia. “ I can recommend it as a valuable aid to the student.”—C. N. Ellinwood, M. D., Professor of Physiology, Cooper Medical Col- lege, San Francisco. “ This is a well written little book.”—London Lancet. No. 5. OBSTETRICS. A Compend of Obstetrics. For Physicians and Students. By Henry G. Landis, m.d., Professor of Obstetrics and Diseases of Women, in Starling Medical College, Columbus. Illustrated. “We have no doubt that many students will find in it a most val- uable aid in preparing for examination.”—The American Journal of Obstetrics. “ It is complete, accurate and scientific. The very best book of its kind I have seen.”— J. S. Knox, M.D., Lecturer on Obstetrics Rush Medical College, Chicago. Price of each Book, Cloth, $1.00. Interleaved for Notes, $1.25. THE ? QUIZ-COMPENDS ?. THE ? QUIZ-COMPENDS ?. “ I have been teaching in this department for many years, and am free to say that this will be the best assistant I ever had. It is ac- curate and comprehensive, but brief and pointed."—Prof. P. D. Yost, St. Louis. No. 6. MATERIA MEDICA. Revised Ed. A Compend on Materia Medica and Therapeutics, with especial reference to the Physiological Actions of Drugs. For the use of Medical, Dental, and Pharma- ceutical Students and Practitioners. Based on the New Revision (Sixth) of the U. S. Pharmacopoeia, and in- cluding many unofficinal remedies. By Samuel O. L. Potter, M.A., m.d., U. S. Army. “ I have examined the little volume carefully, and find it just such a book as I require in my private Quiz, and shall certainly re- commend it to my classes. Your Compends are all popular here in Washington.”—John E. Brackett, M.D., Professor of Materia Medica and Therapeutics, Howard Medical College, Washington. “ Part of a series of small but valuable text-books. . . . While the work is, owing to its therapeutic contents, more useful to the medical student, the pharmaceutical student may derive much use- ful information from it.”—N. Y. Pharmaceutical Record. No. 7. CHEMISTRY. Revised Ed. A Compend of Chemistry. By G. Mason Ward, m.d., Demonstrator of Chemistry in Jefferson Medical Col- lege, Philadelphia. Including Table of Elements and various Analytical Tables. “ Brief, but excellent. ... It will doubtless prove an admirable aid to the student, by fixing these facts in his memory. It is worthy the study of both medical and pharmaceutical students in this branch.”—Pharmaceutical Record, New York. No. 8. VISCERAL ANATOMY. A Compend of Visceral Anatomy. By Samuel O. L. Potter, m.a., m.d., U. S. Army. With 40 Illustrations. *** This is the only Compend that contains full descriptions of the viscera, and will, together with No. i of this series, form the only complete Compend of Anatomy published. No. 9. SURGERY. Illustrated. A Compend of Surgery; including Fractures, Wounds, Dislocations, Sprains, Amputations and other opera- tions, Inflammation, Suppuration, Ulcers, Syphilis, Tumors, Shock, etc. Diseases of the Spine, Ear, Eye, Bladder, Testicles, Anus, and other Surgical Diseases. By Orville Horwitz, a.m., m.d., with 43 Illustra- tions. Price of Each, Cloth, $1.00. Interleaved for Notes, $1.25. THE ? QUIZ-COMPENDS ? No. 10. ORG-ANIG CHEMISTRY. JUST PUBLISHED. A Compend of Organic Chemistry, including Medical Chemistry, Urine Analysis, and the Analysis of Water, and Food, etc. By Henry Leffmann, m.d., Pro- fessor of Clinical Chemistry and Hygiene in the Phila- delphia Polyclinic; Professor of Chemistry, Penn- sylvania College of Dental Surgery ; Member of the N. Y. 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Recommended as a Text-book at University of Pennsylvania, Long Island College Hospital, Yale and Harvard Colleges, Bishop’s College, Montreal, University of Michigan, and over twenty other Medical Schools. A HANDBOOK OF THE THEORY AND PRACTICE OF MEDICINE. By Frederick T. Roberts, m.d., m.r.c.p., Professor of Clinical Medicine and Therapeutics in University College Hospital, London. Fifth Edition. Octavo. CLOTH, $5.00; LEATHER, $6.00. *** This new edition has been subjected to a careful revision. Many chapters have been rewritten. Important alterations and additions have been made throughout, and new illustrations intro- duced. “A clear, yet concise, scientific and practical work. It is a capi- tal compendium of the classified knowledge of the subject.”—Prof. J. Adams Allen, Rush Medical College, Chicago. “ I have become thoroughly convinced of its great value, and have cordially recommended it to my class in Yale College.”— Prof. David P. Smith. “ I have examined it with some care, and think it a good book, and shall take pleasure in mentioning it among the works which may properly be put in the hands of students."—,4. B. Palmer, Prof, of the Practice of Medicine, University of Michigan. “ It is unsurpassed by any work that has fallen into our hands, as a compendium for students preparing for examination. It is thoroughly practical, and fully up to the times.”— The Clinic. “ Our opinion of it is one of almost unqualified praise. The style is clear, and the amount of useful and, indeed, indispensable information which it contains is marvelous.”—Boston Medical and Surgical Journal. BIDDLE’S MATERIA MEDICA. Ninth Revised Edition. Recommended as a Text-book at Yale College, University of Michigan, College of Physicians and Surgeons, Baltimore, Baltimore Medical College, Louisville Medical College, and a number of other Colleges throughout the U. S. BIDDLE’S MATERIA MEDICA. For the Use of Students and Physicians. By the late Prof. John B. Biddle, m.d., Profes- sor of Materia Medica in Jefferson Medical College, Philadelphia. The Ninth Edition, thoroughly revised, and in many parts re- written, by his son, Clement Biddle, m.d., Past Assistant Surgeon, U. S. Navy, assisted by Henry Morris, m.d. CLOTH, $4.00; LEATHER, $4.75. “ I shall unhesitatingly recommend it (the 9th Edition) to my students at the Bellevue Hospital Medical College.—Prof. A. A. Smith, New York, June, 1883. “ The standard ‘ Materia Medica ' with a large number of medi- cal students is Biddle’s.”—Buffalo Medical and Surgical Journal. “ The larger works usually recommended as text-books in our medical schools are too voluminous for convenient use. This work will be found to contain in a condensed form all that is most valuable, and will supply students with a reliable guide.”—Chicago Abed. Jl. *** This Ninth Edition contains all the additions and changes in the U. S. Pharmacopoeia, Sixth Revision. STANDARD TEXT-BOOKS. BLOXAM’S CHEMISTRY. Inorganic and Organic, with Ex- periments. Fifth Edition. Revised and Illustrated. 8vo, cloth, $3.75; leather, $4.75 CARPENTER ON THE MICROSCOPE and Its Revelations. Sixth Edition, Enlarged. With 500 Illustrations and Colored Plates, handsomely printed. Demi 8vo, cloth, $5.50 DRUITT’S SURGERY. A Manual of Modern Surgery. Elev- enth London Edition. 369 Illustrations. Demi 8vo, cloth, $5.00 FLOWER, DIAGRAMS OF THE NERVES of the Human Body, Origin, Divisions, Connections, etc. 4to. Cloth, #3.50 GALLABIN’S MIDWIFERY. A Manual for Students. Illus- trated. In Preparation. GLISAN’S MODERN MIDWIFERY. A Text-book. 129 Illustrations. 8vo, cloth, $4.00; leather, $5.00 HOLDEN’S ANATOMY and Manual of Dissections of the Human Body. Fourth Edition. Iljus. New Ed. In Press. HOLDEN’S OSTEOLOGY. A Description of the Bones, with Colored Delineations of the Attachments of the Muscles. Sixth Edition. 61 Lithographic Plates and many Wood Engravings. Royal 8vo, cloth, $6.00 HEATH’S PRACTICAL ANATOMY and Manual of Dissec- tions. Fifth Edition. 24 Colored Plates and nearly 300 other Illustrations. Demi 8vo, cloth, $5.00 HEADLAND, THE ACTION OF MEDICINE in the System. Ninth American Edition. 8vo, cloth, #3.00 KIRKE’S PHYSIOLOGY. A Handbook for Students. Tenth Edition. 420 Illustrations. Demi 8vo, cloth, $5.00 MANN’S PSYCHOLOGICAL MEDICINE and Allied Ner- vous Diseases ; including the Medico-Legal Aspects of Insanity. With Illustrations. 8vo. cloth, $5.00; leather, S6.00. MACNAMARA ON THE EYE. A Manual for Students and Physicians. Illustrated. Demi 8vo, cloth, $4.00 MEIGS AND PEPPER ON CHILDREN. A Practical Trea- tise on Diseases of Children. Seventh Edition, Revised. 8vo, cloth, $6.00 ; leather, $7.00 PARKES’ PRACTICAL HYGIENE. Sixth Revised and En- larged Edition. Illustrated. 8vo, cloth, S3.00 RIGBY’S OBSTETRIC MEMORANDA. 32010, cloth, .50 SANDERSON & FOSTER’S PHYSIOLOGICAL LABOR- ATORY. A Handbook for the Laboratory. Over 350 Illustra- tions. 8vo, cloth, $5.00 ; leather, $6.00 WILSON’S HUMAN ANATOMY. General and Special. Tenth Edition. 26 Colored Plates and 424 Illustrations. S6.00 WYTHE’S MICROSCOPIST. A Manual of Microscopy and Compend of the Microscopic Sciences. Fourth Edition. 252 Illustrations. 8vo, cloth, S3.00 ; leather, $4.00 AITKEN, THE SCIENCE AND PRACTICE OF MEDI- CINE. A New (Seventh) Edition. 2 Vols. 8vo, cloth, $12.00; leather, $14.00 ACTON, ON THE REPRODUCTIVE ORGANS. Their Functions, Disorders and Treatment. 6th Edition. Cloth, $2.00 FENNER, ON VISION. Its Optical Defects and the Adaptation of Spectacles. 2d Edition, Enlarged. Illus. 8vo., cloth, $3.50 FOTHERGILL, ON THE HEART. Its Diseases and their Treatment Second Edition. 8vo, cloth, $3.50 HARLEY ON THE LIVER. Diagnosis and Treatment. Col- ored Plates and other Illustrations. 8vo, cloth, $5.00; sheep, $9.00 &8“-An Encyclopedia of Medical Knowledge. INDEX OF DISEASES; WITH TREATMENT AND FORMULAE. By THOS. HAWKES TANNER, M.D. REVISED AND ENLARGED BY DR. BROADBENT. Octavo, Cloth. Price $3.00. *** The worth of a work of this kind, by so eminent a professor as Dr. Tanner, cannot be over-estimated. As an aid to physicians and druggists, both in the country and city, it must be invaluable. It contains a full list of all diseases, arranged in alphabetical order, with list of formulae, and appendix giving points of interest regard- ing health resorts, mineral waters, and information about cooking and preparing food, etc., for the invalid and convalescent. The page headings are so indexed that the reader is enabled to find at once the disease wanted ; its synonyms, classification, varie- ties, description, etc., with the course of treatment recommended by the best authorities, and is referred, by number, to the several prescriptions that have proved most efficacious. These prescrip- tions are also arranged so that they can be easily referred to, with directions how to use them, when to use them, and what diseases they are generally used in treating. The directions for cooking foods and preparing poultices, lotions, etc., are very full. The work will be found specially useful to students and young physicians. RICHTER’S CHEMISTRY, A TEXT-BOOK of INORGANIC CHEMISTRY for STUDENTS. By PROF. VICTOR von RICHTER, University of Breslau, Authorized Translation from the Third German Edition, By EDGAR F. SMITH, M.A., Ph.D., Professor of Chemistry in Wittenberg College, Springfield, Ohio; formerly in the Laboratories of the University of Pennsyl- vania; Member of the Chemical Society of Berlin. 12mo. 89 Wood-cuts and Col. Lithographic Plate of Spectra. $2.00 In the chemical text-books of the present day, one of the striking features and difficulties we have to contend with is the separate presentation of the theories and facts of the science. These are usually taught apart, as if entirely independent of each other, and those experienced in teaching the subject know only too well the trouble encountered in attempting to get the student properly in- terested in the science and in bringing him to a clear comprehension of the same. In this work of Prof, von Richter, which has been received abroad with such hearty welcome, two editions having been rapidly disposed of, theory and fact are brought close together, and their intimate relation clearly shown. From careful observa- tion of experiments and their results, the student is led to a correct understanding of the interesting principles of chemistry. The de- scriptions of the various inorganic substances are full, and embody the results of the latest discoveries. In preparation, “ORGANIC CHEMISTRY,” By the same author. Translated. BYFORD, DISEASES OF WOMEN. NEW REVISED EDITION. The Practice of Medicine and Surgery, as applied to the Diseases of Women. By W. H. Byford, a.m., m.d., Professor of Gynaecology in Rush Medical College; of Obstetrics in the Woman’s Medical College; Sur- geon to the Woman’s Hospital; President of the American Gynaecological Society, etc. Third Edition. Revised and Enlarged; much of it Rewritten; with over 160 Illustrations. Octavo. PRICE, CLOTH, $5.00; LEATHER, $6.00. “ The treatise is as complete a one as the present state of our science will admit of being written. We commend it to the diligent study of every practitioner and student, as a work calculated to in- culcate sound principles and lead to enlightened practice.”—New York Medical Record. “ The author is an experienced writer, an able teacher in his de- partment, and has embodied in the present work the results of a wide field of practical observation. We have not had time to read its pages critically, but freely commend it to all our readers, as one of the most valuable practical works issued from the American press.”—Chicago Medical Examiner. DAY ON CHILDREN. Second Edition. The Diseases of Children. A Practical and Systematic Treatise for Practitioners and Students. By William H. Day, m.d., Author of “ Headaches; Their Causes, Nature and Treatment;” Member of the Royal College of Physicians of London; Physician to the Samaritan Hospital for Women and Children, etc. Second Ed. Rewritten and very much Enlarged. 8vo. 752 pp. PRICE, CLOTH, $5.00; SHEEP, $6.00. " A careful examination of this book leads us to characterize it as a plain, straightforward treatise on the subject upon which it treats . . . giving sound practical advice,”—Philad'a Med. Times. “ On the whole, we must confess we are pleased with this book and can heartily recommend it—a recommendation which it does not appear to need, as it has already reached its second edition.”— American fournal of Medical Science. MACKENZIE. THE THROAT AND NOSE. By Morell Mackenzie, m.d., Senior Physician to the Hospital for Diseases of the Chest and Throat; Lecturer on Diseases of the Throat at the London Hospital, etc. Vol. I. Including the Pharynx, Larynx, Trachea, etc. 112 Illustrations. Cloth, $4.00; Leather, $5.00 Vol. II. Diseases of the (Esophagus, Nasal Cavities and Neck. Cloth,$3.00; Leather, $4,00 The two volumes at one time. Cloth, $6.00; Leather. $7.50 YEO’S PHYSIOLOGY. A MANUAL FOR STUDENTS. JUST READY. 300 CAREFULLY PRINTED ILLUSTRATIONS. FULL GLOSSARY AND INDEX. By Gerald F. Yeo, m.d., f.r.c.s., Professor of Physi- ology in King’s College, London. Small Octavo. 750 pages. Over 300 carefully printed Illustrations. PRICE, CLOTH, $4.00; LEATHER, $5.00. “ By his excellent manual, Prof. Yeo has supplied a want which must have been felt by every teacher of physiology. * * * * In conclusion, we heartily congratulate Prof. Yeo on his work, which we can recommend to all those who wish to find within a moderate compass a reliable and pleasantly written exposition of all the essential facts of physiology as the science now stands.”— The Dublin Journal of Med. Science. “The work will take a high rank among the smaller text-books of Physiology.”—Prof. H. P. Bowditch, Harvard Med. School, Boston. “ The brief examination I have given it was so favorable that I placed it in the list of text-books recommended in the circular of the University Medical College.”—Prof. Lewis A. Stimpson, M. D., S7 East 33d Street, New York. “ For students’ use it is one of the very best text-books in Physi- ology.”— Prof. L. B. how, Dartmouth Med. College, Hanover, N. H. RINDFLEISCH. THE ELEMENTS OF PATHOLOGY. TRANSLATED BY WM. H. MERCUR, M.D. REVISED AND EDITED BY PROF. JAS. TYSON, Of the University of Pennsylvania. OCTAVO. CLOTH. NEARLY READY. *** It is the object of Prof. Rindfleisch to present in this volume of moderate size the fundamental principles of Pathology A large number of the general processes which underlie disease, a knowledge of wdiich is essen- tial to the practical physician, are plainly presented. They include, among others, inflammation, tumor forma- tion, fever, derangements of nutrition, including atrophy, derangements of the movement of the blood, of blood formation and blood purification, hypersesthesia, anaesthe- sia, convulsions, paralysis, etc. The well-known reputa- tion of the author, his thorough familiarity with, and his method of treating the subject, make this most recent work peculiarly useful to the student, as well as to the prac- ticing physician who wishes to brush up his pathology. Richters Inorganic Chemistry. JUST PUBLISHED. A Text-Book for Students, in which the Theory and Facts of the Science of Chemistry are brought together and their intimate relations clearly shown. A TEXT-BOOK OF INORGANIC CHEMISTRY. By Prof. Victor von Richter, University of Breslau. Authorized Translation from the Third German Edition, by Edgar F. Smith, m.a., ph.d., Member of the Chemical Society of Berlin, Prof, of Chemistry, Wittenberg College, formerly in the Laboratories of the University of Pennsylvania. 89 wood-cuts and colored plate of Spectra. i2mo. 424 pages. FROM THE THIRD EDITION. Price, Cloth, $2.00. RECOMMENDATIONS. " Knowing the value of the excellent work of Prof, von Richter in the original, I am pleased to hear of a forthcoming English translation, by such an able chemist and admirable trans- lator as Prof. Smith. “ The work is of undoubted value. The theory of chemistry, which is generally the bugbear of students, is in this book very clearly explained, and the explanations are so well distributed through the book that students are brought easily from the simplest to the most difficult problems. “ That part descriptive of the elements and their compounds is full, and all that could be de- sired in a text-book, while the cuts, with which the work is profusely illustrated, are an ex- cellent aid to the student. Altogether, it is one of our best modern works on chemistry.”— John Marshall, M.D., Nat. Sc.D. (Tubingen), Demonstrator of Chemistry in the Univer- sity of Pennsylvania, Medical Department. &gpTn Press, ORGANIC CHEMISTRY, by the same Author and Translator. MARSHALL & SMITH’S CHEMICAL ANALYSIS of URINE. ILLUSTRATED. As none of the existing books on Urine Analysis deal sufficiently with the chemi- cal side of the subject, this little handbook has been prepared to fill the gap THE CHEMICAL ANALYSIS OF THE URINE. Based in part on Casselmann’s Analyse des Harns. By John Marshall, m.d., Demonstrator of Chemistry, Medical Department, University of Pennsyl- vania, and Edgar F. Smith, ph.d., Professor of Chemistry, Wittenberg College. Illustrated, i2mo. Price, Cloth, $1.00. RECOMMENDATIONS. “ It seems to me to be very clearly written and well adapted for f.he use of the medical student and practitioner, as an available handbook, being detailed descriptions of the most trustworthy methods of detection of the chief normal as well as the abnormal constituents of the urine; and the accompaning calculations add greatly to its value as a handy reference book.”—Prof. Sam’ l P. Sadtler, Professor of General and Organic Chemistry, University of Pennsyhiania, and Prof, of Chemistry, Philadelphia College of Pharmacy. “ The illustrations are well done, and in point of clearness of expression and accuracy of statement, the book leaves little to be desired.”—N. Y. Medical Journal. P. BLAKI8TON, SON & CO., Medical Publishers and Booksellers, 1012 WALNUT STREET, PHILADELPHIA. BIDDLE’S Materia Medica. NINTH REVISED EDITION. fContaini all Changsa in the New Pharmacopoeia.) Recommended as a Text-book at Yale College, University of Michigan, College of Physicians and Surgeons, Baltimore, Baltimore Medical College, Louisville Medical College, and a number of other Colleges throughout the United States. BIDDLE’S MATERIA MEDICA. For the Use of Students and Physicians. By the late Prof. John B. Biddle, m.d., Professor of Materia Medica in Jefferson Medical College, Philadelphia. The Ninth Edition, thoroughly revised, and in many parts rewritten, by his son, Clement Biddle, m.d., Assistant Surgeon, U. S. Navy, assisted by Henry Morris, m.d. Containing all the additions and changes made in the last revision of the United States Pharmacopceia. Octavo. Ready. Bound, in Cloth. Price $4.00; Leather, $4.75. .RECOMMENDATIONS. “ It will be found a useful handbook by students, especially, who may be under the instruction of its able and accomplished author.”—American Med- ical Journal. “ In short, it is just the work for a student, embracing as it does what will be discussed in a course of lectures on materia medica.”—Cincinnati Medical News. “ In truth, the work is well adapted to the wants of students.”—The Clinic. “ Nothing has escaped the writer’s scan. All the new remedies against disease are duly and judiciously noted. Students will certainly appreciate its shapely form, grace of manner, and general multum in parvo style.”—Ameri- can Practitioner. “ Biddle’s ‘ Materia Medica ’ is well known to the profession, being a stand- ard text-book in several leading colleges.”—New York Medical Journal. “ It contains, in a condensed form, all that is valuable in materia medica, and furnishes the medical student with a complete manual on this subject.”— Canada Lancet. “ The necessity for a new edition of this work in so short a time is the best proof of the value in which it is held by the profession.”—Medical and Surg- ical Reporter., “ The standard ‘ Materia Medica’ with a large number of medical students is Biddle’s.”—Buffalo Medical and Surgical Journal. “The larger works usually recommended as text-books in our medical schools are too voluminous for convenient use. This work will be found to contain in a condensed form all that is most valuable, and will supply students with a reliable guide.”—Chicago Medical Journal. This Ninth Edition contains all the additions and changes in the U. S. Pharmacopceia, Sixth Revision. P. BLAKHS TON, SON & OO., Publishers and Booksellers, 1012 WALNUT STREET, PHILADELPHIA. MEIGS AND PEPPER Diseases of Children. Recommended at thirty-five of the principal Medical Colleges in the United States, including Bellevue Hospital, New York, University of Pennsylvania, and Long Island College Hospital. SEVENTH REVISED EDITION. A PRACTICAL TREATISE ON THE DISEASES OF CHILDREN. By J. Forsyth Meigs, m.d., one of the Physicians to the Pennsylvania Hospital, Consulting Physician to the Children’s Hospital, etc., and William Pepper, m.d., Professor of Clinical Medicine, University of Pennsylvania, Provost and ex-officio President of the Faculty, Physician to the Philadelphia Hospital, Fellow of the College of Physi- cians, etc. The Seventh revised and improved edition. In one volume, of over 1000 royal octavo pages. Price, in Cloth, $6.00; Leather, $7.00 The rapid sale of six large editions of Drs. Meigs and Pepper’s work on Children, and the demand for the new edition now ready, is sufficient evidence of its great popularity. The large practice, of many years’ standing, of the authors imparts to it a value unequaled, probably, by any other book on the subject now before the profession. The whole work has been again subjected to an entire and thorough revision. Some articles have been rewritten; many additions made; and great care observed by the authors that it should be most effectually brought up to the light, pathological and therapeutical, of the present day. The publishers have very many favorable notices of the previous editions, received from numerous sources, foreign and domestic. They append a few from leading journals, which will give a general idea of the value placed upon it, both as a text book for the student and a work of reference for the General Practitioner. JBBCOMMENDATIONS. “ It is the most complete work upon the subject in our language. It contains at once the results of personal and the experience of others ; its quotations from the most recent authori- ties, both at home and abroad, are ample, and we think the authors deserve congratulations for having produced a book unequaled for the use of the student, and indispensable as a work of reference for the practitioner.”—American Medical Journal. “ But as a scientific guide in the diagnosis and treatment of the diseases of children, we do not hesitate to say that we have seldom met with a text-book so complete, so just, and so readable, as the one before us, which in its new form cannot fail to make friends wherever it shall go, and wherever great erudition, practical tact, and fluent and agreeable diction are appreciated.”—American Journal of Obstetrics. " It is only three years since we had the pleasure of recommending the Fifth Edition of this excellent work. With the recent additions, it may safely be pronounced one of the best and most comprehensive works on diseases of children of which the American practitioner can avail himself, for study or reference.”—New York Medical Journal. P. BLAKISTON, SON &, CO., Publishers and Booksellers 1012 WALNUT STREET, PHILADELPHIA