Part 8 (2/2)

140. One shoulder may be elevated, and no injurious results follow, provided care is taken not to keep it in the raised position too long, or if the opposite shoulder is elevated for the same period of time.

The right shoulder projects more frequently than the left. This arises from the greater use of the right hand with the shoulder elevated, and not unfrequently the oblique positions a.s.sumed in performing the daily vocations of life. With proper care, and by calling into action the left shoulder, this deformity can be prevented.

What experiment is mentioned? What does fig. 34 represent? 140. How can one shoulder be elevated and no injurious results follow?

[Ill.u.s.tration: Fig. 35. A representation of a deformed trunk.]

141. The loss of symmetry and diminution of height from deformed spines are minor considerations, compared with the distortions that the chest experiences, thereby impairing respiration and inducing diseases of the heart and lungs. The invasion of the functions of these two important organs lessens the vitality of the whole system, and causes general ill health. Again, the curvature of the spinal column is frequently attended by irritation and disease of the spinal cord.

Why does the right shoulder project more frequently than the left? How can this deformity be prevented? 141. What is said of deformed spinal columns?

142. Eminent physicians, both in this country and France state that not more than one female in ten, who has been fas.h.i.+onably educated, is free from deformities of the shoulder or spinal column. Teachers, as well as mothers, should notice the positions of the child in performing the tasks allotted to it, whether studying or pursuing any employment. The feebler the organization of the child, the more frequently should there be a change of position.

143. When a slight projection of the shoulder, with a curvature of the spine, exists, it can be improved by walking with a book, or something heavier, upon the head; to balance which, the spinal column must be nearly erect. Those people that carry burdens upon their heads seldom have crooked spines.

_Observation._ Persons from the North, in travelling through the Southern States, are surprised to see the heavy burdens that the porters carry on their heads. It is not unusual to see them walking at a rapid pace, with one or two trunks, weighing fifty or eighty pounds each, upon their heads. Occasionally, we meet an itinerant toy-man, with his tray of fragile merchandise upon his head, walking with as much apparent security, as though his toys, or images, were in his hands. This is the easiest method of carrying burdens, because the position of the head and spinal column is erect.

144. _If the animal and earthy matter of the bones is not deposited in proper proportions, they are deficient in strength._ If the gelatin predominates, the bones are weak, and become distorted. When nutrition is defective in the cylindrical bones, the heads are generally enlarged, and the shafts crooked; if in the spinal column, it may be curved; or in the cranium, it may be enlarged. This disease is familiarly known by the name of rickets. It is most common among these who have poor and insufficient food, live in dark, damp rooms, and breathe a vitiated air. The prevention and remedies for this disease are cleanliness, regular exercise, pure air, and nutritious food.

142. What statement by eminent physicians respecting deformities of the spine? What caution to teachers and mothers? 143. Why should we stand and sit erect? How may slight deformities of the spine be prevented? What is frequently noticed in travelling South? 144. What is the effect upon the bones when the gelatin preponderates?

145. When a bone is broken, some days elapse before the substance that reunites it is thrown out from the blood. In young persons, it may be secreted during the second or third week, and in individuals advanced in life, usually during the third and fourth week. When the bone is uniting, during the second, third, or fourth week, the attention of a surgeon is more needed than during the first week. At this time, the ends of the bone should be placed together with accuracy, which requires the careful application of proper dressing. After the bones have united, it will take some weeks to consolidate the uniting material and render the ”callus,” or union, firm. During this time, the limb should be used with care.

_Observation._ When a bone is fractured, a surgeon is immediately called, and the bone is ”set.” While the limb remains swelled and painful, the surgeon is required to attend and keep the dressings (bandages and splints) on. When the swelling has abated, and the pain subsided, frequently the patient intimates to the surgeon that his services can be dispensed with, as the ”limb is doing well.” This is the most important period, as the bone is uniting, and, unless the ends are nicely adjusted, the dressing properly applied, the person will find, on recovery, a shortened and crooked limb. The surgeon is then censured, when he is not blamable.

What is one cause of rickets? What are the prevention and remedies for this disease? 145. Does the time vary when the reuniting substance of the bone is secreted from the blood? When is the surgeon's care most needed? Why?

146. It is seldom that a bone is displaced without injury to the connecting ligaments and membranes. When these connecting bands are lacerated, pain, swelling, and other symptoms indicating inflammation succeed, which should be removed by proper treatment, directed by a surgical adviser.

147. In sprains, but few, if any, of the fibres of the connecting ligaments are lacerated; but they are unduly strained and twisted, which occasions acute pain at the time of the injury. This is followed by inflammation and weakness of the joints. The treatment of these injuries is similar to that of a dislocated bone after its reduction.

The most important item in the treatment during the few first days, is rest.

148. In persons of scrofulous const.i.tutions, and those in whom the system is enfeebled by disease, white swellings and other chronic diseases of the joints frequently succeed sprains. Such persons cannot be too a.s.siduous in adopting a proper and early treatment of injured joints.

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