Part 134

"I recollect Dr A. Todd Thomson, in his excellent lectures, relating a case he had attended where a young lady appeared to be dying from the evil effects of tightlacing. He cut open her stays and she gradually came to herself. If the worthy doctor had not quickly done what he did, she would soon have been a corpse! Dr Thomson has kindly favoured me with the following interesting particulars of the case for publication:[263]--'Some years since I was requested to hasten to a house not far from my own to see a lady who had fallen from her chair in a fit whilst eating her dinner. On being ushered to the drawing room of the house where the circumstance had taken place, I saw a lady lying upon a sofa, apparently dead, and several ladies hanging over the couch in great distress. I found little appearance of life except that the temperature of the body was natural; the pulse had ceased to beat, and no respiratory action could be detected. On laying my hand over the region of the heart, I felt that the stays were extremely tightly laced; and conceiving that the suspension of animation arose from that cause, I requested a penknife to be given me, with which I instantly ripped down the stays and gown. In an instant the chest dilated, on the binding matter giving way, which was almost like splitting an overbraced drum; and in a few seconds respiration recommenced and animation returned. In this case the waist was drawn in to a degree that gave a complete hour-glass appearance to the figure, and prevented the descent of the diaphragm, whilst the blood could not circulate, or be renewed in the lungs from the general obstruction of many of the cells and smaller tubes. The quantity of residual air also in the lungs was too small; and this was still diminished by the warmth of some soup, which the lady was eating when she fell from the chair, dilating the gas in her stomach, and consequently pressing that enlarged organ upwards on the lungs. Had I not lived close by, the time necessary to get medical aid from a greater distance might have rendered it unavailable.' The above narrative by Dr Thomson is valuable not only as illustrating the dangers arising from tightlacing, but also as emphasizing the rationale of its action as stated by ourselves. In the present article we have explained why it is the use of corsets is to be deprecated. We hope we have succeeded in showing how imperatively the abandonment of stays is called for.

[Footnote 263: Dr Chavasse, 'Counsels to a Mother.']

Another variety of distortion is that brought about by wearing tight boots and shoes, or boots and shoes constructed upon false principles; for, a boot or shoe may be productive of considerable inconvenience to the wearer, as well as the cause of a certain amount of twisting out of place of the bones of the foot, without necessarily being too small. Amongst the consequences arising from the adoption of tightly fitting or badly constructed boots or shoes may be mentioned the following:--Considerable bodily discomfort, and pain in walking; corns and bunions; growing in of the nails; chronic enlargement of the base of the great toe; caries or ulceration of the bones of the feet; and flat feet. That these are not altogether minor evils may be inferred when it is stated that, in order to obtain relief from the effects of a bunion, partial amputation of the foot has been sometimes found necessary; that the first attacks of gout mostly seize the joint of the ball of the great toe when that joint has become weakened by displacement following the use of faulty boots and shoes; and that a flat foot interferes with the proper performance of walking.

The above figure (No. 1) represents the skeleton of the foot with the bones which form it in their natural position, and in which they are admirably adapted for executing the various movements required of them.

It will be seen to consist of twenty-six bones, fourteen of which constitute the toes; the remaining twelve bones enter into the formation of what are termed the _tarsus_ and _metatarsus_.

The five long bones (_a_) are the _metatarsal_ bones. The toes form joints with the fore part of these _metatarsal_ bones. The remaining seven are the _tarsal_ bones; _b_, which is one of these, is named the _astragalus_, and being gripped on each side by a continuation from the bones of the leg called the _malleolus_, thus forms the ankle-joint.

Fig. 2 gives a representation of the inner aspect and side view of the foot. It will be seen that it is an arch resting in front on the anterior heads of the five metatarsal bones, _a_, but chiefly on that of the great toe, and on the _calcaneum_ or heel (_b_) behind.

The astragalus, _c_, forms the key-stone of the arch. This arch, which supports the superincumbent weight of the body, retains its curved form by means of strong ligaments or bands, which unite the bones which compose it into a compact but withal flexible mass. The arch, owing to the pressure thrown upon it from above, becomes flattened when the foot is resting on the ground; but when this pressure is removed and the foot hangs free, the curvature of the arch increases. In front of the metatarsal bones are placed the toes, which are connected with the metatarsal bones by joints. The great toe has one joint; each of the smaller ones has two.

Fig. 3 depicts the skeleton of a foot with the bones thrown out of their natural position, the contortion being the result of wearing tightly fitting or unscientifically constructed boots or shoes. The following extracts from Dr Hermann Meyer will best illustrate how nature's simple mechanical arrangements must be thwarted when coverings for the feet are permitted to be constructed which can give rise to distortions such as those represented in Figure 3. Dr Meyer says "the great toe plays by far the most important part in walking; because when the foot is raised from the ground with the intention of throwing it forwards, we first raise the heel, then rest for a second on the great toe, and in lifting this from the ground the point of it receives a pressure which impels the body forwards. Thus, in raising the foot the whole of the sole is gradually, as it were, 'unrolled' up to the point of the great toe, which again receives an impetus by contact with the ground.

The great toe ought, therefore, to have such a position as will admit of its being unrolled in the manner described; that is to say, it must so lie _that the line of its axis, when, carried backwards, will emerge at the centre of the heel; and this is its position in the healthy foot_. The sole of an almost sound foot is given in Fig. 4, and the true position of the great toe is indicated by the dotted line. This relation is still better brought out in Fig. 5, which represents the well-preserved foot of a child about two years old. The line drawn through both figures is that in which the foot _unrolls_ itself from the ground. The smaller toes, however, are by no means without their uses. In standing they rest on the ground and give lateral support to the foot; while in walking they are bent in a peculiar manner, so that they are firmly pressed against the ground; and here too they support the foot laterally. The first joint is strongly bent upwards, while the second is hollow above. This peculiar curvature enables the toe in a measure to lay hold of the ground as with bird's claws."

Dr Meyer then proceeds to show how the application of these principles is entirely disregarded in the manufacture of our boots and shoes, and to demonstrate that their neglect gives rise to the objectionable consequences we have before alluded to. As boots and shoes are at present constructed, the foot is made to adapt itself to the sole, not the sole to the foot. This pernicious system must be abandoned if we wish to preserve our feet, as well as our personal comfort.

"A sole," says Dr Meyer, "is of the proper construction when a line (see Fig. 6, _c d_) drawn at half the breadth of the great toe distant from, and parallel to, the inner margin of that toe shall, when carried backwards, pass through the centre of the heel. In the usual form of a sole this line passes out of the inner margin of the heel (see Fig. 7). If, then, the preservation of the primary straight line is, as has been already shown, the principal point in the formation of a proper sole, it follows that, if it be thought desirable to have pointed shoes, the pointing must be effected from the outer side, as indicated in the annexed Fig. 8. In a pair of shoes made on these principles, placed side by side with the heels in contact, the inner margins of the front part of the foot are also brought close together" (Fig. 9).

Dr Meyer's pamphlet contains the following strictures on 'High heels' to boots and shoes: "It is usual, in all shoes of even moderate strength, to make the heel a little higher by means of what is called the _heel-piece_. These heel-pieces are generally of some little use, especially in dirty weather, and we cannot wholly deny their right to existence. But at the same time they ought to be as low as possible, and heels an inch thick, as is at present very commonly the case, have very serious disadvantages indeed.

"The weight of the body is by this means thrown in a disproportionate ratio on the toes, the joints of which are consequently overstrained. Moreover, with a high heel the sole is so oblique in its direction that the foot must be constantly gliding forwards and forcibly pressing the toes into the point of the shoe. The toes, therefore, even when the shoe is sufficiently long, are subjected to the same injuries and disfigurations as if it were too short, and the effects are doubly hurtful when the form of the sole is also incorrect. High heels, especially if they are also very small; are peculiarly liable to wear obliquely, and so the shoe gets trodden on one side; they must, therefore, be peculiarly favorable to origin of flat-foot.

High and small heels are therefore quite unsuitable. The heel-piece ought to be as low and broad as possible."

Further and more explicit knowledge on this subject may be obtained from Dr Meyer's excellent little pamphlet entitled 'Procrustes ante portas,' very ably translated into English by Mr J. T. Craig, L.R.C.E., under the title of 'Why the Shoe Pinches.'

=DIURE'SIS.= See URINE.

=DIURET'ICS.= _Syn._ DIURETICA. Medicines which promote the secretion of urine. The principal diuretics are--aqueous fluids, which act by increasing the watery portion of the blood, and--substances which promote the action of the kidneys. Most of the first produce copious diuresis if the skin is kept cool. Among the last are acetate, bitartrate, and nitrate of potassa; oils of juniper, turpentine, cajeput, and copaiba; dilute spirit, and sweet spirits of nitre; decoction of common broom, &c.

=DIVIDIVI.= An astringent substance imported from Jamaica. It contains above 5% of tannin; whilst gall-nuts contain less than 3·5%, and the best oak-bark only 1·35%. Hence its value in tanning.

=DOBEREINER'S LAMP.= A portable apparatus for obtaining instantaneous light by the action of a jet of hydrogen on a small piece of spongy platinum.

=DOCHMIUS DUODENALIS.= An intestinal parasitic worm. Its length is from 1/3 to 1/2 an inch and its breadth about 1/60th of an inch. It is furnished with hooklets. It is found in the duodenum, the ileum, and the jejunum of man, and Greisinger seems to have pretty conclusively established that it is the cause of the disease so prevalent in Egypt, and known as the Egyptian chlorosis. Anemia, dysentery, and hemorrhoids and liver diseases are also frequently caused by it amongst the natives of Arabia, Brazil, and Northern Italy. In India it is also stated to give rise to some very alarming maladies. Leuchart affirms that it obtains an entrance into the system through drinking impure water.

=DOC'IMACY or DOCIMAS'TIC ART.= See ASSAYING.

=DOG.= The effect of medicines on dogs is much the same as on man; but there are some striking exceptions to this rule. Thus, whilst the dog can take a dose of aloes six or eight times as large as that given to man, the administration of half as much calomel or oil of turpentine would be productive of serious injury to the animal. The idea usually entertained, therefore, that medicines may be given to dogs in doses equalling those taken by man requires considerable modification. Dogs have a short and straight alimentary canal, in consequence of which purgative medicines act more quickly upon them than they do on other veterinary subjects. The facility with which dogs can be made to vomit is also another peculiarity possessed by them. Vomiting may be produced by their swallowing nauseous or unpalatable matters, as well as from their eating various sorts of grass. A good plan to prevent dogs vomiting their medicines is to keep the head well raised for an hour after the administration; and this may be easily accomplished by attaching a chain or cord to the collar, and fixing it at the requisite height, to any object. The kidneys are acted upon with much more difficulty than with the horse, whilst the skin seems nearly, if not altogether incapable of being affected. We give below a list of medicines for dogs; premising that the doses required vary considerably according to the strength, size, and age of the dog, all of which should always be duly taken into account. The doses prescribed in the following formulæ are for moderately large dogs:--

PHYSIC BALLS AND OTHER PURGATIVE MEDICINES:--

1. Barbadoes aloes, 8 oz., antimonial powder, 1 oz., ginger, 1 oz., palm oil, 5 oz.; beat together into a mass.--_Dose._ From 1/2 dr. to 2 dr. every 4 or 6 hours, till the bowels are relieved. (Youatt.)

2. The same, with the addition of 1 oz. of calomel. He directs from 45 gr. to 2 dr. for a dose. (Clater.)

3. Aloes, 1/2 dr. to 2 dr. made into a ball with syrup of ginger.

4. Aloes, 1/2 dr. to 1-1/2 dr., calomel, 2 to 5 gr., syrup to form a ball; in inflammation of the bowels, and in worms. (Blaine.)

5. Cape aloes, 1/2 dr. to 1 dr., calomel, 2 to 3 gr., oil of caraway, 6 drops, syrup to form a ball. (M'Ewen.)

6. Calomel, 12 gr., aloes, 3 dr., opium, 1 gr., syrup q. s. to form a mass, for 4, 6, or 8 balls; one every 4 or 5 hours till the bowels are relieved. (Blaine.)

7. Croton oil, 1 drop, Castile soap, 20 gr., conserve to form a ball.

8. Castor oil, 3 parts, syrup of buckthorn, 2 parts, syrup of poppies, 1 part.--_Dose._ From 1 to 2 tablespoonfuls.--Mr Youatt's purge. [Mr Clark says syrup of buckthorn for dogs should be made with treacle, and the spices omitted.]

9. Epsom salts, from 1 to 4 dr., wrapped in tissue paper, dividing the doses into convenient-sized packets.

10. In costiveness with inflammation: 1/2 oz. to 2 oz. castor oil. (Mr Spooner.)

ALTERATIVE BALLS AND POWDERS:--

1. Sulphur, 2-1/2 lb.; nitre, 1/2 lb.; Æthiops mineral, 4 oz.; linseed meal, 1/2 lb.; palm oil, 1 lb., or as much as may be required; beat together, and keep in a jar for use.--_Dose_, from 2 scruples to 1-1/2 or 2 dr. (Clater.)

2. Ethiops mineral, 20 to 40 gr.; cream of tartar, 20 to 40 gr.; nitre, 5 to 10 gr.; night and morning, made into a ball with butter. (Spooner.)

3. _Tonic Alterative._ Mercurial pill, 1 dr.; aloes 2 dr.; myrrh, benzoin, balsam of Peru, of each 1-1/2 dr.; to be divided into 10, 15, or 20 pills: one every evening, for the yellows, after aloes and calomel. (Blaine.)

4. _Alterative Powder._ Æthiops mineral, 2 to 5 gr.; cream of tartar, 4 to 10 gr., tartarised iron, 1 to 3 gr., once a day. (Clater.)

5. _To give a fine skin._ Give a table-spoonful of tar made up with oatmeal. (Mayer.)

ASTRINGENT BALLS, &c.:--

1. Catechu, 1-1/2 dr.; sulphate of quinine, 20 gr.; opium, 5 gr.; ginger, 1 dr.; conserve of roses, q. s. to form a mass, to be divided into 8, 6, or 4 balls. (Blaine.)

2. Prepared chalk, 2 oz.; powdered gum Arabic, 1/2 oz.; powdered catechu, 1/2 oz.; powdered oak bark, 1/2 oz.; powdered ginger, 1/4 oz.; opium, 15 gr.; palm oil, 1 oz.; beat well together.--_Dose_, 1/2 dr. to 2 dr., morning, noon, and night, in the advanced stage of distemper. (Clater.)

3. Opium, 5 gr.; catechu, 2 dr.; gum Arabic, 2 dr.; ginger, 1/2 dr.; syrup of poppies, q. s.; divide into 12, 9, or 6 balls: in diarrh[oe]a. (Blaine.)

4. Myrrh, 1 dr.; ipecacuanha, 1 scruple; opium, 3 gr.; chalk, 2 dr.; carbonate of iron, 1 dr.; as No. 3. (Blaine.)

5. In obstinate cases: Alum, 1 dr.; chalk, 2 dr.; opium, 6 gr.; resin, 3 dr.; into 4, 6, or 8 balls.

6. In diarrh[oe]a, after 1 to 4 dr. of Epsom salts; prepared chalk, 1 to 3 scruples; catechu, 5 to 10 gr.; opium, 1/4 to 2 gr.; twice a day. (Spooner.)

COUGH BALLS IN ASTHMA, &c.:--

1. _After a few emetics._ Calomel, 3 gr.; foxglove, 3 gr.; cream of tartar, 1 dr.; antimonial powder, 12 gr.; honey to form 6 boluses. One twice a day. (Blaine.)

2. Digitalis, 20 gr.; antimonial powder, 40 gr.; nitre, 2 dr.; sulphur, 3 dr.; palm oil, 3 dr., or q. s. Divide into 10, 15, or 20 balls, according to the size of the dog, morning and night, interposing an emetic every third or fourth day. (Clater.)

3. _In old cases._ P. squill, 1/2 gr. to 1 gr.; gum ammoniac, 5 gr.; balsam of Peru, 8 gr.; benzoic acid, 1 gr.; balsam of sulphur to form a ball.

4. Extract of hemlock, 1/2 dr.; extract of henbane, 10 gr.; p. digitalis, 20 gr.; conserve of roses to form a mass. Divide into 8, 10, or 6 balls. One night and morning. (Blaine.)

DISTEMPER MEDICINES:--

1. Turbeth mineral, 1 to 3 gr.; assaf[oe]tida, 1/2 dr.; aloes, 20 gr.; soap, 10 gr.; syrup of poppies to form a ball. To be preceded by an emetic, and given every third day.

2. After an emetic, give a physic ball; and afterwards the following, two or three times a day:--Antimonial powder, 2, 3, or 4 gr.; nitre, 5, 10, or 15 gr.; ipecacuanha, 2, 3, or 4 gr.; form a ball. If the disease proceed to the debilitating stage, give the _Tonic Ball_ No. 2; in the putrid or malignant stage give the _Astringent Ball_ No. 1. (Blaine.)

3. After the Emetic Powder No. 1 (which should be repeated every 3rd or 4th day) give the _Cough Ball_ No. 2, from 1/2 dr. to 2 dr. in weight. And if the dog lose flesh, give equal parts of the cough ball and the Tonic Ball (No. 1). In the more advanced stages give the tonic alone; or the _astringent ball_ if diarrh[oe]a comes on. (Clater.)

4. Give a third of a paper of James's powder mixed with butter, and afterwards warm broth or milk. In 2 hours, another third; and if this neither vomit nor purge, give the other third at the end of 4 hours. (Daniel.)

5. Blaine's distemper powders, which are sold in packets, with directions for use.

6. Camphor, 3 to 5 gr.; charcoal, 10 gr.; opium, 1 gr.; aromatic confection, q. s. to form a ball.--In the malignant stage, with diarrh[oe]a.

7. Antimomal powder, 2 to 4 gr.; nitre, 5 to 10 gr.; digitalis, 1/4 to 2 gr. Afterwards the Tonic Pills No. 4. (Spooner.)

_Poudre Kusique_: a French nostrum. Mix 45 gr. of nitre, 45 of sulphur, and 1 charcoal. Divide into 3 doses. Give 1 for 2 successive mornings, and the third on the 4th morning, mixed with lard or butter, or in milk. For a large dog a second packet (of 3 powders) may be required. (Habert.)

Another French nostrum. Hemel's Powder is of a similar kind.

8. A strong solution of salt, to the amount of 1/2 pint daily.

9. Powdered tin, sulphur, gunpowder, of each 1 oz.; lard sufficient to form a mass. The size of a nutmeg to be given twice or thrice a week.

10. Physic Ball No. 11.

11. 1/4 oz. to 1 fl. oz. of cod-liver oil twice a day, according to size.

12. Emetics, gentle laxatives, milk diet, and from 5 to 15 gr. of chlorate of potash twice a day. (Finlay Dun.)

WORM MEDICINES:--

1. Carbonate of iron, 1/2 oz.; Æthiops mineral, 1 dr.; gentian, 1 oz.; ginger, 1/2 oz.; levigated glass, 1 oz.; palm oil, 9 dr.; beat well together.--_Dose_, from 3/4 to 2 dr. (Clater.)

2. As much very finely-powdered glass as will lie on a sixpence, mixed with butter (Blaine). Mr Youatt says from 1/2 dr. to 1 dr.; powdered glass, with a little ginger, made into a ball with lard.

3. Aloes, sulphur, prepared hartshorn, and juice of wormwood, made into a mass; the size of a hazel nut to be given three times a week, fasting, wrapped in butter. (Daniel.)

4. Tin filings, or pewter filings, 1/2 dr. to 1 dr., with butter or lard.

5. Jalap, 10 to 15 gr.; calomel, 2 to 3 gr. mixed with butter; no cold liquid should be allowed. (White.)

6. Cowhage, 1/2 dr.; iron filings, 4 dr.; conserve q. s. to form a mass, to be divided into 4, 6, or 8 balls; one every night and morning; and afterwards the purgative No. 4. (Blaine.)

7. Epsom salts, 1 oz.; common salt, 1 dr.; give a small or large teaspoonful daily.

8. Give green walnut leaves boiled in milk. (Mayer.)

9. From 1/2 dr. to 2 dr., according to size. Betel nut in coarse powder, made into a ball.

10. _For Tapeworm._--Oil of turpentine, 1/2 dr., mixed with yolk of egg; for very large dogs, 2 scruples. Some writers prescribe larger doses (1 to 2 dr.), but these sometimes prove fatal. (Blaine.) 2 to 6 dr. of cusso according to size.

11. _For Tapeworm._--Oil of turpentine and olive oil, of each 1/2 oz.; mix, and give carefully; 3 or 4 hours after give 1 oz. castor oil. But see No. 9. (White.)

12. _For Stomach Worms._--Give the emetic powder (see further back) and afterwards a physic ball.

13. _Threadworms._--These are destroyed by an aloetic clyster.

OINTMENTS AND LOTIONS FOR THE MANGE:--

N.B.--An alterative ball should be given daily and a physic ball occasionally. Bleeding is sometimes prescribed.

_For Scabby Mange._--Sulphur, 4 oz.; sal ammoniac, 1/2 oz.; aloes, 1 dr.; Venice turpentine, 1/2 oz.; lard, 6 oz.; mix. After four applications, wash well with soap and water. (Blaine.)

2. Horse turpentine and palm oil, each 1/2 lb.; train oil, 1/2 pint. Melt together, and while cooling, stir in 3 lbs. of flowers of sulphur. (Clater.)

3. Aloes, 2 dr.; hellebore, 1/2 oz.; sulphur, 4 oz.; lard or train oil, 6 oz. (McEwen.)

4. Sulphate of zinc, 1 dr.; snuff, 1/2 oz.; white hellebore, 1/2 oz.; sulphur, 4 oz.; aloes, 1/4 oz.; soft soap, 6 oz. (Blaine.)

5. Charcoal powder, 2 oz.; sulphur, 4 oz.; salt of tartar, 1 dr.; Venice turpentine, 1/2 oz.; lard, 6 oz.

6. _For Red Mange._--Add 1 oz. of strong mercurial ointment to 6 oz. of either of the above.

7. Charcoal, 1 oz.; chalk, 1 oz.; sugar of lead, 1 dr.; white precipitate, 2 dr.; sulphur, 2 oz.; lard, 5 oz. (Blaine.)

8. _Wash for Red Mange._--Corrosive sublimate, 20 gr.; spirit of wine, 2 dr.; dissolve and add milk of sulphur, 1/2 oz.; lime-water, 1/2 pint. Apply by means of a sponge. (Clater.)

9. _For Ulcerated Mange._--Ointment of nitrated quicksilver, 2 dr.; sugar of lead, 20 gr.; flowers of sulphur, 1/2 oz.; lard, 1 oz.; mix. (Blaine.)

FLEAS:--

1. Rub the skin with the powdered resin and bran.

2. Let the dog sleep on deal shavings.

3. Scotch snuff steeped in gin. (Meyer.) (This requires caution.)

4. Oil of aniseed. (Finlay Dun.)

5. Persian insect powder.

=DOG-BALLS= (A. H. Bôldt, Genf). Hard pills, weighing 15 grammes, of irregular shape and unequal size, composed of aloes with 1/3 of gentian, and covered with a brown powder containing liquorice root. (Hager.)

=DOORS.= Much annoyance is sometimes experienced from the creaking of doors. This may be prevented by rubbing a little soap or a mixture of tallow and black-lead on the hinges; or by applying to them with a feather a little sweet oil once or twice a year. The trifling trouble and expense (a penny or two a twelvemonth) will be amply repaid by their noiselessness and greater durability. To prevent the noise of doors slamming, a small piece of vulcanised india rubber, cork, or leather may be placed so as to receive the shock.