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continues, showing that the blood is constantly flowing from the heart 169 through the arteries, into the veins; and the increased size of the veins shows that the pressure of the tape prevents its flowing back to the heart.

361. State the influences that propel the blood from the heart. 362. Demonstrate by the first experiment that the blood flows to the heart. By the second experiment.

363. The influences that return the blood to the heart through the veins, are not so easily understood as those that act on the blood in the arteries. Some physiologists have imputed an active propulsive power to the capillary vessels in carrying the blood through the veins. This is not easily explained, and perhaps it is as difficult to understand. An influence upon which others have dwelt, is the suction power of the heart in active dilatation, acting as a vis a fronte (power in front) in drawing blood to it.

364. Another influence that aids the venous circulation is attributed to the propulsive power of the heart. It is not easy to comprehend how this power of the heart can be extended through the capillary vessels to the blood in the veins. Again, an important agency has been found, by some physiologists, in the inspiratory movements, which are supposed to draw the blood of the veins into the chest, in order to supply the vacuum which is created there by the elevation of the ribs and the descent of the diaphragm.

365. One of the most powerful causes which influence the venous circulation, is the frequently-recurring action of the muscles upon the venous trunks. When the muscles are contracted, they compress that portion of the veins which lie beneath the swell, and thus force the blood from one valve to the other, toward the heart. When they are relaxed, the veins refill, and are compressed by the recurring action of the muscles.

Observation. The physician, in opening a vein, relies on the energetic contractions and sudden relaxations of the muscles, when he directs the patient to clasp the head of a cane, or the arm of a chair; these alternate motions of the muscles cause an increased flow of blood to the veins of the ligated arm.

363. What is said of the influences that return the blood to the heart? What is said of the propulsive power of the capillaries? Of the suction power of the heart? 364. Give another influence. State another agency. 365. What is one of the most powerful causes which influence venous circulation? Give practical observation.

170

Fig. 75.


Fig. 75. An ideal view of the circulation in the lungs and system. From the right ventricle of the heart, (2,) the dark, impure blood is forced into the pulmonary artery, (3,) and its branches (4, 5) carry the blood to the left and right lung. In the capillary vessels (6, 6) of the lungs, the blood becomes pure, or of a red color, and is returned to the left auricle of the heart, (9,) by the veins, (7, 8.) From the left auricle the pure blood passes into the left ventricle, (10.) By a forcible contraction of the left ventricle of the heart, the blood is thrown into the aorta, (11.) Its branches (12, 13, 13) carry the pure blood to every organ or part of the body. The divisions and subdivisions of the aorta terminate in capillary vessels, represented by 14, 14. In these hair-like vessels the blood becomes dark colored, and is returned to the right auricle of the heart (1) by the vena cava descendens, (15,) and vena cava ascendens, (16.) The tricuspid valves (17) prevent the reflow of the blood from the right ventricle to the right auricle. The semilunar valves (18) prevent the blood passing from the pulmonary artery to the right ventricle. The mitral valves (19) prevent the reflow of blood from the left ventricle to the left auricle. The semilunar valves (20) prevent the reflow of blood from the aorta to the left ventricle.

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366. The muscles exercise an agency in maintaining the venous circulation at a point above what the heart could perform. As the pulsations are diminished by rest, so they are accelerated by exercise, and very much quickened by violent effort. There can be little doubt that the increased rapidity of the return of blood through the veins, is, of itself, a sufficient cause for the accelerated movements of the heart during active exercise.

Observation. The quantity of blood in different individuals varies. From twenty-five to thirty-five pounds may be considered an average estimate in a healthy adult of medium size. The time in which the blood courses through the body and returns to the heart, is different in different individuals. Many writers on physiology unconditionally limit the period to three minutes. It is undeniable that the size and health of a person, the condition of the heart, lungs, and brain, the quantity of the circulating fluid, the amount and character of the inspired air, and the amount of muscular action, exert a modifying influence. The time probably varies from three to eight minutes.

366. What causes the accelerated movements of the heart during active exercise?

Note. Let the pupil review the anatomy and physiology of the circulatory organs from fig. 75, or from anatomical outline plates, No. 6 and 7.

172 CHAPTER XIX. HYGIENE OF THE CIRCULATORY ORGANS

367. If any part of the system is deprived of blood, its vitality will cease; but, if the blood is lessened in quantity to a limited extent, only the vigor and health of the part will be impaired. The following conditions, if observed, will favor the free and regular supply of blood to all portions of the system.

368. The clothing should be loosely worn. Compression of any kind impedes the passage of blood through the vessels of the compressed portion. Hence, no article of apparel should be worn so as to prevent a free flow of blood through every organ of the body.

369. The blood which passes to and from the brain, flows through the vessels of the neck. If the dressing of this part of the body is close, the circulation will be impeded, and the functions of the brain will be impaired. This remark is particularly important to scholars, public speakers, and individuals predisposed to apoplexy, and other diseases of the brain.

370. As many of the large veins lie immediately beneath the skin, through which the blood is returned from the lower extremities, if the ligatures used to retain the hose, or any other article of apparel, in proper position, be tight and inelastic, the passage of blood through these vessels will be 173 obstructed, producing, by their distention, the varicose, or enlarged veins. Hence elastic bands should always be used for these purposes.

367–386. Give the hygiene of the circulatory organs. 367. What effect will be produced on the body if it is deprived of blood? If the blood is only lessened in quantity? 368. Why should the clothing be worn loose? 369. What is said of dressing the neck? To what persons is this remark applicable? 370. How are enlarged veins frequently produced?

371. An equal temperature of all parts of the system promotes health. A chill on one portion of the body diminishes the size of its circulating vessels, and the blood which should distend and stimulate the chilled part, will accumulate in other organs. The deficiency of blood in the chilled portion induces weakness, while the superabundance of sanguineous fluid may cause disease in another part of the system.

372. The skin should be kept not only of an equal, but at its natural temperature. If the skin is not kept warm by adequate clothing, so that chills shall not produce a contraction of the blood-vessels and a consequent paleness, the blood will recede from the surface of the body, and accumulate in the internal organs. Cleanliness of the skin is likewise necessary, for the reason, that this condition favors the free action of the cutaneous vessels.

Observation. When intending to ride in a cold day, wash the face, hands, and feet, in cold water, and rub them smartly with a coarse towel. This is far better to keep the extremities warm, than to take spirits into the stomach.

373. Exercise promotes the circulation of the blood. As the action of the muscles is one of the important agents which propel the blood through the arteries and veins, daily and regular exercise of the muscular system is required to sustain a vigorous circulation in the extremities and skin, and also to maintain a healthy condition of the system. The best stimulants to improve the sluggish circulation of an indolent patient, whose skin is pale and whose extremities are cold, are the 174 union of vigorous muscular exercise with agreeable mental action, and the systematic application to the skin of cold water, attended with friction.

371. Why should the temperature of the body be equal? 372. Why should the skin be kept at its natural, as well as at an equal temperature? What practical observation when intending to ride in a cold day? 373. Why does exercise promote health? What are good stimulants for sluggish circulation in the indolent?

Illustration. The coach-driver and teamster throw their arms around their bodies to warm them when cold. The muscles that are called into action in swinging the arms, force a greater quantity of blood into the chilled parts, and consequently, more heat is produced.

374. When a number of muscles are called into energetic action, a greater quantity of blood will be propelled to the lungs and heart in a given time, than when the muscles are in a state of comparative inaction. It is no uncommon occurrence, that before there is a proper expansion of the respiratory organs to correspond with the frequency and energy of the movements of the muscles, there is an accumulation of blood in the lungs, attended by a painful sensation of fulness and oppression in the chest, with violent and irregular action of the heart. This condition of the organs of the chest, called congestion, may be followed by cough, inflammation of the lungs, asthma, and a structural disease of the heart.

375. To avoid these sensations and results, when we feel necessitated to walk or run a considerable distance in a short time, commence the movements in a moderate manner increasing the speed as the respiratory movements become more frequent and their expansion more extensive, so that a sufficient amount of air may be received into the lungs to purify the increased quantity of blood forced into them. The same principles should be observed when commencing labor, and in driving horses and other animals.

Observation. When a large number of muscles are called into action after repose, as when we rise from a recumbent or 175 sitting posture, the blood is impelled to the heart with a very strong impetus. If that organ should be diseased, it may arrive there in larger quantities than can be disposed of, and death may be the result. Hence the necessity of avoiding all sudden and violent movements, on the part of those who have either a functional or structural disease of the heart.

Mention the illustration. 374. What is the effect when a number of muscles are called into energetic action? What effect has this accumulation of blood in the lungs? 375. How can such disagreeable sensations be avoided? Mention a practical observation.

376. The mind exercises no inconsiderable influence upon the circulatory organs. When an individual is stimulated by hope, or excited by anger, the heart beats more forcibly, and the arteries act more energetically, than when a person is influenced by fear, despair, or sorrow. Consequently, the system is more fully nourished, and capable of greater exertion, when the former condition obtains, than when the latter

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