- Email: [email protected]
THE PHYSIOLOGY OF MARCHING.
THE PHYSIOLOGY OF MARCHING.
1355
remedy for them. The excellent society, over which present and then only for a brief period. The nitrogenSir William Richmond presides, is a remarkably alert, containing’ substanceswere just the. same on the d4yii and active one. It has received but small support either of rest and of marching, so- that there was no increase from the public or the medical profession and deserves much of metabolism in the albumin of the body, nor was the wider noticeand much more generous help. Medical men composition of the contents of’ the intestine materially have many ways, perhaps more strictly medical in their different on days of work and days of rest. Subsequent direction, of .getting rid of their spare guineas, but this sections of the essay deal with the exchange of gases’ during society is one thatwould appeal with particular force to the work and while at rest, as well as the heat’ value of the taymindif the therapeutic nature of its work were under- work done. 70 per cent. of the heat generated is carried off stood. We wish all our London readers would impress by the sweat and the greater the amount of heat produced upon their patients the fact that to abate coal smoke in the by work the more abundant is the secretion of sweat, but metropolis is to improve the public health of the city in a many factors have to be considered, as the temperature and degree of moisture of the air, the velocity of the wind, and marked manner. a
,
As the became moretrained exposure to the exercise the amount of sweat diminished. by sun.
THE PHYSIOLOGY OF MARCHING. " THE Physiology of Marching’" is the title of an essay by Herr N. Zuntz and Herr Schumburg recentlypublished in Berlin by Hirschwald and abstracted in the l’rntrrc.lblrrtt fiir
die Medicinishen Wissenschaften for October. Theirinvestigations;, which have been carried on for some years, were undertaken to ascertain the limits of weight that a soldier on the march ’could’ advantageously carry. They experimented on five healthy students who had already seen service and who for a longperiod marched fully equipped about 15½miles daily.. Amongst the more important points noted were that sphygmograms taken before, during, and after the march showed that the increased work of the heart consequert upon the muscular exertion prolonged the systole of the heart and the ascending line of the pulse curve at the cost 4Jrthe diastole-an effect that was distinctly visible after a march, of only 12 miles. This prolongation of the systole rose,with the amount of weight carried to such a degree that when’the beats of the heart were between 140 and 150 per minute the duration of the systole was to that of the diastole as-1ie to. 1. So that the period of the rest of the heart became cot-tstaiitly less, indicating a not inconsiderable degree of increase in the work of the heart. An increase of the regulation weight carried by German soldiers from the ordinary amount of 48’4 pounds to 59-4 pounds produced the Mmc effect, whilst when the weight was raised to 78’4 pounds the danger of seriously injuring the heart was greatly increased as shown by a fall of the bloodpressure and of the arterial tension. Simultaneously an acute dilatation of the heart, recognisable by percussion, and enlargement of the liver in consequence of blood stasis and
accumulation of blood in that organ were observable. As a result of the dyspnoea from exertion the driving force of the heart became still further reduced, the volume of blood propelled into the aiteries was diminished, and the blood in the great veins re-entered the’ heart in smaller quantity and In healthy persons the dilatation of the heart more slowly. graduallydisappears and in the course of two or three hours the normal conditions are restored. Speaking generally the number of red corpuscles and the specific gravity of the blood increased during the march owing to the great loss of fluid by the lungs and skin. The frequency of the respirations was increased whilst marching, though after a short rest the number returned to the normal. The vital capacity was diminished. The heat of the increased on the to quite a remarksometimes march, body able extent and even though the weight increased and there was more or less physical exhaustion. In one case it amounted to 4u° C. (1040 F.) and more. In order to determine the consumption of food and the nature and quantity of the excreta the diet was kept as uniform as possible. It appeared, to the great surprise of the experimenters, that notwithstanding the abundant secretion of sweat the urine on marching days was more abundant and of less specific gravity than on the days when rest was taken. Albumin, indicated by a precipitate on boiling, was,rarely
men
"
THE HOSPITALS AT ATHENS.
Phonographic Record for October Dr. G. F. Atchley (consulting surgeon to the Bristol General Hospital) gives am interesting account of a visit he recently made to the hospitals at Athens. The children’s hospital, about two and a half miles outside the city, "consists of one large ward containing 16 to 18 beds with a small isolation ward and nurses’ rooms. The original design contemplated six of these pavilions, but, as usual, want of funds has hitherto prevented further building. The situation is perfect; abundance of room for any possible extension or for playgrounds. The building has been ’scamped,’ the tiled floors are all going to pieces, the windows do not fit, and generally the work has IN the
been done in a very inferior manner. - I understand that more A care will be taken in future to secure better work. number of in bed with were various large patients forms of tubercle, especially tubercular peritonitis. The were nurses all English. It’ is found very difficnlt to get Greek nurses to stay ; they all want to be nearer Athens....... At present any cases which require operation are sent to the Evangelismos Hospital, where the facilities for operating are almost perfect. The Evangelismos is a over for 200 large general hospital patients and having both medical and surgical sides. Here I found everything’ in the highest state of efficiency. The practical part of medicine and surgery was up to date and in some respects even in advance of our best English hospitals." Dr. Atchley saw Dr. Tsakonas operate on a boy with stone and on a woman with ovarian tumour. "The operation chosen for the calculus was suprapubic. It was most successfully carried out, the wound in the bladder being stitched with catgut (continuous suture) and the outer wound being treated in the same manner." For the removal of the ovarian tumour "anew method of anaesthesia was used....... A needle, made especially for the purpose and like a long hypodermic needle, was connected with a syringe and inserted opposite the second lumbar vertebra just outside the backbone. It was made to penetrate the spinal canal and only a little cerebro-spinal fluid escaped. Then cocaine In about 20 minutes anaesthesia was prowas injected. duced over the whole lower half of the body below the umbilicus. Although in this instance not quite enough cocaine had been used and a little chloroform became’ necessary, Dr. Tsakonas told me that he had used it’ in 163 cases without a single accident. Usually the anaesthesia. is complete. The patient remains perfectly conscious all the’ time of the operation and there are positively no aftersymptoms whatever. The practical difficulty seems to be to ascertain exactly the amount of cocaine which should be allowed to enter into the spinal canal. Probably eucaine or one of the similar compounds would be less to be injurious should an overdose be injected. It has now become a customary practice in this hospital an
likely
1355
remedy for them. The excellent society, over which present and then only for a brief period. The nitrogenSir William Richmond presides, is a remarkably alert, containing’ substanceswere just the. same on the d4yii and active one. It has received but small support either of rest and of marching, so- that there was no increase from the public or the medical profession and deserves much of metabolism in the albumin of the body, nor was the wider noticeand much more generous help. Medical men composition of the contents of’ the intestine materially have many ways, perhaps more strictly medical in their different on days of work and days of rest. Subsequent direction, of .getting rid of their spare guineas, but this sections of the essay deal with the exchange of gases’ during society is one thatwould appeal with particular force to the work and while at rest, as well as the heat’ value of the taymindif the therapeutic nature of its work were under- work done. 70 per cent. of the heat generated is carried off stood. We wish all our London readers would impress by the sweat and the greater the amount of heat produced upon their patients the fact that to abate coal smoke in the by work the more abundant is the secretion of sweat, but metropolis is to improve the public health of the city in a many factors have to be considered, as the temperature and degree of moisture of the air, the velocity of the wind, and marked manner. a
,
As the became moretrained exposure to the exercise the amount of sweat diminished. by sun.
THE PHYSIOLOGY OF MARCHING. " THE Physiology of Marching’" is the title of an essay by Herr N. Zuntz and Herr Schumburg recentlypublished in Berlin by Hirschwald and abstracted in the l’rntrrc.lblrrtt fiir
die Medicinishen Wissenschaften for October. Theirinvestigations;, which have been carried on for some years, were undertaken to ascertain the limits of weight that a soldier on the march ’could’ advantageously carry. They experimented on five healthy students who had already seen service and who for a longperiod marched fully equipped about 15½miles daily.. Amongst the more important points noted were that sphygmograms taken before, during, and after the march showed that the increased work of the heart consequert upon the muscular exertion prolonged the systole of the heart and the ascending line of the pulse curve at the cost 4Jrthe diastole-an effect that was distinctly visible after a march, of only 12 miles. This prolongation of the systole rose,with the amount of weight carried to such a degree that when’the beats of the heart were between 140 and 150 per minute the duration of the systole was to that of the diastole as-1ie to. 1. So that the period of the rest of the heart became cot-tstaiitly less, indicating a not inconsiderable degree of increase in the work of the heart. An increase of the regulation weight carried by German soldiers from the ordinary amount of 48’4 pounds to 59-4 pounds produced the Mmc effect, whilst when the weight was raised to 78’4 pounds the danger of seriously injuring the heart was greatly increased as shown by a fall of the bloodpressure and of the arterial tension. Simultaneously an acute dilatation of the heart, recognisable by percussion, and enlargement of the liver in consequence of blood stasis and
accumulation of blood in that organ were observable. As a result of the dyspnoea from exertion the driving force of the heart became still further reduced, the volume of blood propelled into the aiteries was diminished, and the blood in the great veins re-entered the’ heart in smaller quantity and In healthy persons the dilatation of the heart more slowly. graduallydisappears and in the course of two or three hours the normal conditions are restored. Speaking generally the number of red corpuscles and the specific gravity of the blood increased during the march owing to the great loss of fluid by the lungs and skin. The frequency of the respirations was increased whilst marching, though after a short rest the number returned to the normal. The vital capacity was diminished. The heat of the increased on the to quite a remarksometimes march, body able extent and even though the weight increased and there was more or less physical exhaustion. In one case it amounted to 4u° C. (1040 F.) and more. In order to determine the consumption of food and the nature and quantity of the excreta the diet was kept as uniform as possible. It appeared, to the great surprise of the experimenters, that notwithstanding the abundant secretion of sweat the urine on marching days was more abundant and of less specific gravity than on the days when rest was taken. Albumin, indicated by a precipitate on boiling, was,rarely
men
"
THE HOSPITALS AT ATHENS.
Phonographic Record for October Dr. G. F. Atchley (consulting surgeon to the Bristol General Hospital) gives am interesting account of a visit he recently made to the hospitals at Athens. The children’s hospital, about two and a half miles outside the city, "consists of one large ward containing 16 to 18 beds with a small isolation ward and nurses’ rooms. The original design contemplated six of these pavilions, but, as usual, want of funds has hitherto prevented further building. The situation is perfect; abundance of room for any possible extension or for playgrounds. The building has been ’scamped,’ the tiled floors are all going to pieces, the windows do not fit, and generally the work has IN the
been done in a very inferior manner. - I understand that more A care will be taken in future to secure better work. number of in bed with were various large patients forms of tubercle, especially tubercular peritonitis. The were nurses all English. It’ is found very difficnlt to get Greek nurses to stay ; they all want to be nearer Athens....... At present any cases which require operation are sent to the Evangelismos Hospital, where the facilities for operating are almost perfect. The Evangelismos is a over for 200 large general hospital patients and having both medical and surgical sides. Here I found everything’ in the highest state of efficiency. The practical part of medicine and surgery was up to date and in some respects even in advance of our best English hospitals." Dr. Atchley saw Dr. Tsakonas operate on a boy with stone and on a woman with ovarian tumour. "The operation chosen for the calculus was suprapubic. It was most successfully carried out, the wound in the bladder being stitched with catgut (continuous suture) and the outer wound being treated in the same manner." For the removal of the ovarian tumour "anew method of anaesthesia was used....... A needle, made especially for the purpose and like a long hypodermic needle, was connected with a syringe and inserted opposite the second lumbar vertebra just outside the backbone. It was made to penetrate the spinal canal and only a little cerebro-spinal fluid escaped. Then cocaine In about 20 minutes anaesthesia was prowas injected. duced over the whole lower half of the body below the umbilicus. Although in this instance not quite enough cocaine had been used and a little chloroform became’ necessary, Dr. Tsakonas told me that he had used it’ in 163 cases without a single accident. Usually the anaesthesia. is complete. The patient remains perfectly conscious all the’ time of the operation and there are positively no aftersymptoms whatever. The practical difficulty seems to be to ascertain exactly the amount of cocaine which should be allowed to enter into the spinal canal. Probably eucaine or one of the similar compounds would be less to be injurious should an overdose be injected. It has now become a customary practice in this hospital an
likely