Conrad Ferdinand Meyer - "Die Hochzeit des Moenchs"

Walter Horatio Pater - "Appreciations, With An Essay on Style"

William Shakespeare - "Der Erste Theil von Koenig Heinrich dem vierten"

Richard F. Burton - "The Book of the Thousand Nights and a Night, Volume 3"

Annual Bibliography of Commonwealth Literature 2007
This paper argues that discourses of love in Ghanaian market literature for youth offer a view into complex negotiations of agency and empowerment. Drawing on Deborah Durham's notion of youth as "social `shifters'" and Francis Nyamnjoh's conception of the "interconnectedness" of agency, I take Ghanaian market literature as one specific case of how African literature for youth foregrounds questions of continuity and change as African societies enter into increasingly complex global relations. In this literature for youth, received notions of love, often constructed out of impressions from American pop and hip hop music, carry new notions of agency that compete with existing "domesticated" forms. Authors like Ike Tandoh and Evelyn Tay employ discourses of love to offer youth alternative avenues for empowerment in a context of socio-economic disenfranchizement. In a creative process of "straddling", this writing both reveals and reproduces the contradictions that obtain in youth configurations of agency.

A Handbook of Health

W >> Woods Hutchinson >> A Handbook of Health




One of the first of these branches to be given off by the aorta is a
large blood pipe, or artery, to supply the shoulder and arm; this artery
runs across the chest, thence across the armpit, and down the arm to the
elbow. Here it divides into two branches, one to supply the right, and
the other the left, side of the forearm and hand. These branches have by
this time got down to about the size of a wheat straw; the one supplying
the right side is the artery which we feel throbbing in the wrist, and
which we use in counting the pulse. From it run off smaller branches to
supply the thumb and fingers. These branches break up again into still
smaller branches, and they into a multitude of tiny capillaries, which
run in every direction among all the muscle cells, delivering the food
and oxygen at their very doors, as it were. The muscle cells eagerly
suck out the food-stuffs, and breathe in the oxygen of the blood; at the
same time, they pour into it their waste stuffs of all sorts, including
carbon dioxid. These rob the blood of its bright red oxygen color and
turn it a dirty purplish, or bluish, tint.

The loops of capillaries again run together, as they did in the liver
and in the lung, to form tiny veins; and these run together at the base
of the thumb and in the wrist, to form larger ones through which the now
poor and dirty blood is carried back up the arm over much the same
course as it took in coming down it. Indeed, the veins usually run
parallel with, and often directly alongside of, the arteries. The blood
passes through the armpit, across the chest, into the great main pipe
for impure blood, the vena cava, and through this into the right side of
the heart, where it again meets the rich, but waste-laden blood from the
food tube and liver, and starts on its circuit through the lungs and
around the body again.

The blood reaches every portion of our body in precisely this same
manner, only taking a different branch of the great pure-blood delivery
pipe, the aorta, according to the part of the body which it is to reach,
and coming back by a different vein-pipe.

Why the Arteries are more deeply Placed than the Veins. In the limbs
and over the surface of the body generally, the arteries are more deeply
placed than the veins, so as to protect them from injury, because the
blood in the arteries is driven at much higher pressure than in the
veins and spurts out with dangerous rapidity, if they are cut. Some of
the veins, indeed, run quite a little distance away from any artery and
quite close to the surface of the body, so that you can see them as
bluish streaks showing through the skin, particularly upon the front and
inner side of the arms.

The Capillaries. Of course, the blood pipes into which the food is
sucked through the walls of the food tube, and those in the lung,
through which the oxygen is breathed, as well as those in the thumb
through which food is taken to the muscle-cells, have the tiniest and
thinnest walls imaginable. For once, the name given them by the wise
men--capillaries (from the Latin _capilla_, a little hair)--fits them
beautifully, except that the hairs in this case are hollow, and about
one-twentieth of the size of the finest hair you can see with the naked
eye. So tiny are they that they compare with the big veins near the
heart into which they finally empty much as the smallest and slenderest
twigs of an elm do with its trunk. What they lack in size, however, they
more than make up in numbers; and a network of them as fine and close as
the most delicate gauze goes completely around the food tube between its
mucous lining and muscular coat.

Though thickest and most abundant on the inner and outer surfaces of the
body, every particle of the body substance is shot through and through
with a network of these tiny tubes. So close and fine is this network in
the skin, for instance, that, as you can readily prove, it is impossible
to thrust the point of the finest needle through the skin without
piercing one of them and "drawing blood," as we say, or making it bleed.
From this network of tiny, thin-walled tubes, the body-cells draw their
food from the blood.

[Illustration: DIAGRAM OF ARTERY, CAPILLARIES, AND VEIN]

The Meaning of Good Color. It is the red blood in this spongy network
of tiny vessels that gives a pink coloring to our lips and the flush of
health to our cheeks. Whenever for any reason the blood is less richly
supplied with food or oxygen, or more loaded with "smoke" and other body
dirt than it should be, we lose this good color and become pale or
sallow. If we will remember that our hearts, our livers, our brains, and
our stomachs, are at the same time often equally "pale" and sallow--that
is, badly supplied with blood--as our complexions, we can readily
understand why it is that we are likely to have poor appetites, poor
memories, bad tastes in our mouths, and are easily tired whenever, as we
say, our "blood is out of order." The blood is the life. Starve or
poison that, and you starve or poison every bit of living stuff in the
body.


THE HEART

Structure and Action of the Heart. Now what is it that keeps the blood
whirling round and round the body in this wonderful way? It is done by a
central pump (or more correctly, a little explosive engine), with thick
muscular walls, called the _heart_, which every one knows how to find by
putting the hand upon the left side of the chest and feeling it beat.
The heart is really a bulb, or pouch, which has ballooned out from the
central feed pipe of the blood supply system, somewhat in the same way
that the stomach has ballooned out from the food tube.

The walls of this pouch, or bulb, are formed of a thick layer of very
elastic and powerful muscles almost as thick as the palm of your hand.
When the great vein trunk has poured blood into this pouch until it is
swollen full and tight, these muscles in its walls shut down sharply and
squirt or squeeze the blood in the heart-pouch into the great
artery-pipe, the aorta. In fact, you can get a very fair, but rough,
idea of the way in which the heart acts by putting your half-closed hand
down into a bowl of water and then suddenly squeezing it till it is shut
tight, driving the water out of the hollow of your hand in a jet, or
squirt.

"But," some of you will ask at once, "what is to prevent the blood in
the heart, when the muscle wall squeezes down upon it, from shooting
backward into the vena cava, instead of forward into the aorta?"

Nature thought of that long ago, and ingeniously but very simply
guarded against it by causing two little folds of the lining of the
blood pipes to stick up both where the vena cava enters the heart and
where the aorta leaves it, so as to form little flaps which act as
valves. These valves allow the blood to flow forward, but snap together
and close the opening as soon as it tries to flow backward. While
largest and best developed in the heart, these valves are found at
intervals of an inch or two all through the veins in most parts of the
body, allowing the blood to flow freely toward the heart, but preventing
it from flowing back.

As the heart has to pump all the blood in the body twice,--once around
and through the lungs, and once around and through the whole of the
body,--it has become divided into two halves, a right half, which pumps
the blood through the lungs and is slightly the smaller and the thinner
walled of the two; and a left half, which pumps the purified blood,
after it has come back from the lungs, all over the rest of the body.

[Illustration: THE EXTERIOR OF THE HEART

Showing the strands of muscle that compose it, the arteries and veins
that feed and drain the muscle coat, and fat protecting these.]

Each half, or side, of the heart has again divided itself into a
receiving cavity, or pouch, known as the _auricle_; and a pumping or
delivering pouch, known as the _ventricle_. And another set of valves
has grown up between the auricle and the ventricle on each side of the
heart. These valves have become very strong and tough, and are tied back
in a curious and ingenious manner by tough little guy ropes of tendon,
or fibrous tissues, such as you can see quite plainly in the heart of an
ox. It is important for you to remember this much about them, because,
as we shall see in the next chapter, these valves are one of the parts
of the heart most likely to wear out, or become diseased.

[Illustration: DIAGRAM OF VALVES IN THE VEINS AND HEART

In _A_ the blood flows forward naturally. In _B_ and _C_ is shown what
would happen were the blood to reverse its course, as it does when it
meets an obstruction: the pockets would fill until they met and closed
the passageway.]

Heart Beat and Pulse. The heart fills and empties itself about eighty
times a minute, varying from one hundred and twenty times for a baby,
and ninety for a child of seven, to eighty for a woman, and seventy-two
for a full-grown man.

When the walls of the ventricles squeeze down to drive out their blood
into the lungs and around the body, like all other muscles they harden
as they contract and thump the pointed lower end, or _apex_, of the
heart against the wall of the chest, thus making what is known as the
_beat_ of the heart, which you can readily feel by laying your hand upon
the left side of your chest, especially after you have been running or
going quickly upstairs. As each time the heart beats, it throws out half
a teacupful of blood into the aorta, this jet sends a wave of swelling
down the arteries all over the body, which can be felt clearly as far
away as the small arteries of the wrist and the ankle. This wave of
swelling, which, of course, occurs as often as the heart beats, is
called the _pulse_; and we "take" it, or count and feel its force and
fullness, to estimate how fast the heart is beating and how well it is
doing its work. We generally use an artery in the wrist (_radial_) for
this purpose because it is one of the largest arteries in the body which
run close to the surface and can be easily reached.

Summary of the Circulation of the Blood. We will now sum up, and put
together in their order, the different things we have learned about the
circulation of the blood through the body.

[Illustration: THE BLOOD-ROUTE THROUGH THE HEART

_R.A._, right auricle; _L.A._, left auricle; _R.V._, right ventricle;
_L.V._, left ventricle; _A_, aorta; _P.A._, pulmonary artery; _P.V._,
pulmonary veins; _V.C.s._, Vena cava superior; _V.C.i._, Vena cava
inferior. At the entrance to the pulmonary artery are shown two of the
pockets of the valve, the third pocket having been cut away with the
front side of the artery. The other blood-tubes have similar valves, not
shown in the diagram.]

Starting from the great vein trunk, the vena cava, it pours into the
receiving chamber, or auricle, of the right side of the heart, passes
between the valves of the opening into the lower chamber, the right
ventricle. When this is full, the muscles in the wall of the ventricle
contract, the valve flaps fly up, and the blood is squirted out through
the pulmonary artery to the lungs. Here it passes through the
capillaries round the air cells, loses its carbon dioxid, takes in
oxygen, and is gathered up and returned through great return pipes to
the receiving chamber, or auricle, of the left side of the heart. Here
it collects while the ventricle below is emptying itself, then pours
down between the valve flaps through the opening to the left ventricle.
When this is full, it contracts; the valves fly up and close the
orifice; and the blood is squirted out through another valve-guarded
opening, into the great main artery, the aorta. This carries it, through
its different branches, all over the body, where the tissues suck out
their food and oxygen through the walls of the capillaries, and return
it through the small veins into the large vein pipes, which again
deliver it into the vena cava, and so to the right side of the heart
from which we started to trace it.

Although the two sides of the heart are doing different work, they
contract and empty themselves, and relax and fill themselves, at the
same time, so that we feel only one beat of the whole heart.

One of the most wonderful things about the entire system of blood tubes
is the way in which each particular part and organ of the body is
supplied with exactly the amount of blood it needs. If the whole body is
put to work, so that a quicker circulation of blood, with its millions
of little baskets of oxygen, is needed to enable the tissues to breathe
faster, the heart meets the situation by beating faster and harder.
This, as you all know, you can readily cause by running, or jumping, or
wrestling.




CHAPTER XII

THE CARE OF THE HEART-PUMP AND ITS PIPE-LINES


The Effect of Work upon the Heart. Whatever else in this body of ours
may be able to take a rest at times, the heart never can. When it stops,
we stop! Naturally, with such a constant strain upon it, we should
expect it to have a tendency to give way, or break down, at certain
points. The real wonder is that it breaks down so seldom. It has great
powers of endurance and a wonderful trick of patching up break-downs and
adjusting itself to strains.

Every kind of work, of course, done in the body throws more work upon
the heart. When we run, or saw wood, our muscles contract, and need more
food-fuel to burn, and pour more waste-stuff into the blood to be thrown
off through the lungs; so the heart has to beat harder and faster to
supply these calls. When our stomach digests food, it needs a larger
supply of blood in its walls, and the heart has to pump harder to
deliver this. Even when we think hard or worry over something, our brain
cells need more blood, and the ever-willing heart again pumps it up to
them. This is the chief reason why we cannot do more than one of these
things at a time to advantage. If we try to think hard, run foot races,
and digest our dinner all at one and the same time, neither head,
stomach, nor muscles can get the proper amount of blood that it
requires; we cannot do any one of the three properly, and are likely to
develop a headache, or an attack of indigestion, or a "stitch in the
side," and sometimes all three. So the circulation has a great deal to
do with the intelligent planning and arranging of our work, our meals,
and our play. If we are going to increase our endurance, we must
increase the power of our heart and blood vessels, as well as that of
our muscles. The real thing to be trained in the gymnasium and on the
athletic field is the heart rather than the muscles.

Fortunately, however, the heart is itself a muscle, alive and growing,
and with the same power of increasing in strength and size that any
other muscle has. So that up to a proper limit, all these things which
throw strain upon the heart in moderate degree, such as running,
working, and thinking, are not only not harmful, but beneficial to it,
increasing both its strength and its size. The heart, for instance, of a
thoroughbred race-horse is nearly twice the size, in proportion to his
body weight, of the heart of a dray-horse or cart-horse; and a deer has
more than twice as large a heart as a sheep of the same weight.

[Illustration: THE SCHOOL PHYSICIAN EXAMINING HEART AND LUNGS]

The important thing to bear in mind in both work and play, in athletic
training, and in life, is that this work must be kept easily within the
powers of the heart and of the other muscles, and must be increased
gradually, and never allowed to go beyond a certain point, or it becomes
injurious, instead of beneficial; hurtful, instead of helpful. Over-work
in the shop or factory, overtraining in the gymnasium or on the
athletic field, both fall first and heaviest upon the heart.

Importance of Food, Air, and Exercise. At the same time, the system
must be kept well supplied through the stomach with the raw material
both for doing this work and for building up this new muscle. When
anyone, in training for an event, gets "stale," or overtrained, and
loses his appetite and his sleep, he had better stop at once, for that
is a sign that he is using more energy than his food is able to give him
through his stomach; and the stomach has consequently "gone on a
strike."

How to Avoid Heart Overstrain and Heart Disease. The way, then, to
avoid overstrain and diseases of the heart and blood vessels is:--

First, to take plenty of exercise, but to keep that exercise within
reasonable limits, which, in childhood, ought to be determined by a
school physician, and in workshops and factories by a state factory
physician.

Second, to take that exercise chiefly in the open air, and as much of it
as possible in the form of play, so that you can stop whenever you begin
to feel tired or your heart throbs too hard--in other words, whenever
nature warns you that you are approaching the danger line.

Third, to keep yourself well supplied with plenty of nutritious,
wholesome, digestible food, so as to give yourself, not merely power to
do the work, but something besides to grow on.

Fourth, to avoid poisonous and hurtful things like the toxins of
infectious diseases; and alcohol, tobacco, and other narcotics, which
have a harmful effect upon the muscles, valves, or nerves of your heart,
or the walls of your blood vessels.

Fortunately, the heart is so wonderfully tough and elastic, and can
repair itself so rapidly, that it usually takes at least two, and
sometimes three, causes acting together, to produce serious disease or
damage. For instance, while muscular overwork and overstrain alone may
cause serious and even permanent damage to the heart, they most
frequently do so in those who are underfed, or badly housed, or
recovering from the attack of some infectious disease. While the poisons
of rheumatism and alcohol will alone cause serious damage to the valves
of the heart and walls of the blood vessels, yet they again are much
more liable to do so in those who are overworked, or underfed, or
overcrowded.

The Disease of the Stiffening of the Arteries. The points at which our
pipe-line system is most likely to give way are the valves of the heart,
and, more likely still, the muscles of the heart wall and of the walls
of the blood vessels. These little muscles are slowly, but steadily,
changing all through life, becoming stiffer and less elastic, less
alive, in fact, until finally, in old age, they become stiff and rigid,
turning into leathery, fibrous tissue, and may even become so soaked
with lime salts as to become brittle, so that they may burst under some
sudden strain. When this occurs in one of the arteries of the brain, it
causes an attack of _apoplexy_, or a "stroke of paralysis." Overstrain,
or toxins in the blood, may bring about this stiffening of the arteries
too soon, and then, we say that the person is "old before his time." A
man is literally "as old as his arteries."

The causes which will hasten the stiffening of the arteries are, first
of all, prolonged overwork and overstrain,--due especially to long hours
of steady work in unwholesome shops or surroundings; second, the
presence in the blood of the poisons of the more chronic infectious
diseases, like tuberculosis; third, the waste products that are formed
in our own body, and are not properly got rid of through lungs, skin,
and kidneys; and fourth, the use of alcohol, tobacco, and other
narcotics.

The Bad Effects of Alcohol. Alcohol is particularly likely to damage
the walls of the blood vessels and the heart, first, because it is a
direct poison to their cells, when taken in excess, and often in what
may appear to be moderate amounts, if long continued; secondly, because
it is frequently taken, especially by the poorer, underfed class of
workers, as a substitute for food, causing them literally to "spend
their money for that which is not bread," and to leave their tissues
half-starved; and thirdly, because, by its narcotic effects, it
decreases respiration and clogs the kidneys and the skin, thus
preventing the waste products from leaving the body.

How the Heart Valves may be Injured. The valves of the heart are
likely to give way, partly because they are under such constant strain,
snapping backward and forward day and night; and partly, because, in
order to be thin enough and strong enough for this kind of work, they
have become turned, almost entirely, into stringy, half-dead, fibrous
tissue, which has neither the vitality nor the resisting power of the
live body-stuffs like muscles, gland-cells, and nerves. They are so
tough, however, that they seldom give way under ordinary wear and tear,
as the leather of a pump valve, or of your shoes, might; but the thing
which damages them, nine times out of ten, is the germs or poisons of
some infectious disease.

These poisons circulating through the blood, sometimes set up a severe
inflammation in the valves and the lining of the heart. Ulcers, or
little wart-like growths, form on the valves; and these may either eat
away and destroy entirely parts of the valves or, when they heal, leave
scars which shorten and twist the valves out of shape, so that they can
no longer close the openings. When this has happened, the heart is in
the condition of a pump which will not hold water, because the leather
valve in its bucket is broken or warped; and we say that the patient
has _valvular_ or _organic_ heart disease.

The disease which most frequently causes this serious defect is
rheumatism, or rheumatic fever; but it may also occur after pneumonia,
typhoid, blood poisoning, or even after a common cold, or an attack of
the grip. This is one of several reasons why we should endeavor, in
every way, to avoid and stop the spread of these infectious diseases;
not only are they dangerous in themselves, but although only two of
them, rheumatism and pneumonia, frequently attack the heart, all of them
do so occasionally, and together they cause nearly nine-tenths of all
cases of organic heart disease.

Should you be unfortunate enough to catch one of these diseases, the
best preventive against its attacking the heart, or causing serious
damage, if it does, is a very simple one--rest in bed until the fever is
all gone and your doctor says it is perfectly safe for you to get up;
and avoid any severe muscular strain for several months afterward.

This is a most important thing to remember _after all infections and
fevers_, no matter how mild. Even where the heart valves have been
seriously attacked, as in rheumatism, they will often recover almost
completely if you keep at rest, and your heart is not overtaxed by the
strain of heavy, muscular work, before it has entirely recovered. Ten
days' "taking it easy" after a severe cold, or a bad sore throat, may
save you a serious strain upon the heart, from which you might be months
or even years in recovering.

But even where serious damage has been done to the heart, so that one of
its valves leaks badly, nature is not at the end of her resources. She
simply sets to work to build up and strengthen and thicken the heart
muscle until it is strong enough to overcome the defect and pump blood
enough to keep the body properly supplied--just as, if you are working
with a leaky pump, you will have to pump harder and faster in order to
keep a good stream of water flowing. It is astonishing how completely
she will make good the loss of even a considerable part of a valve.

Doctors no longer forbid patients with heart disease to take exercise,
but set them at carefully planned exercise in the open air, particularly
walking and hill-climbing; at the same time feeding them well, so as to
assist nature in building up and strengthening the heart muscle until it
can overcome the defect. In this way, they may live, with reasonable
care, ten, fifteen, or twenty years--often, in fact, until they die of
something else.

Don't worry about your heart if it should happen to palpitate, or take a
"hop-skip-and-jump" occasionally. You will never get real heart disease
until you have had some fever or serious illness, which leaves you short
of breath for a long time afterward.

Danger to the Heart through the Nervous System. The other chief way in
which the heart may be affected is through the nervous system. Being the
great supply pump for the entire body, it is, of course, connected most
thoroughly and elaborately by nerve wires with the brain and, through
it, with every other organ in the body. So delicately is it geared,--set
on such a hair-trigger, as it were,--that it not only beats faster when
work is done anywhere in the body, but begins to hurry in anticipation
of work to be done anywhere. You all know how your heart throbs and
beats like a hammer and goes pit-a-pat when you are just expecting to do
something important,--for instance, to speak a piece or strike a fast
ball,--or even when you are greatly excited watching somebody else do
something, as in the finish of a close race.

Two-thirds of the starts and jumps and throbbings that the heart makes,
are due to excitement, or nervous overstrain, or the fact that your
dinner is not digesting properly; and they don't indicate anything
serious at all, but are simply useful danger signals to you that
something is not just right.

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