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effort or “ catching the breath " is caused, and if the face at the instant is covered with water, strangulation from drawing water into the lungs is the result. When waves are dashing in his face, the person must guard himself against this spasmodic inspiration by holding his breath at such times, or he may even grasp his nose and close his mouth with one hand and thus prevent the possibility of strangulation, if such effort can be made without sinking the body too low in the water.

CHEST DEVELOPMENT IN YOUNG PERSONS.

BY J. J. BERRY, M. D.,
MEMBER OF THE STATE BOARD OF HEALTH,

PORTSMOUTH, N. H.

In the perfection of modern educational methods, the physical needs of the individual have been almost entirely ignored. Facilities for the acquirement of strength and endurance have been, to a great degree, wanting. Teachers have, as a rule, possessed no knowledge of the laws of physical growth and development, and consequently the student who desired to perfect himself physically was obliged either to exercise according to his best judgment, which is bad, or to put himself under the care of incompetent instructors, which is even worse. The past few years have, it is true, given us gymnasia and various apparatus for physical development, but have they been properly used ? Evidently not. In the report of the Commissioner of Education for 1889, that official regrets his inability to report a general adoption of physical training in the public schools and says that “though thousands of dollars have been invested in apparatus to be used in the development of the mind, no provision worthy of serious consideration has as yet been made for strengthening the body, upon whose sound condition effective mental effort greatly depends."

It is not my intention to advance, in the present paper, the claims of physical education, or to illustrate the definite and remarkable results of judicious and persistent exercise. I prefer rather to bring to the attention of parents, teachers, and others but one phase of the question, which seems to me to outrank all others in its importance to the present, as well as to future generations. The child who first enters the school-room is deficient physically as well as mentally. The body is undeveloped and often unsymmetrical. There is most likely imperfect lung expansion from the very first, and, in default of any rational treatment for it, the condition becomes more and more exaggerated until finally it is past all hope of remedy. The student may have attained a high degree of scholarship, but he has acquired at the same time a physical conformation unfit for endurance and incapable of resisting disease. Consumption destroys fully one seventh of our population, and it is during school life that the foundations of the disease are too often laid. It is pre-eminently a disease of imperfect nutrition. It attacks the crippled and poorly developed lung just as certainly as it shuns the one which is fully expanded and in constant and active service. Numerous observations have established the existence of a constant ratio between consumption and deficient lung expansion. In those cases where the degree of development fell below a certain figure, chronic disease was extremely prevalent, while in the others it was of extremely rare occurrence. In view of these and other facts, it is extremely doubtful whether consumption can co-exist with complete lung expansion.

The effects of this form of physical culture have been so well summarized by a recent writer that a few extracts from his article are here quoted. He states: “While it is true that many undeveloped persons enjoy fair organic health, greater respiratory and muscular power would unquestionably make such lives more effective and longer. A roomy thorax and strong heart are no mean allies in resisting the assaults of disease. A few extra cubic inches of respiratory capacity, or a small reserve of disciplined cardiac power may suffice to determine a favorable issue in pneumonia, pleurisy or typhoid. Every inch which a man adds to his chest measure adds to the measure of his days. Physical development can, perhaps, be excessive, yet resulting injury is limited and personal, whereas neglect of bodily improvement sins against posterity." There is a great lack of information among people generally regarding the beneficial results of such training and the amount of development which may be attained. For the information of such it may be stated that nowhere are these effects more definite and invariable. They are as capable of demonstration as any mathematical problem, and no one need fail to secure results proportionate to the amount of labor expended. Abundant confirmatory evidence may be found in almost any work on this subject.

By one hour's daily exercise for eight months, twelve men from nineteen to twenty-eight years of age were found by Maclaren to have gained an average of two and seven eighths inches in chest expansion, while the greatest gain in a single individual was five inches. In four and a half months, twenty-one students of Woolwich Academy, averaging eighteen years of age, gained on an average two and five tenths inches in chest measurement, while the largest gain was five and a quarter inches. At the end of one year's steady practice, two persons, aged sixteen and twenty years, were found to have gained in chest growth five and six inches respectively. The reports from Amherst College, as reported by Dr. Hitchcock, show that the students, at the end of their four years' course, by a half hour's light exercise four times a week, gained one and twenty-one hundredths inches in chest expansion, while those of Bowdoin College, by the same expenditure of time in heavier exercises, gained in six months one and seventy-five hundredths inches. These figures not only serve to illustrate the constant and progressive growth that occurs, but they also indicate that decided improvement may be counted upon even in those who have attained or passed the age of maturity.

In order to more fully appreciate and utilize the various methods for promoting chest development, it is necessary to consider briefly some points in the anatomy and physiology of the lungs. These may be described as collections of air cells, inclosed within elastic walls composed of bones and muscles and bounded below by a strong muscular partition which forms the floor of this cavity and which is known as the diaphragm. Their function is respiration, a process by which oxygen is introduced into the body and effete material removed from the same. The respiratory act is composed of two movements, inspiration and expiration. During the first the chest is enlarged in all its diameters — vertically, by the contraction and descent of the diaphragm, and transversely and laterally by the rotation of the ribs upon their axes and the action of the various muscles attached to the chest walls. During expiration, the reverse occurs. The diameters of the cavities are shortened by the ascent of the diaphragm, the depression of the ribs, and the recoil of the elastic tissue of the lungs. When it is performed forcibly, several of the chest and abdominal muscles share in the act. Inspiration is an active process and most of the force exerted is for the purpose of overcoming the resistance offered by the elastic tissues of the lungs and of the cavity containing them. Hence the necessity for muscular development in these parts. In the physiology of respiration we find many important and suggestive facts which have a direct bearing on the subject in hand.

The capacity of the lungs is about two hundred thirty cubic inches. Of this amount of air, about one hundred cubic inches remains constantly within them and cannot be expelled. It is renewed very slowly under the laws governing the diffusion of gases. About one hundred more cubic inches is more rapidly changed, as it can be taken in and expelled by means of forced breathing. During ordinary inspiration, however, only about twenty or twenty-five cubic inches is inhaled and only about one tenth of the whole amount is renewed. It has been shown, and this can be understood from the facts above quoted, that the capacity of these organs is nearly a third greater than is really necessary to support life, the surplus being held in reserve for emergencies which may arise. Hence it follows that if two thirds or three fourths of the lungs perform the work of the whole, there are portions which remain inactive. And such is really the case. The apices and small sections of the circumference and bases are, in many persons and by ordinary methods of breathing, very little used, and it is a most suggestive fact that these are the very portions of the lungs which are first seized upon by consumption. Mays has recently offered valuable negative proof of the above by showing that women who lace excessively and are thus obliged to practice clavicular breathing, are remarkably free from disease of the upper thirds of the lungs.

To fully develop the chest and put into active service each individual air-cell, is therefore the object of the gymnastic exercises here described. The proper performance of the respiratory

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