Bauhaus-Universität Weimar

Titel:
The Cyclopaedia of Anatomy and Physiology, vol. 4: Pla [corr.: Ple] - Wri
Person:
Todd, Robert Bentley
PURL:
https://digitalesammlungen.uni-weimar.de/viewer/image/lit29465/1048/
1038 
THORAX. 
large liver, are in activity and pushing up the 
diaphragm. The superior opening or true apex 
is greater from before backwards than trans¬ 
versely, which is the very contrary to the 
adult conformation. The inferior or true 
base of the thorax is extremely wide in every 
direction, from the encroachment of the ab¬ 
dominal viscera. At birth the thorax sud¬ 
denly enlarges, by the air expanding the lungs 
to two or three times their previous cubic 
dimensions. As age increases, the curvatures 
of the ribs increase, and, with the vertebrae, 
running up through the very centre of the tho¬ 
rax, form the two great lateral grooves, peculiar 
to man, for lodging the chief bulk of the lungs. 
The depth of the thorax is diminished, while 
its breadth is increased, and this participates 
in that more perfect development of the 
system at the age of puberty. It is at this 
time that malformation of the chest fre¬ 
quently becomes obvious, particularly in 
females. In the adult age the thorax still 
grows, but in a degree less apparent, until it 
assumes the form of what is termed an 
open chest, capable of expanding in any di¬ 
rection, supplying us with air under violent 
exercise, and resisting severe blows. As agq 
advances, through the decline of life, the 
thorax has a tendency to collapse ; the bony 
framework threatens to unite into one rigid 
cage, the true apex droops forward, the shoul¬ 
ders appear higher, and the round back of old 
age becomes apparent, so that we may make a 
tolerable guess at the age of an individual by 
the conformation of the back. The erect 
thorax is absolutely necessary to healthy 
vigour, while the drooping-forward chest is 
always accompanied with proportionate feeble¬ 
ness. 
Sex. — The chief difference of external 
conformation between the sexes is due to the 
largeness of the mammae, and the less width 
across the shoulders in women than in men. 
There is no distinguishing the sexes by the 
internal form of the thorax, they so perfectly 
resemble each other. The chest of the 
female is only absolutely smaller, but not al¬ 
ways that, certainly not relatively so, The 
nipples are not uniformly in the same posi¬ 
tion ; those of the female are generally closer 
together than those of the male. 
Conformation of the thorax affected by 
disease and occupation. — The conformation 
of the thorax chiefly depends upon the healthy 
condition of the main pillar of support, the 
spine ; but not always so, for that deformity 
called “ chicken breast ” appears to be inde¬ 
pendent of the condition of the spine. And, 
again, emphysema of the lungs tends to pro¬ 
trude the ribs and advance the sternum. 
Disease, as caries of the vertebrae, or an 
atonic condition of the thoracic muscles, owing 
to which the spinal column may yield, either 
laterally, producing “ lateral curvature,” or an¬ 
teriorly, giving “ angular curvature,” produces 
the most marked distortion of this pillar of 
support, and consequently of the whole thorax. 
In youth, particularly in females, (from the pre¬ 
sent system of education,) the spinal column, 
which is at all times sufficiently flexible, bendà 
under the weight of the head and arms ; and 
for want of proper exercise the muscles of the 
back become enfeebled, and unable to restore it 
to the erect position. When “ rickets” attack 
the spine, it may curve in any direction, com¬ 
pressing the ribs and projecting the sternum. 
It is surprising to witness to what an extent 
of deformity the thorax may attain, and yet 
life still remain (see fig. 666., where costal 
respiration could not exist ; and where all 
the abdominal viscera must have been 
forced up into the cavity of the thorax, 
for the 10th rib is nearly touching the 
crista of the ilium). We have noticed a case 
where such was the effort of nature to pre¬ 
serve the thoracic and spinal cavities, that life 
was maintained in a boy 14 years of age, 
though 7 bodies of dorsal vertebræ were com¬ 
pletely absorbed. 
In emphysema of the lungs, the sternum is 
protruded, and the antero-posterior diameter 
of the thorax is increased sometimes by an 
inch, the shoulders are raised, and the person 
assumes always the form of a man who has 
made the deepest inspiration. 
In phthisis pulmonalis, the thorax changes 
its form, which is manifested by the shoulders 
inclining forwards, the anterior and superior 
parts bending in the same direction ; the 
otherwise round full apex becomes flattened, 
collapsing upon itself ; and there is an in¬ 
capacity to extend the apex ; this is a sure 
and delicate test of that disease threatening, 
before any symptoms can be detected by au¬ 
scultation. In other stages there is a loss of 
symmetry in the sides. In pleuritic effusion or 
in empyema, one side may be full and immov¬ 
able, whilst the other has to perform the 
respiratory functions. In fact, disease of 
the respiratory organs may produce a change 
in the form of the thorax, either downwards, 
upwards, or outwards, or by collapse of the 
apex. 
Frequently repeated or permanent compres¬ 
sion, may produce many varieties of conforma¬ 
tion of the thorax. Cruveilhier observes that 
infants, in whom the thorax was perfectly well 
formed at birth, have become deformed and 
flattened on the sides of the thorax, by pres¬ 
sure from the hands of the nurse. Slight ex¬ 
ternal pressure in early life may be productive 
of permanent deformity of the thorax, The 
effect of strong and permanent constriction, as 
from tight stays, occasions a distortion in 
the form of the chest. This kind of com¬ 
pression principally affects the lower part of 
the thorax ; so that the 5th, 6th, 7th, 8th, 9th, 
and 10th ribs are pressed forwards and in¬ 
wards, because the length of their cartilages 
allow them to yield readily : and the viscera 
corresponding to these ribs, also undergo 
alteration in their position and figure, en¬ 
croaching upon the thoracic cavity, com¬ 
pressing the lungs upwards, into the apices of 
the chest. The imprudent custom of females 
wearing a hard unyielding piece of wood, steel, 
or whalebone up the front of their corset, 
commonly produces a compression inwards of
        

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