Page:Popular Science Monthly Volume 10.djvu/211

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following are examples: Varicose ulcers from dress; skin-diseases from want of cleanliness; chest-diseases and fevers from defective ventilation. The vast number of ulcerated legs treated in the outpatient department of hospitals, in workhouse infirmaries, and in private practice, arise from varicose veins. Now, a varicose ulcer is caused by a distended condition of the veins of the leg, which have to sustain the pressure of the blood caused by gravitation. In varicose veins, the valves which help to support the column of blood are to a great extent destroyed, through the veins having been distended by mechanical obstruction to the free return of the blood from the extremities, thereby distending the lower 'veins and separating the edges of the valves. Thus, the weight of an uninterrupted column has to be borne by the veins. This, of course, causes further distention, giving rise to congestion of the capillaries of the skin, and causing swelling, eczema, and ultimately ulceration. This is the varicose ulcer so common in the laboring-classes. It is always difficult to heal, and often impossible, except by prolonged rest in bed. Hence it is the dread of the surgeon, and the cause of misery to thousands. Varicose ulcers are seldom admitted into general hospitals, so that hundreds of poor families are driven to the workhouse, and such cases form a majority in the workhouse infirmary. The most frequent and flagrant cause of obstruction is the ordinary elastic garter. Children should never wear them at all, as the stockings can be perfectly well kept up by attachment of elastic straps to the waistband. If garters are worn, it is important to know how to apply them with the least risk of harm; at the bend of the knee the superficial veins of the leg unite, and go deeply into the under part of the thigh beneath the ham-string tendons. Thus a ligature below the knee obstructs all the superficial veins, but if the constriction is above, the ham-string tendons keep the pressure off the veins which return the blood from the legs; unfortunately, most people, in ignorance of the above facts, apply the garter below the knee. Again, in nine out of ten laboring-men, we find a piece of cord or a buckled strap tightly applied below the knee, for what reason I could never learn. Elastic bands are the most injurious. They follow the movements of the muscles, and never relax their pressure on the veins. Non-elastic bands during muscular exertion become considerably relaxed at intervals, and allow a freer circulation of the blood.

2. The habit of tight lacing again predisposes to varicose veins, in consequence of the abdominal viscera being pushed downward into the pelvis, causing undue pressure on the veins of the lower extremities when they enter the pelvis. Physicians also have reported numerous cases of heart and lung disease caused by this pernicious habit.

3. The use of dress is often misunderstood. Most persons evidently study and practise it with regard to appearance, or only to keep out wet and cold. The hygienic use of clothes, however, is not so much