Robert L. Dickinson

“ Tight lacing may act on the liver in three ways—according to the situation, the tightness, and the duration of the constricting cause.
"a. The liver may be displaced upward or downward according as the pressure is applied below or above. The precise situation where the pressure is applied will vary with the prevailing fashion of dress; but most commonly in this country the displacement is downward, and this may be to such an extent that the lower margin reaches the ilium, and the liver appears to fill up the whole of the right side and front of the abdomen." ”

“ In a man of five feet one inch the vital capacity averages 175 cubic inches, and it varies eight cubic inches for each inch in height. I have not been able to find the average height of woman, or any statements relating to her vital capacity as compared with man's. From occasional measurements in gymnasiums, however I know that it is less than man's in proportion to her height.
Effects of the Pressure on the Abdomen,—The abdominal cavity has far greater pressure and much more marked alteration in shape to stiffer than the thoracic. ”

“ They lack precision, but are necessary. We can not determine any limit of contraction in inches as the dividing line, since in cases cited farther on 11⁄2 inch lessening of waist measure with one woman will cause more pressure and more distress than 5 inches in another. The guide must be the patient's sensations-when we can trust her testimony—and signs that are readily appreciated, such as the restricted respiration and movement, evident discomfort when the corset is first hooked, flushing of the face in a warm room, and the indentations in the skin after removal of the corset. ”

“ The thoracic organs may readily accommodate themselves to a pressure that simply squeezes out some residual air, the abdominal viscera must be displaced. Accommodation can only be favored by expulsion of blood from the cavity and reabsorption of the gases distending the intestine. Let us first consider the cavity of the chest. ”

“ Relaxation and habit seem to affect these factors largely. The capacity for expansion of the chest was found to be restricted one fifth when the corset was on. The thoracic character of the breathing in women is largely due to corset-wearing. The thoracic cavity is less affected by the corset than the abdominal. The abdominal wall is thinned and weakened by the pressure of stays. The liver suffers more direct pressure and is more frequently displaced than any other organ. The pelvic floor is bulbed downward by tight lacing one third of an inch (0.9 cm.) ”

“ Tracings from their costal and abdominal respiratory movements showed a very close analogy to those of the civilized male, and that, "so far as the Indian is concerned the abdominal is the original type of respiration in both male and female, and that the costal type in the civilized female is developed through the constricting influence of dress around the abdomen. ”

“ That the compression acts on muscle as well as fat is clear when we call to mind the contrast between the hard abdominal parietes of the average man and the lax belly of most women. How could the gynæcologist make his bimanual were it otherwise? Engel reports cases in which the peristaltic movements could be watched through walls thinned from tight lacing. Of course disuse and the less need of constantly balancing the body has much to do with the atrophy of the abdominal muscles of the female. ”

“ The form of the chest and the respiratory movements do not differ perceptibly in girls and boys below the age of ten. Although the form of the chest remains nearly the same until the age of twelve, the abdominal movement is then somewhat less and the thoracic somewhat greater in girls than boys. At this age and earlier stays are Worn and though they do not compress the body materially, yet they restrain the free expansion of the lower ribs during free exercise. After the age of fourteen the form of the chest and the respiratory movements differ materially in females and males. ”

“ So that we find that (1) where the solid organs are, the greatest pressure comes; (2) where the hollow viscera lie, little pressure comes; (3) on organs that are comparatively fixed in their places, much stress is brought to bear; and (4) on organs freely movable, like the intestines, less direct displacing force is exerted.
Effect of Pressure on the Abdominal Wall.—Long-continued compression of the wall of the abdomen in the epigastric and hypochondriac regions gradually brings about a thinning of its adipose layer.* Below the ring of constriction the fat accumulates. ”

“ If we were forced," he says, "to the admission that the activity of infra-clavicular respiration-movement in the female is in the main designed by nature"—
for which no cause can be detected—" and independent of extraneous influence, still I can not help thinking that the great excess of that movement and the limitation of thoracic play to the upper thorax in the civilized adult female are due in no small part to the unyielding cases interfering with inferior costal and phrenic action. The agricultural woman, who knows not stays, breathes more like a man than the town female. ”

“ The corset reverses this. The constriction binds closest the broadest part; the viscera are displaced downward; the lower umbilical region swells out; the greatest area must grow small, and the smallest enlarge.
The point of greatest pressure, we have seen, was over the cartilages. On both sides the liver will be pressed upon, and this at a point where it is covered by lung only during deep inspiration (Fig. 12) . The lateral pressure will crowd liver and spleen toward the median line. ”

“ It will be seen that without the corset the breasts project beyond the abdomen, just as in a finely developed man the pectorals first touch a perpendicular; whereas, when the corset has raised the "bust" and crowded the abdomen down and out, the supra-pubic wall becomes the most prominent and projecting part of the profile. ”

“ All these are women who work, and, consequently, should have a more vigorous muscular system and better expansion than wealthier corset wearers, although Dr. Hall states that these servants lace tighter and are less healthy in appearance than the young ladies of the institution in which the observations were made. Among women who lead less active lives, while wearing closer-fitting street- and evening- dresses, it might be expected that the interference with expansion would be greater and of more serious import. ”

“ Flabby, old, or obese persons are especially prone to pile up panniculus adiposus below the navel. I have examined many stout young men in good condition, and have yet to find one in whom this tendency is evident. On the contrary, the fatty layer above the umbilicus is usually thicker than that below it. These men wear suspenders. In eleven healthy women below thirty who have been in the habit of wearing corsets (of varying degrees of tightness) the fat below the navel has always been found to be more than twice as thick as that above, while one to three is no uncommon ratio. ”

“ Above the furrow, in the upper division of the right lobe, which is often much thinned from pressure, one sometimes encounters two deep indentations which run from behind obliquely or directly forward. ”

“ In the discussion following the reading of this paper instances were cited to show that a habit of wearing about the waist a very tight cord or belt by men will cause like furrows, and that such fissures may result in more or less complete detachment of portions of the organ. ”

“ Besides, during sleep the conditions of pectoral and ventral action of the female are much less strikingly different from those in the male than in the waking state; the waist is relieved for a time from constriction. And, further, the male and female dog breathe almost exactly alike, as do the horse and mare ”

“ The man and woman were each twenty-one years of age. The woman, Braun says, was well developed and finely formed, and her abdominal wall had never been stretched by a pregnant uterus, as one would suppose at first glance. Above the pubes the wall is four times as thick as it is higher up. ”

“ One other change may be noted in some frozen sections, and is occasionally observed in examination of the chest— namely, a more marked inward curve in the lower part of the sternum than is usually found in men, whereby the antero-posterior diameter of the lower part of the chest is somewhat diminished. ”

“ It can be studied only in the horizontal position, either by tracings taken from the thin lead strip passed along the groove from symphysis to sacrum and accurately molded, or by measurement of the projection of the floor by the instrument of Dr. ”