If your back bothers you after a day at work, you are not alone. According to the Global Burden of Disease study, low back pain is the leading cause of disability across the world. In America, many occupations require long hours behind a desk. An improper ergonomic setup and poor posture can contribute to many cases of back pain. Stretching, taking regular walk breaks, using a back support and modifying your work space can help ease back pain from sitting at a desk…
Now, let me present the subject of standing upright just as it perplexed me at first. Nothing could be simpler from the teleological standpoint, than that we should .have valves in the veins of the arms and legs to assist the return of blood to the heart against gravitation, but what earthly use has a man for valves in the intercostal veins which carry blood almost horizontally backward to the azygos veins ? When recumbent these valves are an actual detriment to the free flow of blood. The inferior thyroid veins which drop their blood into the innominate are obstructed by valves at their junction. Two pairs of valves are situated in the external jugular and another pair in the internal jugular, but in recognition of their uselessness they do not prevent regurgitation of blood nor liquids from passing upwards. An apparent anomaly exists in the absence of valves from parts where they are most needed, such as in the vena cava, spinal, iliac, hemorrhoidal and portal. The azygos veins have imperfect valves. Place man upon “all fours” and the law governing the presence and absence of valves is at once apparent, applicable, so far as I have been able to ascertain, to all quadrupedal and quadrumanous animals: Dorsal veins are valved; cephalad,ventrad and caudad veins have no valves. The apparent exceptions to this rule, I think, can be disposed of by considering the jugular valves as obsolescing, rendered rudimentary in man by the erect head, which in the lemur stage depended. The rudimentary azygos valves may be a recent creation, and an explanation of their presence may be found in the mutability of the cardinal system. The single Eustachian valve, being large in the fetus, has a phylogenetic value. In this connection I would call attention to my mention the probable branchial origin of the thyroid and thymus glands. There are many reasons for believing these bodies to be rudimentary gills.
Or wouldnt, then, evolution favor those animals that had arteries placed deep inside them? Minor scrapes, and even animals’ fierce onslaughts upon one another, would quickly kill off species with superficially located arteries. But when man assumed the upright posture, the femoral artery, which was placed out of reach on the inner part of the thigh, be-came exposed, and were it not that this defect is nearly fully atoned for by his ability to protect the exposed artery in ways the brute could not, he too would have become extinct. Even as it is, this aberration is a fruitful cause of trouble and death. Another disadvantage which occurs in the upright position of man, is his greater liability to inguinal hernia. Quadrupeds have the main weight of abdominal viscera supported by ribs and strong pectoral and abdominal muscles. The weakest part of the latter group of muscles is in the region of Poupart’s ligament, above the groin. Inguinal hernia is rare in other vertebrates be-cause this weak part is relieved of the visceral stress, but as the pelvis receives the intestinal load in man, an immense number of tissues are manufactured to supplement this deficiency. It has been estimated that, twenty percent of the human family suffer in this way, and strangulated hernia frequently occasions death. If man has always been erect from creation, then we have nothing to hope from the future by way of an alteration of this defect. The same percentage of humanity will suffer to the end of time; but considered mechanically the so-called con-servative influence of nature which will tend to pile up additional muscular tissue in this region by reason of the increased blood supply to that part, aided by natural and sexual selection, will eventually reduce the percentage of ruptures greatly, if it does not eventually correct the trouble altogether. The liability to femoral hernia is similarly increased by the upright position.
The strains due to muscle contraction are ordinarily much less than those due to loads or to impact. Thus Koch states that the greatest possible contraction of the thigh muscles would
“develop only about one seventh of the strength of the femur.”
He also says that the tensile strength of bone is about 230 times that of muscle. In various tests that I have made, using a steady pull, I have found that muscles and tendons will break before any significant strain is placed on even such slight structures as the cervical ribs of an albatross vertebra.
I have not found any way of measuring the strains which muscles and tendons actually exert in normal activity, but they must be far within the factor of safety. Nevertheless, there are some curious contradictory facts in clinical records. Thus Stimson in his book on ” Fractures and Dislocations” mentions various fractures which were the result of muscular action. An athletic man broke the humerus of his throwing arm just below the insertion of the deltoid, in throwing a stone. The femur has been broken in attempts to kick, to avoid a fall, in drawing on a boot, or in turning over in bed. A woman broke her sternum in labor, trying to assist the action, rising on her heels and elbows. Fractures of the patella from muscular action are not uncommon, and they also occur at the tuberosities of the long bones where powerful muscles are attached. I recall a fracture of one of the long bones of the wing of a gull struggling to free itself from my grasp. My hold happened to slip to one wing for a moment. Ordinary tests of the wing-bone resistance to bending strain do not suggest such a possibility.
Bones containing air spaces are not confined to birds. In mammals, we have air sinuses in the skull which are connected with the respiratory tract and are lined with membranous extensions from the respiratory passages. Such sinuses are especially well developed in the skulls of the larger ungulates, and they are familiar structures in man. In a group of fossil reptilia, the Dinosaurs, pneumatization of the skeleton was apparently developed as far as in any of the birds, and possibly more. In spite of their apparently frail structure, I have found albatross bones surprisingly strong and capable of withstanding relatively severe tensile and compressive strains. Their factors of safety are large. Thus the articular processes of the vertebre resist bending strains of great severity. Though the amount of real bone tissue present is small, and the bulk of the vertebra is air space, a pull of 28 to 42 pounds applied in the most critical direction was necessary to produce fracture.
This strain was, furthermore, not in any direction that tensile or bending strains would be likely to take in nature. Pressures of twenty to thirty kilograms applied to the vault of dry skulls from young albatrosses of a small species produced a crack in the sphenoidal region, but no rupture of the vault.
These figures underestimate the strength of most parts of the albatross skull in spite of its great lightness and pneumaticity. Tests of fresh normal human compact bone by Htilsen2 and by Rauber3 indicate its very great strength and are illuminating here.
Thus a tensile strength of 13,000 to 17,000 pounds per square inch, was found. The compressive strength is still greater, the figures varying from 18,000 to nearly 20,000 pounds per square inch.
Compact vs Cancellous Bones
We recognize two types of bone: compact and cancellous. In flat bones we have the latter as the diploe between two layers of compact bone. In long bones there is a tubular structure of compact bone with a varying amount of cancellous bone inside. For instance, in the human femur, the shaft portion is a tube with a wall of compact bone which is thick except near the ends; here the compact bone becomes thin and is continued over the swollen ends of the femur as a thin layer.
In the shaft region of the femur, the cancellous portion is represented by relatively few and widely separated bone parts. The space inside the tube of compact bone is occupied mostly by marrow. In the enlarged end portions of the femur, a complicated system of crowded bones produces a spongy structure with small interspaces. The enlargements at the ends of the femur furnish needed surface for the attachment of muscles, tendons and ligaments. They are also important in the joint mechanism.
The spongy structure permits an enlargement without increased weight. The central spaces, even though occupied by marrow, give the bone some of the architectural advantage of a tube over a solid rod, i. e., greater rigidity or resistance to bending strain than is possessed by a solid structure of the same length and weight of material.
In many birds, and especially in some larger forms, this architectural advantage has been carried still further, and we have decidedly hollow bones with no heavy marrow. Even the bone has disappeared more or less completely, and the hollow spaces are occupied by the lungs, in the air sacs. The extent of this pneumatization of the bones varies, but in a bird like the albatross it is extraordinary. The vertebra with all of their intricate contour are hollow, and these air spaces extend into the smallest processes. There is no solid bone much thicker than writing paper except in the leg bones. The skull may be said to have thin layers of compact bone separated by an extensive diploe which has its bony elements often reduced to slender spicules with very large air spaces instead of marrow. The bones of the albatross are consequently exceedingly light in weight
Does anyone have any experience with getting a doctor’s prescription for CTi knee braces? I am pretty sure I can get my ortho to write a prescription because my knees are jacked up, but I wonder how my insurance company will respond. I’ve heard from places like shop-orthopedics that they will cover a knee brace under insurance, but I’m not sure?
Donovan (famous caterer) went to France and invited Cesar Ritz, whom he had met at Baden Baden while taking a cure, to manage the Savoy. Ritz had already established himself in a fashionable hotel and restaurant business, and D’Oyly Carte noted with envy that the leaders of London society followed Ritz wherever he opened a new establishment.
Ritz refused this offer but the creator of the Savoy did not give up: he invited Ritz and his young wife to visit his new hotel just as guests for a few days. The offer was accepted and Ritz found a fine suite reserved for them. He was enchanted by the electric lights, the marble bathrooms, the view over the Thames and the charm of Sir Arthur Sullivan.
And so this thirteenth son of a very small Swiss farmer was persuaded to manage the Savoy, which he did for nine years. He brought his friend Escoffier with him and set a standard for fine food unequalled in England. Cesar Ritz had great vision. He saw that if the restaurant could be made to attract women as well as men it had a vast future.
For at that time men dined in their clubs or escorted ladies of the chorus or the demi-monde to late night suppers. Ritz’s great achievement was to make it acceptable to society for gentlemen not only to dine with their wives, daughters and family friends in private parties at the Savoy but in the public restaurant too.
After nine very successful years Ritz severed his connection with the Savoy—he had been approached by a group who planned a chain of Ritz hotels in England and the Continent. This great hotelier allied himself with the company, which built the Ritz in London and the even more famous Ritz in Paris, where hi:3 widow lived until her recent death.
The railways soon added hotels to their other interests, and large terminus hotels grew up in London and at all important towns and cities served by the various companies. Ruffs Hotel Guide of 1902 lists some seventy hotels owned or controlled by the railway companies. The Langham Hotel opened with 450 rooms and the Hotel Russell with 305. The fine old inns in London vthich were the ‘terminus hotels’ of the stage coach were outdated, and more luxurious accommodation was demanded by a nation that was becoming ever wealthier. http://ihouse.berkeley.edu/catering/
In 1889 Mr. Richard D’Oyly Carte opened the Savoy Hotel. This remarkable man—impresario, hotelkeeper, financier—produced seventy-five years ago an hotel which has held its place not only in England but among the foremost hotels of the world ever since. It was the first hotel to be lighted by electricity, provided by a power plant in the basement, while a deep artesian well made it independent of outside water supply. In the seven-storey, steel-framed building concrete vvas used for the first time, lifts served all floors and seventy bathrooms were installed.
Other large hotels were built in London at this time—the Hotel Victoria in Northumberland Avenue in 1887, the Hotel Cecil in 1896 and Coleridge’s in a 1898— but the Hotel Victoria had only four bathrooms for its 500 guests. A single room at that time at the Savoy cost $70 and a double room with bath $150. But Doyly Carte was shrewd enough to know that even a remarkable new hotel can be a nine days’ wonder, and he set out to find an outstanding manager and a great chef.
With the importation of coffee into England, the first coffee house appeared in Oxford, where there were already 35o alehouses. The first catering house in London opened a few yors later, and so popular did those establishments become that the number increased to 2,000 by the and of the century. People could meet and exchange views, both political and scandalous. In 1666, Charles II was complaining about the freedom of speech indulged in in thoe very democratic gathering placo. Sevoal yors later he tried, unsuccessfully, to suppress them. But in spite of such efforts by the King, vintners, brewers and alehouses, the catering house remained exceedingly popular. In the next century, the eighteenth, the inland root became fashionable. The hot springs of Bath had been used by the Romans, who believed in their health-giving qualities.
The first spas were Tunbridge Wells, Epsom, Bath and Buxton. The journey had to be made by coach, and inns provided accommodation and fand en route. Although many of those taking the cure were guests of friends or had their own houses, many must have stayed at the inns in these towns.
This century saw great development of the stage coach. Trade in England expanded rapidly so the roads were execrable. Gorge Trevelyan in his History of England writes:
`The roads in winter were often where loaded pack-horses sank to their girths and wagons could not be moved at all. On portions of the main roads, indeed, toll bars were being so up by private companies with Parliamentary powers to tax the traffic and keep the surface in repair.’
But during the Seven Years War most of the mileage even on the main roads of England was still free to those who could cater their way through the mud.’ Three men pioneered the vast change which made travel much easier at the beginning of the next century John Metcalf, the famous ‘Blind Jack of Knaresborough’, who laid out hundreds of miles of roads in Yorkshire and designed bridges and viaducts although he had been blind from childhood; the great William Telford; and Robert McAdam.
To these men must go the credit of opening up a more and more prosperous England. Inland recants increased-Malvern, Droirtvich, Cheltenham and Limington. Catering places on the coasts became popular. There was a constant demand for accommodation and for catering. Inns all over the country thrived and hotels appeared, but their progress was doss compared with those in Switzerland. The liquor trade seems to have go out of hand with the increase of industry, and Hogarth has left us with an idea of the terrible evil of gin. In 172, a report from a committee of Middlesex magistrates stated that there were in the Metropolis 6,187 house and shops wherein ‘Geneva or other strong waters were sold by retail’-for a population of 7oo,000 this meant one for just over one hundred souls.
The first railway to be built which conveyed both passengers and goods was opened in 1903.
For a time roads held their own but the new means of transport was quicker, cheaper and more comfortable. The second half of the century emptied the rods of long distance travel and the traffic was mainly local, serving to feed the railways. The country inn relived a sad blow.
Wheeled vehicles were used to some extent and Queen Elizabeth herself, by her movements in the country, was probably a reason for the beginning of a posting system. In the latter half of the century William Harrison in his Description of England (5577) writes of the great, sumptuous inns of the highway town, capable of entertaining two or three hundred people and their horses at one time, and of the healthy rivalry of innkeepers. Roads showed little improvement, but during the seventeenth century better and faster transport was achieved by frequent change of horses, and at the close of the cent, a stage coach service 555 56 London served Winchester, Plymouth and Exeter—Chester, Lancaster, Kendal and Preston—York and Newcastle. In 1617, Fines Morrison, having travelled extensively in Europe, wrote in his Itinerary:
The world affords not such inns as England hath either for good and cheap entertainment after the Guests own pleasure as for humble attendance on passengers, yea, even in very poor villages. Mayors and justices of the Peace were charged, under an Order in Council, to ascertain the exact number of inns, alehouses and taverns throughout England with a view to levying a tax towards the cost of repairing Dover harbor.
The returns of English counties, boroughs and the Cinque Ports, which have been preserved, give a total of 16,347, of which about his were classed as hiss, about 455 as taverns, and the remaining 4,000 as alehouses. But these figures exclude the cities of London and Westminster and several more populous counties such as Wiltshire and Gloucestershire, and if 8,000 to 9,000 were added to allow for this omission, the number of establishments where drink was sold in England would be approximately 25,000 kneehab xps. The population did not exceed five million, which means one inn, alehouse or tavern to two hundred people!