the contact of its extended surface with the conditions existing around us we come into most intimate rapport with air, light, heat, and electricity. It is continuously conveying to the brain the information of well- or ill- being. Dr. Maudsley does not state the case too strongly when he says, in speaking of certain insane hallucinations, "Were a sane person to wake up some morning with the cutaneous sensibility gone, or with a large area of it sending up to the brain perverted and quite unaccountable impressions, it might be a hard matter, perhaps, for him to help going mad."

So intimate, in fact, is the relation of different parts of the body presided over and governed by the nervous system, that many physiologists, notably the eminent Dr. Carpenter, have insisted that concentration of thought upon a portion of the body determines action there. What kind of action,voluntary? Certainly not, for voluntary action, being voluntary, depends upon the will's directly setting up the action. The action set up in the brain and transmitted thence to the point upon which the mind is concentrated, affects the circulation and the involuntary muscles at that point. There is much evidence that this is the fact, but any one can see the probability of the truth of the theory by reflecting that, as periph eral disturbance, even if it proceed no farther than itching, is transmitted to the brain, translated there as to its nature into psychical terms, similar means of communication are also open for producing effect in the opposite direction, even if it does not reach the degree sufficient to make it rise into consciousness. Where there are afferent (conveying) nerves to bring information into consciousness, there are also efferent (returning) nerves to transmit a message in the reverse direction.

The celebrated Laura Bridgman, blind, deaf, and dumb, lay like a wreck on the shores of time until communication was established with her through the sense of touch. How limited

her range of thought must have been when shut out from the world through the non-existence of two avenues of sense, and before she had slowly learned the language of the touch! There is an aphorism that, "nihil in intellectu quod not erat priusquam in sensu,”—that is, the intellect can conceive nothing which has not reached it through the portals of sense. This is not strictly true, as the case of Laura Bridgman, if there were no other, would show, for she was found, when communication was established with her, to be possessed of thought and of high intelligence, and, of course, these did not come into being at a bound. What, however, is true, is that without the channels of communication with the outside world, called the senses, certain orders of conception are impossible, because they necessitate previous perceptions. Beethoven composed music after he had become deaf, but if he had from birth been deaf he would not have been able to compose after losing his hearing, because he could not have learned the relations to each other of musical sounds. Their mathematical relations within themselves are fundamental laws of their being which can convey no impression of their sensory effects. So far as conceptions derivable from sensory data other than feeling were concerned, Laura Bridgman was dead, and so remained. By communication with her own and other minds, she eventually lived in all matters in which the pure intellect is concerned. The instrument of thought was there from the first, in the brain; thought itself within certain limits was there, much potential, not actual, much for all time impossible. Had the sense of touch, as well as the other senses, been absent, she could have barely been said to exist. That sense not having been denied her, she awaked to knowledge with the thrill of life under the patient teaching that she received.

To this added illustration of the range of capacity in the skin, we add that the day is past for physicians to regard it,

even in disease, as though it were an independent organ. Nothing in the body is independent. It is now well known that the skin, as well as all other parts of the body, depends for its integrity upon the general nervous system. The skin is pervaded, except at the horny layer, by an infinite number of nerves in direct communication with the central nervous system of the body. Disturbance anywhere in the body acts upon the skin, and, conversely, any disturbance in the skin acts upon the central nervous system. A simple case of indigestion often manifests itself over considerable areas of it. A person badly scalded or burned frequently dies on account of the whole nervous system sympathizing through the inflammation of the skin; dies thus of shock. Lesser agencies produce lesser effects; but remember this, that the skin is always being acted upon by the general health of the system, and that the general health of the system is always being acted upon by the skin. If a prize-fighter is to be fitted for his task, he is fitted for it largely through processes which involve the healthy action of the skin. If a horse is to race, similarly he is put in the best condition largely through the treatment of his skin. Equally is it true, whether the case be man, woman, or child, that bodily health and vigor are inseparable from a healthy condition of the skin.

To enable the reader to realize the facts mentioned, it will be well now to set forth some of the work which the skin performs in the animal economy, by specifying what the organ effects in eliminating from the system injurious products, and in imbibing the life-giving principle of oxygen.

The skin has been shown to be an organ of sensation, and to some degree one of protection, the horny layer of the scarf-skin not only shielding the sensitive papillæ, but preventing too rapid escape of heat and moisture from the tissues. It is also an organ of secretion, excretion, and absorption. It forms various prod ucts, and expels them with those formed in deeper-lying tissues.

It takes up, to some extent, matter in solution. Far more important, however, than that particular kind of absorption is its capacity of respiration, of imbibing oxygen, and liberating carbonic acid. It is true that its liberation of carbonic acid amounts in the adult, on the average, to only 10 grammes in the course of twenty-four hours, but the amount is extremely variable, depending upon how well certain internal organs of the body are performing their task of eliminating effete matter, and upon temperature, exercise, and other conditions. It is, however, a function of the skin which can be stimulated to increased activity by diaphoresis, or artificially induced profuse sweating, and thus the skin may be called upon in emergency for relieving stress in internal organs caused by disease.

If, however, it is true that the amount of oxygen imbibed by the skin and the amount of carbonic acid liberated by it are both small, this cannot be said of the skin's power of excretion of matter in the watery solution of the perspiration. The skin is continuously engaged in expelling, in connection with sensible and insensible perspiration, salts, acids, including urea (and sometimes offensively as to that), sugar, proteids, bile, pigment, and sometimes broken-down blood-corpuscles. The amount of solid matter in solution thus expelled by the skin actually exceeds that expelled by the lungs, in the proportion of eleven to seven parts. The lungs are more effective than it in ridding the body of the noxious gas called carbonic acid, for they liberate daily in the adult several hundred grammes of it, in return for about the same amount of oxygen, while, as we have said, the skin liberates in the same time only about 10 grammes of carbonicacid gas. But it is to be observed that, when it comes to matter in watery and oily solution and suspension, the skin's capacity for eliminating it from the system exceeds that of the lungs in the proportion already mentioned, of eleven to seven parts.

As of intimately associated interest, it is well here to

amplify slightly the statement as to the work which the lungs perform in absorbing oxygen and liberating carbonic-acid gas. Carbonic-acid gas is composed of two equivalents of oxygen and one equivalent of carbon. Ordinary air is composed of a mere trace of carbonic-acid gas, with its main constituents, oxygen and nitrogen. The adult body absorbs oxygen in respiration by the lungs to the extent of a little over 5 per cent. of the sum-total volume of air inhaled, and returns, in the form of carbonic-acid gas, with traces of other gases, a little less than 5 per cent. of the sum-total volume of air exhaled. The poisonous products of the body in the form of carbonic-acid gas are therefore liberated, and the life-giving oxygen is absorbed, the oxygen which has disappeared having gone toward nourishing the blood and tissues of the body.

It will readily be perceived from what has been said that, simply from unhygienic habits, the skin may, even in health, become the vehicle for offensive matter. In the early part of the century some printed advice to school-girls in England appeared from a well-known female authority, aimed at correcting in them the pernicious practice of neglecting the daily prompting of nature to defecation. One of the remarks made was, that any physician could detect in such girls the fact of the neglect, simply from the appearance of the complexion. The lady could have said more, that any one, physician or not, can detect the neglect by the color and odor of the skin. Happily this neglect has, through greater diffusion of hygienic knowledge, been largely abated. It is almost incredible, and yet it is true, that it had arisen and been promoted by the false notion that such offices of nature are unworthy of the attention of the refined. What a commentary on the general intelligence of the period among the sex represented by the better classes! What delicate consequences these, thus invited to place themselves in clearest evidence!