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 ANATOMY
PHYSIOLOGY
The Unity of Form and Function
Ninth Edition

KENNETH S. SALADIN
Distinguished Professor of Biology, Emeritus
Georgia College

Digital Authors
CHRISTINA A. GAN
Highline College

HEATHER N. CUSHMAN
Tacoma Community College

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 THE EVOLUTION OF A
STORYTELLER

Ken Saladin’s first step into authoring was a 318-page paper on the ecology
of hydras written for his tenth-grade biology class. With his “first book,”
featuring 53 original India ink drawings and photomicrographs, a true story-
teller was born.

When I first became a textbook writer, I found myself bringing the same
enjoyment of writing and illustrating to this book that I first discovered
when I was 15.
 —Ken Saladin

Courtesy of Ken
Saladin

Ken’s “first book,” Hydra One of Ken’s drawings

Ecology, 1965 from Hydra Ecology
Courtesy of Ken Saladin Courtesy of Ken Saladin
Ken in 1964

Ken began working on his first

book for McGraw-Hill in 1993, and in
1997 the first edition of The Unity of
Form and Function was published. In
2020, the story continues with the
ninth edition of Ken’s best-selling
A&P textbook.

The first edition (1997)

The story continues (2020)

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 PREFACE

Anatomy & Physiology: The Unity of Form and Function tells a story comprised of many layers, including core science, clinical applica-
tions, the history of medicine, and the evolution of the human body. Saladin combines this humanistic perspective on anatomy and physi-
ology with vibrant photos and art to convey the beauty and excitement of the subject to beginning students.
To help students manage the tremendous amount of information in this introductory course, the narrative is broken into short seg-
ments, each framed by expected learning outcomes and self-testing review questions. This presentation strategy works as a whole to create
a more efficient and effective way for students to learn A&P.

Writing Style and Level

Saladin’s text is written using plain language for A&P students who may be taking this course early in their curricula. Careful attention
has been given to word selection and paragraph structure to maintain the appropriate writing level for all students.

CHANGES TO THE NINTH EDITION

New Science
This edition draws on recent literature and scientific conferences attended by the author to update many topics, including but not limited
to molecular, vascular, and brain imaging techniques; peroxisome and mitochondrial behavior; the DNA damage response; gene regula-
tion; epigenetics; the tissue interstitium; regenerative medicine; osteoporosis; prosthetic joints; fibromyalgia; sleep physiology; trigeminal
neuralgia; pain physiology; endocrine functions of osseous and adipose tissue; diabetes mellitus; cord blood transplants; thrombopoiesis;
AIDS; prostate diseases; breast cancer; aging; life expectancy; and assisted reproductive technology.
New Deeper Insight sidebar essays have been added on cardiac tamponade; biopsy; stem-cell therapy; regenerative medicine; osteo-
malacia and rickets; vertebral disc herniation; rotator cuff injury; carpal tunnel syndrome; shinsplints; calcaneal tendon rupture; plantar
fasciitis; brain connectomics and diffusion tensor imaging; lumbar puncture; stroke; blindness; alcoholic ascites; diverticulosis and diver-
ticulitis; colorectal cancer; and cleft lip and palate.
While new science has been added, keeping up with such growth also means pruning back topics discredited by newer literature. For
this edition, these include adult cerebral neurogenesis; endorphins and runner’s high; human pheromones; pineal tumors and precocial
puberty; prophylactic use of low-dose aspirin; myocardial regeneration; female ejaculation; and the free-radical DNA damage theory of
senescence.
In consideration of user and reviewer suggestions to reduce detail in a few areas, this edition has more concise discussions of some
topics: chromatin coiling; apoptosis; skin grafting; the hair cycle; calcium and phosphate homeostasis; and spinal cord tracts.

New Art and Photography

This edition features new drawings of epidermal histology, flat bone structure, lever mechanics, Parkinson disease, lumbar puncture, hand
innervation, Bell palsy, the vagus nerve, olfactory pathways, erythropoiesis, cardiac innervation, regulation of cardiac output, air embo-
lism, colonic histology, lipoprotein structure, cleft lip and palate, and senescent muscle atrophy.
New photos in this edition include digital subtraction angiography, molecular-scale cryo-EM imaging, diabetic gangrene, embryonic
stem cells, albinism, jaundice, osteocyte SEM, rickets, muscle fiber histochemistry, diffusion tensor imaging of the brain connectome,
shingles, cataracts, glaucoma, forelimb veins used for phlebotomy, kidney stones, gallstones, hepatic cirrhosis, MRI of obesity, and intra-
cytoplasmic sperm injection.

Organizational Changes
For improved readability, narrative descriptions of some systems are moved from tables into chapter text; selected illustrations are moved
outside of the tables; and tables are distilled to more concise summaries. These include the skeletal muscles (chapter 10), spinal nerve
plexuses (chapter 13), cranial nerves (chapter 14), and blood vessels (chapter 20). A detailed list of changes by chapter follows.

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 Detailed List of Changes
Chapter 1, Major Themes of Anatomy and Physiology, now includes digital subtraction angiography among the common clinical imag-
ing techniques.
Atlas A, General Orientation to Human Anatomy, has an added Deeper Insight A.1 on cardiac tamponade in relation to body cavities
and membranes.
Chapter 2, The Chemistry of Life, has added the Nobel-winning new technique of cryo-electron microscopic imaging of biological
structure at the atomic level.
Chapter 3, Cellular Form and Function, has enhanced discussions of limitations on cell size, the origin of peroxisomes, mitochondrial
fusion and fission, and clinical mitochondrial transfer and three-parent babies.
Chapter 4, Genes and Cellular Function, updates protein processing by the Golgi complex, epigenetics, the DNA damage response, and
the role of the nuclear lamina in gene silencing.
Chapter 5, The Human Tissues, has a new perspective on the tissue interstitium, updates on stem-cell therapy and regenerative medicine,
and a new Deeper Insight on biopsy methods.
Chapter 6, The Integumentary System, has a new drawing of epidermal histology, new discussion of the evolutionary genetics of apo-
crine glands, an update on skin-grafting technology, and a simpler description of the hair growth cycle.
Chapter 7, Bone Tissue, gives a less detailed overview of calcium and phosphate homeostasis, adds a Deeper Insight on osteomalacia
and rickets, and updates the pathology and treatment of osteoporosis.
Chapter 8, The Skeletal System, conforms the description of normal and pathological spinal curvatures to orthopedic terminology and
has a new Deeper Insight on herniated discs.
Chapter 9, Joints, improves the discussion of joint biomechanics and updates the discussions of temporomandibular joint dysfunction
and engineering of prosthetic joints.
Chapter 10, The Muscular System, pulls illustrations and narrative descriptions from the muscle tables, converts the narrative to easier-
to-read normal text, and condenses the tables to more concise summaries. It updates inguinal hernias and adds new Deeper Insights on
rotator cuff injury, shinsplints, calcaneal tendon rupture, and plantar fasciitis.
Chapter 11, Muscular Tissue, adds a photo of the histochemistry of fast glycolytic and slow oxidative muscle fiber types and updates
the discussion of fibromyalgia.
Chapter 12, Nervous Tissue, includes updates on astrocyte functions, beta-endorphin and enkephalin, mutations affecting neurotransmit-
ter reuptake and neurological disorders, and the implication of lipofuscin in some diseases. It introduces the frontier neuroscience of brain
connectomics and the use of diffusion tensor imaging to visualize the connectome. There is now an illustration of the midbrain histological
change and body posture characteristic of Parkinson disease.
Chapter 13, The Spinal Cord, Spinal Nerves, and Somatic Reflexes, adds a new Deeper Insight and illustration of lumbar puncture,
reduces detail on spinal cord tracts, reformats the tables of spinal nerve plexuses, illustrates regional innervation of the hand by the major
forearm nerves, and adds a photo of a shingles lesion.
Chapter 14, The Brain and Cranial Nerves, now adopts the concept of brainstem as excluding the diencephalon. It adds Deeper Insights
on stroke and diffusion tensor imaging, and updates the Deeper Insight on trigeminal neuralgia and Bell palsy, adding an illustration of
the latter. It updates sleep physiology and the functions of the midbrain colliculi and pretectal nuclei. It corrects a common misconception
about the subdural space. The discussion and table of cranial nerves are reorganized.
Chapter 16, Sense Organs, has an updated discussion of pain physiology and includes phantom limb pain. It updates the genetics and
functions of some taste sensations and flawed assumptions about human olfactory sensitivity. It deletes discredited or dubious views of
endorphins and runner’s high and human pheromones. It enhances the figure of olfactory projection pathways; adds the dorsal and ventral
streams of visual processing pathways; adds photos of cataracts and glaucoma; adds macular degeneration and diabetic retinopathy to the
Deeper Insight on blindness; and has better insights into the functions of the cornea, choroid, and vitreous body.
Chapter 17, The Endocrine System, updates the histology and cytology of the thyroid gland and pancreatic islets and the effects of mela-
tonin; adds new information on hormones of osseous and adipose origin; updates the enteroendocrine system; and adds effects of
lipocalin 2 on insulin action. It deletes the now-questionable idea about pineal tumors and precocial puberty. It updates the pathologies
of Addison disease and myxedema, and the genetic, immunological, and treatment aspects of diabetes mellitus.

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 Chapter 18, The Circulatory System: Blood, now explains how blood is fractionated to obtain plasma and then serum, and the uses of
blood serum. It has an enhanced explanation of the functional significance of the discoidal shape of erythrocytes, and includes cell pro-
liferation in the illustration of erythropoiesis. It reports updated clinical research on the number of known blood groups and RBC antigens,
cord blood transplants, other methods of bone marrow replacement, and pharmaceutical anticoagulants. It adds the surprising new discov-
ery of abundant platelet production by megakaryocytes in the lungs and megakaryocyte migration between the lungs and bone marrow.
Chapter 19, The Circulatory System: Heart, is reorganized at section 19.1 to place figures closer to their references. Cardiac innervation
is moved to section 19.6 on regulation of cardiac output, with a new illustration. The electrocardiogram is described with more detailed
attention to interpretation of each wave, segment, and interval, with an added table. The section on cardiac arrhythmias includes a fuller
explanation of atrial fibrillation.
Chapter 20, The Circulatory System: Blood Vessels and Circulation, has improved discussions of the vasa vasorum and metarterioles;
describes the measurement of blood pressure in more depth; adds photos of edema, circulatory shock, and upper limb veins most often
used for phlebotomy; and has a new drawing of air embolism. It discusses the difficulty of pancreatic surgery in light of the complex, deli-
cate branches of the celiac trunk. The Deeper Insight on ascites is rewritten to relate it to alcoholism. The tables of blood vessels and
routes of flow are now converted to normal, easier-to-read text.
Chapter 21, The Lymphatic and Immune Systems, updates bone marrow histology; the sources of macrophages; T cell diversity;
asthma and AIDS mortality; and the obstacles to treating AIDS in pandemic countries. It adds the risk in splenectomy and the role of ATP
and ADP as inflammatory chemoattractants.
Chapter 22, The Respiratory System, enhances descriptions of the nasal epithelium; the cricothyroid ligament in relation to emergency
tracheotomy; the Deeper Insight on tracheotomy; cor pulmonale; and squamous cell carcinoma. It adds a mutational cause of Ondine’s
curse; discovery of pulmonary platelet production; and the potential of electronic cigarettes and legalization of recreational marijuana as
emerging risk factors for lung cancer.
Chapter 23, The Urinary System, adds to the function of glomerular mesangial cells and has an improved Deeper Insight on kidney
stones, with a new photo.
Chapter 24, Fluid, Electrolyte, and Acid–Base Balance, has further information on sodium and the effects of hypernatremia, and has
added a new table summarizing the major electrolyte imbalances.
Chapter 25, The Digestive System, includes additions on the immune role of the omenta; dental proprioception; aspirin and peptic ulcer;
the cell-signaling function of the intestinal mucous coat; anatomical variability of the colon and a new drawing of its histology; an updated
Deeper Insight on gallstones, with a photo; a new Deeper Insight on diverticulosis and diverticulitis; a new Deeper Insight on colorectal
cancer; and an improved description of intestinal lymphatic nodules.
Chapter 26, Nutrition and Metabolism, includes new MRI images of a morbidly obese individual compared to one of normal BMI; a
new drawing of lipoprotein structure and chart of composition of the lipoprotein classes; new information on the effects of leptin on sym-
pathetic nerve fibers and lipolysis; and a new photo of hepatic cirrhosis.
Chapter 27, The Male Reproductive System, has a new table and discussion of the composition of semen and function of the bulboure-
thral preejaculatory fluid, and updates on benign prostatic hyperplasia and prostate cancer. It adds discussion of zinc deficiency as a cause
of infertility, hypothalamic maturation and GnRH in relation to the onset of puberty, and andropause in relation to declining androgen
secretion.
Chapter 28, The Female Reproductive System, has improvements in hymen anatomy and the figure of ovarian structure; a new perspec-
tive on morning sickness as a possible factor mitigating birth defects; and updates on contraception and on breast cancer genes, risk fac-
tors, and mortality.
Chapter 29, Human Development and Aging, adds the role of the sperm centrosome in fertilization; chromosomal defects as a leading
cause of first-trimester miscarriages; and the formation of monozygotic twins. It adds a new Deeper Insight and illustration of cleft lip
and palate. It updates the telomere theory of senescence but deletes the now-doubtful theory of DNA damage by endogenous free radicals.
It adds a new, MRI-based drawing of muscle atrophy in old age and a discussion of pineal gland senescence as a factor in the insomnia
experienced by some older people. It updates statistics on human life expectancy and the major causes of death. The final Deeper Insight
is retitled Assisted Reproductive Technology and has a new photo of intracytoplasmic sperm injection.
Appendix D, The Genetic Code and Amino Acids, now adds a table of the 20 amino acids and their symbols, and the structural formulae
of the amino acids.

xi

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 ACKNOWLEDGMENTS Valerie Kramer, Marketing Manager;
Donna Nemmers, Senior Product Devel-
Kyle P. Harris
Temple University
Peer review is a critical part of the scientific oper; Vicki Krug, Senior Content Project Karen L. Kandl
process, and very important to ensure the Manager; Lori Hancock, Lead Content Western Carolina University
content in this book continues to meet the Licensing Specialist; Brent dela Cruz, Stephen A. Kash
needs of the instructors and students who Senior Content Project Manager; Egzon Oklahoma City Community College
use it. We are grateful for the people who Shaqiri, Designer; and Jeanne Patterson, Stephanie Matlock
agree to participate in this process and thank freelance copy editor. Their efforts have Colorado Mesa University
them for their time, talents, and feedback. yielded another great edition of the text Deborah T. Palatinus
The reviewers of this text (listed here) have and its companion media suite of Connect Roane State Community College
contributed significant comments that help products. Jeffrey Alan Pence
us refine and update the print and digital Excelsior College
components of this program.
Timothy A. Ballard Carla Perry
Christina Gan and Heather Cushman University of North Carolina—Wilmington Community College of Philadelphia
have updated the question bank and test
Barry N. Bates Franz Sainvil
bank to closely correlate with the intricate
Atlanta Technical College Broward College–Central Campus
changes made in this ninth edition and
Christopher I. Brandon Jr. Brian Stout
have greatly increased the educational
Georgia Gwinnett College Northwest Vista College
value of these books through their work to
create self-assessment tools and align Nickolas A. Butkevich Andrew Van Nguyen
Schoolcraft College The City University of New York–
McGraw-Hill’s Connect resources with
the textbook. This has contributed signifi- John W. Campbell Queensborough Community College
cantly to student and instructor satisfac- Oklahoma City Community College Kimberly Vietti
tion with our overall package of learning Jennifer Cochran Biederman Illinois Central College
media and to the students’ success as they Winona State University Beth L. Williams
master A&P en route to their career Mary B. Colon Wallace State Community College
aspirations. Seminole State College of Florida Delon Washo-Krupps
I would also like to extend apprecia- Abdeslem El Idrissi Arizona State University
tion to members of the Life Sciences Book College of Staten Island, City University Samia Williams
Team at McGraw-Hill Education who have of New York Santa Fe College
worked with me on this project, including Bagie George
Matthew Garcia, Senior Portfolio Manager; Georgia Gwinnett College

xii

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 THE STORY OF
FORM AND FUNCTION

INNOVATIVE CHAPTER SEQUENCING

Some chapters and topics are presented in a sequence that is more instructive than the conventional order.

Early Presentation of Heredity Urinary System Presented Close to Circulatory

Fundamental principles of heredity are presented in the
last few pages of chapter 4 rather than at the back of
the book to better integrate molecular and Mendelian
genetics. This organization also prepares students
to learn about such genetic traits and conditions as
cystic fibrosis, color blindness, blood types, hemophilia,
cancer genes, and sickle-cell disease by first teaching
them about dominant and recessive alleles, genotype
and phenotype, and sex linkage.
and Respiratory Systems
Most textbooks place this system near the end of the book because of
its anatomical and developmental relationships with the reproductive
system. However, its physiological ties to the circulatory and respiratory
systems are much more important. Except for a necessary digression
on lymphatics and immunity, the circulatory system is followed almost
immediately with the respiratory and urinary systems, which regulate
blood composition and whose functional mechanisms rely on recently
covered principles of blood flow and capillary exchange.

BRIEF CONTENTS

About the Authors iv

Muscle Anatomy and
Physiology Follow Skeleton
and Joints
The functional morphology of
the skeleton, joints, and muscles
is treated in three consecutive
chapters, 8 through 10, so
when students learn muscle
attachments, these come only
two chapters after the names of
the relevant bone features. When
they learn muscle actions, it is in
the first chapter after learning the
PART ONE
ORGANIZATION OF THE BODY 1
1 Major Themes of Anatomy and
Physiology 1
ATLAS A General Orientation to Human
Anatomy 27
2 The Chemistry of Life 40
3 Cellular Form and Function 74
4 Genes and Cellular Function 109
5 The Human Tissues 137
PART TWO
SUPPORT AND MOVEMENT 174
6 The Integumentary System 174
7 Bone Tissue 198
8 The Skeletal System 223
9 Joints 267
10 The Muscular System 299
ATLAS B Regional and Surface
Anatomy 362
11 Muscular Tissue 384
PART FOUR
CIRCULATION AND DEFENSE 655
18 The Circulatory System: Blood 655
19 The Circulatory System: Heart 689
20 The Circulatory System: Blood Vessels and
Circulation 724
21 The Lymphatic and Immune Systems 782
PART FIVE
INTAKE AND OUTPUT 825
22 The Respiratory System 825
23 The Urinary System 866
24 Fluid, Electrolyte, and Acid–Base
Balance 901
25 The Digestive System 925
26 Nutrition and Metabolism 974
PART SIX
REPRODUCTION AND THE LIFE CYCLE 1007
27 The Male Reproductive System 1007
28 The Female Reproductive System 1037
29 Human Development and Aging 1075

terms for the joint movements. APPENDIX A: Answer Keys A-1

PART THREE APPENDIX B: Symbols, Weights, and Measures A-14
This order brings another INTERNAL COORDINATION AND CONTROL 420 APPENDIX C: Periodic Table of the Elements A-16
advantage: The physiology of 12 Nervous Tissue 420 APPENDIX D: The Genetic Code and Amino Acids A-17

13 The Spinal Cord, Spinal Nerves, and APPENDIX E: Medical Word Roots and Affixes A-19
muscle and nerve cells is treated Somatic Reflexes 459
in two consecutive chapters (11 14 The Brain and Cranial Nerves 492
Glossary G-1
Index I-1
and 12), which are thus closely 15 The Autonomic Nervous System and
Visceral Reflexes 542
integrated in their treatment of 16 Sense Organs 563
synapses, neurotransmitters, and 17 The Endocrine System 612

membrane electrophysiology. iii

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 THE STORY OF
FORM AND FUNCTION
LEARNING TOOLS
Engaging Chapter Layouts
∙∙ Chapters are structured around the way students learn.

CHAPTER
∙∙ Frequent subheadings and expected learning outcomes help
students plan their study time and review strategies.

BONE TISSUE
Deeper Insights highlight areas of interest
and career relevance for students.

Chapter Outlines provide quick previews

of the content.
A bone cell (osteocyte) surrounded by calcified bone matrix
Eye of Science/Science Source

CHA P T ER O U T L IN E 7.4 Physiology of Osseous Tissue D E E P E R I NS I G H TS

7.4a Mineral Deposition and Resorption
7.1 Tissues and Organs of the Skeletal 7.1 Medical History: Bone Contamination
7.4b Calcium Homeostasis
CHAPTER 3 Cellular Form and Function 75 System 7.2 Clinical Application: Achondroplastic
7.4c Phosphate Homeostasis
7.1a Functions of the Skeleton 7.4d Other Factors Affecting Bone Dwarfism
7.1b Bones and Osseous Tissue 7.3 Clinical Application: Rickets and
Schwann and other biologists originally believed that cells 7.5 Bone Disorders
BRUSHING UP 7.1c General Features of Bones Osteomalacia
came from nonliving body fluid that somehow congealed and 7.5a Fractures and Their Repair
acquired a membrane and nucleus. This idea of spontaneous 7.2 Histology of Osseous Tissue 7.4 Clinical Application: Osteoporosis
● The transport of matter through cell membranes follows the 7.5b Other Bone Disorders
principles of flow down gradients (see section 1.6e). generation—that living things arise from nonliving matter—was 7.2a Bone Cells
Connective Issues
7.2b The Matrix
● To adequately understand the structure of the cell surface, it rooted in the scientific thought of the times. For centuries, it Study Guide
7.2c Compact Bone
is essential that you understand glycolipids and glycoproteins, seemed to be simple common sense that decaying meat turned 7.2d Spongy Bone
as well as phospholipids and their amphipathic nature (see into maggots, stored grain into rodents, and mud into frogs. 7.2e Bone Marrow
sections 2.4c and 2.4d). Schwann and his contemporaries merely extended this idea to
7.3 Bone Development
● The proteins of cell membranes have a great variety of cells. The idea of spontaneous generation wasn’t discredited until
7.3a Intramembranous Ossification
functions. To understand those depends on an acquaintance some classic experiments by French microbiologist Louis Pasteur
7.3b Endochondral Ossification
with the functions of proteins in general and how protein in 1859. 7.3c Bone Growth and Remodeling
function depends on tertiary structure (see “Protein Structure” By the end of the nineteenth century, it was established be-
and “Protein Functions” in section 2.4e). yond all reasonable doubt that cells arise only from other cells and Module 5: Skeletal System
every living organism is composed of cells and cell products. The
cell came to be regarded, and still is, as the simplest structural and 198
functional unit of life. There are no smaller subdivisions of a cell

A ll organisms, from the simplest to the most complex, are

composed of cells—whether the single cell of a bacterium
or the trillions of cells that constitute the human body. These
cells are responsible for all structural and functional properties
of a living organism. A knowledge of cells is therefore indispens-
able to any true understanding of the workings of the human
body, the mechanisms of disease, and the rationale of therapy.
Thus, this chapter and the next one introduce the basic cell biol-
or organism that, in themselves, have all or most of the fundamen-
tal characteristics of life described in section 1.6a. Enzymes and
organelles, for example, are not alive, although the life of a cell
depends on their activity.
The development of biochemistry from the late nineteenth to
the twentieth century made it further apparent that all physiologi-
cal processes of the body are based on cellular activity and that
the cells of all species exhibit remarkable biochemical unity. The

Tiered Assessments Based on

ogy of the human body, and subsequent chapters expand upon various generalizations of these last two paragraphs now constitute
this information as we examine the specialized cellular structure the modern cell theory.
and function of specific organs.

3 .1 Concepts of Cellular Structure

Expected Learning Outcomes
When you have completed this section, you should be able to
a. discuss the development and modern tenets of the cell
theory;
b. describe cell shapes from their descriptive terms;
c. state the size range of human cells and discuss factors
that limit their size;
d. discuss the way that developments in microscopy have
changed our view of cell structure; and
e. outline the major components of a cell.
3.1a Development of the Cell Theory
Cytology,1 the scientific study of cells, was born in 1663 when
Robert Hooke observed the empty cell walls of cork and coined
the word cellulae (“little cells”) to describe them (see section 1.2).
Soon he studied thin slices of fresh wood and saw living cells
“filled with juices”—a fluid later named cytoplasm. Two centuries
later, Theodor Schwann studied a wide range of animal tissues and
concluded that all animals are made of cells.
3.1b Cell Shapes and Sizes
We will shortly examine the structure of a generic cell, but the
Key Learning Outcomes
generalizations we draw shouldn’t blind you to the diversity of
cellular form and function in humans. There are about 200 kinds
of cells in the human body, with a variety of shapes, sizes, and
∙∙ Chapters are divided into brief sections,
functions.
Descriptions of organ and tissue structure often refer to the
enabling students to set specific goals for
shapes of cells by the following terms (fig. 3.1):
• Squamous2 (SKWAY-mus)—a thin, flat, scaly shape, often
short study periods.
with a bulge where the nucleus is, much like the shape of a
fried egg “sunny side up.” Squamous cells line the esopha-
∙∙ Section-ending questions allow students to
•
gus and form the surface layer (epidermis) of the skin.
Cuboidal3 (cue-BOY-dul)—squarish-looking in frontal
check their understanding before moving on.
sections and about equal in height and width; liver cells are
a good example.
• Columnar—distinctly taller than wide, such as the inner
lining cells of the stomach and intestines.
• Polygonal4—having irregularly angular shapes with four, Each chapter begins with Brushing Up to
five, or more sides.
• Stellate5—having multiple pointed processes projecting
emphasize the interrelatedness of concepts, which
from the body of a cell, giving it a somewhat starlike shape.
The cell bodies of many nerve cells are stellate. is especially useful for adult students returning to
2
the classroom, and serves as an aid for instructors
squam = scale; ous = characterized by

1
3
cub = cube; oidal = like, resembling
4
poly = many; gon = angles
5
when teaching chapters out of order.
cyto = cell; logy = study of stell = star; ate = resembling, characterized by

Each major section begins with Expected Learning Outcomes to help

focus the reader’s attention on the larger concepts and make the
course outcome-driven. This also assists instructors in structuring their
courses around expected learning outcomes.

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 CHAPTER 9 Joints 271

Questions in figure legends and Apply What You
Know items prompt students to think more deeply
separation between the bones and length of the fibers give these
joints more mobility than a suture or gomphosis has. An especially
mobile syndesmosis exists between the shafts of the radius and
ulna, which are joined by a broad fibrous interosseous membrane.
This permits such movements as pronation and supination of the
forearm. A less mobile syndesmosis is the one that binds the distal
ends of the tibia and fibula together, side by side (see fig. 9.2c).
9.1c Cartilaginous Joints
(fig. 9.4a). (The other costal cartilages are joined to the sternum by
synovial joints.)
Symphyses
In a symphysis9 (SIM-fih-sis), two bones are joined by fibrocarti-
lage (fig. 9.4b, c). One example is the pubic symphysis, in which
the right and left pubic bones are joined anteriorly by the carti-
laginous interpubic disc. Another is the joint between the bodies
of two vertebrae, united by an intervertebral disc. The surface of

about the implications and applications of what they
have learned. This helps students practice higher
order thinking skills throughout the chapter.
A cartilaginous joint is also called an amphiarthrosis7 (AM-fee-
ar-THRO-sis). In these joints, two bones are linked by cartilage
(fig. 9.4). The two types of cartilaginous joints are synchondroses
and symphyses.
Synchondroses
A synchondrosis8 (SIN-con-DRO-sis) is a joint in which the
bones are bound by hyaline cartilage. An example is the temporary
joint between the epiphysis and diaphysis of a long bone in a child,
formed by the cartilage of the epiphysial plate. Another is the at-
tachment of the first rib to the sternum by a hyaline costal cartilage
each vertebral body is covered with hyaline cartilage. Between the
vertebrae, this cartilage becomes infiltrated with collagen bundles
to form fibrocartilage. Each intervertebral disc permits only slight
movement between adjacent vertebrae, but the collective effect of
all 23 discs gives the spine considerable flexibility.
▶ ▶ ▶ A PPLY W HAT YO U K NOW
The intervertebral joints are symphyses only in the cervi-
cal through the lumbar region. How would you classify
the intervertebral joints of the sacrum and coccyx in a
middle-aged adult?

7
amphi = on all sides; arthr = joined; osis = condition
8 9
syn = together; chondr = cartilage; osis = condition sym = together; physis = growth

Clavicle Sternum

Rib 1
Intervertebral
Costal disc (fibrocartilage)
cartilage

296 PART TWO Support and Movement

ST U DY
(a) G U I DE
▶ Assess Your Learning Outcomes
(c) extension, hyperexten- Body of vertebra
To test your knowledge, discuss the following 3. Three essential components of a lever 12. The same for flexion,
FIGURE
topics 9.4partner
with a study or in writing,Joints.
Cartilaginous ideally 4. The meaning of mechanical advantage (MA); sion, and lateral flexion of the spine, and
from(a)
memory.
A synchondrosis, represented by how the MA of a lever can be determined right and left rotation of the trunk
from measurements of its effort and resis- 13. The same for elevation, depression, protrac-
9.1 the costal
Joints andcartilage joining rib 1 to the
Their Classification tance arms; and the respective advantages of tion, retraction, and lateral and medial excur-
sternum. (b) The pubic symphysis.
1. The fundamental definition of joint (articu- levers in which the MA is greater than or less sion of the mandible
(c) Intervertebral discs, which join
lation) and why it cannot be defined as a than 1.0 14. The same for dorsiflexion, plantar flexion,
adjacent vertebrae to each other by
point at which one bone moves relative to an 5. Comparison of first-, second-, and third-class inversion, eversion, pronation, and supina-
symphyses. Interpubic disc
adjacent bone levers, and anatomical examples of each tion of the foot
2. ? What is the
Relationships and difference
differences betweenbetween the 6. Variables that determine a joint’s range of (fibrocartilage)
9.3 Anatomy of Selected CHAPTER 9 Joints
Diarthroses 297
the pubic
sciences symphysis
of arthrology, and the
kinesiology, and motion (ROM), and the clinical relevance
Pubic symphysis
interpubic disc?
biomechanics of ROM (b) 1. Features of the jaw (temporomandibular)
3. The typical system for naming most joints 7. Axes of rotation and degrees of freedom in joint including the mandibular condyle,

ST U DY
after the bones they involve; examples of joint movement, and how this relates to the mandibular fossa, synovial cavity, articular
296 PART thisTWO Support and Movement
4. Basic criteria for classifying joints G U I DE classification of joints as monaxial, biaxial,
or multiaxial
disc, and principal ligaments
2. Features of the shoulder (glenohumeral)
5. Characteristics and examples of bony joints 8. Six kinds of synovial joints; how each is joint including the humeral head, glenoid
(synostoses) classified as monaxial, biaxial, or multiaxial; cavity and labrum, five major ligaments
ST U DY 4. Whichofoffibrous
6. Characteristics the following joints cannot be
joints (synar- imperfectionsd. always
in this produces
classification;an MA andless than 1.0. and four 12.bursae,
A fluid-filled
and tendons sac that eases
of the the movement
biceps
The end-of-chapter Study Guide offers several methods throses) and G U I DE
circumducted?
each of their subclasses, with
examples a. carpometacarpal
examples of e. each
9. The concept of
is applied
move
type inonthe
zeroaposition
one
resistance
bodyside of the fulcrum to brachii andoffour
andonhowtheitother side. 3. Features of the elbow;
a tendon
rotatorover
.
cuffa muscles
bone is called a/an
the three joints that

for assessment that are useful to both students and

b. metacarpophalangeal
7. Characteristics of cartilaginous joints (am- relates 8.
to the description of joint function
Which of the following joints has anterior occur 13. here;Athe olecranon bursa and
joint allows onefour
bone to swivel on
phiarthroses)c. glenohumeral
and each of their subclasses, 10. Examples and of each of thecruciate
following limb major ligaments
posterior ligaments? another.
▶ Assess Your Learning Outcomes
with examplesd. coxal movements, a. including
the shoulder an ability to 4. Features of the hip (coxal) joint including
instructors. 9.2 Synovial Joints
e. interphalangeal describe orb.demonstrate
the elbow them: flexion,
14. is the science
the femoral head, fovea capitis, acetabulum of movement.
To test your knowledge, 5. discuss the following terms3.denotes
Whichtheoffollowing gen-extension,
Three aessential c.hyperextension,
components hipa lever abduction, 12. The same for
the of and labrum,
flexion,
15. The and fivebetween
extension,
joint principal
hyperexten- ligaments
a tooth and the mandible
1. Thepartner
topics with a study definition
or in
eral and anatomical
writing,
condition ideally
that featuresthe
includes of
4. other four? adduction,
aThe meaning d.hyperabduction,
of mechanical theadvantage
knee hyperadduction,
(MA); sion, and5.lateral
Features ofis the
flexion kneea/an
of the
called (tibiofemoral
spine, and . and
from memory. synovial joint (diarthrosis), examples of this
a. gout how the MAcircumduction,
of a levere.canthe medial
be determined
ankle rotation, and lateralright and left patellofemoral
rotation of thejoints),trunk including the menisci,
type, and why this type is of greatest interest rotation cruciate16.andIn aother ligaments, suture, andthe articulating
four major bones
b. arthritis from measurements of its effort and resis- 13. The same for elevation, depression, protrac-
Assess Your Learning Outcomes provides students 9.1 Joints andfor Their
2. General
1. The fundamental
Classification
kinesiology
c. rheumatism
anatomy
definition ofofjoint
tendons,
d. osteoarthritis (articu-
11. The
tance arms;
ligaments, levers in which flexion,
9.respective
same
and the
the MA
To
for bend
andisradial
greater
backward
supination,
advantages
offlexion
the
atofthe waist
pronation,
thanvertebral
ofless
or
ulnarinvolves
column. sion of the
the forearm
bursae
tion, retraction,
have interlocking
andaround
lateralthe
Features oflike
6. mandible
andpatella
theaankle
medial excur-
dovetail
wavy margins, somewhat
joint in carpentry.
(talocrural) joint,
lation) and bursae, ande. tendon sheaths, aand their contri- than 1.0 and hand, a. androtation
opposition, reposition, abduc- including thekicking
malleoli, calcanealwhattendon,
typeand
a study outline for review, and addresses the needs of point at which
why it cannot
butions to joint
one bone
be defined
rheumatoid
function
moves
as
arthritis
relative to an
6. In the adult, the ischium and pubis
5. Comparisontion, of first-, b. hyperextension
and adduction
second-,
are and anatomicalc.examples
of the
and
dorsiflexion
thumb
third-class
14. The same for dorsiflexion,
17. In
major ligaments
inversion, eversion, pronation,
plantar
does the knee
flexion,
a football,
and supina-
joint exhibit?
of action

adjacent bone levers, of each tion of the foot

instructors whose colleges require outcome-oriented united
sciences of arthrology,a.kinesiology,
by
2. Relationships and differences between the
a synchondrosis.and motion (ROM), and the
d. abduction
6. Variables that determine a joint’s range of
e. clinical
flexionrelevance 9.3 Anatomy of Selected
18. The angle through which a joint can move is
called its
Diarthroses .

▶ Testing Your Recall

b. a diarthrosis. 19.(temporomandibular)
The menisci of theinknee are functionally
syllabi and assessment of student achievement of the biomechanics
3. The typical system forc.naming a synostosis.
d. external
most joints
an amphiarthrosis.
of ROM 10. The rotator cuff includes the 1.
7. Axes of rotation and degrees of freedom
of the following in
muscles
Features
tendons of the jaw
of all Answers
similar tocondyle,
except joint including the mandibular the
Appendix A
of the temporoman-
after the 1.
bones they and
Internal involve; examples
rotationof of the joint movement,
2. Which andof how thissubscapularis.
the the
a. relatesisto
following thetheleast mov- mandibular of dibular
fossa, synovial
3. Which joint.articular
cavity,
the following movements are
expected learning outcomes. this
4. Basic criteriaa. for
e.
classifying
pivot
a symphysis.
humerus is made possible by a
joints
7. In a second-class
classification
joint.
lever, the effortor multiaxial
of jointsb.as the
able?
a. a diarthrosis
monaxial,
c. the infraspinatus.
biaxial,
supraspinatus. disc, and principal
2. Features of a.
unique20. ligaments
to
shoulder
thethe
At
the dorsiflexion
ulate
foot?ankle, both the tibia and fibula artic-
(glenohumeral)
and inversion
with what tarsal bone?
5. Characteristics and examples
b. condylar of bony
a. is applied to joints
the end opposite 8. Sixthekinds ofb.synovial joints;
a synostosis
d. the how
biceps each is
brachii. joint including the humeral
b. elevation andhead, glenoid
depression
(synostoses)c. ball-and-socket fulcrum. classified asc.monaxial, e.biaxial,
a symphysis the teres or multiaxial;
minor. cavity and labrum, five major ligaments
c. circumduction and rotation
6. Characteristics of fibrous
d. saddle b. isjoints
applied(synar-
to the fulcrum itself. imperfectionsd. ina synovial
this classification;
joint and and four bursae, and tendons
d. abduction and of the biceps
adduction
11. The lubricant of a diarthrosis is called
End-of-chapter questions build on all levels of throses) ande.each
examples
of their subclasses, with
hinge c. is applied between the fulcrum and
resistance.
examples of each type in the
e. a condylar joint
.
body
9. The concept of zero position and how it
brachii and four rotator cuff muscles
e. opposition and reposition
3. Features of the elbow; the three joints that
7. Characteristics of cartilaginous joints (am- relates to the description of joint function occur here; the olecranon bursa and four
Bloom’s Taxonomy in sections to phiarthroses) and each of their subclasses,
with examples
10. Examples of each of the following limb
movements, including an ability to
major ligaments
4. Features of the hip (coxal) joint including
▶ Building Your Medical Vocabulary Answers in Appendix A
1. test simple recall and analytical thought; 9.2 Synovial Joints
describe or demonstrate them: flexion,
extension, hyperextension, abduction,
the femoral head, fovea capitis, acetabulum
and labrum, and five principal ligaments
State a meaning
1. The definition and anatomical features of a of each word element, and give 3. -ate
adduction, hyperabduction, hyperadduction, 5. Features of the knee 7. (tibiofemoral
kinesio- and
2. build medical vocabulary; and a medical term
synovial joint (diarthrosis),
type, and why this slight
typevariation
from this
examples chapter thatcircumduction,
of this
of it. interest
is of greatest
uses it or a
rotation
medial rotation, and lateral
4. cruci- patellofemoral joints),8. men- including the menisci,
cruciate and other ligaments, and four major
5. cruro- 9. supin-
3. apply the basic knowledge to new clinical for kinesiology 1. ab-
2. General anatomy of tendons, ligaments,
11. The same for supination,
flexion, and radial 6. flexion
-duc
pronation, ulnar
of the forearm 6.
bursae around the patella
Features of the ankle (talocrural)
10. -trac joint,
bursae, and tendon2.sheaths,
arthro-and their contri- and hand, and opposition, reposition, abduc- including the malleoli, calcaneal tendon, and
problems and other situations. butions to joint function tion, and adduction of the thumb major ligaments

▶ What’s Wrong with These Statements? Answers in Appendix A

▶ Testing Briefly
Yourexplain
Recall 4. Menisci occur in the elbow and knee joints. Answers in Appendix
8. The knuckles A
are amphiarthroses.
What’s Wrong with These Statements? questions
why each of the following state-
ments is false, or reword it to make it true.
5. Reaching behind you to take something out 9. Synovial fluid is secreted by the bursae.
1. Internal and external rotation of the 2. Which of the following is the least mov- 3. Which of the following movements are
1. More people get rheumatoid arthritis than of your hip pocket involves flexion of the
further address Bloom’s Taxonomy by asking humerus is made possible by a
a. pivot
osteoarthritis.
joint. able?
a. a diarthrosis
shoulder.
10. Like most ligaments, the periodontal liga-
unique to the foot?
ments attach one bone (the tooth) to another
a. dorsiflexion and inversion
b. condylar 2. A doctor who treats arthritis is called a
b. a synostosis 6. The cruciate ligaments are in theb.feet. (the mandible or maxilla).
elevation and depression
the student to explain why the false statements c. ball-and-socket kinesiologist.
d. saddle
c. a symphysis c. circumduction and rotation
7. The femur is held tightly in the acetabulum
d. a synovial joint d. abduction and adduction
3. Synovial joints are also known as mainly by the round ligament.
are untrue. e. hinge
298 e. a condylar joint
synarthroses. PART TWO Support and Movement
e. opposition and reposition

STUDY
Testing Your Comprehension questions address GUIDE
Bloom’s Taxonomy in going beyond recall to
▶ Testing Your Comprehension
application of ideas. 1. All second-class levers produce a mechani-
cal advantage greater than 1.0 and all third-
class levers produce a mechanical advantage
less than 1.0. Explain why.
2. For each of the following joint movements,
state what bone the axis of rotation passes
through and which of the three anatomical
planes contains the axis of rotation. You
may find it helpful to produce some of
these actions on an articulated laboratory
skeleton so you can more easily visualize
the axis of rotation. (a) Plantar flexion;
(b) flexion of the hip; (c) adbuction of the
thigh; (d) flexion of the knee; (e) flexion of
the first interphalangeal joint of the index
finger. (Do not bend the fingers of a wired
laboratory skeletal hand, because they can
break off.)
3. In order of occurrence, list the joint actions
(flexion, pronation, etc.) and the joints
where they would occur as you (a) sit
down at a table, (b) reach out and pick
up an apple, (c) take a bite, and (d) chew
it. Assume that you start in anatomical
position.
4. The deltoid muscle inserts on the deltoid
tuberosity of the humerus and abducts the
arm. Imagine a person holding a weight
in the hand and abducting the arm. On a
laboratory skeleton, identify the fulcrum;
measure the effort arm and resistance arm;
determine the mechanical advantage of
this movement; and determine which of
the three lever types the upper limb acts as
when performing this movement.
5. List the six types of synovial joints, and for
each one, if possible, identify a joint in the
upper limb and a joint in the lower limb that
fall into each category. Which of these six
joints has/have no examples in the lower
limb?
xv

sal56006_fm_i-xxii.indd 15 11/26/19 7:08 PM

 THE STORY OF
FORM AND FUNCTION
Medullary cords

ARTWORK THAT INSPIRES Stroma:

Capsule
Medullary sinus

LEARNING
Reticular tissue
Macrophage
Trabecula

Trabecula

The incredible art program in this textbook sets the standard Lymphocytes

in A&P. The stunning portfolio of art and photos was created Cortex: Reticular fibers
Subcapsular sinus
with the aid of art focus groups and with feedback from Lymphatic nodule Artery
and vein
Venule
Germinal center
hundreds of accuracy reviews. Cortical sinuses
(b)

Medulla:
Medullary sinus Efferent
lymphatic Lymphocytes
Medullary cord
vessel

Reticular fibers

Vivid Illustrations Afferent lymphatic

vessels

Rich textures and shading and bold,

bright colors bring structures to life.
(a) (c) 10 μm

Francis Leroy, Biocosmos/Science Source

Frontal sinus
Cribriform plate
Nasal conchae: Auditory tube
Superior
Middle Sites of respiratory control nuclei:
Inferior Pons
Medulla oblongata
Meatuses
Nasopharynx
Hard palate Uvula
Oropharynx
Tongue
Laryngopharynx
Larynx:
Epiglottis
Vestibular fold
Vocal cord

Trachea
Vertebral column
Cadaver dissections are paired with
Esophagus
carefully drawn illustrations to show
(a) intricate human detail.
Rebecca Gray/McGraw-Hill Education

Meatuses:
Frontal Superior
sinus Middle
Nasal conchae: Inferior
Superior Sphenoidal sinus
Middle Posterior nasal
aperture
Inferior Pharyngeal
Vestibule tonsil
Guard hairs Auditory Nasal septum:
tube
Naris (nostril) Perpendicular plate
Hard palate Soft palate
Upper lip Uvula Septal cartilage

Palatine tonsil Vomer

Tongue
Lower lip Lingual tonsil
Pharynx:
Mandible Epiglottis Nasopharynx

Oropharynx

Vestibular fold Laryngopharynx

Vocal cord
Larynx
Trachea
Esophagus
(b) (c)

xvi

sal56006_fm_i-xxii.indd 16 11/26/19 7:08 PM

 Palmaris longus tendon (cut) Flexor digitorum superficialis
tendon
Orientation Tools Flexor carpi radialis tendon Flexor digitorum profundus
tendon
Saladin art integrates Flexor carpi ulnaris tendon
Flexor pollicis longus tendon
tools to help students Ulnar artery
quickly orient themselves Palmar carpal ligament (cut)
Ulnar nerve
within a figure and make
Radial artery
connections between ideas. Flexor retinaculum covering
carpal tunnel
Median nerve
Bursa

Trapezium Superficial palmar

arterial arch

(a) Anterior view

Palmaris longus
tendon Median nerve
Thenar muscles Ulnar artery
Flexor digitorum Flexor retinaculum
superficialis tendons
Carpal tunnel
Trapezium
Flexor digitorum Hypothenar muscles
profundus tendons
Ulnar bursa
Radial artery
Anterior Hamate
Trapezoid
Capitate
Lateral Medial
Scaphoid Extensor tendons

Posterior
(b) Cross section

Process Figures
Conducive to Learning Saladin breaks complicated physiological
∙∙ Easy-to-understand process figures processes into numbered steps for a
∙∙ Tools for students to easily orient themselves manageable introduction to difficult
concepts.

10
1 Blood enters right atrium from superior
and inferior venae cavae.

Aorta 2 Blood in right atrium flows through right

Left pulmonary AV valve into right ventricle.
11 artery
3 Contraction of right ventricle forces
5 5 pulmonary valve open.

9 4 Blood flows through pulmonary valve

Pulmonary trunk
Superior into pulmonary trunk.
vena cava
4 6 Left pulmonary 5 Blood is distributed by right and left
veins
Right 6 pulmonary arteries to the lungs, where it
pulmonary unloads CO2 and loads O2.
veins Left atrium
1
Aortic valve 6 Blood returns from lungs via pulmonary
7 veins to left atrium.
3 Left AV valve
7 Blood in left atrium flows through left AV
Right
8 valve into left ventricle.
atrium
Left ventricle 8 Contraction of left ventricle (simultaneous with
2
Right AV step 3) forces aortic valve open.
valve
9 Blood flows through aortic valve into
Right
ventricle ascending aorta.

Inferior 10 Blood in aorta is distributed to every organ in

vena cava 11 the body, where it unloads O2 and loads CO2.

11 Blood returns to right atrium via venae cavae.

xvii

sal56006_fm_i-xxii.indd 17 11/26/19 7:08 PM

 ®

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 FOR STUDENTS

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 McGraw-Hill Connect® empowers students to learn and succeed in the
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sal56006_fm_i-xxii.indd 20 11/26/19 7:08 PM

 LETTER TO
STUDENTS
W
hen I was a young boy, I became interested in what I
then called “nature study” for two reasons. One was the
sheer beauty of nature. I reveled in children’s books
with abundant, colorful drawings and photographs of animals,
plants, minerals, and gems. It was this esthetic appreciation of
nature that made me want to learn more about it and made me hap-
pily surprised to discover I could make a career of it. At a slightly
later age, another thing that drew me still deeper into biology was
to discover writers who had a way with words—who could capti-
vate my imagination and curiosity with their elegant prose. Once I
was old enough to hold part-time jobs, I began buying zoology and
anatomy books that mesmerized me with their gracefulness of
writing and fascinating art and photography. I wanted to write and
draw like that myself, and I began teaching myself by learning
from “the masters.” I spent many late nights in my room peering
into my microscope and jars of pond water, typing page after page
of manuscript, and trying pen and ink as an art medium. My “first
book” was a 318-page paper on some little pond animals called
hydras, with 53 India ink illustrations that I wrote for my tenth-
grade biology class when I was 16 (see page viii).
Fast-forward about 30 years, to when I became a textbook
writer, and I found myself bringing that same enjoyment of writing
and illustrating to the first edition of this book you are now hold-
ing. Why? Not only for its intrinsic creative satisfaction, but
because I’m guessing that you’re like I was—you can appreciate a
book that does more than simply give you the information you
need. You appreciate, I trust, a writer who makes it enjoyable for
you through his scientific, storytelling prose and his concept of the
way things should be illustrated to spark interest and facilitate
understanding.
I know from my own students, however, that you need more
than captivating illustrations and enjoyable reading. Let’s face it—
A&P is a complex subject and it may seem a formidable task to
acquire even a basic knowledge of the human body. It was difficult
even for me to learn (and the learning never ends). So in addition
to simply writing this book, I’ve given a lot of thought to its
sal56006_fm_i-xxii.indd 21
pedagogy—the art of teaching. I’ve designed my chapters to make
them easier for you to study and to give you abundant opportunity
to check whether you’ve understood what you read—to test your-
self (as I advise my own students) before the instructor tests you.
Each chapter is broken down into short, digestible bits with a
set of Expected Learning Outcomes at the beginning of each sec-
tion, and self-testing questions (Before You Go On) just a few
pages later. Even if you have just 30 minutes to read during a lunch
break or a bus ride, you can easily read or review one of these brief
sections. There are also numerous self-testing questions in a Study
Guide at the end of each chapter, in some of the figure legends, and
the occasional Apply What You Know questions dispersed
throughout each chapter. The questions cover a broad range of
cognitive skills, from simple recall of a term to your ability to
evaluate, analyze, and apply what you’ve learned to new clinical
situations or other problems. In this era of digital publishing, how-
ever, learning aids go far beyond what I write into the book itself.
SmartBook®, available on smartphones and tablets, includes all of
the book’s contents plus adaptive technology that can give you
personalized instruction, target the unique gaps in your knowledge,
and guide you in comprehension and retention of the subject
matter.
I hope you enjoy your study of this book, but I know there are
always ways to make it even better. Indeed, what quality you may
find in this edition owes a great deal to feedback I’ve received from
students all over the world. If you find any typos or other errors, if
you have any suggestions for improvement, if I can clarify a con-
cept for you, or even if you just want to comment on something
you really like about the book, I hope you’ll feel free to write to
me. I correspond quite a lot with students and would enjoy hearing
from you.
Ken Saladin
Georgia College
Milledgeville, GA 31061 (USA)
ksaladin2@windstream.net
xxi
11/26/19 7:08 PM
sal56006_fm_i-xxii.indd 22 11/26/19 7:08 PM
 PART ON E : OR GAN IZ AT IO N O F TH E BO DY

1
CHAPTER
MAJOR THEMES
OF ANATOMY
AND PHYSIOLOGY

A colorized MRI scan of the human body

©Science Photo Library/Getty Images

C HA P T E R OU T LIN E 1.5 Human Structure DEEPER I NS I GHTS

1.5a The Hierarchy of Complexity
1.1 The Scope of Anatomy and Physiology 1.1 Evolutionary Medicine: Vestiges of
1.5b Anatomical Variation
1.1a Anatomy—The Study of Form Human Evolution
1.1b Physiology—The Study of Function 1.6 Human Function 1.2 Clinical Application: Situs Inversus and
1.6a Characteristics of Life Other Unusual Anatomy
1.2 The Origins of Biomedical Science
1.6b Physiological Variation 1.3 Medical History: Men in the Oven
1.2a The Greek and Roman Legacy 1.6c Negative Feedback and Homeostasis
1.2b The Birth of Modern Medicine 1.4 Medical History: Obscure Medical Word
1.6d Positive Feedback and Rapid Change
1.2c Living in a Revolution Origins
1.6e Gradients and Flow
1.3 Scientific Method 1.5 Clinical Application: Medical Imaging
1.7 The Language of Medicine
1.3a The Inductive Method 1.7a The History of Anatomical Terminology
1.3b The Hypothetico–Deductive Method 1.7b Analyzing Medical Terms
1.3c Experimental Design 1.7c Plurals, Adjectives, and Possessive
1.3d Peer Review Forms
1.3e Facts, Laws, and Theories 1.7d Pronunciation
1.4 Human Origins and Adaptations 1.7e The Importance of Spelling
1.4a Evolution, Selection, and Adaptation 1.8 Review of Major Themes
1.4b Our Basic Primate Adaptations
Study Guide Module 1: Body Orientation
1.4c Walking Upright
1

sal56006_ch01_001-026.indd 1 11/23/19 2:59 PM

 2    PART ONE Organization of the Body
N o branch of science hits as close to home as the science of
our own bodies. We’re grateful for the dependability of our
hearts; we’re awed by the capabilities of muscles and joints dis-
played by Olympic athletes; and we ponder with philosophers the
ancient mysteries of mind and emotion. We want to know how our
body works, and when it malfunctions, we want to know what’s
happening and what we can do about it. Even the most ancient
writings of civilization include medical documents that attest to
humanity’s timeless drive to know itself. You are embarking on a
subject that is as old as civilization, yet one that grows by thou-
sands of scientific publications every week.
This book is an introduction to human structure and function,
the biology of the human body. It is meant primarily to give you
a foundation for advanced study in health care, exercise physi-
ology, pathology, and other fields related to health and fitness.
Beyond that purpose, however, it can also provide you with a
deeply satisfying sense of self-understanding.
As rewarding and engrossing as this subject is, the human
body is highly complex, and understanding it requires us to
comprehend a great deal of detail. The details will be more
manageable if we relate them to a few broad, unifying concepts.
The aim of this chapter, therefore, is to introduce such concepts
and put the rest of the book into perspective. We consider the
historical development of anatomy and physiology, the thought
processes that led to the knowledge in this book, the meaning
of human life, some central concepts of physiology, and how to
better understand medical terminology.
The Scope of Anatomy
1 .1
and Physiology
Expected Learning Outcomes
When you have completed this section, you should be able to
a. define anatomy and physiology and relate them to
each other;
b. describe several ways of studying human anatomy; and
c. define a few subdisciplines of human physiology.
Anatomy is the study of structure, and physiology is the study of
function. These approaches are complementary and never entirely
separable. Together, they form the bedrock of the health sciences.
When we study a structure, we want to know, What does it do?
Physiology thus lends meaning to anatomy; conversely, anatomy is
what makes physiology possible. This unity of form and function
is an important point to bear in mind as you study the body. Many
examples of it will be apparent throughout the book—some of
them pointed out for you, and others you will notice for yourself.
1.1a Anatomy—The Study of Form
There are several ways to examine the structure of the human
body. The simplest is inspection—simply looking at the body’s
appearance, as in performing a physical examination or making
sal56006_ch01_001-026.indd 2
a clinical diagnosis from surface appearance. Physical examina-
tions also involve touching and listening to the body. Palpation1
means feeling a structure with the hands, such as palpating a swol-
len lymph node or taking a pulse. Auscultation2 (AWS-cul-TAY-
shun) is listening to the natural sounds made by the body, such
as heart and lung sounds. In percussion, the examiner taps on
the body, feels for abnormal resistance, and listens to the emitted
sound for signs of abnormalities such as pockets of fluid, air, or
scar tissue.
But a deeper understanding of the body depends on d ­ issection
(dis-SEC-shun)—carefully cutting and separating tissues to reveal
their relationships. The very words anatomy3 and dissection4 both
mean “cutting apart”; until the nineteenth century, dissection was
called “anatomizing.” In many schools of health science, one of
the first steps in training students is dissection of the cadaver,5
a dead human body. Many insights into human structure are
obtained from comparative anatomy—the study of multiple
species in order to examine similarities and differences and ana-
lyze evolutionary trends. Anatomy students often begin by dis-
secting other animals with which we share a common ancestry
and many structural similarities. Many of the reasons for human
structure become apparent only when we look at the structure of
other animals.
Dissection, of course, is not the method of choice when
studying a living person! It was once common to diagnose dis-
orders through exploratory surgery—opening the body and
taking a look inside to see what was wrong and what could be
done about it. Any breach of the body cavities is risky, however,
and most exploratory surgery has now been replaced by ­medical
imaging techniques—methods of viewing the inside of the body
without surgery, discussed at the end of this chapter (see Deeper
Insight 1.5). The branch of medicine concerned with imaging is
called radiology. Structure that can be seen with the naked eye—
whether by surface observation, radiology, or dissection—is
called gross anatomy.
Ultimately, the functions of the body result from its individ-
ual cells. To see those, we usually take tissue specimens, thinly
slice and stain them, and observe them under the microscope.
This approach is called histology6 (microscopic anatomy).
­Histopathology is the microscopic examination of tissues for
signs of disease. Cytology7 is the study of the structure and func-
tion of individual cells. Ultrastructure refers to fine detail, down
to the molecular level, revealed by the electron microscope.
1.1b Physiology—The Study of Function
Physiology8 uses the methods of experimental science discussed
later. It has many subdisciplines such as neurophysiology (physi-
ology of the nervous system), endocrinology (physiology of
1
palp = touch, feel; ation = process
2
auscult = listen; ation = process
3
ana = apart; tom = cut
4
dis = apart; sect = cut
5
from cadere = to fall down or die
6
histo = tissue; logy = study of
7
cyto = cell; logy = study of
8
physio = nature; logy = study of
11/23/19 2:59 PM

hormones), and pathophysiology (mechanisms of disease). Partly
because of limitations on experimentation with humans, much
of what we know about bodily function has been gained through
comparative physiology, the study of how different species have
solved problems of life such as water balance, respiration, and re-
production. Comparative physiology is also the basis for the de-
velopment of new drugs and medical procedures. For example,
a cardiac surgeon may learn animal surgery before practicing on
humans, and a vaccine cannot be used on human subjects until
it has been demonstrated through animal research that it confers
significant benefits without unacceptable risks.
BEFORE YOU GO ON
Answer the following questions to test your understanding of
the preceding section:
1. What is the difference between anatomy and physiology?
How do these two sciences support each other?
2. Name the method that would be used for each of the fol-
lowing: listening to a patient for a heart murmur; studying
the microscopic structure of the liver; microscopically
examining liver tissue for signs of hepatitis; learning the
blood vessels of a cadaver; and performing a breast
self-examination.
The Origins of
1. 2
Biomedical Science
Expected Learning Outcomes
When you have completed this section, you should be able to
a. give examples of how modern biomedical science emerged
from an era of superstition and authoritarianism; and
b. describe the contributions of some key people who
helped to bring about this transformation.
Any science is more enjoyable if we consider not just the cur-
rent state of knowledge, but how it compares to past under-
standings of the subject and how our knowledge was gained. Of
all sciences, medicine has one of the most fascinating histories.
Medical science has progressed far more in the last 50 years
than in the 2,500 years before that, but the field didn’t spring
up overnight. It is built upon centuries of thought and con-
troversy, triumph and defeat. We cannot fully appreciate its
present state without understanding its past—people who had
the curiosity to try new things, the vision to look at human
form and function in new ways, and the courage to question
authority.
1.2a The Greek and Roman Legacy
As early as 3,000 years ago, physicians in Mesopotamia and
Egypt treated patients with herbal drugs, salts, physical ther-
apy, and faith healing. The “father of medicine,” however, is
sal56006_ch01_001-026.indd 3
CHAPTER 1 Major Themes of Anatomy and Physiology    3
usually considered to be the Greek physician Hippocrates
(c. 460–c. 375 bce). He and his followers established a code
of ethics for physicians, the Hippocratic Oath, which is still
recited in modern form by graduating physicians at some medi-
cal schools. Hippocrates urged physicians to stop attributing
disease to the activities of gods and demons and to seek their
natural causes, which could afford the only rational basis for
therapy.
Aristotle (384–322 bce) was one of the first philosophers to
write about anatomy and physiology. He believed that diseases and
other natural events could have either supernatural causes, which
he called theologi, or natural ones, which he called physici or phys-
iologi. We derive such terms as physician and physiology from the
latter. Until the nineteenth century, physicians were called “doctors
of physic.” In his anatomy book, On the Parts of Animals, Aristotle
tried to identify unifying themes in nature. Among other points, he
argued that complex structures are built from a smaller variety of
simple components—a perspective that we will find useful later in
this chapter.
▶▶▶APPLY WHAT YOU KNOW
When you have completed this chapter, discuss the
­relevance of Aristotle’s philosophy to our current ­thinking
about human structure.
Claudius Galen (129–c. 200), physician to the Roman gladi-
ators, wrote the most influential medical textbook of the ancient
era—a book worshipped to excess by medical professors for cen-
turies to follow. Cadaver dissection was banned in Galen’s time
because of some horrid excesses that preceded him, including
public dissection of living slaves and prisoners. Aside from what
he could learn by treating gladiators’ wounds, Galen was therefore
limited to dissecting pigs, monkeys, and other animals. Because
he was not permitted to dissect cadavers, he had to guess at much
of human anatomy and made some incorrect deductions from ani-
mal dissections. He described the human liver, for example, as
having five fingerlike lobes, somewhat like a baseball glove, be-
cause that’s what he had seen in baboons. But Galen saw science
as a method of discovery, not a body of fact to be taken on faith.
He warned that even his own books could be wrong and advised
his followers to trust their own observations more than any book.
Unfortunately, his advice was not heeded. For nearly 1,500 years,
medical professors dogmatically taught what they read in Aris-
totle and Galen, seldom daring to question the authority of these
“ancient masters.”
1.2b The Birth of Modern Medicine
In the Middle Ages, the state of medical science varied greatly
from one religious culture to another. Science was severely re-
pressed in the Christian culture of Europe until about the six-
teenth century, although some of the most famous medical
schools of Europe were founded during this era. Their professors,
however, taught medicine primarily as a dogmatic commentary
on Galen and Aristotle, not as a field of original research. Medi-
eval medical illustrations were crude representations of the body
11/23/19 2:59 PM
Another random document with
no related content on Scribd:
rafforzassero in vece il carattere e sollecitassero l’ingegno alle
imprese memorabili?»
Dai libri di poesia, ch’egli continuamente leggeva, saliva al suo
cervello, come un profumo inebriante, il culto fanatico, la
glorificazione, l’apoteosi della grande passione, che l’Arte ha
generato e cui l’Arte filialmente venera. Per quei poeti, gente nobile
e illustre, l’Amore era tutto: era l’armonia dell’universo, la fiaccola del
genio, era la gioja, era l’ideale, era la divinità. Senza l’Amore, il
mondo non aveva più sole; senza l’Amore, la pace, la gloria, le
ricchezze, la stessa fede non eran se non parole vuote di senso,
ornamenti derisorii gittati sopra un corpo piagato e difforme. —
Perchè vivere se non per amare? — si chiedevan quei poeti,
volgendo in torno gli sguardi assetati di felicità. E il cuore del giovine
ripeteva profondamente, come un’eco fedele: «Perchè, perchè
vivere se non per amare?»
In quegli ultimi giorni, ispirato da quelle voci fascinevoli, sospinto dal
pensiero che l’altro stava per ritornare, Aurelio divenne ardito,
risoluto, intraprendente, non trascurando mezzo alcuno a fin di
raggiungere il suo scopo nel termine prefisso. Ormai nessuna
incertezza rimaneva in lui su quanto avrebbe dovuto fare per
costringere Flavia a una risposta sincera e decisiva: occorreva
parlarle a cuore aperto, dichiararle senza ambagi il suo sentimento,
chiederle con lealtà se lo potesse ella, ora o in un giorno non
lontano, contraccambiare; bisognava abbandonare i piani lenti e
astuti per appigliarsi alle risoluzioni rapide ed energiche. Ma come
trovarla sola? Con qual pretesto domandarle un colloquio in
disparte? Ed era forse possibile ottenere un risultato da una
conversazione a bassa voce in cospetto delle altre donne?
La migliore occasione per trovarla sola era irremissibilmente
sfumata. Dal giorno, in cui egli s’era spinto fino al sommo della
pineta, Luisa aveva pregato la zia di trasportarle l’esercizio di
pianoforte alla mattina, e non aveva più lasciato Flavia durante
l’intero pomeriggio. Aurelio, risalito là per ben due volte pien di
speranza, aveva dovuto ritornarsene deluso e scorato in palazzo,
dopo aver passato un’ora di supplizio ineffabile accanto alle due
giovinette.
Egli procurò dunque di farsi intendere da lei a sguardi, a reticenze,
ad allusioni velate durante i ritrovi comuni sul rialto; si diede a
corteggiarla nettamente e volgarmente, sedendole con ostentazione
sempre vicino, cercando di trascinarla per gradi ad appartarsi dal
crocchio, a discorrere con lui solo di cose intime, discrete,
confidenziali. Più volte, nella mezz’ombra dei crepuscoli caduchi,
sdrajato al suo fianco su l’erba dello scalere, egli, approfittando d’un
momento opportuno, riuscì a parlarle del mutamento avvenuto in lui
negli ultimi tempi e ad accennarle i suoi nuovi desiderii; anche tentò,
con qualche inchiesta astuta, d’investigare a fondo nel mistero della
sua sensibilità. Ma le presenze estranee esercitavan pur sempre sul
suo spirito una bizzarra influenza: egli, per sottrarsi alla loro
soggezione, doveva dare alle sue frasi sentimentali un tono fatuo e
giocoso; egli doveva discorrere scherzando, a similitudine d’un
balbuziente che, per vincere la difficoltà di parola, bisogna che canti.
Flavia, d’altra parte, pareva che si prestasse amabilmente a quel
giuoco: lo ascoltava con visibile piacere, e gli rispondeva a tratti
ridendo, schermendosi dalle celie con altre celie più leggere.
— Via, signor Aurelio, — gli diceva talvolta, oppressa dalla sua
insistenza: — sarebbe tempo di finirla con questa burla. Io non
posso credere a una sola dalle sue parole. Non posso credere
ch’ella parli da senno; e, le confesso, non mi garba d’esser burlata.
— Ma io parlo da senno, signorina, — egli affermava, cercando
d’atteggiare il viso a una espressione più seria.
— Lei? con le sue idee? con il suo orgoglio? con le sue belle
opinioni su le donne?... Ma mi stima dunque così ingenua e,
diciamolo pure, così sciocca da credere cecamente a tutto quanto mi
si racconta? Ella, caro signore, vuol divertirsi un poco alle mie spalle;
ma io, benchè non sia che un povero essere inferiore, ho però
almeno tanta intelligenza quanta ne occorre per intenderlo.
Altra volta, gli chiedeva anche con voce grave, quasi malinconica:
— Perché mi dice queste cose, signor Aurelio? Se scherza, ha torto
di scherzare. E se parla sul serio, ho torto io d’ascoltarlo.
E il giorno ultimo venne, inaspettato, senza che Aurelio avesse
potuto effettuare anche in minima parte il piano di conquista, che gli
era già sembrato così agevole e d’esito quasi sicuro!
Ritornò il padre Boris, ritornarono gli ospiti, riapparve il pretendente
basso e tarchiato, dalla pelle olivastra e dagli occhiali d’oro. Venne
anche a sera lo Zaldini, più fresco e più giocondo che non mai,
essendo stato chiamato per lettera dall’Imberido in sèguito alle
preghiere insistenti di Luisa.
La comitiva a bastanza numerosa, divisa in tre imbarcazioni, lasciò il
villaggio verso le cinque del pomeriggio per passare la notte a
Baveno ed esser pronta, la mattina dopo per tempo, a intraprender
l’ascensione del monte. In una lancia erano l’ingegnere Boris, il
Siena e le due fanciulle; in un’altra la signora Teresa, sua cognata e
Giorgio Ugenti; e nella terza infine, donna Marta accompagnata da
Camilla, e Aurelio e Luciano ai remi. La vecchia quantunque
indisposta e sofferente, aveva voluto seguire la comitiva almeno fino
a Baveno, dove sarebbe rimasta con la fantesca in aspettazione, per
far ritorno a Cerro insieme con gli altri nella sera successiva.
Una grande tristezza occupò l’anima del giovine durante la lunga
traversata e durante il pranzo interminabile alla tavola rotonda
dell’Hôtel Belle-Vue. Nel silenzio del lago, battuto da un sole
bianchissimo, nella gran sala oblunga, popolata d’Inglesi impassibili
e di Tedeschi ciarlieri, il pensiero di Flavia non lo abbandonò un solo
istante, e la presenza del rivale, sempre accanto a lei, non cessò di
martoriarlo, come un cancro ostinato che gli rodesse il cuore. In
vano lo Zaldini tentò più volte di farlo sorridere con le sue storielle e
il racconto grottesco d’una sua recente avventura d’amore; Aurelio
rimase pertinacemente muto e grave, finchè questi, tediato dalla sua
indifferenza, si risolvette a volgergli le spalle e ad appiccar discorso
con un vecchio signore inglese, suo vicino di mensa. Ora Luciano
chiacchierava allegramente e senza ritegni con il nuovo suo amico,
decantando nel più pretto idioma britannico la bellezza
incomparabile delle misses e l’eccellenza del gin e del whisky come
eccitanti delle più pazze fantasie.
— Io, se per avventura m’ammoglierò, — diceva lo Zaldini a voce
alta, — sarà senza dubbio con una signorina del vostro felice paese,
perchè adoro il biondo dei capelli e delle sterline. E voglio, la sera
delle nozze, rinnovare il celebre aneddoto del campanello elettrico,
che voi probabilmente conoscete, poichè l’eroe ne fu un vostro
compatriota, anonimo ma non per questo meno degno di memoria...
Il vecchio accennava di no col capo, incoraggiandolo a continuare
con un’occhiata piena di curiosità lasciva. E il giovine infatti, senza
farsi pregare, raccontava l’aneddoto salace, piegando il capo verso
di lui, soffiandogli le parole fioche all’orecchio, scoppiando a tratti in
una risata sonora, che trasfigurava per incanto il viso terreo e severo
dell’ascoltatore.
Nulla irritava di più lo spirito ansioso dell’Imberido che il cicaleccio
frivolo e ininterrotto de’ suoi due vicini. A intervalli, tra lo strepito
dell’acciottolìo e delle conversazioni diffuso per la vasta sala,
giungeva a lui, come un avvertimento di sventura, la voce fessa e
nasale dell’avvocato, seduto al fianco di Flavia a quattro posti in
distanza dal suo. Egli, roso dalla gelosia, aguzzava l’udito a quel
suono sgradevole, che pareva per poco dominare ogni altro romore;
a volte, credeva di comprendere qualche frase inconcludente,
un’affermazione, un ringraziamento, il nome dell’amata proferito
dalle labbra odiose; ratteneva profondamente il respiro per afferrare
il senso dell’intero discorso. Ma uno scroscio d’ilarità si levava
d’improvviso presso di lui, e tosto la voce si disperdeva nel clamore,
vinta e soffocata.
Aurelio doveva fare un enorme sforzo di volontà per contenere il suo
dispetto contro l’amico e vincere l’impulso cieco di levarsi in piedi e
allontanarsi da quella sedia di tortura. Almeno gli fosse toccato in
sorte un posto di fronte a Flavia e al rivale! Avrebbe potuto scrutarli,
spiare i loro movimenti, i loro sguardi, le loro espressioni! Avrebbe
potuto leggere su le loro facce il sentimento che li occupava! In vece,
da quel posto, non gli era dato nè di vederli nè d’ascoltarli! Egli,
anche sporgendo il capo in avanti, non riusciva a scorgere se non le
loro mani, così prossime che parevan toccarsi, così mobili nella
comune bisogna, che tal volta egli non sapeva distinguere le une
dalle altre!...
Dopo il pranzo, la comitiva uscì dall’albergo per fare una breve
passeggiata prima di coricarsi, e si diresse a piccoli gruppi verso
Stresa su la gran via provinciale che costeggia il lago fino ad Arona.
Il vespero era chiaro, pallido, còrso come da un brivido voluttuoso. I
vasti boschi di castagni, che avvolgono le falde del Motterone,
piovevano su la strada polverosa una frescura umida, un profumo
penetrante di terra e di vegetazione. Dal lago, a pena increspato
presso le rive, saliva un odor caldo di pesci e d’erbe fracide. L’isola
Superiore, sola su le nebbie delle lontananze, spiccava nitida dalle
acque, con le sue case fitte e inghirlandate, con il bianco campanile
della chiesuola acuminato verso il cielo, come un ideale.
Le donne procedevano insieme; poi venivan gli uomini in due file: il
Boris d’avanti tra l’Ugenti e il Siena; e Aurelio e Luciano in coda.
Luisa, accanto a Flavia, accennava a mezza voce,
malinconicamente, l’aria preferita del Faust; donna Marta, eccitata
dalla novità del luogo e dalla compagnia numerosa, parlava forte,
con animazione quasi febbrile, al braccio della signora Teresa e della
sorella dell’ingegnere.
L’Imberido, che si sentiva più calmo e come rassicurato, domandò
sorridendo all’amico:
— Perchè hai tardato tanto a ritornare a Cerro? Hai dunque sùbito
dimenticato la signorina Luisa e i tuoi entusiasmi sentimentali per
lei?
— Dimenticata? non del tutto. Ma, che vuoi? appena giunto a Milano
fui travolto in quell’avventura eroica, che t’ho narrata e tu non hai
avuto la bontà d’apprezzare. Ho corso due volte serio pericolo di
vita; ho passato intere ore rinchiuso in un armadio, come un vecchio
soprabito; ho visto un marito passarmi d’innanzi col lume in una
mano e un’enorme mazza ferrata nell’altra. Capirai: le commozioni
violente esercitano una certa influenza su la memoria: ed io per il
momento ho scordato la bionda incantatrice e l’innocente idillio
campagnuolo. Però, come vedi, al solo nome di lei apparso in una
tua lettera d’invito, io non ho esitato a lasciar Milano, ed ora sono
qui. Che puoi pretendere di più dalla mia fedeltà?
— E... come hai trovato Luisa al tuo ritorno? — ridomandò Aurelio
con ironia.
— Ah, per questo, mutata, molto mutata! Forse, te lo confesso, mi
son lasciato troppo desiderare. Ma... e tu, tu come te la sei passata
in questi due mesi di convivenza con l’altra, con la bruna, nel
palazzo fatato, tra i boschi maravigliosi? Sarei curioso d’accogliere
oggi le tue confidenze: credo che ne sentirei di carine. L’eremita mi
ha l’aria d’essersi fatto diavolo. M’inganno?
— Assolutamente, — rispose sicuro l’Imberido, fissando gli occhi a
terra. — La signorina Boris è in teneri rapporti con quel signore dagli
occhiali d’oro, che ci precede. Si parla anzi d’un prossimo
matrimonio con lui.
Lo Zaldini parve molto maravigliato dalla notizia.
— Davvero? Ma ella sarebbe fortunatissima, caro mio! — egli
esclamò. — Io conosco il Siena da molti anni. È un giovine
coltissimo e simpaticissimo! Uno degli avvocati più apprezzati e
meglio retribuiti di Milano! E poi, è molto ricco: figùrati che ha
ereditato, or non è un anno, cinquecento mila lire da uno zio di
Ferrara. E sua madre è nata di casa Orbetello, figlia del celebre
banchiere di Roma, arcimilionario. Se è vero quanto mi racconti, la
signorina Boris fa uno dei più splendidi matrimonii che si possano
imaginare.
Aurelio ascoltò, contenendosi a stento, l’elogio del rivale aborrito,
detto senza malizia da una bocca fraterna. Non ebbe un gesto di
protesta; non una contrazione di spasimo, non un tremito delle mani,
non un battito delle palpebre. Ammutolì, si fece smorto in viso,
sentendo penetrare nel cuore a una a una le parole dell’amico, come
trafitture di spillo. Gli parve che tutto crollasse intorno a lui. Gli parve
di udire la sua condanna mortale pronunciata da un giudice
inappellabile. — Che valeva omai resistere? Che valeva lottare? A
che servivan la sua ostinazione e il suo orgoglio? Costui era il
preferito, era il vittorioso, era il più forte. Costui era l’invincibile,
d’avanti al quale bisognava per necessità cedere o soccombere.
Una divina speranza si spegneva, troncata da quelle affermazioni,
irreparabilmente. La luce non era più luce, la vita non era più vita!
Nel ritorno egli non parlò più.
Scendeva la sera e il vento aumentava su la montagna oscurata.
Dalla gola di Mergozzo, già invasa dalle tenebre, venivano a
intervalli i soffii striduli e subitanei, si riversavano scrosciando su le
acque, giungevan senza freni alla terra, e quivi, irritati dall’ostacolo,
imperversavano contro la foresta, che si piegava e si torceva con un
fragor formidabile di ruina. E l’anima del giovine avvizzita e divelta
dal dolore, pareva seguire travolta il cammino della corrente aerea,
anelando alla distruzione, alla dispersione, all’annientamento totale
di sè stessa, tra il folto di quegli alberi conquassati, verso le
lontananze misteriose, dove le raffiche ululando s’inabissavano.
La notte era ancora profonda, quando la comitiva lasciò l’albergo e
s’incamminò al lume fioco delle lanterne su per le falde boscose del
monte. Durante un lungo tratto nessuno parlò per il calle aspro e
angusto, serpeggiante sotto la verzura profonda: procedettero tutti,
uno dietro l’altro, in silenzio, ancora un poco ottusi dal sonno
bruscamente interrotto, intenti con gli sguardi al suolo, che le
sporgenze delle radici e delle rocce rendevano insidioso. A metà
della selva per la prima volta riposarono: le donne più affaticate
sedettero su i macigni o su l’erba, gli uomini rimasero in piedi vicino
a esse, in aspettazione.
L’aria era fresca e ancor buja: il vento, alquanto scemato di forza,
stormiva tra le fronde, spostando i brani di cielo visibili in cui
palpitavano gli astri. Verso l’oriente l’azzurro incominciava a
impallidire.
Si scambiarono poche parole durante la sosta, che fu assai breve: le
signore, assalite dai brividi, si lamentarono del freddo e sollecitarono
la partenza. Ripresero tutti insieme il cammino, nel medesimo ordine
di pocanzi, con la stessa svogliatezza muta, con una maggiore
preoccupazione del terreno. Man mano che salivano, il sentiero si
faceva più ripido e più scabro, l’ànsito dei viandanti, più frequente e
più grave. E il bosco si diradava, e i castagni immiserivano tra la
ghiaja, e il cielo costellato si schiudeva più libero sopra le loro teste.
Si udiva solo, nel silenzio antelucano, il ticchettare monotono dei
passi contro le pietre mobili del calle, si scorgeva omai là, lontano
sotto di loro, il lago, simile a una vasta distesa di pece brunastra,
simile a un immane stagno limaccioso in mezzo alle incerte forme
delle montuosità.
La comitiva, un poco avvivata dall’aria più leggera, giunse al confine
della selva e in vista della vetta, quando l’alba imperlava già
l’orizzonte sopra i colli di Lombardia. Gli ultimi alberi crescevano sul
ciglio d’uno sprone scosceso, al sommo del quale l’erta d’un tratto
s’addolcisce larghe praterie irrigue s’incurvano mollemente,
appoggiate a una tenue concavità e quindi al pendìo terrigno del
monte. Nel chiaror livido dell’ora, quei prati avevano una tinta cupa e
unita, d’una inimitabile morbidezza; e qua e là, di tra l’erbe,
balenavano foscamente le grandi pozze degli abbeveratoi o
spiccavano le macchie nere delle stalle e delle capanne pastorizie.
Un tintinnìo languido di campani e qualche sordo muggito venivan
dall’alto, dove una mandria usciva in quel punto per il pascolo.
Come la viottola si stendeva più larga e più agevole, la comitiva
ruppe per ragunarsi l’ordine primiero di marcia, e le conversazioni
non tardarono ad accendersi. Camminavano tra i prati, quasi su un
piano, disposti in due schiere, stretti gli uni agli altri, rinvigoriti e
imbaldanziti dalla brezza e dalla vision della mèta. L’Ugenti e lo
Zaldini apparivano allegrissimi, e gareggiavano in dir motti e
sciocchezze, che sollevavan l’ilarità delle quattro donne; e il Siena a
volte li secondava, con la sua flemma mordace e quasi maligna. Ma
Aurelio seguiva astratto e taciturno i compagni, volgendo gli occhi
inquieti su la severa maestà del paesaggio.
Era in lui, dal momento in cui aveva lasciato l’albergo, una
perplessità strana e confusa, che era andata a grado a grado
addensandosi fino a opprimerlo come un’angoscia. Aveva passato
una notte insonne, sprofondando gli sguardi nel vortice della sua
infelicità; aveva sentito più volte morire le sue speranze e risuscitare
per novamente morire; aveva singhiozzato come pazzo nelle
tenebre, immemore dell’amico che dormiva tranquillamente accanto
a lui. Ma poi, quasi per un prodigio, appena su la via, ogni triste
ricordo s’era spento, ogni doloroso residuo erasi dileguato nel suo
pensiero; ed egli era caduto in una specie di torbida incoscienza
animale, rotta da fuggevoli proponimenti e da incerte fantasie. Ora
egli seguiva i compagni astratto e taciturno, occupato tutto da un
pensiero ignoto, da un’ignota volontà, da un’intenzione che rimaneva
occulta nei recessi impenetrabili dell’essere.
Il pianoro fu ben presto attraversato. Il calle per giungere alla cima si
drizzò più arduo che non mai, lungo il dorso eretto, sdrucciolevole
per le infiltrazioni delle acque, che costituisce la mole centrale della
montagna. La comitiva dovette sbandarsi di nuovo, e ciascuno
separatamente intraprese l’ultima ascensione, chi seguendo il
cammino più comodo tra i margini del sentiere, chi cercando il
tramite più diretto su le zolle madide del prato.
Un superbo spettacolo si svolse frattanto, da ogni parte, intorno a
loro. La luce aumentò con rapidità, come regolata da una mano
impaziente: l’erbe splendettero, si copersero d’innumerevoli fiori; le
pozze degli abbeveratoi si rischiararono; le stalle e le capanne
pastorizie spiccarono con le loro forme pittoresche tra il verde
uniforme delle praterie. Di qua e di là, su la frescura dei pascoli,
apparvero distintamente le mandrie e i greggi, che si udivan prima
tintinnare, muggire e belare nell’ombra. Quando il chiarore si diffuse
più crudo, le catene dei monti, abbraccianti il Verbano, si fecero tutte
palesi nella loro ricca vegetazione fino alle estreme punte
settentrionali, si propagarono come un’immensa successione di
gigantesche onde impietrite rimaste a vestigio d’una qualche
primordiale fluttuazione tellurica. E, in basso, il lago opaco e inerte si
mostrò lucido e bianco nell’alba, simile a un bel fiume di latte, simile
a una favolosa lama d’argento piombata dall’alto e affondatasi per la
sua gravità nelle onde della terra molle.
In fine l’aurora venne a tinger di rosa l’orizzonte lontano. Sul monte
Nudo, sul Sasso del Ferro, su i colli di Mombello, lungo la linea quasi
diritta delle campagne d’Ispra e di Ranco, una zona di luce rancia si
prolungò in guisa d’un nastro serico che orlasse per vaghezza i
capricci del litorale. Quasi sùbito, alcune strisce di vapori si formaron
per incanto nell’aria pura; parvero imbeversi, come spugne, delle
tinte calde dell’aurora; s’accesero, fiammeggiarono preannunziando
l’avvento glorioso del sole. E questo maravigliosamente comparve,
fuor del dosso precipitoso che incombe sopra Laveno, prima come
un punto incandescente e poi come una gran bolla di fuoco espressa
dalle viscere del monte. Le vette s’imporporarono; i raggi discesero a
grado a grado per le chine, cospargendole d’oro; avvolsero in una
nebbia adamantina le falde boscose; s’infransero in ultimo su la
superficie delle acque, provocando nell’urto l’accensione subitanea
d’infinite scintille.
Il nuovo giorno era fatto. Le campane dei villaggi squillarono a festa,
in segno di saluto.
La comitiva fu sbandata e dispersa dalle difficoltà sempre crescenti
dell’ascesa. I più giovini e i più validi, procedendo lunghesso i prati,
s’allontanarono dagli altri che rimasero in basso, trattenuti
dall’affanno e dal calore. L’Ugenti e lo Zaldini, offrendo le mani a
Luisa, trascinandola a forza su per l’erta, scomparvero primi alla
vista dei compagni in una valluccia angusta, avvivata da un ruscello
garrulo e schiumeggiante. Il Siena più cortese restò sul sentiere
tortuoso con la signora Boris, l’ingegnere e sua sorella, per
soccorrerli nei passi disagevoli. Aurelio e Flavia si trovarono d’un
tratto soli e liberi, come smarriti nel monte deserto, su una piccola
prominenza erbosa a metà della china.
Quando il giovine se n’avvide, volgendo gli occhi in torno, ebbe un
sussulto improvviso e violento in tutto l’essere. — Flavia era là,
d’avanti a lui, come in quel giorno lontano sul minuscolo prato al
sommo della pineta! Ella saliva pianamente per quella distesa
inclinata, tra l’intonsa verzura, lasciando dietro di sè un mobile solco
di fili prosternati. Portava ancora, come in quel giorno, l’abito grigio,
attillato, senza guarnizioni, che una cintura d’un color di lilla pallido
avvinceva strettamente sopra i fianchi sobrii e a pena arcuati. E
recava in testa il cappellaccio di paglia dalle tese larghe e convesse,
su cui risaltavan due tulipani sanguigni in un ciuffo di foglie e di
spiche.
Oh, le memorie, le memorie! — Aurelio si volse, fissò gli sguardi
laggiù verso il lago, all’opposta riviera dove biancheggiava il villaggio
solitario. Era là, sotto di lui, remotissima, la pineta del palazzo, simile
a un ammasso di cose oscure, indefinibili; era là il luogo nascosto e
favorevole, dov’ella aveva per la prima volta incantato la natura e la
sua anima. Ancora ella lo incantava; ancora e più, ella con la sua
grazia annobiliva e irraggiava le apparenze per mezzo a cui
passava. Eretta su lo sfondo verde e fiorito, come in quel giorno
lontano, ella era simile a un’imagine immortale e immutabile. Anche
una volta il giovine, contemplandola, non vide in lei la fanciulla
ch’egli ben conosceva: vide l’arbitra del suo destino mortale, la
custode della sua felicità, l’incarnazione portentosa del suo più
schietto Sogno di giovinezza; vide l’Unica che avrebbe potuto far di
lui un essere giojoso.
Con un impeto subitaneo, come spinto a tergo da una forza
esteriore, accelerò il passo sul pendìo; e, giunto presso colei che lo
precedeva, disse:
— Flavia, m’ascolti. È la prima volta, dopo molti giorni, che ci
troviamo soli. Io ho passato due settimane di tortura ineffabile,
cercando un mezzo per poterle liberamente parlare..... Oggi
finalmente il caso mi ha favorito.... Ho bisogno di farle una
confessione assai grave e di chiederle un consiglio.
— A me? — ella domandò con un accento ambiguo, d’incredulità e
d’ironia, volgendo a pena il viso verso di lui.
— A lei, Flavia, a nessun altri che a lei.
Poi, dopo una pausa in cui parve ch’egli ascoltasse i palpiti
accelerati del suo cuore, soggiunse:
— Ella mi troverà molto mutato; si stupirà del mio cambiamento
radicale da un mese a questa parte. Io non ne ho colpa alcuna; ho
fatto il possibile, signorina, per soffocare i nuovi desiderii e le nuove
commozioni del mio spirito, per esser forte, per riprendermi e per
dominarmi. Tutto fu inutile. Dirò meglio: ogni sforzo della mia volontà
ribelle non riuscì che ad accrescere i miei turbamenti e le mie
angosce. Io sento oggi che una sola via di salvezza mi rimane:
quella di rivolgermi con tutta franchezza a lei, e di rimettere
fiduciosamente nelle sue mani il destino della mia vita.
— Mio Dio! — esclamò la fanciulla, tentando di sorridere. — È una
responsabilità troppo grave ch’ella mi vuole addossare! Io non credo
d’esser da tanto, signor Aurelio.
Il viso del giovine si coprì di pallore; le sue mani tremarono; i suoi
occhi si volsero inquieti in torno, come se un passo estraneo fosse
risonato d’improvviso dietro di lui.
— Per carità, Flavia, non rida, non scherzi! — egli riprese a dire,
rassicurato dalla solitudine; — ella deve comprendere ch’io parlo ora
con tutta l’anima mia; ella da molto tempo deve aver compreso ch’io
la cerco, ch’io la seguo, ch’io non perdo un’occasione di potermi
avvicinare a lei. Ricorda, Flavia, quel giorno che son salito lassù,
sapendo di trovarla sola, e l’ho interrogata? Ricorda il mio sgomento,
la confusione delle mie parole? Ricorda bene la mia ultima
domanda? Già fin d’allora avrei voluto confidarmi a lei interamente....
Era salito per questo, ella deve averlo compreso... E m’ha dato una
risposta così fredda, così crudele!
Ella, che sempre camminava, sorrise.
— Crudele, ma meritata, — mormorò con un fil di voce, senza levar
gli sguardi dal prato.
— No, meritata, no. Forse, prima; ma poi, poi.... e in quel momento!..
Ebbene, Flavia, ella non sa, non può sapere quanto io ne soffersi.
Ella non sa ch’io ho passato giorni e notti intere, meditando quella
risposta, analizzandola, rivolgendola dentro di me, cercando sotto le
parole i sentimenti che potevano averla dettata.
— E perchè? — ella domandò, interrompendo, con un tono forte di
voce e un atto superbo della testa, che diedero al semplice motto
una significazione profonda.
Egli anche si eresse; egli anche per poco la fissò, sicuramente. Ma
lo sguardo di lei dal basso in alto, uno sguardo armato, turbinoso,
pieno di mistero, lo vinse, obbligandolo ben tosto a distoglier di
nuovo gli occhi dal suo viso. Egli rispose dunque, umilmente, a capo
chino:
— Perchè io l’amo, signorina Flavia.
La fanciulla non si scosse alla grande confessione. Si fermò, in
aspetto indifferente, e mormorò dopo una pausa, abbassando le
palpebre:
— Fermiamoci qui. Aspettiamo gli altri.
— Oh, Flavia! Flavia! — proruppe egli con impeto, irritato da quella
freddezza, esaltato dalla sua audacia, deciso a combattere fino
all’estremo. — Ella non mi risponde? Non ha nulla da dirmi, almeno
per cuore, per pietà? Ella mi respinge dunque così....?!
— No, io non la respingo, — disse Flavia tranquillamente, rimanendo
ritta di fronte a lui. — Non è ch’io la respinga. M’aveva chiesto un
consiglio, e volevo pensare coscienziosamente prima di risponderle,
appunto perchè le sue parole m’hanno colpita e il suo sentimento
non mi può che insuperbire. Essere prescelta da lei, nobile,
intelligente, coltissimo: è certo l’ideale sognato da una donna. Ma io
ho sofferto, signor Aurelio; le tristi vicende della vita m’hanno resa
cauta e diffidente.... Io so, io sento che, secondando l’impulso
momentaneo, preparerei la mia, la nostra sventura avvenire... E
questo non voglio.
— Oh, Flavia....
— Ricordo bene le sue parole, — ella continuò, senz’interrompersi,
con un accento vibrato e sicuro, sempre ritta, sempre immobile di
fronte a lui. — «L’uomo deve rimaner solo, libero, senza impegni,
senza legami, se vuol riuscire nel suo intento, se vuol vincere e
dominare.... L’amore è un’umiliazione... La donna è una ruina, un
essere inferiore che affascina e che distrugge!...» Ella vede, Aurelio,
io le ricordo tutte; e le ricordo perchè le ho a lungo considerate e
meditate. Ho creduto allora a lei, come credo adesso; ma devo alle
prime parole prestare una fede maggiore, perchè quelle eran dette
pacatamente, risolutamente, senza influenza di commozione o di
sentimentalità. Ora, pensi, pensi, Aurelio: come potrei, con la
memoria lucidissima delle sue massime sconfortanti, abbandonarmi,
spensierata e fiduciosa, all’illusione presente, al fascino ingannevole
d’un sentimento, che in lei non può durare?...
— Oh, Flavia, ella dubita di me? — egli chiese, con la voce strozzata
dall’affanno.
— Dio me ne guardi! Ma anche lei oggi si illude; anche lei s’inganna,
in preda a un’esaltazione passaggera, che basterà la più piccola
contrarietà a calmare e a disperdere.... Se io poi le intralciassi il
cammino? Se io potessi un giorno esserle d’ingombro? Se in
avvenire le dovessi costare il sacrificio de’ suoi ideali e delle sue
giuste ambizioni? Ella avrebbe pure il diritto di rimproverarmi questo
momento di debolezza e di malintesa condiscendenza; ed io avrei
segnata per sempre la mia condanna!
— Le mie ambizioni! — egli esclamò, con doloroso sarcasmo. — I
miei ideali! Io non rammento più neppure d’averli sognati!...
— E questo è appunto ciò che più mi sgomenta. Perché un giorno
ella potrà dire con uguale sincerità: «Il mio amore! Io non ricordo più
neppure d’averlo supposto!» E in quel giorno, gli ideali e le ambizioni
si saranno di nuovo impadroniti di tutta la sua anima, come e forse
più che in passato!... Ah, no, no, rifletta bene, signor Aurelio: è
impossibile, impossibile! A lei è riserbato un avvenire di gloria, ben
diverso dal mio. Ella deve restar solo. Alle sue idee predilette, alle
grandi battaglie della vita, ella deve consacrare tutto quello che v’ha
di alto, di buono, di nobile nel suo intelletto e nel suo cuore.
Solamente così potrà vedere giorni felici; poichè il sogno, che ella ha
accarezzato dai primi anni di sua giovinezza, è ben di quelli che si
realizzano o rendono intollerabile qualunque altra realità.
Ella parlava con una tale sicurezza e una tal limpidità, che le sue
affermazioni assumevano su l’animo dell’ascoltatore un’irresistibile
virtù persuasiva. Egli non osava più interromperla; egli la guardava
con un’indicibile angoscia, sentendo a poco a poco passare
nell’anima sua le idee ch’ella gli veniva esponendo e impossessarsi
contro ogni volontà della sua ragione. E vedeva l’ostacolo crescere
tra loro, salire a mano a mano come una nebbia densa, dividerli per
sempre e respingerli indietro, sempre più indietro, verso due plaghe
remote, inaccessibili l’una per l’altra.
— Pensi poi al mio passato, al mio tristissimo passato, signor
Aurelio! Esso pesa sopra di noi non meno grave del suo lieto
avvenire. Pensi alla delusione, ch’io ho sofferta e m’ha distrutto ogni
ingenuità del cuore, ogni fede, ogni entusiasmo! Che cosa potrei
darle io oggi, in cambio del suo affetto? Un povero fiore, sì, ancora,
ma senza profumo e che la bufera ha già fatto baciar la terra!.. Ella
vede dunque: è meglio, è necessario per entrambi che questa follìa
non continui. Lasciamoci da buoni amici, che si conoscono e si
stimano. E proseguiamo senza rimpianti le nostre due vie, che son
diverse e non possono confondersi. Più tardi, creda, ella penserà a
me con riconoscenza; più tardi mi saprà grado d’essere stata forte e
riflessiva in un momento in cui ella non lo era.
Flavia s’arrestò, calma, pensierosa, un poco triste, e lo fissò negli
occhi intensamente.
— Ella, in cuor suo, già m’approva, non è vero? — chiese, con un
pallido sorriso. — Addio, dunque. E... grazie!
Disse anche, dopo un silenzio:
— Si ricordi di me come d’un’amica sincera, devota, immutabile. Io
non dimenticherò quest’ora della mia vita mai, mai...
E gli stese con un atto franco la mano.
Aurelio, passivo e attonito, la prese nella sua, la strinse con forza.
Si udivan da lontano le risa della bionda echeggiare contro il monte
solitario; si udivan di qua e di là tintinnare i campani delle mandrie e
dei greggi su i pascoli.
Il Sogno pareva disperdersi, e il risveglio era assai desolato. Egli era
solo, senza più una speranza, senza più un’illusione. Egli sentiva
nell’anima la necessità fatale d’esser solo, «per riuscire nel suo
intento, per vincere e dominare.» Qualcuno aveva affermata questa
necessità; ed egli se n’era persuaso. Su, su, sempre più in alto, egli
sarebbe dovuto andare, continuamente andare, portando la croce
della sua sapienza, anelando affaticato alla sommità del suo
Golgota, dove avrebbe trovato ad aspettarlo la Morte. Quale forza
terrena sarebbe riuscita a opporsi a una disposizione superna? «Chi,
chi può dunque mutare il destino?»
Così era e così doveva essere. Le gioje dei mortali non eran per lui,
non eran per quelli che son destinati a sacrificarsi a un Ideale, a
versare il loro sangue più puro per fecondar la terra o per imbevere
le sabbie. Su, su, sempre più in alto, egli avrebbe dovuto andare,
continuamente andare, chiudendo gli occhi agli spettacoli giocondi
della vita, per non morire lungo il cammino d’invidia e di desiderio!
Ma non gli era dunque riserbato un conforto, un unico conforto nella
sua gloriosa sventura? Egli cercò avidamente nel suo cuore se un
conforto esisteva. E l’imagine sparuta della nonna gli sorrise benigna
di tra le tenebre, come la prima e l’ultima dolcezza del suo infinito
abbandono.
 X.
Tra l’Amore e la Morte.

La sera del dì successivo l’ingegnere e gli ospiti partirono. Anche

Luisa, richiamata dal padre, dovette lasciare la villa e far ritorno a
Milano in compagnia della sorella Boris. Su la spiaggia donna Marta
e il nipote discesero a salutarli.
Quando le due barche piene, dove avevan preso posto anche Flavia
e sua madre, scomparvero alla vista, la vecchia, ch’era stata prodiga
d’effusioni per tutti e aveva versato anche qualche lacrima
abbracciando la bionda che pure piangeva, ebbe d’improvviso un
colpo di tosse secca, violenta.
— Vedi? Vedi? — le disse Aurelio, impensierito, prendendola sotto il
braccio per ricondurla in palazzo. — Tu oggi dovevi fermarti a letto.
Dopo l’imprudenza di jeri, tu non saresti dovuta alzarti. Prendere
tutta quell’acqua! Arrivare a casa inzuppata come se avessi fatto un
bagno nel lago! E tutto questo, per la tua ostinazione, per non
volermi ascoltare mai, mai!... Non si poteva forse restare un’altra
notte a Baveno? Non si poteva, poiché il tempo minacciava,
rimandare il ritorno a questa mattina? Ma tu, no, tu, come sempre,
hai voluto agire di tua testa; tu hai voluto tentare la traversata,
soltanto perché io ti pregava di non farlo! E, lo sai, io te ne pregava
soltanto per la tua salute.... Ora, vedi? Vedi? Hai la tosse. Ora ti
ammalerai...
— Crepi l’astrologo! — esclamò donna Marta, ridendo.
— Non scherzare, mamma, — proseguì serio e accalorato il giovine:
— quella tosse non mi piace, e bisogna che tu la curi prima che
sopravvenga una qualche complicazione. Alla tua età i mali più
leggeri son sempre pericolosi. Domani in tanto rimarrai a letto. Io
esigo che domani tu rimanga a letto.
— Domani farò quel che mi piacerà.
— No, domani invece farai quel che a me piace, e sarà forse la
prima volta che un caso tanto straordinario accade nella nostra vita.
Donna Marta, ancora commossa dalla scena dei saluti, non era in
vena di discutere e di litigare; e concluse con un sorriso di
compatimento per il nipote:
— Ebbene, domani ne riparleremo.
La mattina dopo; quando Aurelio si presentò nella camera dell’avola,
la ritrovò mezzo vestita d’avanti alla specchiera, in atto di pettinarsi.
Egli ebbe un moto subitaneo d’irritazione che a stento potè
contenere. Le domandò guardandola negli occhi:
— Come? Ti alzi?
Ella rispose:
— Sì, mi alzo.
Ma era più pallida del giorno prima. Era bianca come i suoi capelli,
come la sua camicia. Egli richiese:
— Hai tossito stanotte?
Ella rispose:
— A bastanza. Non ho potuto chiuder occhio fin verso l’alba.
— E ti alzi ugualmente?
— Sì.
— Perchè, mamma? Perchè?
— Perchè lo voglio. Perchè so che, se rimango a letto un giorno, non
mi rialzo più.
— Che sciocchezza!... Del resto, se farai così, quando ti deciderai
infine a rimanervi, sarà troppo tardi e forzatamente il tuo triste
presagio si avvererà.
Egli si avvicinò a lei, la baciò su i capelli, le disse con la voce più
dolce, implorando:
— Sii buona: ritorna a letto, mamma! Ascoltami!
— Non seccarmi! — ella proruppe d’un tratto, irosa. — Non ho voglia
d’esser seccata, stamane! Lo vedi, non mi sento bene! Mi sembra
d’avere il cuore sospeso a un filo! È una crudeltà questa tua di farmi
arrabbiare nello stato in cui sono! Vattene via! Lasciami in pace!
Aurelio comprese ch’era inutile insistere. Uscì dalla camera di donna
Marta, inseguito da un presentimento sinistro. Come fu solo su la
loggia, sentì gli occhi bruciare e inumidirsi; mandò un gran sospiro di
rassegnazione desolata. «Mio Dio! Quanto era pallida! Quanto era
breve la sua respirazione! Se mi morisse?!» egli pensò, trasalendo,
affondando per un attimo paurosamente gli sguardi nell’avvenire.
Durante la colazione, donna Marta si mostrò vivace, ciarliera,
oltremodo allegra, di quella sua allegria nervosa e scomposta che
ricordava un poco l’eccitazione d’un ebro. Domandò con insistenza
al nipote i particolari dell’ascensione, alla quale era stata afflittissima
di non poter prender parte; discorse a lungo dei vicini, profondendosi
in elogi e in attestazioni di simpatia per essi; lo rassicurò anche a più
riprese su la sua salute, affermando che in verità ella non si sentiva
nè meglio nè peggio di prima. Quanto a quel po’ di tosse, càspita,
non c’era proprio di che impensierirsi: ella aveva già ordinato a
Laveno certe polveri miracolose, le quali senza dubbio ne
l’avrebbero liberata in due o tre giorni al più tardi.
— E se non ostante le tue polveri, la tosse continuasse? — chiese
Aurelio, sempre serio, sempre più triste quanto ella si dimostrava più
gaja.
— Non temere: passerà.
— E se non passasse? Due o tre giorni senza cure posson esser
causa di complicazioni anche molto serie, che oggi si riuscirebbe
senza difficoltà a evitare. Pensaci! Vuoi che vada io a Laveno per
chiamare il medico?
— Il medico? Guàrdati bene! Io non voglio saperne di medici! Non
ne ho mai voluto sapere! E poi, ora, non è il caso neppur di parlarne.
Si tratta probabilmente d’un semplice raffreddore; e tu, al solito,
esageri....
Finita la colazione, il giovine uscì dal palazzo, sedette al sole sul
rialto, invaso da una strana malinconia, da un’ansietà inesplicabile.
Erano i residui del colloquio definitivo avuto con Flavia su la
montagna, che gli infondevan quella cupa tristezza? No; gli
avvenimenti di due giorni innanzi gli sembravano irreali e
lontanissimi. Sentiva anzi una discontinuità profonda tra lui e il suo
essere anteriore, tra quel che era stato e quel che era. Le sue
speranze distrutte, il suo amore respinto, la coscienza del suo
avverso destino lo lasciavano freddo e impassibile, com’esse non
riguardassero più la sua persona, ma bensì un’altra ch’egli aveva già
amata ed ora a pena ricordava. Che gli importava di Flavia? Che
parte rappresentava ella nella sua vita? Che conforto avrebbe egli
potuto trarre anche dalla speranza d’essere amato da lei? Ohimè,
nell’ora presente, nessun conforto, nessuno! Altre cure, e più gravi,
assai più gravi, occupavano omai tutto il suo spirito: altri dubbii, altri
pensieri, altri sentimenti. Quali? Egli non sapeva bene e non cercava
di sapere. Egli aveva paura di inoltrarsi nel mistero del suo
accasciamento; provava orrore solo a rivolgervi di sfuggita gli occhi
dell’anima; evitava d’investigarsi, per la tema di precisare il
fantasma, d’udire in fondo a sè l’eco d’una tremenda profezia.
Il sole, un sole autunnale senza forza e senza vita, slargava i suoi
raggi pallidi e velati sul prospetto del palazzo. Qua e là nel cielo
alcuni fiocchi bianchicci di vapore intorbidivano l’azzurro,
oscurandosi e addensandosi verso la pianura. Un silenzio di morte
teneva la spiaggia deserta, dove le barche s’allineavano in disordine,
immobili e abbandonate come carcasse respinte dall’onda.