An Invitation to Health Dianne R.

Hales
Visit to download the full and correct content document:
https://textbookfull.com/product/an-invitation-to-health-dianne-r-hales/
More products digital (pdf, epub, mobi) instant
download maybe you interests ...

An Invitation to the Sociology of Emotions Second

Edition Scott R Harris

https://textbookfull.com/product/an-invitation-to-the-sociology-
of-emotions-second-edition-scott-r-harris/

An Invitation to Geomathematics Willi Freeden

https://textbookfull.com/product/an-invitation-to-geomathematics-
willi-freeden/

An Invitation to Feminist Ethics Hilde Lindemann

https://textbookfull.com/product/an-invitation-to-feminist-
ethics-hilde-lindemann/

An Invitation to Computational Homotopy 1st Edition

Graham Ellis

https://textbookfull.com/product/an-invitation-to-computational-
homotopy-1st-edition-graham-ellis/
An Invitation to Model Theory 1st Edition Jonathan
Kirby

https://textbookfull.com/product/an-invitation-to-model-
theory-1st-edition-jonathan-kirby/

An Invitation to Alexandrov Geometry CAT 0 Spaces

Stephanie Alexander

https://textbookfull.com/product/an-invitation-to-alexandrov-
geometry-cat-0-spaces-stephanie-alexander/

Essentials of Meteorology: An Invitation to the

Atmosphere C Donald Ahrens

https://textbookfull.com/product/essentials-of-meteorology-an-
invitation-to-the-atmosphere-c-donald-ahrens/

Women Prisoners and Health Justice Perspectives Issues

and Advocacy for an International Hidden Population 1st
Edition Dianne Hatton

https://textbookfull.com/product/women-prisoners-and-health-
justice-perspectives-issues-and-advocacy-for-an-international-
hidden-population-1st-edition-dianne-hatton/

Agricultural Ethics An Invitation Robert L. Zimdahl

https://textbookfull.com/product/agricultural-ethics-an-
invitation-robert-l-zimdahl/
 Tap into engagement
MindTap empowers you to produce your best work—consistently.

MindTap is designed to help you master the material. Interactive

videos, animations, and activities create a learning path designed
by your instructor to guide you through the course and focus on
what’s important.

MindTap delivers real-world

activities and assignments
that will help you in your academic life as well as your career.

Flashcards
readspeaker
progress app MindTap helps you stay
MyNotes organized and efficient
& highlights by giving you the study tools to master the material.
selF QuizziNg
& practice

MindTap empowers
and motivates
with information that shows where you stand at all times—both
individually and compared to the highest performers in class.

“MindTap was very useful – it was easy to follow and everything

was right there.”
— Student, San Jose State University

“I’m definitely more engaged because of MindTap.”

— Student, University of Central Florida

“MindTap puts practice questions in a format that works well for me.”
— Student, Franciscan University of Steubenville

Tap into more info at: www.cengage.com/mindtap

Source Code: 14M-AA0105

Engaged with you.

www.cengage.com
Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 An Invitation to Health

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 An Invitation
to Health
The Power of Now

Dianne Hales
17th Edition

Australia • Brazil • Mexico • Singapore • United Kingdom • United States

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
This is an electronic version of the print textbook. Due to electronic rights restrictions, some third party content may be suppressed. Editorial
review has deemed that any suppressed content does not materially affect the overall learning experience. The publisher reserves the right to
remove content from this title at any time if subsequent rights restrictions require it. For valuable information on pricing, previous
editions, changes to current editions, and alternate formats, please visit www.cengage.com/highered to search by
ISBN#, author, title, or keyword for materials in your areas of interest.

Important Notice: Media content referenced within the product description or the product text may not be available in the eBook version.

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 An Invitation to Health: The Power of Now, © 2017, 2015 Cengage Learning
17th Edition
WCN: 02-200-203
Dianne Hales
ALL RIGHTS RESERVED. No part of this work covered by the copyright herein
Product Manager: Krista Mastroianni may be reproduced, transmitted, stored, or used in any form or by any means
Content Developers: Nedah Rose, Trudy Brown graphic, electronic, or mechanical, including but not limited to photocopying,
Product Assistant: Victor Luu recording, scanning, digitizing, taping, Web distribution, information networks,
or information storage and retrieval systems, except as permitted under
Marketing Manager: Ana Albinson Section 107 or 108 of the 1976 United States Copyright Act, without the prior
Content Project Manager: Tanya Nigh written permission of the publisher.
Art Director: Michael Cook
Manufacturing Planner: Karen Hunt For product information and technology assistance, contact us at
Cengage Learning Customer & Sales Support, 1-800-354-9706.
Production Service and Compositor: Graphic
For permission to use material from this text or product,
World, Inc.
submit all requests online at www.cengage.com/permissions.
Photo and Text Researcher: Lumina Further permissions questions can be e-mailed to
Datamatics Ltd. permissionrequest@cengage.com.
Text Designer: Liz Harasymczuk
Cover Designer: Michael Cook Library of Congress Control Number: 2015945046
Cover Image: iStockphoto/mel-nik
Student Edition:
ISBN: 978-1-305-63800-6

Loose-leaf Edition:
ISBN: 978-1-305-86929-5

Cengage Learning
20 Channel Center Street
Boston, MA 02210
USA

Cengage Learning is a leading provider of customized learning solutions

with employees residing in nearly 40 different countries and sales in more
than 125 countries around the world. Find your local representative at
www.cengage.com.

Cengage Learning products are represented in Canada by Nelson

Education, Ltd.

To learn more about Cengage Learning Solutions, visit www.cengage.com.

Purchase any of our products at your local college store or at our preferred
online store www.cengagebrain.com.

Printed in Canada
Print Number: 01 Print Year: 2015

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Brief Contents
Chapter 1 the power of Now 1
Chapter 2 Your psychological and Spiritual Well-Being 23
Chapter 3 Caring for Your Mind 47
Chapter 4 personal Stress Management 77
Chapter 5 Your Social health 105
Chapter 6 personal Nutrition 137
Chapter 7 Managing Your Weight 177
Chapter 8 the Joy of Fitness 205
Chapter 9 Sexual health 245
Chapter 10 reproductive Choices 281
Chapter 11 Lowering Your risk of Sexually transmitted Infections 321
Chapter 12 addictions 345
Chapter 13 alcohol 385
Chapter 14 tobacco 419
Chapter 15 Major Diseases 443
Chapter 16 Infectious Illnesses 491
Chapter 17 Consumer health 517
Chapter 18 personal Safety 547
Chapter 19 a healthier environment 573
Chapter 20 a Lifetime of health 597

Making this Chapter Work for You 623

Glossary 625
references 635
Index 651

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Contents
Chapter 1 Boost Emotional Intelligence 26
Meet Your Needs 26
the power of Now 1 Boost Self-Esteem 27
Health and Wellness 2 Pursue Happiness 27
The Dimensions of Health 2 The Roots of Happiness 28
Physical Health 3
What Does and Doesn’t Make Us Happy 28
Psychological Health 3 Become Optimistic 29
Spiritual Health 3 Manage Your Moods 29
Social Health 3 Feeling in Control 30
Intellectual Health 3 Develop Autonomy 30
Environmental Health 3 Assert Yourself 30
Occupational Health 3 Spiritual Health 31
Health in America 4 Spirituality and Physical Health 31
How We Lag Behind 4 Deepen Your Spiritual Intelligence 32
Closing the Gap 4 Clarify Your Values 32
Healthy People 2020 5 Enrich Your Spiritual Life 33
Health Disparities 5 Consider the Power of Prayer 34
Why Race Matters 6 Cultivate Gratitude 34
Cancer Screening and Management 6 Forgive 35
Cardiovascular Disease 7 Sleepless on Campus 35
Diabetes 7 Student Night Life 36
Infant Mortality 7 Sleep’s Impact on Health 37
Mental Health 7 What Happens When We Sleep? 37
How Much Sleep Do You Need? 38
Infectious Disease 7
To Nap or Not to Nap? 38
HIV and Sexually Transmitted Infections 7
Sleep Disorders 39
Sex, Gender, and Health 7
Insomnia 39
Health on Campus 8 Breathing Disorders (Snoring and Sleep Apnea) 40
College and Health 9
Movement Disorders 40
How Healthy Are Today’s Students? 10
Why “Now” Matters 11 Circadian Rhythm Sleep Disorders 40
Student Health Norms 11 Sleeping Pills 40
The Promise of Prevention 12 The Power of Now! 41 • Self Survey 42 • Making This Chapter
Protecting Yourself 12 Work for You 44
Understanding Risky Behaviors 12
Making Healthy Changes 13 Chapter 3
Understanding Health Behavior 13
Predisposing Factors 14 Caring for Your Mind 47
Enabling Factors 14 The Brain: The Last Frontier 48
Reinforcing Factors 14 Inside the Brain 48
Communication within the Brain 49
How and Why People Change 14
Sex Differences in the Brain 50
Health Belief Model 14
The Teenage and 20-Something Brain 50
Self-Determination Theory 15
Motivational Interviewing 15 Understanding Mental Health 51
Self-Affirmation Theory 15 What Is a Mental Disorder? 51
Transtheoretical Model 15 Personality and Health 52
The Stages of Change 16 Mental Health on Campus 52
The Processes of Change 17 Students at Risk 53
Self-Efficacy and Locus of Control 18 The Toll on Students 53
Seeking Help 53
The Power of Now! 19 • Self Survey 19 • Making This Chapter
Depressive Disorders 55
Work for You 20
Depression in Students 55
Chapter 2 Gender and Depression 55
Female Depression 55
Your psychological and Spiritual Male Depression 56
Well-Being 23 Major Depressive Disorder 57
Emotional and Mental Health 24 Treating Depression 57
The Lessons of Positive Mental Health 25 Bipolar Disorder 58
Know Yourself 25 Anxiety Disorders 58
Develop Self-Compassion 26 Specific Phobia 59

vii

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Panic Attacks and Panic Disorder 59
Generalized Anxiety Disorder 60
Other Common Disorders 60
Obsessive-Compulsive Disorder 60
Attention-Deficit/Hyperactivity Disorder
ADHD on Campus 61
Treating ADHD 61
Autism Spectrum Disorder
Autism Spectrum Disorder on Campus
Schizophrenia 62
Nonsuicidal Self-Injury 63
Suicide 63
Suicide on Campus 64
Factors That Lead to Suicide
Suicidal Behavior Disorder
Mental Disorders 65
Substance Abuse 65
Hopelessness 65
Combat Stress 65
Family History 65
Physical Illness 66
Brain Chemistry 66
Access to Guns 66
Other Factors 66
Overcoming Problems of the Mind
Self-Help Strategies 67
Eating Right 67
Exercise 67
Books and Websites
Virtual Support 67
Peer Support 68
Where to Turn for Help 68
Types of Therapists 68
Choosing a Therapist 69
Types of Therapy 69
Brief Psychotherapies 70
Psychodynamic Psychotherapy 70
Cognitive-Behavioral Therapy (CBT) 70
Behavioral Therapy 70
Family-Focused Therapy (FFT) 70
Interpersonal Therapy (IPT) 70
Other Treatment Options
Psychiatric Drugs 70
Alternative Mind–Mood Products
The Power of Now! 72 • Self Survey 73 • Making This Chapter
Work for You 74
Chapter 4
personal Stress Management 77
What Is Stress? 78
Eustress and Distress 78
Stress and the Dimensions of Health
Physical 79
Psychological 79
Spiritual 79
Social 79
Intellectual 79
Occupational 79
Environmental 79
Types of Stressors 80
Stress in America 80
Stress on Campus 81
viii Contents
Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Stress and Student Health 82
Gender Differences 82
Students under Age 25 83
Students over Age 25 83
61 Minority Students 83
Entering Freshmen 84
Test Stress 85
62 Other Stressors 85
62 The Anger Epidemic 85
Economic Stress 86
Job Stress 86
Burnout 86
Illness and Disability 87
65 Traumatic Life Events 87
65 Acute Stress Disorder 87
Posttraumatic Stress Disorder (PTSD) 88
The Stress Response 90
General Adaptation Syndrome (GAS) 90
Cognitive Transactional Model 91
Yerkes-Dodson Law 91
The Impact of Stress 91
Stress and the Heart 91
Stress and Immunity 91
Stress and the Gastrointestinal System 92
Stress and Cancer 92
66
Other Stress Symptoms 92
Psychological Responses to Stress 93
Defense Mechanisms 93
Cognitive Restructuring 93
67
Managing Stress 93
Journaling 94
Exercise 94
Routes to Relaxation 94
Meditation and Mindfulness 94
Yoga 95
Resilience 96
Stress Prevention: Taking Control of
Your Time 97
Are You Running Out of Time? 97
Time Management 98
Overcoming Procrastination 98
The Power of Now! 100 • Self Survey 101 • Making This Chapter
70 Work for You 101
71 Chapter 5
Your Social health 105
The Social Dimension of Health 106
Communicating 107
Learning to Listen 107
Being Agreeable but Assertive 107
How Men and Women Communicate 108
Nonverbal Communication 108
Forming Relationships 109
79
Friendship 109
Loneliness 109
Shyness and Social Anxiety Disorder 110
Building a Healthy Community 111
Doing Good 111
Living in a Wired World 111
Social Networking on Campus 112
Facebook 112
Self-Disclosure and Privacy in a Digital Age 112
Digital Sexual Disclosures 113
Problematic Cell Phone and Internet Use 113
 Dating on Campus 115 The Way We Eat 161
Hooking Up 115 Campus Cuisine: How College Students Eat 161
Why Students Hook Up 116 Fast Food: Eating on the Run 163
Consequences of Hooking Up 116 His Plate, Her Plate: Gender and Nutrition 163
Friends with Benefits 117 You Are What You Drink 163
Loving and Being Loved 117 Soft Drinks 163
Intimate Relationships 117 Energy Drinks 165
What Attracts Two People to Each Other? 118 Taking Charge of What You Eat 166
Infatuation 118 Portions and Servings 166
The Science of Romantic Love 118 Nutrition Labels 166
A Psychological View 118 What Is Organic? 167
An Anthropological View 119 Choosing Healthful Snacks 168
A Biochemical View 119 Food Safety 168
Mature Love 119 Fight BAC! 168
Dysfunctional Relationships 119 Avoiding E. Coli Infection 169
Intimate Partner Violence 119 Food Poisoning 169
Emotional Abuse 120 Pesticides 170
Codependency 121 Food Allergies 170
Signs of Codependency 121 Nutritional Quackery 170
Enabling 122 The Power of Now! 172 • Self Survey 173 • Making This Chapter
When Love Ends 122 Work for You 174
Partnering across the Lifespan 122
The New Transition to Adulthood 122
Cohabitation 123 Chapter 7
Long-Term Relationships 124
Marriage 124
Managing Your Weight 177
Preparing for Marriage 125 Weight in America 178
Weight on Campus 179
The Benefits of Marriage 125
Marriage Equality 125
What is a Healthy Weight? 180
Body Mass Index (BMI) 180
Issues Couples Confront 126
Waist Circumference 181
Conflict in Marriage 127 Waist-to-Hip Ratio (WHR) 182
Saving Marriages 127 Measuring Body Fat 182
Divorce 128 Skinfold Measurement 182
Family Ties 128 Home Body Fat Analyzers 182
Diversity within Families 129 Laboratory Methods 182
Unmarried Parents 129
Understanding Weight Problems 183
The Power of Now! 130 • Self Survey 131 • Making This Chapter How Did So Many Get So Fat? 183
Work for You 133 Health Dangers of Excess Weight 184
The Impact on the Body 184
Chapter 6 The Emotional Toll 186
personal Nutrition 137 If You’re Too Thin: How to Gain Weight 186
Dietary Guidelines for Americans 138 A Practical Guide to a Healthy Weight 186
The Building Blocks of Good Nutrition 139 Why We Overeat 187
Calories 139 Weight Loss Diets 187
Essential Nutrients 140 High-Protein Diets 187
Water 140 Low-Carbohydrate, Low-Fat Diets 187
Protein 140 The Bottom Line 188
Carbohydrates 142 Do Weight Loss Programs Work? 188
Fats 145 Physical Activity and Exercise 189
Vitamins 146 Complementary and Alternative Medicine (CAM)
Minerals 152 for Obesity 189
Vegetables and Fruits 155 Common Diet Traps 190
Milk and Milk Products 156 Maintaining Weight Loss 190
Alcohol 156 Treating Severe Obesity 191
Phytochemicals 156 Prescription Drug Therapy 191
Dietary Supplements 157 Obesity Surgery 191
Healthy Eating Patterns 158 Unhealthy Eating on Campus 193
MyPlate 158 Body Image 193
The USDA Food Patterns 159 “Fat Talk” 194
The DASH Eating Plan 159 Disordered Eating 194
The Mediterranean Diet 159 Extreme Dieting 194
Vegetarian Diets 159 Compulsive Overeating 195
Ethnic Cuisines 160 Binge Eating 196

Contents ix

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Eating Disorders 196 Recovery 225
Anorexia Nervosa 197 Core Strength Conditioning 226
What Causes Anorexia Nervosa? 197 Muscle Dysmorphia 226
Health Dangers and Treatment 197 Drugs Used to Boost Athletic Performance 226
Bulimia Nervosa 198 Becoming More Flexible 228
What Causes Bulimia Nervosa? 198 The Benefits of Flexibility 228
Health Dangers and Treatment 199
Stretching 229
Stretching and Warming Up 230
The Power of Now! 200 • Self Survey 201 • Making This Chapter Stretching and Athletic Performance 230
Work for You 202 Mind–Body Approaches 231
Yoga 231
Chapter 8 Pilates 231
the Joy of Fitness 205 T’ai Chi 232
What Is Physical Fitness? 206 Keeping Your Back Healthy 232
Athletic, or Performance-Related, Fitness 207 Evaluating Fitness Products and Programs 233
Fitness and the Dimensions of Health 207 Exercise Equipment 233
Working Out on Campus 207 Athletic Shoes 233
The Perils of Inactivity 208 Barefoot Running and Alternative Running
Shoes 235
Physical Activity and Exercise 209 Fitness Centers 235
Exercise Is Medicine 209
The Benefits of Exercise 209 Sports Nutrition 235
Water 236
Longer Life 211
Sports Drinks 236
Healthier Heart and Lungs 211 Dietary Supplements 236
Protection against Cancer 211 Energy Bars 237
Better Bones 211 Safe and Healthy Workouts 237
Lower Weight 212 Temperature 237
Better Mental Health and Functioning 212 Heat Cramps 237
Benefits for Students 212 Heat Syndromes 237
Brighter Mood and Less Stress 212 Heat Exhaustion 238
A More Active and Healthy Old Age 213 Heat Stroke 238
Enhanced Sexuality 213 Protecting Yourself from Cold 238
Exercise Risks 213 Exercise Injuries 239
Physical Activity Guidelines for Americans 214 PRICE 239
How Much Exercise Is Enough? 214 Overtraining 239
Your Exercise Prescription 215 Exercise Addiction 239
The Principles of Exercise 215
The Power of Now! 240 • Self Survey 241 • Making This Chapter
Overload Principle 216
FITT 216 Work for You 241
Frequency 216
Intensity 216 Chapter 9
Time (Duration) 216 Sexual health 245
Type (Specificity) 216 Sexual Health 246
Reversibility Principle 217 Sexuality and the Dimensions of Health 246
Improving Cardiorespiratory Fitness 217 Becoming Male or Female 247
Monitoring Intensity 217 Are You an X or a Y? 247
Target Heart Rate 217 How Hormones Work 247
The Karvonen Formula 218 Sexual and Gender Identity 248
Rating of Perceived Exertion (RPE) 218 Women’s Sexual Health 249
Designing an Aerobic Workout 219 Female Sexual Anatomy 249
Warm-up 219 The Menstrual Cycle 249
Aerobic Activity 219 Men’s Sexual Health 253
Cool Down 219 Male Sexual Anatomy 253
Your Long-Term Fitness Plan 219 Circumcision 254
Aerobic Options 220 Responsible Sexuality 254
Stepping Out: Walk the Walk 220 Creating a Sexually Healthy Relationship 255
America on the Move 220 Making Sexual Decisions 255
Jogging and Running 220 Saying No to Sex 256
Other Aerobic Activities 221 Sexual Behavior 257
Building Muscular Fitness 222 Sexual Initiation: The First Time 257
Muscles at Work 222 Sex on Campus 257
Designing a Muscle Workout 224 Hooking up 257
Free Weights vs. Machines 224 Friends with Benefits 259

x Contents

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Choosing Sexual Partners 259 Diaphragm 296
Romantic Relationships 259 Cervical Cap 297
Ethnic Variations 260 FemCap 297
Sex in America 260 Hormonal Contraceptives 298
Sexual Diversity 261 Oral Contraceptives 298
Heterosexuality 261 Combination Oral Contraceptives (COCs) 298
Bisexuality 261 Progestin-Only Pills 299
Homosexuality 261 Before Using Oral Contraceptives 299
Roots of Homosexuality 262 A Special Caution 300
Coming Out 262 Extended-Use Pills 300
Homosexuality on Campus 262 Seasonale and Seasonique 300
The Gender Spectrum 263 Lybrel, the “No-Period” Pill 301
Sexual Activity 263 Contraceptive Patch 301
Celibacy 263 Contraceptive Vaginal Ring (CVR) 302
Abstinence 263
NuvaRing 302
Fantasy 264
Pornography 264 Long-Acting Reversible Contraceptives 302
Masturbation 265 Intrauterine Device (IUD) 303
Nonpenetrative Sexual Activity Contraceptive Injection 303
(Outercourse) 265 Contraceptive Implant 304
Intercourse 266 Fertility Awareness Methods (FAMs) 304
Oral Sex 266 Emergency Contraception 305
Anal Stimulation and Intercourse 266 Sterilization 306
Cultural Variations 266 Male Sterilization 306
Sexual Response 267 Female Sterilization 306
Excitement 267 Essure 307
Plateau 267 When Pregnancy Occurs 307
Orgasm 267 Unwanted Pregnancy 307
Resolution 269 Abortion 308
Other Models of Sexual Response 269 Medical Abortion 308
Sexual Concerns 269 Other Abortion Methods 308
Safer Sex 269 The Psychological Impact of Abortion 309
Sexual Difficulties and Dysfunctions 269 The Politics of Abortion 309
Erectile Dysfunction (ED) 270 A Cross-Cultural Perspective 310
Orgasm Problems in Men 271 Pregnancy 310
Female Sexual Dysfunction 272 Preconception Care 310
Sex Therapy 272 Home Pregnancy Tests 310
Drugs and Sex 272 Prenatal Care 311
Atypical Behavior 273 A Healthy Diet 311
Sexual Addiction 273 Exercise 311
Sexual Deviations 273
Avoid Smoking and Smoke 311
The Business of Sex 274
Don’t Use Alcohol or Drugs 311
The Power of Now! 275 • Self Survey 276 • Making This Chapter How a Woman’s Body Changes during Pregnancy 311
Work for You 277 How a Baby Grows 312
Complications of Pregnancy 312
Chapter 10 Ectopic Pregnancy 312
reproductive Choices 281 Miscarriage 313
Reproductive Responsibility 282 Infections 313
Genetic Disorders 313
Conception 282
Premature Labor 313
Abstinence and Nonpenetrative Sexual Activity 283 Childbirth 314
Contraception 284 Preparing for Childbirth 314
The Benefits and Risks of Contraceptives 288 Labor and Delivery 314
Birth Control in America 289
Caesarean Birth 315
Reproductive Coercion 289
A Cross-Cultural Perspective 290 Other Conditions or Choices 315
Birth Control on Campus 290 Infertility 315
Contraception Choices 290 Options for Infertile Couples 315
Barrier Contraceptives 290 Artificial Insemination 315
Nonprescription Barriers 290 Assisted Reproductive Technology 315
Condoms 290 Adoption 316
Childfree by Choice 316
Contraceptive Sponge 294
Vaginal Spermicides and Film 295 The Power of Now! 316 • Self Survey 317 • Making This Chapter
Prescription Barriers 296 Work for You 318

Contents xi

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Chapter 11 Chapter 12
Lowering Your risk of Sexually addictions 345
transmitted Infections 321 Addictive Behaviors: Risks and Rewards 346
Sexually Transmitted Infections and Diseases 322 Addictive Behaviors and the Dimensions of Health 347
STI Risk Factors and Risk Continuum 322 Gambling and Behavioral Addictions 347
The ABCs of Safer Sex 324 Problem Gambling 347
A Is for Abstain 324 Gambling Disorder 348
B Is for Be Faithful 325 Gambling on Campus 348
C Is for Condoms 325 Risk Factors for Problem Gambling 349
STIs and Gender 326 Drug Use on Campus 349
If You Are a Woman 326 Why Students Don’t Use Drugs 349
If You Are a Man 326
Why Students Use Drugs 350
STIs on Campus 327 Understanding Drugs and Their Effects 351
What College Students Don’t Know Routes of Administration 352
about STIs 327 Dosage and Toxicity 352
Individual Differences 353
Common STIs and STDs 328 Gender and Drugs 353
Human Papillomavirus (HPV) 328 Setting 353
Incidence 328 Types of Action 353
HPV Vaccination 329 Interaction with Other Drugs or Alcohol 354
HPV Vaccination on Campus 329 Caffeine and Its Effects 354
Signs and Symptoms 330 Caffeine Intoxication 355
Diagnosis and Treatment 330 Caffeine-Containing Energy Drinks 355
Genital Herpes 330 Medications 356
Incidence 331 Over-the-Counter Drugs 356
Signs and Symptoms 331 Prescription Drugs 357
Diagnosis and Treatment 331 Physical Side Effects 357
Chlamydia 331 Psychological Side Effects 357
Incidence 332 Drug Interactions 358
Signs and Symptoms 332 Drugs and Alcohol 358
Diagnosis and Treatment 332 Generic Drugs 358
Pelvic Inflammatory Disease Buying Drugs Online 358
(PID) 332 Substance Use Disorders 359
Incidence 333 Dependence 359
Signs and Symptoms 333 Abuse 360
Diagnosis and Treatment 333 Intoxication and Withdrawal 360
Gonorrhea 333 Polyabuse 360
Incidence 333 Coexisting Conditions 360
Signs and Symptoms 333 Causes of Substance Use Disorders 360
Diagnosis and Treatment 334 The Biology of Dependence 360
Nongonococcal Urethritis The Psychology of Vulnerability 361
(NGU) 334 Drugged Driving 361
Syphilis 334 Prescription Drug Abuse 361
Incidence 334 Prescription Drugs on Campus 361
Signs and Symptoms 334 Prescription Stimulants 362
Diagnosis and Treatment 335
Prescription Painkillers 362
Chancroid 335 Common Drugs of Abuse 363
Pubic Lice and Scabies 335 Cannabinoids 363
Trichomoniasis 335 Medical Marijuana 364
Bacterial Vaginosis 336 Legalized Marijuana 365
HIV and AIDS 336 Dependence 365
Incidence 336 Withdrawal 365
Reducing the Risk of HIV Transmission 337 Herbal Drugs 365
Sexual Transmission 337 Salvia 365
Nonsexual Transmission 337 Khat 365
Preventing HIV Infection 338 Synthetic Designer Drugs 366
Recognizing and Treating HIV/AIDS 338 Synthetic Marijuana 366
HIV Testing 338 Synthetic Cathinone 366
Diagnosing AIDS 339 Club Drugs 367
Treatments 339 Ecstasy 367
Herbal Ecstasy 368
The Power of Now! 340 • Self Survey 341 • Making This Chapter
GHB and GHL 369
Work for You 342
Nitrites 369

xii Contents

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Stimulants 369 African American Community 406
Amphetamine 369 Hispanic Community 406
Methamphetamine 370 Native American Community 406
Cocaine 372 Asian American Community 406
Depressants 374 Alcohol Use Disorders 407
Benzodiazepines and Barbiturates 374 Alcohol Use Disorder 407
Opioids 375 Causes 407
Hallucinogens 376 Medical Complications 408
Dissociative Drugs 376 Alcoholism Treatments 408
Ketamine 377 Detoxification 408
PCP 377 Medications 409
Inhalants 377 Inpatient or Residential Treatment 409
Treating Substance Dependence and Abuse 378 Outpatient Treatment 409
Principles of Drug Addiction Treatment 378 Behavioral Therapies 409
12 Step Programs 379 Moderation Training 409
Relapse Prevention 379 12 Step Self-Help Programs 410
The Power of Now! 380 • Self Survey 380 • Making This Chapter Harm Reduction Therapy 410
Work for You 381 Alternatives to AA 410
Recovery 410
Chapter 13
Alcoholism’s Impact on Relationships 411
alcohol 385 Growing Up with an Alcoholic Parent 411
Drinking in America 386 Adult Children of Alcoholics 411
Why People Don’t Drink 386 The Power of Now! 412 • Self Survey 413 • Making This Chapter
Why People Drink 387 Work for You 415
How Much Do Americans Drink? 388
Drinking on Campus 388
Why Students Don’t Drink 389 Chapter 14
Why Students Drink 389
High-Risk Drinking on Campus 391 tobacco 419
Binge Drinking 391 Smoking in America 420
Who Binge-Drinks in College? 391 Why People Smoke 421
Why Students Binge-Drink 392 Limited Education 421
Binge Drinking and Disordered Eating 392 Underestimation of Risks 421
Predrinking/Pregaming 392 Adolescent Experimentation and Rebellion 421
Why Is Predrinking Popular? 393 Stress 421
The Perils of Predrinking 393 Parent Role Models 421
Underage Drinking on Campus 393 Addiction 421
Alcohol Mixed with Energy Drinks (AmED) 393 Genetics 422
Defensive Drinking 394 Weight Control 422
Why Students Stop Drinking 394 Mental Disorders 422
Alcohol-Related Problems on Campus 395 Tobacco Use Disorder 422
Consequences of Drinking 395 Tobacco Use on Campus 423
Drinking and Driving 396 Social Smoking 423
Secondhand Drinking Problems 397 College Tobacco-Control Policies 424
How Schools Are Sobering Up 397 Smoking, Gender, and Race 424
Understanding Alcohol 397 Tobacco’s Immediate Effects 425
Blood-Alcohol Concentration 398 How Nicotine Works 425
Moderate Alcohol Use 400 Tar and Carbon Monoxide 426
Alcohol Intoxication 401 Health Effects of Cigarette Smoking 426
Alcohol Poisoning 401 Health Effects on Students 426
The Impact of Alcohol on the Premature Death 426
Body 402 Heart Disease and Stroke 427
Digestive System 402 Cancer 428
Weight and Waists 403 Respiratory Diseases 428
Cardiorespiratory System 403 Other Smoking-Related Problems 429
Cancer 403 Emerging Tobacco Products 429
Brain and Behavior 403 Electronic Cigarettes 429
Interaction with Other Drugs 404 Water Pipes (Hookahs) 429
Immune System 404 Other Forms of Tobacco 431
Increased Risk of Dying 404 Cigars 431
Alcohol, Gender, and Race 405 Pipes 431
Gender 405 Bidis 431
Race 406 Clove Cigarettes (Kreteks) 431

Contents xiii

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Smokeless Tobacco 432 Stress 463
Snus 432 Depression 463
Quitting Tobacco Use 432 Anger and Hostility 463
Physical Benefits of Quitting 432 Personality Types 464
Psychological Benefits of Quitting 432 Other Risk Factors 464
Quitting on Your Own 433 Inflammation and C-Reactive Protein 464
Virtual Support 433 Homocysteine 464
Stop-Smoking Groups 433 Illegal Drugs 464
Nicotine Replacement Therapy (NRT) 433 Bacterial Infection 464
Nicotine Gum 434 Aspirin and the Heart 464
Nicotine Patches 434 The Heart of a Woman 465
Nicotine Inhaler 434 Crises of the Heart 465
Medications 434 Coronary Artery Disease 465
Other Ways to Quit 434 Atherosclerosis 465
Combined Treatments 435
Unclogging the Arteries 466
Quitting and the Risks Associated with Smoking 435
Electronic Cigarettes 435 Angina Pectoris 466
Heart Attack (Myocardial Infarction) 467
Environmental Tobacco Smoke 435 Is It a Heart Attack? 467
Health Effects of Secondhand Smoke 436
Cardiac Arrest 467
Thirdhand Smoke 437
Saving Hearts 467
The Fight for Clean Air 437
Stroke 468
The Power of Now! 438 • Self Survey 438 • Making This Chapter Risk Factors 468
Work for You 439 Causes of Stroke 469
Silent Strokes 469
Chapter 15 Transient Ischemic Attacks (TIAs) 469
Major Diseases 443 Treatments for Strokes 470
Your Cardiometabolic Health 444 Cancer 471
Cardiometabolic Risk Factors 445 Understanding Cancer 471
Risk Factors You Can Control 445 Cancer Staging 472
Risk Factors You Can’t Control 447 Who Is at Risk? 472
Metabolic Syndrome 448 Heredity 472
Who Is at Risk? 448 Racial and Ethnic Groups 473
What Are the Signs? 449 Obesity 473
Diabetes 449 Infectious Agents 474
Insulin Resistance 450 Common Types of Cancer 475
Prediabetes 450 Skin Cancer 475
Diabetes Mellitus 450 Cervical Cancer 479
Who Is at Risk? 451 Ovarian Cancer 480
Types of Diabetes 451 Testicular Cancer 480
Detecting Diabetes 452 Colon and Rectal Cancer 480
Diabetes Signs and Symptoms 452 Prostate Cancer 481
Diabetes Management 453
Treatment 453 Other Major Illnesses 481
Can Diabetes Be Cured? 453 Epilepsy and Seizure Disorders 481
Asthma 482
Hypertension 454 Ulcers 482
Hypertension in the Young 454
What You Need to Know 455 The Power of Now! 484 • Self Survey 485 • Making This Chapter
Who Is at Risk? 455 Work for You 486
What Is a Healthy Blood Pressure? 456
Lowering High Blood Pressure 456 Chapter 16
Reducing Sodium 457
The DASH Eating Pattern 457
Infectious Illnesses 491
Understanding Infection 492
Exercise 457
Agents of Infection 492
Medications 457
Viruses 492
Your Lipoprotein Profile 458 Bacteria 492
What Is a Healthy Cholesterol Reading? 458
Fungi 493
Lowering Cholesterol 459
Protozoa 493
Lifestyle Changes 459
Helminths (Parasitic Worms) 494
Medications 460
How Infections Spread 494
Cardiovascular (Heart) Disease 460 Animals and Insects 494
How the Heart Works 460
People 494
Heart Risks on Campus 461
The Power of Positive Emotions 462 Food 494
Psychological Risk Factors 462 Water 494

xiv Contents

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 The Process of Infection 494
Who Develops Infections? 495
How Your Body Protects Itself 495
Immune Response 496
Immunity and Stress 497
Immunity and Gender 498
Immune Disorders 498
Allergic Rhinitis 498
Autoimmune Disorders 499
Immunization 499
Childhood Vaccinations 499
Adult Vaccinations 499
Upper Respiratory Infections 500
Common Cold 500
Preventing Colds
Antibiotics 502
Influenza 502
H1N1 Influenza (Swine Flu)
The Threat of a Pandemic 503
Meningitis 503
Preventing Meningitis 504
Recognizing Meningitis 504
When to Seek Medical Care 505
Hepatitis 505
Hepatitis A 505
Hepatitis B 505
Who Develops Hepatitis B? 506
Hepatitis C 506
Other Infectious Illnesses 507
Epstein-Barr Virus and Infectious
Mononucleosis 507
Myalgic Encephalomyelitis/Chronic Fatigue
Syndrome (ME/CFS) 507
Herpes Gladiatorum (Mat Herpes, Wrestler’s Herpes,
Mat Pox) 507
Tuberculosis 508
The “Superbug” Threat: MRSA 508
Preventing MRSA 508
Who Is at Highest Risk?
Insect- and Animal-Borne Infections 509
Lyme Disease 509
West Nile Virus 509
Avian Influenza 510
Emerging Infectious Diseases 510
SARS 510
Ebola 510
Smallpox 510
Reproductive and Urinary Tract Infections 510
Vaginal Infections 510
Urinary Tract Infections 511
The Power of Now! 512 • Self Survey 513 • Making This Chapter
Work for You 513
Chapter 17
Consumer health 517
The Affordable Care Act (ACA) 518
What You Need to Know 519
Consumer-Driven Health Care 519
Improving Your Health Literacy 520
Finding Good Advice Online 520
Getting Medical Facts Straight 521
Evidence-Based Medicine 521
Outcomes Research 522
Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Personalizing Your Health Care 522
Your Family Health History 522
Gender Differences 523
Personal Health Apps and Monitors 523
Self-Care 524
Oral Health 524
Becoming a Savvy Health-Care Consumer 525
Making the Most of a Medical Visit 525
Scheduling the Appointment 525
Before Your Appointment 525
At Your Appointment 526
The Physical Examination 526
Talking with Your Health-Care Provider 526
After Your Visit 528
500 Diagnostic Tests 528
Screening Tests 529
Preventing Medical Errors 529
503 Avoiding Medication Mistakes 529
Your Medical Rights 530
Your Right to Be Treated with Respect and Dignity 530
Your Right to Information 530
Your Right to Privacy and Access to Medical
Records 531
Your Right to Quality Health Care 531
Elective Treatments 531
Vision Surgery 531
When is LASIK Not for You? 532
Cosmetic Surgery 532
Body Art Perils 533
Health Hoaxes and Medical Quackery 533
Nontraditional Health Care 533
Types of CAM 534
Alternative Medical Systems 534
Mind–Body Medicine 535
Biologically Based Therapies 536
Manipulative and Body-Based Therapies 536
Energy Therapies 537
The Health-Care System 537
508 Health-Care Practitioners 537
Physicians 537
The Health-Care Team 537
Dentists 538
Chiropractors 538
Health-Care Facilities 538
College Health Centers 538
Outpatient Treatment Centers 539
Hospitals and Medical Centers 539
Emergency Services 539
Inpatient Care 539
Home Health Care 539
The Power of Now! 540 • Self Survey 541 • Making This Chapter
Work for You 542
Chapter 18
personal Safety 547
Unintentional Injury 548
Why Accidents Happen 548
Safety on the Road 549
Avoid Distracted Driving 549
Don’t Text or Talk 550
Stay Sober and Alert 550
Buckle Up 551
Contents xv
 Check for Air Bags 551 Lead 584
Rein in Road Rage 551 Carbon Monoxide and Nitrogen Dioxide 584
Cycle Safety 552 Chemical Risks 585
Safety at Work and at Home 552 Agricultural Pesticides 585
Computers and Your Health 553 Chemical Weapons 586
Repetitive Motion Injuries 553 Multiple Chemical Sensitivity 586
Vision Problems 553 Invisible Threats 586
At Home 554 Electromagnetic Fields 586
Which Gender Is at Greater Risk? 554 Cell Phones 586
Violence in America 554 Microwaves 587
Gun Violence 555 Ionizing Radiation 587
Mass Shootings 556 Diagnostic X-Rays 587
A Public Health Approach 556 Your Hearing Health 588
Violence and Crime on Campus 557 How Loud Is That Noise? 588
Hazing 558 Effects of Noise 588
Hate or Bias Crimes 559 Are Earbuds Hazardous to Hearing? 589
Shootings, Murders, and Assaults 559 Hearing Loss 589
Consequences of Campus Violence 559 The Power of Now! 591 • Self Survey 592 • Making This Chapter
Sexual Victimization and Violence 560 Work for You 593
Cyberbullying and Sexting 560
Sexual Harassment 560 Chapter 20
Stalking 561 a Lifetime of health 597
Intimate Partner (Dating) Violence 561 An Aging Nation 598
Risk Factors for Intimate Partner Violence 561 Will You Live to 50? 598
Disclosure and Support 562 Successful Aging 599
Nonvolitional Sex and Sexual Physical Activity: It’s Never Too Late 600
Coercion 562 Nutrition and Obesity 601
Rape 563 The Aging Brain 601
Types of Rape 563 Cognitive Aging 602
Acquaintance, or Date, Rape 564 Memory 602
Stranger Rape 565 Women at Midlife 602
Male Nonconsensual Sex and Rape 565 Menopause 603
Impact of Rape 565 Hormone Replacement Therapy 603
What to Do in Case of Rape 566 Men at Midlife 604
Helping the Victims of Violence 566 Low Testosterone 604
The Power of Now! 568 • Self Survey 569 • Making This Chapter Prostate Problems 604
Work for You 570 Sexuality and Aging 604
The Challenges of Age 605
Mild Cognitive Impairment (MCI) 606
Chapter 19 Alzheimer’s Disease 606
a healthier environment 573 Osteoporosis 607
The Environment and Your Health 574 Preparing for Medical Crises and the End of Life 607
Climate Change 574 Advance Directives 608
Global Warming 574 Health-Care Proxies 608
The Health Risks 575 Living Wills 608
The Impact of Pollution 576 The Five Wishes 608
The Air You Breathe 577 DNR Orders 608
Ozone 577 Holographic Wills 609
Particle Pollution 578 Ethical Dilemmas 609
Working toward Sustainability 578 The Gift of Life 609
The Water You Drink 579 Death and Dying 610
Is Bottled Better? 580 Death Education 610
Portable Water Bottles 580 Defining Death 610
Indoor Pollutants: The Inside Story 580 Denying Death 611
Environmental Tobacco Smoke (ETS) 580 Emotional Responses to Dying 611
Secondhand Smoke 580 How We Die 612
Thirdhand Smoke 581 A “Good” Death 613
Radon 581 Caregiving 613
Molds and Other Biological Contaminants 582 Hospice: Caring When Curing Isn’t Possible 613
Household Products 582 Near-Death Experiences 614
Formaldehyde 583 Suicide 614
Pesticides 583 “Rational” Suicide 614
Asbestos 584 Euthanasia and Assisted Suicide 614

xvi Contents

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
The Practicalities of Death 615 answers for Making this Chapter
Funeral Arrangements 615
Autopsies 615 Work for You 623
Grief 616
Grief’s Effects on Health 616 Glossary 625
The Power of Now! 617 • Self Survey 618 • Making This Chapter
Work for You 619 references 635
Index 651

Contents xvii

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
 Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Key Features
CoN S u M e r a L e rt Seven Secrets to a Good Sexual Relationship 256
Reducing Your Risk of STIs 326
Sleeping Pill Precautions 39 Develop a Positive Addiction 346
The Pros and Cons of Antidepressants 58 Drink Less, Save More 390
Online Flirting and Dating 113 The Toll of Tobacco 420
Dubious Diets 188 Lowering Your Cardiometabolic Risks 445
Watch Out for “Pump Fiction” 224 Caring for Your Cold 502
Safe Sex in Cyberspace 264 Getting Your Money’s Worth from the Health-Care System 527
Should You Get the HPV Vaccine? 330 A Do-It-Yourself Security Program 558
Alcohol and Drug Interactions 404 No- and Low-Cost Ways to Green Your Space 581
E-cigarettes 430 Reduce Your Future Health-Care Costs 601
How to Get an Accurate Lipoprotein Profile 458
Are You Addicted to Tanning? 475 S Na p S ho t: oN Ca M p u S NoW
Protecting Yourself from the Perils of Piercing 506
Too Good to Be True? 522 Student Health 10
Bicycle Helmet Heads-Up 552 Sleepy Students 36
What Difference Does a Lightbulb Make? 579 Student Mental Health 54
Stressed-Out Students 82
h e a Lt h NoW! All the Lonely Students 110
Are You Eating Your Veggies? 156
First Steps 12 The Weight of Student Bodies 179
Accentuate the Positive 26 Student Bodies in Motion 208
Count Your Blessings 53 The Sex Lives of College Students 258
Write It Out! 94 Birth Control Choices of College Students 291
Assessing a Relationship 122 Students and STIs 327
More Healthful Fast-Food Choices 163 Student Drug Use 350
Thinking Thinner 190 Student Drinking 389
Excise Exercise Excuses 209 Student Smoking 423
Developing Sexual Responsibility 257 Cancer Preventive Strategies 472
Choosing a Contraceptive 288 Vaccinations 501
Telling a Partner You Have an STI 328 What’s Trending in Who Uses Complementary and Alternative
Recognizing Substance Abuse 359 Medicine 535
If Someone Close to You Drinks Too Much 411 How Safe Do Students Feel? 557
Kicking the Habit 435 Do Students Care about the Environment? 574
Infection Protection 495 Dying Young: Leading Causes of Death 610
Is a CAM Therapy Right for You? 536
How to Avoid Date Rape 565 You r S t r at eGI e S For C h a NGe
Protecting the Planet 575
Preparing for a Medical Crisis in an Aging Relative 609 How to Forgive 35
How to Cope with Distress after a Trauma 88
h e a Lt h oN a Bu D Ge t How to Become More Resilient 97
How to Assert Yourself 108
Invest in Yourself 13 How to Cope with an Unhealthy Relationship 121
Happiness for Free! 29 Creating a Healthy Eating Pattern 158
The Exercise Prescription 67 Make Smart Choices 162
How to Handle Economic Stress 85 The Right Way to Walk and Run 221
Money Can’t Buy Love 120 If You Have an STI 326
Frugal Food Choices 162 How to Lower Your Blood Pressure 457
Hold the Line! 180 Learning about Death 611
Low-Cost Fitness Aids 233 How to Cope with Grief 616

xix

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
You r S t r at eGI e S For How to Say No to Drugs 361
p r e v e N t IoN How to Recognize the Warning Signs of Alcoholism 408
How to Lower Your Risk of Type 2 Diabetes 452
If You Are at Risk 6 How to Recognize a Stroke 468
How to Help Someone Who Is Depressed 57 Save Your Skin 477
Steps to Prevent Suicide 66 How to Protect Yourself and Others from Influenza 504
How to Handle Test Stress 84 How to Avoid MRSA 508
How to Protect Yourself from Food Poisoning 170 How to Boost Health Understanding 519
Keeping the Pounds Off 192 How to Take Care of Your Mouth 525
How to Avoid Stretching Injuries 230 What to Do in an Emergency 548
How to Protect Your Back 232 How to Protect Your Ears 589
How to Stay Safe in the “Hookup Era” 261 Keep Your Bones Healthy 608

xx Key Features

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
preface
to the Student: Starting Now • Nine in ten college students report feeling stressed.
• One in three reports binge drinking at least once in the previous
College prepares you for the future. But when it comes to health, two weeks.
your future starts now! Such risky behaviors take a toll. According to an international study,
Every day you make choices and take actions that may or may not young Americans are less likely to survive until age 55 than their
have long-term consequences in the future. Yet they do have imme- peers in other developed nations. Those who do live to middle age
diate effects on how you feel now. Here are some examples: and beyond are more likely to suffer serious chronic diseases and
• You stay up late and get less than five hours’ sleep. The next day disabilities.
you feel groggy, your reflexes are off, and you find it harder to You do not have to be among them. An Invitation to Health: The
concentrate. Power of Now shows you how to start living a healthier, happier,
• You scarf down a double cheeseburger with bacon, a supersized fuller life now and in the years to come.
side of fries, and a milkshake. By the time you’re done with your
meal, harmful fats are coursing through your bloodstream.
• You chug a combo of Red Bull and vodka and keep partying for
hours. Even before you finish your first drink, your heart is racing to the Instructor
and your blood pressure rising. If you keep drinking, you’ll reach
dangerous levels of intoxication—probably without realizing how You talk to your students about their future because it matters. But
inebriated you are. in the whirl of undergraduates’ busy lives, today matters more. As
recent research has documented, payoffs in the present are more
• Too tired to head to the gym, you binge-watch streaming videos for powerful motivators for healthful behaviors than future rewards. Indi-
hours. Your metabolism slows; your unexercised muscles weaken. viduals exercise more, eat better, quit smoking, and make positive
• Just this once, you have sex without a condom. You wake up the changes when immediate actions yield short-term as well as long-
next morning worrying about a sexually transmitted infection (STI) term benefits.
or a possible pregnancy. An Invitation to Health: The Power of Now incorporates this underly-
• You don’t have time to get to the student health center for a flu ing philosophy throughout its chapters. As you can see in the Pref-
shot. Then your roommate comes down with the flu. ace for students, we consistently point out the impact that everyday
• You text while driving—and don’t notice that the traffic light is choices have on their health now and in the future. Each chapter
changing. highlights specific, practical steps that make a difference in how stu-
dents feel and function. The “Health Now!” feature gives students
There are countless other little things that can have very big conse- step-by-step guidance on how to apply what they’re learning in their
quences on your life today as well as through all the years to come. daily lives. “The Power of Now!” checklist at each chapter’s end
But they don’t have to be negative. Consider these alternatives: reinforces key behavioral changes that can enhance and safeguard
• Get a solid night’s sleep after studying, and you’ll remember more health.
course material and probably score higher on a test. I also am introducing a new interactive “check-in” feature that
• Eat a meal of a low-fat protein, vegetables, and grains, and you’ll engages students as they read by posing questions that relate
feel more energetic. directly to their lives, experiences, and perspectives. After the defi-
nitions of wellness in Chapter 1, for instance, a “check-in” asks
• Limit your alcohol intake, and you’ll enjoy the evening and feel “What does wellness mean to you?” In the section on healthy habits,
better the morning after. another “check-in” instructs students to rate their own health habits.
• Go for a 10-minute walk or bike ride, and you’ll feel less stressed As they learn about behavioral changes, this feature prompts them
and weary. to identify a health-related change they want to make and their stage
of readiness for change.
• Practice safe sex always, and you won’t have to wonder if you’ve
jeopardized your sexual health. As an instructor, you can utilize the “check-in” features in different
ways. For instance, you might suggest that students use them to
• Keep up with your vaccinations, and you lower your odds of seri-
test their comprehension of the material in the chapter. You might
ous sicknesses.
assign them to write a brief reflection on one or more “check-ins.” Or
• Pay attention to the road when you drive, and you can avoid you might draw on the “check-ins” to spark classroom discussion
accidents. and increase student engagement.
In addition to their immediate effects, the impact of health behaviors This textbook is an invitation to you as an instructor. I invite you to share
continues for years and decades to come. Consider these facts: your passion for education and to enter into a partnership with the edi-
• More than 40 percent of college students are already overweight torial team at Cengage Learning. We welcome your feedback and sug-
or obese. gestions. Please let us hear from you at www.cengage.com/health.
• One in four college students may have at least one risk factor for I personally look forward to working with you toward our shared goal
cardiovascular disease. of preparing a new generation for a healthful future.

xxi

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
What’s New in An Invitation As I tell students, An Invitation to Health: The Power of Now can
serve as an owner’s manual to their bodies and minds. By using
to Health: The Power of Now this book and taking your course, they can acquire a special type of
power—the power to make good decisions, to assume responsibil-
Some things don’t change: as always, this Invitation presents up- ity, and to create and follow a healthy lifestyle. This textbook is our
to-date, concise, research-based coverage of all the dimensions of invitation to them to live what they learn and make the most of their
health. It also continues to define health in the broadest sense of health—now and in the future.
the word—not as an entity in itself, but as an integrated process for
discovering, using, and protecting all possible resources within the
individual, family, community, and environment. an overview of Changes
What is new is the theme that threads through every chapter: pro-
viding students with practical knowledge and tools they can apply
and updates
immediately to improve their health and their lives. One of the keys to Following is a chapter-by-chapter listing of some of the key topics
doing so is behavioral change, which has always been fundamental that have been added, expanded, or revised for this edition.
to An Invitation to Health. The one feature that has appeared in every
edition—and that remains the most popular—is “Your Strategies for Chapter 1: the power of Now
Change.” College and health; occupational health; dimensions of health; stu-
Every chapter concludes with “The Power of Now!,” a checklist that dent health norms; self-affirmation theory; health belief model (HBM)
students can use to assess their current status and work toward
specific goals, whether by creating better relationships (Chapter 5), Chapter 2: Your psychological and Spiritual
getting in better shape (Chapter 8), or taking charge of their alcohol
intake (Chapter 13). Chapter 17, Consumer Health, contains updated Well-Being
information on the Affordable Care Act as well as ways to evaluate Positive psychology and positive psychiatry; most effective positive
health information, prepare for a medical exam, get quality traditional psychology interventions; positive effects of optimism, autonomy,
and alternative health care, and navigate the health-care system. and self-compassion; most effective gratitude interventions; track-
ing moods; sense of purpose; sleep times; sleep and sex; electronic
Throughout this edition, the focus is on students, with real-life exam- devices and sleep onset; napping; snoring; Exploding Head Syndrome
ples, the latest statistics on undergraduate behaviors and attitudes,
and coverage of new campus health risks, including alcohol mixed Chapter 3: Caring for Your Mind
with energy drinks (AmEDs), HPV, piercing and body art, electronic Mental health on campus; top concerns of undergraduates; students
cigarettes and vaping, hookah (water pipe) smoking, the combina- at risk; recognizing the characteristics of depression; ADHD; autism
tion of binge drinking and disordered drinking, polysubstance abuse, spectrum disorder; self-injury; suicide; psychiatric medications
“bath salts,” cyberbullying, and campus stalking.
An interactive feature, “On Campus Now,” showcases the latest Chapter 4: personal Stress Management
research on student behavior, including their sleep habits (Chapter 2), Stress in America; occupational stress; discrimination and stress;
stress levels (Chapter 4), weight (Chapter 7), and sexual experi- stress and the heart; stress-management apps; self-compassion;
ences (Chapter 9). “Health Now!” presents practical, ready-to-use burnout
tips related to real-life issues such as recognizing substance abuse
(Chapter 12), infection protection (Chapter 16), preventing accidents Chapter 5: Your Social health
(Chapter 18), and going green (Chapter 19). Loneliness; companion pets; cyberstalking and cyberbullying; col-
Other popular features that have been retained and updated include lege students’ cell phone use; the brain in love; trends in sexual
“Health on a Budget” and “Consumer Alert.” A “Self Survey” for each relationships; hookup culture; same-sex marriage; long-term health
chapter can be found within MindTap. End-of-chapter resources consequences of divorce
include “Review Questions,” “Critical Thinking Questions,” and “Key
Terms.” At the end of the book is a full Glossary as well as complete Chapter 6: personal Nutrition
chapter references. Preliminary 2015 Dietary Guidelines for Americans; calorie balance;
Because health is an ever-evolving field, this edition includes many eating patterns in the United States and worldwide; student use of
new topics, including the latest reports on dietary guidelines for dietary supplements; food allergies; Mediterranean diet; nutrition
Americans, students’ mental health, merging tobacco products, the labels; artificially sweetened drinks; sugar consumption; fruit and
impact of stress, campus hookups, same-sex marriage, self-injury, fruit juices; vitamin supplements
suicide prevention, vitamin supplements, exercise guidelines, STIs,
gun violence, attention-deficit/hyperactivity disorder (ADHD), autism Chapter 7: Managing Your Weight
spectrum disorder, caffeinated alcoholic beverages, binge drinking, Weight on campus; body mass index (BMI); evaluating weight loss
weight management, metabolic syndromes, myalgic encephalomy- programs; CAM for obesity; emotional eating
elitis/chronic fatigue syndrome (ME/CFS), and the latest recommen-
dations for prevention and treatment of infectious illnesses. Chapter 8: the Joy of Fitness
All the chapters have been updated with the most current research, “Exercise Is Medicine,” countering dangers of sedentary living, how
including many citations published in 2015, and incorporating the much exercise is enough, barefoot running, bariatric surgery, salt
latest available statistics. The majority come from primary sources, supplements
including professional books; medical, health, and mental health
journals; health education periodicals; scientific meetings, federal Chapter 9: Sexual health
agencies, and consensus panels; publications from research labora- Changes in sexual behavior; casual sex on campus; sex among
tories and universities; and personal interviews with specialists in a young adults; why students hook up; culture and sexual messages;
number of fields. In addition, “What’s Online” presents reliable Inter- homophobia; LGBT health disparities; female ejaculation; sexual
net addresses where students can turn for additional information. dysfunction

xxii Preface

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Chapter 10: reproductive Choices coercion and violence; hate crimes; victimization based on sexual
Contraceptive information sources for young adults; impact of con- orientation; sexting; dating violence
traception on women’s lives; statistical “snapshot” of current birth
control in the United States; reproductive coercion on campus; Chapter 19: a healthier environment
student access to condoms; long-acting reversible contraceptives Effects of global warming on health; pollution’s health impact; indoor
(LARCs); female condoms; abortion; pregnancy-related mortality and outdoor air quality; electromagnetic fields; cell phone dangers;
rates energy-efficient lightbulbs

Chapter 11: Lowering Your risk of Sexually Chapter 20: a Lifetime of health
transmitted Infections Health problems of seniors; impact of feeling younger than actual
Risks factors for sexually transmitted infections (STIs); update on age; Mediterranean diet and longevity; quality of sleep and aging;
Human papillomavirus (HPV); meeting sex partners online; bacterial disabilities in older Americans; age-related memory loss; Alzheimer’s
vaginosis (BV); syphilis disease; advance health directives; quality of life in final years

Chapter 12: addictions

Drugs in America; students and drugs; substance-free reinforcement; Supplemental resources
polysubstance abuse; gambling disorders; caffeine-containing energy
drinks (CCEDs); stimulants; marijuana’s effects on health; medical
marijuana; legalized marijuana; artificial reproductive technology
Health MindTap for An Invitation to Health:
The Power of Now! (Instant access Code:
Chapter 13: alcohol ISBN-13: 978-1-305-86621-8)
Alcohol-free programs on campus; drinking in America; toll of alco- MindTap is a personalized teaching experience with relevant assign-
hol; drinking on campus; how schools are sobering up; work hours ments that guide students to analyze, apply, and improve thinking,
and drinking; discrimination and drinking; alcohol-related cues; allowing you to measure skills and outcomes with ease.
alcohol mixed with energy drinks (AmEDs); alcohol poisoning; cir-
• Personalized Teaching: Becomes yours with a Learning Path
rhosis; consequences of light drinking; trauma and abuse as risk
that is built with key student objectives. Control what students
factors for drinking; behavioral therapies; medicines for alcohol
see and when they see it. Use it as-is or match to your syllabus
recovery
exactly—hide, rearrange, add, and create your own content.
Chapter 14: tobacco • Guide Students: A unique learning path of relevant readings, mul-
Smoking in America; smoke- and tobacco-free policies on cam- timedia and activities that move students up the learning taxon-
pus; tobacco bans; smoking and mortality; health consequences of omy from basic knowledge and comprehension to analysis and
smoking; emerging tobacco products; electronic cigarettes; vaping; application.
hookahs; secondhand smoke; thirdhand smoke • Promote Better Outcomes: Empower instructors and motivate
students with analytics and reports that provide a snapshot of
Chapter 15: Major Diseases class progress, time in course, engagement, and completion
Importance of “now” for health; global toll of obesity; American rates.
Heart Association’s steps to safeguard health; evaluating meta-
bolic risk; role of healthy diet and weight; diabetes; blood pressure; Diet & Wellness plus
hypertension in the young; high cholesterol; psychological factors; Diet & Wellness Plus helps you gain a better understanding of
impact of stress; benefit of antidepressants; women and heart how nutrition relates to your personal health goals. It enables you
disease; reducing heart disease risk; cancer in America; external to track your diet and activity, generate reports, and analyze the
causes of cancer; internal causes of cancer; cancer staging; risk nutritional value of the food you eat. It includes more than 55,000
factors for skin cancer; lowering the risk of breast cancer; treat- foods in the database, custom food and recipe features, the latest
ments for breast cancer Dietary References, as well as your goal and actual percentages
of essential nutrients, vitamins, and minerals. It also helps you to
Chapter 16: Infectious Illnesses identify a problem behavior and make a positive change. After
New tick-borne pathogen; new guidelines for treating allergic rhinitis; you complete a Wellness Profile questionnaire, Diet & Wellness
childhood and adult vaccinations; common cold treatments; drug- Plus rates the level of concern for eight different areas of wellness,
resistant superbugs; tests and treatments for hepatitis C; myalgic helping you determine the areas where you are most at risk. It then
encephalomyelitis/chronic fatigue syndrome; Ebola outbreaks; bac- helps you put together a plan for positive change by helping you
terial Clostridium difficile (C. difficile) infections select a goal to work toward, complete with a reward for all your
hard work.
Chapter 17: Consumer health Diet & Wellness Plus is also available as an app that can be accessed
Update on the Affordable Care Act (Obamacare), consumer-driven from the app dock in MindTap and can be used throughout the
health care, personal health apps and monitors, privacy of personal course to track diet and activity, as well as behavior change.
health information, trends in plastic surgery, CAM use in America
and on college campuses Instructor Companion Site
This site offers everything you need for your course in one place!
Chapter 18: personal Safety This collection of book-specific lecture and class tools is avail-
Risk factors for unintentional injury in young adults; factors that able online via www.cengage.com/login. Access and download
impair driving; bicycle fatalities; cell phone use and driving; gun PowerPoint presentations, images, the instructor’s manual, videos,
violence; mass shootings; mental illness and violent crime; sexual and more.

Preface xxiii

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Cengage Learning testing powered Carol Allen, Lone Community College
Lana Arabas, Truman State University
by Cognero Judy Baker, East Carolina University
Cengage Learning Testing Powered by Cognero is a flexible online Marcia Ball, James Madison University
system that allows you to: Jeremy Barnes, Southeast Missouri State University
Rick Barnes, East Carolina University
• Author, edit, and manage test bank content from multiple Lois Beach, SUNY-Plattsburg
Cengage Learning solutions Liz Belyea, Cosumnes River College
Betsy Bergen, Kansas State University
• Create multiple test versions in an instant
Nancy Bessette, Saddleback College
• Deliver tests from your LMS, your classroom, or wherever you want Carol Biddington, California University of Pennsylvania
David Black, Purdue University
Global health Watch (Instant access Code: Jill M. Black, Cleveland State University
Cynthia Pike Blocksom, Cincinnati Health Department
ISBN-13: 978-1-111-37733-5; printed access Laura Bounds, Northern Arizona University
Card: ISBN-13: 978-1-111-37731-1) James Brik, Willamette University
Mitchell Brodsky, York College
Updated with today’s current headlines, Global Health Watch is a Jodi Broodkins-Fisher, University of Utah
one-stop resource for classroom discussion and research projects. Elaine D. Bryan, Georgia Perimeter College
This resource center provides access to thousands of trusted health James G. Bryant, Jr., Western Carolina University
sources, including academic journals, magazines, newspapers, vid- Conswella Byrd, California State University East Bay
eos, podcasts, and more. It is updated daily to offer the most current Marsha Campos, Modesto Junior College
news about topics related to your health course. Richard Capriccioso, University of Phoenix
James Lester Carter, Montana State University
Jewel Carter-McCummings, Montclair State University
Careers in health, physical education, and Peggy L. Chin, University of Connecticut
Sport, 2nd edition (ISBN-13: 978-0-495-38839-5) Olga Comissiong, Kean University
This unique booklet takes students through the complicated process Patti Cost, Weber State University
Maxine Davis, Eastern Washington University
of choosing the type of career they want to pursue; explains how to
Maria Decker, Marian Court College
prepare for the transition into the working world; and provides insight Laura Demeri, Clark College
into different types of career paths, education requirements, and rea- Lori Dewald, Shippensburg University of Pennsylvania
sonable salary expectations. A designated chapter discusses some Julie Dietz, Eastern Illinois University
of the legal issues that surround the workplace, including discrimi- Peter DiLorenzo, Camden County College
nation and harassment. This supplement is complete with personal Robert Dollinger, Florida International University College of Medicine
development activities designed to encourage students to focus on Rachelle D. Duncan, Oklahoma State University
and develop better insight into their futures. Sarah Catherine Dunsmore, Idaho State University
Gary English, Ithaca College
Victoria L. Evans, Hendrix College

acknowledgments
Melinda K. Everman, Ohio State University
Michael Felts, East Carolina University
Lynne Fitzgerald, Morehead State University
One of the joys of writing each edition of An Invitation to Health is Matthew Flint, Utah Valley University
the opportunity to work with a team I consider the best of the best in Kathie C. Garbe, Kennesaw State College
textbook publishing. I thank Krista Mastroianni, product manager, for Gail Gates, Oklahoma State University
Dawn Graff-Haight, Portland State University
her enthusiasm and support. Nedah Rose, senior content developer,
Carolyn Gray, New Mexico State University
contributed in countless ways to many editions, making each one Mary Gress, Lorain County Community College
stronger. I applaud Alexandria Brady for taking over the reins and Janet Grochowski, University of St. Thomas
shepherding this edition through completion. Michael Cook, senior Jack Gutierrez, Central Community College
designer, provided the evocative cover and eye-catching design. Autumn R. Hamilton, Minnesota State University
I am also grateful to Yolanda Cossio, both personally and profes- Christy D. Hawkins, Thomas Nelson Community College
sionally, for her wisdom and guidance. Stephen Haynie, College of William and Mary
Amy Hedman, Mankato State University
I thank Victor Luu, our editorial assistant, for his invaluable aid; Tanya Ron Heinrichs, Central Missouri State University
Nigh, senior content project manager, for expertly shepherding this Candace H. Hendershot, University of Findlay
edition from conception to production; Liz Harasymczuk for the Michael Hoadley, University of South Dakota
vibrant new design; and Evelyn Dayringer of Graphic World Publish- Debbie Hogan, Tri County Community College
ing Services for her supervision of the production process. Veerabh- Margaret Hollinger, Reading Area Community College
agu Nagarajan, our photo researcher, provided images that capture Harold Horne, University of Illinois at Springfield
the diversity and energy of today’s college students. Ganesh Krish- Linda L. Howard, Idaho State University
Mary Hunt, Madonna University
nan coordinated text permissions, and Christine Myaskovsky man-
Kim Hyatt, Weber State University
aged the overall permissions process. Bill Hyman, Sam Houston State University
My thanks to Ana Albinson, marketing manager; to Alexandria Brady, Dee Jacobsen, Southeastern Louisiana University
who managed the creation of MindTap; and to Kellie Petruzzelli, who John Janowiak, Appalachian State University
guided the ancillaries. Peggy Jarnigan, Rollins College
Jim Johnson, Northwest Missouri State University
Finally, I would like to thank the reviewers whose input has been so Chester S. Jones, University of Arkansas
valuable through these many editions. Herb Jones, Ball State University
Jane Jones, University of Wisconsin, Stevens Point
Ghulam Aasef, Kaskaskia College
Lorraine J. Jones, Muncie, Indiana
Andrea Abercrombie, Clemson University
Walter Justice, Southwestern College
Daniel Adame, Emory University
Becky Kennedy-Koch, The Ohio State University
Lisa Alastuey, University of Houston
Margaret Kenrick, Los Medanos College

xxiv Preface

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Anthony F. Kiszewski, Bentley University Miguel Perez, University of North Texas
Mark J. Kittleson, Southern Illinois University Pamela Pinahs-Schultz, Carroll College
Darlene Kluka, University of Central Oklahoma Dena Pistor, Rollins College
John Kowalczyk, University of Minnesota, Duluth Rosanne Poole, Tallahassee Community College
Debra A. Krummel, West Virginia University Thomas Roberge, Norwich University
Roland Lamarine, California State University, Chico Keisha Tyler Robinson, Youngstown State University
David Langford, University of Maryland, Baltimore County Joel Rogers, West Hills Community College District
Terri Langford, University of Central Florida Linda J. Romaine, Raritan Valley Community College
Beth Lanning, Baylor University Pamela Rost, Buffalo State College
Norbert Lindskog, Harold Washington College Karla Rues, Ozarks Technical Community College
Loretta Liptak, Youngstown State University Veena Sallan, Owensboro Community & Technical College
Raymond A. Lomax, Kean University Sadie Sanders, University of Florida
David G. Lorenzi, West Liberty State College Steven Sansone, Chemeketa Community College
S. Jack Loughton, Weber State University Debra Secord, Coastline College
Rick Madson, Palm Beach Community College Behjat Sharif, California State University–Los Angeles
Ashok Malik, College of San Mateo Andrew Shim, Southwestern College
Michele P. Mannion, Temple University Agneta Sibrava, Arkansas State University
Jerry Mayo, Hendrix College Steve Singleton, Wayne State University
Wajeeha Mazhar, California Polytechnic State University–Pomona Larry Smith, Scottsdale Community College
Jessica Middlebrooks, University of Georgia Teresa Snow, Georgia Institute of Technology
Claudia Mihovk, Georgia Perimeter College Sherm Sowby, Brigham Young University
Kim H. Miller, University of Kentucky Carl A. Stockton, Radford University
Susan Milstein, Montgomery College Linda Stonecipher, Western Oregon State College
Esther Moe, Oregon Health Sciences University Ronda Sturgill, Marshall University
Kris Moline, Lourdes College Jacob W. Surratt, Gaston College
Richard Morris, Rollins College Rosemarie Tarara, High Point University
Rosemary Moulahan, High Point University Laurie Tucker, American University
Sophia Munro, Palm Beach Community College Julia VanderMolen, Davenport University
John W. Munson, University of Wisconsin–Stevens Point Emogene Johnson Vaughn, Norfolk State University
Ray Nolan, Colby Community College Jennifer Vickery, Winthrop College
Shannon Norman, University of South Dakota Andrew M. Walker, Georgia Perimeter College
Anne O’Donnell, Santa Rosa Junior College David M. White, East Carolina University
Terry Oehrtman, Ohio University Sabina White, University of California–Santa Barbara
Shanyn Olpin, Weber State University Robert Wilson, University of Minnesota
David Oster, Jefferson College Roy Wohl, Washburn University
Randy M. Page, University of Idaho Martin L. Wood, Ball State University
Carolyn P. Parks, University of North Carolina Sharon Zackus, City College of San Francisco
Anthony V. Parrillo, East Carolina University
Lorraine Peniston, Hartford Community College

Preface xxv

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
about the author
Dianne Hales is one of the most widely published and honored freelance journalists in the
country. She is the author of 15 trade books, including Mona Lisa: A Life Discovered; La Bella
Lingua; Just Like a Woman; Think Thin, Be Thin; and Caring for the Mind, with translations
into Chinese, Japanese, Italian, French, Spanish, Portuguese, German, Dutch, Swedish,
Danish and Korean.
Hales has received the highest honor the government of Italy can bestow on a foreigner, an
honorary knighthood, with the title Cavaliere dell’ Ordine della Stella della Solidarietà Italiana
(Knight of the Order of the Star of Italian Solidarity) in recognition of her book La Bella Lingua:
My Love Affair with Italian, the World’s Most Enchanting Language, as “an invaluable tool for
promoting the Italian language.”

Julia Hales
Hales is a former contributing editor for Parade, Ladies’ Home Journal, Working Mother, and
American Health and has written more than 1,000 articles for publications including Family
Circle, Glamour, Good Housekeeping, Health, The New York Times, Reader’s Digest, The
Washington Post, Woman’s Day, and The World Book Encyclopedia.
Hales has received writing awards from the American Psychiatric Association and the Ameri-
can Psychological Association, an EMMA (Exceptional Media Merit Award) for health report-
ing from the National Women’s Political Caucus and Radcliffe College, three EDI (Equality, Dignity, Independence) awards for print journalism
from the National Easter Seal Society, the National Mature Media Award, and awards from the Arthritis Foundation, California Psychiatric
Society, CHADD (Children and Adults with Attention Deficit/Hyperactivity Disorder), Council for the Advancement of Scientific Education, and
New York City Public Library.

xxvi

Copyright 2017 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
Editorial review has deemed that any suppressed content does not materially affect the overall learning experience. Cengage Learning reserves the right to remove additional content at any time if subsequent rights restrictions require it.
Another random document with
no related content on Scribd:
 Fig. 154—Young larva of Stylops on a bee's-hair. Greatly magnified.
(After Newport.)

There is no exact information as to how the young triungulins find

their way to the bee-larvae they live in. Here again the discrepancy
of opinion that prevails is probably due to great difference really
existing as to the method. When a Stylops carried by an Insect (a
Hymenopteron, be it noted, for we have no information whatever as
to Hemiptera) produces young, they cover the body of the host as if
it were powdered, being excessively minute and their numbers very
great; many hundreds, if not thousands, of young being produced by
a single Stylops. The species of the wasp genus Polistes are
specially subject to the attacks of Stylops; they are social Insects,
and a stylopised specimen being sickly does not as a rule leave the
nest; in this case the Stylops larva may therefore have but little
difficulty in finding its way to a Hymenopterous larva, for even though
it may have to live for months before it has the chance of attaching
itself to a nest-building female, yet it is clearly in the right
neighbourhood. The bee genus Andrena has, however, quite
different habits; normally a single female makes her nest
underground; but in the case of a stylopised female it is certain that
no nest is built, and no larvae produced by a stylopised example, so
that the young triungulins must leave the body of the bee in order to
come near their prey. They can be active, and have great powers of
leaping, so that it is perhaps in this way possible for them to attach
themselves to a healthy female bee.
 Fig. 155.—Portion of early stages of Xenos rossii. (After von Siebold.)
A, Small male larva; B, small female larva; C, full-grown male
larva; D, full-grown female larva; E, the so-called "cephalothorax"
and adjacent segment of adult female. (The newly-hatched larva
is very much like that of Stylops shown in Fig. 154.)

We have still only very imperfect knowledge as to the structure and

development of Strepsiptera. Indeed but little information has been
obtained since 1843.[160] Before that time the mature female was
supposed to be a larva, and the triungulins found in it to be
parasites. Although the erroneous character of these views has been
made clear, the problems that have been suggested present great
difficulties. Apparently the change from the triungulin condition (Fig.
154) to the parasitic larvae (Fig. 155, A, B) is extremely great and
abrupt, and it appears also that during the larval growth considerable
sexual differentiation occurs (Fig. 155, C, D); details are, however,
wanting, and there exists but little information as to the later stages.
Hence it is scarcely a matter for surprise that authorities differ as to
which is the head and which the anal extremity of the adult female.
Von Siebold apparently entertained no doubt as to the part of the
female that is extruded being the anterior extremity; indeed he called
it a cephalothorax. Supposing this view to be correct, we are met by
the extraordinary facts that the female extrudes the head for
copulatory purposes, that the genital orifice is placed thereon, and
that the young escape by it. Meinert[161] contends that the so-called
cephalothorax of the adult is the anal extremity, and that fertilisation
and the escape of the young are effected by the natural passages,
the anterior parts of the body being affected by a complete
degeneration. Nassonoff, in controversion of Meinert, has recently
pointed out that the "cephalothorax" of the young is shown by the
nervous system to be the anterior extremity. It still remains, however,
to be shewn that the "cephalothorax" of the adult female
corresponds with that of the young, and we shall not be surprised if
Meinert prove to be correct. The internal anatomy and the processes
of oogenesis appear to be of a very unusual character, but their
details are far from clear. Brandt has given some particulars as to the
nervous system; though he does not say whether taken from the
male or female, we may presume it to be from the former; there is a
supra-oesophageal ganglion, and near it a large mass which
consists of two parts, the anterior representing the sub-oesophageal
and the first thoracic ganglia, while the posterior represents two of
the thoracic and most of the abdominal ganglia of other Insects; at
the posterior extremity, connected with the other ganglia by a very
long and slender commissure, there is another abdominal ganglion.
[162]

It is a matter of great difficulty to procure material for the prosecution

of this study; the fact that the instars to be observed exist only in the
interior of a few Hymenopterous larvae, which in the case of the bee,
Andrena, are concealed under ground; and in the case of the wasps,
Polistes, placed in cells in a nest of wasps, adds greatly to the
difficulty. It is therefore of interest to know that Strepsiptera occur in
Insects with incomplete metamorphosis. They have been observed
in several species of Homoptera; and the writer has a large
Pentatomid bug of the genus Callidea, which bears a female
Strepsipteron apparently of large size. This bug[163] is abundant and
widely distributed in Eastern Asia, and it may prove comparatively
easy to keep stylopised examples under observation. Both v. Siebold
and Nassonoff think parthenogenesis occurs in Strepsiptera, but
there appear to be no facts to warrant this supposition. Von Siebold
speaks of the phenomena of Strepsipterous reproduction as
paedogenesis, or pseudo-paedogenesis, but we must agree with
Meinert that they cannot be so classed.

The males of Strepsiptera live for only a very short time, and are
very difficult of observation. According to Hubbard the males of
Xenos dash about so rapidly that the eye cannot see them, and they
create great agitation amongst the wasps in the colonies of which
they are bred. Apparently they are produced in great numbers, and
their life consists of only fifteen or twenty minutes of fiery energy.
The males of Stylops are not exposed to such dangers as those of
Xenos, and apparently live somewhat longer—a day or two, and
even three days are on record. The individuals of Andrena
parasitised by Stylops are apparently greatly affected in their
economy and appear earlier in the season than other individuals; this
perhaps may be a reason, coupled with their short lives, for their
being comparatively rarely met with by entomologists.

Fig. 156.—Abdomen of a wasp (Polistes hebraeus) with a

Strepsipteron (Xenos ♀) in position, one of the dorsal plates of the
wasp's abdomen being removed. a, Projection of part of the
parasite; b, line indicating the position of the removed dorsal
plate.

It is not possible at present to form a valid opinion as to whether

Stylopidae are a division of Coleoptera or a separate Order. Von
Siebold considered them a distinct Order, and Nassonoff, who has
recently discussed the question, is also of that opinion.
 CHAPTER VI

LEPIDOPTERA—OR BUTTERFLIES AND MOTHS

Order VI. Lepidoptera.

Wings four; body and wings covered with scales usually

variegate in colour, and on the body frequently more or less like
hair: nervures moderate in number, at the periphery of one wing
not exceeding fifteen, but little irregular; cross-nervules not more
than four, there being usually only one or two closed cells on
each wing, occasionally none. Imago with mouth incapable of
biting, usually forming a long coiled proboscis capable of
protrusion. Metamorphosis great and abrupt; the wings
developed inside the body; the larva with large or moderate
head and strong mandibles. Pupa with the appendages usually
adpressed and cemented to the body so that it presents a more
or less even, horny exterior, occasionally varied by projections
that are not the appendages and that may make the form very
irregular: in many of the smaller forms the appendages are only
imperfectly cemented to the body.

Lepidoptera, or butterflies and moths, are so far as ornament is

concerned the highest of the Insect world. In respect of intelligence
the Order is inferior to the Hymenoptera, in the mechanical
adaptation of the parts of the body it is inferior to Coleoptera, and in
perfection of metamorphosis it is second to Diptera. The mouth of
Lepidoptera is quite peculiar; the proboscis—the part of the
apparatus for the prehension of food—is anatomically very different
from the proboscis of the other Insects that suck, and finds its
nearest analogue in the extreme elongation of the maxillae of certain
Coleoptera, e.g. Nemognatha. The female has no gonapophyses,
though in certain exceptional forms of Tineidae, there are
modifications of structure connected with the terminal segments, that
have as yet been only imperfectly investigated. As a rule, the egg is
simply deposited on some living vegetable and fastened thereto.
Lepidoptera are the most exclusively vegetarian of all the Orders of
Insects; a certain number of their larvae prey on Insects that are
themselves filled with vegetable juices (Coccidae, Aphidae) and a
very small number (Tinea, etc.) eat animal matter. In general the
nutriment appears to be drawn exclusively from the fluids of the
vegetables, the solid matter passing from the alimentary canal in
large quantity in the form of little pellets usually dry, and called frass.
Hence the quantity of food ingested is large, and when the
individuals unduly increase in number, forest trees over large areas
are sometimes completely defoliated by the caterpillars.

Fig. 157.—Metamorphosis of a Lepidopteron (Rhegmatophila alpina,

Notodontidae). (After Poujade, Ann. Soc. ent. France, 1891.)
Europe. A, Egg; B, young larva, about to moult; C, adult larva; D,
head and first body-segment of adult larva, magnified; E, pupa, ×
2⁄1; F, male moth in repose; G, female moth in repose.

Lepidoptera pass a larger portion of their lives in the pupal stage

than most other Insects do; frequently during nine months of the year
the Lepidopteron may be a pupa. In other Orders of Insects it would
appear that the tendency of the higher forms is to shorten the pupal
period, and when much time has to be passed between the end of
the feeding up of the larva and the appearance of the imago, to pass
this time as much as possible in the form of a resting-larva, and as
little as may be in the form of a pupa; in Lepidoptera the reverse is
the case; the resting-larva period being usually reduced to a day or
two. Hence we can understand the importance of a hard skin to the
pupa. There are, however, numerous Lepidopterous pupae where
the skin does not attain the condition of hardness that is secured for
the higher forms by the chitinous exudation we have mentioned; and
there are also cases where there is a prolonged resting-larva period:
for instance Galleria mellonella spins a cocoon in the autumn and
remains in it as a resting larva all the winter, becoming a pupa only in
the spring. In many of these cases the resting-larva is protected by a
cocoon. It is probable that the chief advantage of the perfect
chitinous exudation of the Lepidopterous pupa is to prevent the tiny,
complex organisation from the effects of undue transpiration.
Bataillon has suggested that the relation of the fluid contents of the
pupa to air and moisture are of great importance in the physiology of
metamorphosis.

The duration of life is very different in various forms of Lepidoptera. It

is known that certain species (Ephestia kuehniella, e.g.) may go
through at least five generations a year. On the other hand, certain
species that feed on wood or roots may take three years to complete
their life-history; and it is probable that some of the forms of
Hepialidae are even longer lived than this.

Lepidoptera have always been a favourite Order with entomologists,

but no good list of the species has ever been made, and it would be
a difficult matter to say how many species are at present known, but
it can scarcely be less than 50,000. In Britain we have about 2000
species.

The close affinity of the Order with Trichoptera has long been
recognised: Réaumur considered the latter to be practically
Lepidoptera with aquatic habits, and Speyer pointed out the
existence of very numerous points of similarity between the two.
Brauer emphasised the existence of mandibles in the nymph of
Trichoptera as an important distinction: the pupa of Micropteryx (Fig.
211) has however been recently shown to be similar to that of
Trichoptera, so that unless it should be decided to transfer
Micropteryx to Trichoptera, and then define Lepidoptera and
Trichoptera as distinguished by the condition of the pupa, it would
appear to be very difficult to retain the two groups as distinct.

Structure of Imago.—The head of a Lepidopteron is in large part

made up of the compound eyes; in addition to these it frequently
bears at the top a pair of small, simple eyes so much concealed by
the scales as to cause us to wonder if seeing be carried on by them.
The larger part of the front of the head is formed by the clypeus,
which is separated by a well-marked line from the epicranium, the
antennae being inserted on the latter near its point of junction with
the former. There is sometimes (Saturnia, Castnia) on each side of
the clypeus a deep pocket projecting into the head-cavity. The other
parts of the head are but small. The occipital foramen is very large.
[164]

Fig. 158—External structure of a female butterfly, Anosia plexippus.

(After Scudder.) a, Base of antenna; b, pronotum; b2, scutum of
mesothorax; c, clypeus; cx, coxa; d, scutellum; d1, scutellum of
metathorax; e, post-scutellum (= base of phragma); em,
epimeron; ep, episternum; f, scutum of metathorax; m, basal part
of proboscis (= maxilla); o, eye; p, labial palp; r, mesosternum; s,
prothoracic spiracle; t, tegula; tr, trochanter; 1-9, dorsal plates of
abdomen.

The antennae are always conspicuous, and are very various in form;
they are composed of numerous segments, and in the males of
many species attain a very complex structure, especially in
Bombyces and Psychidae; they doubtless function in such cases as
sense-organs for the discovery of the female.

The largest and most important of the mouth-parts are the maxillae
and the labial palpi, the other parts being so small as to render their
detection difficult. The labrum is a very short, comparatively broad
piece, visible on the front edge of the clypeus; its lateral part usually
forms a prominence which has often been mistaken for a mandible;
Kellogg has applied the term "pilifer" to this part. In the middle of the
labrum a small angular or tongue-like projection is seen just over the
middle of the base of the proboscis; this little piece is considered by
several authorities to be an epipharynx.

Fig. 159—Mouth of Lepidoptera. Tiger-moth, Arctia caja. A, Seen from

front; B, from front and below, a, Clypeus; b, labrum; c,
epipharynx; d, mandibular area; d′, prominence beneath
mandibular area; e, one side of haustellum or proboscis; f,
maxillary palp; g, labial palp.

Mandibles.—Savigny, Westwood, and others considered the parts

of the labrum recently designated pilifers by Kellogg to be the
rudimentary mandibles, but Walter has shown that this is not the
case.[165] The mandibles are usually indistinguishable, though they,
or some prominence possibly connected with them,[166] may
frequently be detected in the neighbourhood of the pilifers; they are,
according to Walter, largest and most perfectly developed in
Eriocephala, a genus that was not distinguished by him from
Micropteryx and was therefore termed "niedere Micropteryginen," i.e.
lower Micropteryges. The opinion entertained by Walter that
Micropteryx proper (his "höhere Micropteryginen") also possesses
rudimentary mandibles is considered by Dr. Chapman, no doubt with
reason, to be erroneous.[167] The mandibles, however, in the vast
majority of Lepidoptera can scarcely be said to exist at all in the
imago; there being only an obtuse projection—without trace of
articulation—on each side of the labrum; and even this projection is
usually absent. Meinert recognised these projections as mandibles in
Smerinthus populi, and Kellogg in Protoparce carolina, another large
Sphinx moth. They appear to be unusually well developed in that
group. In Castnia they are even more definite than they are in
Sphingidae.

The Maxillae are chiefly devoted to the formation of the proboscis.

Their basal portions are anatomically very indefinite, though they
exist very intimately connected with the labium. Each usually bears a
small tubercle or a segmented process, the representative of the
maxillary palpus. The proboscis itself consists of the terminal, or
outer, parts of the two maxillae, which parts are closely and
beautifully coadapted to form the spirally coiled organ, that is
sometimes, though incorrectly, called the tongue. The exact
morphology of the Lepidopterous proboscis has not been
established. The condition existing in the curious family Prodoxidae
(see p. 432), where a proboscis coexists with another structure
called a maxillary tentacle, suggests a correspondence between the
latter and the galea of a typical maxilla; and between the proboscis
and the lacinia or inner lobe of a maxilla: but J. B. Smith is of opinion
that the tentacle in question is a prolongation of the stipes. The
condition of the parts in this anomalous family (Prodoxidae) has not,
however, been thoroughly investigated, and Packard takes a
different view of the proboscis; he considers that "it is the two galeae
which become elongated, united and highly specialised to form the
so-called tongue or glossa of all Lepidoptera above the
Eriocephalidae."[168] The proboscis in some cases becomes very
remarkable, and in certain Sphingidae is said to attain, when
unrolled, a length of ten inches. In some cases the maxillary lobes
do not form a proboscis, but exist as delicate structures, pendulous
from the mouth, without coadaptation (Zeuzera aesculi, the Wood-
leopard moth). In other forms they are absent altogether (Cossus,
e.g.), and in Hepialus we have failed to detect any evidence of the
existence of the maxillae. On the other hand, in Micropteryx the
maxillae are much more like those of a mandibulate Insect; and
various other Microlepidoptera approach more or less a similar
condition. In the genus last mentioned the maxillary palpi are largely
developed, flexible and slender. According to Walter various forms of
palpus intermediate between that of Micropteryx and the condition of
rudimentary tubercle may be found amongst the Microlepidoptera.
[169]

Labium.—The labial palpi are usually largely developed, though but

little flexible; they form conspicuous processes densely covered with
scales or hairs, and curve forwards or upwards, rarely downwards,
from the under side of the head, somewhat in the fashion of tusks.
The other parts of the labium are frequently represented merely by a
membranous structure, united with the maxillae and obstructing the
cavity of the pharynx. Where the proboscis is absent it is difficult to
find any orifice leading to the alimentary canal, such opening as may
exist being concealed by the overhanging clypeus and labium. In
some forms, Saturnia, e.g., there appears to be no buccal orifice
whatever. In Hepialus the labium is in a very unusual condition; it
projects externally in the position usually occupied by the labial palpi,
these organs being themselves extremely short. It is very difficult to
form an opinion as to the structure of the labium and other mouth-
parts when the maxillae are not developed, as in these cases the
parts are of a delicate membranous nature, and shrivel after death.
This is the explanation of the fact that in descriptive works we find
vague terms in use such as "mouth aborted" or "tongue absent."

The mouth of the Lepidopterous imago is a paradoxical structure; it

differs very greatly from that of the larva, the changes during
metamorphosis being extreme. We should thus be led to infer that it
is of great importance to the creatures; but, on the other hand, the
various structures that make up the mouth, as we have remarked,
are frequently absent or reduced to insignificant proportions; and
even in forms where the apparatus is highly developed the
individuals seem to be able to accomplish oviposition without taking
food, or after taking only very minute quantities. It is therefore difficult
to understand why so great a change should occur during the
metamorphosis of the Insects of this Order. It has been ascertained
that in some forms where the mouth is atrophied the stomach is in a
correlative condition; but we are not aware that any investigations
have been made as to whether this correspondence is general or
exceptional.

The exact mode in which the proboscis acts is in several respects

still obscure, the views of Burmeister and Newport being in some
points erroneous. Towards the tip of the proboscis there are some
minute but complex structures considered by Fritz Müller to be
sense-organs, and by Breitenbach to be mechanical instruments for
irritating or lacerating the delicate tissues of blossoms. It is probable
that Müller's view will prove to be correct. Nevertheless the
proboscis has considerable power of penetration; there being a
moth, "Ophideres fullonica" that causes considerable damage to
crops of oranges by inserting its trunk through the peel so as to suck
the juices.[170] The canal formed by each maxilla opens into a cavity
inside the front part of the head. This cavity, according to Burgess,
[171] is a sort of sac connected with five muscles, and by the aid of
this apparatus the act of suction is performed: the diverticulum of the
alimentary canal, usually called a sucking-stomach, not really
possessing the function formerly attributed to it.

The Prothorax is very small, being reduced to a collar, between

the head and the alitrunk, of just sufficient size to bear the front pair
of legs. Its most remarkable feature is a pair of processes, frequently
existing on the upper surface, called "patagia." These in many cases
(especially in Noctuidae) are lobes capable of considerable
movement, being attached only by a narrow base. In Hepialus, on
the contrary, they are not free, but are merely indicated by curved
marks on the dorsum. The patagia are styled by many writers
"tegulae." They are of some interest in connection with the question
of wing-like appendages on the prothorax of Palaeozoic insects, and
they have been considered by some writers[172] to be the
equivalents of true wings. The Mesothorax is very large, especially
its upper face, the notum, which is more or less convex, and in the
higher forms attains a great extension from before backwards. The
notum consists in greater part of a large anterior piece, the meso-
scutum, and a smaller part, the meso-scutellum behind. In front of
the scutum there is a piece termed prae-scutum by Burgess. It is
usually small and concealed by the front part of the scutum; but in
Hepialus it is large and horizontal in position. It is of importance as
being the chief point of articulation with the prothorax. The scutellum
is more or less irregularly rhomboidal in form; its hinder margin
usually looks as if it were a lobe or fold placed in front of the base of
the abdomen or metathorax, according to whether the latter is
concealed or visible. In some of the higher forms this meso-scutellar
lobe is prominent, and there may be seen under its projection a
piece that has been called the post-scutellum, and is really the base
of the great mesophragma, a chitinous piece that descends far down
into the interior of the body. In addition to the front pair of wings the
mesothorax bears on its upper surface another pair of appendages,
the tegulae: in the higher forms they are of large size; they are
fastened on the front of the mesothorax, and extend backwards over
the joint of the wing with the body, being densely covered with scales
so that they are but little conspicuous. These appendages are
frequently erroneously called patagia, but have also been called
scapulae, pterygodes, paraptera, and shoulder-tufts, or shoulder-
lappets. The lower surface of the mesothorax is much concealed by
the large and prominent coxae, but the sternum and the two pleural
pieces on each side, episternum and epimeron, are easily detected.
The area for attachment of the anterior wing on each side is
considerable, and appears to be of rather complex structure; its
anatomy has been, however, but little studied.

The Metathorax is small in comparison with the preceding

segment, to which it is intimately co-adapted, though the two are
really connected only by delicate membrane, and can consequently
be separated with ease by dissection. The metanotum consists of (1)
the scutum, which usually appears externally as an anterior piece on
each side; (2) the scutellum, forming a median piece placed behind
the scutum, which it tends to separate into two parts by its own
extension forwards. In order to understand the structure of the
metathorax it is desirable to dissect it off from the larger anterior
segment, and it will then be found that its appearance when
undissected is deceptive, owing to its being greatly arched, or folded
in the antero-posterior direction. A broad, but short phragma
descends from the hind margin of the metascutellum into the interior
of the body. It should be noted that though the metanotum is forced,
as it were, backwards by the great extension of the mesonotum in
the middle line of the body, yet at the sides the metanotum creeps
forward so as to keep the points of attachment of the hind wings
near to those of the front wings. In many forms of Hesperiidae,
Sphingidae, Noctuidae, etc. the true structure of the metanotum is
further concealed by the back of the mesoscutellum reposing on,
and covering it.

Difference of opinion exists as to the thoracic Spiracles; there is one

conspicuous enough in the membrane behind the pronotum, and it is
thought by some writers that no other exists. Westwood and
Scudder, however, speak of a mesothoracic spiracle, and Dr.
Chapman considers that one exists. Minot describes[173] a structure
behind the anterior wing, and thinks it may be an imperfect spiracle,
and we have found a similar stigma in Saturnia pavonia. At the back
of the thorax there is on each side in some Lepidoptera (Noctuidae,
Arctia, etc.), a curious large cavity formed by a projection backwards
from the sides of the metasternum, and a corresponding
development of the pleura of the first abdominal segment. Minot and
others have suggested that this may be an organ of hearing.

The Abdomen differs according to the sex. In the female seven

segments are conspicuous dorsally, but only six ventrally, because
the first segment is entirely membranous beneath, and is concealed
between the second abdominal ventral plate and the posterior
coxae. Besides these segments there are at the hind end two others
smaller, more or less completely withdrawn into the body, and in
certain cases forming an ovipositor. These nine segments are
usually considered to constitute the abdomen; but according to
Peytoureau,[174] a tenth dorsal plate is represented on either side of
the anal orifice, though there is no trace of a corresponding ventral
plate. In the male the segments, externally conspicuous, are one
more than in the female. According to the authority quoted,[175] this
sex has also truly ten abdominal segments, the ninth segment being
withdrawn to a greater or less extent to the inside of the body, and
modified to form part of a copulatory apparatus; its dorsal portion
bears a process called the "uncus"; the anal orifice opens on the
inner face of this process, and below it there is another process—
developed to a greater or less extent—called the "scaphium." The
ventral portion of the ninth segment bears a lobe, the "saccus"
(Peytoureau, l.c.). On each side of the ninth abdominal segment
there is a process called the "valve," the internal wall of which bears
some hook-like or other processes called "harpes"; it is continued as
a membrane surrounding the "oedeagus," or penis, and—bearing
more or less distinct prominences—connects with the scaphium. In
many forms the parts alluded to, other than the valves, are
concealed by the latter, which come together when closed, and may
be covered externally with scales like the rest of the abdomen.
Peytoureau considers that the uncus is really the dorsal plate of a
tenth segment, and that the scaphium is the tenth ventral plate.
Thus, according to this view, the ninth segment is extensive and
complex, being very highly modified in all its parts: while the tenth
segment is greatly reduced. The structure of the male organs is
simpler in Lepidoptera, and less varied than it is in the other great
Orders of Insects. There are seven pairs of abdominal spiracles on
the upper parts of the membranous pleurae.

Fig. 160—Acherontia atropos. The termination of ♂ body, one side

removed. IX, Ninth dorsal plate; IX’, ninth ventral; s, lobe, saccus,
of ninth ventral plate; X, tenth dorsal plate, or uncus; sc,
scaphium, or tenth ventral plate; a, position of anus; b, chitinised
band of scaphium; V, valve or clasper; c, hooks, or harpes, of
clasper; p, penis (or oedeagus). (After Peytoureau.)

Legs.—The legs are long, slender, covered with scales, and chiefly
remarkable from the fact that the tibiae sometimes bear articulated
spurs on their middle as well as at the tip. The front tibia usually
possesses on its inner aspect a peculiar mobile pad; this seems to
be in some cases a combing organ; it also often acts as a cover to
peculiar scales. The tarsi are five-jointed, with two small claws and a
small apparatus, the functional importance of which is unknown,
between the claws.

Wings.—The wings are the most remarkable feature of this Order; it

is to them that butterflies owe their beauty, the surfaces of the wings
being frequently adorned with colours and patterns of the most
charming and effective nature. These effects are due to minute
scales that are implanted in the wing-membrane in an overlapping
manner, somewhat similar to the arrangement of slates on the roof of
a house. The scales are very readily displaced, and have the
appearance of a silky dust. We shall describe their structure and
allude to their development subsequently. The wings are usually of
large size in comparison with the Insect's body: in the genus
Morpho, the most gorgeous of the butterflies, they are enormous,
though the body is small; so that when deprived of these floats the
Insect is insignificant. The great expanse of wing is not correlative
with great powers of flight, though it is perhaps indicative of flying
with little exertion; for the small-winged Lepidoptera, Sphingidae,
etc., have much greater powers of aërial evolution than the large-
winged forms. The area of the wing is increased somewhat by the
fact that the scales on the outer margin, and on a part or on the
whole of the inner margin, project beyond the edges of the
membrane that bears them: these projecting marginal scales are
called fringes. In many of the very small moths the actual size of the
wing-membranes is much reduced, but in such cases the fringes
may be very long, so as to form the larger part of the surface,
especially of that of the hind wings. Frequently the hind wings are of
remarkable shape, being prolonged into processes or tails, some of
which are almost as remarkable as those of Nemoptera in the Order
Neuroptera.
The wings are very rarely absent in Lepidoptera; this occurs only in
the female sex, no male Lepidopterous imago destitute of wings
having been discovered. Although but little is known of the
physiology of flight of Lepidoptera, yet it is clearly important that the
two wings of the same side should be perfectly coadapted or
correlated. This is effected largely by the front wing overlapping the
hind one to a considerable extent, and by the two contiguous
surfaces being pressed, as it were, together. This is the system
found in butterflies and in some of the large moths, such as
Lasiocampidae and Saturniidae; in these cases the hind wing always
has a large shoulder, or area, anterior to its point of insertion. In most
moths this shoulder is absent, but in its place there are one or more
stiff bristles projecting forwards and outwards, and passing under a
little membranous flap, or a tuft of thick scales on the under face of
the front wing; the bristle is called the "frenulum," the structure that
retains it a "retinaculum." In Castnia (Fig. 162) and in some
Sphingidae there is the unusual condition of a highly-developed
shoulder (s) coexisting with a perfect frenulum (f) and retinaculum
(r). The frenulum and retinaculum usually differ in structure, and the
retinaculum in position, in the two sexes of the same moth; the male,
which in moths has superior powers of flight, having the better
retaining organs. Hampson says "the form of the frenulum is of great
use in determining sex, as in the males of all the forms that possess
it, it consists of hairs firmly soldered together so as to form a single
bristle, whilst in nearly all females it consists of three or more bristles
which are shorter than that of the male; in one female Cossid I have
found as many as nine. Also in the large majority of moths the
retinaculum descends from the costal nervure in the male, while in
the female it ascends from the median nervure."[176] This sexual
difference in a structure for the discharge of a function common to
the two sexes is a very remarkable fact. There are a few—very few
—moths in which the bases of the hind wings are not well coadapted
with the front wings, and do not possess a frenulum, and these
species possess a small more or less free lobe at the base of the
front wing that droops towards the hind wing, and may thus help to
keep up an imperfect connexion between the pair; this lobe has been
named a jugum by Professor Comstock. Occasionally there is a
jugum on the hind as well as on the front wing. There is usually a
very great difference between the front and the hind wings; for
whereas in the front wing the anterior portion is doubtless of great
importance in the act of flight and is provided with numerous veins,
in the hind wing, on the other hand, the corresponding part has not a
similar function, being covered by the front wing; hence the hind
wing is provided with fewer nervures in the anterior region, the
divisions of the subcostal being less numerous than they are in the
front wing. In the moths possessing a jugum the two wings differ but
little from one another, and it is probable that they function almost as
four separate wings instead of as two pairs.

Wing-nervures.—The nervures or ribs of the wings are of great

importance in Lepidoptera, as at present they furnish the chief
characters for classification and for the discussions of phylogeny that
are so numerous in entomological literature. On looking at wings that
have been deprived of their scales it will be noticed (Fig. 161) that
the ribs are much more numerous at the outer margins than they are
near the points of attachment of the wings, and that there is usually
but one cell (or area completely enclosed by ribs). This latter point is
one of the chief peculiarities of the Lepidopterous wing; in Insect-
wings generally the number of cells in proportion to the area of the
wings and to the number of nervures is greater than it is in
Lepidoptera, for in the latter there are few or no cross-nervures.
Hence there is sometimes no closed cell at all on the wing (Fig. 161,
II. B). The maximum number of closed cells is six; this is found in
some species of Micropteryx, while in Hepialus there may be three
or four; but the rule is that there is only one cell in the Lepidopterous
wing. When the number of cells is increased this is not necessarily
due to an increase in the cross-nervures; and in fact it is generally
due to irregular forking or to the sinuous form of the longitudinal
nervures themselves (see wing of Castnia, Fig. 162, A.). Some
authorities consider that all transverse or cross-veins in Lepidoptera
are merely portions of longitudinal veins having diverted courses.
When a portion of a nervure beyond the basal or primary portion
serves as a common piece to two forked parts external to it, it is
called a stalk (Fig. 162, A, e). There are cases in which the furcation
takes place in the opposite direction, so that a nervure is double at
the base of the wing (Fig. 161, I, A, 1a, and B, 1b). This important
condition has not yet been adequately discussed.

Fig. 161.—Wing-nervuration of Lepidoptera. I, Diagram of moths' wings

(after Hampson); II, of a butterfly's wings (Morpho menelaus ♂ ,
after Staudinger and Schatz). A, front, B, hind wing. I.—c, costal;
sc, subcostal; m, median; 1a, 1b, 1c, internal nervures; f,
frenulum; 2, 3, 4, branches of median nervure; 5, lower radial; 6,
upper radial; 7-11, divisions of the subcostal; 12, termination of
costal; c, cell; d, discocellular nervure. II.—C, costal; SC,
subcostal; M, median; SM and SN, submedian nervures; 1A,
inner-margin nervure; UR, lower radial; OR, upper radial; SC1 to
SC5, divisions of subcostal; M1 to M3, divisions of median nervure;
C, cell; DC, discocellulars.

Turning to the mode of designation of the nervures,[177] we may

commence by remarking that no system satisfactory from a practical
as well as from a theoretical point of view has yet been devised. The
diagrams given in figure 161 will enable us to explain the methods
actually in vogue; I. representing the system, dating from the time of
Herrich-Schaeffer, chiefly used by British naturalists, and II. that
adopted by Staudinger and Schatz in their recent great work on the
Butterflies of the world. The three anterior nervures in both front and
hind wings correspond fairly well, and are called, looking at them
where they commence at the base of the wing, "costal," "subcostal,"
and "median" nervures. The nervures near the inner margin of the
wing (that is the lower part in our figures) differ much in the front and
hind wings, consisting either of two or of three separate portions not
joined even at the base. British entomologists call these "branches
or divisions of the internal nervure": the Germans call the more
anterior of them the "submedian," and the more internal the "inner-
margin nervure"; they are also frequently called anal nervures. The
cross-nervure that closes the cell is called discocellular; when
apparently composed of two or three parts joined so as to form
angles, the parts are called, according to position, upper, lower, and
middle discocellulars. One or more short spurs may exist on the front
part of the basal portion of the hind wing; these are called
praecostal. The branches or terminal divisions of the nervures
should be called nervules; they are usually mentioned by the
numbers shewn in the diagram (Fig. 161, I.). In addition to this, it is
only necessary to remember that number 2 is always assigned to the
posterior division of the median nervure, the nervules below this
being all called 1, and distinguished by the addition of a, b, c when
requisite. This course is necessary, because if it were not adopted
the corresponding nervules on the front and hind wings would bear
different numbers.

The use of this system of numbers for the nervules is becoming

general, and it answers fairly well for practical purposes. On the
other hand, extreme discrepancy exists as to the nomenclature of
the nervures and nervules, and there are almost as many systems
as there are authorities.

The normal number of nervules is, on the front wing, 11 + 1 or 2

inner marginal, and on the hind wing 7 + 2 or 3 inner marginal. In the
aberrant moths of the genus Castnia the nervuration is unusually
complex and irregular (Fig. 162), and an analogous condition occurs
in our common Goat-moth (Cossus ligniperda). In Hepialus and
Micropteryx (the jugate moths of Comstock) the hind wings are less
dissimilar in nervuration from the front wings than they are in other
Lepidoptera.[178]