THE LIBRARY
OF
THE UNIVERSITY
OF CALIFORNIA
PRESENTED BY
PROF. CHARLES A. KOFOID AND
MRS. PRUDENCE W. KOFOID
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PHYSIOLOGY,
GENERAL ANATOMY,
AND
PATHOLOGY,
BICHAT.
BY THOMAS HENDERSON, M. D.
-ss==-
PROFESSOR OF THE THEORT AND PRACTICE OF MEDICINE IN THE
COLUMBIAN COLLEGE, WASHINGTON CITT.
PHILADELPHIA:
CAREY, LEA & CAREY CHESNUT STREET.
1829.
<n
EASTERN DISTRICT OF PENNSYLVANIA, to wit:
BE IT REMEMBERED, that on the fourteenth day of March, in the
fifty-third year of the independence of the United States of America,
A. D. 1829, Carey, Lea and Carey of the said district, have deposited
in this office the title of a book, the right whereof they claim as
Proprietors, in the words following, to wit:
" An Epitome of the Physiology, General Anatomy, and Pathology,
of Bichat. By Thomas Henderson, M. D. Professor of the Theory and
Practice of Medicine in the Columbian College, Washington City."
In conformity to the act of the Congress of the United States, enti-
tuled, " An act for the encouragement of learning, by securing the co-
pies of maps, charts, and books, to the authors and proprietors of
such copies, during the times therein mentioned." And also to the
act, entitled, " An act supplementary to an act, entitled, * An act for
the encouragement of learning, by securing the copies of maps, charts,
and books, to the authors and proprietors of such copies during the
times therein mentioned,' and extending the benefits thereof to the
arts of designing, engraving, and etching historical and other prints."
D. CALDWELL,
Clerk of the Eastern District of Pennsylvania
SKEBRBTT NINTH STREET,
PHILADELPHIA.
''.Bib-jo
TO
I
LATE PROFESSOR OF ANATOMY IN RUTGERS MEDICAL
COLLEGE, NEW YORK.
SIR,
I dedicate this little volume to you, as a testimony of my
respect for you as a man of learning, and especially in ac-
knowledgmeht of your distinguished character as a teacher of
anatomy.
I regret that ill health has compelled you to retire from a
sphere of duty, in which you were doing so much good, and
acquiring so much fame.
I consider you a conspicuous instance of what genius, in-
dustry, and honourable ambition will accomplish; an example
which the American medical student should ever be proud to
follow.
Great interest is felt by the medical profession and others
in the restoration of your health. I partake largely of that
feelingj and though personally a stranger to you, I am happy
and sincere in assuring you, of the great respect of
Sir, your obedient,
And very humble servant,
THOMAS HENDERSON.
Washington, November, 1828.
PREFATORY REMARKS.
THE works legitimately ascribed to Bichat are volumi-
nous and expensive. In the French there are about ten
volumes, in the translations seven; .and they are not al-
ways, perhaps not generally, all found in private libraries.
These circumstances in part, induced me to attempt an
epitome of the works of this great man. The decisive
motive was the fact, that his works at large are, from va-
rious causes, toa little read by students, before they com-
mence their public studies, or before they graduate. I
allude now to the great proportion of medical students in
the interior of the country. It has been frequently said
too, that the arguments in support of his principles, and
the experiments illustrating their truth, are detailed by
Bichat with unnecessary prolixity and minuteness.
If any causes tend to keep from the medical student a
familiar acquaintance with the writings of Bichat, they
should be removed; if any thing can be done to render
them more accessible, it should be done. I have thought,
and the plan has been approved by judicious friends, that
such an attempt as this volume exhibits might have these
effects; and it will be a great source of satisfaction to me,
if it in any measure succeeds.
In all the sciences there is a disposition to familiarize
students with the most important authors, by reducing
their works to the compendious form of manuals. This
is done usually, in the aphoristic, or in the interro-
gatory style. The last has been pronounced, if not the
VI PREFATORY REMARKS.
least useful, the least dignified. I have, after much consi-
deration, determined to adopt the form of question and
answer. I found this very useful and agreeable to me
when a student; my private pupils have been happily
aided by it; it certainly greatly facilitates the private in-
struction of pupils. This last reason, of the truth of which
there can be no doubt, would have been sufficient to decide
me. It appears to me also, that in submitting the question
and giving the answer, the mind undergoes a double ope-
ration, favourably concentrates the student's attention, and
leads to a correct intellectual result. I therefore readily
submit it to the student of this work to decide, after he
has completed the perusal of it, whether or not I have
erred in adopting the catechetical method. If this method
be generally unsystematic, it is replied that I give the
system of Bichat, and that is my object. If, as was sug-
gested by a medical friend, in pursuing the course most
useful to students I have sacrificed the dignity of author-
ship, the latter is most freely surrendered in order to ensure
the former.
On another account it is thought this work may be well
received. Modern publications are interposed between
the medical student and Bichat; and on this ground, that
they omit his errors, embrace his truths, and introduce
subsequent improvements. There is some foundation for
this; but as to the supposed erroneous views of Bichat,
may not "the stone which the builders rejected" be yet
found the sure one for the building? And those views
which are esteemed improved ones, have many of them
yet to bear the sternness of critical and experimental in-
vestigation. It is scarcely to be expected that a student
will, after reading the summaries of Horner, and of Bayle
and Hollard on general anatomy, patiently explore the
PREFATORY REMARKS. Vli
long and intricate paths opened in the elaborate volumes
of Bichat. On the contrary, I fear these books may ma-
terially tend to exclude Bichat from private libraries. If
a compendium of the works of the Father of general ana-
tomy can be made to accompany the recent publications,
I humbly think it will conduce to the student's progress.
I have read with unmingled pleasure the General and
Special Anatomy of Horner; and have seen with pride
how favourably it is noticed abroad, and I know how much
good it is doing at home. The volume of Bayle and Hoi-
lard is an excellent work, and deserving repeated and at-
tentive perusal. But these works, although founded on
the system of Bichat, should never supersede his writings.
There are in the latter so many new, curious and authen-
ticated speculations and facts, not to be found in any pre-
ceding or subsequent work, that they remain unrivalled
in value, immortalizing the author.
To be valuable, such a work as I have executed, should
be well done. Neither time nor devotion to the object
have been spared. It has been my endeavour to catch the
spirit and the meaning of Bichat, and to express them
perspicuously. I do not suppose the work is free from
error, but it is hoped that these errors are neither numer-
ous nor important. I have depended on the French edi-
tions for the correctness of the book, but have been much
aided by the translations.
Now that the works of Bichat are so valued, it is but
an act of justice to acknowledge the obligations of the me-
dical student to those who have translated them. It is due
to the taste and talents of Doctor Tobias Watkins, to an-
nounce him as the first who engaged in that undertaking.
He gave a fine translation of the work on Life and Death.
The treatise on the membranes was translated by Doctor
Vlll PREFATORY REMARKS.
Coffin of Boston, and published in 1813. The general
anatomy has been faithfully rendered into our language
by Doctor Hayward, of Boston. He has displayed not
less talent than persevering industry in laying before the
profession what has been termed, I believe by Professor
Chapman, "a revelation in medicine." By the same pen
Beclard's additions have been translated; and to Mr.
Togno, a student of medicine, we are indebted for the
translation of the posthumous work on Pathology.
I have adhered closely to the works of Bichat. Scarcely
a remark has been made which does not rest with him,
for I neither designed nor desired to assume responsibility.
The few observations on pathology have been presented
principally to introduce those truths which have resulted
from investigations into general anatomy, or which are not
familiarly contained in the books on practical medicine,
or the mere mention of which is calculated to lead to im-
portant reflection.
I intended to preface this work with a biographical
sketch of Bichat. I shall reserve it for another opportunity.
Yet it may be appropriate just to say, that he was born in
France in 1771 his scholastic pursuits were at Lyons
he there commenced professional studies under Petit they
were continued in Paris under Desault in 1797 he gave
his first course of lectures indebted to Pinel for the first
impulse, he originated and highly perfected the science of
general anatomy he continued to lecture till 1802, when,
in consequence of a fall, he contracted a cephalic form of
fever, which ended the life and labours of a man, who,
at the age of thirty-one, had accomplished works, which
will be as lasting as the science they have improved.
Six hundred pupils followed the remains of their highly
revered preceptor to the grave.
ams 01 tne
AN EPITOME,
GENERAL OBSERVATIONS.
Of the Physiological and Physical Sciences, and the
Properties which preside over their Phenomena.
Q. How are the sciences divided?
t#. Into the physiological and physical.
Q. What do you understand by these terms?
t/?. The physiological sciences are those embracing the
philosophy of animate nature. The physical sciences re-
fer to inanimate nature.
Q. To what are the phenomena of animate and inani-
mate nature to be traced?
A. To the operation of vital and non-vital properties.
Q. What classes of objects possess vital properties ?
#. Animals and vegetables.
Q. In what department of nature do you find the non-
vital properties?
t#. In the physical world.
Q. What are the vital properties?
*ft. Sensibility and contractility.
Q. Name some of the non-vital properties.
*#. Gravity, elasticity and affinity.
2
10 GENERAL OBSERVATIONS.
Characters of the Vital Properties compared with
those of the Physical.
Q. The characteristics of the vital and physical pro-
perties in animate and inanimate nature are strikingly
different; in what principally consists this difference?
/?. The physical are determinate and invariable; the
vital vary with every day and person. Attraction and
gravity are always the same; sensibility and contractility
are ever variant.
Q. Is there such a state as disorder of the physical pro-
perties ?
*#. No. Physiology is to living bodies, what astro-
nomy, hydraulics, &c. are to inert ones. There is nothing
in physics analogous to pathology in living bodies.
Q. What would be the consequence of variableness in
physical properties ?
Ji. The effect would be the disorganization of nature.
Q. Then physical laws cannot govern living bodies?
#. No. In one or two functions there is a combined
action of vital and physical properties; such as the eye
and ear. The vital powers always preponderate.
Q. What difference is observable in the elementary ar-
rangements of living and inanimate bodies?
Jl. Composition and decomposition are constantly
changing the elements of living bodies; but the elements
of inert bodies remain the same until destroyed.
Q. Do animate and inanimate bodies resemble each
other in the perpetuity of their properties?
#. Not at all. Vital properties tending to exhaust
themselves, animate bodies but for a limited time; they
GENERAL OBSERVATIONS. 11
.
reach their acme and decline. Physical laws and proper-
ties exist unimpaired as long as matter remains.
Q. Are sympathies found in living or inert bodies?
#. Exclusively in the living. If a stone be bruised or
broken, the parts do not suffer; but if a living body be in-
jured in a part, the whole may or does sympathize.
Q. What are sympathies?
/?. Unnatural vital forces indirectly excited by remote
impressions.*
Q. What properties belong to vegetable life?
*ft. Organic sensibility and insensible organic contrac-
tility.
Q. What vital properties do animals possess beyond
those of vegetables?
t#. Besides organic sensibility and insensible organic
contractility, in animals you find animal sensibility, ani-
mal contractility, and sensible organic contractility.
Q. What are the diseases of vegetables?
Jl. They have not the nervous affections, nor fevers
which arise from exalted animal sensibility, and sensible
organic contractility; but they have tumours, exhalations
and affections which result from their vital properties
above named.
Q. Zoophytes manifest a vital property beyond those
of vegetables; pray what is it?
e/?. Sensible organic contractility.
Q. What are the gradations of properties assigned by
Bichat to the three kingdoms?
* Bichat does not include in this definition healthy sympathies; these
were formerly denominated by many physiologists, synergies. The
term sympathy, however, as at present employed, comprises both these
classes of phenomena healthy and morbid sympathies.
12 GENERAL OBSERVATIONS,
ft. Physical properties to the mineral; physical pro-
perties, organic sensibility and insensible organic contrac-
tility, to the vegetable ; and physical properties and all the
organic and animal vital properties for theamVna/kingdom.
Q. What functions are controlled by organic sensibility
and insensible organic cpntractility?
ft. Circulation, secretion, absorption, nutrition, exha-
lation, &c.
Q. What diseases arise from these properties?
ft. Inflammation, purulent formations, induration, re-
solution, haemorrhagies, unnatural augmentation or dimi-
nution of the secretions, exhalations, increased or dimi-
nished absorptions, dropsies, and many others.
Q. What functions are governed by sensible organic
contractility?
ft. Digestion, the circulation in the large vessels, the
excretion of urine from the bladder, &c.
Q. What are the diseases of these functions?
ft. Vomitings, diarrhoea, irregularities of the heart's
action. ->
Q. What functions depend on animal sensibility?
ft. The external senses, and what are termed by Bichat
the internal senses, as hunger and thirst.
Q. What diseases arise from alterations of animal sen-
sibility?
ft. Pain in its various forms, itching, smarting, tickling,
and so forth.
Q. In what is animal contractility concerned?
ft. In locomotion and the voice.
Q. What is the essence of disease?
ft. An increase, diminution, modification or alteration
of some of the vital properties just named.
GENERAL OBSERVATIONS. 13
Q. What does the treatment of disease imply?
A. A restoration of these properties to a normal state.
Q. Give an illustration of this.
.tf. In inflammation your object should be to reduce
organic sensibility; in dropsy or oedema to increase it. In
convulsions you must reduce animal contractility; in palsy
increase it.
Q. What remedies act on sensible organic contractility?
Jl. Emetics and purgatives.
Q. Give examples of medicines which act on general
insensible organic contractility*
t/?. Tonics, and acids.
Q. Do any act on the insensible organic contractility of
particular parts?
.#. Yes. Nitre in its action on the kidneys; mercury
on the salivary glands.
Q. How do remedies act in reducing animal sensibility?
#. By relieving pain in the parts, as by emollients; or
by rendering the brain insensible by narcotics.
Q. Are medicines necessarily confined in their opera-
tion, to the reduction, increase or modification of any one
of the vital properties?
Ji. No; they often operate on more than one of these.
Of the Vital Properties and their Phenomena consi-
dered in relation to the Solids and Fluids.
Q. Why is it not unreasonable to suppose that the fluids
are destitute of life?
Ji. Because they never manifest sensibility and con-
tractility as do the solids.
14 GENERAL OBSERVATIONS.
Q. What operation of the fluids and solids gives rise to
organic sensibility?
#. That impression of the fluids on the solids, which is
not perceived by the brain, excites organic sensibility.
Q. How does organic differ from animal sensibility?
/?. In this, that animal sensibility is perceived by the
brain.
Q. What pathological principle do you found on the
location of the vital properties in the solids?
*&. As disease is but an alteration of these forces, and
as these forces are found in the solids, therefore diseases
are seated primarily in the solids.
Q. By what avenues does Bichat suppose the fluids may
become so changed as to cause disease?
/?. By matters absorbed through the lacteals, the lungs,
the skin, and through wounded surfaces.
Q. How does he divide the fluids?
#. Into those destined to composition, and those of de-
composition. The first convey the causes of disease.
Q. Are sympathetic impressions conveyed or seated in
the solids or fluids?
#. Always and essentially in the solids.
Q. Does Bichat believe in the vitality of the fluids?
*#. He does, but does not explain it. The blood pos-
sesses vital properties greater than those in the chyle.
Q. What speculation is founded on the vitality of the
fluids?
#. That it may influence their motions.
GENERAL OBSERVATIONS.
15
Of the Properties Independent of Life. .
Q. What are they termed?
A. Properties of texture.
Q. What are they?
/?. Extensibility and contractility of texture.
Q. What do you mean by the horny hardening?
/?. It is a form of contractility which parts undergo
after death, on exposure to heat, acids, &c.
Q. How many kinds of horny hardening are there?
#. Two; the sudden and slow. The first is produced
by fire and acids; the second by neutral salts, air, alcohol,
&c.
Q. What textures are not susceptible of the sudden
horny hardening?
#. The hair, epidermis, and nails.
Q. What textures are most susceptible of it?
#. The fibrous, muscles, tendons, and nerves.
Q. What state is incompatible with slow horny hard-
ening?
Ji. It cannot take place during life, but the sudden
may, as you see in burns.
Q. What destroys both kinds of this hardening?
#. Putrefaction of the texture.
Q. How many kinds of contractility are there?
A. Five.
Q. What do you understand by animal contractility?
*/i. The influence of the nerves on the voluntary mus-
cles.
Q. What is meant by sensible organic contractility?
#. The action of the involuntary muscles from stimuli
16 GENERAL OBSERVATIONS.
Q. What is a third kind of contractility ?
#. The contractility of texture from want of exten-
sion, as it appears in the muscles, skin, arteries, veins.
Q. Where is this contractility of texture obscure?
#. In the nerves, bones, and cartilages.
Q. What is the fourth kind of contractility?
t/?. The horny hardening.
Q. There is yet another contractility?
#. Yes, and a very important one; it is the insen&ible
organic contractility, which, by oscillation, forms the to-
nic forces, or tonicity.
Of Animal Organization.
Q. On what does the existence of the vital properties
depend ?
/?. On organic arrangement, for when organization is
destroyed, the vital properties disappear.
Q. What are animal bodies composed of?
/?. An assemblage of organs.
Q. What are organs composed of?
Ji. Of several textures.
Q. What are the elementary textures?
*#. Twenty-one in number; the cellular, nervous of
animal life, nervous of organic life, arterial, venous, exha-
lent, absorbent, and glandular, osseous, medullary, cartila-
ginous, fibrous, fibro-cartilaginous, muscular of animal life,
muscular of organic life, mucous, serous, synovial, glan-
dular, dermoid, epidermoid, and the pilous.
Q. In what do these textures differ?
A. They differ in form; in their organization; in their
properties of life, as contractility and sensibility.
GENERAL OBSERVATIONS. 17
v.
Q. How are these organized systems divisible ?
#. Into those every where present as a base for all,
and this Bichat calls the generative; and secondly, into the
insulated.
Q. Give examples of the generative tissues.
*#. The cellular, arterial, venous, exhalent, absorbent,
nervous.
Q. What are the insulated textures?
.#. Such as the osseous, cartilaginous, fibrous, mucous,
serous, &c.
Q. Is this distinction absolute?
A. It is not; but so far true as to be physiologically
important.
Q. Which textures exist most generally?
.#. The absorbent and exhalent.
Q. Why is this the case?
#. Because nutrition depends on them.
Q. Which texture is next in extent?
A. The cellular.
Q. What tissues are first developed?
#. The generative or general.
Q. What do you mean by the nutritive parenchyma of
an organ?
Ji. The cellular, vascular, and nervous outline of the
organ.
Q. What is the nutritive matter of an organ?
#. That which establishes a difference between the
organs.
Q. Give examples of this nutritive matter?
A. The phosphate of lime and the gelatine of bones is
one instance; the fibrin in the muscles is another.
Q. Where is this nutritive matter deposited?
3
18 GENERAL OBSERVATIONS.
Ji. In the nutritive parenchyma just mentioned.
Q. What is the first aspect of fetal formation?
.ft. It is a mass of the generative tissues, in which each
organ has its nutritive parenchyma in form ; and in which
parenchyma the nutritive matter is gradually deposited,
giving specific character to each texture and organ.
Q. How is organization enlarged?
/#. First, by an extension of nutritive parenchyma, and
then by a deposition of nutritive matter.
Q. In what does the elective power of an organ on the
blood consist?
#. In the peculiar organic sensibility by which it
chooses or rejects appropriate principles of growth in the
blood.
Q. On what does the theory of secretion exist?
ft. On the power of the peculiar vital forces, and sen-
sibilities of textures, which select from the blood that
which comports with these forces.
Q. Why does the body grow for a certain period?
#. It depends on the ultimate fact that composition ex-
ceeds decomposition.
Q. What is Bichat's theory of secretion?
#. That the parenchyma of nutrition is uniform, that
the nutritive, matter is various, and that the parenchyma
of nutrition exercises an eclectic power over the blood,
selecting materials for the various nutritive substances.
Q. What do you mean by the life of a part?
#. The properties of the texture which compose the
part.
Q. What do you understand by disease of an organ?
#. Aberration from the normal condition of the vital
forces of one of the textures of an organ.
GENERAL OBSERVATIONS. 19
Q. Is disease confined at first to one texture of an
organ?
A. Yes; an organ is seldom attacked at first in all its
tissues.
Q. What governs sympathies?
J2. Principally similarity of texture.
Q. Is fever severest in serous or mucous disease?
#. In diseases of the serous tissues.
Q. How many sets of symptoms are there in inflam-
mation?
ft. Two ; those of the texture, and those of the organ.
Q. What influence has texture on the general pheno-
mena of disease?
Ji. It modifies symptoms and duration of disease.
Q. Be more explicit in your answer.
Jl. The different textures in disease give different kinds
of pain, different degrees of heat, and have a longer or
shorter duration. Hence acute and chronic diseases are
relative to the vital properties of the textures; as for in-
stance, a serous texture goes through a disease sooner than
an osseous tissue.
Q. Why are the mucous, serous, and glandular tissues,
so much oftener diseased than others?
Jl. Because their functions require great energy in the
organic sensibility and insensible organic contractility,
and consequently liability to alterations of these, or in
other words disease.
Q. What is the correct nosological method?
. That of the diseases which affect the several tissues.
20 GENERAL OBSERVATIONS.
Of the. Functions.
Q. What is Bichat's classification of the functions?
<fl. Into those of animal life, those of organic life, and
the functions relating to the species.
Q. What do you mean by the functions of animal life?
A. Those which connect us with external bodies, and
are peculiar to animals.
Q. What do you understand by the functions of organic
life?
*ft. Those which serve for the constant composition
and decomposition of our bodies ; these are possessed by
animals and vegetables ; they distinguish between organic
and inorganic substances.
Q. What are the animal functions?
^. The senses, voluntary muscles, the larynx, and the
nerves which are the agents in these functions.
Q. What is the centre of these?
A. The BRAIN.
Q. Designate the organic functions.
#. Digestion, circulation, respiration, exhalation, ab-
sorption, secretion, nutrition, calorification. The HEART
is the centre of these.
Q. What nerves belong to these two sets of functions?
./?. The cerebral to the animal, the ganglionic or great
sympathetic to the organic functions.
Q. What conspicuous distinction should be drawn be-
tween these two sets of functions?
A. The sensibility and contractility peculiar to. them.
There is the animal sensibility and animal contracti-
lity , and there is the organic sensibility, the sensible
GENERAL OBSERVATIONS. 21
organic contractility, and the insensible organic con-
tractility.
Q. What was the ancient opinion as to proximate
texture.
J2. That the cellular was the substratum of all the solids
of the body, and the fibre, the base of the cellular was
composed of gluten and earthy particles.
Q. What are Beclard's elements of organization?
t/?. Three; viz. the cellular, the nervous, and muscular
fibre.
Q. Are these very distinct?
A. Yes ; in form, chemical composition, and vital
functions.
Q. What is Meckel's doctrine of organization?
t/2. That its elementary substance is globular, a coagu-
lable matter, and a union of these.
OF LIFE.
Q. How do you define the term life?
/?. A principle, the phenomena of which are recog-
nized, the nature of which is concealed; life is the aggre-
gate of the functions which resist death.
Q. How is life divided?
t/?. Into two striking modifications, that of animal life,
and organic life.
Q. What is a conspicuous characteristic of organic life?
.#. That it exists both in animals and vegetables.
Q. Detail the peculiarities of animal life?
*ft. It appertains exclusively, to animals. It is the life
by which animated, establishes relations with all nature.
Q. What are the orders in the functions of animal life?
t#. The first is from the exterior of the body to the
brain, and comprises the receptions, transmission, and per-
ception of the impression ending in sensation. The second
order originates in the brain, where volition, arising from
sensation, acts on the locomotive and vocal organs.
Q. Continue the analysis of these two orders of the
animal functions.
A. In the first the animal is acted on by external bo-
dies; in the second order. of functions the animal reacts on
these bodies. There is proportion between these two or-
ders; a powerful impression from without produces a re-
action correspondently great.
Q. What are the orders of the functions of organic life?
#. They are two; first, that engaged in the composi-
OF LIFE. 23
tion; secondly, that which decomposes the animal: these
operations are incessant.
Q. What processes are involved in the assimilative
functions?
#. Digestion, circulation, respiration, and nutrition.
Q. What processes are concerned in decomposition?
#. Absorption, circulation, exhalation, and secretion
form the second order of the functions of organic life.
Q. State the relations that the brain and sanguiferous
system bear to these animal and organic vital functions.
*#. As the brain is a central system between external
bodily impressions, and the reaction of volition which
follows, so does the sanguiferous system sustain a central
position, in organic life, between assimilation and decom-
position.
Difference between Animal and Organic Life.
Q. What is the essential distinction in the organs of ani-
mal and organic life?
/?. In those of animal life there is symmetry; in organic
life there is the utmost irregularity.
Q. Give examples of these two properties.
A. The double organs of vision, of hearing, the hemi-
spheres of the brain, the double sets of nerves, are in-
stances of the symmetry of the organs of animal life. The
liver, the heart, the spleen, the intestines are always sin-
gle and often very irregularly disposed. There is irregu-
larity in the number of lobes composing the right and left
lungs: the divisions of the pulmonary artery are unlike
each other in several respects. These are a few of the ex-
amples of the irregularity in the conformation of the or-
gans of organic life.
24 OF LIFE.
Q. Why are the animal functions double?
ft. A perpetuation of their existence being essential,
the loss of one is supplied by the duplicate.
Q. The animal and organic functions differ in another
respect, what is it?
/?. In the animal there is harmonious function as well
as symmetrical structure; in the organic there is nothing
of that. This harmony in the animal functions is essen-
tial to concordant sensation.
Q. Give further illustration of this idea of harmony in
function.
#. If the two auditory or optic nerves conveyed dif-
ferent impressions, the sensations and actions must conse-
quently be confused. Discordant action of the hemispheres
of the brain, must produce similar discrepancy.
Q. But this general principle of harmony in function
does not hold good in the action of the right and left sides
of the body.
*ft. It does not; but the superiority of the right arm and
hand is the effect of habit.
Q. Of what consequence is irregularity in organic life?
#. You will infer its unimportance from the fact, that
one kidney may separate more urine than the other; that
one lung may admit more venous or eject more arterial
blood than the other; that more organic action may exist
in one salivary gland than another; that one side of the
spleen, pancreas, or liver may receive more blood than
another, and yet the organic action maintain its integrity
and regularity.
Q. You have already given some of the distinctions be-
tween animal and organic life; there are others, and will
you state one?
OF LIFE. 25
.#. An important one is, that animal life is intermittent
in its functional actions, whereas organic life is perpetually
active from birth to death.
Q. Can you exemplify the preceding answer?
A. The functions of the brain are suspended in sleep,
but those of the heart continue. Muscular action is ex-
hausted by fatigue, but secretion, absorption, and exhala-
tion continue uninterruptedly.
Q. What does a complete intermission of the action of
animal life denote?
*ft. It denotes perfect sleep. This sleep is more or less
complete, as the functions of animal life are one or all in-
volved in this intermission ; particularly as the senses shall,
one or all, have intermitted their connexion with external
objects.
Q. How do you account for dreaming?
Ji. It is the escape of one part of animal life from the
torpidness which pervades the rest.
Q. There is yet another respect in which the animal
and organic functions differ, what is it?
A. Impressions on animal life are ever variant, and they
lose their effect from habit; whereas organic life is regu-
larly under the impression of uniform and accustomed sti-
muli, which do not lose their power from habitual action.
Q. Where are the intellectual faculties and the passions
located?
A. The intellect appertains to animal life, the passions
originate in organic life.
Q. How is it that organic life is the seat of the pas-
sions, if these result from perception and impression on
the brain?
1
"
26 OP LIFE.
*#. The nerves and brain serve merely as conductors
to the impressions which excite passions by irritating or-
ganic life. The brain arrests the impressions that excite
intellect, but it conducts the passions to organic life.
Q. Will you name some of the effects of the passions
on our organs?
fl. Anger hurries the action of the heart; joy does so to
some extent: terror enfeebles the energy of the heart, so
that blood is not sent to the capillaries. These passions act
so intensely on the source of the circulation, as sometimes
to stop the action of the heart, producing syncope. Sor-
row affects the respiratory organs. The passions variously
influence the stomach, spleen, intestines, liver, and even
the blood-vessels, so as to occasion lesions in them. Ex-
halation, absorption, nutrition are less influenced by the
passions. Now, observe, that under all these alterations
of organic life by the passions, the animal functions are
unhurt.
Q. But if organic life is the seat and source of the pas-
sions, how is it that these passions so excite the organs of
animal life?
/?. As some of the passions increase the heart's action,
it follows that an increased volume of blood is sent to the
brain; thus the centre of animal life is excited, and the
functions dependent on it are exalted. So likewise in those
passions which enfeeble the heart's action, the impetus of
blood being lessened, the functions of animal life are, by
the diminished energy of its centre, debilitated.
Q. Is there a common epigastric centre for the passions?
A. There is not. The impulse of passion arises in dif-
ferent persons, under different circumstances, from differ-
tnt passions, involving different abdominal organs.
OP LIFE. 27
Q. Is the term sympathetic nerve, as it is commonly
used, a correct one?
#. It is not. The ganglions give rise to what is called
the sympathetic nerve, not the nerve to the ganglions.
OP THE PROPERTIES OP ANIMATED BEINGS.
Q. How are these properties divided?
#. Into the properties of life, and those of texture.
1. Vital Properties.
Q. What are these?
*ft. Sensibility and contractility.
Q. How is sensibility divided?
#. Into animal and organic sensibility.
Q. What is the great distinction between organic and
animal sensibility?
#. In the first, the organ exhibits the faculty of re-
ceiving an impression, without transmitting it to a com-
mon centre^ animal sensibility implies not only the re-
ception of an organic impression, but the transmission of
that impression to a common centre, and that centre is the
brain. This transmission and cerebral impression consti-
tute the difference between organic and animal sensibility.
Q. What phenomena are supported by organic sensi-
bility?
/?. Digestion, circulation, secretion, exhalation, absorp-
tion, nutrition, and others. This sensibility is common
to the plant, the zoophyte, and the most perfect animal.
Q. What phenomena depend on animal sensibility?
Jl. Sensation, perception, volition, intellect, pleasure,
2S OF LIFE,
pain. Now, this sensibility is not the attribute of vege-
tables.
Q. In what respects do organic and animal sensibility
resemble each other?
Ji. They originate from the same principle, viz. that
of life; and they vary only in degree of exaltation. Hence
organic sensibility can, by irritation, be exalted into ani-
mal sensibility.
Q. Does organic sensibility vary in its nature?
Jl. It does not ; it varies in force. In disease it is in-
creased or diminished. In health, each organ has its pri-
mitive determinate quantum of sensibility, which places
it in relation to its appropriate stimulus, as the -urine to
the bladder, the air to the lungs. The organs in health
will admit no other than their appropriate stimuli.
Q. Can you illustrate this more clearly?
#. In the healthy state, serous exhalants carry serum
only, but let their organic sensibility be exalted into ani-
mal by irritation, and you will see them allowing the pas-
sage of blood. This change is often independent of the
healthy calibre of the vessels; for a vessel large enough in
health to convey a red globule, will, from its organic sen-
sibility, be in relation only to white fluids.
Q. What effect has sudden death on these two kinds of
sensibility?
/?. It annihilates immediately the animal, but more
slowly the organic sensibility.
Q. How is contractility divided and subdivided?
/?. It is divided into animal and organic contractility.
The last is subdivided into sensible and insensible organic
contractility.
Q. What do you understand by the term contractility?
OF LIFE. 29
*fl. It is spontaneous motility, (motilit6,J an inherent
faculty of living bodies.
Q. What features serve to distinguish the two kinds of
contractility from each other?
#. Animal contractility has its impulse from the brain,
submits to the influence of the will, ceases when the com-
munication of the organ with the brain is cut off, has its
seat in what are called the voluntary muscles, and pre-
sides over locomotion and the voice.
Q. Place organic contractility in contrast with the ani-
mal.
/?. It has no common centre, such as the brain is to ani-
mal contractility; it is uncontrolled by the will; finds its
principle in each contracting or moving organ; and pre-
sides over the digestive, secretory, absorbent, exhaling,
and nutritive phenomena.
Q. What effects have sudden death and disease on these
contractilities?
#. This death suddenly destroys animal contractility,
the organic remaining larger in existence. The effects of
disease may be seen in paralysis, where animal contracti-
lity is lost, while the organic remains.
Q. What connexion have these contractilities with their
respective sensibilities?
A. They arise from them, depend on them, inasmuch
as action is the result of sensation.
Q. Is there not a difference in the relation of the two
to their respective sensibilities?
&. There is; for the excitement of animal sensibility
does not necessarily induce animal contractility. For in-
stance, an impression made on a limb or set of muscles,
does not necessarily induce the motion of that member
30 OP LIFE.
or of those muscles. But organic contractility always fol-
lows the excitement of organic sensibility; this is exem-
plified in the action of the heart from the stimulus of the
blood.
Q. How do you explain this difference in the con-
nexion of the two sensibilities and contractilities?
#. In animal life there is an intermediate power, the
brain, which may, or may not, at pleasure, follow animal
sensibility with corresponding contractility : we speak now
of the normal state of these parts. In organic life, there
is no such intermediate, controlling power; for the stimu-
lus to the organic sensibility, the blood for instance, im-
mediately acts on the contractility of the heart, and ex-
cites it to action.
Q. Repeat the division of organic contractility.
/?. Its forms are sensible organic and insensible organic
contractility.
Q. Can you give examples of sensible organic contrac-
tility?
*/?. You perceive it in the motion of the heart, in the
contractions of the stomach, especially in the act of vomit-
ing ; it is likewise sensible in the intestines.
Q. What will exemplify insensible organic contrac-
tility?
*&. The power by which the excretory vessels act on
their respective fluids, that by which the secretory organs
act on the blood which finds access into them, that which
the lymphatics exercise on the substances exposed to their
extremities ; these are all by virtue of insensible organic
contractility.
Q. How does sensible organic contractility differ from
animal contractility?
OF LIFE. 31
J3.. Sensible organic contractility is involuntary, animal
contractility in its ordinary condition involves volition.
Q. Be more particular in distinguishing sensible and in-
sensible organic contractility from each other.
Ji. Uterine contraction, the heart's action, and vomit-
ing, are instances of sensible organic contractility; they
can be felt. The action of the biliary vessels, indeed
of the capillaries generally, are examples of insensible
organic contractility; they cannot be felt. Yet organic
contractility, whether sensible or insensible, is the same
principle in different degrees of exaltation. The fact that
insensible organic contractility is without the sphere of
volition distinguishes it from animal contractility.
Q. There yet remains a difference between organic con-
tractility and organic sensibility, yet to be stated; it is
singular and important, what is it?
ft. You have seen that a mere exaltation of organic sen-
sibility from disease, will convert it into animal sensibility
or pain ; now organic contractility, sensible or insensible,
cannot be converted or exalted to animal contractility.
Q. Should contractility be considered as exclusively
attached to the muscular tissue ?
#. It should not it is a property of all the tissues to
a greater or less extent.
Q. What do the two forms of organic contractility re-
present?
#. The sensible organic contractility is the irritability,
and the insensible organic contractility is the tonicity of
writers.
32 OP LIFE.
2. Properties of Texture.
Q. What are these?
Jl. They are extensibility and contractility of tissue.
Q. Can you offer some examples of extensibility of
texture?
*#. The walls of the abdomen extended by tumours,
serous infiltrations, or pregnancy ; the extension of the
tunica vaginalis in dropsy; that of a part filled with ab-
scess. All this is extensibility of texture, a property in-
dependent of life.
Q. On what do these textural properties depend?
#. They depend on the arrangement of the organic
fibres of parts; where these fibres are loose, there is much
extensibility, as in the muscles, and vice versa.
Q. What organs are most extensible?
Jt. The muscles, skin, and cellular tissue; those least
v so, are the bones, cartilages, tendons, nails, &c.
Q. How can you exemplify contractility of texture?
#. After distending causes have been removed, you
see parts return to their natural state. It is exhibited in
the contraction of the abdominal parietes after delivery,
or on the evacuation of peritoneal dropsy. It appears
again when the stomach or bowels, after great distention
with wind, resume their wonted dimensions.
Q. Is this contractility of texture greater in the dead or
living parts?
*#. Although these properties of texture arc indepen-
dent of life, yet this imparts to them additional force.
Q. Present an example of a part possessing all the va-
rious forms of contractility.
OP LIFE. 33
%/?. A muscle will exemplify this best. Thus, 1st, cere-
bral impulse conveyed through the nerves, occasions a con-
tractility; this is animal contractility, and involuntary;
2d, on the application of a strong stimulant, there will be
a muscular motion, which is sensible organic contracti-
lity, or irritability; this is involuntary; 3dly, a penetra-
tion of all the parts of the muscle by its nutritive fluids,
developes a movement of oscillation, which is insensible
organic contractility or tonicity, and this is involuntary;
4thly, cut across a muscle and its fibres retract; this is the
contractility of texture; lastly, various organs possess
one or more of these forms of contractility.
Q. What form of contractility is possessed by all living
parts?
ft. Insensible organic contractility or tonicity.
Q. Name that contractility which is the attribute of
all parts, living or dead?
A. All tissues, whether living or dead, possess contrac-
tility of texture.
Q. Can you give a tabular recapitulation of. the pro-
perties of living bodies?
#. The general division is into vital and textural pro-
perties.
Vital Properties.
A. Sensibility the faculty which an organ feels.
a. *ftnimal sensibility ; in which the sensation is felt
by the organ, and conveyed to the brain.
b. Organic sensibility ; in which the organ feels, but
the sensation is not conveyed to the brain.
B. Contractility the faculty by which motion volun-
tary or involuntary takes place.
a. Animal contractility voluntary.
5
34 OF LIFE,
b. Organic contractility involuntary.
Organic contractility is divided into
1. Sensible organic contractility; as the motion of
the heart, contractions of the stomach, &c. these
are sensible, but involuntary.
2. Insensible organic contractility ; as capillary action
or motion: this is insensible, and involuntary.
Properties of Texture.
A. Extensibility.
B. Contractility.
Q. What composes the life of the organs?
#. A modification of the above mentioned vital proper-
ties, which control the circulation and temperature of each
organ.
OF ANIMAL LIFE.
Q. What is the first conspicuous distinction between
animal and organic life?
*#. The period of the commencement of the two lives.
Organic life commences with the rudiment of foetal life 5
animal life begins after birth.
Q. Why do you say that animal life is quiescent before
birth?
/!?. None of the senses being in exercise, the foetus does
not feel; there is neither sensation, perception, nor voli-
tion. It is not probable that the liquor amnii causes any
sensation.
Q. Is it true that the surrounding temperature, and the
liquor amnii, are the only external objects capable of ex-
citing sensation in the foetus?
t#. The contact of the uterus may be admitted as a fee-
OP LIFE. 35
ble cause. From all that has been ascertained it may be
inferred that the senses are not in action in the foetus, espe-
cially the touch.
Q. One attribute of animal life certainly exists in the
foetus, if the senses do not, what is it?
#. Locomotion does truly exist, but that of the foetus,
is not the consequence of external sensation or of animal
life. It results from the brain being sympathetically stimu-
lated, by the organs of organic life, in their foetal deve-
lopement. The locomotion exists, it is involuntary. For
example, the foetal heart sends undue measure of blood to
the brain ; it is thereby excited, and thus involuntary mus-
cular action is induced. Now compare this with voluntary
locomotion in independent life, in which sensation, per-
ception, and volition concur.
Q. There is another feature distinguishing animal from
organic life, what is it?
#. The operations of organic life are perfect at birth ;
those of animal life become so only in process of education
and habitual exercise. The senses of the infant trace, at
first, confused general images; so do the perceptions; the
intellectual operations are latest in attaining perfection.
Q. What are the laws governing this education of the
functions of animal life?
*ft. Let it suffice to state one. The improvement or
perfection of any one of these is at the expense of others;
tha of the memory at the cost of judgment, &c. The per-
fection of one sense is at the expense of another. Now it
is curious, that the operations, not the education, of or-
ganic life are under the influence of a gimilar law: the ex-
cessive action of one organ is at the expense of another.
3G OF LIFE,
OF ORGANIC LIFE.
Q. What organ in this system is first developed?
t#. The heart, the punctum saliens.
Q. What is the difference between foetal organic and
independent organic life?
.#. The difference is great as to the number of func-
tions in operation. For instance, in the foetus there is
little assimilation, because the blood comes prepared from
the mother; there is neither digestion nor respiration;
there is no excretion. In after life all these functions are
in play. In foetal organic life there is rapid assimilation,
but slow and slight decomposition.
Q. On what does the perfect operation of organic life
depend?
ttf. Not on education, nor on habit, nor on symmetri-
cal arrangement as in animal life, but on original structure
or organization.
Q. Where is the moral character seated ?
Jl. The passions constituting this, are seated in organic
life!
Q. In natural death, which life, animal or organic, dies first?
A. Animal life does. The senses give way; the skin
becomes tough, and hard, and being deprived of much of
its vascularity, it is the seat of obscure touch. As sensa-
tion is blunted, the mental faculties decline; that declen-
sion weakens volition; the voluntary muscles are disused;
thus the organs of animal life die in detail. Organic life
fails in the same gradual manner; digestion, secretion and
absorption decline pr cease; the capillary circulation from
the loss of tonicity is embarrassed; the general circulation
ceases, and the heart ultimately dies. Such is the natural
death of the. old man.
ON DEATH.
Q. Is the dependence of animal life on organic, or that
of organic life on animal, greatest?
t/?. Intimately as they are related, it is to be observed,
that death of the animal organs, instantly follows that of
the organic; whereas organic life continues some time
after animal life has ceased.
Q. What is the sure indication of complete death?
ft. The termination of the functions or phenomena of
organic life.
Q. What triple alliance is necessary to life?
*fl. The functions of the heart, lungs and brain.
On the Influence of the Death of the Heart upon that
of the Brain.
Q. How does the heart influence the brain?
/2. Through the circulation of the blood, and by ner-
vous transmissions.
Q. How does the circulation of red blood influence the
brain?
#. In two ways: by the motion of the blood in the ar-
teries; and by the intrinsic qualities of red blood, vivify-
ing they may be called. Too great motion of the brain
from the heart's action, or too little will morbidly excite
or debilitate the cephalic functions.
Q. In injection of air into the veins, where is its fatal
impression made?
38 ON DEATH.
.#. On the brain, for the heart continues to live after
animal life is destroyed.
On the Influence of the Death of the Heart upon that
of the Lungs.
Q. What constitutes the functions of the lungs?
/?. Two processes; first, the mechanical one of expan-
sion by the aid of the muscles, and the chemical one of
changing the black blood to red.
Q. In cases where the heart with black blood ceases to
operate, how are the lungs interrupted?
#. There is no blood in the lungs in this case; the brain
is indirectly affected, because the heart, receiving no red
blood from the lungs, sends none to the brain. Without
this red blood the brain is unable to maintain the action of
the ribs and intercostal s, so the mechanical function of the
lung ceases.
Q. How are the lungs affected, when the red blood
heart, is interrupted in its functions?
#. The operation is an indirect one through the brain;
thus, the brain receives no red blood, consequently it
communicates no power to the intercostals and diaphragm;
and the lungs cease to live in consequence of a suspension
of their mechanical functions.
On the Influence of the Death of the Heart upon that
of the Organs generally.
Q. How is the death of the organs generally, induced by
that of the heart with red blood?
.#. The organs of animal life die, because the heart sends
ON DEATH. 39
no red blood to the brain. The organs of organic life cease,
because the arterial movement is extinct, and because they
have not the excitement of red blood.
Q. Explain this motion or arterial impulse which you
say is so important?
*ft. Habitual movement is alike essential to animal as
well as organic life; without it they all languish. You
see muscular motion; the motion given to the brain by the
pulsation of the arteries; the movement of the thoracic
viscera in respiration and that of the heart; and in the
abdominal organs there is the pulsation of the arteries, the
capillary and oscillatory motions, the contractions and
dilatations of the stomach and bowels. You observe how
conspicuous a share in the general motion, arterial impulse
has; now in the death of the red blood heart, it is extinct.
Q. Has not the death of the red blood heart, an indirect
effect in inducing general death?
tf. Yes it does so through the medium of the brain.
Q. Is there any relation between the quantity of blood
conveyed to a part and the vital forces of that part?
*ft. A very important one; the vital forces are exalted
or diminished as the quantity of blood sent to an organ is
increased or diminished.
On the Influence, of the Death of the Heart on General
Death.
Q. Can you trace the influence of the death of the heart
in the production of general death?
JL. The death of the heart arrests the impulse of blood
on the brain, and thus animal life is first extinguished.
This influence on the brain is of two kinds; first, the mo-
40 ON DEATH.
tion given io the brain by arterial action; secondly, the
vivifying power of red blood. The cessation of the same
impulses on organic life induces death in that system, in
which organic sensibility and insensible organic contrac-
tility are last to die. Death in the heart then is felt, first
in the death of the animal, and secondly in that of the or-
ganic system of life.
Q. Why do the vital forces continue longer in organic
than animal life?
*#. Animal life having but one common centre, the
brain, the death of that is followed simultaneously by that,
of all its dependencies. In organic life there being many
ganglionic centres, life is there kept up longer.
Q. Where does death from mental emotion first take
place?
#. It takes place first in the heart.
Q. What organ is primarily affected in syncope?
Ji. The heart always.
Q. What reasons do you assign for this theory of syn-
cope?
/?. The passions affect organic life primarily, and not
animal life; the phenomena of syncope are the same
whether produced by the passions, by cardiac obstructions,
or by haemorrhage ; in the approach of syncope the sensa-
tion is first felt in the heart; the heart is diseased by the
passions, while the brain is not; the heart has direct in-
fluence over the brain, white cerebral influence on the
heart is indirect, for the heart continues to live some
time after the brain dies, whereas the brain dies instant-
ly on the death of the heart; lastly, palpitations and other
impressions on the heart proceed from the same causes
which induce syncope.
ON DEATH. 41
Q. There is a great difference in the mode by which
asphyxia, syncope, and apoplexy induce death, what is it?
Jj. In asphyxia death commences in the lungs, in syrt-
cope in the heart, in apoplexy in the brain.
On the Influence of Death of the Lungs upon that of
the Heart.
Q. In diseases, where does death usually commence?
t/?. In the lungs.
Q. In syncope, what is the condition of the lungs?
#. They are empty and collapsed, because the heart
failing suddenly, blood is not thrown into them.
Q. Repeat the mode in which death takes place in the
lungs?
*ft. By the cessation of its mechanical and chemical
functions.
Q. What causes affect the mechanical functions of the
lungs?
t#. A wound which exposes the lungs in both cavities;
such a section of the spinal marrow as cuts off the inter-
costal and phrenic nerves from cerebral influence; the sud-
den introduction of a large quantity of fluid into the cavities
of the thorax, &c.
Q. How are the chemical functions of the lungs de-
stroyed?
#. By asphyxia, strangulation, submersion, or a vacuum
however produced.
Q. How does an interruption to the mechanical func-
tions of the lungs affect the heart ?
#. The collapse of the lungs mechanically obstructs
the circulation of the blood from the right side of the
6
42 f ON DEATH. f ^
heart; and the lungs do not transmit red blood to the
heart.
Q. How does a cessation of the chemical function of
the lungs affect the heart?
ft. It is by the operation of black blood on the vital
forces of the heart. Understand, it is not contact of black
blood with the lining membrane of the heart, but because
black blood conveyed to the heart through the coronary
arteries fails to maintain its vital forces.
Q. How does black blood destroy life in the organs ge-
nerally ?
ft. By its contact with the minute fibres, &c. of the or-
gans, and not by impression made on the internal surface
of the heart.
Q. Is this operation of black blood-on the minute fibres,
or on the nerves which supply them ?
ft. It rnay be on the nerves.
Q. Why does the left side of the heart always die first?
.#.' Because its supply , of blood fails soonest; for as
death progresses the blood accumulates in the right side of
the heart, keeping it alive longest.
Q. Why are the right heart and the veins always more
loaded with blood in asphyxia, than the red blood heart
and arteries?
ft. Three causes concur to produce this; viz. the kind
of blood in circulation, the state of the lungs, and that of
the heart.
Q. What agency has the blood in inducing this loaded
state of the right side of the heart and of the veins?
ft. In asphyxia the heart circulates black blood; this
being unfit for secretions, exhalations and nutrition, is not
consumed for the purposes of the oeconomy, it therefore
ON DEATH. 43
passes directly to the veins from the arteries and fills
them.
Q. Did you not say that the lungs contributed to this
fulness of the right heart and veins in asphyxia?
tf. The passage of blood from the right heart to the
lungs, is impeded by the weakness of their chemical func-
tion; this weakness arising from the circulation of black
blood, in the bronchial arteries in asphyxia. This state of
the lungs, stagnates blood in the right or black blood side
of the heart.
Q. The third cause for this collection of blood in the
right heart and veins was the condition of the heart itself,
explain this?
/2. The powers of the right auricle and ventricle are
debilitated by the collection of blood in them from the
two causes above assigned; this debility still further fa-
vours the congestion in the large veins near the heart.
Q. Why does the vascular system with red blood, con-
tain so little of that fluid in asphyxia?
JL. Because the obstruction in the lungs prevents the
flow of blood to the aortic side of the heart, and because
the arteries empty themselves by their inherent powers,
into the veins.
Q. How is the lividity of parts in asphyxia to be ac-
counted for?
JJ. It has been attributed to reflected venous blood; it
is, however, owing to the fact that in asphyxia the heart
circulates black blood.
44 ON DEATH.
On the Influence, of the Death of the Lungs upon that
of the Brain.
Q. How does death of the lungs influence that of the
brain in asphyxia?
w2. In the death of the lungs the failure of their chemi-
cal functions sends black blood to the heart; the heart
sending it to the brain, the latter penetrated by black
blood, dies.
Q. Some curious experiments confirm this deleterious
action of black blood on the brain, what are they?
*#. Arterial blood from the carotid of one dog, was
thrown into the carotid of another dog which had a liga-
ture next to the heart; the animal lived. Venous or black
blood was then used in the experiment, and the dog was
killed at once. The black blood did not excite the brain,
or was poisonous to it.
Q. Is not the death in the case above stated owing to
the want of pulsation or arterial motion in the brain ?
A. It is not; because, in the process of asphyxia in
animals, the aorta. pulsates black blood into the brain; in
this then, there was no want of cerebral motion from the
blood.
Q. On what part does asphyxia first produce death?
*ft. On the brain ; animal life first suffers. Those who
have escaped suffocation complain of drowsiness, a general
numbness, head-ache, paralysis, even convulsion, all evi-
dently seated in the brain.
ON DEATH. 15
On the Influence of the Death of the Lungs upon that
of the Organs generally.
Q. How do you ascertain the progress of asphyxia in
animals?
#. Tie the trachea high up; make an opening below
the ligature, introduce a tube with a cock to it. By this
means you can admit air as you please to the lungs. Adapt-
a small tube and cock to the crural artery, and by this you
ascertain the state of the blood in the progress of the
asphyxia.
Q. If the cock of the pipe be shut immediately after
inspiration, what changes are made in the blood? ^
/2. In thirty seconds the blood begins to darken; in a
minute its colour is deepened; in two minutes it is black
blood.
Q. What is the effect of stopping the cock after a strong
expiration?
/?. The blood becomes sooner black.
Q. What takes place when you pump the air from the
lungs with a syringe?
#. The blood blackens immediately; the crural artery
throws a black stream, as soon as the red blood which it
contained can be emptied.
Q. And what if the air cells are completely filled be-
fore the cock is stopped ?
#. The blood is slower in becoming black.
Q. After asphyxia has been established for some mi-
nutes, if the stop be opened, what takes place?
#. A strong expiration first takes place; then several
deep rapid respirations, and an instantaneous, not gradual
restoration of the blood to a red colour. These changes
46 ON DEATH.
are more or less complete according to the quantity of
air admitted.
Q. From the rapidity with which the blood is reddened,
what do you suppose to be the course of the colouring
principle?
A. There can be little doubt that the colouring matter
passes the membranes of the air cells to the blood, and not
through the absorbents.
Q. When asphyxia is removed by the introduction of
air, how is the heart affected ?
fl. Red blood is sent to the left heart, it penetrates the
coronary arteries, and reanimates the forces of the heart,
which were exhausted by the black blood.
Q. If the heart's action is once entirely checked, can it
be restored by the injection of air into the lungs?
ifl. It cannot. The heart having ceased to beat, the
coronary arteries no longer nourish the vital forces of the
heart with blood. A temporary syncope may be removed.
Q. What are the symptoms in asphyxia from hydrogen
and carbonic acid gas?
/?. After a hurried, agitated, embarrassed respiration
for a few minutes, the blood becomes black.
Q. Why is the blood longer in blackening when these
gases are respired?
#. The expelled and reabsorbed air in this process, af-
fords all its vivifying principles to the blood. But when
the tube and cock are simply shut, there is not this agita-
tion of the respirable air remaining in the lungs.
Q. If oxygen be respired, what occurs?
#. The blood is much longer in losing its red colour.'
Q. How do you prove that black blood is circulated in
the organs in asphyxia?
ON DEATH.
*#. By the fact, that the left heart does act for some time
after black blood is thrown into it; which of itself proves
that it must throw black blood into the organs.
Q. Is there not other evidence of the injection of the
organs with black blood in asphyxia?
Jl. Dissection has given beautiful evidence of it in the
muscles. In them you see the black drops of blood oozing
from the vessels of the cut muscle, while the colouring
matter of the muscular fibre preserves them red. Again,
this black blood is seen in the arteries of the nerves. It
is stagnant in the skin, because the black blood does not
sufficiently excite the capillary circulation to action. The
passage of black blood into the mucous and serous mem-
branes is clearly evidenced by exposing these tissues,
and shutting the stop-cock in the trachea.
Q. What phenomena are accounted for by the left heart
circulating black blood?
A. Besides explaining many other pathological facts,
it accounts for the existence of black blood in the arteries
after death; it likewise explains the darkness of the mu-
cous membranes after death.
Q. What effect has the black blood on the tissues ?
#. Defective in exciting power, the vital forces of the
organs penetrated by black blood diminish; this is from a
destruction of their own vital forces that the organs suffer,
not from direct dependence on the heart or brain. The
destruction of organic life is an independent process, as
that of animal life, connected as the two may be.
Q. What effect has asphyxia on the white organs, or
those to which no blood is ordinarily sent?
*ft. The question cannot be answered.
48 ON DEATH.
On the Influence of Death of the Brain on general
Death.
Q. Will you state precisely the order in which death
progresses, when the mechanical function of the lungs is
interrupted?
t/?. First, the mechanical phenomena, then the chemical
fail from want of air; next the cerebral action from want of
red blood excitement; then animal life, sensation, locomo-
tion, and the voice, from the loss of cerebral action and
red blood ; then the general circulation ; next the capillary
circulation, from the want of action excited by red blood
in secretion, absorption, exhalation; lastly, digestion fails.
This is the order of death on loss of the mechanical func-
tion of the lungs. '
Q. Now give the order in which death supervenes when
the chemical function of the lungs ceases?
#. 1st, Interruption of the chemical phenomena; 2d,
Necessary subsequent suspension of cerebral action; 3d,
Cessation of sensation, of voluntary locomotion, of the
voice, and mechanical phenomena of respiration ; 4th, An-
nihilation of the heart's action, and of the general circula-
tion; 5th, Termination of the capillary circulation, of the
secretions, of exhalation, absorption, and consequently of
digestion; 6th, Cessation of animal heat, which is the re-
sult of all the functions. This is the progress of death,
when the chemical functions of the lungs cease.
Q. How do asphyxiae vary?
A. The process is slow or rapid; the subject is convuls-
ed or calm.
Q. What gases produce asphyxia most, speedily?
ON DEATH. , 49
*#. Sulphuretted hydrogen, nitrous gas, effluviae from
privies produce it more speedily than other gases, or than
a vacuum does.
Q. How do you divide asphyxise?,
*#. Into those produced by want of air, and those from
poisonous gases. In the first, death is produced by the
circulation of black blood purely; in the second there is
added to. the black blood a deleterious substance. In some
cases death is produced by the poisonous effluvise alone.
Q. There are two modes by which deleterious gases af-
fect the lungs, what are they ?
*#. They affect the nerves of the lungs, and these react
by sympathy on the brain; and they pass into the blood,
and thus likewise exert a morbid influence on the brain
and organs in general. Simple contact of a deleterious gas
with a mucous surface does not produce death immediately.
Q. Is it certain that air will pass through the membrane
lining the bronchiae, into the blood-vessels?
/?. It is rendered certain by direct and analogical proof.
Experiments on animals show that a quantity of air en-
ters the blood-vessels, and may be drawn off with the
blood. Hydrogen has been drawn from the arteries, almost
as pure as when forced into the blood.
Q. On what system, do the deleterious vapours absorb-
ed into the general circulation, in asphyxia, operate ?
J3. On the brain and nerves. The reasons for this opi-
nion are, that the symptoms are stupor and convulsions;
that the symptoms are the same when the gases are in-
haled, as when injected into the brain; the phenomena, on
restoration from this absorption, are cephalic, such as tre-
mors, pain in the head, &c. These all point to the brain
as the system on which these deleterious poisons operate.
7 i
50 ON DEATH.
The contact of black blood with the organs has doubtless
some agency in inducing death.
Q. In diseases where does death begin?
/?. In the lungs.
Q. What is the colour of the arterial blood after death
from disease?
Jl. It is black, because death commencing in the lungs,
their chemical functions give way, the blood sent to the
left heart is black, and consequently the arterial blood is
so too.
Q. When death begins in the heart, what is the colour
of the arterial blood?
#. It is red, and the lungs are empty.
Q. When death commences in the brain, what is the
condition of the lungs?
#. Generally they are empty of blood.
On the Influence of Death of the Brain upon that of
the Lungs.
Q. Does death of the brain affect the lungs directly or
indirectly?
#. From experiments made in cutting the sympathetic
nerve and par vagum, it is presumed that direct cerebral
influence does not induce death of the lungs. For although
all these nerves be cut, respiration continues for some time;
yet surely if direct cerebral influence operates on the lungs
it is by these nerves.
Q. How then does death of the brain induce that of the
lungs?
#. Indirectly, by cutting off the cerebral influence, pa-
ralysing the diaphragm and intercostal muscles, and thus
destroying the mechanical functions of the lungs.
ON DEATH. 51
Q. What view then shall we take of respiration?
Jl. Respiration is a common function, serving as a point
of contact between the animal and organic lives, attached
to the first by its mechanical, and to the second by its che-
mical functions.
On the Influence, of Death of the Brain upon that of
the Heart.
Q. Is the heart directly influenced by the death of the
brain ?
A. The direct influence of the brain is extended only
to the voluntary organs; the heart not being an organ of
volition, we conclude it is not under direct cerebral influ-
ence. Experiments prove the absence of this direct in-
fluence.
Q. By what intermediate organ does death of the brain
act on the heart?
A. Through the lungs. There is interruption of the
cerebral action; then annihilation of the action of muscles
of animal life, consequently a cessation of the mechanical
functions of the lungs ; next, suspension of the chemical
functions, penetration by black blood of the fibres of the
heart, and its death? *
Q. Why is the blood red or black in different surgical
operations?
/#. This depends on the embarrassment of the pulmo-
nary function; when that is very great the chemical func-
tions of the lungs cease, and the blood discharged is black.
52 ON DEATH.
On the Influence of Death, of the Brain on the organs
generally.
Q. How does the death of the brain affect that of all
the organs?
t#. The organs of animal life die directly, because of
their immediate dependence on the brain.
Q. But is not the influence on organic life equally direct?
#. Evidently not; the phenomena of disease, and ex-
periment, prove it. These experiments show that the brain
exercises only indirect influence on organic life. The death
of the brain destroying the mechanical function of the
lungs, the chemical functions also cease, causing thereby
the penetration of organic parts with black blood; this
overwhelms them, and they die.
On the Influence of Death of the Brain on general
Death.
Q. State distinctly the successive phenomena produced
on the body in general by death of the brain.
#. There is death of the brain, of animal life; cessation
of the mechanical functions of the lungs; cessation of
the chemical functions of the lungs; black blood in the
arteries; death of the heart; death of organic life; cessa-
tion of the capillary circulation; destruction of animal heat,
as well as that of the life of the white organs.
OF THE CELLULAR SYSTEM.
Q. Give a definition of the cellular tissue.
ft. It is composed of an assemblage of filaments, and
soft, whitish laminae interwoven and intersecting each
other in various ways, with very irregular communicating
spaces, forming reservoirs for the fatty and serous fluids.
Q. What relations does this texture bear to the several
organs?
t/?. It surrounds, separates, and connects them; and
continuing to their interior structure, it enters universally
into their composition.
Q. Define more particularly the relations of this tex-
ture to the exterior of the various organs.
*fl. There are organs which have one surface free, the
other adherent; the cellular texture is connected only with
the adherent side of these organs. There are other parts
entirely surrounded by neighbouring organs; the cellular
textuue entirely surrounds these.
Q. Which are the organs with a free and an adherent
surface?
*#. The skin, the serous and mucous membranes.
Of the Sub-cutaneous Cellular Texture.
Q. At what part is the cellular texture most adherent
to the skin?
#. At what is termed the median line of the body;
viz. the middle of the nose, lips, sternum, and linea alba
54 OF THE CELLULAR SYSTEM.
Q. -Where is this sub-cutaneous texture most dense?
*#. On the scalp; on the palmar and plantar surfaces,
and at the annular ligaments.
Q. Why is this texture loose, as in the face and on the
abdomen, and dense elsewhere?
#. To favour the functions of parts, where looseness
avails some, and density others.
Q. How does the density of cellular structure affect
dropsical and emphysematous swellings?
*#. Where it is dense, there is neither a collection of
water nor air.
Q. When is this density of cellular structure at the an-
nular ligaments most observable?
*#. In infants, and in very fat persons.
Q. What are the uses of the sub-cutaneous cellular tex-
ture?
.#. It allows mobility to the skin, facility to the mo-
tions of subjacent parts, and it serves to defend from cold.
It is more abundant in winter than in summer, and it is
found in greater quantity in animals inhabiting cold cli-
mates. Recollect the chilliness which accompanies atte-
nuation in chronic diseases.
Q. In what part of the cellular texture does serum most
readily accumulate?
*ft. In the sub-cutaneous portion, and in this, because of
its laxity.
Of the Sub-mucous Cellular Texture.
Q. What is the great difference between the sub-mucous
and the sub-cutaneous cellular textures?
Jl. The sub-mucous is much more dense in its whole
expansion.
OP THE CELLULAR SYSTEM. 55
Q. What would be the consequence of a loose sub-mu-
cous cellular texture?
*ft. Dropsy would form in a loose texture, and the hol-
low organs be closed by their sides being pressed into
contact.
Q. What exempts the sub-mucous cellular texture from
emphysema?
Jl. The density of its structure, which prevents gaseous
distention.
Q. Why is the sub-cutaneous cellular tissue more liable
to phlegmon than the sub-mucous?
#. Perhaps, because of its laxity of structure, and of
its freer exposure to the causes of phlegmonous inflamma-
tion.
Q. There is yet another important result from the den-
sity of the structure of the sub-mucous cellular coat?
/?. It fits it for giving origin and insertion to the mus-
cular fibres of the hollow organs, such as the stomach,
bowels, and bladder.
Of the Sub-serous Cellular Texture.
Q. Is this texture generally loose or dense?
#. Remarkably loose; it is liable to serous and emphy-
sematous distention.
Q. Why is it thus loose?
*fl. For adaptation to the dilatations and contractions in
the serous membranes.
Q. Can you give some examples of dense, adherent,
serous texture?
#. The two layers of the pericardium the adhesion
of the arachnoides to the dura mater" are instances.
00 OF THE CELLULAR SYSTEM.
Q. What does this intimate union of the serous and
fibrous membranes constitute?
A. They form what are called the sero-fibrous mem-
branes.
Of the Arterial Cellular Texture.
Q. What are the peculiarities of this texture?
&. It is remarkably dense; it is never infiltrated with
serum; fat does not accumulate in it; it is rarely found in
a state of inflammation.
Q. How is this arterial texture formed?
#. It is formed by a gradual condensation of the neigh-
bouring cellular texture.
Q. Are the arterial fibres implanted in this dense coat,
as the muscular fibres of the stomach, &c. are in the sub-
mucous cellular tissue?
*#. No; the arterial cellular tunic adheres too loosely
to the vessels to admit that supposition.
Of the Venous Cellular Texture.
Q. What characterizes this texture?
A. It is not so dense as the arterial, and is more dry.
It is not liable to fatty or serous infiltrations.
Q How is the cellular cylinder of the veins, and arte-
ries to be distinguished from the nervous filaments and
branches?
.#. The cellular texture is white ; the nerves are gray ;
this is ascertained by deliberate maceration.
Q. What other canals have a cellular cylinder?
#. The excretory ducts, those of the pancreas, gall-
OP THE CELLULAR SYSTEM. 57
bladder, &c. If the absorbents did not, by their fine-
ness, preclude demonstration, it would doubtless be
found that they have a cellular coat, as well as the blood-
vessels.
Of the Cellular Texture embracing the Organs on all
tSides.
Q. What organs are included here?
ft. All except those already mentioned.
Q. What are the effects of this cellular investment?
ft. It insulates the several organs ; it insulates likewise
their vitality ; it forms a line of separation between them.
It sometimes prevents the extension of disease from one
organ to a contiguous one; as when the peritoneum is in-
flamed without the viscera being affected, or as when the
sub-cutaneous organs are healthy, while the skin is in
eruption.
Q. Is this the only barrier to the extension of disease in
these circumstances?
*fl. No; the difference in the vital forces of different,
though contiguous organs, also prevents the extension of
disease.
Q. But does this cellular investment always perform
the salutary office of arresting the spreading of diseased ac-
tion?
ft.. It does not; for by taking on disease, it facilitates
its extension.
Q. Can you illustrate the preceding answer?
i#. The extension of tumours, that of phlegmon, and
that of rheumatism swelling a joint, are examples.
8
58 OP THE CELLULAR SYSTEM.
Q. Is there no other influence spread by this cellular
atmosphere around the organs?
t/#. Medicinal agency is conveyed by it.
Q. Give instances of this.
ft. The effect of blisters, cataplasms, and other appli-
cations may be adduced.
Q. How are the vital forces of organs generally in-
jured?
Ji. In three ways: 1st, by direct irritation; 2d, by
sympathy; 3d, by cellular communication. The last is
exemplified in the discolouration and inflammation of the
skin over a carious bone.
Q. What other physiological office is performed by this
cellular investment?
t/2 It facilitates the motion and expansion of organs.
Q. What other means have some organs to facilitate
their mobility?
Ji. The serous membranes perform this office in many
cases.
Of the. Internal Cellular Structure of the Organs.
Q. What relation does this bear to the several organs?
#. It enters intimately into their elementary structure;
it surrounds each vessel, nerve and fibre; it insulates each
by sheathing it; and it favours the mobility of the fibres
and vessels of the organs.
Q. Does it partake of the vital properties of the organs?
Ji. It does not; the cellular texture has its own vital
properties. It has not the sensibility of the nerve into the
structure of which it enters; it has not the contractility of
the muscle, nor yet the secretion of the gland.
OF THE CELLULAR SYSTEM. 59
Q. Are its diseases, distinct from those of the organs
into which it enters?
*#. They are. Tumours form in this cellular texture
within the organ, or suppuration occurs in it; while, as
you will conspicuously see in tumour or abscess of the
liver, the secretion of bile will go on. The function of the
lungs going on, in the course of extensive disease in them,
is another illustration of this principle.
Q. How is this cellular texture discovered in some or-
gans?
*#. Maceration and ebullition will exhibit it.
Q. What proves its existence in bones and cartilages?
ft. The granulations essentially of a cellular nature,
which sprout from these in their diseases and injuries.
Q. Is there any organ destitute of this internal cellular
texture?
#. No it is an essential constituent of the nutritive
parenchyma of every organ.
Cellular Texture of the Head.
Q. Where do you find, on the head, this texture most
abundant?
*ft. In the face; on the cranium there is little.
Q. Is there much in the interior of the cranium ?
A. Very little; a small quantity is found where the ves-
sels go in and out.
Q. To what is the redness of the eye in phrenitis
ascribed?
#. To the cellular communication through the orbit.
Q. What occasions the weight and pain in the head in
coryza?
60 OF THE CELLULAR SYSTEM.
t#. The cellular communication through the cribriform
plate of the ethmoid bone, favours the extension of the
pain in the head.
Q. To what does Bichat ascribe the coup de soleil?
/?. To the cellular connexion between the external and
internal membranes of the cranium through the sutures!!!
Q. Why in erysipelas of the scalp do you see the pus
and serum in the eyelids ?
Ji. Because of the communications of the cellular tex-
ture of the cranium with that of the face.
Of the Cellular Texture of the Trunk and Extremities.
Q. Where is the spinal or vertebral cellular texture
principally found?
#. There is little found along the spine externally;
there is much on the anterior surface of the vertebral co-
lumn. There is very little in the cavity of the vertebral
canal.
Q. Where do depositions from the course of the spine
sometimes show themselves?
/2. In the groin, from cellular communications.
Q. Where is the cervical cellular texture most abun-
dant?
Ji. In the lateral parts, where the lymphatic glands are.
It abounds also about the neck generally.
Q. What evidence is there of the communication of the
cervical and pectoral cellular textures?
A. The extension of emphysema from the lungs to the
neck.
Q. Where is the pectoral cellular texture principally
found?
OP THE CELLULAR SYSTEM. 61
Ji. In the interval formed by the fold of the mediastf-
num, about the pericardium, and where the large vessels
come out.
Q. How does this pectoral texture communicate with
the abdominal ?
fl. Through the diaphragmatic openings.
Q. Where do you meet with external pectoral texture?
*ft. In great quantities in the breasts of women and men,
and under the pectoral muscles.
Q. Why has disease of the peritoneum more influence
on the right pleura than the left?
*ft. The peritoneum on the right side being kept fixed by
the convex surface of the liver, the communications of
the abdominal and pectoral cellular textures are there
more constant and operative, than where the peritoneum,
towards the left pleura, is loose and floating with the
viscera.
Q. With what has the pectoral cellular texture peculiar
relation ?
<fl. With the cellular texture of the superior extremities.
Q. Where is the abdominal cellular texture most abun-
dant?
Ji. Where the large vessels enter the viscera, and about
the kidneys.
Q. What are the principal relations and communica-
tions of the abdominal cellular texture?
#. They are with the genital organs and inferior extre-
mities through the abdominal ring and crural arch. The
abdominal cellular texture bears the relation to that of the
lower extremities, which the pectoral does to that of the
superior.
Q. Is the cellular texture abundant in the pelvis?
62 OF THE CELLULAR SYSTEM.
/?. Very much so, in order to protect the distending
viscera of that cavity.
Q. Where is the cellular texture of the superior and
inferior extremities principally found?
*#. Around the scapulo-humeral, and the ilio-femoral
articulations.
Q. What physiological reason is there for the diminish-
ing quantity of cellular texture towards the extremities?
/?. That the positive operations of the hands and feet
might not be encumbered by it.
Q. What is particularly interesting in the cellular tex-
ture of the different cavities?
A. The communications through the several openings
above mentioned, through which inflammation, and serous
and other infiltrations are extended.
Q. On what does corpulency depend ?
#. On a preternatural distention of the cells of this tex-
ture.
Q. Are these cells increased in size as they are full or
empty ?
#. They enlarge to accommodate the fat and serum ex-
haled.
OF THE FORMS OF THE CELLULAR SYSTEM AND OF THE
FLUIDS IT CONTAINS.
Q. What is the figure of the cells of this texture?
#. There is no uniformity in this respect.
Q. What proves a universal communication of these
cells?
tf. Such phenomena as these j the extension of emphy-
sema; the emptying of a hydropic limb from one or two
OF THE CELLULAR SYSTEM. 63
punctures; the ascent and descent of fluids on pressure
these and other facts prove this communication between
the cells.
Q. By what fluids is this texture exclusively permeable?
A. By fat and serum. Fluids do not pass through this
texture from the stomach to the skin and bladder, as has
been supposed. The vital forces of the cellular texture are
only in relation to fat and serum.
Q. What part of this texture is destitute of fat?
/?. The eyelids, scrotum and prepuce, bones, hair, epi-
dermis, brain, spinal marrow and serous system.
Q. Is there much serum in the healthy state of this tex-
ture?
#. There is not as much as is supposed. Recollect how
it accumulates in disease.
Q. What is the nature of this serum ?
A. It is proved to be albuminous.
Q. In which muscles, those of animal or those of or-
ganic life, is there most fat found?
JL. There is little in the muscles of organic life; it
abounds in those of animal life.
Q. Where is fat almost exclusively found in infants?
t/?. In the sub-cutaneous cellular texture.
Q. Where is it most abundant in adult life?
*#. At that period the abdominal fat is in greatest abun-
dance.
Q. In old age what becomes of the fat?
A. It disappears; perhaps it is not deposited, or the ab-
sorption may be more active.
Q. Is a considerable accumulation of fat to be viewed
as a normal or abnormal process?
64 OP THE CELLULAR SYSTEM,
#. It is a morbid act, somewhat analogous to serous
collections; it is the result of debilitating causes.
Q. To what causes may unnatural corpulency and ema-
ciation be generally ascribed?
t#. The pathological reason is a general or local disease
or debility extended to the cellular texture. This disease
or debility may originate there.
Q. What curious phenomenon is presented in the cel-
lular texture of some birds?
Jl. The ortolan and other birds are said to fatten very
suddenly in foggy weather.
Q. What is the colour of the fat?
*/?. It is white in early life, yellow in advanced life,
and at the latter period it has a peculiar taste and smell.
Q. What causes tend to diminish the fat, or, in other
words, to induce emaciation ?
#. Protracted abstinence, prolonged organic affections,
purulent collections depending on chronic malady, leuco-
phlegmasia, the undue operation of depressing passions,
increased evacuations, watchings, great degrees of heat,
intemperance, and many other causes tend to emaciate the
body.
Q. Has temperature of the body exclusive influence in
preserving the fat fluid?
#. No; for both cold and warm-blooded animals have
the fat fluid. It is a vital influence that keeps it liquid.
Q. What do you find frequently substituted for fat near
the heart, in hydropic and phthisical patients?
#. A yellow transparent fluid, of a gelatinous aspect,
having many of the characters of albumen.
Q. How is the fat formed?
OF THE CELLULAR SYSTEM. 65
/2. By exhalation, through invisible vessels into the cel-
lular texture.
Q. What is the adipose texture, as distinct from the
cellular?
ft. It is the texture in which fat is formed and contained.
Q. What is the structure of this adipose texture?
ft. It is a soft, white structure, manifesting free exten-
sibility and contractility of texture. It assumes the form
of fine, semi-transparent laminae. It is filled with little
vesicles containing fat.
Q. What evidence is there that a peculiar organization
is necessary for the formation of fat?
ft. Because in many parts of the cellular texture there
is no fat.
Q. What physiological fact is established by the absence
of fat in many parts which have been mentioned above?
ft. Its presence would destroy or impede their functions.
Q. Are the adipose vesicles impermeable?
A. They are; for though the fat be rendered fluid, if
the adipose vesicle be unbroken, it does not escape. In
this it differs from the permeability of the cellular texture.
Q. Is there any other material feature in which the adi-
pose and cellular textures differ?
ft. Yes; the uses of the adipose are partial, those of the
cellular are general.
Q. What is the chemical nature of fat?
ft. It is composed of stearine and elaine, of sebacic,
margaric, and oleic acid.
Q. What are soaps?
ft. Salts formed by the uniojn of these acids with the
base that is used.
9,
66 OF THE CELLULAR SYSTEM-
Organization of the Cellular System.
Q. What is the organization of the cellular texture?
*ft. See the answer to the first question on this tissue;
but it may be added here, that there is great diversity of
sentiment on this topic. Of late, some distinguished ana-
tomists have supposed it a homogeneous gelatinous sub-
stance, without evident organization.
Q. Where have you the best view of the organization
of this cellular texture?
/2. A part of the scrotum is the fittest part, as it has no
fat in it.
Q. Are the laminae of this texture delicate?
A. Yes; as much so as vesicles of soap and water blown
from a pipe.
Q. What are the filaments composed of?
#. They are absorbents and exhalents.
Q. What are the evidences of the organic nature of this
texture?
/?. Its liability to disease.
Q. In what portions of this texture are fat and serum
deposited?
t#. In addition to what has been said, above of the adi-
pose texture, it may be observed, that these fluids are de-
posited in little cells, which form reservoirs; these cells
are composed of the transparent, non-filamentous layers.
The cells containing fat are impermeable, those with se-
rum freely communicate with each other.
Q. What remarkable tendency is manifested by the fila-
ments and lavers of the cellular texture ?
OF THE CELLULAR SYSTEM. 67
Ji. They absorb the moisture of the atmosphere, as may
be seen in dissecting rooms in moist weather.
Q. How is this texture classed?
*#. Among the white organs yielding much gelatine.
Q. What are the effects of air, putrefaction, maceration,
and ebullition, on this texture?
/#. It is altered more slowly by exposure to these, than
any of the white organs. It putrefies less readily; by long
boiling it melts.
Q. Is it easily changed by the digestive processes?
/#. It is not; compared with many other textures it is
indigestible.
Q. What are the parts common to the organization of
the cellular texture?
*ft. Blood-vessels, exhalents, absorbents, and nerves.
Q. Which vessels are most numerous?
A. The exhalents, and by their extensive function, they
render this texture the seat of frequent and various dis-
orders.
Q. What evidences the existence of absorbents in this
texture?
*ft. The removal of fat and serum, the absorption of
dropsical serum, and of ecchymosis; the removal of mild
injected fluids; the disappearance of emphysema, and the
drying up of ulcers.
Q. Are the absorbents numerous in proportion to the
quantity of cellular texture in a part ?
A. Yes ; in the brain, where there is little of this tex-
ture, you find few absorbents, perhaps none.
OP THE CELLULAR SYSTEM-
Properties of the, Cellular Texture.
1. Textural Properties.
Q. What are the textural properties of this tissue?
t#. Extensibility and contractility.
Q. How is cellular extensibility evidenced ?
JL. In fatty and serous cellular infiltrations, and in the
extension of this texture in moving the limbs.
Q. Where is this extensibility most evident?
#. In the cellular tissue, under the skin, and between
the muscles. It is slight in the sub-mucous texture.
Q. Is this property suddenly or slowly manifested?
t#. In some instances with great rapidity, as you see in
emphysema, and in cases of sudden tumefaction from
fractures,
Q. What opposes the rupture of this texture?
/?. Its extensibility, and a species of locomotion, by
which, if too violently drawn, it displaces the contiguous
cellular texture, draws it, and thus it is less extended.
Q. Under what circumstances does it Iqse this extensi-
bility? *J .
*ft. In several diseases, such as inflammation and can-
cer, &c. Y'
Q. At what period is the contractility of texture great-
est in this tissue?
J2. In youth: it loses it in advanced life. The wrin-
kles of old age are owing to the cellular texture not con-
tracting as in youth, so as to confine the skin close to the
subjacent organs.
THE CELLULAR SYSTEM. 69
2. Vital Properties.
Q. Does this texture possess much animal sensibility ?
#. Not in its healthy condition; but it is very evident
in the pain which attends phlegmon.
Q. What proves the existence of organic sensibility?
t/?. The exhalation and absorption of fat, serum, and
other liquids are the operations of organic sensibility.
Q. What instances show that all fluids have not the
same relation to the organic sensibility of this texture ?
Ji. Some foreign fluids, as blood, milk, and lymph, do
not excite that property beyond the absorbing point;
while others, as wine, urine, &c. carry it speedily to in-
flammation, and convert organic to animal sensibility.
Q. How do you prove the existence of insensible or-
ganic contractility in this texture?
t#. The phenomena indicating organic sensibility, de-
monstrate the insensible organic contractility j these phe-
nomena are absorption and exhalation.
Q. Does the cellular texture ever manifest sensible or-
ganic contractility?
#. You see it in the scrotum, which contracts on the
application of cold.
Q. On what do the critical deposites frequently ob-
served in acute diseases, depend?
/2. On the sympathy of the cellular tissue with the
diseased organ. " A man in the ward St. Charles, in
consequence of great terror, had a sudden contraction
of the epigastric region; a tinge of jaundice spread over
his face in a few hours. In the evening he had a great
70 OF THE CELLULAR SYSTEM.
oedema, produced sympathetically, by the influence of the
liver on the cellular texture."
Q. In what manner, and at what stages of their dis-
eases, do the heart, lungs, stomach, and liver, affect this
texture?
'/?. Chronic diseases of these organs in the last stages,
induce debility of the cellular texture, with serous infiltra-
tions; this is a sympathetic result.
Q. What inference relative to the cellular tissue is
drawn from the state of the skin in chronic and acute
diseases?
/?. That the cellular texture may be similarly and sym-
pathetically affected, and be like the skin, more or less
dry or humid, at different periods of diseases.
Q. What vital forces are excited in passive cellular
sympathies?
<A. Organic sensibility and insensible organic contrac-
tility, for these predominate in this texture. Sympathetic
action and disease always operate on the predominant vital
forces of a tissue.
Q. You have said that this texture receives sympathetic
impressions, under what circumstances does it radiate
them?
#. When a phlegmonous inflammation excites fever,
gastric and hepatic irritation, you have an example of ac-
tive cellular sympathy.
Q. How may this active sympathy be profitably em--
ployed ?
Jl. In the use of issues; for the cellular active sympa-
thy from the issue, is more powerful than those of the
skin from a blister.
OF THE CELLULAR SYSTEM. 71
Q. Why does inflammation progress more rapidly in
the cellular texture than in the aponeurosis, tendons, and
cartilages?
t/2. Because the cellular vital forces are much more ac-
tive than those of the textures just named.
Q. Does cellular pus differ from cutaneous, mucous, and
osseous pus?
#. It does. Cellular pus is the ordinarily received stan-
dard for pure pus; but erroneously, because the different
textures throw out different kinds of pus, all of which
are as healthy as the cellular.
Q. Has the cellular texture of each organ peculiar vital
forces ?
/?. Certainly not. These forces differ only in degree;
being greater in the cellular tissue of the skin, less in that
of the cartilages.
Q. Why does an artery escape suppuration, though
soaked in pus?
#. Because arterial and venous cellular texture being
altogether filamentous, its vital forces are not excitable to
the point of inflammation, as that texture is which is com-
posed both of filaments and layers.
3. Properties of Reproduction.
Q. What remarkable feature distinguishes the cellular
texture from others?
t#. A property of reproduction, an elongation, a species
of vegetation ! !
Q. What depends on this property?
Ji. The formation of cicatrices, tumours, cysts, &c.
Q. In considering cicatrices, how do you divide them?
72 OP THE CELLULAR SYSTEM.
ft. Into those of the external, and those of the internet,
organs.
Q. What steps does a wound take from its formation
to its cicatrization?
ft. Inflammation, granulation, suppuration, depression
of surface, formation of pellicle at first red, then white.
Q. What purposes does inflammation secure to a wound?
A. By it the organic sensibility of the cellular texture
is raised to animal sensibility; and the insensible organic
contractility is so exalted, that these together excite the
reproductive powers of the texture, in the form of granu-
lations.
Q. What are granulations?
ft. Not fleshy tubercles, but small cellular vesicles fill-
ed with a thick lardaceous substance.
Q. What is the provisional pellicle covering granula-
tions?
ft. That which prevents the contact of air while the
permanent cicatrix is forming.
Q. What are the evidences of the cellular nature of
granulations, and of the pellicle that covers them ?
ft. As granulations are the same in every texture, and
as the cellular tissue is the only one common to all the
organs, it is inferred that they are cellular; again, where
the cellular texture is most abundant, granulations form
most readily; when the cellular texture is removed, the
difficulty of reproduction is great; maceration of the gra-
nulating surface of a wound exposes this textural base.
Q. Then granulations are not elongated vessels?
ft. No; they are cellular elongations; for the cellular
texture alone is capable of self-extension, increase and re-
production.
THE CELLULAR SYSTEM.
73
Q. If granulations are uniformly cellular throughout
the textures, how is it that the various organs are re-
newed?
*#. In the cells of these granulations, depositions are
made of the nutritive matter, peculiar to the various
organs. For instance, when the bone is broken, gelatine
and phosphate of lime are thrown into the granulations ;
if a muscle is to be renewed, fibrine is deposited.
Q. Explain the difference in this third period of cica-
trization in the internal and external lesions?
A. The third period is that of deposition of nutritive
matter spoken of in the last question. Now, in the inter-
nal organs, nutritive matter is deposited; but in external
lesion, pus is exhaled and thrown off, as possessing no-
thing nutritive or reuniting.
Q. In external cicatrices, what comes of the fatty mat-
ter contained in the cells?
t#. They are emptied of it in the process of suppura-
tion.
Q. What follows this emptying of the cells?
#. They sink and adhere to each other, contract, and
thus form a uniform substance covered with a membrane.
Q. When is this membrane of the cicatrix complete?
v?. When the adhesion between all the cells which first
form the fleshy granulations is complete; the membrane
is the result of this adhesion.
Q. Why is this membrane at first red, then white?
A. Because at first red blood circulates in the exhalents;
after a time it leaves them, and returns to its own vessels.
Q. What parts are most favourable to the formation of
cicatrices?
Jl. Those where the skin yields most, as the scrotum.
10
74 OF THE CELLULAR SYSTEM.
Where the skin yields least, as on the head, tibia, and ster-
num, cicatrices are largest.
Q. How does union by the first intention differ from
cicatrization ?
#. In the union, the periods and processes of cicatriza-
tion do not appear: the union is by an agglutination of the
sides of the wound.
Q. By what property do cicatrices contract ?
#. By organic contractility in the cellular vesicles.
Q. What is fungous flesh ?
#. Exuberant formations of cellular vesicles in wounds
and ulcers.
Q. Whence and what are polypi?
#. These and all other excrescences arise from a mor-
bid reproductive effort, or spontaneous elongation of the
cellular texture.
Q. How do you account for the differences in tumours?
t#. They arise from the variety of deposites made in
the elongated cellular texture.
Q. Is there no way to account for this variety in the
deposites ?
*#. It depends on the degree of the vital forces in the
elongated textures; a higher exercise of these forces pro-
ducing one deposite, a lower another.
Q. But are there not tumours independent of this elon-
gating action of the cellular texture ?
A. Yes; those of a chronic character, from infiltration
of the cellular texture.
Q. What is a cyst?
A. A membranous sac without opening, developed ac-
cidentally; cysts contain fluids of different sorts.
Q. What texture forms them ?
OP THE CELLULAR SYSTEM. 75
.#. The cellular. They resemble the serous membranes,
and they are cellular.
Q. What analogies prove the identity of cysts and se-
rous membranes?
.#. Their conformation: their structure, for maceration
and inflation prove cysts to be cellular; they have few
blood-vessels and many exhalents. The vital properties
prove the identity ; they are, in a natural state, destitute
of animal sensibility, but, like serous membranes, when
inflamed they have it exquisitely; cysts have much or-
ganic sensibility. The functions of cysts confirm the iden-
tity, these are absorption and exhalation. Diseases prove
the similarity, their pathological states resemble those of
serous membranes.
Q. Can you demonstrate that absorption takes place in
cysts?
/#. If it does not, how are the fluids in encysted dropsy
removed ?
Q. How are cysts formed?
#. Not, as is commonly supposed, by the gradual de-
position of a fluid in a cell of the cellular texture, but by
a departure from the common process of increase in the
tissue which they resemble; and in which these cysts are
formed.
Q. What relation then is there between the growth of
a cyst, and the increase of the fluid contained ?
A. The membranous sac is first deposited; the exhalents
begin to throw out fluid, and as these vessels increase in
the membrane the fluid is increased, and consequently the
encysted tumour enlarges.
76 OF THE CELLULAR SYSTEM.
DEVELOPMENT OF THE CELLULAR TEXTURE.
Q. What is its aspect in the earliest foetal period?
.#. It predominates almost exclusively in the primor-
dial mucous mass. It is at first mucous, then gluey, then
cellulur texture appears. It becomes less fluid as the foetus
grows.
Q. What is the nature of the fluid so abundant in the
cellular texture, early after conception?
A. It is albuminous and gelatinous.
Q. Is the foetus ever emphysematous?
JL. The delicacy of the cellular layers prevents this
state; they burst rather than bear the pressure of air in
the cells.
Q. What is the condition of the vital energy of this
texture in youth and infancy?
t/2. Very active; hence wounds speedily cicatrize, se-
rous infiltrations are rapidly removed, dropsies seldom
occur in infancy, tumours form and increase rapidly. The
vital forces are energetic.
Q. What is the cause of the roundness of form which
characterizes the infant?
ifl.tThe quantity of cellular texture concealing the
organs.
Q. What change does after and advanced age produce
on this texture?
t/2. It becomes firmer, more condensed, and diminishes
in proportion.
Q. In what temperament does it preponderate ?
*#. In the phlegmatic or lymphatic.
Q- Is it more abundant in males or females?
OF THE CELLULAR SYSTEM- 77
ft. In females, hence the roundness of their forms.
Q. Whence the laxity of the cellular texture in old age?
ft. It arises from the loss of its vital forces, particularly
organic contractility.
Q. Whence the emaciation of age ?
ft. The cellular texture dries, decays, withers away.
Q. Where are osseous incrustations in this texture most
frequently found ?
ft. In the texture between the uterus and rectum.
PATHOLOGY OF THE CELLULAR TISSUE.
Q. What are the principal diseases of this texture?
ft. Phlegmon, carbuncle, furuncle, scleremia, ulcers,
anasarca, oedema, haemorrhage, morbid fatness, emaciation,
emphysema, wens, cysts, steatoma, atheroma, meliceris,
and sometimes hydatids.
Q. To what part of the cellular tissue do you allude
when you speak of its diseased state ?
ft. Principally to that found in the interstices of parts.
Q. What texture of the body is exclusively subject to
swelling?
ft. The cellular; the swelling of all tissues is owing to
the cellular which enters into their composition.
Q. How are diseases extended from one organ to an-
other?
ft. By means of the cellular, continuous texture.
Q. What divisions will you make of the diseases of the
cellular texture?
ft. Into idiopathic, symptomatic, and diseases from
76 OF THE CELLULAR SYSTEM.
continuity of tissue. Phlegmonous inflammation indicates
the idiopathic; the spread of carcinoma, the continuous;
and serous effusion from organic disease, the sympto-
matic.
Q. What are the symptoms of phlegmon?
ft. Swelling, redness, pain, induration, heat, pulsation ;
sometimes general and gastric symptoms.
Q. How does phlegmon terminate?
ft. In resolution, most frequently in suppuration, in
chronic inflammation of the cellular texture, with or with-
out serous effusion, and in gangrene.
Q. Is pus at once immediately deposited in the cavity
of an abscess ?
ft. It is first formed in little cells, which, gradually
communicating, form the cavity of an abscess.
Q. What do you mean by carbuncle?
ft. A tumour having its seat in the sub-cutaneous cel-
lular texture.
Q. What are the distinguishing symptoms of car-
buncle?
ft. A liyid colour, greater hardness than phlegmon,
phlyctense appear on its surface, the skin is gangrenous,
the discharge is ichorous, the pain is peculiarly hot, the
general strength of the patient is much reduced.
Q. Does carbuncle depend alone on the intensity of the
inflammation?
ft. It does not ; there is a poisonous cause, or specific
one, concerned in the production of anthrax.
- Q. There is a recent speculation as to the cause of the
eschar in carbuncle, what is it?
*ft. It is that the portion of cellular texture composing
the eschar, is in an incarcerated, or strangulated condition
OF THE CELLULAR SYSTEM. 79
Q. What do you mean by furuncle?
#. It is an inflammation in the cellular tissue and der-
moid texture, less violent, of slower progress than phleg-
mon, occurring sometimes several at a time, and does not,
like phlegmon, leave a cicatrix,
Q. What parts are exempt from furuncle?
t#. The palms of the hands, the soles of the feet, and
the cranium.
Q. What do you understand by scleremia?
JL. An induration of the sub-cutaneous cellular texture
of infants, when an incision throws ' out yellow fatty
serum.
Q. To what has this disease been ascribed?
t/2. To syphilitic taint, to deranged perspiratory func-
tion, and to an affection of the respiratory process, to an
opening of the foramen ovale.
Q. What do you mean by an ulcer?
#. It is a suppuration of a wound or injury, which is
prolonged after the ordinary stages of inflammation have
been completed.
Q. What are ulcers owing to?
*#. To a chronic inflammation of the cellular texture.
Q. What materially influences the condition of ulcers?
*fl. The peculiar vital forces of different parts.
Q. How is cellular dropsy divided?
/?. Into general and partial.
Q. Where do you find dropsy most frequently ?
#. In the most dependant parts of the cellular texture.
Q. What are other divisions of dropsy ?
#. It is idiopathic and sympathetic. It is symptomatic
of fever and of organic disease.
80 OP THE CELLULAR SYSTEM.
Q. Is the cellular tissue altered in dropsy?
&. It is not; the cells are only distended with the in-
creased exhalation of serum.
Q. To what are the sudden swellings in fractured limbs
and contusions owing?
#. Neither to an cedematous nor emphysematous state
of the cellular texture, but to "a peculiar excitation
of it."
Q. How do you account for swelling of the belly in
enteritis?
#. It is owing to a swelling of the sub-cutaneous cellu-
lar tissue.
Q. What portion of the cellular texture is most liable
to inflammation?
,/#. The sub-cutaneous.
Q. What state of the cellular texture does obesity in-
dicate?
*fl. A debility in the tissue, and an undue disposition to
deposite fat.
Q. Whence does leanness, emaciation, arise?
#. From organic diseases, but not of those of the brain
or heart. It proceeds commonly from organic disease of
the abdominal viscera, and of the lungs. Emaciation is
usually symptomatic. You know that the depressing
passions induce emaciation.
Q. At what part does emphysema commence?
Jl. Always near the thorax, near the lungs. Fractures
of the ribs, wounds of the chest, and vehement vocal ex-
ertions cause it.
Q. What tumours form in the cellular tissue?
#. Wens and cysts.
OP THE CELLULAR SYSTEM. 81
Q. What is the base of the fluids of wens?
A. It is albuminous.
Q. Are the sub-mucous, sub-serous, or vascular cellu-
lar tissues often diseased?
#. You never see disease of the sub-mucous cellular
tissue, unless when an abscess forms near the rectum
In the sub-serous, matter forms more commonly, and it
points externally; while, to prevent the pus finding its
way into the serous cavities, that tissue is thickened. The
sub-vascular cellular tissue is never diseased.
11
NERVOUS SYSTEM.
Q. How should the general nervous system be divided?
.#. Into that belonging to animal life, and that attached
to organic life.
I. NERVOUS SYSTEM OP ANIMAL LIFE.
Q. What is the centre of the nervous system of animal
life, and what are the parts to which it is distributed ?
J2. The brain and its dependencies form the centre,
and the nervous system of animal life is distributed to the
senses and the organs of voluntary motion.
Q. What is the centre of the nervous system of organic
life, and where are the nerves distributed?
Jl. The ganglions are the central points, and the nerves
are distributed to the organs of digestion, circulation, res-
piration, and secretion.
Q. Is the distinction in nervous distribution preserved
with unvarying precision? >
t/?. There are a few comparatively unimportant devi-
ations.
Q. Name a leading peculiarity in this nervous system
of animal life.
ft.. Its symmetrical character; the nerves go off in pairs.
Q. What renders this duplicate organization evident?
/?. Dissection and disease exhibit the right and left
nervous system of animal life. In palsy one side will be
affected, while the integrity of the other side is unimpaired.
NERVOUS SYSTEM. 83
Q. What relation does the size of the brain bear to the
nerves, in man and quadrupeds?
/#. It is in an inverse proportion. In man, the brain is
very large in proportion to his nerves; in quadrupeds, ge-
nerally, the brain is small and the nerves large.
Q. What is the result of this?
/#. That although brutes are superior in some of the
senses to man, man in the sense of touch surpasses animals
greatly. Touch implies intellect beyond instinct; hence
the perfection of the organs of touch and the development
of the brain, are, in man, in proportion to each other.
External forms of the, Nervous System of Animal Life.
Q. From what part of the brain do the cerebral nerves
originate?
A. From the cerebrum, tuber annulare and its conti-
nuations, and from the medulla spinalis.
Q. To what opinion did this origin of these cerebral
nerves give rise?
t#. As none originated from the cerebellum, the cere-
brum was said to be the source of the voluntary, and the
cerebellum that of the involuntary motions.
Q. To what nerves does the cerebrum give rise?
Jl. To the olfactory and the optic.
Q. For what are these nerves remarkable?
t/?. Their adhesion is firm at their origin from the brain,
and they are much softer than most of the other nerves.
Q. What nerves arise from the tuber annulare and its
elongations?
#. The motores communes of the muscles of the eye,
the pathetici, the trigemini, the motores externi of the eye,
84 NERVOUS SYSTEM.
the facial, the auditory, the par vagum, the glosso-pha-
ryngeal, and the great hypoglossal.
Q. Is the adhesion of these nerves to the brain strong?
/?. No; they are so weak as to be torn by the raising
of the pia mater.
Q. What nerves arise from the spinal marrow?
*&. The cervical, eight pairs in number; the dorsal,
twelve pairs; five sets of lumbar; five or six sacral; in all
amounting to thirty or thirty-one pairs. The spinal nerve,
so called, which penetrates the cranium and again emerges
from it, also arises from the spinal marrow.
Q. Are the nerves elongations of the brain?
/?. They are not; they are formed cotemporaneously
with the brain, and are independent organs communicat-
ing with the brain.
Q. What has given rise to the opinion of the decussa-
tion of all the nerves?
Jl. The supposition is founded on the fact, that paralysis
occurs on the side of the body opposite to the hemisphere
of the brain that is injured.
Q. Does anatomy prove this decussation?
Ji. It does not.
Q. Does palsy in the motion of a limb necessarily in-
volve loss of sensation in the member?
#. It rarely suspends sensibility.
Q. On what do discordant hearing and vision often
depend?
Jl. Frequently on a diseased condition of the organ af-
fected, which does not involve a morbid state of the brain.
Q. What membranes are found about the nerves?
&. The dura mater invests them to their exit from the
brain and spine. The tunica arachnoides envelopes thr
NERVOUS SYSTEM. 85
nerves from their connexion or junction with the brain,
to their exit from the bony canal. The pia mater con-
tinues on the nerves.
Q. How do the tunics of the optic nerve differ from
those of other nerves?
Ji. It has a fibrous investment from its origin to the
sclerotic coat.
Q.- What nerves converge after their origin?
*ft. The olfactory; all the rest remain separate.
Q. What nerves go to their destination without com-
municating with other nerves ?
ft. The olfactory, the optic and auditory.
Q. Do the nerves of the spine make their egress imme-
diately opposite their origin ?
#. They do not; the lower or lumbar run several
inches in the spinal canal before they leave it.
Q. Of what practical import is this fact?
ft. In order that moxa should be applied at the origin
of the nerves, the immediate exit of the cervical from the
spine, and the long course within the spinal column which
the lumbar pursue before their exit, should be well known.
Q. How are the plexuses of the spinal nerves formed ?
#. By each nerve sending a branch to the one above
and below it.
Q. How do you best understand the distribution of the
spinal nerves?
Jl. By taking them as they arise from the plexuses and
not regarding them as pairs of nerves.
Q. Are the plexuses confined to those at the exit of the
nerve ?
*fl. No other communicating chords form as the nerves
proceed in their course.
86 NERVOUS SYSTEM.
Q. what are the nervous trunks composed ?
/#. Chords and filaments.
Q. Do the chords of a nervous trunk communicate ?
*ft. They do by filaments. The chords which end the
trunk are not composed of the same filaments which com-
menced them.
Q. Why do you object to the opinion of their being
distinct nervous chords which serve for sensation and mo-
tion?
*#. The inter-communication of the filaments forbids
the supposition.
Q. What do you mean by the termination of the nerve?
#. The point where each filament ends.
Q. How many modes of termination have filaments ?
tf. They have three; with other filaments of the same
system; with filaments of the system of ganglions, forming
anastomoses; and filaments lose themselves in the organs.
Q. How are the filamentary nervous communications
to be distinguished?
Jl. There are those of real anastomosis, and those of
juxta-position and contiguity.
Q. Why are sympathies not exclusively ascribed to
nervous anastomoses ?
J2. Because these anastomoses are rare, compared with
the numerous and diversified sympathies, normal and ab-
normal.
Q. How many kinds of anastomosis are there?
/#. There are three; viz. that formed by two branches
of different nerves; the anastomosis formed by the branches
of the same nerve ; and the one which arises from the union
'of two nerves of the same pair, or of different pairs at the
median line.
NERVOUS SYSTEM. 87
Q. Where is this median anastomosis seen ?
Ji. In the superficial nerves of the neck and chin.
Q. What feature in paralysis does this median anasto-
mosis explain ?
Jl. Probably some mobility in a part which is affected
with paralysis.
Q. What systems are destitute of nerves?
#. The cartilaginous, the fibre-cartilaginous, the pi-
lous, the epidermoid, and others, are unprovided with
nerves.
Q. What peculiarity is found in the terminations of the
optic, olfactory, and auditory nerves ?
Jl. The pulp of these nerves is expanded on the organs
without the covering of the nerve.
I
Organization of the Nervous System ofJlnimal Life,
Q. What is the organization of the nerves of animal
life?
A. Filaments in apposition form chords, and chords in
apposition form trunks of nerves.
Q. Is the internal organization of the nerves uniform?
#. It is not it is singularly diversified.
Q. What is the organization of each nervous filament ?
*ft. An external membrane forming a canal; containing
the medullary matter or pulp.
Q. What is the nature and origin of the nervous coat?
t#. It is the pia mater of the brain and spinal marrow.
Q. What are the three great modifications of the pia
mater ?
/?. On the gray substance surrounding the brain and
cerebellum it is red, highly vascular, loose, and easily se-
83
NERVOUS SYSTEM.
parated and raised up ; on the white substance which in-
vests the tuber annulare and its four elongations received
from the brain and cerebellum, it is not so red, it becomes
firmer, more adherent, not so easily torn; on the spinal
marrow and nerves it increases in density, becoming whit-
ish and resisting.
Q. What purpose does this density of the spinal pia
mater subserve?
#. It serves as a protection and support to the spinal
marrow, especially where the marrow, not filling the ver-
tebral canal, would, without this firm coat, be liable to
concussion.
Q. What effects have acids on this nervous coat?
Jl. They harden it immediately, but it soon regains
its softness. Water hardens the nerves exposed to its ac-
tion.
Q. Whence does the medullary matter of the nerves
originate?
. It is continuous with the medulla of the brain and
spinal marrow.
Q. In what nerves is it most abundant?
ft.. In the auditory and optic nerves. In the progress of
a nerve to its termination it diminishes.
Q. What general influence has loss of natural moisture
on the whiteness of parts?
/?. It destroys their whiteness.
Q. In what respects do the cerebral and nervous me-
dullary substances differ and agree ?
#.. The cerebral medulla putrefies soon, the nervous
slowly. Acids harden both; alkalies soften them. The ce-
rebral substance is digestible; the nerve is not.
Q. Is the medulla the same in all the nerves?
NERVOUS STSTF 89
JJ. It appears to differ, in different nerves, in consist-
ence, in the degree of moisture, in its colour, and other
particulars.
Q. On what does the different sensibility of the various
parts depend ?
*#. On the diversity of organization in the parts, on the
different organization of the nerves, and on the varying ,
consistence and appearances of the medullary matter.
Q. Is the nervous medulla a fluid?
#. It resembles jelly, vjt is more like a fluid than a
solid.
Q. Have the nerves cellular texture?
*ft. In the interior of the brain and spine there is none.
When the nerves emerge from the cranium and spine,
they have much cellular tissue around the trunks, 'chords,
and filaments. Perhaps the nervous coat is the cellular
texture condensed.
Q. How do the arteries supply the nerves ?
<ft. Blood-vessels pass between the chords to supply the
filaments.
Q. What influence has arterial blood on the nerves?
*ft. It is to the nerve what blood is to every organ ; the
stimulus which supports and perpetuates functional power.
Q. What influence has an increased determination of
blood to the nerves?
.#. It increases nervous action, and when the determi-
nation is very great it overwhelms it.
Q. How is the nervous medulla formed ?
#. The arteries of the nerves deposite in the exha-
lents this nervous matter, which is then thrown out.
Q. Then the nervous coat does not secrete it ?
.#. The nervous coat has no more agency in secreting
90 NERVOUS SYSTEM.
the nervous medulla, than the pia mater has in \secreting
the substance of the brain.
Q. Does the brain supply the nervous medulla?
#. On the contrary, it has been just said that the me-
dulla is deposited by the arteries of the nerve.
Q. What pathological facts does this arterial nutrition
of the nerves explain ?
Ji. It accounts for the preservation of the inferior por-
tion of a cut nerve; for the continued nutrition of a nerve
from which cerebral communication has been cut off by
ligature; and for the uninterrupted support of a nerve,
which, in palsy, may have ceased to correspond with the
brain. The secretion of nervous medulla, and the nutri-
tion of nervous organization by the arteries, explain these
facts.
Properties of the Nervous System of Animal Life.
Q. Do the nerves manifest much textural property ?
<&. They do not. If extension be suddenly made, it is
dangerous, but if gradually applied, it is borne to a consi-
derable degree. The nerves possess little contractility of
texture.
Q. How is nervous sensibility divided?
Jl. Into inherent and common.
Q. In what part of a nerve does animal sensibility re-
side?
fl. In the medullary substance; the nervous coat has
very little. This medullary substance has animal sensi-
bility to a very great degree.
Q. Why are nerves not painful when surrounded by
fluids, tumours, or when exposed to the air?
NERVOUS SYSTEM. 91
JL. Because there is so little animal sensibility in the
nervous coat.
Q. What effect has repeated irritation on the animal
sensibility of nerves?
/?. It is gradually diminished, and by rest is reac-
cumulated.
Q. What are the peculiarities of nervous animal sensi-
bility?
J2. Observe the peculiarity of pain in the different or-
gans; how the sensation of pain in the dermoid texture,
for instance, differs from that in the muscular or osseous
texture. Another feature interesting to the physician and
surgeon is, that the trunk of a nerve partially irritated,
the animal sensibility will often be exalted in all the
branches; as when pain is felt along the forearm when
the cubital nerve is compressed or struck at the elbow;
this is further illustrated in tic doloureux, and in irritation
of points of the sciatic nerve. In these the irritated point
is a centre from which painful irradiations are diffused.
Q. Does the increase of animal sensibility ever take
place between the injured point and the brain?
*fl. It does not; it is an affection continued along the
branches.
Q. What example is given to illustrate the different
animal sensibility or pain in different textures ?
t/#. The case of a man is related by Bichat, who in the
course of an amputation, asked the surgeon why it was
that the pain in cutting through the skin was so different
from that felt in the division of the muscles.
Q. How many kinds of sensation arise from the inter-
nal sensitive principle?
#. Two the external and internal.
92 NERVOUS SYSTEM,
Q. How are the external sensations divided ?
4#. Animal sensibility with regard to external sensa-
tions is general and particular. The general refers to
impressions made by bodies on the external surface. The
particular relates to the sensibilities of particular organs
to peculiar impressions, as the eye to light.
Q. But have not some organs of animal life both gene-
ral and peculiar animal sensibility?
*ft. They have. For instance, the tongue may feel the
impression of a substance, without the sense of taste being
excited. The nerves of general and peculiar sensibility
are absolutely distinct.
Q. How does opium relieve pain?
/?. By suspending the action of the brain, so that nei-
ther external nor internal sensations are perceived.
Q. Do the nerves possess animal contractility?
A. Not at all; that property appertains to the muscles.
Q. What agency then have the nerves in the muscular
animal contractility?
Ji. They transmit the principle of motion. In animal
contractility there are three agents; viz. the brain that
wills, the nerve conveying cerebralvolition, the muscle
which obeys in action.
Q. Do the nerves exercise much organic contractility
and sensibility?
<flL. They do not. They exercise these properties of
life so far as nutrition requires them. The nerves abound
with animal sensibility.
Q. Is there a difference in the size of the nerves of a
sound and paralytic side?
#. They are alike. The nerves are not affected in
many diseases. Their nutrition goes on, and organic
NERVOUS SYSTEM, 93
sensibility is so little increased as not to enlarge the ner-
vous trunks.
Q. In what abnormal condition did Bichat once find
the sciatic nerve?
*#. With the veins of the nerve in a varicose state.
Q. Do the cerebral nerves affect the organic sensibility
of textures?
/?. They do not; that property of the textures is be-
yond the sphere of those nerves.
Q. Recapitulate the functions over which organic sen-
sibility presides?
#. It supports capillary circulation; secretion; exhala-
tion; absorption; nutrition.
Q. What excites these functions?
4/2. The fluids excite the organic sensibility of the so-
lids, which last in action exercise insensible organic con-
tractility.
Q. What general considerations induce the belief that
the nerves of animal life do not preside over and influence
these functions?
#. They are said to receive no impulse from the nerves
of animal life, because no filaments from these nerves go
to the capillaries; some of these organic functions are
most active during sleep, at which time the animal ner-
vous system is quiescent; and cartilages which receive no
nerves have nutrition as well as other parts.
Q. Over what diseases do organic sensibility, and in-
sensible organic contractility preside?
#. Over tumours, dropsies, morbid sweating, haemor-
rhagies, disorders of secretion, and such like affections.
Q. What diseases arise from disordered animal sensi-
bility and contractility ?
94 NERVOUS SYSTEM.
#. Spasm, convulsion, palsy, somnolency, .torpor, de-
rangement of the intellectual functions; in a word, every
thing which tends, in disease, to interrupt our relations with
surrounding bodies; these belong to alterations of animal
sensibility and contractility.
Q. Does proneness to inflammation depend on the num-
ber of nerves in a part?
A. Those parts which have the greatest number of
nerves are not most liable to inflammation.
Q. What do you understand by sympathy?
*#. It is an impression in health or disease, not arising
from a natural connexion of functional operation ; the im-
pression is conveyed from an organ to the nervous sys-
tem, or a portion thereof.
Q. How do the nerves sympathize in disease?
ft. There is a sympathy between two nerves of the
same pair; as when one optic nerve induces the other to
sympathy. Again, two nerves of the same side, but not
of the same trunk, sympathize, as when blindness results
from the injury of the frontal nerve. Again, two branches
of one trunk sympathize with each other; and nerves
sympathize actively and passively with other organs.
Q. What is the rationale of nervous sympathy on re-
mote parts ?
*ft. Nervous sympathy operates on the predominant
vital properties of the parts engaged; increasing animal
sensibility in pain of the head; or animal contractility
in sympathetic convulsions; or sensible organic contrac-
tility in the action of the heart, or in contractions of the sto-
mach in vomiting. These, in different cases and persons,
are excited by irritation of a nerve.
Q. What have been considered the media of sympathy ?
NERVOUS SYSTEM. 95
*ft. Nervous anastomoses, vascular communications, or
the continuity of cellular and mucous tissue.
Q. What is the most rational division of sympathies?
A. Into those which actuate animal and organic sensi-
bility and contractility.
Q. Can you explain the sympathies of animal sensibi-
lity?
t/f?. They depend on an irregularity or derangement of
perception in the brain, by which, an impression made on
one part, is referred to another; nervous communication is
not necessary to this.
Q. On what does the sympathy of animal contractility
depend ?
tf. The impression is made on the muscles through the
brain.
Q. Are nerves, when cut, reproduced?
A. They are, as other parts are.
Q. How are external sensations transmitted ?
#. Uniformlyifcy the nerves. The internal sensations
are conveyed in an unknown manner.
Development of the Nervous System of Animal Life.
Q. What is the state of the brain and nerves in the
foetus?
#. Inactive, but much developed. The nerves in in-
fancy are much larger in proportion to the body, than
those at adult life ; so likewise is the brain.
Q. What remarkable change takes place in the animal
nervous system at birth?
/?. In foetal life it is supplied with black blood, at the
commencement of independent life it has red blood.
96 JTCRVOITS SYSTEM.
Q. This red blood performs two functions on the brain
what are they?
/?. It contributes nutrition to the brain, and excitation
as a stimulant
Q. What is necessary to the commencement of animal
life?
Ji. That the organs be influenced by red blood.
Q. What cooperates with this red blood to excite ani-
mal life at birth ?
#. External impressions, and those made on the mu-
cous surfaces.
Q. What is the conspicuous feature in asphyxia?
.#. The apparent absence of animal life.
Q. How does asphyxia differ from foetal life?
*fl. In the foetus, organic life goes on. The blood dif-
fers in the foetus from the black blood of asphyxia one,
the foetal, is a natural state of the, black blood, the other is
a morbid state.
Q. What functions predominate in irtfoncy?
t/?. The animal; hence a constant susceptibility to exter-
nal impressions; the constant action of the voluntary mus-
cles, in the desire to touch and grasp what is seen ; hence
the predominance of the diseases of the animal functions,
the frequency of cerebral disease and convulsions.
Q. Why do infants sleep so frequently and so much?
#. The activity of the animal functions fatigues the
brain, demands repose, and produces sleep.
Q. Are the same systems predominant at different pe-
riods of life?
A. They are not. The brain and nerves predominate
in infancy; the uterus in the girl; the lungs in robust man-
hood; the gastric viscera in advanced life.
NERVOUS SYSTEM, 97
Q. Why does so great a portion of blood go to the brain
in infancy?
#. The predominance of the vital forces of the brain
invites it.
Q. What is the comparative consistence of the brain in
foetal and senile life?
& Nearly fluid in the foetus, it becomes quite firm in
old age, being progressive in its change from the fluid to
the firm state. The vascularity of the animal organs di-
minishes with age; their colour becomes dull. These
changes take place in the brain as well as nerves.
Q. Give a brief account of the formation of the cerebral
mass.
Ji. The hemispheres of the brain assume on their first
development the membranous form. The gray or cortical
substance is formed subsequently to the white. The me-
dullary substance of the brain, and the white substance of
the medulla spinalis, are filamentous and fibrous. The
structure of the cortical substance is not yet ascertained,
perhaps it is fibrous.
Q. What is the chemical composition of the cerebral mass?
Ji. It is composed of a white, shining fatty matter; of a
smaller portion of a red fatty substance; of water, albumen,
osmazone, sulphur, phosphate of potash, lime, magnesia,
with some appearances of muriate of soda.
Q. State briefly Beclard's view of some points in the
nervous structure.
#. He states that the nervous filaments do, at their ori-
gin, penetrate into the substance of the brain. The nerves
probably arise from the gray substance, not from the me-
dullary. The nervous filaments of the medulla oblongata
do decussate. The nervous texture is composed of globules.
13
98 NERVOUS SYSTEM.
Q. What are the principal pathological states of the
brain?
/#. The brain is diminished in concussion, so as not to
fill the cranium. The brain is subject to a softening, as well
as to an induration of its substance. The brain suppurates,
forms tumours, tubercles, osseous depositions. BICHAT
had the lobes of the brain of very unequal size. The
nerves are enlarged in some cases, and atrophic in others.
The nerves cicatrize, but are never preternaturally pro-
duced.
II. NERVOUS SYSTEM OF ORGANIC LIFE,
General Remarks.
Q. How should the ganglions be considered?
*fl. Each as a distinct centre distributing or receiving
nerves.
Q. How does the system of organic nerves differ from
the nerves of animal life?
,#. In the system of animal life the brain is a single
centre; in that of organic life there are as many centres
as ganglions. In animal life the nerves are symmetrical,
in the organic system they are irregular. The nerves of
organic life do not serve for sensation, as those of animal
life do. The nerves of organic life have no connexion
with voluntary locomotion, the animal nerves control this.
The organic system of nerves belongs to internal life, the
animal nerves to the external or life of relation. Lastly,
ganglions are not found in the head.
NERVOUS SYSTEM. 99
Q. Is the sympathetic properly termed a nerve?
*4. It is not one nerve; it is a series of nerves derived
from the ganglions or little brains.
Of the Ganglions.
Q. What are the ganglions?
Jl. The ganglions are small bodies of a red or gray co-
lour, deeply situated along the vertebral column and well
protected; and from them are sent numerous nervous ra-
mifications. They are not moveable.
Q. What do these ganglions or ramifications form ?
Jl. That which is termed the great sympathetic nerve.
Q. What ganglions are uniformly found?
/?. The superior cervical, the semilunar, the ophthal-
mic; others are sometimes wanting.
Q. What is the form of these bodies?
#. They are irregularly formed ; sometimes round, or
flat.
Q. Is the organization of the ganglion and cerebral
substance similar?
Jl. They are not alike in this respect. The ganglions
are susceptible of the horny hardening as solids are; the
cerebral substance does not admit that change. The
ganglions are not fibrous, the cerebral substance is.
Q. What is Scarpa's opinion of the organization of the
ganglions ?
#. That they are a kind of expansion of the filaments
of the nerves. Bichat thinks not, but says they are homo-
geneous and sui generis.
Q. How do the ganglions differ from the ganglionic
nerves ?
100 NERVOUS SYSTEM.
#. In their colour, consistence and properties.
Q. What kind of membrane envelopes the ganglions?
\fi. The cellular membrane, resembling the sub-mucous
and arterial cellular coat.
Q. What are the vital properties of the ganglions?
*#. Organic sensibility and insensible organic contrac-
tility.
Q. What proves that they are destitute of animal sen-
sibility?
t/?. Biehat opened a dog; he irritated the semilunar
ganglion, without giving the animal pain: he irritated a
cerebral nerve, it excited great pain.
Q. What important division is to be made in the gene-
ral class of nervous disorders?
/?. They are divisible into those which arise from the
nerves of animal, and those from the nerves of organic
life.
Q. Name several of the diseases of the nerves of ani-
mal life?
A. Convulsions, palsy, hemiplegia, tetanus, catalepsy,
apoplexy, and the greater number of epilepsies, disorders
of sight, hearing, taste, smell.
Q. Now present some of the diseases of the nerves of
organic life.
ft. Hysteria, hypochondriasis, melancholy, diseases of
the abdomen and chest. Reflect on the difference in the
two classes of diseases alluded to in this and the preced-
ing question.
Q.\ Does the pain felt in the viscera of organic life dif-
fer from that in the viscera of animal life?
#. It does. The intestinal pains, those felt in the loins
from uterine affection, the burning at the stomach, all dif-
NERVOUS SYSTEM. 101
fer much from the pain of the organs of animal life. There
is like difference in convulsive actions of animal and or-
ganic life.
Q. Is the ganglionic system developed as early as the
brain?
/!?. By no means. The ganglions, when first develop-
ed, are not as soft as the foetal brain.
Q. What pathological inference is deducible from the
earlier development of the cerebral organ?
#. That diseases of the animal nervous system prevail
in infancy, from the early development of that system.
Q. Does the connexion of the nerve with the ganglion
resemble that of the nerves with the brain?
t/?. The nerves are more firmly united to the ganglions
than the cerebral nerves are to the brain. The nerves of
organic life differ much more from the ganglion than the
cerebral nerve does from the brain.
Q. What do you mean by cerebral ganglions?
Ji. An enlargement of the spinal nerves at their exit
from the spine; their organization resembles the organic
ganglions, but they differ in sensibility. For example, if
the superior or inferior cervical ganglion be irritated, the
muscles supplied by them remain unaffected: irritate a ce-
rebral ganglion, and behold the convulsions which will be
excited.
Of the Nerves of Organic Life.
Q. What is the course of the organic nerves?
*/l. They communicate with the nerves of animal life;
then each ganglion sends nerves to the next ganglion, with
one exception; some nerves go to the cerebral muscles, the
102' NERVOUS SYSTEM.
diaphragm, and some muscles of the neck; they intercom-
municate chiefly so as to form plexuses, into which the
animal nerves send a few branches.
Q. In any plexus do the animal nerves predominate?
e/?. In the pulmonary the par vagum does.
Q. How do you account for the innumerable interfac-
ings of the organic nerves?
#. The filaments are not generally united in a trunk,
as the animal nerves are; the first run separately, not bound
in bundles.
Q. What is remarkable in the course of the organic
nerves ?
ft. They surround the arteries for some distance, like
a net-work. It is not so with the cerebral nerves, which
are in apposition only with the vessels.
Q. What effects proceed from this reticular nervous en-
velope around the vessels?
/?. The motion of the blood may have some effect on
the nerves. In support of this opinion it may be remark-
ed, that as nature has placed a great number of arteries at
the base of the brain, to agitate it with an alternate mo-
tion, she has also put the most considerable plexus of the
whole organic system upon one of the places to which the
red blood communicates the strongest impulse, viz. upon
the trunk of the coeliac artery.
Q. What is the structure of the organic nerves?
t/?. Some are in chords, like the animal; others are gray
or red filaments, and are very numerous.
Q. What vital properties have these nerves?
Jl. They have neither animal sensibility, nor sensible
organic contractility. They have organic sensibility, and
insensible organic contractility.
NERVOUS SYSTEM. 103
Q. What inference is made from the universal existence
of these ganglions?
A. That they subserve some great though unknown
purpose in the animal economy.
Q. What views does Beclard add to this nervous sys-
tem of organic life?
#. He does not consider it a settled point, that the
sympathetic is an independent nerve; its character may
be only that of different organization.
Q. What are his views of the relations of the filaments
and nerves to the ganglions?
*#. It is proved that nerves and filaments do pass through
the ganglions.
PATHOLOGY OF THE NERVOUS SYSTEMS OF ANIMAL AND
ORGANIC LIFE.
Q. Name the principal diseases of the brain.
JL. Inflammation, congestion, softening, hardening,
scirrhus, ossification, cartilaginous transformation, fungus,
apoplexy, epilepsy, hydatids of the choroid plexus, dila-
tation of the arteries and veins, effusions of blood and
serum, head-ache, diminished volume of the brain.
'Q. What general observation will apply to many of
these affections?
A. That many of them are consequences of the acute
and chronic inflammations of the brain.
Q. What is the first division of the diseases of the
nervous system?
104 NERVOUS SYSTEM,
/?. Into those of the nervous system of animal life, and
those of the nervous system of organic life.
Q. How are the diseases of the animal nervous system
subdivided'?
#. Into the diseases of the brain and those of the
nerves.
Q. Then what is the division of the diseases of the
brain?
#. Into the idiopathic or essential, and the symptoma-
tic or consequential.
Q. What are the forms of inflammation of the brain?
/?. They are acute and chronic; but as separate from
inflammation of the cerebral meninges little is known of
phrenitis.
Q. In the collection of cerebral diseases given above,
which are the effects of inflammation ?
/?. A softening, hardening, scirrhus, effusions of blood
and serum, and head-ache, and formations of pus.
Q. After apoplexy, what- parts are most liable to hemi-
plegia?
#. The face and extremities; the trunk is seldom affect-
ed with hemiplegia.
Q. What does paralysis essentially indicate?
rf. It is symptomatic of a lesion of the nerves.
Q. What is apoplectic stertor owing to?
t/?. To paralysis of the muscles of the larynx.
Q. What inference do spontaneous alvine evacuations
justify in a case of apoplexy?
t/?. That the bowels and sphincters are losing their con-
tractility.
Q. If an apoplectic, bloody effusion takes place in a
NERVOUS SYSTEM. 105
young person, what favourable termination often hap-
pens?
JZ. The clot is encysted, absorbed, and the cavity final-
ly obliterated by an adhesion of the sides of the cyst.
Q. When are bloody effusions found in the brain?
#. They are found in the substance of the cerebral
mass, not in the exterior, nor in the ventricles.
Q. What fluid is usually found in the ventricles and on
the external surface of the brain?
#. Serum; and when this effusion is superficial, its
source is the pia mater, but the serum in the ventricles is
always from the arachnoid.
Q. What disease does serous effusion in the brain con-
stitute, and what in the spinal canal?
*#. In the brain it is termed hydrocephalus; in the spi-
nal column it is hydrorachitis.
Q. What is the pathology of those head-aches, which,
in gastric affections, so severely afflict the forehead and
one eye?
.#. They are sympathetic affections of the mucous mem-
brane of the frontal sinuses, and of the mucous membrane
on the eye-ball.
Q. How do you divide alienation of mind?
%#. Into the congenital and acquired.
Q. What causes the congenital alienation ?
*#. Organic derangement.
Q. What hardening of the brain is most common?
#. A white fibrous hardening in the white substance.
Q. What alteration in volume does the brain undergo?
#. It diminishes, but never morbidly enlarges in its
volume.
Q. What are the diseases of the nerves?
14
106 NERVOUS SYSTEM.
t/?. They are the tic doloureux, inflammation, convul-
sive affections, osseous and cartilaginous transformations,
atrophy, and hypertrophy.
Q. What is the pathology of tic doloureux ?
#. It is not known, but it has been ascribed to an en-
gorgement of the neurilema.
Q. How do you distinguish tic doloureux from rheuma-
tism?
.#. Tic doloureux does not change its locality, as rheu-
matism does.
Q. How are nervous convulsions distinguished from
cerebral?
#. The nervous are local .in their causation and extent,
the cerebral are general.
Q. To what diseases are the ganglia subject?
#. To atrophy and hypertrophy.
Q. What changes are the nerves subject to?
A. To ossification and cartilaginous alteration from in-
flammation.
( 107 )
VASCULAR SYSTEM.
L VASCULAR SYSTEM WITH RED BLOOD.
General Remarks upon the Circulation.
Q. How is the circulation divided?
/?. Into that conveying red, and that which circulates
black blood.
Q. Where does the vascular system with red blood
commence?
t#. It arises in the capillaries of the lungs, and ends in
the arterial terminals or capillaries throughout the body.
Q. Where is the commencement and ending of the vas-
cular system with black blood ?
t/2. It has its origin in the general capillary system, and
ends in the lungs.
Q. What are the channels for conveying the red blood ?
&. The pulmonary veins ; the left side of the heart and
arteries.
Q. Is there one continued or general membrane in these
canals?
/?. There is; the lining membrane is continued from
one capillary system to another. This membranous canal
is strengthened on the pulmonary veins by loose mem-
brane, in the heart by its fleshy walls, in the arteries by a
dense, fibrous, peculiar coat!
Q. What are the channels for the system of black
blood?
108 VASCULAR SYSTEM.
Jl. The veins, the right side of the heart, and the pul-
monary artery.
Q. How are the valves of the veins and arteries formed?
,#. They are formed from the continued lining mem-
brane of these vessels.
Q. What is the conspicuous anatomical view to be taken
of those two circulations?
#. Their entire separation, their distinctness, and the
respective origin and terminations of the two in the pul-
monary and general capillary systems.
<J. What do you mean by their distinct and separate
character?
*#. It is, that separate organization supports them. Even
if the right and left sides of the heart were not united, the
two functions would readily proceed.
Q. At what point in the channels of the respective cir-
culations do you find the greatest collection of blood?
A. In the heart.
Q. What general arrangement of the channels is worthy
of recollection ?
Jl. That the vessels which convey red blood from the
commencement of its circulation to the heart increase in
size and diminish in number; that the vessels which con-
vey red blood from the heart to its termination increase
in number and diminish in size. The same fact obtains
in the arrangement of the vessels conveying black blood,
viewing its vascular system as commencing in the general
capillaries and terminating in the lungs. .
Q. What renders the heart necessary in these two red
and black blood systems?
*#. Without it the parietes of the vessels could not con-
vey the blood from one capillary system to another.
VASCULAR SYSTEM. 109
Q. What then is the use of the heart?
./?. It is purely to give a mechanical impulse to the
blood.
Q. Where do you find this impulsive power greatest?
A. In that circulation which is the most extensive: the
left ventricle has therefore more power than the right.
Q. Has the heart any influence on the qualities of the
blood?
A. It is not probable that any effect is produced on the
blood by the action of the heart other than a more intimate
mixture of its particles.
Q. Can you suppose a case in which the heart could be
dispensed with?
.#. The agency of the heart is required by the extent
of the circulations of red and black blood; as these are less
extensive, the impulsive influence of the heart will in pro-
portion be dispensed with; in no other view can the idea
suggested by the question be admitted.
Q. Is there any motion independent of the heart's im-
pulse ?
A. There is an oscillatory motion as in the branches
which terminate in the porta of the liver; this oscillation
keeps up circulation in syncope.
Q. What are the general uses of the circulation with
red blood?
Ji. It supplies the materials for secretion and nutrition.
The motion of the arteries which convey red blood is use-
ful in aiding functional action.
Q. Does the red blood furnish the material for secretion
to every organ?
Ji. To all except the liver.
110 VASCULAR SYSTEM.
Q. What are the general uses of the circulation with
black blood?
t/?. It is a reservoir for the various substances, from
within and without, which enter into the venous blood,
such as the fluids from the lymphatics, from the thoracic
duct, the chyle, &c.
Q. Under what circumstances will the chylous vessels
take up deleterious substances?
/?. If the organic sensibility is altered or exalted, these
vessels will receive that which in health they would re-
ject. Thus it is with the skin, when it absorbs matters,
and they go into the black blood circulation.
Q. Bring the circulations into nearer relation.
#. The circulation of black blood receives materials
into the system, while that of red blood expends them
on it.
Q. How does this explain plethora?
/?. If the black blood circulation receives more than the
red blood expends, there is plethora; on the contrary, an
impoverished state of the humours shows itself when the
red blood expends more than the black blood receives.
Situation, Forms, and General Arrangement of the
Vascular 'System.
Q. Why does gangrene more frequently appear in the
lower extremities, than in the head and upper extremities?
*ft. Because in the lower extremities the impulse of the
heart in the circulation is weakened, and the free return
of blood is opposed by gravity.
Q- How is the aorta united to the heart?
VASCULAR SYSTEM. Ill
/?. By means of the internal or lining membrane; the
fibrous membrane of the aorta does not unite directly with
the fleshy substance of the heart.
Q. How are the semilunar valves formed?
*#. By the folds of the lining membrane, and the cor-
responding festoons of the fibrous membrane of the aorta.
Q. What advantage results from the undivided trunk of
the aorta descendens?
t/2. The impulsive power of the heart is better preserv-
ed over the great length of the branches of the inferior
aorta.
Q. What is the most accurate estimate of the number
of branches and subdivisions of each artery?
#. That made by Haller, amounting to twenty.
Q. In ramifications from the main trunk of an artery,
what favours the current of blood in the branch ?
#. A projection formed by the folds of the internal
membrane of the artery, corresponding with the angle
coming from without, breaks the column of the blood and
favours the change of its current.
Q. Does the tortuous course of the arteries diminish the
impetus of the blood?
*#. From experiments. made on animals, it was ascer-
tained that the tortuous course of the arteries does not di-
minish it.
Q. Are anastomoses formed near to the heart, or remote
from it?
/?. They are found distant from the heart, and they are
more numerous in those organs whose motions are not con-
trolled in any way by other parts. You see this exempli-
fied in the arteries of the brain.
Q. You see the large arteries deep-seated and well pro-
112 VASCULAR SYSTEM.
tected, is this protection the only benefit derived by^ the
arteries?
<ft. It is not; for the motions of the parts in which
the yood-vessels are imbedded facilitates the passage of
blood, and the arterial pulsation itself favours the func-
tional operations and vital activity of the surrounding
organs.
Q. What are the advantages of the tortuous arterial
courses?
#. It serves to protect the arteries themselves from in-
jury, in the action of some parts; and again, it in other
parts tends to the safety of the organs.
Q. What is the use of arterial anastomosis?
A. It facilitates the passage of blood into the capillaries,
whose vitality being so often deranged are liable to con-
gestion. You are well aware of the value of anastomosis,
after taking up principal arterial trunks.
Q. Is the sum of the diameter of the branches equal to
the calibre of the trunk?
/#. It exceeds it.
Q. Why is aneurism more frequent in the aorta than in
remoter parts of the arterial system ?
ft. Because in proportion to the calibre of the artery,
the parietes are thinner than in the other arteries.
Q. Where do the arteries terminate?
<ft. In the capillaries.
On the Organization of the Vascular System with Red
Blood.
Q. In what arteries is their peculiar coat thickest?
#. In the large arteries, and it becomes thinner in the
VASCULAR SYSTEM. 113
smaller ones. The inner or lining membrane is uniformly
thick in all the arteries.
Q. In what considerable arteries is this fibrous coat thin ?
A. In the vertebral and internal carotid.
Q. What, according to Bichat, is the source of cere-
bral sanguineous effusion?
/?. He supposes it always to proceed from the capilla-
ries, not from the arterial trunks.
, Q. What is the organization of this peculiar coat of the
arteries?
#. It is composed of distinct layers of circular fibres.
There are no longitudinal fibres. The coat is yellow.
Q. Is this fibrous coat of the same texture with muscle?
#. It differs from muscle in its firmness, density, and
slight extensibility. The fibrous coat will even break be-
fore it will stretch. There is no analogy in their vital
properties.
Q. What then is this arterial coat?
#. Bichat considers it a distinct texture.
Q. Why is the arterial structure so strong?
#. To sustain the impulse of the heart, so that the ar-
teries shall not dilate so much as to weaken the onward
progress of the blood.
Q. Does similarity of form alone constitute similarity
of texture?
#. No similarity of properties is likewise necessary.
Q. How does this differ from the fibrous or peculiar
coat of the arteries?
*#. It is thinner; it is transparent; it has no fibres; it is
white.
Q. What tendency has this coat in old age?
15
114 VASCULAR SYSTEM.
*ft. To ossification, which occurs most frequently about
the aorta and mitral valves.
Q. What renders the pulse so intermitting in old age?
tfl. It is probably owing to this ossification of the lining
membrane.
Q. Does this ossification of the lining membrane equally
endanger the old man and the rniddle-aged ?
#. That ossification which is not alarming in the old,
is exceedingly dangerous to the adult.
Q. What cellular investments have the arteries ?
*fl. There is a loose cellular envelope which connects
them with surrounding parts, and a dense cellular coat.
Q. Does cellular substance enter into the organization
of the fibrous coat?
/?. It does not; hence the brittleness of that coat, and
its disposition to rupture in aneurism.
Q. Why are not absorbents found in the arteries?
A. Because in the peculiar and common or lining mem-
brane of these vessels there is no cellular texture.
Properties of the Vascular System with Red Blood.
1. Physical Properties.
Q. What physical property do the arteries possess in
an eminent degree?
t/#. Elasticity, and this property distinguishes them prin-
cipally from the veins.
Q. What tubes in the body are kept open by this elas-
ticity ?
#. The arteries, the trachea, the meatus auditorius of
VASCULAR SYSTEM. 115
the foetus. All the other canals approximate their inner-
surface, and are closed when their distending fluids or
contents are taken away.
Q. How does a flattened, pressed, or bent artery reco-
ver its calibre and form ?
#. By its elasticity.
Q. What do you mean by the locomotion of an artery ?
#. It is the rising of an artery, and the straitening of
its tube, particularly at the curves, when penetrated by
blood or injection, and its return to the natural state after-
wards. This is principally owing to the elasticity of the
arteries; veins manifest no such properties.
Q. On what does this arterial locomotion depend?
#. To it three circumstances are essential ; an impel-
ling power as that of the heart, the tortuosities in the ves-
sels to be strained by the blood impelled, and firm elastic
coats.
Q. Can you distinguish between arterial elasticity and
contractility ?
A. Elasticity is a physical property, contractility an
inherent textural one : elasticity presupposes compression ;
contractility presupposes the absence of distending con-
tents: elasticity is quick and sudden in its commencement
and termination ; contractility is slow with a permanent
tendency to contract: contractility presumes extensibility;
elasticity does not.
2. Properties of Texture.
Q. How do the arteries manifest extensibility ?
#. In two ways; in their diameter and in their length,
The longitudinal extensibility is greatest.
116 VASCULAR SYSTEM.
Q. On what structures do these two kinds of. extensi-
bility depend?
ft. That of the diameter depends on the circular fibres
of the peculiar membranes; the longitudinal on the exten-
sibility of the common lining membrane and its folds, for
there are no longitudinal fibres in either coat.
Q. What results from the limited extensibility of the
peculiar or fibrous coat of the arteries?
ft. Its rupture in aneurism. The more slowly the dis-
tention of the peculiar coat is made, the greater the extent
to which it may be carried.
Q. How is arterial contractility to be divided?
ft. Lake extensibility, it is transverse and longitudinal.
Q. Give instances of transverse, arterial contractility.
A. The union and closure of the umbilical artery and
ductus arteriosus; the emptying of an artery between two
ligatures; the closure of a tied artery from the ligature up
to the first branch given off; and the diminution of the
calibre of arteries in profuse haemorrhage.
Q. How do you account for a small and large pulse?
ft. The contraction of the artery when empty consti-
tutes the small pulse, and the expansion when full of blood
the large one.
Q. Are contractility and irritability the same?
ft. They are entirely different; for contractility is a
property of texture, irritability is a vital property. Con-
tractility continues for a long time after death, irritability
soon disappears; contractility results from the absence of
extension, irritability is the result of stimulus applied.
Q. What important consideration do you infer from
this distinction?
ft. The superiority of that system should be well re-
VASCULAR SYSTEM. 117
collected, which recognises the marked difference between
vital and textural properties.
Q. Give an example of longitudinal arterial contrac-
tility.
Jl. When an artery is cut across it retracts.
Q. In what surgical operation is this kind of contrac-
tility conspicuous?
Ji. The retraction of the spermatic artery is remarkable
when the cord is cut in extirpation of the testicle.
Q. How is this contractility of the artery to be over-
come?
Ji. Tie the artery before the vas deferens is cut; and
then it does not retract within the ring.
3. Vital Properties.
Q. Do the arteries possess animal sensibility?
Ji. Experiments frequently and variously made prove
that they do not.
Q. What nerves supply the arteries?
/?. The nerves of organic life.
Q. Is animal contractility a property of the arteries?
ft. Experiments made on the brain and spinal marrow
with a view to ascertain this point prove, that injuries of
these organs, while they excite the animal contractility
into convulsive action, do not influence the arteries at all:
even galvanism failed to do so.
Q. What medical doctrine do these experiments con
tradict?
/?. The doctrine of the influence of the brain on the
arteries.
118 VASCULAR SYSTEM. '
Q. Do the arteries manifest sensible organic contrac-
tility?
Ji. They do not; irritation, in whatever way applied,
cannot excite it. Contractility of texture has been mis-
taken for sensible organic contractility.
Q. Repeat the organic vital forces of the organs.
/?. Sensible organic contractility; insensible organic
contractility and organic sensibility.
Q. Do the arteries exercise the two last properties in
an eminent degree ?
Ji. Only to obey the requisitions of nutrition; hence
these vessels are little liable to disease.
Q. What is liable to be mistaken for inflammation in the.
arteries?
t/#. A redness which spontaneously appears in them,
particularly in the cerebral arteries, after death.
. Q. What would be the consequence if the arteries were
equally liable with other parts to disease?
#. Inevitable destruction to the life of the part, and in
very many cases general death.
Q. Are the arteries active or passive in this?
*#. From th'e absence of sensible organic contractility it
may be supposed they are passive.
Q. Can you assign reasons for believing in the activity
of the heart, and the passive state of the arteries in circu-
lating the red blood?
*#. These reasons are, the entire difference in the vital
forces of the heart and arteries: affections of the arteries
do not disorder the pulse, but diseases of the heart do: the
artery always ceases to beat below a ligature, except by
anastomosis, and this pulsation is from the heart through
VASCULAR SYSTEM. 119
the anastomosing branches: cut off a dead man's arm, in-
sert a tube in the brachial artery, place the other end of the
tube in the carotid artery of a dog, and the artery in the
wrist will be felt: no animal has arterial pulsations except
those with hearts, or with a vascular arrangement giving
an impulse as the heart does: lastly, the fatal consequences
of independent arterial action must be at 'once evident.
Q. Where does the power of the heart over the blood
cease?
Jl. In the capillaries, where it changes from red to black
blood; it diminishes sooner, but is lost there.
Q. With what textures should the arteries be classed ?
ft. With the cartilaginous, fibro-cartilaginous, and
fibrous textures.
Q. What moves the blood in the capillaries?
J3.. The branches are so minute that insensible organic
contractility or tonicity is sufficient to move it.
Q. What are the causes chiefly affecting the pulse?
#. The increase of the sensible organic contractility of
the heart ; alterations in the quality of the blood render-
ing it more or less irritating to the heart; obstructions in
the capillary system; all these produce variations in the
conditions of the pulse.
Q. Are the sympathies of the arterial texture numer-
ous or active?
*ft. The obscurity of arterial vital properties would
answer negatively. , ,
Q. How do the vital properties of organs generally in-
fluence sympathy?
Jl. Sympathies depend on vital properties; mechanical
or textural properties have capacity neither to radiate nor
receive sympathetic impressions.
120 VASCULAR SYSTEM.
Q. How is the pulse sympathetically affected ?
/?. Always through the heart.
Of the Vascular System of Red Blood in different
tfges.
Q. How does the foramen ovale close?
ft. By the gradual approach of the concave surfaces of
the two crescentic productions forming the foramen ovale,
and which unite and decussate at birth, closing the aper-
ture.
Q. What closes the ductus arteriosus?
t/?. It closes as the pulmonary artery dilates.
Q. Is there red and black blood in the foetus, as in in-
dependent life?
.#. There is not; all the foetal blood is black.
Q. What investigations have proved the black colour of
the foetal blood?
#. Animals have been opened, and the blood of the
young examined, and it has proved to be black : the blood
of the umbilical arteries is black; the blood of the foetus
dead in the mother is always black ; this last is a delusive
circumstance.
Q. Does it follow that the venous blood of the adult,
and black blood of the foetus are similar in qualities, be-
cause they are so in colour?
.#. It does not thus obtain. Foetal blood is unctuous in
its feel; it does not coagulate in the dead body; it has no
fibrin; it does not take the vermilion colour from the
air; it has no phosphoric salts.
Q. How did Sabatier divide the mass of foetal blood?
#. In two circulations; the first is thus laid down:
VASCULAR SYSTEM. 121
The blood of the capillaries of the inferior extremities of
the abdomen and umbilical cord, instead of going from the
inferior cava to the right auricle, passes to the left auricle
through the foramen ovale, and thence through the left ,
ventricle into the carotids and head.
Q. Give Sabatier's second division of the foetal circu-
lation.
./?. It is that the blood returning from the head, passes
along the right auricle, ventricle, and pulmonary artery,
through the ductus arteriosus into the aorta descendens,
thence into the capillary system of the abdomen and ex-
tremities, and partly to the umbilical arteries. So that
there are two circulations in the foetus, with different
origins, trunks, organs of impulse and terminations.
Q. In this system of Sabatier, what part of the heart
impels the blood to the upper and lower parts of the
body?
#. The left ventricle propels it to the head; the right
ventricle to the lower parts of the body. By the gradual
closure of the foramen ovale and ductus arteriosus, the
blood takes its channels for life; the change is not a sud-
den one.
Q. Is the arterial system early developed?
*#. Of course it is, as it conveys nutriment ; but the
texture is soft, yielding, apparently homogeneous. The
arterial strengthens as the heart increases in vigour.
Q. What changes take place at birth?
#. In the red blood system, two changes take place ;
the one is mechanical, the other is chemical.
Q. What are these mechanical and chemical changes?
#. The mechanical 'are the closures of the foramen
16
122 VASCULAR SYSTEM.
ovale and ductus arteriosus; the chemical change is the
action of the air on the blood in the lungs.
Q. How does respiration commence at birth?
#. In consequence of a general excitement produced on
all the moving parts from external impression at birth;
perhaps the intercostals and diaphragm are set in motion
instinctively.
Q. Are you correct in applying the term instinct in
this case?
<A. Yes; for various examples of these instinctive ac-
tions at birth can be presented. Observe, the infant pre-
pares it mouth for sucking; animals seek the teats of the
mother; gallinaceous animals look for grain, &c. to nou-
rish them.
Q. But as the ductus arteriosus is not entirely closed
at birth, how is it that blood does not pass through it?
Ji. It is accounted for in two ways; the capillaries of
the lungs invite blood through the pulmonary artery, and
the vital forces of the duct itself are offended by blood
which is not placental; thus the blood goes on to the
lungs.
Q. How is the, foramen ovale closed?
#. When the blood passes from the pulmonary veins
into the left auricle, one valve of the foramen is pressed
on the opening; and when the blood comes from the cavas
into the right auricle, the two valves are completely united,
and kept so till union permanently takes place.
Q. Can the foramen ovale remain open and the circula-
tion go on?
*#. It can. Bichat has repeatedly seen it; for, though
open, the auricular contraction so throws the valves of the
VASCULAR SYSTEM. 123
foramen into contact, as to close it. Again, the vital forces
of the left auricle may, after birth, reject black venous
blood; this is the elective operation of the vital forces of
the different organs.
Q. You have stated the great development of the cere-
bral arterial system in infancy, where does it predominate
at puberty?
A. In the genital organs and the lungs.
Q. Where is vitality most active in adult life?
#. In the viscera of the abdomen.
Q, How many kinds of bodily growth are there?
t#. Growth in height, and thickness; the first ends
about the eighteenth year, the second continues till the
fiftieth year. When the growth in thickness ceases, the
calibres of the arteries no longer increases, and the arte-
rial development has no local preponderance.
Q. What takes place in the arterial system of old age?
JL. The blood is sent with diminished force to the small
arteries; they gradually close and are obliterated.
Q. What are the two great offices of the circulation of
red blood?
#* To impart nutrition, and excite the organs by the
arterial motion.
Q. -Under what circumstances are the arteries acci-
dentally developed?
#. When their natural course is obstructed ; in tumours;
in pregnancy. Painful tumours, or those in which there
is an exalted animal sensibility, produce this development
more than indolent tumours.
Q. Does Beclard believe that the arteries do not possess
sensible organic contractility?
124 VASCULAR SYSTEM.
A. He is of opinion, with several experimenters sub-
sequent to Bichat, that they do exercise that vital property.
Q. Is this sensible organic contractility most conspi-
cuous in the large or small arteries?
*#. In the smaller ones, because of the great nervous
power distributed to them.
Q. Why do you think that the arteries aid the flow of
blood?
/?. Because the flow from an artery is constant; if it
were dependent on the heart alone, the blood would flow
only when the ventricle contracted.
Q. Why do you suppose the arteries to be self-developed ?
/?. Because vessels exist before the heart does.
Q. Which arterial coat is most liable to inflammation ?
Ji. The internal; in abdominal and thoracic inflamma-
tion, the lining membrane of the aorta is found red and
inflamed.
Q. Name the organic alterations of the arteries.
/?. Inflammation, aneurisms, ossification, cartilaginous
transformation. Ossification frequently brings on the gan-
grene of old persons.
PATHOLOGY OF THE VASCULAR SYSTEM WITH RED
BLOOD.
Q. To what diseases are the arteries liable ?
#. The diseases of the arteries are few. They are in-
flammation of the lining membrane, dilatation of the ar-
tery without lesion, contractions of the arteries, ossifica-
tion, and aneurism.
VASCULAR SYSTEM. 125
Q. Can you give a remarkable fact illustrating the in-
disposition of the arteries to disease?
#. This is one; that they are so constantly found unin-
jured while all the surrounding parts are destroyed.
Q. What appearances during life and after death indi-
cate inflammation of the lining membrane of the arteries?
*ft. There are no conclusive symptoms during life; and
after death the membrane is of a high red colour, some-
what thickened, and is said to be more brittle.
Q. Where do you see dilatation of the arteries without
lesion ?
#. It has been seen general and partial ; the coats thick-
en in proportion to the increase of the size of the artery.
Q. What do you remark of the contraction of the arteries?
t#. It is also general or partial. The first arises when
the vital forces, general and arterial, are much diminish-
ed; the partial is seen in the large arterial trunks.
Q. What coat is most liable to ossification?
#. The internal membrane.
Q. At what age does this ossification occur?
A. Principally in the aged.
Q. How does it affect the pulse?
#. It renders it intermitting and irregular.
Q. Where is aneurism oftenest seen ?
/2. About the curvature of the aorta ; next to that in the
abdominal aorta.
Q. What is a true aneurism ?
fl. An arterial dilatation, where the external coat is un-
ruptured, although the middle and internal may be burst.
Q. Define a false aneurism.
#. It is a collection of blood in the surrounding cellu-
lar texture from rupture of the arterial coats.
126 VASCULAR SYSTEM.
MI. VASCULAR SYSTEM WITH BLACK BLOOD.
Situation, Forms, Division, and General Arrange-
ment.
Q. How is this system divided?
t#. Into two distinct ones. The general black blood
system, and the black blood system of the abdomen.
Q. What proof is there that blood is not formed in the
general capillary system ?
*ft. The fact that no veins arise from parts where arte-
ries are not sent.
Q. What are the two orders of veins?
/2. Those which accompany the arteries, and those
which are superficial, sub-cutaneous.
Q. Where do the veins originate? .
#. From the general capillary system.
Q. Is the arterial system or the venous most capa-
cious?
t/2. The venous is much more capacious than the arte-
rial; there is no fixed disproportion.
Q. On what does the continuance of the circulation de-
pend?
A. On a due relation between the capacity of the sys-
tems of red and black blood, and also between the velo-
city with which the blood is propelled; and on a similar
relation between the origins, agents of impulse, and ter-
minations of the two circulations.
Q. Which side of the heart contains most blood after
death, and what is the reason ?
VASCULAR SYSTEM. 127
^. The black blood side of the heart; and the reason is
that the circulation ordinarily stops first in the lungs, and
the blood is by this pulmonary obstruction, collected in
the right side of the heart.
Q. Why is there weakness of parietes, slowness of mo-
tion, and great capacity in the veins?
#. The parietes are comparatively weak, because the
veins have little impulse to support; the velocity is not so
great as in the arteries, because the force of the heart is so
little felt in the veins ; the capacity is great in the veins
that they may bear accumulations from gravity and other
causes with safety.
Q. What is the result of a diminution of the velocity
of the blood in the veins?
#. It increases the capacity of the veins; hence the dif-
ference in the capacity of the veins of the inferior and su-
perior extremities.
Q. What is the principal point of difference in the
branches of the veins and arteries?
#. The venous are much less tortuous, and hence there
is no locomotion in them.
Q. Where are the ramifications and small branches
of the veins usually found?
Jl. The ramifications form a constituent part of the in-
terior of an organ: the branches lie in the interstices,
lobes and circumvolutions of the organs.
Q. Why are the large arterial and venous trunks deep-
seated ?
<fl. To preserve them from injury.
Q. Considering the venous system as a whole, what
three trunks compose it?
128 VASCULAR SYSTEM.
tf. The cava superior, the cava inferior, and the coro-
nary vein.
Q. What difference is there between the communica- 4
tions of the arteries and of the veins?
/?. The venous are much more numerous than the ar-
terial; the first form reticular anastomoses, such as are not
seen in the latter.
Q. How do you explain the continuance of the venous
circulation, when the sub-cutaneous veins are tied or other-
wise obstructed ?
#. The free communications between the superficial
and deep-seated veins account for it.
Q. Name one great distinctive mark between the red
and black blood circulation?
t/?. The influence of gravity in the venous circulation.
Q. What arrangement is particularly destined to coun-
teract this gravity ?
.#. The valves of the veins.
Q. Why is gravity so powerful in the veins?
. Because there is no agent of impulse at the origin
of the black blood circulation in the general capillary sys-
tem.
Q. What is the office of the vena azygos ?
/?. To anastomose between the superior and inferior
cava. This free anastomosis precludes the idea of hepatic
pressure on the cava producing dropsy; the blood finding
its way through the azygos.
VASCULAR SYSTEM. 129
Organization of the Vascular System with Black
Blood.
Q. Of what is the peculiar membrane of the veins com-
posed?
#. It is a fine layer of longitudinal fibres.
Q. Where is this membrane most conspicuous?
#. In those veins where gravity is the most operative;
and in the superficial veins where pressure does not aid
the circulation as in the deep-seated veins. These fibres
can be better seen in the branches than in the trunks.
Q. What is Bichat's opinion of this membrane?
#. That it is a texture sui generis.
Q. What distinguishes it from the arterial coat?
*&. The absence of elasticity and brittleness; its soft-
ness; its great extensibility of texture j and the longitudi-
nal direction of its fibres. There are no circular fibres in
the veins.
Q. Where is this peculiar membrane found wanting?
ft. In the sinuses of the dura mater there is neither the
cellular coat nor fibrous membrane; the venous coats there
are the dura mater and common lining venous membrane.
Q. How does the common membrane of the black blood
system differ from that lining the arteries?
#. It is more distensible, it is more delicate, it never
ossifies. Hence you do not see ossification in the right
side of the heart.
Q. Where does Beclard say the venous valves are most <
numerous?
<ft. In the superficial veins; in those of the inferior ex-
tremities.
Q. In what part of the venous system are there no valves?
#. There are none in the pulmonary veins, except just
17
130 VASCULAR SYSTEM.
at the heart; they are wanting in the trunk of thecavaas-
cendens, in the emulgent veins, in the cerebral sinuses.
See Horner, Vol. II. p. 158.
Q. How are the venous fibres best exhibited?
*#. By plunging the veins into boiling water or concen-
trated acids, the horny hardening contraction takes place,
and the fibres are seen.
Q. What distinguishes the venous parietes from the
arterial?
.#. The penetration of cellular texture between the
fibres of the peculiar coat of the veins, into the common
lining membrane. This is not seen in the arteries. The
cellular coat of the veins is peculiarly filamentous.
Q. To what extent do exhalation and absorption take
place in the veins?
A. Only to subserve the purposes of nutrition.
Q. Are the veins as abundantly supplied with nerves
as the arteries?
#. They are not; a few ganglionic nerves supply them.
Q. What induces you to believe that the nerves have
no effect on the contraction of the left side of the heart?
/?. The fact that the right side is as abundantly sup-
plied with nerves as the left. We would therefore sup-
pose that nervous influence does not confer the difference
of ventricular power.
Properties of the Vascular System with Black Blood.
1. Properties of Texture.
Q. Are the veins extensible?
JL. They are, but in a transverse direction; the arteries
are so longitudinally.
Q. Have not recent investigations proved that the veins
are extensible longitudinally?
VASCULAR SYSTEM. 131
#. They have; Puschett, a German, has seen them be-
come tortuous and longer in disease.
Q. Are the veins easily or frequently ruptured ?
fl. They are; for example, the haemorrhoidal, the ce-
phalic; even the jugular and cava veins have been ruptur-
ed. Call to mind the thin parietes of the cephalic veins.
Q. Is the venous texture contractile?
/?. Evidently so. The contractility is slight in the lon-
gitudinal, much greater in the transverse direction.
Q. What circumstances affect this contractility?
Jl. Seasons of the year, posture of the body, cold or
hot applications, and period of life.
2. Vital Properties.
Q. Have the veins animal sensibility and contractility ?
fl. Bichat says that experiments prove them destitute
of these properties.
Q. Does notBeclard allow the veins vital contractility?
A. Yes; various experiments, he says, prove that the
veins in the living, contract in a manner not seen in dead
bodies; hence it is a vital, not a textural contractility.
Q. Do the veins possess sensible organic contractility ?
/?. They do not; for in disease the veins manifest none
of those evidences of increased sensible organic contrac-
tility which the heart, stomach, or bladder give out.
Q. What light does disease throw on the predominant
vital forces of our organs ?
/2. Diseases exalt those that are predominant, so as to
show those that prevail in the different organs in health.
Q. How does Bichat account for the venous pulse ?
#. He ascribes it to a reflux of blood from the right
132 VASCULAR SYSTEM.
side of the heart, in consequence of pulmonary obstruction,
or of an irregular action of the heart. These occasion a
psuedo-pulsation, resulting from the contractility of tex-
ture, not from irritability.
Q. How far is this reflux operative?
ft. Rarely beyond the great trunks; it is stopped by
the valves. Haller said it extends to the iliacs.
Q. Why do wounded veins inflame and unite so much
more speedily than arteries?
ft. Because the tonic vital forces are greater in the veins
than arteries, because the action of the arteries may pre-
vent union, and perhaps because there is more cellular tex-
ture in the veins than in the arteries.
Q. How is the blood moved from the general capilla-
ries through the veins?
ft. By the insensible contractility of the capillaries; by
an absorbing power which commences in the venous ra-
mifications, and extends towards the venous trunks.
Q. But as the resistance to the motion of the blood in
the veins is often greater than the impulse, how does it
get forward?
ft. By various aids; by anastomoses; by muscular ac-
tion and pressure ; by assistance from the pulsation of the
neighbouring arteries; by the motion of certain parts, as
the elevation and depression of the cerebral mass; by the
locomotion of other organs, as the gastric ; and by external
frictions and motions.*
Q. Can you give a parallel view of the circulation in
the arteries and veins?
* For a more particular account of the forces, by which the blood
is made to circulate in the veins, see Arnott's Elements of Physics,
American Edition, p. 446, et seq.
VASCULAR SYSTEM. 133
In the arteries there is
Pulsation,
Rapid flow of blood,
Small capacity and
thick parietes,
No necessity for ac-
cessory aid,
Blood flowing per
saltern,
Very little arterial
gravitation.
In the veins there is
No pulsation,
Slow motion of the blood,
Great capacity and thin
parietes,
Necessity for accessory
aid,
Uniform flow of blood,
Power of gravity in the
veins.
Q. What are the effects from an organ of impulse at the
origin of the arteries?
t#. It gives uniformity of pulsation or motion in the
arteries, and you find all the arteries of the body equally
dilated or contracted after death.
Q. Now, what results proceed from the absence of an
organ of impulse at the capillary origin of the veins ?
t/tf. The blood is propelled with very various power in
different parts of th6 body ; and there is great variety in
the states of fulness or contractions of different veins in the
several parts of the body.
Development of the Arterial System with Black Blood.
Q. Is the arterial or venous system most developed in
foetal life?
w2. The arterial much more so; less blood returns by
the veins, because of the quantity exhausted by nutri-
tion.
Q. What' veins have been found developed before the
arteries?
#. The umbilico mesenteric in the chick.
134 VASCULAR SYSTEM.
Q. Why 'are varices rare in foetal life?
./?. Because the venous coats are very strong at that
period; more so in proportion than in after life.
Q. What alterations take place in the veins of old
age?
*#. A dilatation of their parietes, a diminished contrac-
tility in the capillaries, a diminished velocity in the mass
of venous blood from an increased capacity in the veins.
Q. How does Bichat account for the quantity of blood
in old age?
/?. As decomposition prevails over nutrition in ad-
vanced life, and the veins receive the decomposed matter,
they contain a greater quantity of blood.
Q. Where are varices principally found?
A. In the inferior extremities of old persons, and of
pregnant women; the causes are obvious.
Q. Why are the veins enlarged in cancer, fungus, &c.?
A. The arterial deposition being increased, the venous
fulness is in proportion augmented.
Q. Why is the capacity of the veins enlarged in
ascites?
ft. Because their coats have lost a measure of their
elasticity.
Q. What would be the effect on the circulation, if the
blood went from the ventricles by two arterial orifices?
JL. There would be neither unity of impulse, uniformity
of course, or simultaneous pulsation. These are all pre-
served by the single aortal trunk.
Of the Abdominal System with Black Blood.
Q. What organs supply this vena portal circulation?
VASCULAR SYSTEM. 135
Jl. Those concerned in digestion.
Q. Name those organs or parts which do not pour their
blood into this vena portal system.
t/2. The kidneys, ureters, bladder, genital organs, dia-
phragm, and abdominal parietes, do not empty their blood
into the vena portarum.
Q. Do the properties, sympathies, and affections of this
abdominal venous system agree with the general venous
system ?
J2. They do.
Q. What membrane is peculiar to the hepatic portion?
/?. That which is termed the capsule of Glisson; the
use of which is unknown.
Q. What proof is there that the injection of air into the
veins is not fatal by impression made on the heart ?
ft. Because injection of air into the abdominal system
with black blood is not fatal, and yet the air must reach
the heart.
Q. How then does air prove fatal when thrown into
the blood-vessels?
t/2. By its action on the brain. In the case alluded to
in the last question, the air becomes so united, diluted,
&c. before any of it reaches the brain that its power is lost.
Q. How does the common lining membrane of this ab-
dominal system, differ from that of the general venous
system ?
#. It has no valves; these are unnecessary, because the
course of the blood is short. There is no agent of impulse
in the middle of this system, as you see in the right side
of the heart; the effect of such an agent might occasion a
reflux as the action of the right ventricle does.
Q. Is the course of the blood uniform through the liver?
136 VASCULAR SYSTEM.
.#. The want of impulse, the solidity of the liver, the
absence of hepatic dilatation and contraction, all render
the circulation much more uniform than it is in the lungs
where the black blood system terminates.
Q. Do the coats of the abdominal veins differ in strength
from those of the general circulation?
*fl. They are of the same firmness.
Q. What aids the circulation of blood through the ab-
dominal veins?
#. The movements of the diaphragm and abdominal
muscles; the motion, dilatation and contraction of the
hollow viscera; the constant motion of the intestines. You
will observe that in the haemorrhoidal veins, that not
having these aids in their circulation, there are very fre-
quent varicose enlargements.
Q. What induces the belief that the liver performs some
very important though unknown office in the system?
A. The v great disproportion between the size of the
liver and its excretories and reservoirs, and that of the
kidneys, salivary glands, pancreas and their emunctories;
the greater flow of secreted fluids from the test mentioned
viscera than from the liver, although that is in size greater
than all of them collectively taken; the fact that the liver
is universally found in animals; the early foetal develope-
ment of the viscus, its being coeval with the heart and
brain; the great influence the passions have over it; the
conspicuous part it performs in the diseases of the ceco-
nomy; the influence of the liver on temperaments; its
frequent organic diseases; all these impose the belief sug-
gested in the question.
Q. Does the liver effectuate any change on the vena
portal blood?
VASCULAR SYSTEM. 137
v?. Experiment proves that it does not.
Q. What are the evidences that bile is exclusively
formed by the vena portal blood ?
A. This remains but a plausible hypothesis; there is
no positive proof of the fact. Bichat thinks that both the
vena portal blood and that of the hepatic artery concur to
form the bile.
Q. Does the blood of the venaportarum differ from the
black blood in the general system?
#. It has been so supposed, but the reasons are exceed-
ingly doubtful in their character.
Q. Does the slow motion of the blood in the vena por-
tarum favour the biliary secretion?
. As this sluggish circulation does not appear in other
organs, there is no reason to believe it necessary or con-
ducive to the hepatic secretion.
Q. What proof is there that the spleen does not send
matter essential to the formation of bile?
.#. Because, where the spleen is wanting, or removed,
bile has been formed in the usual manner.
Q. Is the flow of bile into the duodenum constant?
A. The hepatic flows constantly; the cystic only during
intestinal digestion.
Q. Does Bichat suppose that bile exists in the stomach?
<ft. From experiments made on animals he believes that
bile is always in the human stomach; and that it is hepa-
tic, not cystic bile, which is found there.
Q. At what stage of life does the liver receive most
blood?
*ft. In the foetal period.
Q. What difference does birth make in the circulation
of the liver?
18
138 VASCULAR SYSTEM.
fl. But one kind of blood enters, and less of that; an
interruption to all communication between the general
and abdominal black blood system takes place, and a
diminished size of the liver.
Q. At what period of life is the circulation in the ab-
dominal system of black blood most active?
<fl. From the thirtieth to the fortieth year; and it is at
that period that diseases of the abdominal system ap-
pear.
Q. What are these diseases?
*ft. Haemorrhoidal affections, and melancholia.
Q. Do you ever see ossification in this system?
rf. Never.
PATHOLOGY OF THE VASCULAR SYSTEM WITH BLACK
BLOOD.
Q. What are the diseases of the veins ?
*#. They are few, and imperfectly understood. There
is inflammation or phlebitis; dilatation; contraction; and
concretions in the veins.
Q. Name a remarkable pathological contrast in the state
of the arteries and veins in fever.
Ji. While the arteries are in tumultuous action, the
veins are quiet as in health.
Q. What are the causes of inflammation of the veins?
*#. The cause is sometimes unknown; usually it arises
either from wounds of the veins, or from ligatures, as in
varicose veins after an operation, or from inflammation of
surrounding tissues, or from a varicose state.
VASCULAR SYSTEM. 139
Q. What are the appearances of an inflamed vein on
dissection ?
t#. There is some redness of the inner coats, with
thickening of the outer tunics. Pus forms on the exterior
coats, and lymph on the internal coat in phlebitis.
Q. In what direction does venous inflammation ex-
tend?
ift. In general between the orifice or puncture and the
heart.
Q. How are venous dilatations divided?
/?. Into local and general; and into those of the gene-
ral venous and those of the vena portal system.
Q. What are these dilatations called ?
*&. Varices in the general venous system; and haemor-
rhoids when they appear in the vena portal system near
the rectum.
Q. What is the appearance of a varix?
,#. It is a blue soft tumour, which increases in propor-
tion to the compression between it and the heart.
Q. What causes a varix?
*#. It occurs when the coats of the vein cannot main-
tain the gravity of a column of blood.
Q. Where are these varices most frequent?
*ft. In the spermatic veins, and those of the inferior ex-
tremities. They are seldom seen in the superior parts of
the body. I have seen an enormous dilatation of the left
jugular vein, from obstruction to the passage of blood from
the right side of the heart.
Q. How many kinds of hsemorrhoidal dilatations ?
A. Two; one with rupture of the venous coats; the
other without. There are haemorrhoids from which the
140 VASCULAR SYSTEM.
blood is evacuated externally ; this is a species of the first
form.
Q. What is an aneurismal varix?
#. The case where there is an abnormal direct com-
munication between the artery and vein.
Q. How are contractions of the veins induced?
#. By chronic inflammation and thickening of the ve-
nous parietes.
Q. Where are venous concretions seen?
#. They have been seen in the pelvic veins, about the
size of a pea.
Q. What great difference is there in the pathological
tendencies of the internal membrane of the veins and that
of the arteries?
#. The venous is not disposed to ossify, the arterial is,
CAPILLARY SYSTEMS.
Q. What are the two capillary systems?
Jl. The general capillary system, which is the seat of
the alteration of the red to the black blood ; and the pul-
monary capillary system in which the blood is converted
from black to red blood.
Q. Whence the great importance of these capillary sys-
tems?
Ji. They are the seats of the most important functions,
such as nutrition, secretion, digestion, absorption, exhala-
tion; the capillary circulations are governed by peculiar
laws; their tubes are the seats of inflammation, metastases;
and animal heat is engendered there.
Q. In what animals are these systems exclusively the
organs of circulation ?
i/2. In the lowest classes of animals.
I. GENERAL CAPILLARY SYSTEM.
Q. What is the extent of this?
t/f. All the organs are composed of myriads of capilla-
ries, intercommunicating in every possible way; arterial
and venous ramifications pass into the interstices of the
organs; the organs themselves are composed of capilla-
ries.
Q. Do yqu say that the capillaries are a class of vessels
distinct from the blood-vessels?
ei. Not only so, but they give rise to the exhalents and
142 CAPILLARY SYSTEMS.
absorbents. The capillary systems are intermediate be-
tween the arteries and veins. Nutritive matter for all the
organs is by them separated from the blood.
Q. How are the general capillaries divided?
#. There are those which carry red blood ; those which
convey white fluids; and those giving passage to both red
and white fluids.
Q. In what systems do the capillaries with red blood
predominate?
*#. In the muscular tissue, in the spleen, in portions of
the mucous system, as the pituitary membrane.
Q. In what systems do the blood and other fluids also
circulate?.
e#. In the capillary systems of the osseous, serous,
some of the fibrous, the dermoid, and glandular tissues,
besides others.
Q. How is this mixed circulation proved?
/#. By the comparison of a piece of healthy serous
membrane in health and the same in a state of inflamma-
tion: by injecting the capillary system of the serous mem-
branes it exhibits a net-work of vessels not apparent in a
natural state: the appearance of the inflamed conjunctiva
is a remarkable illustration of the question proposed. The
proportions of the red and white capillaries vary in dif-
ferent textures; there are fewer red capillaries in the se-
rous tissues, while in the dermoid and mucous tissues they
preponderate greatly.
Q. What hypothesis has Bichat connected with this ?
. That there may be a set of empty vessels, which in
a natural state do not convey blood, but which are pre-
pared to receive it in cases of emergency.
Q. What organs have white capillaries exclusively?
CAPILLARY SYSTEMS. 143
JL. Tendons, cartilages, hair, some ligaments.
Q. How do you prove the existence of any capillaries
in these?
./?. Injections and disease prove it; these tissues are
really vascular.
Q. On what does the number of capillaries in a part_
depend ?
*fl. It depends on the functions they perform. Those
having few capillaries, such as cartilage, have only nutri-
tion to support; others have exhalation and absorption;
and others again have, superadded to all these, secretions
to form.
Q. What is the pathological distinction between active
and passive increased secretion and exhalation?
/!?. Preceding the active there is an increased afflux of
blood; in the passive this is not the case.
Q. What do you mean by an active secretion or exha-
lation ?
Jl. One attended with an increase of the vital forces;
in the passive forms there is a diminution of these forces.
Q. Give a definition of the general capillary system?
Jl. It is a general net-work, which communicates in
every organ, and from one organ to another; forming in
this way free communications for the fluids of the body
from head to foot.
Q. How does this view affect the usually admitted at-
tributes of the cellular texture ?
t/2. It has been thought that the permeability of the
body depended on the cellular texture, but here you see
it ascribed to the capillary system.
Q. Do the capillary vessels conveying red and white
fluids freely communicate?
144 CAPILLARY SYSTEM?.
A. They do very freely wherever they are met with.
Q. What is the pathology of haemorrhage?
J2. It is an active or passive exhalation of blood, as
the case may be; it is not from rupture of vessels.
Q. What relation does this general capillary system
bear to the arteries and veins?
/#. It is a general reservoir, into which arteries pour
red blood, and from which the veins take black blood;
from which also the exhalents with nutritive and other
matters pass; the excretions arise from it; the secretory
vessels elaborate their fluids from the blood in the general
capillary system.
Q. What proves this distinct organization or continuity
of tubes ?
/2. The continuity from the arterial, through the capil-
lary, to the venous system, is proved by the fact that in-
jections from the arteries do not pass into the cellular
texture.
Q. What effect has this permeability of the capillary
system on the appearances of parts on dissection?
.#. Before death, tonic action preserves the fluid in a
precise part; hence in membranous inflammation the red-
ness. But after death, these fluids obeying gravity ,'J,he
parts lose the redness which indicates inflammation, and
the dissector may imagine there was none. Local irrita-
tion, which fixed blood in a part during life and disease,
disappearing after death, the blood is removed.
Q. Does blood disappear equally after death from chro-
nic as from acute inflammation?
ft. It does not; in chronic it is more fixed, forming al-
most a constituent part of the tissue.
VAPILLART SYSTEMS. 145
Q. Why is it, that while the capillary tubes are free
and every where open, the blood does not pass into all?
A. A general physiological reply may serve, viz. that
the organic sensibility of different organs admits certain
matters, and rejects all others. Such is the case with the
trachea and lacteals, and many others.
Q. How then is there an occasional increased flow of
blood to a part?
#. Irritation applied to that part, increases the organic
sensibility, and thus more blood appears in, or is invited
to it.
Q. What is the great difference between organized and
inert tubes or vessels?
*#. The vitality of the organized, and the inert being
under the influence solely of mechanical laws.
Q. Where is it that organic sensibility varies most, and
thus affects the course of the blood?
/?. This takes place in the capillary system ; not in the
large vessels.
Of Inflammation.
Q. What is the first step in the pathology of inflam-
mation ?
#. An alteration and increase of the organic sensibility,
in consequence of an irritant to the part.
Q. How is this local irritation produced?
<fl. By direct irritation, or by organic continuity, or by
sympathy.
Q. What is the second step in the process of inflam-
mation?
t#. An irritation of blood by the increased organic sen-
sibility, and a remora of blood while irritation continues.
19
146 CAPILLARY SYSTEMS,
Q. How is pain produced in inflammation?
Jl. By the alteration and increase of organic sensibility
into animal sensibility, which last is perceived by the brain.
JThe impression of the blood on this increased organic sen-
sibility gives pain.
Q. How is heat evolved in inflammation ?
' #. It is a result of the alteration of the organic vital
forces.
Q. What do you mean by a greater or less degree of
inflammation?
#. An indication of the extent in the increase and al-
teration of the organic sensibility. (
Q. You speak of an alteration as well as an increase of
the organic sensibility, will you explain this?
/?. By a simple increase of this organic sensibility, in-
flammation is produced; by an alteration of the sensibility
the inflammation is modified.
Q. How do the fluids become putrid?
Jl. To make this change in the fluids, a previous de-
struction of the vital forces of the part is essential. *
Q. How do local affections modify fever?
/2. Bichat supposes that each local affection has its ap-
propriate general fever.
Q. What leads to different terminations in inflammation?
<&. Changes in organic sensibility; reduction of animal
sensibility; exhaustion of organic sensibility, according as
it ends in resolution, suppuration, scirrhus, or death.
Q. Why is the agency of the nerves rejected as induc-
ing inflammation?
*#. In the system of Bichat, the nerves are allowed no
control over organic sensibility, in the changes of which
inflammation consists.
CAPILLARY SYSTEMS. 147
Q. What relations do the black and red blood bear to
inflammation?
ft. When the inflammation is active, the red blood is
found in the capillaries; when the inflammation is passive,
black blood is in them.
Q. In what tissues is inflammation most frequent?
ft. In those tissues where there are the greatest num-
ber of capillaries, such as the mucous and serous. It at-
tacks those tissues where the functions of the capillaries
are most diversified, that is, where nutrition, secretion, ex-
halation and absorption exist. Where nutrition is only in
existence in the capillaries of a tissue, inflammation is
comparatively rare.
Q. What accounts for the different aspects of inflam-
mation in the various tissues?
ft. The varieties in the organic sensibility of these tis-
sues.
Q. What inflammation prevails in the cellular texture?
ft. The phlegmonous form.
Q. What inflammation is most common in the skin ?
ft. The erysipelatous.
Q. What is the inflammation observed in the mucous
tissue?
ft. It is the catarrhal.
Q. Do the fluids formed in the terminations of these
inflammations differ?
/?. They do. The pus of phlegmon differs from that of
erysipelas. There is no resemblance between the fluid of
catarrh, and the flaky fluids from the serous surfaces. The
fibrous tissue does not suppurate.
Q. Is there a peculiarity of structure in the capillaries
of the various organs?
148 CAPILLARY SYSTEMS.
*#. It is probable that they partake of the structure of
the different organs; that they have peculiar organic sen-
sibility, and insensible organic contractility, and conse-
quently peculiar diseases.
Of the. Capillary Circulation.
Q. What are the features of this?
.#. Two conspicuous ones invite attention; they are the
motions of the fluids, and the alterations they undergo.
Q. What are these fluids?
/!?. The blood, which is known; the other fluid in ca-
pillary circulation is unknown.
Q. How are the fluids circulated in the capillaries?
&. Not by the heart; but the fluids coming in contact
with the capillaries, excite through their organic sensi-
bility, the insensible organic contractility which propels
them.
Q. What objections are there to the doctrine of the
heart's agency in the capillary circulation?
#. The vessels of the capillary circulation exhibit a
motion different from that of the heart and arteries; where
the heart's action is increased, the exhalations are not, and the
secretions are actually diminished; in some haemorrhagies
the pulse is very weak; the existence of local external dis-
eases, and the inequality of growth in different parts; all
these invalidate the doctrine alluded to in the question,
and substantiate the opinion that the capillaries act inde-
pendently.
Q. Founding the division on the circulation of the
blood, and that of the capillaries, how do you divide dis-
eases?
CAPILLARY SYSTEMS, 149
tf. Into those which involve the general circulation,
and those which belong to the capillary.
Q. Give examples of these.
/?. Fever is a disease of the general circulation, while
the capillaries are the seats of eruptions, tumours, and in-
flammation.
Q. To what classes of animals are fevers confined ?
#. To those with large vessels, in which the blood
moves in mass; where there is no other circulation than
capillary, fever cannot exist.
Q. Which is the most essential circulation?
*#. The capillary, for there is no organized being with-
out it, but there are those without the larger or general
circulation.
Q. When there is irregular motion of the blood in the
capillaries of one part, how is the relation between the
veins and arteries preserved?
*#. When obstructed in one part of the capillary sys-
tem, the determination of blood to another portion of that
system is increased.
Q. Is the whole capillary system ever affected ?
*#. No death is the inevitable result of such a state.
Q. What is a most important law of the vital forces?
<ft. That when increased in one part, it is necessarily
at the expense of other parts.
Q. How do you account for the uneasy sensations ex-
perienced under atmospheric changes?
*ft. They are the effects of greater or less atmospheric
pressure on the equilibrium of internal and external capil-
lary circulation.
Q. What important principle as to blood-letting results
150 CAPILLARY SYSTEMS.
from this separate view of the general and capillary cir-
culation ?
#. That by general blood-letting you do affect the ge-
neral circulation, but at the same time you do not neces-
sarily remove local irritation or capillary congestion.
Of the Capillaries considered as the seat of the produc-
tion of tftnimal Heat.
Q. What is Bichat's theory of animal heat?
Jl. That caloric is taken in the processes of digestion,
respiration, and perhaps by cutaneous absorption; in the
general circulation it is combined; in the capillaries it is
evolved, giving out animal heat. Thus it is with nutri-
tive matter; it is taken in, combined with the general, and
separated in the capillary system.
Q. What then is the process of animal heat?
t/?. It is a function of the general capillary system.
Q. How is this explanation more probable and rational
than the chemical, and mechanical theories of heat?
Ji. It is founded on a uniformity in the operations of
physiological nature.
Q. Is animal heat greater in animals that respire?
/?. It is; and the size of the lungs seems to influence
the temperature.
Q. Does pathology confirm this theory of animal heat?
Ji. It does; animal heat is dependant on the state of the
vital forces ; and when these forces are increased in inflam-
mation and in disease, the heat is increased. On the con-
trary, in those cases where the vital forces are diminish-
ed, the heat is lessened.
CAPILLARY SYSTEMS. 151
Q. Have the tissues different temperatures?
Jl. They have. There is less in the hair, nails, epi-
dermis. There is less heat in the white organs than in
the red.
Q. If this be the case, how is the general temperature
uniform?
/#. The tissues which evolve much caloric supply those
which do not eliminate so much.
Q. How do you account for the peculiar sensations of
heat in the different tissues?
e#. Each has its peculiar heat, as it has of secretion.
All these varieties result from the modification of the
vital forces of the part. Animal bodies alone exhibit these
varieties of heat.
Q. How is the heat increased in the action of fever?
Ji. By the shock given to the capillary system, increas-
ing its- insensible organic contractility.
Q. Why is heat increased by hurried respiration? -
*ft. Because the circulation is likewise increased, and
consequently the vital forces of the capillaries. The ma-
terial of heat is more freely absorbed in hurried than slow
respiration.
Q. Is all the heat of red blood lost in its change to
black blood?
ft. It is not; hence in cases of sudden death from
asphyxia for example, heat remains some time after
death.
Q. Why does heat remain longer in sudden than slow
death?
/?. Because in sudden death the great functions are in-
terrupted, but the tonic forces remain for some time.
152 CAPILLARY SYSTEMS,
Q. Mention some'of the effects of sympathy on animal
heat.
#. In syncope it is greatly reduced; in phthisis the
hands and feet burn; in fever the heat is locally or gene-
rally increased. Now, in all these cases, the vital forces
of the parts are sympathetically changed.
Q. How do you account for the sensations of heat in
a part which are so delusive, that the parts to a bystander
feel cold?
fl. This is a sympathy of animal sensibility; whereas
actual increase of heat is a sympathy of organic sensi-
bility.
Q. Why in the natural state of the body is only a cer-
tain temperature developed ?
/?. It is not known ; nor is it known why the pulse beats
a given number of times in a minute, nor why a certain
number of respirations are made in the same time. It
may be said that this is the primitive order of the vital
actions.
II. PULMONARY CAPILLARY SYSTEM.
Q. What do you mean by this pulmonary capillary
system ?
A. Exclusively the system of vessels between the pul-
monary artery and the pulmonary veins.
Q. In regarding this system, what distinction is to be
drawn?
#. That it be not confounded with the capillaries be-
tween the bronchial arteries and veins; they are attached
to the general capillary system.
CAPILLARY SYSTEMS. 153
Q. Considering the difference in capacity between the
general capillary circulation, and that composing the pul-
monary capillary system, how do all the blood of the
first and the chyle and the lymph, pass through the second
or pulmonary system?
/?. Recollect first that all the fluids in the general ca-
pillary system are not blood; that much of the blood in
the capillaries is expended in the functions of the parts
through which it passes, as in secretion, exhalation, and
nutrition; that the course of the blood is irregular in the
general, but direct in the pulmonary capillary system from
the arteries to the veins; that the blood in the pulmonary
capillaries has no function to subserve; that blood flows
much more rapidly and uninterruptedly from the right
ventricle to the left auricle, because the course is shorter
and more direct, than from the left auricle through the
body to the right ventricle ; that the blood gains in time
of passage what is wanting in capillary space.
Q. Why are the lungs so frequently inflamed?
#. Because of direct exposure to irritation in respira-
tion, and because of their active sympathies with other
tissues, especially the skin.
Q. Does the red or black blood become congested in
the lungs, in their inflammation?
Ji. It is reasonable to believe that, from the sudden
manner in which extensive congestions appear in the lungs,
that the bronchial arteries could not supply them; it is there-
fore the black blood which accumulates in congestion.
Q. How can this crowding of the lungs with sangui-
neous congestion be ascertained?
.#. By percussion.
20
154 CAPILLARY SYSTEMS.
Q. What predisposes the lungs to hepatization ?
Jl. The readiness with which they s receive large quan-
tities of fluid.
Q. Is it blood which fills the lungs in disease?
#. It is not; for on pressing diseased lungs, the fluid
will be white, or even purulent.
Q. Are sacs of pus, or vomicse, frequently found in the
lungs?
t#. They are rare; the pus is effused into the substance
of the lungs.
Q. Does the blood, in inflammation of the lungs, enter
vessels naturally conveying white fluids?
#. It is not certain that there are such vessels in the
lungs ; it is most probable that the blood engorges its ac-
customed channels, or it is exhaled into the pulmonary
texture, overwhelming its functions.
Q. How does the whole blood of the body pass through
the destroyed lungs, in phthisis pulmonalis?
*ft. The quantity of blood in the body is diminished in
proportion as the pulmonary lesion progresses; an evi-
dence of this diminution of the quantity of blood is found
in the feeble pulse.
Q. What would be the consequence of transfusing blood
into the vessels of phthisical persons?
Jl. The lungs could not bear any disproportion of blood,
induced in that way.
Q. Would the same objection apply to transfusion in
haemorrhage?
.#. It would not, because in that case there is simply a
want of fluid without lesion of the lungs; the increase by
transfusion would but supply the materials for the pulmo-
nary function.
CAPILLARY SYSTEMS. 155
Q. How does blood-letting act in inflamnYation of the
lungs?
*fl. It acts by decreasing the quantity of blood which
enters the organ; it diminishes the irritation of the vital
forces which draws blood to the part and retains it. You
well know that as irritation in a part is removed, the flow
of blood diminishes.
Q. How does Beclard say the erectile tissue is formed ?
. He says it is composed of small arteries and veins,
which intercommunicate as the capillary net- work does;
and that there is a much greater developmentof the branches
of the veins in the erectile tissue.
( 156 )
EXHALENT SYSTEM.
Q. In what respects do exhalation and secretion agree?
Jl. In this, that both operations separate fluids differ-
ent from the blood.
Q. In what respects do exhalation and secretion differ?
*#. Chiefly in these particulars; that in the secreting
organs there is an intermediate organ between the arteries
and excretories, but there is none between the arterial
terminations and the exhalents; that the secreted fluids
are much more complicated than those which are exhaled;
that exhalation takes place from an infinite number of dis-
tinct vessels, while the secreted fluids are directed to one
or two tubes which convey them from the organ; that the
secreted fluids are thrown off, becoming excrementitious,
while the exhaled are most of them recrementitious ; that
numerous surfaces receive the exhaled matters, while the
secreted are principally poured out on the mucous and
cutaneous.
Q. Name some of the exhaled fluids.
/?. There is the fat, and the serum, the synovia, the
marrow.
Q. Now indicate some of the secretions.
*#. You have the bile, urine, semen, pancreatic fluid,
saliva, and others.
Q. What do you mean by exhalents?
*ft. They are small tubes or vessels arising from the
capillary system, continuous with the arteries which bring
them the materials for exhalation.
EXHALENT SYSTEM. 157
General Arrangement of the Exhalents.
Q. How are the exhalents divided?
*fl. Into three orders; those terminating on the outlets
at the cutaneous and mucous surfaces, those which termi-
nate on the internal organs, and those which convey the
nutritive matter.
Properties and Functions of the Exhalent System.
Q. What are the properties of the exhalents?
Jl. Destitute of animal sensibility and animal contrac-
tility, their vital properties on which their functions de-
pend are organic sensibility and insensible organic con-
tractility.
Q. How is it that the exhalents of the different organs
and surfaces pour out uniformly their appropriate fluids?
#. As the blood whence the exhaled fluids are derived,
is in all organs the same, the power by which each organ
separates its own fluid must result from peculiarity in the
organic sensibility and contractility of these organs.
Q. Will you be more explicit on this subject?
t/#. It is either because the blood whence the exhalation
proceeds is specifically distinct in the various surfaces, or
the vital properties of the solids so differ as to produce the
various exhalations. There is nothing concerned in the
process but the blood and the solids which it stimulates.
Q. To what has exhalation been ascribed ?
#. To a distillation through the coats of the arteries.
Q. How do you account for morbid or altered exhala-
tions?
158
EXHALENT SYSTEM.
/?. They depend on deranged organic sensibility, a
change of relation between it and the blood.
Q. How is this organic sensibility deranged in the ex-
halents?
#. By the direct impression of irritation, by sympa-
thetic power, and in an unknown way.
Q. Give an instance of direct irritation of the exha-
lents.
\ft. You see it in the action of cold on the skin.
Q. Give an example of sympathetic impression on the
exhalents.
t/2. An instance is found in, the sweating which is in-
duced by pain in the fibrous and muscular tissues.
Q. What exhalents are exclusively exposed to direct
stimulation?
#. The exhalents of the skin and mucous membranes;
besides this exposure to direct irritation, they are liable
to the sympathetic derangements; and hence they are more
frequently diseased than any other exhalents.
Q. Are all the exhalations simultaneously diminished
or increased?
#. In fever they are all diminished. As a general rule,
when one exhalation is increased another is diminished;
as you see the hectic sweats in phthisis diminished by the
dropsical infiltrations which come on in the last stages of
the disease.
Q. How are morbid exhalations divided?
#. Into those attended with exalted vital forces, and
those where these forces are diminished.
Q. What are preternatural exhalations?
*fl. Any discharges from the exhalents which differ
from the natural.
EXHALENT SYSTEM. 159
Q. What exhalents most frequently pour out blood?
t/?. The mucous.
Q. What are the evidences that these mucous haemor-
rhages are exhalations?
/?. The mucous surfaces, though minutely examined
after death, show no ruptured points; pressure on the
uterus after death during menstruation exhibits an issue
of bloody drops, but no rupture can be seen; the womb
would exhibit a surface of cicatrices, if haemorrhages pro-
ceeded from erosion; the sudden translation of haemor-
rhages from one part to another, under sympathetic laws,
tend to confirm the doctrine of exhalation rather than rup-
ture; the causes of haemorrhage from rupture are so dif-
ferent from those of spontaneous haemorrhage; and lastly,
these accidental haemorrhages are not under the laws of
sympathy, as the spontaneous are.
Q. What is the anatomical distinction between haemor-
rhage and inflammation?
t/?. In inflammation the blood accumulates in the capil-
laries; in haemorrhage the blood passes out from (he arte-
ries l>y the exhalents.
Q. Is it not probable that the irritation is differently
located in the two diseases?
Ji. Perhaps it is seated in different vessels in haemor-
rhage and inflammation.
Q. What proof have you that in active haemorrhage the
organic sensibility is altered?
*fl. The previous symptoms of heat, pain, itching, show
that it is altered.
Q. In passive haemorrhages how are the vital forces of
the exhalents affected?
160 EXHALENT SYSTEM.
.#. The organic sensibility and insensible organic con-
tractility are diminished.
Q. What locality has haemorrhage in organic disease?
A. Proximity to the mucous surface governs it; for in-
stance, when the liver is diseased, the haemorrhage will be
from the mucous expansion of the stomach or intestines;
when the heart is diseased, the bleeding will be from the
pulmonary mucous tissue.
Q. Does the whole mucous tissue ever pour out blood
at one time?
ft. Never.
Q. Why are the mucous tissues so liable to haemor-
rhage ?
/?. The short course of the blood in the capillaries to
the mucous surfaces, and the general fulness of these tis-
sues with blood.
Q. Which mucous surfaces are least liable to haemor-
rhage ?
/?. Those lining the sinuses of the face and ear.
Q. Is plethora necessary to active haemorrhage?
#. It is not; for a mere local increase or alteration oi
the vital forces will produce it. Hence there may be ac-
tive haemorrhage without plethora.
Q. How will you account for the varieties in the quan-
tity of the menstrual discharge ?
A. It varies as the vital forces of each uterus do.
Q. What essential difference must be observed in the
treatment of capillary and exhalent haemorrhage, and ar-
terial ?
Jt. In the haemorrhage from the two first named sources,
medicines which act on the organic sensibility of the part
EXHALENT SYSTEM. 161
are successful ; but in the case of the bleeding artery they
have no effect.
Q. How do you know that blood found in serous cavi-
ties is exhaled?
ft. Because, after the most critical examination, no ero-
sion could be ascertained.
Q. What serous cavities are least liable to these bloody
exhalations?
ft. The tunica vaginalis testis, and the tunica arach-
noides.
Q. Are the, bloody exhalations in serous cavities always
from active haemorrhage ?
ft. The exhalation of blood in these cavities is some-
times passive.
Q. Does the water in anasarca being reddish, imply
active haemorrhage or febrile dropsy ?
A. It does not, for the fluid of dropsy is often of this
reddish hue in passive cases.
Q. Are preternatural exhalations uniform?
ft. They vary very much, as you may see in the vari-
ous aspects of fluids in the different serous cavities.
Q. Why are not secretions exhaled as well as fat, se-
rum, and other fluids?
ft. Because the glandular apparatus is different from the
exhalent.
Q. How does Mascagni suppose exhalations to be
made?
<ft. By lateral pores in the vessels.
( 162
ABSORBENT SYSTEM.
Q. What do you mean by the absorbent system?
/?. It is a series of vessels, .uniting in trunks, and en-
larging occasionally, so as to form what are improperly
termed glands.
Of the Msorbent Vessels.
Q. Where do the absorbents arise ?
/?. They take their origin from every part of the body.
Q. Where do the trunks of this system of vessels ter-
minate?
#. In the vena cava of the black blood system.
Q. Why are the enlargements of these vessels impro-
perly called glands?
*/2. Because they do not pour out fluids by excretories
arising from them.
Q. What is the general division of the absorbents?
#. Into the exterior and interior absorbents.
Q. What is the difference between the exterior and in-
terior absorbents?
rf. The external absorbents do not take up the fluids
exhaled; those on the skin do not absorb the perspiration ;
nor do the mucous absorbents take up the pulmonary or
gastric exhalations. They absorb foreign matters. The
internal absorbents are constantly engaged in taking up
what is exhaled.
ABSORBENT SYSTEM. 163
Q. What is it that renders absorption of the solids
practicable for such delicate vessels as the absorbents?
.tf. Solids, like fluids, are composed of minute par-
ticles, and vessels remove a particle of the one as they do
of the pther.
Q. In what system do the absorbents arise?
tfi. Of course they arise in the capillary tissue.
Q. How are the absorbents of the extremities divided ?
'&. Into the superficial and the deep-seated.
Q. How are the absorbents of the trunk divided?
t#. Into the superficial and deep-seated of the parietes
of the trunk of the body; and into the superficial and deep-
seated of the viscera.
Q. Where have they not yet been found ?
#. In the cavity of the cranium.
Q. In form how do the absorbents differ from the
veins?
#. The absorbents do not enlarge in their course as
the veins do; they compensate for their small size by the
number of tubes.
Q. How can you have the best natural view of the ab-
sorbents?
#. By examining the concave surface of the liver, very
speedily after opening the abdomen of the dog or other
large animal.
Q. In what disease are they often remarkably enlarged ?
/?. In dropsy.
Q. What constitutes the difficulty in deciding on the
capacity of the absorbents?
Ji. The same as in the case of the veins; both veins and
absorbents are so extensible and contractile, as to be ever
varying in size.
164
ABSORBENT SYSTEM.
Q. Do they resemble the veins in any other respects?
*#. They resemble them in their frequent anastomoses;
in the aids the motion of their fluids require and receive
from adjacent pressure, and in the influence of gravity on
their fluids.
Q. Why are the legs more swelled, in dropsy, in the
evening than in the morning?
*#. Because of the influence of gravity on the absorb-
ents debilitated by disease.
Q. Why does the arm swell more from pressure of the
head of the humerus in the axilla in certain cases, than
when extensive pressure is made on the upper part of the
arm?
*#. Because in the axilla a greater number of absorbents
are compressed, and swelling of the limb below them
rather depends on this circumstance than on the extent of
the surface compressed.
Q. What visceral enlargement has the greatest influence
in tumefying the lower extremities?
#. That of the uterus, because in its enlargement it com-
presses the greatest number of absorbents.
Q. Have the other abdominal viscera the power of pro-
ducing infiltration by this pressure ?
#. They have not; and when this infiltration arises in
the diseases of other viscera, it is not from pressure but
from an increase in the vital forces of the exhalents.
Q. What has heretofore been the ascribed cause of
dropsy from these visceral enlargements?
*#. It was ascribed to an obstruction of the venous
blood causing effusion ; but it is really owing to an ob-
struction to the absorbents.
Q. What is the structure of the absorbents?
ABSORBENT SYSTEAf. 165
ft. A dense cellular coat, and a lining membrane con-
tinuous with that of the veins. There is no fleshy fibre ob-
servable in the absorbents.
Q. What are the peculiarities of this internal lining
membrane of the absorbents?
ft. It is in the dead body bedewed by an unctuous, and
in the absorbents of the external surface of the lungs fre-
quently covered with a white matter which resembles
plaster.
Of the Lymphatic Glands.
Q. What peculiarities attend the situations of the lym-
phatic glands?
Jl. They are most abundant where cellular texture
abounds, and they are more numerous as they approach
the common trunks.
Q. What is the colour of the glands?
ft. They are red in childhood, gray in adult life, and
yellowish in old age.
Q. At what period of life are they most developed?
ft. They are more fully developed in childhood; they
are least so in old age.
Q. These glands have a common and a peculiar texture
what are they?
ft. The common texture is a loose and dense cellular
investment; the peculiar texture is a pulpy matter, of
greater or less density, resembling the pulp of the nervous
ganglions.
166 ABSORBENT SYSTEM.
Properties of the Absorbent System.
Q. What properties of texture do the absorbents and
glands possess?
*fl. Extensibility and contractility.
Q. What vital properties attach to them?
*#. But little animal sensibility in health, but consider-
able in diseases. They have no animal contractility. Ob-
viously, they have organic sensibility and insensible or-
ganic contractility.
Q. What remarkable phenomenon attends these two
last named properties in the absorbents?
/?. The organic sensibility and the insensible organic
contractility continue some hours after death in some bo-
dies; or in other words, absorption continues after death.
Q. How does the organic sensibility of the absorbents
differ from that of the glands?
#. In the absorbents it is in relation to many fluids;
glands admit but one.
Q. What difference appears between the lining mem-
brane of the absorbents and that of the veins?
#. The greater susceptibility of the first to inflamma-
tion.
Q. What is a common consequence of inflammation of
the lymphatic glands?
t/2. Scirrhus hardness much more frequently follows
inflammation in them than in other structures.
Q. What shows a difference between the vital proper-
ties of the absorbents and lymphatic glands?
Jl. The fact that the glands are so frequently inflamed
by matters which do not affect the absorbents.
ABSORBENT SYSTEM. 167
Q. What are the usual causes of inflamed lymphatic
glands?
Jl. The absorption of matter, and sympathetic impres-
sion.
Q. Give instances of sympathetic affection of the glands.
A. You see them in axillary or inguinal swelling pro-
ceeding from the prick of a thorn, a blister, or any other
irritant of that kind.
Q. In what way are the lymphatic glands most fre-
quently inflamed ?
*#. They take on inflammation in the progress of orga-
nic visceral disease; the glands partaking of the acute,
chronic, or specific action, which prevails in the viscus. In
mammary cancer the axillary glands are diseased; in
scirrhus stomach, or diseased liver, the mesenteric glands
are affected, and so forth.
Q. How does an enlarged strumous lymphatic gland
differ from one enlarged by ordinary causes?
Jl. In the strumous enlargement the structure of the
gland is at first affected; in those enlarged by ordinary
causes, it is secondarily involved. The scrofulous glands
have a whitish substance, which finally destroys the whole
gland.
Of Absorption.
Q. Why do you suppose the action of the absorbents
to depend on vital, and not on capillary power?
Jl. Because fluids are received or rejected according to
their relation to the organic sensibility of the absorbents;
they have a peculiar organic sensibility.
16$ ABSORBENT SYSTEM.
Q. How do medicines act in producing absorption?
J%. By increasing the organic sensibility of the absor-
bents; and such are the variations in the degrees to which
organic sensibility can be raised, as to account for the ab-
sorption of the various fluids.
Q. Will these considerations account for the introduc-
tion of morbific matter by the lungs and lacteals?
ft. They will; for if the organic sensibility of the lac-
teals, or of the pulmonary absorbents be increased, they
will take in matters which in their healthy state would be
rejected.
Q. What circumstances vary the natural type of the
sensibility of the absorbents?
#. Direct causes, such as frictions to the skin ; and
sympathetic causes, as when the absorbents are acted on
by a distant viscus.
Q. What conspicuous difference appears in the chan-
nels of the veins and absorbents?
*ft. The fluid in the absorbents has to pass through nu-
merous glands, in each of which is a kind of capillary
system; this, while it affects the course of the lymph, may
also when the glands are diseased, change the quality of
the lymph. The veins have no such glands to pass through
in their progress to the heart.
Q. What three phenomena always accompany each
other in the organs?
J2. Great development, attended by activity of func-
tion, these giving rise to disposition to disease.
Q. What reference has the answer to the last question
to the absorbent glands?
#. In childhood there is great development of the ab-
ABSORBENT SYSTEM. 169
sorbent system; at that period of life, the functions of this
system, whatever they may be, are in great activity, and
there is great disposition to disease at the same time.
Q. What period of life limits the predominance of the
lymphatic glands ?
A. Puberty.
Q. At what ages do external absorption and nutritive
absorption predominate ?
/?. In childhood and youth the external absorbents are
most active; in advanced life the nutritive absorption is
greatest.
Q. Explain this expression, nutritive absorption.
A. By it is meant that preponderance of absorption in
advanced life over nutrition, which leads to the emaciation
of age.
Q. Why do encysted tumours increase so regularly,
and in some cases so rapidly?
t/2. Because absorption in them is feeble compared to
exhalation.
Q. What, according to Beclard, is the actual structure
of a gland ?
*#. There are vessels going to and from the gland; they
communicate as the veins and arteries do; and there are
little cavities or sacs somewhat resembling the cells of
the erectile textures.
Q. Is it certain that, as Bichat thinks, the absorbents
do not possess sensible organic contractility ?
/?. German physiologists have ascertained that certain
irritants occasion a contraction of the thoracic duct; and
as this does not result from the horny hardening, it is le-
gitimately ascribed to sensible organic contractility.
22
170 ABSORBENT SYSTEM.
PATHOLOGY or THE ABSORBENT SYSTEM.
Q. What are the diseases of this system ?
#. Inflammation, induration, scrofula, ossifications, can-
cer, lymphatic varix, sympathetic bubo.
Q. How should this tissue be divided in considering its
diseases?
/?. There are the diseases of the lymphatic glands, as
they are improperly termed, and those of the vessels.
Q. At what period of life are these diseases most fre-
quent?
/2. In childhood; they are infrequent in age.
Q. What are the divisions of diseases of this tissue?
A. They are idiopathic and symptomatic diseases.
Q. Divide the inflammations of the lymphatic glands.
.#. They are acute and chronic, simple or specific.
Q. How is this inflammation excited?
*#. By a remote irritant, or by absorbing a poison
which comes into contact with a gland.
Q. Is the absorbent which conveys a poison to a gland
necessarily inflamed thereby?
*/?. It is not; the gland may be inflamed alone, or both
vessel and gland may be.
Q. What glands are most liable to inflammation ?
*/?. Those of the axilla and groin.
Q. What peculiarity is there in the symptoms of in-
flamed glands?
Jl. The pain is less acute, and the progress slower than
in phlegmon.
Q. Where is the matter formed in a lymphatic gland ?
ABSOHBENT SYSTEM. 171
fL la the centre of it. The gland is not disorganized,
but enlarged and inflamed.
Q. What absorbent vessels are principally inflamed ?
J3. Those of the inferior extremities.
Q. Where is the scrofulous affection of this tissue most
common?
ft. In the abdomen, thorax, and neck.
Q. What occasions marasmus in tabes mesenterica?
ft. The gradual diminution in the absorption of the
chyle, owing to progressive destruction of the function
and organization of the mesenteric glands.
Q. How is the dyspnoea from tabes mesenterica pro-
duced?
*ft. By co-existent though consecutive disease in the
lymphatics of the lungs.
Q. What are the progressive stages in the scrofulous
disease of a lymphatic gland?
ft. The gland is first in chronic inflammation; next it
is in part steatomatous, then it is completely steatomatous,
and lastly it degenerates into the formation of bad pus and
ichorous fluid. In adopting this view, ascertain whether
the scrofulous degeneration is altogether steatomatous.
Q. Why are not scrofulous swellings of the neck fatal?
- ft. Because their progress is bounded by parts not dis-
posed to take on disease, or not vital if they do.
( 172 )
OF SYSTEMS PECULIAR TO CERTAIN
APPARATUS.
Q. What systems have heretofore been considered?
*#. Such as may be termed primitive; such as are com-
mon to all parts; those which form the nutritive paren-
chyma.
Q. What tissues remain to be considered?
ttf. Those which belong to special purposes in the ani-
mal economy.
Q. Explain this more particularly ?
#. While the above systems are general, there are cer-
tain others which are not so, but are appropriated to cer-
tain functions separately or conjointly. You observe that
the bones, muscles of animal life, the cartilages and fibrous
tissue appertain to locomotion; while the serous, mucous,
and organic muscular systems are particularly directed to
digestion, respiration, and circulation. So it is likewise
with the glandular tissue which belongs to secretion; other
examples might be adduced.
Q. What further difference is observed?
t/2. The primitive are universally found and are conti-
nuous, as the cellular tissue ; the special tissues are insu
lated, and separated from each other by the intervention
of organs, as the bones.
( 173 )
OSSEOUS SYSTEM.
Q. What is this system?
t#. A tissue characterized by hardness and resistance,
admirably calculated for a base, support and protection of
the soft parts.
Forms of the Osseous System.
Q. What are the forms of the bones?
.#. They are long, flat and short.
Q. To what purpose in the animal economy are the
long bones principally appropriated?
/?. To that of locomotion.
Q. Where are the longest bones found?
#. In the superior parts of the upper and lower extre-
mities. The bones diminish in their length, but become
more numerous as you approach the fingers and toes?
Q. What is the consequence of this location of the long
and short bones?
.#. That the superior part of the extremities has the
most extensive motion, while the inferior part has the
greatest number and variety of limited motions.
Q. What is the general conformation of these long
bones?
/?. They are larger at the extremities tlwin in the shaft,
which last is usually rounded.
Q. What advantages result from these enlarged extremi-
ties of the long bones?
174 OSSEOUS SYSTEM.
#. They prevent dislocations, and preserve the sym-
metry of the limb to which they are attached.
Q. What general features are conspicuous in the bodies
of the long bdnes?
t#. The ridges for the implanting of aponeuroses; and
the twist in most of these bones.
Q. At what period is the medullary canal formed ?
ft. At the period of ossification; it does not exist at the
earliest foetal periods. It is not found while the bone is
cartilaginous.
Q. How is this canal formed?
Jl. By the absorption of the gelatine in the centre, no
more of which is exhaled. Observe the different processes
which take place at the same time in the exterior and in-
terior of the bone; for, while the absorbents remove the
gelatine and thus form the medullary canal, and the exha-
lents cease to deposite gelatine, the exhalents on the ex-
ternal surface of the bone are placing a wall of phosphate
of lime to give the bone firmness and smoothness.
Q. In what bones is the medullary canal found?
*ft. In the humerus, in the radius, in the ulna, in the
femur, in the tibia, in the fibula, and in the clavicle.
Q. What is the form of the canal ?
/#. It is cylindrical and straight.
Q. What are the uses of the medullary canal?
t#. It gives lodgement and protection to the medullary
organ, and renders the bone stronger; for a hollow cylin-
der will be less apt to break or bend than a full one.
Q. What would be the inconveniences of a solid cylin-
der for the shaft of a bone? "*
#. They would impede the motion of the limbs, it
OSSEOUS SYSTEM. 175
solid, and of the dimensions of the hollow cylinder; and
if smaller and solid, there would not be surface enough
for the insertion of muscles and aponeuroses.
Q. How is this medullary canal affected in fractures?
#. When callus is first formed, gelatine is so deposited
as to close the canal; but this gelatine is subsequently ab-
sorbed, and the continuity of the canal reinstated.
Q. What purposes do the flat bones serve in the sys-
tem?
*#. They are especially appropriated to form cavities.
Q. Are the cavities usually formed of one or many
bones?
*ft. Of many bones; and hence, in part, their solidity,
and the limits set to their fractures.
Q. Why are fractures of all the bones more infrequent
in children than in adults?
#. Because ossification being incomplete, the bones
yield rather than break.
Q. What is the form of the flat bones?
t#. They have a convex and concave surface. The
curve forms in age a bony arch; a mechanism powerful
for strength and protection.
. Q. At what part is a flat bone thinnest?
.#. It is thinnest in the centre; the circumference being
thickest, forms a broader surface for union, and offers
points for muscular origin in some bones, as the spine of
the ilium.
Q. Are there cells in the flat bones?
#. There are; they are between the two layers.
Q. What purposes in the oeconomy are attained by short
bones?
//. The two great ones of solidity and mobility; hence
176 OSSEOUS SYSTEM.
these bones are found in the spinal column, and in the
hands and feet.
Q. How does their number give solidity or strength ?
#. The bands requisite to unite them are so frequent
and strong as to produce these effects.
Q. And how does their number give mobility?
*ft. Their individual motions tend to communicate ge-
neral mobility.
Q. What is their general appearance ?
*ft. They are very rough, with cavities and eminences
for their articulations, for their muscles and ligaments.
Q. What is their internal structure?
*ft. They are almost entirely cellular.
Q. What influence has this structure on the diseases of
these short bones?
#. It renders them liable to frequent caries.
Q. What is the general name of the bony eminences?
ft. They are usually denominated apophyses.
Q. What do you mean by epiphyses?
<ft. They are points of bony eminence, which are not
entirely united to the principal bone by calcareous union;
epiphyses are united to the bone by cartilage.
Q. How are the bony eminences divided?
#. Into four classes; those of articulation, of insertion,
of reflection, and of impression.
Q. What are attached to the eminences of insertion ?
#. The fibrous organs exclusively, such as ligaments,
tendons, &c.
Q. Where do you find these eminences of insertion
most conspicuous?
#. In strong men, in carniverous animals. The size
of these protuberances indicates the strength of the animal.
OSSEOUS SYSTEM, 177
Q. What do you mean by an eminence of reflection?
ft. One under which a tendon passes when it deviates >
from its original course.
Q. What are the external cavities of bones and their
uses.
ft. They give increased space for aponeurotic and liga-
mentous insertions; they receive, lodge, and protect organs
or portions of organs; they form grooves for the passage
of tendons; they transmit nerves and blood-vessels through
the bones, and those vessels which nourish the bones.
Q. Are these grooves for the tendons, for example, those
at the ends of the long bones, formed by the friction and
pressure of the tendons, or are they of natural, primitive
osseous development?
ft. If formed by the friction of tendons, they ought to
be deep or superficial in proportion to the action of the
muscles and the age of the subject; they should not be
found in the foetal cartilages; they would be very slight
in infancy; on the contrary, they are fully developed at
all periods of life, and are therefore original.
Q. How are the cavities or foramina of nutrition in the
bones divided?
ft. There is that in the body of the bone which con-
veys nutrition to the medullary canal; there are those
which nourish the cellular structure at the ends of the
bones; and there is a third set, viz. those which supply the
compact texture.
Of the Organization of the Osseous Texture.
Q, What is the texture peculiar to the osseous system?
23
178 OSSEOUS SYSTEM,
*fl. It is fibrous. The fibres being differently arranged
so as to constitute the loose or cellular, and the compact,
bony structure.
Q. How is the cellular bony structure formed?
/?. Unknown in the first periods of ossification, the
cells appear in consequence of the absorption of the solid
mass of cartilage, and in its place are deposited by exha-
lation transverse bony fibres, which, by interlacing in
every direction, and no more gelatine being thrown out,
leave the cavities which are the cells of bones.
Q. Can you present a clear illustration of your last an-
swer?
Jl. The os ethmoides is at one period a solid cartilage,
but under the laws and in the process of ossification, the
interlacing bony fibres are exhaled, and the cartilage ab-
sorbed leaving cells.
Q. Do the cells communicate with each other?
*#. Conclusive experiments prove that the cells through-
out the interior of a bone communicate universally.
Q. How does the compact texture of bones differ from
the cellular texture ?
*#. The fibres of the compact texture are in dense juxta-
positipn.
Q. How do these compact fibres run in the long, flat,
and short bones?
*#. These bony fibres are longitudinal in the long, radi-
ated in the flat, and run in every direction in the shortbones.
Q. Do the fibres of this texture, in the apophyses, pur-
sue the same direction as in the main bone?
#. They do not; in some apophyses they are longitu-
dinal, in others the course is entirely irregular.
OSSEOUS SYSTEM. 179
Q. Are the bones larnellated in their compact structure ?
Ji. They are not. If they exfoliate in scales, it is by
an abnormal process, not by the separation of the natural
structure; again, exfoliation does not always assume the
form of scales or layers, for it sometimes takes place in a
direction differing from the course of the supposed layers.
The structure is one of condensed fibres.
Q. What is Beclard's opinion as to the laminated struc-
ture of the bones in general?
#. He thinks, that from a general view of experiments,
that the structure is laminated, connected with fibres, and
with small areolated spaces abounding between laminated
fibrous structure.
Q. How does a bone become affected with rachitis?
*#. In some degree by the absorption of the phosphate
of lime, perhaps too by a diminished exhalation of it;
but this diseased state arises principally from a separation
of the osseous fibres from each other, by which a cellular
instead of a compact bony texture is formed.
Q. What is the usual general arrangement of the spongy
and compact texture of the bones?
#. The compact texture is the exterior, and the cellu-
lar the interior part of the bone.
Q. Is there no exception to this rule?
ft. It is inverted in the case of the spongy bones of the
nose.
Q. Where is the compact texture of the long bones
greatest?
.#. It is greatest in the middle of the bones.
Q. And why. is it so ?
#. That it may give solidity to the bones, and enable.
180 OSSEOUS SYSTEM.
them to resist fractures where they are most exposed to
them, and that the size of the bone may be reduced, where
such reduction is necessary, without injuring its strength.
Q. What is the reticular texture of the bone?
/#. It is a delicate modification of the cellular texture;
and it supports the medullary texture of the bones, and
offers points of insertion to the membrane of the medulla.
Q. How is a light cellular structure at the ends of the
bones advantageous?
/#. The weight of heavy compact structure at the ends
of the levers would be difficult to raise, and thereby im-
pede locomotion.
Q. Where are the compact and cellular structures found
in the flat bones?
/?. The compact is in the centre, the cellular is at the
periphery.
Q. What texture prevails in the short bones?
#. The cellular structure principally forms them.
Q. Of what do the osseous protuberances consist?
#. Principally of compact texture.
Q. What are the elements which enter into the com-
position of the osseous texture?
t/?. A calcareous and gelatinous substance.
Q. What is this calcareous substance?
/?. It is the phosphate of lime; and there are a few
other unimportant saline matters that enter into the com-
position of bone.
Q. Is the proportion of the constituent parts of bony
structure uniform ?
/?. It is not; on the contrary, it varies much. The teeth
have much more earthy substance than other bones.
OSSEOUS SYSTEM.
181
Q. Is the softer substance plire cartilage or gelatine?
#. That it is fibrous texture cannot be doubted ; it is
neither exclusively cartilage nor gelatine; the phosphate
of lime is deposited between these fibrous spaces, and thus
constitutes bone.
Q. What part of the bone possesses vitality and affords
nutriment?
Ji. The gelatinous substance.
Q. What vessels deposite the calcareous bony matter?
#. The red blood-vessels.
Q. Does a different set of vessels deposite the gelatine?
A. It is poured out by white vessels.
Q. What is the aspect of osseous vascularity, at different
periods of life?
/2. The vascularity of the bones diminishes with age,
and with this diminution of vascularity is a corresponding
declension in the readiness to form callus.
Of the Properties of the Osseous System.
Q. What are the physical properties?
#. The bones are extremely solid, and hard ; in the
bones of young persons there is slight elasticity, which is
entirely lost in advanced life.
Q. Do the bones possess or exhibit textural properties?
t#. Bichat supposes that in spina ventosa extensibility
of bony texture is manifested ; and this is also exhibited
in the distention of the antrum with polypus. On the
contrary, the alveoli contract when the teeth are removed;
the orbit contracts when a cancerous eye has been re-
moved.
182 OSSEOUS SYSTEM.
Q. What are the vital properties of the bones?
+3. They have no animal sensibility in health, but ma-
nifest it in very great degree in disease. They have no
animal contractility; they are destitute of sensible organic
contractility. One would scarcely admit an insensible or-
ganic contractility in the firm structure of bones.
Q. On what does the vitality of the osseous tissue de-
pend?
/?. It is dependant on organic sensibility and insensible
organic contractility. These two properties they certainly
possess.
Q. What influence has the obscurity of the osseous vital
properties on the diseases of that texture ?
t/2. The vital properties of the bones are slow in the
production and prosecution of diseased action.
Q. There are two sets of symptoms in all acute diseases,
what are they ?
/?. Those that relate to the affected organ, and those
that sympathetically connect this organ with the vital
forces of other parts.
Q. Are the bones readily acted on by the vital forces
of other organs?
/?. They are not; they remain unaffected. Their vitality
does not admit of the sudden alterations in acute diseases.
Q. In what part of the osseous tissue are the vital pro-
perties seated?
/#. In the cartilaginous or gelatinous substance.
Q. What produces a morbid brittleness in the bones?
#. A deposition of phosphate of lime, in quantity dis-
proportioned to the gelatiiie.
OSSEOUS SYSTEM. 183
Articulations of the Osseous System.
Q. How are the general classes of articulations divided?
Jl. Into those with, and those without mobility.
Q. To what purposes are the articulations with mobility
directed?
Jl. They belong to the bones of locomotion.
Q. Where are those without mobility found?
*ft. In the bones whose union forms cavities to defend
the important organs.
Q. What motions do the articulations with mobility
allow ?
ft. There are four motions, viz. of opposition, circum-
duction, rotation and sliding.
Q. What do you understand by the motion of opposi-
tion?
#. It is simple flexion and extension abduction and
adduction.
Q. What is the motion of circumduction?
A. Circumduction is a movement in which the bone
describes a kind of cone, the apex of which is in the su-
perior articulation, and the base in the inferior. Circum-
duction comprises all the motions of opposition.
Q. How does rotation differ from circumduction?
#. In this, that in circumduction the bone has loco-
motion, in rotation there is none; in rotation the bone
turns on its own axis.
Q. What is the sliding articulation?
A. It is a motion appertaining to all the articulations,
and one described by the term.
184 OSSEOUS SYSTEM.
Q. What indicates the disposition to luxation in an ar-
ticulation?
/?. The number and freedom of its motions.
Q. What articulations afford extension, opposition, cir-
cumduction, and rotation?
ft. The humerus and scapula, the femur and ilium.
Q. What advantages arise from the location of these
extensive motions at the upper part of the extremity?
tfl. The joints are less exposed to accident and luxation;
the powers of motion being located in the superior articu-
lations, the whole limb has extensive motion, thereby
making up for the necessarily limited motion of the joints
below.
Q. What form of articulating surfaces is necessary for
these extensive motions?
./?. That the receiving surface should be concave, and
the moveable one convex.
Q. What are the principal differences between the mo-
tions of the humeral and femoral articulations?
/2. In the humeral there is much circumduction, but
little rotation; in the femoral there is much rotation, but
little circumduction. There is pronation and supination
for the hand to compensate for the want of rotation in the
humeral articulation; while the rotation of the femoral ar-
ticulation renders pronation and supination unnecessary,
in the lower extremity.
Q. On what principle in the mechanical arrangements
of the articulations, does the facility of circumduction de-
pend?
*ft. It depends on the " axis of the bone, and that of the
motion being the same," as is seen in the humeral articu-
OSSEOUS SYSTEM.
185
lation, where there is much circumduction. The circum-
duction of the femur is impeded by the distance of the
axis of motion from that of the bone being the whole
length of the neck of the thigh bone.
Q. Give examples of articulations in which opposition
and circumduction are alone met with.
Jl. In the angle of the jaw is a conspicuous one; you
see others in the wrist and radius, in the first phalanges.
Q. Mention instances of the motion of opposition con-
fined to one direction, without circumduction and rotation.
A. The knee, the elbow, second phalanges of the fin-
gers. These articulations are found in the middle joints
of limbs,
Q. What conformation marks these articulations of
opposition, without circumduction or rotation?
A. Prominences, such as condyles on the articular sur-
faces j or eminences and cavities fitted for each other;
these, with some other arrangements, prevent other mo-
tions than those just mentioned. These articulations are
remarkable for breadth of surface.
Q. Why are luxations of these articulations more dan-
gerous than others?
<ft. Because so many bands and ligaments are torn up
in their dislocation.
Q. On what side is there the greatest motion in these
articulations?
#. On that of flexion; hence the strength of the flexor
fibres, and also the location of the nerves and vessels for
security.
Q. Can you give examples of articulation with rotatory
motion alone?
24
186 OSSEOUS SYSTEM.
*#. v The ulna with the radius rotates only, the atlas
with the dentatus; in these, luxation is very difficult.
Q. Where do you find the articulations with sliding
motion alone?
<ft. They are very numerous; the vertebra? on each
other; the carpus and metacarpus; the tarsus and meta-
tarsus; the sternal end of the ribs.
Q. What do you mean by the immoveable articulations?
Ji. Those where surfaces of juxta-position are so
wedged in as to retain the part; as the malar bone con-
fined between several other bones of the face. There is
an order of indented articulations immoveable as by suture;
there is another with implanted surfaces, as the teeth.
Q. What effect has age on the articulation by suture?
./?. It obliterates the suture by bony union.
Q. Why do not the teeth unite to their sockets by
age?
#. Because there is an intervening mucous membrane
not disposed to ossify. The teeth constitute the only or-
der with implanted surfaces.
Q. What preserves the union of the immoveable articu-
lations?
.#. Cartilages and membranes. The cartilages are
most conspicuous in infancy.
Q. How are the moveable articulations united?
Jl. By ligaments and muscles; these bonds of union are
freer in youth than age.
Q. How does the office of cartilage differ in the im-
moveable and moveable articulations ?
Jl. It is a bond of union in the first, and facilitates mo-
tion in the second,
OSSEOUS' SYSTEM, 187
Development of the Osseous System.
Q. At what period is ossification complete ?
*#. From the eighteenth to the twentieth years.
Q. What are the states of the bones during growth?
#. There are the remarkable states of the osseous tex-
ture; viz. the mucous, the cartilaginous, and the osseous.
Q. At what period do you see the mucous state?
A. It appears in the earliest periods of the development
of the embryo, and continues till the vessels commence
conveying gelatine. The cartilaginous state succeeds this,
and finally the deposition of phosphate of lime takes place.
Q. What is the first indication of calcareous deposition?
#. The appearance of red blood in the cartilaginous
bed of the bone. This blood enters vessels which formerly
conveyed gelatine. There is always in the process of
earthy exhalation a red layer which is vascular, between
the cartilage and that portion of the bone where calcare-
ous deposition has taken place.
Q. Why do the vessels which once conveyed white
fluids, afterwards admit red blood ?
/2. Such is the fact in the deposition of calcareous mat-
ter in ossification, and it proceeds from a change in the
relation of the vital forces of the vessels to the fluids, re-
ceiving at one time white, at another red fluids.
Q. At what period does the osseous state commence?
/?. It appears first in the clavicle, the ribs, &c. about
the end of the first month.
Q. Where do the long bones increase in length?
/?. Only at the extremities, not in the middle. An ac-
188 OSSEOUS SYSTEM.
curate experiment, made by Mr. Hunter, proves this; he
bored holes in the middle of a long bone, and although
the bones had grown considerably longer, the holes were
no farther apart.
Q. In what way does a bone grow after the twentieth
year?
#. It grows in thickness. Observe the difference in a
thigh bone eighteen years old and one of forty.
Q. What evidence is there that exhalation and absorp-
tion go on in the bones ?
t/2. The experiment of feeding with madder makes this
manifest; this colouring substance is alternately deposited
and removed. It is never coloured when gelatine alone is
in the bone; now this proves that the calcareous exhala-
tion is the vehicle of it.
Q. Can you, by giving gelatine or phosphate of lime,
supply a defect of these constituents in the bony system?
*#. No; unless you can bring the organic sensibility of
the exhalents of the bones in due relation to the blood
containing these principles, the vascular system of the
bones would reject it.
Q. What changes take place in the bones of old persons?
J2. They become of a grayish colour, and they are hea-
vier in old people, owing to the preponderance of calca-
reous deposition.
Q. Beclard mentions a cause of the brittleness of bones
in advanced life, what is it?
*ft. Usually, as the medullary canal enlarges, so does .
the exterior of the bone; but sometimes, in advanced life,
the canal continues to enlarge, at the expense of the thick-
ness of the walls, and hence the bone is more brittle.
OSSEOUS SYSTEM. 189
Q. What organs are most prone to take on the process
of ossification in advanced life?
Jl. Those, the nutritive matter of which, is habitually
gelatine, as cartilage. The exception to this is the arterial
ossifications which so commonly take place.
Q, How many periods are there in the development of
callus?
t#. There are three; the formation of cellular granula-
tions, the change of these granulations to the cartilagin-
ous state, and the deposition of bone or calcareous sub-
stance.
Q. What prevents the union of broken bones?
/?. Such frequent motion of the ends of the broken
bones, as prevents the union of the parenchymas of nutri-
tion.
Q. Why is union more difficult in a compound frac-
ture?
/#. Because the process of suppuration wastes the nu-
tritive restorative matter.
Q Of what are the teeth composed?
\fr. Of enamel, of ordinary bone, and a cavity con-
taining a spongy substance, with which we are unac-
quainted.
Q. What experiment proves the difference between the
enamel and the ordinary bony substance of the teeth ?
.#. Diluted nitric acid, while it softens both portions,
whitens the enamel, and renders the osseous portion yel-
low.
Q. Is the enamel an organized substance?
*&. While it has sensibility to external impression, it
does not take on diseased action; it is neither absorbed
190 OSSEOTTS SYSTEM.
nor re-deposited; on the whole, the question is by no means
a settled one.
Q. What vital property is conspicuous in the mem-
brane of the teeth ?
t/2. Animal sensibility to a most acute degree.
Q. What sympathies are excited by diseases of the
teeth?
#. Those of animal sensibility, and of animal contracti-
lity. The first is exemplified in the pains of the teeth ;
the second in the convulsions produced by teething.
Q. Present examples of the organic sympathies.
Ji. Those of sensible organic contractility, such as vo-
miting, purging, and increased frequency of the heart's
action. You see those of organic sensibility and of insensi-
ble organic contractility in the profuse salivary discharges
from dentition, and other tooth affections; you see them
likewise in the swellings of the face.
Q. How do the teeth usually sympathize with each
other?
<fl. They sympathize in the frequent affections of cor-
responding teeth, on the opposite sides of the face.
Q. To what tissue does the membrane lining the tooth
belong?
*#. It is serous; as evidenced by its appearance, by its
having the double night-cap fold, and by the fluid exhaled
from it.
Q. How is formation of the bony part of the tooth con-
ducted?
#. In layers, as it were, from without inward. This
is done for the protection of the outer part of the tooth,
as that part is first exposed to the'contact of foreign bodies.
OSSEOUS SYSTEM. 191
Q. How do you account for double rows of teeth?
A. The temporary set are not removed ; the permanent
take another direction, usually an internal one, appearing
as an inner row of teeth.
Q. Do the sesamoid bones lie in the direction of the ex-
tension or flexion of a joint?
*fl. In all cases in the flexures of the joints, except in
the instance of the patella.
Q. What is remarkable in the structure of these bones ?
. Their fibro-cartilaginous, and fibro-osseous state.
Q. Where are they most numerous and conspicuous?
#. In the lower extremities; and they are not seen in
any part of the bones of the trunk.
Q. Where are they exclusively developed?
t#. In the fibrous organization, as in the tendons or
ligaments.
Q. Do you mean to say that in their most complete
state of ossification, the sesamoid bones are partly fibrous?
A. They are; for the tendinous fibres on the upper and
lower side of these bones so penetrate its osseous sub-
stance, as to be continuous.
Q. At what age are they most numerous?
*#. They are found in greatest number in advanced life.
Q. In their union after fracture, how do they differ
from other bones?
.#. They differ in the interposition of a kind of fibro-
cartilaginous substance, or, as it has been termed, ligament,
Q. In what disease have they been seen remarkably
developed ?
*#. In gout.
192 OSSEOUS SYSTEM,
OF THE MEDULLARY SYSTEM OF THE BONES.
Q. Is there a membrane, or what may be termed an in-
ternal periosteum, in the osseous cells.
*ft. Bichat thinks not; but supposes the medulla to be
exhaled by a vascular net-work.
Q. What part of the osseous medullary system possesses
animal sensibility?
*#. That vital property is found only in the middle of
the long bones. The same part of the system possesses
extensibility and contractility of texture.
Q. Where are the pains usually ascribed to the bones
themselves, really seated?
/?. In the medullary texture in the middle of the long
bones.
Q. How is the medullary system divided?
A. .There is the medullary system of the ends of the
long bones; that of the short and flat; and that of the mid-
dle of the long bones.
Q. In what interesting particular does the medullary
system of the middle of the long bones differ from the
others ?
*#. In this, that the vital forces of that system are much
more active than in those of the short and flat bones, or
even in the ends of the long bones.
Q. Is the marrow altered in diseases?
A. In some chronic affections it becomes mucilaginous
or gelatinous, resembling in many respects foetal marrow
in which there is no fat.
Q. What do you mean by internal necrosis?
fl. The destruction of the medullary substance of the
OSSEOUS SYSTEM. 193
bone, in which case the periosteum assumes the position
of nutritive parenchyma in which osseous matter is depo-
sited.
Q. Is there in reality any marrow in the foetus?
<fi. Beclard says there cannot be, because there is no
medullary membrane.
Q. Have the medullary membrane, or the marrow any
agency in producing the synovia?
Ji. They have not: for you may destroy the medullary
membrane, and still the formation of synovia continue
uninterrupted; again, the marrow is in greatest abundance
in those parts of the bone most remote from the synovia:
lastly, in children, where there is no marrow, synovia
abounds.
Q. What is spina ventosa?
*2. Beclard says it is a true cancer of the medullary
membrane.
PATHOLOGY OP THE OSSEOUS TISSUE.
Q. What are the diseases of the osseous tissue?
#. Inflammation, caries, necrosis, exostosis, osteo-sar-
coma, fragility, and rachitis.
Q. What gives peculiar aspect to the diseases of the
bones?
A. The feebleness in their vital forces.
Q. Give an example of healthy osseous inflammation ?
ft. You, have it in the process of reuniting a fractured
bone.
Q. What is caries ?
25
194 OSSEOUS SYSTEM.
ft. It is a chronic inflammation of the bones.
Q. How does necrosis differ from caries ?
. In necrosis the hone is dead, in caries it is in dis-
ease.
Q. What bones are most liable to caries?
#. The spongy bones.
Q. How many forms are there of exostosis ?
#. There is one form in which the enlarged bone is
perfectly hard, another in which the exostosis is lamellat-
ed, and a third in which there is a mixture of fleshy gra-
nulations sprouting from the bony disease.
Q. What is remarkable of the hard exostosis?
/?. That the affection of the soft parts bears no propor-
tion to the extent of the ossification.
Q. What bones are most liable to exostosis?
fl. The cranium and tibia. You often see them on the
inside of the head and in the pelvis.
Q. Is there resolution or suppuration in exostosis?
#. In the hard and lamellated there are neither; but
the carneous exostosis accompanies caries, arid this is vas-
cular, and there is the termination of the inflammation in
suppuration.
Q. To what is the fragile bone or brittleness owing ?
#. To a deficiency of gelatine.
Q. What is the pathology of rickets ?
A. It is a deficiency of calcareous deposition.
Q. How is osseous malformation jdivided?
#. Into congenital and accidental.
OSSEOUS SYSTEM. 195
Of the Medullary System.
Q. What is the disease of this tissue?
A. That which is usually termed spina ventosa.
Q. What is spina ventosa?
A. It is a " tumour arising from the clevelopment of the
bone and increase of its fleshy granulations."
Q. Where is spina ventosa never known?
A. It is never found in the short flat bones.
( 196 )
CARTILAGINOUS SYSTEM.
Q. How is this divided?
#. Into the cartilaginous and nbro-cartilaginous tissues.
Q. What do you mean by cartilage?
ft. It is a substance characterized by hardness, white-
ness, elasticity, apparently but not actually inorganic,
Forms of the Cartilaginous System.
Q. What are the three classes of cartilages?
A. Those at the ends of the moveable bones, those at
the union of the immoveable bones, -those on the parietes
of cavities, as the ribs and nose.
Q. What utility results from cartilages at the moveable
joints?
ft. By the properties of suppleness, elasticity, and
yielding, they increase the facility and extent of the mo-
tions of the joints, while they break by yielding a little,
the violence of the shocks the limbs experience.
Q. Is the nutritive parenchyma of the bone continued
into the cartilage ?
*ft. No; they are different, or rather distinct.
Q. Why are the cartilages at the ends of the moveable
joints more polished and shining than those elsewhere?
./?. The extension of the synovial membrane over those
joints communicates that shining appearance.
Q. Do you recollect any instances of cartilages in the
immoveable articulations?
CARTILAGINOUS SYSTEM. 197
A. Those in the sutures of the head, and those in the
bones of the face.
Q. In what respect do the cartilages in the moveable and
immoveable joints differ?
#. In the tendency of the cartilages of the immoveable
joints to ossification, particularly those of the sutures of
the head.
Organization of the Cartilaginous System.
Q. What is the peculiar organization of cartilage ?
/#. It is an intensely dense interlacing of fibres, longi-
tudinal and transverse.
Q. Is cartilage disposed to putrescency?
A. It resists putrefaction longer than any part, except
bones.
Q. What change takes place in disease ?
Jl. It becomes in some instances, as in hip disease,
soft, lardaceous, and vascular. Sometimes it is even os-
seous, and then medullary cavities are formed and fluid
deposited.
Q. Bichat mentions another remarkable change of the
cartilaginous tissue in disease, what is it?
#. In two instances he saw the cartilages of the hip
and thigh bones converted into a substance like ivory.
Q. What is the common organization of cartilage?
#. Cellular substance, and in health white fluids, exha-
lents and absorbents. In disease red fluids are conveyed;
in jaundice the cartilages become very yellow. No nerves
have been found in cartilages.
Q. What proves the existence of cellular texture in
cartilage?
198 CARTILAGINOUS SYSTEM.
)
3. The granulations in wounds of this tissue, besides
other evidences, particularly the spongy appearances in
diseased cartilage.
Properties of the Cartilaginous System.
Q. What physical property is most eminently possess-
ed by cartilage?
.#. Elasticity, and this is greatest in adults.
Q. Where are cartilages placed, and what general prin-
ciples govern their location?
*ft. They are placed where a peculiar union of physical
properties as well as vital forces are necessary to the
functions of parts.
Q. What elementary constituent contributes mainly to
the elasticity of parts of the body ?
ft.. Perhaps it is more owing to the proportion of gela-
tine than to any thing else.
Q. Are the properties of texture much developed in
cartilage ?
JL. Extensibility and contractility are scarcely observa-
ble in cartilage.
Q. What vital properties belong to cartilage?
*#. The functions of cartilage imply insensible organic
contractility and organic sensibility. Animal sensibility
is developed only in their diseases. Animal contractility
is foreign from them. Sympathies, either active or passive,
are inoperative with cartilages.
Q. What then is the general character of the vital pro-
perties of cartilage ? ,
#. It is that they are slow in operation, and obscure in
existence; and consequently their diseases are chronic.
CARTILAGINOUS SYSTEM. 199
Q. What important consideration does the general cha-
racter of the vital forces of various parts inculcate on the
pathologist?
*ft. That these forces are exceedingly various in differ-
ent tissues. Active in some, their diseases are acute and
rapid, and their restoration speedy. Slow in others, their
diseases are chronic, and their reunion very tardy. And
again, that acute and chronic inflammation are relative,
not arbitrary terms; governed in their application by the
activity of the vital forces of the part.
Development of the Cartilaginous System.
Q. What constitutes the mucous bed of the osseous and
cartilaginous systems in the foetus?
A. The cellular and vascular parenchyma; this is after-
wards penetrated by the peculiar saline and gelatinous
substances, which form the bone and cartilage.
Q. What effect has age on the deposition of gelatine?
. It diminishes as we advance in life; young animals
yield the most jelly.
Q. What appearances take place in macerating the car-
tilages of young animals in water?
. They become of a reddish colour.
Q. It has been said that the motions of the cartilages in
the moveable articulations prevents their ossifications;
may not another physiological reason be given for this?
#. In the moveable articulations the organic sensibility
of the cartilage not being in relation to the red blood' and
.calcareous substance, they are neither conveyed to the
cartilage nor deposited in it; hence ossification does not
take place.
200 CARTILAGINOUS SYSTEM.
Q. What change is manifested in the cartilages at ad-
vanced periods of life?
Ji. They become ossified in many cases.
Q. What does the early tendency of the cartilages of
the cavities to ossification often induce?
ft. More frequent caries of these than of other carti-
lages.
Q. What laryngeal cartilages are most disposed to
ossify?
*#. The arytenoid; in every case of laryngeal phthisis
this has appeared on dissection.
Q. What different causes give rise to osseous and carti-
laginous depositions, where these should not be?
ft. Age produces the bony deposition; disease gives rise
to the cartilaginous formations.
Q. Where is preternatural cartilage most frequently
found?
#. In the spleen and in the lungs.
Q. What is the composition of the cartilages?
#. Varying in the constituent proportions at different
periods of life, they are composed of albumen, mucus,
oil, acetic acid, water, phosphate of lime, and other salts.
Q. What is the morbid anatomy of the cartilages?
#. Swelling and softness in white swelling; they are
sometimes absorbed or converted to bone; they ulcerate.
When broken they reunite by means of bony bands and
bonds.
( 201 )
FIBROUS SYSTEM.
Of the Forms and Divisions of the Fibrous System.
Q. How are the fibrous forms divided?
#. Into membranes and. fasciae.
Q. How are the fibrous organs of a membranous form
arranged?
Jl. Into the orders of fibrous membranes, fibrous cap-
sules, fibrous sheaths, and into aponeuroses.
Q. Give some examples of the fibrous membranes.
Jl. You see them in the periosteum, dura mater, the
sclerotica, albuginea, the peculiar membrane of several
organs, as the spleen and kidney.
Q. Where are the fibrous capsules found?
A. They are met with around the articulations of the
arm and hip, and some others, and wherever found their
office is to strengthen the joint.
Q. What situations do the fibrous sheaths occupy?
#. They bind down the tendons as they pass on the
bones.
Q. How are the fibrous aponeuroses divided?
A. Into those which are spread out as coverings over
parts, and those which afford muscles places for insertion.
Q. How are the fibrous organs in form of fasciae di-
vided ?
#. Into tendons and ligaments.
Q. Where are tendons found?
#. At the origin, middle, or insertion of muscles.
26
202 FIBROUS SYSTEM
Q. Where do you meet with ligaments?
#. Their office being to strengthen the joints, they
are met with about the bony or cartilaginous articulations.
Q. What is the common centre of the fibrous organs?
Jl. The periosteum.
Q. Why is the periosteum thus considered?
*#. Because, generally speaking, the fibrous organs are
attached to the periosteum.
Q. What are the principal exceptions to this anatomical
arrangement?
*#. The albuginea of the eye, the membranes of the
spleen and liver.
Organization of the Fibrous System.
Q. What is the organization of the fibrous system?
Jl. It is a peculiar, hard, slightly elastic fibrous base,
destitute of sensibility, and nearly so of contractility. The
fibres are, in tendons, in juxta-position; they are so like-
wise in ligaments. In membranes, the fibres are crossed
in every direction.
Q. Is the power of resistance in the fibrous system
great?
./?. Sometimes it is even greater than that of the bones,
as the patella. Recollect the violence requisite to draw
criminals asunder by horses, in the punishments of the
ancients.
Q. Why are tendons always ruptured, rather than the
muscular fleshy fibres?
/?. Because the fleshy fibre is in such constant con-
traction and approximation, as to enable the strength of
the muscle to exceed that of the tendon.
FIBROUS SYSTEM.
203
Q. Why do you doubt the identity of muscular and
fibrous tissues?
*#. Those tissues cannot be alike which vary so much
in chemical composition, in organization, in vital pro-
perties, and in functions.
Q. What portions of the fibrous system are most liable
to inflammation?
#. In those where there is most vascularity.
Properties of the Fibrous System.
Q. What physical properties belong to the fibrous sys-
tem?
/?. Elasticity, and that quite obscure.
Q. Are there any textural properties in this tissue?
t#. Extensibility, which takes place slowly. In their
extension, the fibrous organs become sometimes thinner
than natural, in other cases they are thicker. Contractility
is also seen in these, and it is as slow in development as
the extensibility.
Q. Give instances of the extension and contraction of
the fibrous system.
.#. The dura mater in hydrocephalus; the fibrous or-
gans in the abdomen in pregnancy and ascites; now in the
restoration of these parts to their natural size, you see the
contractility of the fibrous organs.
Q. What are the vital properties of this system?
,#. Organic sensibility and insensible organic contrac-
tility; but animal contractility, and sensible organic con-
tractility do not belong to it.
Q. What is the peculiarity of the animal sensibility in
this tissue?
204 FIBROUS SYSTEM.
tfl. It is that ordinary stimulants do not excite it. It
is put in action by violent extension or sudden distention;
hence the acute pains of straining, stretching, or twisting
the joints or the spine. You will also here bear in mind
the severity of pain, when pus is confined by an aponeu-
rosis.
Q. Are the vital forces of the fibrous system active?
/#. Much more so than those of the osseous and carti-
laginous tissues; but the forces vary in different parts of it.
Q. What remarkable circumstance is observed in in-
flammation of this system?
ft. That it does not produce pus.
Q. But does not the dura mater suppurate?
t/?. Bichat says it does not; that the pus proceeds from
the tunica arachnoides on the dura mater.
Q. What sympathies arise from this fibrous system ?
t#. They are various. The animal sensibility of the
whole limb may be increased ; again, animal contractility
of remote parts is excited as in tetanic symptoms from
wounds, or in the sardonic grin from punctured diaphragm.
At another time you find the organic sensibility of parts
is exalted, as when the pericranium is inflamed from sym-
pathy with the dura mater. The sensible organic contrac-
tility is disturbed, as when the stomach vomits from wound
of the sclerotica, or when the heart is disturbed by fibrous
pain.
Q. What vital property in the tissues is apt to be ex-
cited by sympathetic compressions?
#. The predominant vital force of each system.
FIBROUS SYSTEM. 205
Development of the Fibrous System.
Q. What consequence results from the softness and
want of resistance in the fibrous systems of early years?
^. That luxations are more rare; that sprains are less
violent; that the articulations are more extensible than in
after life, when the ligaments are stiff and strong. The
weakness of the vital forces in this tissue in infantile life,
renders it less liable to rheumatism.
Of the Fibrous Membranes in General.
Q. How are these distinguishable from serous and. mu-
cous membranes?
#. The fibrous are, with one exception, exactly adapt-
ed to the form of the organs they cover; the exception is
the dura mater. The two surfaces of these membranes are
adherent, and they are perforated for the passage of ves-
sels. Now, in all these respects, they differ from the serous
and mucous membranes.
Q. Is it certain that the membrane of the corpus caver-
nosum penis is fibrous ?
Jl. Various 1 experiments prove the difference between
the membrane of the corpus cavernosum penis and the
spongy textures, and substantiate its resemblance to the
fibrous tissues.
Of the Periosteum.
Q. For what is the periosteum remarkable in infancy ?
A. For its greater thickness, its feebler connexion with
the bones, and its softer, more spongy, and gelatinous as-
pect, than in after life.
Q. Is the periosteum continued over the articulations?
206 FIBROUS SYSTEM.
../?. It is not. The ligaments intermix with it, serve as
a means of communication, and thus is it continued.
Q. What bony parts are destitute of it?
-ft. The crown of the tooth, and the bony projections
on the heads of animals.
Q. What different morbid processes take place when
the medullary substance and periosteum are diseased ?
ft. In the disease of the medullary substance, necrosis
seizes the whole bone; in that of the periosteum, the ex-
ternal laminae are alone affected.
Q. What is the direction of the fibres of the perios-
teum?
ft. It is that of the fibres of the long and short bones,
but not radiated as the fibres of the flat bones are.
Q. Are the fibrous organs inserted into the periosteum,
or are they more immediately connected with the bone?
ft. In infancy they are not connected with the bone;
but as ossification progresses, it attaches the inner layers of
the fibrous organs, and thus firmly supports the powerful
action of the muscular lever.
Q. What are the uses of the periosteum ?
ft. It protects the bones from the action of surround-
ing parts: it assumes the ossific process when disease
destroys the bones : by the ossification of its inner layers it
increases the thickness of the bones: but above all, it af-
fords to the fibrous organs a general, solid, resisting sup-
port
Of the Fibrous Capsules.
Q. Where are they found?
ft. Almost exclusively on the scapulo-humoral and
ilio-fe moral articulations.
FIBROUS SYSTEM. 207
Q. Why are they only found there?
A. Because these articulations having equal motion in
all directions, require, equal support in all directions.
Q. What is the use of the fibrous capsules ?
tf. To give strength to the articulations; they do not
exhale the synovia.
Q. Are the capsules which form around unreduced
heads of bones fibrous?
*ft. They are not; no fibres can be traced in them they
are serous.
Of the Fibrous Sheaths.
Q. How are they divided?
A. Into partial and general.
Q. Explain this division.
A. The partial are attached to one or two tendons; the
general confine or belong to an assemblage of muscles or
tendons, as at the wrist and ankle, where the annular liga-
ments are.
Q. What muscles in the limbs have the partial fibrous
sheaths ?
/2. Only the flexors; the extensors are destitute of them.
The reason of this is the flexors require more strength and
support than the extensors.
Of the Aponeuroses.
Q. How are the aponeuroses divided?
Ji. Into those for covering and those for insertion.
Q. How are the aponeuroses for covering sub-divided?
208
FIBROUS SYSTEM.
. Into those for general and those for partial 'cover-
ing.
Q. Where are those for general covering found?
.#. Around the extremities, where they tie down the
muscles. These aponeuroses are thick and strong in pro-
portion to the size and action of the muscles they cover.
When it is otherwise, as in the gastrocnemii muscles,
these muscles are liable to a species of dislocation and
cramp.
Q. What do you mean by the tensor muscles?
/?. They are muscles inserted into the aponeuroses for
general covering, to tighten or relax them, as the situa-
tion of the limb may require.
Q. With what tissue do these general aponeuroses pe-
culiarly intermix?
/#. In some parts of the limbs they are gradually
merged or lost in the cellular tissue.
Q. What are the uses of these aponeuroses?
<&. Besides confining the muscles, they by compression
favour the circulation of the red and white fluids. Hence
dropsy is rarer and later in forming in the sub-aponeurotic
cellular tissue than in the superficial.
Q. Where are the aponeuroses for partial covering
found ?
/#. On the hand, on the back and abdomen, some of
the muscles of which they cover and aid.
Q. How are the aponeuroses of insertion divided ?
A. Into those with a broad surface, those in the form
of an arch, and those with separate fibres. Those in the
arched form are to allow vessels to pass under them.
FIBROUS SYSTEM. 209
Of the Tendons.
Q. Are tendons active or passive in their functions?
A. They are passive, being moved by the muscles.
Q. At which extremity of a muscle are they usually
found?
*ft. At that end of the bone where the motion is
greatest.
Q. What are the forms of the tendons?
t#. Some are flat; most of them are round; some are
bifurcated. Their union is exclusively with fibrous mem-
branes, never with serous or mucous membranes.
Q. What is the organization of the tendons?
#. They are a union of fibres, connected by compact
cellular membrane.
Q. What is the character of their vital forces?
#. They are very weak.
Q. What muscles are destitute of tendons?
#. Those of organic life, and nearly all those of animal
life, which form the sphincters.
Of the Ligaments.
Q. What is the difference in the attachments of the ten-
dons and ligaments ?
A. One end of a tendon is attached to a muscle, whereas
both ends of a ligament are attached to the periosteum.
Q. How is it that the ligaments execute a double pro-
perty ?
#. By strength they unite the bones, and by flexibility
they allow free motions.
27
210 FIBROUS SYSTEM.
Q. To what is club-foot owing?
.#. To weakness and relaxation of the ligaments.
Q. What changes does white swelling produce in the
ligaments and tendons?
*#. A softening, thickening, and consequent impotence
in these muscular and cuticular attachments.
Q. Is morbid fibrous tissue ever produced?
#. Frequently in the uterus, vagina, and other parts.
Of the Yellow Elastic Tissue.
Q. What additional division in the fibrous system does
Beclard make?
Jl. He describes what he terms the yellow elastic tis-
sue, as it is found in man and animajs. It is seen in the
vertebrae, in the peculiar membrane of the arteries, in the
ligamentum nuchae of animals, and it supports the abdo-
minal parietes of animals. It is in the cat's claw. This
tissue is remarkable for its elasticity. It is not only in
the peculiar membrane of the arteries, but in that of the
vascular system generally.
PATHOLOGY OF THE FIBROUS SYSTEM,
Q. What are the diseases of this tissue?
A. Inflammation; osseous, fungous, cartilaginous, car-
cinornatous transformation; but these are much modified
by the portions of the system affected.
Q. Does rheumatism affect the tendons?
FIBROUS SYSTEM. 211
#. It is said not; the ligaments are its seats about the
joints; the tendons are not painful in rheumatism.
Q. Is the dura mater liable to inflammation?
t#. If so, it is not much disposed to it. Inflammation
which has been ascribed to the dura mater was really in
the arachnoides.
Q. How do you distinguish periosteal tumour from
exostosis ?
& The tumour of the periosteum is more painful, of
more rapid increase, and is softer than exostosis.
Q. Is there much difference between inflammation of
the periosteum and spina ventosa?
tf. In the first the bony cylinder of periosteum cases a
portion of dead bone; in spina ventosa the diseased and
healthy bone are continuous.
Q. How does periosteal inflammation terminate?
A. It usually ends in suppuration.
Q. But as a general observation, how does inflamma-
tion of the fibrous tissue terminate?
/I. In resolution or thickening.
Q. How are the cicatrices of the liver formed ?
t#. They are fibrous adhesions.
OF THE FIBRO-CARTILAGINOUS
SYSTEM.
Q. Where is this found?
Ji. In the ear, in the alac of the nose, in the trachea, in
the eye-lids. It is found in the spinal inter-articular sub-
stance, in the iliac and pubic symphysis, and it appears
sometimes as tendinous sheaths.
Q. Of what does this system consist?
#. Of a mixture of fibrous and cartilaginous substance,
of which the former is the base.
Q. What are the functions of this tissue ?
/?. It has great power; it preserves the vertebrae, knee,
jaw, and other articular surfaces in place. It is in most
instances destitute of perichondrium.
Q. Does any-other structure enter into the fibre-cartila-
ginous tissue, than those indicated by its name?
A. It has a little, very condensed cellular texture. Few
blood-vessels, and no nerves can be seen in this texture.
Q. What properties appertain to this tissue?
Jl. The physical are elasticity and suppleness to a great
degree: observe these in the spinal column, nose and ears.
Q. What are the textural properties of this system?
#. Both extensibility and contractility. The nose
dilates from tumours and polypus, and contracts slowly
when the distention is removed.
Q. . You have frequently met with and mentioned clas-
FIBRO-CARTILAGINOUS SYSTEM. 213
ticity, extensibility, and contractility; how do these pro-
perties principally differ?
e/2. Elasticity is a rapid, the others are slow actions.
Q. What are the vital properties of this tissue?
#. Organic sensibility and insensible organic contrac-
tility ; and these in a degree sufficing only for the nutri-
tion of the tissue. Neither active nor passive sympathies
are met with here.
Q. Have the fibro-cartilages much disposition to ossify ?
#. Not near so great as the cartilages. Beclard accu-
rately observes that there are temporary and permanent
fibro-cartilages. The first having served their purposes,
ossify; the second remain fibro-cartilaginous.
("214 )
MUSCULAR SYSTEM.
Q. How is the general muscular system divided?
&. Into the muscular systems of animal and organic
life.
Q. In what respects do these differ from each other?
/?. They differ in the vital forces which animate them-,
in their external forms ; in their mode of organization ;
and the parts they perform in animal and organic life.
I. OF THE MUSCULAR SYSTEM OF ANIMAL LIFE.
Q. What are its first conspicuous characters ?
/?. The size it attains, and space it occupies; and its
agency in, and adaptation to the defence of the vital or-
gans.
Of the Forms of the Muscular System of Animal Life.
Q. How are these muscles divided?
#. As the bones are, into long, broad, and short mus-
cles.
1. Of the Long Muscles,
Q. Where do you find these?
A. Generally in the limbs.
Q. What external and internal layers belong to them?
MUSCULAR SYSTEM. ' 215
A. The aponeurosis between them and the skin, and
the 1 periosteum between them and the bones, form for them
a fibrous sheath, in which they play.
Q. Where are the longest of these muscles ?
*ft. The external muscles are the longest; the deep-
seated the shortest.
Q. What separates the muscles from each other?
#. Cellular layers are interposed between the muscles.
Q. How are the long muscles divided?
ft. Into the simple and compound. Composed of a sin-
gle fasciculus, they are single; where fasciculi unite, the
muscles are compound.
Q. What purpose is served when several of the long
muscles are united by aponeurosis ?
/2. The force and direction of muscular power are
concentrated.
2. Of the Broad Muscles.
Q. Where are they generally found?
/?. Covering the parieties of the cavities of the body.
Q. What offices do they perform ?
ft. Three; they in some extent contribute to the for r
mation of the parietes; they protect the contained organs;
and aid these last in the discharge of their functions by
the motions they communicate.
Q. Why is cramp never felt in these broad muscles?
t#. As cramp arises from the displacement of a muscle,
and as these broad muscles are not liable to dislocation,
they do not suffer from cramp.
Q. The circumstance of these broad muscles not being
216 MITSCITLAR SYSTEM.
liable to displacement, accounts for an anatomical fact,
what is it?
J2. They are not often covered with aponeuroses.
3. Of the Short Muscles.
Q. What do you mean by these ?
Ji. They are a class of muscles equal in length, breadth
and thickness, fitted by this formation for strong yet cir-
cumscribed motion.
Q. Where are they found ?
*#. About the shoulder and hip joints; about the jaw,
the palm of the hand, and so forth.
Organization of the Muscles.
Q. What peculiar organization is found in muscles?
tf. A red, flabby (molasse) fibre, with uniformity of
size in the large and small muscles, running its course
without bifurcation. A single fibre is not visible, but as
they are always united in a bundle, they are thus dis-
tinctly seen.
Q. What constitutes general contraction of a muscle?
#. The union of many separate, distinct, and indepen-
dent contractions.
Q. What is the direction of the fibres of the voluntary
muscles ?
#. Straight, except in the sphincters.
Q. How does muscular texture differ from fibrous?
*tf. In its softness and small degree of resistance.
MUSCULAR SYSTEM. rf 217
Q. How then is it that muscles are so rarely ruptured?
*ft. Because the concentrated contraction of a great num-
ber of fibres, compensates for the weakness of one.
Q. What is the proximate principle, the essence of the
muscular texture?
*#. When by various means you have separated the co-
louring matter, gelatine, albumen, and saline principles
from the muscle, you will have left a gray fibre, which is
not soluble in warm water, but is so in weak acids. This
fibre gives out much azote when exposed to nitric acid,
and it resembles the fibrin of the blood. This substance
constitutes the nutritive matter of muscles, as phosphate
of lime does that of bones.
Q. What relation does this fibrous substance bear to the
blood?
*#. There is, in general, a constant relation between the
quantity of this fibrous substance contained in the muscles,
and the quantity of it that the blood contains.
Q. What organization is common to the muscles and
other parts?
/?. Cellular substance, which abounds greatly, envelop-
ing every muscle, fasciculus, and fibre.
Q. What is the use of this cellular texture in the mus-
cles?
Ji. It fixes them in their place, and greatly facilitates
their motions.
Q. There is another constituent in muscular organiza-
tion, what is it?
A. It is red blood which enters largely into it.
Q. Is it the mere circulation of that fluid which colours
a muscle?
2S
218 MUSCULAR SYSTEM.
./?. No; it is that portion of it which combines with the
peculiar muscular texture.
Q. Why do you suppose that to be the case?
Jl. Because in asphyxiated animals while black blood
circulates, the muscular colouring substance does not be-
come black; and because in many parts which have mus-
cular fibres, red blood circulates freely, yet does not co-
lour the fibres. It is not the mere circulation of red blood
which colours the fibres. Another reason is here, that
in some animals in which red blood circulates, the muscles
are white.
Q. In what class of diseases do the muscular vessels
allow the escape of blood?
/?. In diseases of debility; never in those of increased
activity.
Q. Whence are the nerves of the muscles of animal life
derived ?
/?. Almost entirely from the brain and spinal marrow;
if there are exceptions, you will find that even there the
brain sends a part of the nerves.
Q. Are the muscles abundantly supplied with nerves?
&. As much so as any other parts. The great nervous
trunks run in the direction of the flexors.
Q. Are the flexor or extensor muscles the strongest?
#. Evidently the flexors; in hysteria, in infantile, and
all other involuntary spasmodic motions, the flexors pre-
dominate. So they do in old people; under all circum-
stances the motions of the flexors are most powerful.
MUSCULAR SYSTEM. 219
Properties of the Muscular System of Jlnimal Life.
Q. For what are these properties remarkable?
*/l. The muscles have slight physical and conspicuous
vital properties. You have heard that the muscles are
slightly elastic and soft.
1. Properties of Texture.
Q. What property of texture is most remarkable?
t/#. Extensibility; and this is in the flexor or extensor,
as the one or the other may be passive. Extensibility is
confined to the muscular fibre, not extending to the ten-
dons.
Q. What morbid phenomena remarkably illustrate this
property in the muscles?
/?. The distention of the muscles with tumours, and
that in pregnancy. The aponeuroses have some influence
in preventing their distention in the extremities.
Q. On what is contractility of texture, so conspicuous
in muscles, dependant?
/?. Not on the action of the nerves, not entirely on life;
it is on the structure of the muscles that it essentially de-
pends/
Q. How do you distinguish contractility of texture in
the muscles from the vital forces?
*ft. Between the extreme points of extension and flexion
of the moveable parts of the body there is a resting point,
or a middle one. To remove a limb from this point of
rest, animal contractility or a vital force must act on the
220 MUSCULAR SYSTEM.
muscles. Now, as long as this vital voluntary power is
in action, the textural contractility of the muscle is over-
come. But as soon as this vital force ceases to act, the
contractility of texture restores the limb to the medium or
resting point. When the will acts on the muscles, vital
forces are in play; when it ceases, contractility of texture
restores the limb to rest.
Q. What is the cause of the extended limbs in typhus
fever in its last stages?
A. It does not proceed from increased action of the ex-
tensors, but from a loss of textural contractility in the
flexors.
Q. Can you give instances of this contractility of tex-
ture in action ?
*/#. When a muscle is cut through, the fibres retract
considerably; when a woman is delivered, the abdominal
muscles return to a natural state by means of this contrac-
tility of texture. Repeated distention diminishes this
textural property.
Q. How does long-continued ascites, affect respiration
even after the water has been removed?
*ft. Long-continued pressure of the water on the dia-
phragm diminishes its contractile power, and dyspnoea
continues; so it is after repeated pregnancy.
Q. To what is this contractility of texture relative?
#. It is in proportion to the length of the fibres of the
muscle ; it is greatest in the longest muscles, and for this
reason in amputation the superficial muscles contract the
most. In sleep the legs are most contracted.
Q. There is another obvious difference between this
contractility of texture and the vital properties, what is it?
MUSCULAR SYSTEM. 221
*fl. The contractility depends on the development of
muscular texture; the vital forces depend on the varying
impulses of cerebral nervous energy.
Q. What destroys contractility of texture in the muscles?
*#. Putrefaction; death diminishes, but does not imme-
diately destroy it.
Q. What distinguishes this contractility from the horny
hardening?
J2. In the same organ the last is great, the first slight,
as in the fibrous organs. Contractility acquires force
from life, the other does not. Contractility is lost in the
dried organs, the other is not. Contractility is slowly
manifested, the other rapidly. The absence of extension
excites contractility, but foreign bodies are necessary to
produce the hardening.
2. Vital Proper ties of the Muscular System of Animal
Life.
Q. Is animal sensibility well marked in healthy muscle ?
/?. It is the most obscure of all the vital properties;
pain in cutting a muscle is not severe; irritants do not
much excite them; in short, the peculiar texture of the
muscle has but little animal sensibility.
Q. But there are circumstances in which this property
is manifestly conspicuous, what are they?
/?. In the lassitude from fatigue, and that which pre-
cedes many diseases, it is seen. In the first, it warns
against continued exertion; in the* second, it admonishes
of the approach of disease. In the inflammation of the
peculiar texture of muscles, this sensibility is most acutely
increased^ and this differs from lassitude.
222 MUSCULAR SYSTEM.
Q. What vital property is exclusively seated in the
muscular system of animal life?
JL. Animal contractility, on which depend locomotion
and the voice.
' Q. In what does this animal contractility consist?
ft.. In the faculty of moving under cerebral influence,
whether this influence is produced by the will, or any
other cause.
Q. In what general character do the vital properties of
animal life differ from those of organic life?
ft. In this; that the exercise of the properties of or-
ganic life is concentrated in the organs, while the exer-
cise of those of animal life depend on the organ, the brain,
and the nerves.
Q. How do you prove the brain thus essentially con-
nected with the muscular system?
ft.. Causes which increase the energy of the brain have
that effect on the muscles, and those which diminish that
energy, debilitate the muscles.
Q. In what forms are sudden and powerful impres-
sions on the brain manifested in the muscular system of
animal life?
ft. As in convulsions and palsy. Indeed this muscular
system indicates the condition of the brain. The muscles
are to the brain what the arteries are to the heart.
Q. What three great functions have their seatinthe brain?
ft.. Perception, voluntary motion, and intellect. These
may be separately or entirely destroyed or affected.
Q. There are two circumstances whicli influence the
cerebral power over the muscles, what are they ?
ft.. The disposition of the nerves to convey this power,
and that of the muscles to receive it.
MUSCULAR SYSTEM.
Q. Do the nerves proceed directly from the brain to
the muscles of animal life ?
/?. Some do, but the greater number go from the me-
dulla spinalis.
Q. What evidence is there that the nerves of motion
proceed from the medulla spinalis?
./?. If the medulla spinalis is irritated, convulsions arise;
and as this irritation is higher or lower on the medulla,
are the superior or inferior parts irritated.
Q. Why are injuries of this medulla, at its upper part,
so dangerous?
.#. Because the functions of the diaphragm and inter-
costal muscles are destroyed.
Q. What nerves go directly from the brain to the mus-
cles of animal life?
Jl. Those to supply the tongue, face, and eyes, and
some others.
Q. Are all the nerves of animal life equally disposed to
convey irritation from the brain?
/?. No ; those of respiration are least so, and the wis-
dom of this is evident. The muscles of the extremities,
face, larynx, pelvis, abdomen, intercostals, and diaphragm,
are, in the order mentioned, disposed to take on irritation
from the brain.
Q. In what direction is nervous influence propagated?
/?. From the superior to the inferior part of the nerve
only.
Q. What circumstances affecting the muscles, alter the
animal contractility of that texture?
*ft. Inflammation, contusion, infiltration of serum; in-
terruption to the flow of blood, for the arterial motion,
and that conveying red blood, is necessary to muscular
224
MUSCULAR- SYSTEM.
animal contractility; opium thrown into contact with the
muscular texture; all these alter the contractility of the
muscles.
Q. Repeat the actions necessary to excite animal con-
tractility in the muscular tissue?
*#. The action of the brain which originates, that of
the nerves which propagates, and that of the muscles
which receive the principle of motion.
Q. What causes acting on the brain produce animal
contractility?
*#. The exercise of the will ; and there are involuntary
ones which excite this property without the concurrence
of, or even in opposition to the will. These involuntary
causes are directly applied to the brain, or influence that
organ by sympathy.
Q. Are these sympathetic impressions always attended
with increased determination of blood ?
*#. They are not; it is irritation simply; and this irrita-
tion excites the brain to a degree beyond the control of
volition, and convulsions ensue.
Q. How does fear act on the muscles?
#. Through the intervention of the brain, and this fear
deprives the brain of its power to originate the impulse of
the contractility.
Q. How do you account for muscular action in the
foetus, where the will evidently cannot act?
*/2. Sympathetic impression, derived from the visceral
organs, acts on the brain producing involuntary muscular
action or animal contractility.
Q. Can you explain the muscular motion after decapita-
tion in man and animals?
#. The brain conveys for a short time lo the face, and
MUSCULAR SYSTEM. 225
the nerves from the spine convey to the muscles of the
body and limbs, the principle of animal contractility.
This circumstance clearly shows the difference between
the voluntary and involuntary contractility. So that after
decapitation, and by the influence of galvanism, the prin-
ciple of animal contractility can be conveyed; that is, after
intellect and respiration, and the heart's action have irre-
coverably ceased.
Q. Why is galvanism more powerful after death than
during life ?
t/2. Because during life the will in a great measure
counteracts the irritation of the galvanic fluid.
Q. What is the difference between animal contractility
and irritability?
*ft. Animal contractility originates in the brain and
nerves, and its power is passively received by the mus-
cles. Irritability is an innate principle of motion in a
muscle; it exists before and after death.
Q. In what part of the nervous system does animal
contractility cease first and last?
#. It is first lost in the brain, next in the spinal mar-
row, last in the nerves; and it is excited by metallic irri-
tation when all other is inefficient.
Q. By what means can you distinguish sensible organic
contractility from animal contractility?
jl. Recollect that sensible organic contractility is or-
ganic action independent of the brain, the animal contrac-
tility is purely dependent on the brain. If you cut all the
nerves which convey influence to the muscle, still that
muscle on irritating it will contract; now this is the sen-
sible organic contractility, the irritability of physiologists.
29
226 MUSCULAR SYSTEM,
This irritability actuates a muscle from contractions down
to oscillations.
Q. What tends most to develope the sympathies of
this system?
.#. The great development of animal sensibility in any
organ; hence it is that pain so often produces involuntary
animal contractility of the muscles, or, in other words,
spasms.
Q. Is this sympathy direct between the organ and the
muscles?
ft. The pain acts on the brain, and that reacts on the
muscles.
Q. Do the organic sensibilities and contractilities ra-
diate sympathetic reciprocity through the brain on the
muscles?
*#. No; none but the animal sensibility and contrac-
tility are sympathetically operative through the brain; the
organic vital properties operate directly from organ to
organ.
Q. Is there an anatomical or physiological reason for this?
/?. There is; for the brain does not influence organic
vital properties through the nerves, but it does affect the
animal properties of the muscle.
Q. State instances of animal sensibility in the muscular
system sympathetically excited.
#. Take as instances of this the pain, languor, and las-
situde of fever.
Q. Do convulsive motions indicate disease of the mus-
cles?
#. They do not; they indicate cerebral excitement as
the varieties of the pulse indicate affections of the heart
MUSCULAR SYSTEM. 227
Q. Is the muscular texture very liable to organic dis-
ease?
#. No; it is but little subject to this. It is seldom that
the tumours, or suppurations, or other organic affections,
so much met with elsewhere, are found in the muscular
texture.
Phenomena of the Action of the. Muscular System of
Animal Life.
Q. How do you form your estimate of the force of
muscular contraction ?
A. It is in the ratio of the force of the organization of
the muscle, and that of the cerebral excitement
Q. What are the three sources of muscular contraction ?
Ji. Irritating the brain in experiments, excitement of
the 'brain in the natural state, and sympathetic influence.
Q. Does the rapidity of muscular contraction depend
on the number of the branches of the nerves, supplying
the muscles, which may be irritated?
A. The contractions are as rapid if you irritate one
branch, as if all the branches are irritated.
Q. Are all the phenomena of muscular contraction
identical?
A. No; cut a muscle and there is slow and insensible
contractility of texture, and this is seen in muscles where
the antagonizing muscles are palsied. Then you have the
rapid contraction, either voluntary, or from irritation of
the nerve; and lastly, you have that oscillation which a
chill or fear produces.
Q. How do you estimate the effect which a muscle in
228 MUSCULAR SYSTEM.
the straight direction produces on the bones into which it
is inserted?
.#. Take the direction of the muscle from its fixed to
its moveable point, then take the inverse of this course,
and you have the direction of the motion.
Q. How do you estimate the action of a broad muscle,
which is united in a single tendon or point?
./?. Take the middle line of direction of all its fibres.
Q. And how, when the fibres attached at two points
form several fasciculi?
>ft. You must estimate the line of the direction of each
fasciculus, and then you can decide on the action of the
muscle.
Development of the Muscular System of Animal
Life.
Q. What is the colour of the muscles in the foetus?
A. The tinge is that of venous blood.
Q. What excites the action of the muscles so univer-
sally as they are seen to be at the moment of birth?
Ji. The contact of air, which excites the brain to per-
ception of impressions new to it; then the diaphragm is
excited to motion, and respiration sends red blood to the
brain; this blood proving an additional stimulus to cere-
bral influence, the constant and active muscular motions
of infancy are produced.
Q. What effect has disease on the colour of the mus-
cles?
.#. Acute diseases have little effect; in chronic cases it
often becomes pale; in dropsy it is quite pale.
MUSCULAR SYSTEM. 229
Q. How does age affect muscular contractility of tex-
ture?
*#. It diminishes it remarkably.
Q. Is the muscular fibre globular, hollow, or solid?
#. Meckel and Home consider it globular; some ana-
tomists suppose it to be an assemblage of vessels of a par-
ticular order; others say it is solid and not penetrated by
fluids.
II. OF THE MUSCULAR SYSTEM OP ORGANIC LIFE.
Q. Where do you find the muscles of this tissue?
A. In the thorax, abdomen, and pelvis; and the heart
and oesophagus, the stomach and intestines, the bladder
and uterus, compose it
Forms and Organization of the Muscular System of
Organic Life.
Q. What are the forms of these muscles?
. They form hollow muscular cavities; they are with-
out tendons; they do notarise from fibrous membranes,
nor are they inserted into them ; they proceed from, and
terminate in cellular substance; they have a thin, flat,
membranous form.
Q. What is the direction of the fibres?
/?. It is not single as in the muscles of animal life, but '
they interlace in every direction.
Q. What advantage is this interlacing of fibres ?
*1. It favours the diminution of the diameters of the
cavities formed by these muscles.
230 MUSCULAR SYSTEM.
Q. Does cellular substance abound in these muscles?
j2. Not at all; very little is found; hence it is that drop-
sies are not met with in this tissue.
Q. Are blood-vessels numerous here ?
*#. Yes; blood is found in full proportion in this tissue.
Q. Whence do they derive their nerves?
/?. From the cerebral and ganglionic system.
Q. In what organ of this tissue do the cerebral nerves
predominate?
A. In the stomach the par vagum.
Properties of the Muscular System of Organic Life.
1. Properties of Texture.
Q. For what properties are the organic muscles re-
markable?
/?. Especially for those of texture, viz. extensibility
and contractility.
Q. What is conspicuous in the extensibility of these
muscles?
/?. The rapidity with which it acts, and the extent of
which it is susceptible. Observe this in the distention of
the stomach and bladder.
Q. Why are the muscles of animal life incapable of this
rapid and great extensibility?
fl. Perhaps because they are intersected by numerous
aponeuroses, and because the layers of their fibres are
very thick.
Q. Do you not find in some of the organic muscles an
extensibility of a peculiar kind?
MUSCULAR SYSTEM. 231
tf. We do, as in the gravid uterus and aneurismatic
heart. It is in these the result of nutrition, where thick-
ness of parietes is added to extension.
Q. When is contractility of texture most obvious in
these muscles?
.#. When they are empty.
Q. What property or power empties them of their con-
tents?
t#. Organic contractility; and after this has emptied
the hollow muscles, then contractility of texture closes
them.
Q. What regulates the degree of organic contractility
in the organic muscles?
.#. It is in proportion to the fleshy fibres; hence it is
in such activity in the left ventricle of the heart, in the
O3sophagus, and in the rectum.
2. Vital Properties.
Q. Have the muscles of organic life much animal sen-
sibility?
t/2. It is slight. Harvey found the heart insensible, the
bladder is so in living animals.
Q. Is lassitude felt in these muscles?
t#. It is probable that hunger may be partly owing to
this. The sensation in the bladder when permanently
contracted may be that of lassitude. Perhaps the feeble
pulse after long fevers may result from a lassitude of the
fleshy fibres of the heart.
Q. What have you to say of the animal contractility of
these muscles of organic life?
*#. That from the nature of the property it is foreign
232 MUSCULAR SYSTEM,
to them. Cerebral influence and irritation are necessary
to animal contractility; now, as the will has no influence
over these muscles, animal contractility cannot be expect-
ed in them. Irritate the brain with the scalpel, with
opium, intoxication, wounds of the head, mania, and while
all these excite the animal contractility of the muscles of
animal life, there being no such property in the muscles
of organic life, they are unmoved.
Q. But do you not find the brain affected by disorder
of the muscles of organic life?
#. No in most vomitings, the irregular motions of the
intestines which take place in diarrhoeas, in affections of
the heart, &c. the brain is not diseased.
Q. In syncope is the brain or heart first affected?
.#. The heart is.
Q. The brain does certainly influence the stomach
through the par vagum ?
#. It does; but cutting the par vagum does not affect
the stomach as the section of a nerve going to a muscle
of animal life, does that muscle. While irritating the par
vagum induces the stomach to contract, yet if both nerves
of that pair be divided, violent vomiting is induced. Now
you never induce contraction in a muscle of animal life by
cutting off its supply of nervous influence.
Q. Do you consider Bichat's arguments and facts with
regard to the independence of the organic muscles of ce-
rebral influence as conclusive?
Jl. No. He is not convinced himself; for a mixed in-
fluence is admitted, with the nature of which he is unac-
quainted; but of one thing he is assured, that the cerebral
influence on the organic muscles is entirely different from
that on the animal muscles.
MUSCULAR SYSTEM. 233
Q. What property predominates in the muscles of or-
ganic life ?
*#. Sensible organic contractility ; but organic sensibi-
lity is also very conspicuous.
Q. How are stimuli divided with reference to the sen-
sible organic contractility of the organic muscles?
#. Into natural and artificial. The blood is the natu-
ral stimulus to the heart, the urine to the bladder, food
and faeces for the stomach and bowels. Artificial stimuli
are irritants applied after death, or in experiments.
Q. How is the sensible organic contractility of this tis- ^
sue affected by natural stimuli?
*ft. It is altered by changes in the quality and quantity
of fluids. See how the heart is hurried when chyle enters
it after digestion, and likewise when fluids are thrown into
the veins.
Q. Is this sensible organic contractility the same in all
the organs?
ft It is not. It is peculiar, inasmuch as each organ re-
sponds to its peculiar or natural stimuli such is the blood
to the heart, the urine to the bladder.
Q. What is the state of this property at different ages?
A. It is most active in youth; it becomes less so in
adult and advanced life. The action of the heart, bladder,
and rectum at these periods of life, will fully illustrate
this.
Q. Does temperament present different states of this
property?
*ft. In different temperaments, you see a predominance
of this property, in some over others. Having no common
centre or source of influence, as the animal muscles have,
30
234 MUSCULAR SYSTEM,
the contractility of the organic muscles is seldom uni-
form; one organ having a greater quantum than others.
Q. Is stimulus applied directly to the organic muscles?
#. No; a membrane interposes, as the continuous mem-
brane from the blood-vessels in the heart, the mucous
membrane for the stomach and intestines.
Q. Does this property remain after death?
*#. It is obvious after sudden general death ; you do not
see it after death from chronic disease.
Q. In which of the organic muscles is sympathy most
frequently and actively developed?
t/2. In the heart, next in the stomach, then the intes-
tines, and lastly the bladder. In this order the sympa-
thetic activity is conspicuous.
Q. What are the two modes in which the heart sym-
pathizes ?
/#. By having its action enfeebled, as in syncope, and
hurried, as in fever. This increased action is engendered
in three ways; by foreign matters mixed with the blood,
by preternatural irritability, and by sympathy.
Q. What is the sensible organic contractility of the
stomach?
#. Vomiting.
Q. Is bile found in the stomach in health?
.#. Bichat says he has always found it in animals. Vo-
miting is not occasioned by the bile, but by a sympathetic
action of the fibres of the stomach, to which is doubtless
superadded in some cases a sympathetic affection of the
mucous lining of the stomach. It is these which occasion
vomiting, not the 4 bile in the stomach.
Q. What property in a tissue is affected by disease?
MUSCULAR SYSTEM. 235
%/?. That which predominates in a tissue.
Q. Will you illustrate tins observation?
.#. In those textures, the mucous, serous, and cutane-
ous, for instance, where insensible organic contractility is
predominant, acute phlegmasiae are most common, because
this property presides over these acute inflammations. In
the organic muscles, insensible organic contractility is fee-
ble, the diseases therefore of these muscles are those of
the predominant property, which is sensible organic con-,
tractility. Hence aqute inflammation comparatively
rarely attacks the muscular substance of the heart or sto-
mach. Again, animal contractility being predominant in
the muscular system of animal life, you find that property
deranged in its diseases,
Phenomena of the action of the Muscular System of
Organic Life.
Q. What is to be observed of the force of the contrac-
tions of this texture?
Jl. That its action is more uniform than those of the
muscles of animal life; this action never being either con-
vulsed or palsied, as that of the animal muscles is.
Q. What controls the force of the contractions of the
organic muscles?
. Power adapted to function, and the circumstance
of there being solid or fluid contents to evacuate.
Q. In the animal muscular system antagonizing mus-
cles act in inducing relaxation after contraction, as the
triceps and biceps; now as there are no antagonizing or-
ganic muscles, how is their relaxation effected?
$. Dilatation is, from observation, proved to be as
236 MUSCULAR SYSTEM.
much an active effort as contraction, in the organic mus-
cles; the powers of both are s6 intermingled as not to be
separable.
Development of the Muscular System of Organic Life.
Q. Is it the action of the brain at birth which sets the
' organic muscles into activity ?
e#. The principle has been adopted that these muscles
are independent of the brain.
Q. What causes then excite them?
<&. One cause is sympathy with the external skin, which
is irritated by the contact of air at birth; another is, the
excitement on the beginning of the mucous surfaces, and
on the whole lungs, in breathing. Other causes are fluids
taken into the stomach, the red. blood penetrating the or-
ganic muscles, instead of fetal black blood; and lastly, the
meconium stimulates the bowels.
Q. Does growth in the external parts, and in the or-
ganic muscles, cease at the same time?
ft. No; each part has its period of full growth; the or-
ganic muscles are longer in attaining this than others.
The organic muscles are not subject to the irregularities
of growth, that so remarkably characterize the animal
muscles.
Q. Why do nutrition and growth vary in different tex-
tures?
#. Because they depend on the vital forces, which vary
in every tissue.
Q. Which of the muscular systems is soonest exhausted?
#. Both in exercise and life the animal muscular sys-
tem is soonest exhausted.
MUSCULAR SYSTEM. 237
Q. Does Beclard suppose that the brain influences the
organic muscles?
*ft. He thinks it does not ordinarily, but may contin-
gently.
Q. What'distinguished French pathologist was an in-
stance of the controlling power of the will over one of the
organic muscles?
ft. Bayle could at will suspend the action of the heart.
/ *
PATHOLOGY OF THE MUSCULAR TISSUE.
Q. What are the diseases of the muscular system of
animal life?
/?. Rheumatism, lassitude, atrophy, and hypertrophy.
Q. Is inflammation frequent in the muscular tissue?
Jl. It is not; it arises in the cellular tissue of the mus-
cles.
Q. What is to be observed of the diseases of the mus-
cles of organic and of animal life?
A. That those of the organic muscles are various, from
the variety of organs, and those of the animal muscles are
few, from the uniformity of the texture.
Q. What are the diseases of the heart?
#. Inflammation, acute and chronic; syncope; palpita-
tion; aneurism; rupture.
Q. What is the pathology of syncope?
/?. It is a loss of contractility in the heart.
Q. What do you observe of the intermittent pulse in
fever and disease of the heart?
238 MUSCULAR SYSTEM.
Jl. That pulse is more dangerous in fever than in dis-
ease of the heart.
Q. What are the causes of palpitation ?
A. It arises from fulness of blood; from excitation of
the heart by mental emotion; from obstruction" to the pas-
sage of blood through the lungs; it proceeds also from me-
chanically distended stomach.
Q. How do you distinguish suffocation caused by the
heart, and that produced by the lungs?
Ji. In that caused by the heart, the patient cannot bear
the recumbent posture, there is violent dry cough. When
the patient lies down, the heart presses against the lungs,
and occasions the suffocation.
Q. What is' the seat of polypus of the uterus?
Jl. It is either on the mucous surface, or arises from
the muscular tissue of the uterus.
Q. What muscles are least affected with rheumatism?
<&. The abdominal.
Q. What symptom attends diaphragmatic rheumatism?
Jl. Hiccup.
Q. What occasions atrophy of the muscles of animal
life?
t#. Paralysis, tyi,ng up the artery which supplies the
muscle.
239 )
MUCOUS SYSTEM.
Q. Why is this called the mucous system?
fl. From the fluid which is found on the surface of the
tissue which composes it. ,
Of the Divisions and Form of the Mucous System.
Q. In what form does this texture appear?
/2. Always in a membranous form.
Q. Where are these membranes found?
ft. They line all the interior surfaces which communi-
cate externally.
Q. How are these membranes generally divided?
/?. Into the gastro-pulmonary and genito-urinary.
Q. Is there no mucous tissue which is not embraced in
these two divisions?
/?. There is a small mucous surface in the tubes of the
nipple.
Q. Give a general view of the gastro-pulmonary mucous
membrane.
/#. It lines the mouth, nose, anterior face~of the eyes,
the ducts of the glands of the mouth and throat; it lines
the Eustachian tube, the trachea, lungs, the oesophagus,
stomach, the biliary, pancreatic and cystic ducts, the in-
testines, and finally unites with the skin at the rectum.
Q. Give a similar view of the genito-urinary mucous
membrane.
A. This is spread in men on the urinary canals up to
240 MUCOUS SYSTEM.
the kidneys, along the seminal ducts and tubes; and in
women on the urinary canals, on the vagina, uterus, and
fallopian tubes, and by the opening of these tubes it com-
municates with the peritoneum.
Q. Is it common for the mucous and serous membranes
.to communicate?
/#. This just stated is the only instance.
Q. State some interesting pathological considerations
which refer to these two mucous surfaces.
e/?. The diseases of these two great divisions of the mu-
cous membranes are distinct, and sympathies radiate be-
tween them comparatively rarely. But there are sympa-
thies which play between them deserving recollection,
such as that between the utero-mucous and pulmonary
mucous surfaces, constituting vicarious haemorrhage from
the lungs when menstruation is interrupted. The trans-
lation of gonorrhoea to the mucous membrane of the eye
is another instance.
Q. Will you state some curious sympathetic irritations
which arise in the courses of these two divisions of the
mucous system?
#. The irritation at the end of the penis occasioned by
a stone in the bladder is one, and the itching of the nose
occasioned by worms on the intestinal surface is another.
Q. How many surfaces are presented by each mucous
membrane ?
Jl. Two; an adherent one to the neighbouring organs,
and a free villous one.
Q. What are the uses of the adherent mucous surface?
.#. By its adhesion to the muscles of organic and animal
life, it has a constant agitation, favourable to the secretion
of mucus; it gives form to the organ it lines ; it gives force
MUCOUS SYSTEM. 241
to the mucous surface, and it resists the contents of the
mucous cavities.
Q. Will you name an important aspect in which the
mucous system deserves here to be considered:'
tf. It is the constant exposure of the mucous surfaces
to foreign bodies and matters; the tissue serves to defend
organs from the contact of these bodies; in this office it is
to the internal organs what the skin is to the external.
Organization of the Mucous System.
Q. What is the mucous chorion ?
Jl. The layer and papillae of the free surface.
Q. What is the texture lining the ear?
ft. Its continuity with the pituitary membrane, its mu-
cous discharge, its diseases, its want of fibres, prove it to
be mucous tissue.
Q. Where is the mucous chorion thickest?
/?. In the gums and palate; it is finest in the sinuses
of the face and internal ear. Diseases thicken it very
much.
Q. What is its texture?
ft. It is soft and thick, like velvet, in the stomach and
intestines; as it approaches the external openings, it be-
comes denser. The extreme softness of the texture in the
internal organs will not allow of the variolous pustule ;
these pustules appear on the mucous surface, where its
density will support their structure.
Q. Where is the mucous chorion of the deepest colour?
Jl. In the stomach, where blood gives it this colour; it
is paler in the bladder and rectum.
Q. What effect have the mucous surfaces on milk?
31
242 MUCOUS SYSTEM.
*fl. The dried membrane coagulates it.
Q. In what is the peculiar sensibility of the mucous
texture seated ?
#. In the papillae of the mucous chorion.
Q. In what part of the mucous tissue does functional
power, such for example as the secretion of gastric juice,
reside ?
t#. In the vascular net-work at the base of the villi,
not in the villi themselves, as has been supposed. The
villi are adapted to sensibility, not to secretion.
Q. What experiment decided the function of the villi ?
#. Irritate the villi after removing the epidermis, and
great pain is felt; introduce an instrument so as to irritate
the internal surface of the chorion, and no pain is felt.
The base of the papillae is nervous, and the papillae receive
the impression of foreign bodies.
Q. Are these papillae susceptible of erection?
#. Certain portions, as the tongue and nose, are sup-
posed to have an erectile capacity, somewhat resembling
the corpus cavernosum penis.
Q. Whence proceeds the mucus which lines this texture?
*ft. From the glands called mucous. They are found un-
der the chorion; they are largest in the velum palati and
mouth, and they are rounded in form.
Q. What difference is observable in the serous and
mucous fluids?
*#. The mucus is secreted; the serum exhaled.
Q. If the glands are seated beneath the chorion, how
are they excited to secretion by foreign bodies?
*#. These bodies irritate the extremities of the ducts
which convey the mucus, and thus the glands are irri-
tated.
MUCOUS SYSTEM. 243
Q. What becomes of the mucus which is poured out so
freely ?
#. It is evacuated from the various outlets; it is en-
tirely excrementitious.
Q. What pathological consideration is inferred from
the vast quantity of mucus secreted?
.#. Amongst others this, that the secretion, when sup-
pressed, must give rise to disease.
Q. What general difference is observed in the destina-
tion of secreted and exhaled fluids?
./?. Secretions are excrementitious; exhaled fluids are
recrementitious. One of many proofs of the excrementi-
tious tendency of mucus, is the uneasiness an accumula-
tion of it occasions, and the efforts by coughing to re-
move it.
Q. Is this texture full of blood-vessels?
*#. It receives a great many blood-vessels.
Q. Where is it most red?
t/2. In the stomach; and the colour depends on a net-
work of blood-vessels, which penetrate the mucous cho-
rion spread on its surface, and embrace the papillae.
Q. What results from the superficial situation of the
blood-vessels?
JL. The frequency of haemorrhage from the mucous
tissue.
Q. What arises from long exposure of portions of the
mucous surface to the air?
A. It is brought to resemble the skin; in certain cases
of vaginal prolapsus, hermaphrodism has been affirmed.
Q. Is there any reason to believe that the redness of
the mucous membranes is owing to the blood being oxy-
genated through their surfaces, as it is in the lungs?
244
MUCOUS SYSTEM,
ft. Experiments contradict the supposition,
Q. Does the redness of this tissue depend on the blood
circulating in the arteries?
<fl. It does not; it arises from the colouring matter of
the blood combined with the texture.
Q. Why is it of so much importance to know the nor-
mal colour of the mucous membranes?
*#. In order to decide on their pathological state.
Q; How do the exhalents on this texture favour haemor-
rhage?
JL. By the course being so very short from the artery,
through the exhalent, to the mucous surface. From this
it is inferred that haemorrhage is from exhalation and not
from rupture; and haemorrhage is incomparably more fre-
quent from this, than from other textures.
Q. What forms the pulmonary perspiration?
#. A considerable portion of it is a solution of the mu-
cous fluid which lubricates the bronchiae.
Q. How is absorption evidenced in this texture?
#. By the absorption of chyle and fluids swallowed,
on the intestinal surfaces; by the absorption of morbid
matters; by the absorption of the urine in the bladder; by
the absorption of turpentine vapours on the bronchial sur-
face.
Q. How do the mucous and serous absorptions differ?
#. Exhalations and absorption are relative to each
other, and regular on the serous surfaces; but not so on
the mucous.
Q. What nerves supply the origins of the mucous sur-
faces ?
#. Where these surfaces are in relation to external bo-
MUCOUS SYSTEM. 245
dies like the skin, the cerebral nerves go to them; other-
wise the mucous nerves are ganglionic.
Q. Recapitulate the organization of the mucous tissue?
A. It consists of an adhering sub-mucous cellular coat,
of a free surface, a mucous chorion, a vascular net-work
composed of blood-vessels, nerves, exhalents, mucous
glands, and papillae.
Properties of the Mucous System.
1. Properties of Texture.
Q. What properties of texture are manifest in the mu-
cous tissue?
#. Extensibility and contractility are evident, but these
are unequally active in the tissue. The stomach and
bowels possess them to a great degree; the ureter is more
distensible than the urethra.
Q. When fluids cease to pass through the mucous ca-
nals, what takes place?
/?. They contract, but never adhere. When blood
ceases to pass through an artery, it closes and becomes li-
gamentous; not so with the mucous canals. What bad
consequences must result if there existed in the bowels or
urethra a disposition to close.
2. Vital Properties.
Q. What are the active vital properties of the mucous
tissue?
A. Animal sensibility is essential and conspicuous. In
the perception of odours, on the vaginal and urethral sur-
246 MUCOUS SYSTEM.
faces, and on the glans penis, it is much more acute than
on the skin.
Q. Why is animal sensibility so manifest on this tis-
sue?
*ft. In order to watch the impression of foreign bodies,
to the contact with which it is constantly liable.
Q. What effect has habit on the animal sensibilities of
the mucous tissues?
t/?. It renders sensations which are at first painful,
either indifferent or pleasant, and vice versa. As you ad-
vance in life, repeated and habitual contact diminishes the
sensibility of the tissue.
Q. Why is it that the gall-bladder does not perceive
bile?
*#. Because habit and uniformity of perception allow
no comparative sensations.
Q. What effect has disease on the animal sensibility of
this texture ?
A. It raises it considerably, but never to such exalta-
tion as is felt in the serous and cellular tissues.
Q. Is there much animal contractility in the mucous
tissue?
#. There is none.
Q. What organs feel most acutely in disease?
t/?. Those which feel least in a natural state.
Q. What properties of organic life are conspicuous in
the mucous tissue?
Ji. Both organic sensibility and insensible organic con-
tractility; and these are kept in activity by the nutrition,
exhalation, absorption, and secretion, which go on in
these tissues.
MUCOUS SYSTEM.
Q. What is remarkable of the properties alluded to in
the last answer?
*/?. That they are liable to higher degrees and greater
varieties of exaltation than in other tissues. From this fact
results the consequence that these tissues are subject to a
variety of diseases.
Q. How does Bichat divide the sympathies of this tex-
ture?
t/tf. Into active and passive. In the first it influences
other parts; in the second it is influenced by those parts.
Q. Repeat the general law of sympathies, which we
have more than once alluded to.
/?. That they act on the predominant vital properties
of a part; for instance, exciting animal sensibility where
that predominates, or animal contractility, or sensible or-
ganic contractility, according as the one or other may be
the principal vital property.
Q. It is important to recollect the active sympathies of
the mucous surfaces, will you give illustrations of them?
*/2. Irritation on the pituitary membrane excites the
animal contractility of the diaphragm to sneezing.
ftnimal sensibility is excited sympathetically at the glans
penis, by a stone irritating the mucous membrane of the
bladder; the same vital property is in action when worms
in the intestines induces itching at the nose. The semen
passing the urethra, excites the sensible organic contrac-
tility of the heart to increased action; the same vital pro-
perty in the stomach is exalted in the vomiting occasion-
ed by the irritation of a stone on the lining membrane of
the pelvis of the kidney. You see a sympathetic excite-
ment of organic sensibility and insensible organic con-
2 ib MUCOUS SYSTEM.
tractility^ when a sialogogue acting on the extremity of
the salivary duct, induces a discharge of saliva from the
glands; another instance of this sympathy is, when the
mucous membrane on the tongue is furred in consequence
of disordered stomach ; and lastly, a very remarkable sym-
pathy of these properties with the mucous membranes is,
when the cutaneous organ sympathizes with them during
digestion. To the sympathies of insensible organic con-
tractility and organic sensibility, are to be ascribed the
haemorrhages which one mucous tissue assumes vicarious
to those of another portion of this texture.
Q. In passive sympathies this tissue is influenced by
diseases of other textures, give examples of this.
t#. In several diseases of other tissues you have burning
sensations in the mucous membranes of the mouth, bowels,
and stomach ; in some cases there is great thirst. Now,
in these cases the animal sensibility of the mucous tis-
sue is in passive sympathy. Again, the influence of cold
applied to the skin, on haemorrhage of the mucous tissue,
is a passive sympathy of the insensible organic contrac-
tility; so likewise are the catarrhs from exposure to cold,
and the effect of warm bathing in catarrh ; also the disor-
der of certain portions of the mucous membrane in some
diseases, as that of the throat in eruptive cases; lastly, the
diarrhoea in chronic diseases, and the pectoral haemor-
rhages in the last stages of organic diseases; these are all
passive sympathies of the insensible organic contractility
of the mucous membranes.
Q. Why are there not sympathies of the other vital
properties in the mucous texture?
t#. Because these properties are either not in existence,
MUCOUS SYSTEM.
or are not the predominating ones of the texture; for you
know sympathies play upon the predominant vital proper-
ties of a tissue.
Q. State the most important characters of the vital pro-
perties of this texture.
Jl. They are constantly active; each portion of the tis-
sue has its peculiar modification of vital properties in con-
sequence of peculiar organization; and from these varieties
in the vital forces result the various diseases of this tissue.
Q. Can you explain what you refer to the peculiarity
of the vital forces?
ft. One stimulus exalts those of the pituitary mem-
brane, another those of the urethra, while a third increases
those of the stomach. The vital force of each is in rela-
tion to its peculiar stimulus.
Q. Is the mucous secretion alike in all parts of the
tissue?
&. In different parts of the texture it is very different
both in health and disease.
Q. What part of the mucous system has the most ex-
tensive range of sympathies?
A. That of the stomach ; the least affection of which
organ induces by sympathy the greatest uneasiness.
Q. But is it the mucous membrane of the stomach
which is the source and seat of the active and passive
sympathies?
A. The other tissues of the stomach, such as the serous
and muscular, have common organization, while that of
the mucous is peculiar. Hence it is probably the seat of
normal and abnormal sympathy,
32
250 MUCOUS SYSTEM
Development of the Mucous System.
Q. Is there any thing remarkable in the development
of the mucous surfaces at the various periods of life?
*/2. It is highly important that the physician should re-
collect the following circumstances: the sudden impulse
given to the vital forces of this, tissue at birth, when the
meconium and urine stimulate to their discharge; that the
soft delicacy of the mucous tissues of the stomach, lungs,
and bowels, may render children so liable to cough, vo-
miting, and diarrhoea; that haemorrhages from this texture
in youth are very active; that the colour of the mucous
membrane is bright red till the thirtieth year; that this
colour varies greatly in redness, and that at particular
periods of life the gastro-pulmonary and genito-urinary
mucous tissues are in especial susceptibility to disease.
Q. Why are contagious diseases less liable to be taken
at advanced periods of life?
/#. Because the mucous membranes are less irritable,
and not so susceptible of disease as in youth.
Q. What does Beclard consider as the structure of the
papillae or villi?
#. That they are a net-work of vessels of the form of
leaflets, slightly curved round each other, but it is not
clearly shown whether they have orifices or not.
Q. What is meant, according to Beclard, by the mu-
cous follicles?
Jl. They are what have been improperly termed mu-
cous glands. Instead. of being glands, they are inversions
under the free surface of the membrane in which they are
formed ; they are folded, form a cul-de-sac, and end in an
MUCOUS SYSTEM. 251
opening on the free surface. They vary much in size;
they are simple or compound.
Q. What do you understand by the alveolar structure
of the mucous tissues?
t#. They are small superficial cavities found in the gas-
tric and intestinal mucous surface by Mr. Hewson, and
more accurately described by Mr. Home. They are
called alveolar from their resemblance to the cells of bees.
Q. How do they differ from follicles?
#. In this, that their mouths are broader than their
bottoms.
Q. State an important fact as to the follicles and
alveoli.
*ft. It has been ascertained that in herbivorous animals,
the follicles are more complicated in structure, and secrete
a more active juice. In carnivorous animals they are
more simple, and resemble alveoli. In omnivorous animals,
in man, they are of both kinds on the mucous surface.
Q. How does follicular secretion differ from glandular,
and from exhalation?
A. In follicles, the secreted fluid is brought directly by
the extremities of the arteries; the secreted fluid remains
in the follicular cavity to be elaborated before it is thrown
out on the organ.
Q. What is the nature of the membrane lining abscesses
and fistuke?
./?. They are'evidently mucous.
Q. Under what circumstances do mucous canals close?
t#. When by any cause an inflammation arises which
destroys the mucous surfaces; then the parts in contact
cicatrize.
MUCOUS SYSTEM-
PATHOLOGY OP THE Mucous TISSUE,
Q'. What are the diseases common to all the mucous
tissues?
*#. Increased action to inflammation; mucous discharge;
haemorrhage; aphthae; and fungous excrescences.
Q. Are all the increased mucous discharges from in-
flammation ?
#. They are not; both irritation and relaxation will
produce them.
Q. What are the inflammations or catarrhs of this tissue
most usually produced by ?
*ft. By atmospheric changes.
Q. How do these changes act?
.#. Directly on some of the mucous tissues, and by
means of cutaneous sympathy on others.
Q. What is the character of the pain in these mem-
branes?
#. It is not lancinating or severe, as in other tissues.
Q. What effeqt has mucous inflammation on the neigh-
bouring cellular texture?
J2. That texture is not excited to inflammation by mu-
cous disease, as in the diseases of other tissues.
Q. What is the colour of the mucous membranes in in-
flammation ?
A. They are from a rose colour to deep brown; this
colour is sometimes arborescent, and sometimes in dotted
points, when the villi are inflamed; lastly, the colour is
in red spots.
Q. How do these inflammations terminate?
#. Not in adhesion, but in mucous discharges, or
MUCOUS SYSTEM. 253
mu co-purulent 5 in haemorrhage; in thickening of the mu-
cous membranes. They terminate rarely in gangrene.
This does take place in angina.
Q. There is one remarkable termination omitted.
/?. It is the formation of membranes as in croup and
in the intestines.
Q. Is the morbid mucus alike in all the membranes ?
t/2. It is not; it varies in them very much ; and even in
the same membrane at different periods the mucus is of
different colour and nature, becoming pus.
Q. When mucous membranes are, from any unnatural
cause, disused, what takes place?
/#. They contract and close.
Q. What is the nature of the membrane lining fistulse?
i/?. It is mucous.
Q. On what do the morbid growths and enlargements
on the mucous membranes depend?
t/?. On morbid action and development of the mucous
capillaries, from long-continued irritation and chronic in-
flammation.
Q. What are the causes of mucous haemorrhage?
t#. They are from exhalation and disorganization, not
from rupture.
Q. Whence may exhalation of blood in mucous mem-
branes arise?
#. From an exaltation or diminution of the vital forces
of the membranes. Hence the active and passive haemor-
rhages.
Q. What is the pathology of aphthae?
. They are either little tubercles ulcerated, or small
tumefied glands.
254 MUCOUS SYSTEM.
Q. What are fungi of the mucous membranes?
/?. They are thickenings of the mucous parietes.
Q. What general division of the diseases of this tissue
do you make?
/?. The idiopathic and symptomatic.
Q. What are the diseases of the conjunctiva?
A. Ophthalmia and fungus.
Q. Name the diseases of the pituitary membrane.
*ft. They are coryza, ozoena, polypi, abscess in the
malar antrum, and inflammation of the Eustachian tube,
and haemorrhage.
Q. What renders the pituitary membrane so liable to
haemorrhage?
*# Its great vascularity.
Q. How do you divide polypi of this membrane?
#. Into the vesicular and hard; the last is most dan-
gerous.
Q. Is the mucous membrane of the mouth prone to in-
flame?
e/#. It is less so than any of the mucous surfaces.
Q. What persons are most liable to aphthse?
#. Children, and those who at any age have chronic
diseases.
Q. There is another disorder to which the mucous
membrane of the mouth is little disposed, what is it?
t/2. Haemorrhage rarely proceeds from it.
Q. What active sympathy does this mucous surface
maintain?
*fl. That of the tongue with the stomach.
Q. To what are the foul tongue and the black tongue
owing?
MUCOUS SYSTEM. 255
t#. To disease of the subjacent glands of the mucous
membrane or of the tongue.
Q. What affection most frequently appears on the mem-
brane of the pharynx?
#. Venereal ulceration.
Q. Name the principal diseases of the laryngeal mu-
cous surface.
t/2. Croup, and laryngeal phthisis.
Q. Where is the force of the last disease expended?
t#. Originating in the mucous membrane, it fixes on and
destroys the arytenoid cartilages by ulceration.
Q. What are the general pathological states of pulmo-
nary catarrh?
Ji. Those of acute and chronic mucous inflammation.
Q. Name another frequent disease of the pulmonary
mucous membrane.
*fl. Haemoptysis, which ends in phthisis.
Q. What are the diseases of the gastric mucous mem-
brane ?
*ft. It has its catarrhal state. You find also the haema-
temesis, and cancer; if indeed the last arises from the mu-
cous surface.
Q. To what affections is the intestinal mucous mem-
brane liable?
#. To acute and chronic diarrhoea and dysentery.
Hemorrhage does not often occur there.
Q. In what part of the intestinal tract do you find
cancer?
#. Chiefly about the rectum.
Q. Whence is tympanites?
/?. It is a collection of air in the bowels; the gas is se-
creted from the mucous membrane.
256 MUCOUS SYSTEM.
Q. There are two causes for gonorrhoea, what are
they?
ifl. The disease is from ordinary and specific causes.
Gonorrhoea from filth, illustrates the first; that from syphi-
lis, the second.
Q. Where is gonorrhoea seated ?
tfi. It is a disease of the mucous glands. Recollect the
fluor albus in females.
( ->57 )
SEROUS SYSTEM.
Q. Why is it so called ?
.#. From the kind of fluid that constantly lubricates
one of its surfaces.
Of the Extent, Forms, and Fluids of the Serous System,
Q. Name the principal serous membranes.
^?. They are the peritoneum, the pleura, the pericar-
dium, the arachnoides, the tunica vaginalis testis.
Q. What form does the serous tissue assume ?
Jl. Always that of membrane.
Q. What distinctive observation here arises between
the serous and mucous membranous expansions?
#. The serous membranes are spread out over the ex-
ternal surface of the organs; the mucous membranes line,
the interior of the organs.
Q. Which is the most extensive system of the two?
&. The serous tissue.
Q. Mention another distinguishing trait in these two
tissues.
#. The serous tissues pour out, by exhalation, an albu-
minous fluid; the mucous tissues secrete mucus.
Q. Does the serous surface exceed the cutaneous in
extent?
A. It does; it is even probable that the serous exhala-
tion exceeds in quantity the fluid prepared on the cuta-
neous and pulmonary surfaces collectively.
33
258 SEROUS SYSTEM,
Q. Is serum an excrementitious fluid?
*#. Entirely the reverse; it is recrementitious.
Q. What is the form of each serous membrane?
#. That of a sac without an opening; like a double
night-cap folded within itself.
Q. Into how many parts can a serous membrane be
divided?
/?. Remembering that it is continuous, it may be di-
vided into the membrane that lines the inner surface of a
cavity, and that which invests the outer surface of the or-
gans contained in that cavity. Take for illustration the
costal pleura and the pulmonary pleura.
Q. What do you understand by the free and adherent
surfaces of the serous membranes?
t/2. The adherent surface covers the organs; the free
surface the interior of the sac.
Q. What is Bichat's doctrine of organic life?
Jl. That each organ has its peculiar life, resulting from
a particular modification of its vital forces; this modifica-
tion establishing one in the circulation, nutrition.and tem-
perature of each organ.
Q. Is any influence on these separate lives produced by
the serous investitures?
Jl. The serous membranes so insulate the organs as to
favour the theory and operation of separate lives.
Q. What influence have the serous investments on the
spread of diseased action from one organ to another?
Jl. They are unfavourable to such extension of morbid
action.
Q. In what pathological point do the serous and mucous
tissues conspicuously differ?
#. In their respective dispositions to form adhesions
SEROUS SYSTEM, 259
You will observe that the serous surfaces are as prone to
adhere, as you have seen the mucous tissues reluctant to
do so.
Q. Where are these serous adhesions most frequently
found?
ft. They occur most frequently in the pleura. They
are seldom met with in the tunica arachnoides.
Q. These adhesions vary much; will you describe some
of these varieties ?
#. Sometimes they are so extensive and close as to
form but one membrane; again they are loose and easily
separable. Then you will see elongations from the fixed
to the free serous surface, these elongations have canals in
them. Bichat thinks these elongations are original for-
mations, not the result of diseased action; and lastly, there
are adhesions of cellular layers, without these canals.
Q. What is to be observed of the connexions of the se-
rous and mucous membranes in disease?
t/2. That as their organization differs, and as their vital
forces vary, they are distinct and unconnected in disease.
Q. What is the nature of the serous fluids?
/?. It is a dew, a halitus in health; the serum is albu-
minous in its nature. In disease it is found changed to
pus, albuminous flakes, bloody, and fluids of various other
colours.
Organization of the Serous System.
Q. What are the characters of the organization of serous
tissue?
Jl. It is a single, transparent, whitish, shining mem-
260 SEROUS SYSTEM,
brane. It differs from the mucous tissue in having but a
single layer.
Q. What is the nature of this membrane ?
#. It is cellular. It has the common organization of
the cellular tissue, without any peculiar structure; it has
not, for instance, any peculiar structure, such as the mus-
cles have in their fibrin, or as the bones have in their phos-
phate of lime.
Q. What proof have you that this serous tissue is cel-
lular?
t#. It is proved to be so by the identity of function and
that of disease; it is cellular, because it is inflated or infil-
trated by air; and in the process of maceration, the absence
of fibrous structure proves negatively the identity of the
serous and cellular tissues.
Q. What gives to some parts of the body a deeper
black in putrefaction than others?
t#. The blackness in putrefaction depends on the quan-
tity of blood in the putrefied part.
Q. In what pathological points do the serous and cel-
lular tissues differ?
<ft. In the first, being subject to a slow inflammation
producing tubercles, and in the circumstance that the se-
rous pus differs from that in the cellular texture.
Q. What are the parts common to the serous mem-
branes?
Ji. Exhalents, absorbents, and blood-vessels.
Q. Are the blood-vessels numerous?
Jl. No; in health they are few and small.
Q. What shows the existence of exhalents in this tis-
sue ?
/?. Expose a serous surface in the living animal, wipe
SEROUS SYSTEM. 261
it dry, and you will very soon see it covered with new
serum from the exhalents.
Q. How will you have a view of the absorbents?
A. Macerate a beef's heart for several hours in water,
and you will see its serous surface covered with absorb-
ents; this among other modes of showing them.
Q. What varieties of organization do the serous tissues
present ?
t#. Perhaps each membrane has its peculiar structure.
There is the thin, soft, tender arachnoides; the thick,
compact peritoneum.
Q. What pathological principle do you derive from this
variation in structure?
<ft. Diversity in disease; greater or less liability to acute
and chronic inflammation.
Q. To what peculiar affection is the pericardium sub-
ject?
*ft. To the formation of thick white layers on its inter-
nal surface; such as are not found elsewhere in the serous
surface.
Q. What tissues are exclusively the seats of serous ef-
fusion ?
. The serous and synovial textures.
Properties of the Serous System.
\. Properties of Texture.
Q. Do the serous membranes manifest much extensi-
bility ?
#. From the dilatations they undergo, you would sup-
262 SEROUS SYSTEM.
pose the tissue was very extensible. Not so, however; for
in these dilatations the folds of the serous membranes are
developed, or there is a kind of displacement of these
membranes. This is the case in ascites and pregnancy.
The texture is but slightly distensible.
Q. Under what circumstances are these displacements
of the serous membranes painful?
#. They are severely so in inflammation.
Q. What have you to say of the contractility of this
texture ?
Jl. That it is evident, though not very great. It is
evident in hydrocele and ascites after the water is evacu-
ated. After long and repeated distention these membranes
lose their contractility.
2. Vital Properties.
Q. What vital properties predominate in these tissues?
#. Insensible organic contractility and organic sensi-
bility. The other vital properties are wanting.
Q. What effect has disease on these properties?
t/2. By it they are so exalted as to give acute pain, and
the texture of these membranes is readily changed.
Q. When the serous tissues sympathize with affections
of other organs, where is the effusion of serum found?
#. In the serous cavity nearest the affected organ; as
in the chest when the heart is diseased.
Q. What distinction does Bichat draw between idiopa-
thic and sympathetic serous disorder?
#. In the idiopathic disorder, the exhalents and ab-
sorbents of the texture are in a diseased state; in the sym-
SEROUS SYSTEM. 263
pathetic they are not. In the idiopathic the serum is greatly
altered in colour, consistence, &c.; in the sympathetic the
serum is healthy.
Development of the Serous System.
Q. How does the development of the serous tissues pro-
gress?
#. . In proportion to that of the organs they cover.
Q. Which is earliest and most rapidly developed?
/?. The arachnoides, and hence hydrocephalic effusion
is so frequent in infancy: next in development is the
pleura, hence the frequency of pleurisy in youth.
Q. What alteration in form often takes place in diseases
of the serous tissues?
Jl. They become in some cases much thicker, and in
others thinner than in their healthy state.
Q. Why is it of practical importance to know the dis-
placements of the serous membranes?
/?. Because in these displacements there is a change in
the relations of parts.
Q. What is the nucleus of the various tubercles, tu-
mours, &c. which are seen in such numbers on the serous
membranes?
#. The nucleus is formed by a concretion of albumen
which becomes vascular.
Q. In what points do hydatids and cysts differ?
t/?. Cysts are connected with surrounding parts by cel-
lular substance and blood-vessels; hydatids are not. The
parietes of cysts have a degree of consistence which hyda-
tids do not exhibit. Hydatids have granular substances
on some part of their surface ; cysts have not.
264 SEROUS SYSTEM
PATHOLOGY OF THE SEROUS TISSUE,
Q. Give a general division of the serous diseases.
#. They are idiopathic or essential, and sympathetic,
Q. What is the most frequent disease of this tissue?
#. Inflammation, acute and chronic.
Q. Are all the membranes equally disposed to inflame ?
A. No; they exhibit this disposition in the following
order, viz. the pleura, peritoneum, pericardium, tunica
vaginalis, and the arachnoid membrane.
Q. What is the most frequent cause of serous inflam-
mation?
#. Suppressed perspiration.
Q. What conspicuous symptoms attend serous inflam
mation?
t#. A peculiar lancinating pain and great fever.
Q. What is the common termination of serous inflam-
mation?
*ft. It is by adhesion; and this takes place by a new
membrane, or by an elongation of fibres, or by contact
and blending of the surfaces of the membranes.
Q. What is the order of liability, in the serous mem-
branes, to this adhesion?
ft. It is as follows: the pleura is most given to form
adhesion, next the peritoneum, then the pericardium, the
tunica vaginalis, and lastly the arachnoides.
Q. As serous inflammation terminates in effusion and
suppuratibn, what fluids are found in the sacs ?
Jl. It sometimes resembles milky serum, sometimes it
has flakes swimming in the serum; the serum is again
bloody; and lastly there is pus.
SEROUS SYSTEM. 265
Q. What indicates the formation of pus in the serous
sacs?
.#. Alteration of the pain from its acuteness; there is a
sensation of weight, and the symptomatic constitutional
signs of the suppurative process.
Q. In which serous tissue does gangrene oftenest ap-
pear?
ft. In the peritoneum; but observe that the blackest
peritoneum is not always the most gangrenous.
Q. There is another important and common termina-
tion of acute serous inflammation which has not been
named.
t/tf. It is the chronic inflammation. You will recollect
that this is very often an original form of disease, as well
as a consequence of the acute serous inflammation.
Q. Is chronic inflammation of the serous membranes
habitually extended from one to another?
,#. Very rarely ; but observe the continuous affections
of the mucous membranes.
Q. What is the character of die pain in chronic inflam-
mations of the serous membranes?
#. It is an obscure, pricking pain.
Q. What is the most interesting pathological result of
this chronic inflammation of the serous membranes?
*#. Dropsy; the correct pathology of which is, that it
is a chronic inflammation of the serous membranes.
Q. Can you point out a difference in the symptomatic
and idiopathic dropsies?
.#. When dropsy is symptomatic of an organic disease,
the cellular tissue is infiltrated; but when idiopathic, it is
in the serous cavities alone.
Q. What fluids are deposited in dropsy?
. 34
266 SEROUS SYSTEM.
*ft. Serum, bloody serum, greenish serum, serum with
flakes, blood itself.
Q. What is the autopsic demonstration in the serous
tissues after chronic inflammation?
*fl. They are slightly thickened and swollen.
Q. There is yet another pathological state of the serous
membranes.
*ft. Yes. They are the seats of miliary eruption ; this is
especially true of the peritoneum. In these cases the mem-
brane is red, an$ the disease arises from repelled eruptions
and from cold.
Q. What is the first pathological process in the course
of serous inflammation ?
/?. It is to check the exhalation of serum.
Q. What is the most frequent sympathetic disease of
the serous membranes?
A. Dropsy; which arises either from the disease of the
organ invested with serous membranes, or from the debi-
lity of protracted organic disease, as consumption. The
last are passive exhalations of serum.
Q. What serous membranes are most obnoxious to
symptomatic dropsies?
. The peritoneum, the pleura, and the pericardium,
in the order in which they are named.
Q. What are the diseases of the pleura ?
A. Acute and chronic inflammation.
Q. Why is acute pleurisy so frequent?
A. This frequency is occasioned by proximity to the
lungs, which are so constantly exposed to the air ; another
cause, the susceptibility of the pleura to take on disease
from suppressed perspiration.
Q. With what is pleurisy apt to be confounded?
SEKOUS SYSTEM- 3()7
fl. With peripneumonia.
Q. How are they distinguished?
/?. The pain in pleurisy is acute, in peripneumony it is
obtuse or deep-seated; in pleurisy external pressure gives
pain, but it is not so in peripneumony. The dyspnoea in
pleurisy is attended with acute pain, and full inspiration
is impossible in peripneumony, owing to the oppression
and the obtuse pain. The face in peripneumony is very
red, even livid ; in pleurisy it has the ordinary febrile red-
ness. The pulse is full, strong, and hard in pleurisy, but
in peripneumony it is oppressed, and not necessarily hard
or full. Lastly, auscultation gives obscure sound in pe-
ripneumony, not so in pleurisy.*
Q. What does the protracted pain in pleurisy indicate?
#. The continuance of inflammation ; for inflammation
does not suddenly, but gradually subside.
Q. What are the signs of suppuration in pleurisy?
/?. Diminution of force and increase of frequency in
the pulse; irregular chills, hectic flush, sweats, alteration
of pain from acuteness to a sense of weighty pain, expan-
sion of the affected side.
Q. What two modes are important in ascertaining the
presence of pus?
#. Percussion is one; and pressure on the epigastrium,
which, by throwing the pus up, occasions a sense of suffo-
cation.
* At the commencement of pleurisy, before any adhesions take place,
or fluid is effused, the sound on auscultation is natural; but when the
effusion is considerable from the commencement, or becomes so dur-
ing the progress of the disease, the sound is dull. If the effusion is
moderate, the sound is dull in the lower part of the thorax, both la-
terally and posteriorly.
268 SEROUS SYSTEM.
Q. How does chronic pleurisy differ from phthisis?
#. The cough is drier, there are no night sweats; the
pain is fixed, and in pleurisy there is local dropsy with its
indications ; whereas, in phthisis there is cellular dropsy.
Q. What effects have diseased lungs on the pleura?
Ji. They induce chronic pleurisy.
Q. Are there any certain indications of effusion in the
pericardium?
.#. If any one will distinguish it from surrounding dis-
ease, it is pressure on the epigastric region, which throw-
ing up the fluid, occasions suffocation.
Q. What are the terminations of pericarditis?
t#. In adhesion, suppuration, in effusion of serum, and
in a greatly increased thickness.
Q. Is the peritonitis as local as the pain in that dis-
ease?
ft. Although the pain may be locally very acute, yet
the inflammation is diffused. It is the same case with
pleurisy, in which the pain is pointed, although the in-
flammation is extensive.
Q. Whence does the vomiting in peritonitis arise ?
#. It is sympathetic, not from irritating gastric con-
tents.
Q. Mention a very remarkable distinction between pe-
ritonitis and dysentery.
#. In peritonitis the bowels are costive or natural, in
dysentery the stools are characteristic of mucous irrita-
tion.
Q. How does peritonitis terminate?
#. In adhesions of the intestines to each other, in
serous effusion, in the formation of pus, and in gangrene
Q. Where are these adhesions most conspicuous?
SEROUS SYSTEM. 269
*#. In the large intestines. I have seen all the intes-
tines perfectly glued together by adhesions* in chronic pe-
ritonitis; they could not be separated.
Q. To what is the abdominal swelling in puerperal
fever owing?
*tf. To a distention of the cellular texture subjacent to
the serous membranes.
Q. What symptoms are peculiar to puerperal perito-
nitis?
./?. The condition of the breasts, and the lochial dis-
charge.
Q. Whence does ascites originate?
*#. From idiopathic and symptomatic chronic inflam-
mation of the peritoneum. The hydrocele is from acute
or chronic inflammation of the tunica vaginalis.
Q. What are the diseases of the arachnoid membrane?
Ji. Phrenitis, hydrocephalus.
Q. Are there not other seats of these diseases in the
brain than the arachnoid membrane?
*fl. As the other tissues in the cranium are not suscepti-
ble of inflammation, the answer is in the negative.
( 270 )
SYNOVIAL SYSTEM.
Q. In what respects does this system resemble the se-
rous?
. In its form, the sac without opening; in its texture,
which is cellular ; and in its functions, those of exhalation
and absorption.
Q. In what respects do they differ?
*#. In the composition of their fluids. Dropsical affec-
tions of the cellular and serous tissues do not induce sy-
novial dropsies, and vice versa. The synovial tissues are
not so subject to tubercular diseases as the serous. Adhe-
sions do not take place in the synovial tissues as in the se-
rous. The synovial membranes are not locomotive as the
serous were said to be. The fluids of synovial and general
dropsy are not alike.
Q. How is the synovial system divided ?
*#. Into that of the joints, and that of the tendinous
grooves.
1. Of the Articular Synovial System.
Q. How are the fluids of the system separated from the
blood?
%#. In three ways. By secretion from a gland, inter-
mediate to the blood-vessels, which bring the blood, and
the excretory which carries off the secreted fluid; by ex-
halation, where there is a direct continuity of blood-ves-
SYNOVIAL SYSTEM. 271
sel and exhalent, without an intervening gland; by t
dation, which takes place after death.
Q. Why do you object to the formation of synovial
fluid by secretion?
#. Because the glands, ducts, and other apparatus of
secretion do not .exist.
Q. Why do you oppose the doctrine of the transuda-
tion of the synovia?
/?.' Because the operation of transudation is in opposi-
tion to vitality, and compatible only with death in the
vessels.
Q. Can you maintain the doctrine of exhaled synovia?
*ft. It is reasonable to adopt the doctrine of exhalation,
because the serous and synovial fluids resemble each other,
being both albuminous. The use of the two fluids is the
same, both being destined to lubricate surfaces admitting
of free motions. The serous and synovial fluids are both
liable to be suppressed by inflammation. The synovial
membranes, when they do adhere, in this resemble the
serous. The two tissues are both liable to dropsy; and
finally, both fluids are absorbed.
Q. What is the appearance of the synovial fluid?
/?. It is a white, viscid, transparent, ropy, unctuous
fluid, supposed to have a peculiar kind of albumen.
Q. What is the form of the synovial membrane?
/?. A sac without an opening, spread on the articular
surfaces.
Q. How is this form ascertained ?
JL. By dissection, and by the appearance of the mem-
brane when thickened by disease.
Q. What difference appears between the fibrous cap-
sules and the synovial membranes?
272
SYNOVIAL SYSTEM.
A. They are totally distinct, in function and organiza-
tion, from those capsules, which last are found only in one
or two articulations.
Q. What are the red fatty bunches found about the ar-
ticulations?
ft. They are points at which the blood-vessels going to
the synovial membrane divide most minutely: but they
are not glands, as has been supposed.
Q. What properties of texture and of life belong to this
synovial tissue?
.#. Slow extensibility, organic sensibility and insensi-
ble organic contractility. In disease the organic is exalt-
ed to animal sensibility, producing pain.
Q. What experiment proves the presence of fibrous
capsules about a joint?
A. Twist a joint where these capsules are, and there is
much pain ; but where the synovial membrane exists alone,
there is not this pain from twisting the joint.
Q. Are the sympathies of the synovial tissue active?
#. On the contrary they are few and weak.
Q. What is the function of this texture?
#. To. exhale synovia for the lubrication of the joints ?
Q. At what period of life does this tissue bear the
greatest proportional development?
Jl. In the foetus and the infant; for the reason that the
articulations are larger in a cartilaginous than in their
osseous state.
2. Synovial System of the Tendons.
Q. Where is this found?
#. In the tendons of the extremities, but not in ti><
trunk.
SYNOVIAL SYSTEM.
273
Q. What general observations have you to make on this
tissue?
Jl. That in its organization, properties, functions, sym-
pathies, it resembles precisely the articular synovial sys-
tem.
Q. What do you mean by synovial fringes?
A. They are elongations and duplicatures of the mem-
branes, from which the synovia is almost exclusively ex-
haled.
Q. Are there not points of difference in the serous and
synovial systems, besides those already stated?
t#. The serous tissues have more blood-vessels, more
lymphatic, and apparently fewer laminae.
( 274 )
GLANDULAR SYSTEM.
Q. How do you define a gland?
#. It is a body from which flows, by one or many ducts,
a fluid, which this body separates from the blood received
by vessels which go to it.
Q. What important peculiarity is found in this system?
#. That the texture peculiar to it is not precisely the
same in all the organs that compose the system. The tex-
ture of the liver differs from that of the kidney.
Q. Name the glands.
t#. Those on the head are, the salivary, the lachrymal,
the meibomeian and ceruminous of the ear, and the amyg-
dala. On the thorax, the mammae. In the abdomen the
liver, pancreas and kidneys. In the pelvis, the prostate
and testicles. On the trunk and face the mucous glands.
Q. Are there glands on the extremities?
t/2. There are none.
Situation, Forms, Division, Sec. of the Glandular Sys-
tem.
Q. What is to be observed of the position of these
glands ?
/2. They are in two situations, sub-cutaneous, and deep-
seated.
Q. Does the motion communicated to the glands by the
neighbouring parts, induce their excretion?
GLANDULAR SYSTEM. 275
A. It does not. That operation is the result of vital ac-
tion; still the motion given to some glands may be acces-
sory to excretion.
Q. Under what circumstances is this accessory motion
necessary ?
#. It is found wherever the parietes of the organ are
not very powerful.
Q. Besides the division of glands into sub-cutaneous
and deep-seated, there is another, what is it?
V?. Into single and double glands. The liver is a single
gland; the kidneys are double, in pairs.
Q. Is there the exact symmetry in two glands of the
same pair as is found in the organs of animal life?
#. There is not; because the harmony of action in ani-
mal life requires the utmost exactness.
Q. What circumstance materially controls these varie-
ties of form in the glandular tissue?
*fl. The fact of their being invested by a strong mem-
brane has great influence in this respect. The liver, which
is contained in a membrane, has much fewer varieties than
the lachrymal, or the salivary, which are without such in-
vestment.
Organization of the Glandular System.
Q. In what is the texture of the glands peculiar?
#. The oblique or longitudinal fibrous linear arrange-
ment met with in the muscular, osseous, nervous tissues,-
is not seen at all in the glands. They are agglomerated,
and slightly united by cellular texture.
Q. How is the parenchyma of glands to be divided?
rf. Into three forms.
276 GLANDULAR SYSTEM.
Q. What are they?
A. There is first, the glandular parenchyma with larger
lobes, separated from each other by cellular substance;
these larger lobes are resolved into smaller lobes, which
are agglomerated ; and these smaller lobes are composed
of glandular grains.
Q. What glands are thus organized?
*#. The pancreas, the salivary and lachrymal glands.
Q. What is the second form of the glandular paren-
chyma?
#. It is that of glandular bodies connected by cellular
substance without the lobulated structure of the first form.
Q. What glands are examples of this?
. The liver and the kidneys.
Q. Designate the third form of the glandular paren-
chyma.
*#. The third form comprising the amygdalae and mu-
cous glands have a soft, pulpy parenchyma, without lobes
or grains.
Q. Is the organization of all the glands included in
these forms?
#. It is not. The mammary glands and the testicles
have a peculiar texture.
Q. What peculiar effect does ebullition produce on this
glandular texture?
#. All the tissues acquire the horny hardening in the
first ebullition, but as the boiling is continued they be-
come soft. Now the glands differ from the textures in
this, that the longer they are boiled the harder their sub-
stance becomes.
Q. What is the origin of the excretory ducts?
*#. They arise as capillaries, one from each glandular
GLANDULAR SYSTEM.
277
point in a gland ; they unite and form ducts. These excre-
tory ducts are known only in the glandular system.
Q. Is the number and arrangement of these ducts uni-
form in the glands?
ft. They are not uniform in either respect. Some glands
excrete by several ducts which do not communicate with
each other; this you see illustrated in the nipple. There
are some which excrete by a single duct; instances of
which you see in the parotids, the sublingual glands, and
the pancreas. There is a third set of glands which have
reservoirs for their secretions, of which the liver, testicles
and kidneys are examples.
Q. Where do the excretory ducts open?
/#. They all empty themselves either on the external
surface, or on the mucous membranes. They never open
on cellular or serous surfaces, for the secreted fluids are
all intended to be thrown off from the body.
Q. Can secreted fluids be introduced into the blood-
vessels with safety?
,#. They may be thrown in through the veins, or the
crural artery; but not through the carotids, for then they
make a fatal impression on the brain.
Q. What lines the excretories of the glands?
*ft. The mucous membrane.
Q. In what glands is there the greatest abundance of
cellular texture?
*ft. In those glands which have the organization of a
granulated white parenchyma, such as the heart, the pan-
creas, and the salivary glands.
Q. In what glands is there least cellular substance?
A. In those with compact parenchyma, as the liver,
kidney, prostate and mucous glands.
278
GLANDULAR SYSTEM.
Q. How do you explain the coexistence of extensive
disease of the liver, and yet a secretion of healthy bile?
#. The cellular texture of the organ is diseased, while
the peculiar glandular structure is unaffected.
Q. There are two causes for the size of the female
breast, what are they ?
*#. It may be large from the size of the gland, and from
an undue portion of cellular texture is another.
Q. How do the glands receive their arteries?
Jl. Those not invested with membranous expansions
receive their blood-vessels, on all sides, from the sur-
rounding parts. Those which have membranous cover-
ings receive these vessels at one point, usually in a fissure,
and they enter at that part of the gland which is least ex-
posed to external injury.
Q. What are the ultimate arterial ramifications in a
gland ?
#. Each glandular grain receives a capillary artery.
Q. Has arterial motion any other effect on a gland than
to circulate its blood?
A. Yes; it communicates an internal motion, very fa-
vourable to their functions.
Q. How does disease of the right auricle of the heart
affect the liver ?
Ji. By obstructing the flow of blood from the hepatic
vein, it has a direct congestive influence on the liver.
Hence at least one cause of the frequent simultaneous oc-
currence of diseased heart and liver.
Q. In what glands is there most blood ?
#. It is in greatest quantity in the liver and kidney;
and there is least blood in the pancreas, salivary, and la-
chrymal glands.
GLANDULAR SYSTEM, 279
Q. Are the nerves of the glands cerebral or ganglionic?
.#. Some receive cerebral nerves, such as the salivary,
lachrymal, &c. others are supplied by the ganglions.
Q. Have the nerves influence on secretion?
<ft. Whatever influence they may exercise, it is not es-
sential ; for we find, in many instances, that secretion goes
on, although the nerves of the part are destroyed.
Properties of the Glandular System.
1. Properties of Texture.
Q. To what extent does the glandular tissue manifest
properties of texture?
ft. Extensibility and contractility of texture exist to a
very limited degree.
2. Vital Properties.
Q. Have the glands the vital properties of animal life,
to any great degree?
.#. They have no animal contractility ; but some of the
glands, for example, the testicles, have, when pressed, and
others have, when cut, much animal sensibility.
Q. Is the pain of an inflamed gland peculiar?
/?. It is of a dull, obtuse character; not acute, as in the
cellular texture, nor sharp and biting, as in the skin.
Q. What as to their properties of organic life ?
*ft. Inafcnsible organic contractility, and organic sensi-
bility exist in their utmost activity in the glands. These
are the prominent properties that control the functions,
280
GLANDULAR SYSTEM.
and direct the pathology of glands. Sensible organic con-
tractility is wanting.
Q. How is glandular secretion executed?
*#. The blood contains the materials for secretion; the
organic sensibility of the gland elects from the blood the
appropriate elements, and the insensible organic contrac-
tility admits or rejects the fit or unfit elements.
Q. On what principle and power do secretion, exhala-
tion, and nutrition depend?
*#. On the power that organic sensibility exercises in
the gland, to select the materials for secretion; in the
serous membranes for exhalation; and in all the organs
for nutrition.
Q. On what does increased or diminished secretion
depend?
#. On an exaltation or depression of the predominant
vital forces of the glands.
Q. How is it that each gland exercises a peculiar
power so as to form its own secretion, as the liver to form
bile, the kidneys urine, &c.?
*ft. The power depends on a modification of the organic
sensibility in each organ.
Q. Are the glands easily affected by impressions from
other parts?
t#. These foreign impressions constitute the passive
sympathies of the glands. They are numerous, and they
appear in health and in the course of disease.
Q. Designate the normal passive sympathies of the
glands?
t/?. The effect of aliments on the salivary glands, the
irritation of the pituitary membrane producing tears; the
GLANDULAR SYSTEM. 281
passage of food into the duodenum occasioning a flow of
bile. These all take place on the mucous surfaces, and
are passive normal sympathies.
Q. You have said that the passive sympathies of the
glands were frequently abnormal or morbid.
#. They are so. Consider how the liver, kidneys, and
mucous glands, are affected by diseases, and particularly
the influence of diseased stomach on the mucous glands of
the tongue.
Q. How do you explain the effects of grief on the
glands of the eye?
fl. The first impression of grief is on the epigastric
region, and with this region the lachrymal glands sympa-
thize.
Q. What glands are least disposed to assume abnormal
sympathetic action?
ft. The testicles and prostate glands, because their
functions are insulated from the rest. But as the greater
number of the other glands are intimately connected with
the process of digestion, which process supports the very
existence of all the organs; for this reason we say that
these glands sympathize more readily and fully with all
the organs.
$. Are the active sympathies of the glandular system
numerous?
4#. They are not so much so as the passive. The most
remarkable is the effect of the development of the testi-
cles on the voice. The diseases of the generative system
or seminal organ has much effect on the pulmonary mu-
r.ous system.
Q. You have said that each gland has its modification
of vitality, whence does this arise ?
' 38
282 GLANDULAR SYSTEM.
fl. From peculiarity of texture. From these modifi-
cations of vitality and peculiarities of textures, it results
that the different glands have certain substances in relation
to them. From these, likewise, arise the peculiar sym-
pathies of each gland, the particular character of the in-
flammation of each gland, and their predispositions to dis-
ease.
Q. Give some examples of the exclusive relation of
certain glands with certain substances.
ft. The conspicuous instance under this head is the
fact, that one gland secretes one fluid, another a different
one invariably. Again, this relation explains the opera-
tion of mercury on the salivary, and of cantharides on the
renal glands.
Q. Will you state some of the peculiar modes of glandu-
lar sympathies?
ft. There is that of the liver with the brain, the testi-
cles with the pectoral organs; the disorders of the kidneys
in exciting vomiting, the sympathy of the uterus with the
mammae.
Q. Give examples of the different inflammation in dif-
ferent glands.
ft. The inflammation of the kidney differs from that of
the liver; that of the prostate gland from the testicles.
There is a difference in the symptoms.
Q. You have said that the glarfds have their particular
forms of diseases, specify this position.
ft. While the liver is subject to hydatids, the salivary
glands and testicle never have them. Observe how much
more frequent sarcocele is, than a scirrhus of the parotids.
Q. What characters appertain to the vitality of the
glands?
GLANDULAR SYSTEM.
283
fc/2. They are the peculiarity of the life of the glands;
the remittent action of glandular life; the whole of the
glandular system is never increased in its vital forces at
the same time; glandular vitality is influenced by climate
and season; sex has great influence on the vitality of the
glands. These are the remarkable characters in the vita-
lity of the glands.
Q. What do you mean by remission in the glandular
life?
*#. It is this; that although secretion is constantly going
on, yet it is much more active at some times than at
others.
Q. How does season affect the glandular system?
#. In the winter the internal glandular system is active,
and the skin torpid ; while in summer the skin is active at
the expense of the internal glands.
Development of the Glandular System.
Q. What is the state of the glands in the foetus?
#. Much developed, but inactive. There is little need
for secretion, and no room for excretion in the foetus.
Q. What causes excite the glandular system at birth?
.#. The change in their blood from black to red; and
the excitement carried to their excretories by air, food,
and other irritations at their mouths.
Q. What glands are most disordered in infancy ?
#. The mucous and lachrymal glands.
Q. Is the glandular system most diseased in infant life
or after growth?
./?. It is most diseased after growth. In infancy the
lymphatic System is most affected, in adults the glandular.
284 GLANDULAR SYSTEM.
Q. Mention some of the glands which are particularly
active at different periods of life?
<ft. The lachrymal glands are most remarkably active
in infancy; the genital glands are so in youth; the hepatic
system is most energetic in adult life.
Q. How do you account for the activity of many glands
in old age?
#. Decomposition requires many things to be cast off
by the excretories ; the functions of the skin ceasing, a de-
termination takes place to the glands of the abdomen.
Q. Is the communication between the arteries and ex-
cretory ducts of a gland direct, or is there an intermediate
substance?
A. In the liver, testicles, and kidneys, there is this evi-
dent, direct communication; but in others it is not demon-
strable.
PATHOLOGY OF THE GLANDULAR SYSTEM.
Q. What are the diseases of this texture?
A. Each gland has its own diseases. The glands differ
in structure, are without common properties, and there-
fore in detailing diseases of the glands, each organ is to be
separately mentioned.
Q. There are^ some affections in common with all
glands.
A. These are enlargement and diminution of size.
Q. Inflammation has a common effect on all the glands.
A. It alters the secretions of all; it checks altogether
the secretory action in many.
GLANDULAR SYSTEM. 285
Q. What are the diseases of the lachrymal gland?
A. It is so little liable to disease, as to require no con-
sideration here.
Q. Enumerate the salivary glands ?
*ft. They are the parotid, the maxillary, and the sub-
lingual.
Q. What are the diseases of the parotid glands?
fl. Indisposed to suppurate, they inflame, enlarge, and
resolve. They are the seat of mumps they become
scirrhous.
Q. Is it the substance of the gland or the surrounding
tissue that enlarges so much in these cases?
/2. It is doubtless ascribable to both; but the surround-
ing texture is materially concerned in it.
Q. What is the most frequent disease of the liver?
A. Inflammation, acute and chronic.
Q. Are the membranes and substance of the liver
usually inflamed at the same time?
Jl. Not usually; the texture of the two varies.
Q. When does singultus appear in hepatitis?
Ji. When the convex surface is inflamed, the diaphragm
is so irritated as to occasion hiccup. Cough ia likewise
more frequent in this case.
Q. What symptoms are specially connected with in-
flammation of the concave surface of the liver?
JL. Vomiting.
Q. How does hepatitis terminate ?
A. By resolution and suppuration.
Q. What are the products of chronic hepatitis ?
J3. Great enlargement of the liver, and again the op-
posite state of diminished volume
286 GLANDULAR SYSTEM.
Q. There are other hepatic disorganizations?
*#. Steatomatous tumours, tubercles, fatty depositions,
hydatids, &c. It is not necessary particularly to notice
jaundice, as it arises in common from the liver and gall-
bladder. There are numerous symptomatic diseases of the
liver.
Q. With what affections is inflammation of the kidney
confounded ?
#. With lumbago and phlegmon in the region of the
kidney.
Q. What are the principal diagnostics?
#. The pain of nephritis is increased by pressure; and
in nephritis the conditions of the urine are much al-
tered.
Q. Name some other morbid states of the kidney.
*fl. There is flaccidity of the organ and hydatids.
Q. At what period of life does the prostate gland as-
sume disease?
&. Not usually before puberty.
Q. What are the diseases of the prostate?
*#. Inflammation, induration, varices, cancer.
Q. How do you, in diseases of the testicle, distinguish
sarcocele from hydrocele?
Ji. The sarcocele is harder than hydrocele. This is one
way to distinguish them.
Q. Are the testicles equally liable at all times of life to
disease?
A. Like the prostate gland, they are seldom diseased
before puberty.
Q. What are the principal diseases of the mammary
gland?
GLANDULAR SYSTEM.
287
<fl. Inflammation, ending in abscess during lactation
and cancer, chiefly at advanced periods of life.
Q. What have you to say of diseases of the spleen?
#. That inflammation of that gland is very rare; sup-
puration is still more so. Intermittents chiefly induce dis-
ease of the spleen. It is liable to cartilaginous and osseous
indurations.
Q. What is the disease of the thyroid gland?
*#. Goitre.
( 288 )
DERMOID SYSTEM.
Q. What are the uses of this texture?
*#. To defend parts from external injury; to eliminate
much of the residue of nutrition and digestion; and to
throw it into relation with external bodies. It connects
the existence of man with surrounding objects.
Forms of the Dermoid System.
Q. There are several kinds of wrinkles on the skin, to
what are they owing?
ft. To the subjacent muscles, to the motions of parts,
and to old age. In this last the wrinkles are owing to
the removal of sub-cutaneous fat.
Q. If the sub-cutaneous fat be removed by emaciation
in young persons, do you perceive wrinkles in the skin?
Ji. No; because the organic contractility is not lost, as
in old age, and the skin adapts itself to the emaciated
parts.
Q. How does the connexion of the skin with the sub-
jacent parts in man, differ from that connexion in ani-
mals?
Jl. In animals the skin lies over a fleshy layer called
panniculus, which the animal moves at pleasure. In man
the only resemblance to this is the occipito-frontalis and
the platisma myoides muscles.
BERM01D SYSTEM.
Organization of the Dermoid System.
I. Texture peculiar to the Organization.
Q. What does the dermoid texture comprise?
#. The chorion, the reticular body, and the papillae.
a. Of the Chorion.
Q. On what parts is the chorion thickest?
/?. On the sole of the foot, the palm of the hand, the
scalp, and on the back. It is thinnest on the female breast,
on the penis and scrotum.
Q. In which sex is it thinnest?
#. In females.
Q. What modifications does the dermoid chorion exhi-
bit on its internal face?
.#. On the sole of the foot and palm of the hand it is
firmly connected with the cellular substance by strong
and numerous fibres. This fibrous connexion is important
to the functions of the parts.
Q. What are the peculiarities of the internal face of the
chorion on other parts of the body?
t#. On the internal face over the body there are but
few fibres, and the skin hangs loosely; between the fibres
are spaces filled with small fatty parcels. On the back of
the hand and foot, on the scalp, and where the beard
grows, there are openings only for the hairs to go through,
the surface being white and smooth.
Q. What effect has long maceration on the chorion?
#. It shows that the chorion on the external face is
37
^
290 PERMOID SYSTEM.
actually perforated by foramina for the passage of the
hairs, the nerves, blood-vessels, exhalents, absorbents, &c.
Q. What texture does the chorion most resemble?
#. In its appearance in certain parts, in its serving for
the insertion of muscles, in its melting gradually into gela-
tine, and in some other respects, it resembles the fibrous
tissue.
Q. On which surface of the chorion do eruptive diseases
form?
#. On the external altogether. Phlegmon forms in the
cellular substance beneath the chorion; the small-pox,
erysipelas, &c. are found on the exterior face.
Q. What then are the functions of the chorion ?
t/?. Being intended neither for sensation nor circulation,
it serves to protect and defend the body.
b. Of the Reticular Texture.
Q. What do you understand by this?
*fl. It is a capillary net-work of vessels on the exterior
of the chorion, forming with the papillae a layer between
the chorion and epidermis.
Q. What fluids are contained in this reticular texture?
*#. Those which give the colour or teint to the indivi-
dual.
Q. What proves that this teint is foreign to the chorion
and epidermis?
/?. These two having the same colour in whites and
blacks.
Q. Is the reticular texture ever renewed after once be-
ing destroyed?
#. It is not; cicatrices are white in all persons.
DERMOTD SYSTEM, 291
Q. Is there not another set of capillaries in the reticu-
lar body besides that which contains the colouring princi-
ple?
<fl. Yes; there are thos^ which furnish the exhalents of
the perspiration.
Q. Why is this last portion of the reticular body so im-
portant to pathologists?
tf. Because it is the seat of the eruptive diseases, erysi-
pelas, &c.
Q. What is the reason that in serous effusions on the
serous membranes, bladders of that fluid do not form, as
on the skin?
JL. Because on these membranes there is no epidermis
to form the blister.
Q. What'part of this reticular capillary system is most
apt to be filled with blood?
#. The facial portion.
Q. What' is the reason of this?
#. Because in the face the communication between the
reticular texture and the arteries of the chorion is more
free, and because the sensibility of the texture in the face
is greater than it is elsewhere in that tissue.
Q. In what three modes^does the face express the pas-
sions?
#. In the eye, in the muscles of the face, and in the
facial reticular texture. This last is entirely involuntary.
Q. Can you say how this reticular tissue expresses the
passions? jp
#. By the quantity of blood, as in blushing under
mental emotion, and by the absence of blood, as in the
paleness of fear.
Q. What pathological fact arises from this natural
DERMOID SYSTEM,
susceptibility to increased sanguineous fulness in the
face?
#. That in cutaneous diseases, especially variola, the
face is most violently affected. The affections of this re-
ticular tissue of the face are indicative in many cases of
internal visceral disease.
Q. Repeat the two anatomical divisions of the reticular
capillary system.
t#. That which contains the colouring teint, and that
which affords the fluids of transpiration.
c. Of the Papillse.
Q. What do you mean by these?
Jl. They are small eminences arising from the external
chorion, which pierce the reticular surface, and become
contiguous to the epidermis.
Q. What are apt to be confounded with these papillae?
<ft. Certain cellular, vascular, or nervous bunches, or
sebaceous glands, which are lodged in the small oblique
canals, terminated by the openings of the chorion under
the epidermis. These bunches or bundles, or eminences,
are observable on the outside of the arms, and on the
back.
Q. What occasions the petechiae of adynamic fevers ?
t#. Extravasation of blood in the cellular texture of the
small pores, which open on the exterior of the chorion,
to transmit the hair$ &c. This occasions these petechiae.
Q. What is the structure of the papillae?
#. Analogy supposes them to be nervous terminations,
but this analogy has not been sustained as yet by demon-
stration.
DERMOTD SYSTEM. 293
Action of Different Bodies on the Dermoid Texture,
Q. What effect has light on the dermoid texture?
A. It whitens it, and this independently of heat. A
proof of this is, that clothing which does not exclude the
influence of heat from the skin, prevents the blanching of
the skin which light occasions.
Q. What are the effects of heat on the dermoid tissue ?
*#. The first effect is to expand the texture and increase
the flow of fluids to and through it. In a higher degree,
heat produces redness, a kind of erysipelas. Applied more
powerfully, it reddens and vesicates the skin. In greater
intensity it produces the horny hardening, and lastly, it is
blackened and reduced to carbon.
Q. In the production of redness and vesication, on
what does heat act?
#. On the vital forces of the part; but the subsequent
steps are on the textural properties, and take place alike
in the dead and living skin.
Q. Does the skin preserve an equality of texture?
/?. It does. It prevents the effects of a greatly in-
creased heat, refusing admission to the caloric; while in
very cold countries, it prevents the rapid escape of animal
internal heat. It is a curious fact, that internal organs ex-
posed to the air do not thus resist the changes of tempera-
ture.
Q. How does cold affect the dermoid texture?
#. Variously, according to the degree at which it is
applied. First it contracts the vessels so that the usually
passing fluids cannot escape; the next degree produces
dermoid redness; and lastly, it brings on gangrene.
294 DERMOID SYSTEM.
Q. There are two phenomena in gangrene carefully to
be distinguished, what are they?
#. The mortification of the part, and the putrefaction
of the mortified part.
Q. What hastens the putrefaction of the mortified part?
*#. The process is rapid in proportion to the quantity
of blood it contains.
Q. Then antisceptic is a relative term, to be under-
stood in a double sense?
t/2. It is; for it may prevent the mortification of a
part, and also the putrefaction of a part already mortified.
How different are these two objects.
Q. In what distinctive sense are the exhalation and
solution of transpired fluids to be understood?
/?. In this, that the exhalation of the perspiration is a
vital phenomenon ; its solution in the air is physical. They
are totally independent of each other.
Q. Sweating, then, is owing to two causes wholly in-
dependent of each other, what are they ?
*fl. The one is the increase of exhalation, the other is a
diminished solution by the air of what is exhaled.
Q. What are the several causes which increase exhala-
tion by the skin?
/?. Whatever increases the determination of fluids to
the surface, as severe exercise, fever, &c. are one set of
causes. The exhaled fluid is increased by external causes,
which relax and expand the cutaneous organ, as the heat
of summer, warm bathing, &c. The action of the skin is
sympathetically increased in diseases; you see this in the
sweats of phthisis. The passions, by acting on the epi-
gastric organs, increase sweating by sympathy.
Q. What effect has bathing in water on the skin?
DERMOID SYSTEM.
Jl. It cleanses it from saline and oily matter. It may,
in certain cases, increase or diminish the vital forces of the
skin, but it does not alter its texture.
Q. At what season is bathing most useful?
t/?. In summer, when exhalation is greatest and most
compound.
2. Paris common to the. Organization of the Dermoid
System.
Q. Does cellular texture abound in the chorion ?
#. It does, in great abundance. The chorion may be
considered as a sponge, the interstices of which are filled
with cellular texture. When the chorion has lost its cel-
lular texture it is like a sieve.
Q. Do acute diseases affect the texture of the chorion ?
fl. They do not; they attack its cellular tissue. The
chorion is disorganized in elephantiasis.
Q. Does the cellular texture of the chorion extend to
is external surface beneath the epidermis?
J2. The fact that granulations do not arise when the
epidermis is destroyed would induce the belief that there
is no cellular substance on the external surface of the
chorion; because, wherever there is cellular substance,
there you will see granulations, when the cellular texture
is laid bare.
Q. There are two sets of absorbents on the chorion,
name them.
ft. Those which arise from the chorion and return its
materials to the blood, and those which absorb foreign
substances through the epidermis.
296 DERMOID SYSTEM.
Q. Do you not beg the question, in asserting the ex-
istence of cutaneous absorption, as the term is ordinarily
accepted ?
#. The following considerations establish its existence.
The sub-cutaneous absorbents are vastly too numerous in
proportion, to carry back the fat and serum of the parts;
they must therefore have other offices. Mercury, can-
tharides, emetics, and purgatives, are evidently absorbed.
Bichat, while in a dissecting room, breathed through a
tube communicating with the external air, yet his breath
was as fetid as if he had inhaled it by breathing the air of
the room. This proves that there is some other route for
the vapour of the dissecting room, than by the lungs; this
is the skin.
Q. What reason is there for denying the nervous trans-
mission of these metallic and other odours and vapours?
#. The fact that in certain punctures the whole course
of the absorbents and glands is affected ; and particularly
that by frictions, and transfusions into the veins of the
same substances used in frictions, similar effects are pro-
duced.
Q. How do you account for the experiments which dis-
prove cutaneous absorption?
4#. They are explained by the ever-varying sensibility
of the skin. This is witnessed every day in the reception
or rejection of contagions, such as the vaccine and small-
pox.
Q. What persons and circumstances are most favour-
able to cutaneous absorption?
t/?. Children and women are the persons most suscep-
tible of contagions; and, as during sleep and hunger the
DERMOID SYSTEM. 297
vital forces are feeblest, it is under those circumstances
that the skin is most susceptible of the action of these
poisons.
Q. How are the cutaneous absorptions from which dis-
eases arise to be divided ?
Jl. Into those which act through the cuticle, as the
itch, herpes, tinea, and the pestilential diseases; and into
those which require the removal of the cuticle, as the vac-
cine, variola, hydrophobia, the bite of the viper.
Q. Where do the cutaneous exhalents arise?
A. From the external capillary system which surrounds
the chorion and embraces the papillae.
Q. What proves the existence of exhalents ?
/?. It is proved by the injections which are poured out
on the skin, and the sanguineous exhalation in the form
of bloody sweating.
Q. To what cause are many winter coughs to be as-
cribed ?
#. To irritating matters, which in pulmonary transpi-
ration are lodged in the lungs; and this accounts for coughs
which are irritating without increased mucous effusion.
Q. Where are the cutaneous exhalents most abundant?
<fl. In the face and chest, where sweating is most pro-
fuse.
Q. What effect has season on cutaneous transpiration ?
#. It is most abundant in summer. In winter the pul-
monary exhalation and urinary secretion act vicariously.
Q. Whence is the source of the oily fluid which is
thrown out on the skin?
t/?. It is an oily exhalation, such as that of fat which
takes place in the cellular tissue. Bichat has never been
able to discover sebaceous glands.
38
298 UERMOID SYSTEM.
Q. What is the office of this oily fluid?
/#. It serves to soften the skin so as to prevent its
cracking.
Q. Why not consider this oil as an exudation of fat
through the skin?
/?. Because, in several parts where there is the least fat,
there is the most oil, and vice versa. Besides, physical
transudation is denied on vital principles.
Properties of the Dermoid System.
1. Properties of Texture.
Q. What properties of texture are found in the dermoid
tissue?
*tf. Extensibility and contractility to great extent. See
this in dropsies, in pregnancy, in tumours. Observe how
the skin retracts in a wound. You will find that these pro-
perties of texture are manifested in dead bodies. They
are not dependent on vital forces, but derive an increase
of energy from them.
Q. When the extension of the gkin is increased, what
takes place in the fibres of the dermis, and in the* spaces
between them ?
*#. The fibres are separated, and the spaces increase.
Q. How is the contraction of the dermoid texture from
cold explained?
/?. The fibres and spaces are much diminished on the
inner surface of the chorion; but as the external face of
the chorion does not contract in the same degree, a rough-
ness is occasioned.
DERMOID SYSTEM. 299
Q. In cases of dermoid extension, is the chorion ren-
dered thinner?
Jl. It is in almost every case.
2. Vital Properties.
Q. What property of animal life is most conspicuous
in the $ikin?
e/2. Above all others, animal sensibility.
Q. What functions does this property govern?
#. Those of feeling and of touch.
Q. In what does feeling differ from touch?
t#. Feeling perceives the impression and general mo-
difications of surrounding bodies; touch ascertains the spe-
cial modifications of those bodies, as to form, dimensions,
&c.
Q. In what does touch differ from other senses?
#. Touch requires no peculiar modification of sensi-
bility; the eye, the ear, the organ of smelling, all require
this peculiarity of sensibility. The touch is exercised on
the qualities of bodies emphatically tangible, and not on
their colour, flavour, and such like qualities. The touch is
exercised from voluntary impulse; it is not so with the
other senses. Touch is an operation somewhat consequen-
tial to the action ofHhe other senses. All the other senses
require not only peculiar sensibility, but a peculiarity of
structure; whereas accurate touch only requires form con-
venient for exposing surfaces of contact; such form is seen
in the hand of man.
Q. What part of the dermoid texture belongs to animal
life, and what to organic life?
,*#. The papillae are governed by animal sensibility.
300 DERMOID SYSTEM.
The reticular body belongs to organic life. The chorion
is passive.
Q. When the animal sensibility of the papilla? is ex-
alted in disease, what peculiar symptoms are presented?
# A smarting, burning pain, known only to the pa-
pillae; such is the case with blisters, erysipelas. You have
itching, which is a sensation also peculiar to the papillae,
as well as the curious sensation from tickling. ISlpne of
these sensations are known on the mucous, serous or other
tissues.
Q. Is there any other particular of the papillary animal
sensibility worthy of notice?
*#. That it is much regulated by habit, as you see in
the exposure of the skin in some nations; the nakedness
of some, and the full dress of others.
Q. What destroys feeling?
*ft. Inflammation, paralysis, and other morbid states.
Q. When animal sensibility is in exercise, is there an
erection of the papillae?
*ft. Observation would answer in the negative.
Q. Does animal contractility exist in this texture?
J2. It does not.
Q. What functions presuppose the activity of organic
sensibility and of insensible organic contractility in this
texture ? *
t/#. Exhalation, absorption, the exhalation of the oily
matter, the capillary circulation, and the nutrition of the
whole dermoid texture; and lastly, the excitement from
external bodies.
Q. How are the diseases of the skin to be divided?
*#. Into those of the papillae in which animal sensibility
is exalted or diminished; the first v in certain acute sensibi-
DERM01D SYSTEM. 301
lities, the second in paralysis. .Next, there are the diseases
of the cellular texture of the chorion, as the inflammation
of that texturfe over a bile or phlegmon. Then there are
diseases of the external capillary net-work, as erysipelas,
herpes, measles, scarlatina. The chorion, lastly, is subject
only to chronic affections, as elephantiasis.
Q. What important inference is to be deduced from
this division of the diseases of the skin?
#. That all those diseases, except those in which ani-
mal sensibility is exalted or diminished, proceed from an
alteration of the organic sensibility and insensible organic
contractility of the parts. And it is from these alterations
that numerous phenomena are to be accounted for, as the
failure of blisters to draw from too much or too little ex-
citement, in the greater or less sweating at different times.
Q. Will you enumerate some remarkable passive sym-
pathies of the dermoid telkture?
/#. One very striking one is the sensation of cold pro-
duced by disorder of the internal organs; these affect the
animal sensibility of the skin. Flushes of heat are also
from this cause. Digestion, the emission of semen, the
diseases of the serous and mucous systems, all produce
chilliness.
Q. The sensations, then, of heat and cold, arise from
various causes?
*#. Yes. They arise from an increase or diminution of
atmospheric temperature; from preternatural development
in some diseases, as of heat in phlegmon; there is a dimi-
nution of heat in other cases, as where an artery is tied.
Caloric Ss disengaged sometimes, generally or locally,
without inflammation; lastly, there are sympathetic sensa-
tions of heat and cold.
; .
302 DERMOID SYSTEM
Q. Are the organic vital properties of the dermoid tex-
ture sympathetically affected?
/?. They are; as when cold drinks check, or warm
fluids taken into the stomach, increase perspiration.
Q. Whence the most usual excitant of these passive
cutaneous sympathies?
Jl. They most frequently arise from the mucous mem-
branes of the stomach; but they often proceed likewise
from the lungs.
Q. What are the active sympathies of the papillae?
*#. When vpmiting or syncope follow, tickling, you
have an example of an active cutaneous sympathy.
Q. How do the organic forces of the dermoid texture
excite active sympathies?
.#. These sympathies are produced not by translation
of morbific matter, nor by the repercussion of fluids, but
by exciting the predominant vital forces of the sympa-
thizing organs.
Q. Give an example of this.
#. In inflammation of the thoracic serous membrane,
the perspiration is checked by cold. What does this mean,
but that the organic vital forces of the external capillary
tissue of the skin are altered; a sympathetic impression is
made on the organic forces of the exhalents of the pleura;
these last, which only admit serum in health, are placed
in relation to blood, and inflammation takes place.
Q. At what season of the year are the organic forces of
the dermoid texture most exalted?
ft.. In the hot seasons; hence the active sympathies are
then most prevalent, and most to be dreaded.
Q. How is it that the active cutaneous sympathies vary
in different persons?
DERMOID SYSTEM. 303
/?. Because of the great difference, in various persons,
in predisposition to disease. In one, a cutaneous sympa-
thy excites the predominant forces of a serous, and in
another of a mucous tissue.
Q. Why is it that the sympathies of animal contracti-
lity, and of sensible organic contractility in the skin are
not active?
d. Because the dermoid texture has not these proper-
ties.
Q. What are the important characters of dermoid life
and vital forces?
#. Animal sensibility is more acute in some parts than
others; it is more acute in the palms of the hands and
soles of the feet, and in the hypochondriac regions. Or-
ganic sensibility varies in force in different parts.
Q. There is an important difference between the ani-
mal and organic forces of the dermoid texture, what is it?
/?. The animal vital forces of the skin are intermit-
tent in action, the organic forces are continually opera-
tive. During sleep, these organic forces are said to be
increased in activity;
Q. What arises from this increased activity of the or-
ganic vital forces of the skin during sleep?
Ji. Hence it is that those diseases have their exacerba-
tions at night, which affect mostly the organic forces;
whereas those that affect the animal vital forces of the
skin, are not thus exacerbated at night.
Q. What effect has sex on the cutaneous vital forces?
*#. The animal vital forces of the skin are more acute
in. the female than in the male sex.
304 DERMOTD SYSTEM.
Development of the Dermoid System,
Q. At what period of life does most blood enter the skin ?
.#. In the foetal period. In advanced life there is least
blood in the dermoid texture.
,(?. What evidence is there that the organic vital forces
of the skin in the foetus are active?
#. The formation of the unctuous viscid fluid which is
seen on the foetal skin. Perhaps the liquor amnii is form-
ed and absorbed by the foetal skin.
Q. What do you infer from the foetal skin remaining
livid some time after birth ?
t/#. That the pulmonary function is not free.
Q. At what period of life is there least sweating?
*ft. During childhood and infancy.
Q. Why does the skin radiate active sympathies more
freely when it is sweating than when dry?
.#. Because, while perspiring, its organic vital forces
are most active; and hence these sympathies.
Q. What substance predominates in the skin of child-
hood and of age?
#. In early life, , gelatine predominates; and in age, a
fibrous substance.
Q. Why is the skin a more frequent source of disease
than other textures?
*#. Because, from its exposed situation, it is liable to
so many variations of its vital forces.
Q. Why is it that touch is more actively employed in
infancy and childhood than in old age?
/?. Because every thing is novel to the young, and
known to the aged.
SYSTEM.
305
Q. Whence the oily matter on the skin, according to
Beclard ?
J2. He supposes it to be secreted by the sebaceous
glands, which resemble in structure the mucous glands.
Q. What are the striae so often seen on the abdomens
of women who have borne children ?
#. Cicatrices in the skin, the consequences of excessive
distention.
Q. What texture gives rise to warts?
.#. The dermis.
Q. What are the different sources of horny, cutaneous
elevations ?
#. They arise sometimes from the cicatrices of wounds;
again, from the sebaceous follicles ; and lastly, from the
horny layer of the skin.
Q. Whence the wens, the atheromas, the steatomas, and
melicerous tumours?
v2. They are morbid enlargements of the sebaceous fol-
licles.
Q. In what part of the dermoid texture is tinea seated?
t/?. In the sebaceous follicles.
Q. Where are the naevi materni seated?
A. In the vascular net-work, the reticular texture.
PATHOLOGY OF THE DERMOID TEXTURE.
Q. How are the diseases of the skin to be divided?
#. Into the idiopathic and symptomatic.
Q. What is the seat of the symptomatic cutaneous dis-
eases?
39
306
DERMOID SYSTEM.
/#. They are seated in the capillaries of the reticular
and teguments external to the chorion.
Q. How are the cutaneous textures affected by dis-
tention ?
v#. In great distention, the fibres of the chorion are
torn and separated; folds and wrinkles also arise from this
cause.
Q. What effect has chronic disease on the skin?
Ji. It deranges the dermoid texture, rendering it rough
and sallow.
Q. What division of the causes of erysipelas do you
make?
#. They are external and internal, or extrinsic and
constitutional.
Q. Where is erythema or erysipelas seated?
/2. In the reticular texture; the chorion is unaffected.
Q. Is the chorion always sound in erysipelas?
*#. In some cases the intense phlogosis affects that part
of the skin, and even the subjacent cellular texture; and
in these cases there is phlegmon, with great erysipelatous
tension.
Q. What is the nature of the pain in erysipelas?
Ji. It is an acute but burning pain.
Q. Where is erysipelas most violent and dangerous?
./?. On the head and face.
Q. Why is this?
.#. It is owing to the peculiar vascularity and irrita-
bility of the reticular texture of the face, and the danger
proceeds from the cerebral symptoms which cephalic ery-
sipelas induces.
Q. What do you call erysipelas of the trunk ?
#. It is the herpes zoster, the shingles,
i
DERMOIT) SYSTEM, 307
What are the terminations of erysipelas?
The mildest termination is in desquamation; it ends
in phlyctenae, in oedema, and in suppuration, in which
case there is phlegmon.
Q. Does erysipelas manifest metastasis?
#. It shifts from place to place; and in some cases the
translations, or the sympathetic phenomena, are on inter-
nal organs, as the brain, and are usually fatal.
Q. What texture is the seat of measles'?
A. That disease is in the reticular texture external to
the chorion.
Q. Where are the pustules of small-pox located?
A. In the chorion.
Q. Are all the herpetic affections located in the same
parts of the dermoid texture?
.#. No; some affect the reticular texture, and others
are deeper seated, and involving the chorion. Some of
the herpes are diseases of the sebaceous follicles.
Q. Which is the seat of tinea ?
A. Most of the forms of tinea are found on the surface
of the chorion; but the tinea favosa arises from the seba-
ceous follicles.
Q. Whence do warts originate?
A. From the chorion.
Q. Where are secondary syphilitic symptoms seated?
fl. In the vascular reticular texture.
Q. Whence do the horny excrescences proceed?
*A. From sebaceous follicles.
Q. In a former conversation you said the anthrax arose
from a strangulation of the cellular texture.
Ji. Yes; but there is another opinion, that the eschars
306
DERMOID SYSTEM.
of anthrax and furuncle proceed from specific secretory
deposition.
Q. What is the difference between sympathy of heat
and sympathetic heat?
A. In sympathy of heat there is a delusive impression
that the skin is very hot, when its temperature is not ele-
vated. Sympathetic heat means the heat of one organ oc-
casioned by a disease of another part.
.
309 )
EPIDERMOID SYSTEM.
Q. Why is the epidermoid texture considered sepa-
rately from the dermoid ?
/?. Because its organization, properties, functions, and
growth, differ from those of the dermoid.
Q. What belongs to the epidermoid tissue?
/?. The external epidermis, the mucous epidermis, and
the nails.
Of the External Epidermis.
Q. What passes from the dermis through the epider-
mis?
/?. The exhalents and hairs. The absorbents pass from
without inward.
Q. What causes destroy the adhesion of the cuticle to
the cutis?
Ji. Inflammation of the skin, cutaneous eruptions, idio-
pathic fevers, diseases of the viscera, and violent rubefa-
cients.
Q. How do these causes act?
t#. By an alteration of the vital forces of the parts, per-
haps of the dermis.
Q. What is the organization of the epidermis?
%/?. It is a single layer over the whole body, except on
the palms of the hands and bottoms of the feet; no fluid
penetrates it; it has neither nerves nor cellular texture 5
310 EPIDERMOIl) SYSTEM.
it is the most incorruptible of the textures. It is almost
inorganic.
Q. Has it vital forces ?
A. It has none; it is destitute of sympathies.
Q. How then would you describe the epidermis?
#. As a semi-organized, or even inorganic body, placed
by nature between external inanimate substances, and the
organized dermis, in order to assist their passage and guard
against their force.
Q. How does it differ from other tissues?
. In the property of reproduction; and from some
textures it differs in this, that whereas, in diseases these
textures assume animal sensibility, foreign to them in
health, and thus feel pain, the epidermoid system is inca-
pable, either in health or disease, of assuming animal sen-
sibility.
Q. How are the epidermoid pores seen?
Jl. Their places are seen in those of the distinct drops
of sweat on the skin; the pores can be seen if a piece of
epidermis be held up between the eye and a strong light,
but you cannot distinguish the exhalent from the absorb-
ent pores.
Q. What unites the epidermis to the cutis?
.#. The exhalents, absorbents, and hairs.
Q. Whence arises the thickness of the epidermoid sys-
tem on the hands and feet?
*ft. It arises from numerous epidermoid layers, and
perhaps there is some unknown difference in the organi-
zation.
EPIDERMOID SYSTEM. 311
Of the Internal Epidermis.
Q. Where do. you find this?
#. At the entrance of the mouth, of the anus, of the
urethra, and of the nasal fossa. As it passes along the mu-
cous surfaces, it gradually disappears; in the stomach it
disappears at the cardia.
Q. Does it exist in the deep-seated mucous membranes?
A. It does not; it is lost on them.
Q. What are the properties of the mucous epidermis ?
t#. They are the same with those of the external epi-
dermis.
Q+ What are its uses?
t#. The same with those of the external epidermis, to
defend the subjacent papillae.
OF THE PILOUS SYSTEM.
Q. What is the organization of the hairs?
*#. An external epidermis, and an internal vascular
tissue, which is the pilous texture.
Q. What reason have you for supposing the internal
texture vascular?
A. Because, in disease, as the plica polonica, the hair
bleeds.
Q. To what texture is the pilous analogous ?
t#. To the reticular of the skin, which has a colouring
and a vascular tissue.
Q. What phenomena depend for explanation on the vas-
cular character of the internal texture of the hair?
#. The change of colour of the hair suddenly, from
fright, grief, &c.; the bleeding of the plica polonica; the
pain of the head from cutting, or from too much hair.
Q. What is the origin of the hair?
/?. It arises from the sub-cutaneous fat or the cellular
texture. Each hair is contained in a small, membranous
canal.
Q. Have the hairs vital properties?
*fl. They are destitute of animal sensibility, but organic
forces are seen in the diseases of the hair. They are said
to have nerves.
ANALYTICAL TABLE OF CONTENTS.
GENERAL OBSERVATIONS.
Of the Physiological and Physical Sciences, and the Properties which pre-
side over their Phenomena.
Of animate and inanimate beings. Of the sciences which treat of their
phenomena. Of vital and non-vital properties. - 9
Characters of the Vital Properties compared with those of the Physical.
Extreme variableness of the first. Consequences of this principle as it
regards their phenomena. There can only be diseases where there
are vital properties. Of sympathies. Properties of vegetable and
animal life. Phenomena which result from these properties. 10
Of the Vital Properties and their Phenomena considered in relation to the
Solids and Fluids.
The vital properties essentially seated in the solids. These are the
seat of most diseases. The fluids may however be affected. Ave-
nues by which the fluids become affected. Division of the fluids into
those of composition and decomposition. Sympathetic impressions
conveyed and seated in the solids. - 13
Of the Properties Independent of Life.
Properties of Texture. Of contractility by horny hardening. Of ani-
mal contractility. Of sensible organic contractility. Of contractility
of texture from want of extension. Of insensible organic contracti-
lity. - .... 15
Of Animal Organization.
Cause upon which the vital properties depend. Of the elementary
textures. Division of the organized systems. Of the generative tis-
sues. Of the insulated tissues. Of the nutritive parenchyma and
nutritive matter of an organ. Of the first aspect and of the progress
of organization. Elective power of an organ. Secretion Life of a
part. Disease. Sympathies. Influence of texture on disease.
Acute and chronic diseases relative to the vital properties of the
textures. - 16
Of the Functions.
Functions of animal and organic lives, their centres, and the nerves
belonging to each. Beclard's elements of organization. MeckePs
doctrine of organization. - 20
40
314 ANALYTICAL TABLE OP CONTENTS.
OF LIFE.
Definition. Division Characteristics of organic life. Peculiarities
of animal life. Functions of animal life. Functions of organic
life. 22
Difference between Animal and Organic Life.
Symmetry in animal life, irregularity in organic life. Animal life in-
termittent, organic life perpetually active from birth to death.
Dreaming. Impressions on animal life variant, on organic life uni-
form. Location of intellect and the passions. Effects of the pas-
sions on the organs 23
OF THE PROPERTIES OF ANIMATED BEINGS.
1. Vital Properties.
Sensibility and contractility. Animal and organic sensibility. Effect
of sudden death on these two kinds of sensibility. Animal and or-
ganic contractility. Sensible and insensible organic contractility.
Effects of sudden death on these contractilities. Connexion of
these contractilities with their respective sensibilities. Difference
in their relation. Difference between sensible and insensible orga-
nic contractility. Difference between organic contractility and or-
ganic sensibility. Contractility not the exclusive property of mus-
cular tissue. - - - ...... 27
2. Properties of Texture.
Extensibility and contractility of tissue. Cause on which the textural
properties depend. 32
OF ANIMAL LIFE.
Distinction between animal and organic life. Period of commence-
ment of the two lives. Laws governing the education of the func-
tions of animal life. 34
OF ORGANIC LIFE.
Organ in this system first developed. Difference between foetal orga-
nic and independent organic life. Perfection of organic life depends
on organization. Seat of the moral character. Animal life dies
first. ------ 36
ON DEATH.
General Observations. 37
On the Influence of the Death of the Heart upon that of the Brain.
Manner in which the heart influences the brain. - - - 37
ANALYTICAL TABLE OP CONTENTS. 315
On the Influence of the Death of the Heart upon that of the Lungs.
Functions of the lungs. Manner in which the lungs are affected when
the red blood heart is interrupted in its functions. - - 38
On the Influence of the Death of the Heart upon that of the Organs gene-
rally.
Manner in which death of the heart produces death of the organs ge-
nerally 38
On the Influence of the Death of the Heart on General Death.
Influence of the death of the heart on the production of general death.
On death from mental emotion. On syncope. ... 39
On the Influence of Death of the Lungs upon that of the Heart.
Condition of the lungs in syncope. Death takes place in the lungs by
the cessation of their mechanical and chemical functions. Manner
in which these functions are destroyed. Effect of the interruption
of the functions of the lungs upon the heart. Influence of the black
blood upon the organs generally. State of the heart in asphyxia. 41
On the Influence of the Death of the Lungs upon that of the Brain.
Manner in which death of the lungs produces that of the brain. 44
On the Influence of the Death of the Lungs upon that of the Organs ge-
nerally.
Experiments showing the progress of asphyxia in animals. Effect of
black blood. 47
On the Influence of Death of the Lungs on General Death.
Death from interruption of the mechanical function of the lungs.
Death from interruption of the chemical functions of the lungs.
Asphyxia from gases. Modes in which deleterious gases affect the
lungs. Deleterious vapours absorbed into the general circulation in
asphyxias operate on the brain and nerves. In diseases death com-
mences in the lungs. Colour of the arterial blood after death. 48
On the Influence of Death of the Brain upon that of the Lungs.
Mode in which death of the brain affects the lungs. . - 50
On the Influence of Death of the Brain upon that oftfie Heart.
Mode in which death of the brain affects the heart. 51
On the Influence of Death of the Brain on the Organs generally.
Mode in which death of the brain affects the organs generally. 52
On the Influence of Death of the Brain on General Death.
Successive phenomena produced on the body in general by death of
the brain. 52
'*!(> ANALYTICAL TABLE OP CONTENTS.
SYSTEMS COMMON TO ALL THE APPARA-
TUS.
OF THE CELLULAR SYSTEM.
General Remarks. - - - 52
Of the Cellular System considered in relation to the Organs,
Of the Sub-cutaneous Cellular Texture 53
Of the Sub-mucous Cellular Texture. ..._. 54
Of the Sub-serous Cellular Texture. 55
Of the Arterial Cellular Texture. 56
Of the Venous Cellular Texture. 56
Of the Cellular Texture embracing the Organs on all Sides. 57
Of the Internal Cellular Structure of the Organs.
Its relation to the other organs. Its properties. - - 58
Of the Cellular System considered independently of the other Organs.
Cellular Texture of the Head and Face. ...... 59
Of the Cellular Texture of the Trunk and Extremities.
Vertebral cellular texture. Cervical cellular texture. Pectoral cel-
lular texture. Abdominal cellular texture. Cellular texture of the
pelvis. Cellular texture of the extremities. - - - 60
Of the Forms of the Cellular System and of the Fluids it contains.
Of the cells. Of the serum of the cellular system. Of the cellular
fat. - - - 62
Organization of the Cellular System.
Parts which enter into its organization. 66
Properties of the Cellular Texture.
1. Textural Properties. Extensibility. Contractility. - 68
2. Vital Properties. Animal sensibility. Organic sensibility. Insen-
sible organic contractility. Sensible organic contractility. Sympa-
thies. Character of the Vital properties. - 69
3. Properties of Reproduction. Influence of the cellular texture on the
formation of cicatrices. Inflammation. Granulations. Suppura-
tion. Contraction of the granulations. Adhesion. Union by the
first intention. Influence of the cellular tissue in the formation of
tumours and cysts. 71
Development of the Cellular Texture.
States of the cellular system in the first age and in after ages. 76
PATHOLOGY or TIIK CELMTLAH Tissi i
Diseases of the cellular tis __.--- 77
I
ANALYTICAL TABLE OF CONTENTS. 317
NERVOUS SYSTEM.
General Divisions. 82
I. NERVOUS SYSTEM OF ANIMAL LIFE.
Centre of the nervous system of animal life. Centre of the nervous
system of organic life. Nervous system of animal life symmetrical.
Relative size of the brain and nerves. 82
External Forms of the Nervous System of Animal Life.
Of the cerebral nerves. Of the nerves arising- from the cerebrum. Of
the nerves originating from the tuber annulare and its elongations.
Of the spinal nerves. Of the decussation of the nerves. Of the
nervous tunics. Communications of the nerves. Course and plex-
uses of the spinal nerves. Nervous trunks. Nervous branches.
Nervous anastomoses. Systems destitute of nerves. -
Organization of the Nervous System of Animal Life.
Nervous filaments and chords. Nature and origin of the nervous coat.
Action of certain substances on the nervous coat. Medullary sub-
stance. Comparison between the cerebral and nervous medullary
substance. Cellular texture of the nerves. Blood-vessels. 87
Properties of the Nervous System of Animal Life.
1. Properties of texture, very slightly marked. 90
2. Vital Properties. Animal sensibility. Internal and external sensa-
tions. Influence of the nerves on the animal contractility of other
parts. Organic contractility and sensibility. Influence of the nerves
on the organic properties of other parts. Sympathies of the
nerves. 90
3. Properties of Reproduction. 95
Development of the Nervous System of Animal Life.
State of the system in the fa-tus. In after life. Pathological states of
the brain. - - - - - - .... 95
II. NERVOUS SYSTEM OF ORGANIC LIFE.
General Remarks.
Of the Ganglions.
Definition. Situation. Form. Organization. Properties. Diseases.
Development. Cerebral ganglions.
Of the Nerves of Organic Life.
Course. Plexuses. Structure. Properties. General remarks. 101
PATHOLOGY OF THE NERVOUS SYSTEMS OF ANIMAL AND ORGANIC LIFE.
Diseases of the brain. Diseases of the nerves. - - 103
318 ANALYTICAL TABLE OF CONTENTS,
VASCULAR SYSTEM.
I. VASCULAR SYSTEM WITH RED BLOOD.
General Remarks upon the Circulation.
Division of the circulation. Circulation of red blood. Circulation of
black blood. General mechanical phenomena of the two circula-
tions. General uses of the circulation with red blood. General
uses of the circulation with black blood. - - - 107
Situation, Forms, and General Arrangement of the Vascular Sys-
tem. 110
On the Organization of the Vascular System with Red Blood.
Peculiar membrane of the arteries. Common membrane of the red
blood. 112
Properties of the Vascular System with Red Blood.
1. Physical Properties. Elasticity. . - - - - 114
2. Properties of Texture. Extensibility. Contractility. 1 15
3. Vital Properties. Influence of the heart on the motion of the red
blood. Of the pulse. Sympathies. 117
Of the Vascular System of Red Blood in different Ages.
State in the foetus. Sabatier's division of the foetal circulation.
Changes which take place at birth. State in after life. General
observations. 120
PATHOLOGY OF THE VASCULAR SYSTEM WITH RED BLOOD.
Diseases of the Arteries. 124
II. VASCULAR SYSTEM WITH BLACK BLOOD.
Situation, Forms, Division, and General Arrangement. - - 126
Organization of the Vascular System with Black Blood.
Peculiar membrane of the veins. Common membrane of the black
blood. Valves of the veins. Action of reagents upon the venous
texture. ^-Cellular texture. Exhalents and absorbents. Nerves. 129
Properties of the Vascular System with Black Blood.
1. Properties of Texture. Extensibility. Contractility. - 130
2. Vital Properties. Venous pulse. Vital forces greater in the veins
than arteries. -Motion of the black blood. Parallel between the cir-
culation in the arteries and veins. 131
Development of the Arterial System with Black Blood.
State in foetal life. State in old age. - - 133
Of the Abdominal System with Black Blood.
Venn portal circulation. Properties and sympathies of the abdominal
ANALYTICAL TABLE OF CONTENTS. 319
venous system. Peculiar membrane of the hepatic portion. Influ-
ence of the injection of air into the veins. Common lining mem-
brane of the abdominal portion. Course of the blood through the
liver. Circulation of the abdominal veins. On the liver. Blood of
the vena portarum. Spleen. Of the bile. Development. 134
PATHOLOGY OF THE VASCULAR SYSTEM WITH BLACK BLOOD.
Disease of the veins. -------- 138
CAPILLARY SYSTEMS.
Division. - - 141
I. GENERAL CAPILLARY SYSTEM.
Its extent. Its division. Capillaries which carry red blood. Those
which convey white fluids. Those which give passage to both red
and white fluids. Causes upon which the number of capillaries in a
part depend. Active and passive secretion and exhalation. Defi-
nition of the general capillary system. Anastomoses. Pathology
of haemorrhage. Relation of the general capillary system to the ar-
teries and veins. The effect of this relation on the appearance of
parts on dissection. How, notwithstanding the general communicar
tion of the capillary system, the blood and the fluids differing from
it remain separate. Irritation. Organic sensibility. - - 141
Of Inflammation. 145
Of the Capillary Circulation. The fluids. The motions of the fluids.
Division of diseases. Influence of atmospheric changes. Blood-
letting. 148
Of the Capillaries considered as the Seat of the Production of Jlnimal
Heat 150
II. PULMONARY CAPILLARY SYSTEM.
Definition. How all the blood of the general system can go through
the pulmonary. Diseases of the lungs. Pulmonary circulation in
diseases. Erectile tissue. 152
EXHALENT SYSTEM.
General remarks on exhalation and secretion, and exhaled and secreted
fluids. 156
General Arrangement of the Exhalents. Division. - - - 157
Properties and Functions of the Exhalent System.
Vital properties. Natural exhalations. Morbid exhalations. 157
320 ANALYTICAL TABLE OF CONTENT-
ABSORBENT SYSTEM.
Definition. - - 162
Of the Absorbent Vessels.
Their origin. Termination. Course and division. Forms. -Capa-
city. Anastomoses. Effects of obstruction of the absorbents
Structure of the absorbents. 162
Of the Lymphatic Glands.
Situation. Colour. Development. Texture. - 165
Properties of the Absorbent System.
1. Properties of Texture. Extensibility. Contractility. 166
2. Vital Properties. Animal sensibility. Organic sensibility. Orga-
nic contractility. Character of the vital properties. Inflammation.
Sympathies. - - - 166
Of Absorption.
Influence of the vital forces on this function. Influence of medicines.
Absorption of morbific matter. Causes which vary the natural
type of the absorbents. Absorption at different ages. Structure of
a gland. Sensible organic contractility. - - - - 167
PATHOLOGY OP THE ABSORBENT SYSTEM.
Diseases of the absorbent system - 170
OF SYSTEMS PECULIAR TO CERTAIN AP-
PARATUS.
General Observations. - - 172
OSSEOUS SYSTEM.
Definition. - ........ 173
Forms of the Osseous System.
Long bones. Flat bones. Short bones. Bony eminences. Osseous
cavities. 173
Of the Organization of the Osseous Texture.
Texture peculiar to the osseous system. Texture with cells. Com-
pact texture. Arrangement of the two osseous textures in three
kinds of bones. Composition of the osseous texture. Parts which
enter into the organization of the osseous system. 177
Of the Properties of the Osseous System.
1, Physical Properties. - - - - - ' - - 181
ANALYTICAL TABLE OF CONTENTS. 321
2. Textural Properties. - .... 181
3. Vital Properties. Character of these properties. - - 182
Articulations of the Osseous System.
Division of the articulations. Moveable articulations. Immoveable
* articulations. 183
Development of the Osseous System.
Period at which the osseous system is complete. Mucous, cartilagi-
nous, and osseous states of the bones. State of the osseous system
after its growth. Changes which take place in old age. Develop-
ment of the callus. Of the teeth. Of the sesamoid bones. 187
OF THE MEDULLARY SYSTEM OF THE BONES.
Origin. Properties. Division. Diseases of the medulla. Develop-
ment. Functions. Spina ventosa. 192
PATHOLOGY OF THE OSSEOUS TISSUE.
Diseases of the osseous tissue. ... 193
PATHOLOGY OP THE MEDULLARY SYSTEM.
Diseases of the medullary tissue 195
CARTILAGINOUS SYSTEM.
Division. Definition. ... - - 196
Forms of the Cartilaginous System.
Cartilages of the moveable articulations. Those of the immoveable
bones. Those of the parietes of cavities. .... 196
Organization of the Cartilaginous System.
Peculiar organization of cartilage. Change effected in cartilage by
disease. Common organization of cartilage. ... 197
Properties of the Cartilaginous System.
1. Physical Properties. Elasticity. Position of cartilages. 198
2. Textural Properties. 198
3. Vital Properties. Character of the vital properties. - - 198
Development of the Cartilaginous System.
State in the first age. State in after ages. Diseases. - 199
FIBROUS SYSTEM.
Of the Forms and Divisions of the Fibrous System.
Of the fibrous membranes. Fibrous capsules. Fibrous sheaths. Fibrous
aponeuroses, Fibrous fascia. Tendons. Ligaments. - - 201
41
322 ANALYTICAL TABLE OF CONTENTS.
Organization of the Fibrous System.
Texture of the fibrous system. - ... 202
Properties of (he Fibrous System.
1. Physical Properties. 203
2. Textural Properties. 203
3. Vital Properties. Character of the vital properties. Sympa-
thies. ^ 203
Development of the Fibrous System.
Fibrous system in early years. 205
Of the Fibrous Membranes in General.
General Remarks. - - - - 205
Of the Periosteum. - 205
Of the Fibrous Capsules. - 206
Of the Fibrous Sheaths. - - 207
Of the Aponeuroses. 207
Of the Tendons. - - 209
Of the Ligaments. - - 209
Of the Yellow Elastic Tissue, ------- 210
PATHOLOGY OF THE FIBROUS SYSTEM.
Diseases of the fibrous system. - - - - - 21
OF THE FIBRO-CARTILAGINOUS SYSTEM.
10
Organs where it is found. Functions of the tissue. Organization.
Properties. State of the system in after ages. - - - 212
MUSCULAR SYSTEM.
General Division. - - - 214
I. Or THE MUSCULAR SYSTEM OF ANIMAL LIFB.
Characters. - - - 214
Of the Forms of the Muscular System vf Animal Life.
1. Of the Long Muscles. .... 214
2. Of the Broad Muscles. - ' - 215
3. Of the Short Muscles. 216
Organization of the Muscles.
Texture peculiar to their organization. Fibres. Their composition.
ANALYTICAL TABLE OF CONTENTS. 323
Parts common to the organization of this system. Cellular texture.
Blood-vessels. -Nerves. - - - - - - 216
Properties of the Muscular System of Animal Life.
1. Properties of Texture. Extensibility. Contractility of texture. 219
2. Vital Properties. Properties of Animal Life. -Sensibility. Animal
contractility. Animal contractility considered in the brain, in the
nerves, in the muscles. Causes which excite animal contractility.
Contractility in the foetus, and after death. Difference between ani-
mal contractility and irritability. Parts in which animal contractility
first and last ceases. Sensible organic contractility. Sympathies.
Characters of the vital properties. 221
Phenomena of the Action of the Muscular System of Animal Life.
Force of muscular contraction. Rapidity of contraction* Effect of
muscular contraction. ..._.- 227"
Development of the Muscular System of Animal Life.
State in the foetus. During- growth. Effect of disease. - 228
II. OF THE MUSCULAR SYSTEM OF ORGANIC LIFE.
Where found. - - - - 229
Forms and Organization of the Muscular System of Organic Life.
Forms. Organization. 229
Properties of the Muscular System of Organic Life.
1. Properties of Texture. Extensibility. Contractility. 230
2. Vital Properties. Animal sensibility. Animal contractility. Or-
ganic properties. Sensible organic contractility. Effect of stimuli,
age, temperament, and death, on this property. Sympathies. Cha-
racter of the vital properties. 231
Phenomena of the action of the Muscular System of Organic Life.
Force of contraction. Dilatation. - 235
Development of the Muscular System of Organic Life.
Causet which set the muscles of organic life into activity. Their
growth. Controlling power of the will over the organic muscles. 236
PiTTTOLOGY OF THE MUSCULAR TlSSUE.
Diseases of the muscular tissue of animal and of organic life. - 237
MUCOUS SYSTEM.
Whence it derives its name. - 239
Of the Divisions and Forms of the Mucous System.
Forms. Gastro-pulmonary and gastro-urinary mucous membranes.
Pathological considerations. Surfaces. - - - 239
324 ANALYTICAL TABLE OF CONTENTS.
* '
Organization of the Mucous System.
Mucous chorion. Mucous papillae. Mucous glands and the fluids they
secrete. Blood-vessels. Exhalents. Absorbents. Nerves. 241
Properties of the Mucous System.
1. Properties of Texture. Extensibility. Contractility. - 245
2. Vital Properties. Animal sensibility. Properties of organic life.
Sympathies. Characters of the vital properties. - 245
Development of the Mucous System.
State at birth. After ages. Structure of the papillae. Mucous folli-
cles. Alveolar structure, Membrane lining abscesses and fis-
tulae. 250
PATHOLOGY OF THE Mucous TISSUE.
Diseases of the mucous tissues. - - - - - - 252
SEROUS SYSTEM.
Why so called. - - - 257
Of the Extent, Forms, and Fluids of the Serous System.
Principal mucous membranes. Their forms. Extent. Fluids.
Form of each serous membrane. Free surface. Adhering surface.
Doctrine of organic life. Disease. Serous fluids. - - 257
Organization of the Serous System.
Characters of the organization of the serous tissue. Nature of this
membrane. Exhalents. Absorbents. Blood-vessels. Pathologi-
cal phenomena. . 259
Properties of the Serous System.
1. Properties of Texture. Extensibility. Contractility. - 261
2. Vital Properties. Sympathies. 262
Development of the Serous System. *
Progress of development. Alterations produced in the serous system
by disease. - - - 263
PATHOLOGY OF THE SEROUS TISSUE.
Diseases of the serous system. 264
SYNOVIAL SYSTEM.
Points of resemblance and difference between the synovial and serous
systems. Division of the synovial system. - 270
ANALYTICAL TABLE OF CONTENTS. 325
1. Of the Articular Synovial System.
Manner in which the synovia is formed. Appearance of the synovia.
Form of the synovial membrane. Properties of the synovial tissue.
Sympathies. Development. 270
2. Synovial System of the Tendons.
Where found. Organization, properties, functions, and sympathies.
Synovial fringes. ..-..--. 272
GLANDULAR SYSTEM.
General Observations. - - - 274
Situation, Forms, Division, &?c. of the Glandular System.
Position of the glands. Excretion. Division. Forms. - - 274
Organization of the Glandular System.
Peculiar texture. Forms. Excretory ducts. Cellular texture.
Blood-vessels. Blood. Nerves. - - - - - 275
Properties of the Glandular System.
1. Properties of Texture. Extensibility. Contractility. - 279
2. Vital Properties. Properties of animal life. Properties of organic
life. Sympathies. Characters of the vital properties. - 279
Development of the Glandular System.
State in the fetus. During growth. After growth. In old age. 283
PATHOLOGY OF THE GLANDULAR STSTBM.
Diseases of the glands 284
DERMOID SYSTEM.
Uses of this texture. , --..... 288
Forms of the Dermoid System.
Wrinkles. Connexion of the skin with the subjacent parts - 288
Organization of the Dermoid System.
1. Texture peculiar to the Organization. - - - - 289
a. Of the Chorion. 289
b. Of the Reticular Texture. - - - . . . 290
c. Of the Papillse. - - - - . . . 292
Action of Different Bodies m the Dermoid Texture. - - . 293
2, Parts common to the Organization of the Dermoid System. Cellular
326 ANALYTICAL TABLE OF CONTENTS.
texture; its diseases and extent. Absorbents. Exhalents. Exha-
led fluid '295
Properties of the Dermoid System.
1. Properties of Texture. Extensibility. Contractility. - - 298
2. Vital Properties. Animal sensibility. Parts governed by animal
sensibility, and those which belong 1 to organic life. Disease. Sym-
pathies. Characters of the vital properties. - 299
Development of the Dermoid System.
State in the foetus. During growth. In old age. Oily matter of the
skin. Morbid structures. 304
PATHOLOGY OF THE DERMOID TEXTURE.
Diseases of the skin 305
EPIDERMOID SYSTEM.
General Remarks. 309
Of the External Epidermis.
Forms. Organization. No vital forces. Definition. Difference from
other tissues. Pores. Connexion with the cutis. - - 310
Where found.
PronerHfts and uses.
Of the Internal Epidermis.
Mucous Epidermis.
311
311
OF THE PILOUS SYSTEM.
Organization. Properties
ERRATA.
Page 19, line 17, for and have, read and their diseases have.
20, " 14, for The senses, read Those of the senses.
22, " 15, for receptions, read reception.
26, tc 19, for is, read be.
29, " 20, for larger, read longer.
31, " 15, for r/e* *o be, read fo 6e.
33, " 25, for faculty -which, read faculty by -which.
41, " 14, for its, read their.
44, ' last, for seated in, read/rom.
47, 28, for that of, read z's Ma* of.
48, 1 , for brain, read lungs.
49, 9, for effluvia, read effluvia.
49, 23, forjorced, read inspired.
100, 30, for viscera, read organs.
105, 5, for wfen, read where.
107, 22, for on, read m.
113, 27, for Mz's d#er, read ^ fe'nwj^ membrane differ.
134, 25, for ventricles, read ventricle.
142, 18, for of healthy serous, read of serous.
145, 29, for irritation, read invitation.
277, 28, for tearf, read