General Anatomy, Applied to Physiology and Medicine, Vol. 2 (of 3)Bichat, Xavier
Science
General Anatomy, Applied to Physiology and Medicine, Vol. 2 (of 3)
Bichat, Xavier
Human anatomy; Human physiology
3d. What I have said of the serous exhalations, must be said of the
cellular; some of them are active, such as those of pus and the
serum that sometimes accompanies it; others are passive, as the
leucophlegmasia after organic diseases. The same observation is to be
made as before; there is an accumulation of blood in the capillary
system in the first kind, a diminution of this fluid in the second.
Observe the fatty exhalation; a man in health who is very fat, has a
rosy colour upon the integuments distended with fat, which indicates
the abundance of blood in the capillary system. On the contrary, in
certain cases of sudden corpulency after diseases, in that which
is called false fat, and accompanies weakness, a general paleness
corresponding with the fatty bloating, indicates the absence of the
sanguineous fluid.
4th. Mucous exhalations present also an analogous phenomenon. I
shall prove soon that the hemorrhages from the mucous surfaces are
real exhalations; now some of them are active, a name which Pinel
has given them in his Nosography; these are the nasal, pulmonary,
gastric, uterine hemorrhages, &c. of young people and even of adults.
All these hemorrhages are accompanied by a local increase of action,
by greater heat, by a deeper colour of the mucous membrane, by the
greater abundance of blood in the capillary system. Who does not
know, that Galen predicted a hemorrhage from the redness which he
saw upon the nose and the eye of the patient? On the other hand,
observe the hemorrhages of the mucous surfaces, which take place
after long diseases, hemoptysis, which terminates the diseases of the
heart, hematemesis, the effect of organic derangement of the liver,
hemorrhages from the intestinal canal, so frequent at the end of all
the long organic diseases of the abdomen, &c. nasal hemorrhages in
certain low fevers, those which take place in scurvy from the different
mucous surfaces, the gums especially, &c. all these hemorrhages, which
are truly passive are not accompanied by this preliminary sanguineous
congestion in the capillaries, by this increased activity of vital
action; it might be said that it is the blood, which transudes, as
in the dead body, through the pores, that have not power to retain
it. This distinction is so true, that without making a theory of it,
physicians conform to it in their practice. We bleed to arrest an
active hemoptysis, but would you bleed to stop that which comes on in
the chronic diseases of the thorax? The same observation applies to
all the hemorrhages; they require means wholly opposite, according as
they are active or passive; a remark moreover that is applicable to
all diseases that have increased exhalations or secretions, whatever
may be their seat. It is not the phenomenon that we are to resist, but
the cause that has produced it. We diminish the forces, when serum is
accumulated in the thorax, from a pleurisy; we increase them, when it
accumulates from a disease of the heart, the lungs, &c.
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