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
It is the same of heat. I shall say hereafter how it is produced. It is
sufficient now to show that it is, like the passage of the blood in the
capillary system, only an effect of the change that has taken place in
the organic sensibility of the part; now this is evident, since it is
always consequent upon this change.
There happens then in inflammation exactly the reverse of what
Boerhaave thought. The blood accumulated according to him, in the
capillary vessels, and pushed _à tergo_ by the heart, as he termed it,
was truly the immediate cause of the affection, whereas, from what I
have said, it is only the effect.
If we reflect a little upon the innumerable varieties of the causes
which can alter the organic sensibility of the capillary system, it
will be easy to understand of what infinite varieties inflammation
is susceptible, from the momentary blush that comes and goes in the
cheeks, to the most serious phlegmon and erysipelas. We might make a
scale of the degrees of inflammation. By taking the cutaneous, for
example, we should see at the bottom the redness that arises and
disappears suddenly by the least external excitement upon the dermoid
system, which we can produce at will, and in which there is only an
afflux of blood; then those that are a little more intense, which
occasion cutaneous efflorescences of some hours, but without fever;
then those that continue for a day, with which there is some fever;
then erysipelas of the first order; then that which is more intense,
and which gangrene soon terminates. All these different degrees do
not suppose a different nature in the disease; the principle of them
is always the same; there is always, 1st, an antecedent increase of
organic sensibility, or alteration of this property; 2d, afflux of
the blood only if the increase is not great, afflux of the blood,
heat, pulsation, &c. if it is. As to fever, it is a phenomenon common
to every severe, acute local affection; it appears to depend on the
singular relation which connects the heart with all parts; it has
nothing peculiar in inflammation, but the particular modification it
receives from it.
The afflux of the blood in an irritated part takes place in
inflammation, as in an incision. In this the divided point has been
irritated by the instrument; soon the whole blood in the neighbourhood
flows there and escapes by the wound. This afflux is so evident a
result of irritation, that in a slight incision, the blood scarcely
flows at the instant of the division of the integuments, because there
is but little of this fluid at the divided place; but a moment after,
the irritation which has been felt, produces its effect, and it flows
in a quantity disproportioned to the incision.
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