General Anatomy, Applied to Physiology and Medicine, Vol. 2 (of 3) — John Shaqi
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
No organ in the animal economy acquires by inflammation, so great a
size in so short a time, and such excessive weight, as the lungs.
All who open dead bodies know this. Observe the lungs of one dead
of pneumonia; cut them, and you would say at first that they were
solid; they often look like liver, they exhibit the appearance of such
a heavy mass; but macerate them and soon the whole will escape in
fluids. Now examine comparatively the skin, the stomach, the liver,
the kidnies, &c. when they have been the seat of acute inflammation,
that has destroyed the patient; they have nothing approaching to this
enormous increase of fluid, which is seen in the substance of inflamed
lungs. Not only the cavity of the cells is full, but the organ is
also much dilated. I have often had occasion to open those who have
died of pneumonia, in whom one of the lungs was entirely sound; now,
the disproportion of weight between it and the affected one, was
incomparably greater than that between an inflamed kidney and a sound
one.
This phenomenon evidently arises from the fact, that the lungs alone
receive as much blood as the whole body, so that when an inflammation
of this viscus interrupts the course of the fluids, a very great
quantity of them can accumulate there in a given time. It is not
however, properly speaking, the blood that is found crowding the lungs
in pneumonia; the fluid appears whitish when pressed out; we should
say that it was a kind of pus. Much has been said of vomicæ after
pneumonia; but they are extremely rare; there is almost always effusion
in the lungs; the fluid is not collected in a sac.
In pulmonary inflammation, does the blood pass through vessels that do
not ordinarily circulate it, as happens so evidently upon the serous
surfaces, or conjunctiva, &c. when inflamed? I do not think it does,
for we do not know any vessels in the lungs, except the sanguineous.
It appears evident that the blood or the other fluids are effused into
the pulmonary texture, in which they are deposited by exhalation. There
is no doubt that in some phlegmons, this fluid passes, as I shall
say, into the cells of the cellular texture; now it appears that it
happens here in the same way. By breaking or cutting inflamed lungs,
we see clearly that its whole texture is crowded, and filled; whereas
in examining an inflamed serous surface, we see that the blood is
evidently contained in the capillaries.
It is a great mistake to try to represent inflammation as being
everywhere the same, as exhibiting always the fluids, like their
vessels, in the same state. Boerhaave for example thought, that there
could be no inflammation without an _error loci_. There is according
to the state of the parts, their structure, their vital properties, a
thousand different modifications in the new anatomical order that this
affection gives to the organs.
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