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
Hence we see that the mucous hemorrhages have nothing in common,
but the extravasation of blood, with those which are the effect of
hemorrhoids, and always suppose a rupture of the veins, with those
that aneurisms or varices produce, with those that are the effect of a
cut, of a violent concussion, &c. They form a class by themselves, and
resemble those only that the exhalants furnish upon the other surfaces
where they open.
If I should class hemorrhages, I should distinguish them, 1st, into
those that come from exhalation; 2d, into those that are produced
by rupture. I should place among the first the bloody sweats, the
mucous, serous, cellular hemorrhages, &c.; among the second, those that
accompany wounds, aneurisms, &c. In order to embrace in one view all
the sanguineous evacuations that can happen in the animal economy, I
think it absolutely necessary to adopt this division which moreover
accords with the phenomena and treatment of hemorrhages. Would you
bleed to arrest a hemorrhage from rupture? undoubtedly not; but you
would bleed to check an active hemorrhage by exhalation, because by
diminishing the mass of blood, you diminish the excess of organic
sensibility which produces the hemorrhage; it is nearly the same as
when we bleed for inflammation. It is certainly necessary that the
hemorrhage should be stopped as it has been produced; it is necessary
that the sensibility of the exhalants should return to its natural type
before the blood ceases to flow. We do not bleed to draw the blood
to another place, as has been said; if it was so it should be done
in passive hemorrhages. Most of those who bleed much in hemorrhages,
believe that plethora is the sole cause that produces them, that the
vessels containing too much blood, require a part of it to be taken
away; but there are many more cases of active hemorrhage in which
there are no signs of plethora, than there are of those in which these
signs exist. There may be a real deficiency of this fluid in the
great vessels, but if the exhalants of a part are by their peculiar
sensibility in relation with it, they will pour it out in as great
abundance as if there was an excess of it. It is as in the increase
of natural secretions, exhalations, &c. Whether there was plethora
or not in the great vessels, when the local affection has raised the
peculiar sensibility of the secretories or the exhalants, they would
draw abundantly from the blood. The influence of plethora upon the
increase of the different fluids which are separated from the blood,
is evidently one of the remains of the opinions of Boerhaave. If the
heart agitated everywhere the fluids, if it propelled the blood, the
serum, &c. that go out by the exhalants, the, secreted fluids that go
out by their ducts, this influence would necessarily be real; but since
all the fluids going from the capillary system are necessarily beyond
every action of the heart, as in their circulation, they are wholly
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