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
Gravity, external motions, different compressions, &c. have upon the
motion of this fluid, the same influence as upon that of the veins;
gravity especially has much influence. We know that if the powers are
a little diminished after long diseases, too long standing renders the
legs œdematous; hence why they are always more swelled in the evening
than in the morning. As to compression, if it is only moderately great
and acts upon many absorbents, it also produces œdema. It is not
the size of the surface compressed that has an influence upon this
phenomenon; it is only the number of absorbents that pass through this
surface. Thus by the head of the humerus being in the axilla, the arm
is frequently made to swell, whilst more extensive compressions across
the deltoid muscle, where there are fewer absorbents, do not produce
this effect.
From these phenomena, it is necessary then that there should be the
same means to favour the lymphatic circulation, that there are to aid
the venous. These means are especially the anastomoses; it is by them
that the first of these circulations is continued, notwithstanding
all the external obstacles that our clothes in certain places create,
notwithstanding the different pressure that the organs make upon
each other. It is only when the whole of the absorbents of a part is
compressed, that the motion of the lymph is interrupted. Thus the womb
becoming very large in pregnancy, and pressing upon all those of the
lower extremities, these extremities become dropsical. I hardly know
any organ in the abdomen but this, which by its position can produce
these general infiltrations by compression. The liver and all the
other organs are not capable of producing a similar phenomenon. When
dropsy takes place from an affection of them, it is rather because the
functions of the exhalants are increased.
_Remarks upon the Difference of Dropsies that are produced by the
increase of exhalation, and those that are the effect of a diminution
of absorption._
This leads to an observation that appears to me to be very important
in dropsies, viz. the determining when the defect of the action of the
absorbents produces them, and when they arise from the increase of that
of the exhalants.
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