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
I call those exhalations and secretions active, which are preceded
and accompanied by an evident development of vital forces; and
those passive which exhibit an opposite phenomenon. If we examine
the phenomena of the animal economy, it will be easy to see this
distinction, which appears to me essential in diseases; now, in
whatever organ you study it, you will always see every active
exhalation or secretion preceded by a greater afflux of blood to the
part; all passive exhalations and secretions present an opposite
phenomenon. Let us begin with exhalations.
1st. Cutaneous exhalation is active from violent running, or a paroxysm
of fever, as I have said, from the action of caloric upon the body,
hard work, &c.; the skin is then more expanded and deeper coloured;
more blood enters it, &c. This excitement of the skin makes it more
fit to be influenced by external agents, and to influence in its turn
all the other organs. It is the suppression of these transpirations
which causes so many accidents in the animal economy. Observe, on the
contrary, the complexion of the body in phthisical sweats, in those
produced by internal suppurations, in those that are the effect of
fear, in all those that are called colliquative, &c.; this complexion
is more pale than in a natural state; it is not capable of being
influenced, because its vital activity is then small, and its forces
languish.
2d. In the exhalations of the serous surfaces, there are some that are
essentially active; such is that of pus; for we shall see that the
formation of this fluid upon these membranes is without any kind of
erosion, that it flows evidently from the exhalants, instead of serum;
very often even it flows at the same time. Nothing is more frequent, in
fact, than the milky or purulent serum that is found in the peritoneum,
the pleura, &c. whether the fluids are exactly mixed, or the pus
floats in flakes in the serum. Now this active exhalation of serum or
of pus, which appears to be here principally coagulated albumen, this
exhalation, I say, is evidently preceded by a considerable accumulation
of blood in the capillary system, an accumulation which constitutes
inflammation, and without which exhalation cannot take place. Observe,
on the contrary, serous exhalation, increased by the weakness that any
organic disease gives to the serous membranes; to furnish this fluid,
the blood is never accumulated in them in greater quantity. Open the
membranous sacs, after the diseases of the heart, the womb, the lungs,
the liver, the spleen, &c. you will find them full of water, but more
diaphanous than usual, because they have received less blood.
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