General Anatomy, Applied to Physiology and Medicine, Vol. 3 (of 3)Bichat, Xavier
Science
General Anatomy, Applied to Physiology and Medicine, Vol. 3 (of 3)
Bichat, Xavier
Human anatomy; Human physiology
The remarkable separation which the two edges of a wound experience,
that is made by a cutting instrument, is owing to the contractility
of texture. This separation which takes place upon the dead body,
proves what we have already often remarked, viz. that the properties of
texture, absolutely inherent in the organic texture, are foreign to the
vital forces from which they only borrow an increase of energy; thus
the cutaneous retraction is much stronger during life in a longitudinal
or transverse wound. But it is particularly in amputation that we
observe this increase of contractility from the vital action. No part,
not even the muscles retract so much as the skin; hence the precept so
much recommended in this operation of saving the integuments as much
as possible; hence the essential modifications that have been made in
the ancient methods. The muscular retraction is more sudden; but this,
which is more durable, ultimately prevails; so that in the ancient mode
of amputation, where every part was cut at the same level, they had a
conical stump, the summit of which was formed by the bone, in which was
next seen the muscles, arteries, &c. and in which the skin representing
the base, terminated on the side of the limb.
There are however many cases in which the dermoid extensibility is less
than it at first seems to be. For example, in large sarcoceles, the
skin of the neighbouring parts of the scrotum being drawn, is applied
upon the tumour, and makes up for the extensibility that is wanting in
the skin of this part; that of the penis especially is almost wholly
employed to cover the tumour; so that this organ disappears. It is to
the limits placed to the cutaneous extensibility that must also be
referred the following phenomenon; in a wound with loss of substance,
the fleshy granulations, in contracting by the evacuation of the
white substance that filled them, draw the neighbouring skin in order
to cover the wound; now this drawing produces not only an extension
but a real locomotion. Hence why when the skin, naturally tense and
adherent, cannot yield to this locomotion, the cicatrices are formed
with so much difficulty, as we see upon the cranium, the sternum, &c.;
why on the contrary on the scrotum, the fold of the axilla, &c. they
take place with so little; why in dissecting out tumours, it is so much
recommended to save the sound integuments, &c.
Public-domain text, read in full here on John Shaqi.
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