Physiological Researches on Life and DeathBichat, Xavier
Science
Physiological Researches on Life and Death
Bichat, Xavier
Death (Biology); Life (Biology)
From these many considerations, we may conclude that the primitive
seat of the attack in syncope, is the heart, which does not cease
to act, because the action of the brain has been interrupted, but
because it is the nature of some of the passions in such way to
affect it, the brain at the same time, suffering a temporary death,
because it no longer receives the fluid, which is necessary to its
excitement. The nature of syncope is well enough illustrated, by
the vulgar expression of being sick at heart.
It is of no importance to our present purpose, whether syncope
depend on polypi, on aneurism, or be the result of some violent
emotion. The successive affection of the organs is always the same.
They die for the moment in the same way, as they really perish when
the heart is wounded, or a ligature put upon the aorta. In the same
manner also are those sorts of syncope produced, which succeed
after any great evacuation of blood, pus or water. The heart is
affected from sympathy, the brain for want of its excitant.[78]
Those cases of syncope which are occasioned by peculiar odours,
by antipathies, &c. appear also to be attended with the same
progression of symptoms, though their character be much less easily
understood. There is a great difference between syncope, asphyxia,
and apoplexy, in the first it is by the heart, in the second by the
lungs, in the third by the brain that begins the general death of
the body.
Death, as it happens in consequence of disease, in general
exemplifies a concatenation of these different symptoms. The
circulation, respiration, or cerebral action cease, the other
functions are afterwards interrupted of necessity, but in these
sorts of death, it rarely happens that the heart is the first to
die. This however is sometimes the case. After long continued
suffering, great suppuration, and sometimes, in dropsy, certain
fevers, and gangrenes, one fit of syncope comes on after another,
at last a longer one succeeds, and the patient dies, but whatever
be the part affected, whatever the diseased viscus or organ,
whenever the phenomena of death commence by the heart, they succeed
each other as we have described them to do in sudden death, from
lesion of that organ. In other cases, the heart is the last to act,
is the ultimum moriens.
In general, in morbid affections, we much more commonly observe the
ingress of death to be made by the lungs, than either by the heart,
or the brain.
Whenever disease is terminated by syncope, the lungs are found to
be almost empty, and if not affected by any organic disease, are
collapsed, occupy a part only of the cavity of the thorax, and are
of their natural colour.
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