No 586.

LONDON, SATURDAY, NOVEMBER 22, 1834. [1834-35.

PHYSIOLOGY.

LECTURES

ON THE

PHYSICAL CONDITIONS

OF THE

TISSUES OF THE HUMAN BODY

AS APPLIED TO THE EXPLANATION OF

VITAL PHENOMENA.

Delivered at the College of France in 1834,By F. MAGENDIE,

Professor of Physiology and Medicine in the College.

LECTURE VIII.

The Physical distinguished from the possi-bly Tiital Phenomena of Imbibition andAbsorption.—Universal Porosity of Liv-ing Organized Bodies.—Changes effectedin imbibed Substances.—Fivid in tite

Cerebro-Spinal Cavity of the Arachnoid.—Transudation of Fluids through Mem-branes after Death.—Eximbibition orExhalation of Fluids by iie Lungs.—Changes in, and escape of, the Blood duringsome Discases.—Experimental Injectionqf Prussiate of Potass into the Lungs.—Experimental Injection of Solutions ofCamphor, Ether, and Phosphorus, intothe Rectum and Circulatory Apparatus,to show their Transudation through thePulm mary Membrane.

IN the preceding lectures, Gentlemen, Ihave endeavoured to explain to you thatthe phenomena resulting from the imbi-bition of substances bv the animal tissuesare of two kinds, same which dependsolely on physical conditions, while ethersare connected with a different principle,the real nature of which is at presentcompletely unknown. The first, or physi-cal phenomena, are readily explained bythe laws governing the action of all ma-terial bodies; but the latter, which it isMseful in many points of view to separate

from the former, depending, as they do,on a vital power or principle, have not,as yet, received any satisfactory explana-tion. I shall, therefore, put them aside,since I cannot pretend, in the presentstate of medical knowledge, to explainthem, with this single remark-that manyphenomena which now appear vital, may,when further experiments have enlargedour views, be converted into purely phy-sical facts. Thus we have been able toshow, that some vital phenomena, whenstrictly examined, are converted into phy-sical, and by that means are susceptible ofan easy explanation.

’

Absorption presents you with an exam-ple of this kind. Twenty years ago thisfuliction was regarded as one in the high- *est degree vital, and the proximate causewas involved in the greatest obscurity. Va-rious opinions were adopted by different! authors, and three different views weresupported by the most contradictory rea.-sons ; but the expel iments which I havemade before you, and the facts I have de-veloped, are, I hope, sufficient to convincei you all, that the phenomena of absorptionare not so far beyond our knowledge, butdepend on certain physical conditions ofmaterial bodies, through which they aresatisfactorily and amply explained. Thisis a result of the highest interest, andholds out much encouragement fur thefurther prosecution of the subject. Whenwe apply the same principle to various

’ other vital phencmona, and endeavour toresolve in this manner the diffieult qms-tion of life, our experiments, even if they

! should not he attended with complete sue-cess, at lease trace out the way in whichothers may follow, and at the last mayestablish a foundation for a more solid andrational theory than that to which phy-siologists of the present day universallyincline.

I Living bodie?. Gentlemen, present manyphysical properties, which may be appliedon a variety cf occasions to the explana-tion of actions denominated vital; theseproperties may he distinguished into twokinds, viz., general and secondary. With

regard to the first species, you have seeu

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how porosity belongs to all living organ- It is a well-known fact, that the weightized bodies ; there is not a single living of a man who abstains from taking anybody which does not present an example nutriment, diminishes every hour; theof this property in every part of its com- loss is not, perhaps, very great, but if ac-

position ; it exists in vegetables as well curately estimated, you will find that itas in animals of every kind, in the paren- amounts to several ounces: the diminu-chyma of a leaf, and in all human tissues. tion of weight, under these circumstances,We have taken this simple property of is attributed to what physiologists callorganized bodies, and applied it, in the insensible perspiration; that is to say, thefirst instance, to the phenomena of imbi- liquid part of the body gradually parses tobition, showing how it explains the intro- the surface, penetrates the skin from theduction of substances from the exterior to interior to the exterior, and is removedthe interior of the human frame. We in the form of vapour. You have alreadyhave then followed up and developed this been prepared to understand this pheno-principle, have applied it to medicine, and menon by the experiments which showedarrived at several conclusions of high prac- how easily fluids are transmitted from thetical importance. Thus various ques- internal surface of the skin to the exter-tions of pathology are attached to porosity, nal, even when the epidermis remains in-and many morbid symptoms are removed tact. In reptiles this phenomenon some-more certainly, and with greater rapidity, times takes place to such a degree, as to

by a method of cure founded on this pro- produce complete desiccation of the ani-perty. I need scarcely cite to you the mal. The fluids are conveyed from tissueendermic method of treating disease ; to tissue by gradual imbibition, exhalethere are, for example, many local pains from the surface of the body, and finallyof a nervous kind, which can only be re- leave the reptile almost perfectly dry.moved by the endermic treatment, which It is not long sincj I established, byconverts a point of the skin into an im- observations on the living body, and bybibing surface, and thus affords a means experiments upon animals, that the cere-of introducing medicinal substances into bro-spinal cavity of the arachnoid alwaysthe economy with the greatest advantage. contains a certain quantity of fluid, whichWe shall now, Gentlemen, pursue the may amount in the healthy subject to

study of these physical properties, laying about two or three ounces. This fact wasaside, as I said before, all that may seem for a long time disputed, because, on ex-to belong to vital phenomena. amiuing the body, twenty-four or thirtyThe question of imbibition comprehends hours after death, this fluid is seldom or

the transmission of all substances from the never found. Why? During the last mo-exterior to the interior of the human body; ments of life, or immediately after the de-in fact, all substances, when placed in cease of the individual, the cerebro-spinalcontact for a certain time with the animal fluid is imbibed by the surrounding tissuestissue, are taken into the interior of the and completely disappears; hence the

frame, and produce different effects, ac- anatomist is inclined to deny the exist-cording to the nature and form of the ence of that which he does not find aftersubstance so introduced. This is an uni- death, although observations made uponversal fact, comprehending bodies of every living animals, prove incontestably its pre-variety, whether solid, liquid, in a state of sence in the cavity of the arachnoid.vapour, or reduced to the more subtile The phenomena of transudation may beform of gas: they are imbibed indiscrimi- also seen in certain changes which takenately, and produce their effects, each place in the human eye after death. Thisafter its kind. ’’ organ is, as you know, composed in greatBut in order to complete the history of part of fluids; during lite it presents a full,

imbibition, we have to consider it under a round, and brilliant ball, projecting moreform of a different nature. Every organ- or less from the socket; but after death theized body is composed, as you know, of change is most remarkable; the brilliantsolids and liquids mixed in various pro- appearance is totally lost, the eye becomesportions ; now we want to ascertain in small and shrunk in the orbit, and as-what manner these different substances sames an appearance familiar to all whoact upon each other, and under what con- are in the habit of frequenting a hospital,ditions the liquids of the human body are or dissecting in the amphitheatres. If youimbibed by the surrounding tissues. Hi. examine the eye in the dead subject, you.tberto we have considered the action of find little remaining except the crystal-external agents; now we would trace the line lens and the tunics. Why is this?changes which daily take place in the As soon as circulation has ceased in thecomposition of the human body, and en- vessels of the organ, imbibition com-

deavour to see how far these may be con- mences, the fluids pass to the surface, andnected with the property of imbibition. are gradually removed, giving to the eye

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that peculiar aspect and character which the pulmonary surface that this mass ofhave from time immemorial been noted in fluids circulating with the blood is se-

the dead body. parated and transpires. Physiologists ofBut this fact of the imbibition of the, former times gave rather a fanciful ex-

fluids of the eye may, under certain cir- ; planation of this phenomenon. They ima-cumstances, take place even during life.! gined that water was formed in the lungsThis, Gentlemen, is almost incredible, but by the combustion of hydrogen gas duringit is not the less true: we had occasion the process of respiration, and exhaled into remark it too often, in a high degree,: the form of insensible vapour, but thisduring the prevalence of epidemic cholera, theory is now completely exploded. WeThe eye of a person gravely attacked by’ know, on the contrary, that the vapourthis disease, resembles the eye of a dead’ which transpires from the pulmonary sur-subject ; it is empty, withered, and loses all face exists in the form of a fluid in theits brilliancy ; the fluids are gradually im- bloodvessels, and is transmitted by imbibi-bibed, because the eye of a cholera patient tion through the membranous tissue to theis placed in the same physical conditions exterior. This is a fact almost too wellas in the dead subject. The capillary cir- known to require comment; however, weculation is arrested, the property of imbi- shall explain it by one or two experimentsbit ion commences to act according to its for your satisfaction.own laws, and we have the same effects You are to remark, that the pulmonaryproduced as if the individual were com- transpiration is in exact proportion to thepletely deprived of life. quantity of serum or fluid matter contained

These facts, Gentlemen, are sufficient in the circulating mass. Whenever theto demonstrate, that the imbibition of the bloodvessels hold a large quantity of se-fluids forming a component part of the i ru:n, the pulmonary surface is employedhuman body, may take place during life,’ to discharge the superabundance, and ex-under certain circumstances, and does halation goes on from that organ withactually occur, whenever the physical! great activity; on the contrary, when theconditions exist which are necessary for mass of the blood contains less fluid matterthe development of that phenomenon. I than usual, the pulmonary transpirationhave already drawn your attention to the is very insignificant or totally suspended.rapid imbibition presentecl by the pulmo- This may be provecl by direct experiment.nary surface, and have demonstrated the If you take a dog, and inject a quantity offact by several experiments. You saw an fluid into his veins, the exhalation from theanimal die immediately after having re- lungs is soon developed in a high degree,spired the vapour of prussic acid, and the and the water escapes rapidly by the pul-same result was produced hy injecting a monary surface. However, in making thisquantity of a poisonous fluid into the tra- experiment, you must he careful not tochea. But the pulmonary surface pos- inject too much water at a time, especiallysesses a property of a different kind, and if the animal be small, for you may killin a very high degree also. This is the him on the spot, as took place in the pre-property of eximbibition, which is perpe- sentinstance. We directed some water to be

tually exercised by the lungs in a very ac- thrown into the veins of this little dog, intive manner. I make use of the phrase order to show you the manner in whicheximbibition, rather than employ the term the pulmonary transpiration is acceleratedexhalation, because the latter is supposed by the operation, but he died, as you seeto include some vital act or agency ; but in a few minuter. I cannot say exactJ)the phenomenon to which I would now why; perhaps the fluid became extrava-direct your attention, is one of a strictly sated in the lungs, and produced death byphysical nature, depending on the physi- suffocation. We will, however, open himcal structure of the tissue, not upon any presently, and see the reason. We cannotpeculiar sensibility or vital power enjoyed on account of this accident, demonstrateby it. the fact by direct experiment, but had theThe property of eximbibition is, as I animal lived, you would have seen the re-

said, exercised by the lungs in a highly spiration become rapid and panting, as

energetic manner. In fact, a great part soon as a certain quantity of water wasof the fluids which are removed from the thrown in; a large discharge of vapourhuman body pass off by that channel ; and would soon have taken place from the pul-perhaps we may say, one-half of those monary surface, and after some time theexcreted are discharged by the membrane transpiration would have become so en-of the lungs. We are daily in the habit of ergetic and rapid as to furnish a liquidtaking a vast quantity of various fluids into flowing from the animal’s mouth. Thisthe stomach. These are absorbed, as every shows the rapid manner in which fluids arebody knows, and conveyed into the cir- exhaled through the medium of the lungs,culation, but it is through the medium of and the circulation is thus relieved from a

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mass of extraneous material which might in degree and intensity according to theotherwise occasion considerable incon- nature of the case, and effusions of bloodvenience, if not become a cause of dis- take place in different parts of the body.ease. ! A female, to whose case I will allude, pre-We shall now proceed to examine the seated an appearance exactly similar to

body of the animal, and eudeavour to as- : this piece of lung in my hand, and, pro-certain why he died. I think it not im- bably, from a similar cause. The wholeprobable that the proximate cause of death surface of her body was covered withwill be found in the lungs. In the mean: ecchymoses of a dark purple colour.time remark the external appearance cf. These were most remarkable about thethe dog; althoagh originally small and eyelids, face, and upper part of the trunk;lean, he now looks bloated and even fat. the tongue was also much changed inThis arises Horn the manner in which the colour and considerably swollen, no

circulating system is filled with an ex- (loubt from the presence of blood extra’traordinary quantity of water, which vasated into its substance. In this casesometimes makes the animal appear to the nature of the blood must be altered inbe of double its natural size. The chest such a. way that it can be no longer re-has now been laid open, and you see at tained 1)y its vessels, and hence the vitalonce the cause of death. There is a quan- fluid escapes at all the surfaces. Inueeii

tity of blood extravasated into the paren- never saw an example of this peculiarchymatous substance of the lung, and disposition in so high a degree ; she vomitshere you may remark several dark ex- blood occasionally, and passes it by stool,tensive patches on the anterior surface of and traces may also be found in her urine.the organ. These pathological appear- I drew a few ounces of blood from the armances confirm the opinion I have just of this woman, in order to examine it atgiven as to the cause of death. The cir- my leisure, and here it is in this bottle.culating system, especially that part which The physical properties are, as you see,traverses ê,he respiratory organs, has been ! manifestly changed. The clot has notdistended and gorged with a large quantity that firm and solid feel which it ought toof extraneous fluid; the fine branches, have, and the whole mass contains a greatwhich ramify on the surface of the lungs ! deal more serum than is natural. In thisbecome thus distended in a manner in- latter respect it approaches the conditioncompatible with a regular or healthy dis- ’ of the blood in the dog whose veins we in-position of the organ; their function is! jected a short time since. The colouringderanged, respil-ation becomes more and matter is net retained with the fibrine,more embarrassed a:-, the small vessels be- but is in great measure dissolved in thecome more engorged, and death results serum, and separated from that part of theeither in consequence of effusion, me- blood with winch it is usually-connected.chanically produced, er from the impos- These circumstances sufficiently poiutsibility of carrying on the fanction of re- out a change of some kind in the nature £

spiration. of blood, without having recourse to any1 have at present an example cf this; chemical experiments. Should the patient

condition of tio. bloodvessels in a female die, as is not improbable, we shall mostunder my care at the Hétel Dieu. This likely find an effusion of blood in the

woman presents several remarkable symp- lungs, similar to that observed in the dogtoms, arising from what I must consider which was killed by the introduction ofa pecujiar disposition of the blood, for al- water into the circulation.though I am by 1,0 mears s a favourer of I would now, Gentlemen, irect yourthe humoral patholegy, which has long attention to the result of an experimentsince given place to views of a mere ex- which we made before the lecture, andtensive and enlightened nature, I am still v.’hich proves the imbibition of a substanceobliged to confess that many morbid from the internal to the external surfacephenomena can LailE’ be explained by a re- of a membrane, or the faet of ex-imbi-ference to the fluids contained in the dif- ! bition, if you like so to call it. We in-ferent organs and conduits, not to any jectecl a solution of the prussiate of potasschange in’ the containing parts them-: into the lungs of this little dog; lie is nowselvcs. Thus whenever it comes to pass dead, not because he was poisoned by thethat the watery parts of the blood go off substance, bat because too great a quan-in any considerable quantity, and that tity was introduced at cne time; this how-certain other elements of this fluid are re- ever is of no consequence, for you willmoved, by which a series of bad sympte ms find traces of the prussiate in all the tis-is produced, resulting from tl;e circum- slles of the animal’s body; here we openstance that the bicocl cannot be contained the cav ity of the abdomen, and let us seein its proper vessels, the surface of the ; whether we can establish the presence ofbody is covered with ecchymoses, differing prussiate of iron in the abdominal pa-

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rietes; we now place a portion of the ap- lile as it is. for the camphor has becomepropriate test, a solution of sulphate of precipitated, and is not sufiiciently dis-iron, and wherever we touch, you see the solved to pass through the syringe; wepresence of the prussiate indicated by the mmt therefore take a larger instrument,change of colour ; the same phenomenon and employ heat to redissolve the portionis exhibited as you see when I touch the which remains at the brl;to2n of the flask;surface of an intestine. It is unnccessary in the meantime, let rue remark to vouto pursue our search farther ; you have that camphor preduces some very strangeseen enough to he certain that inihibition effects upon animals. I have seen somehas taken place, for the presence of the who leaped several feet from the groundmedicinal substance was cstablished in ; when a strong solution of camphor wasseveral different tissues; it wonld even be injected into the rectum; others are seizedpossible to measure the rate at winch im- wich convulsive movements cf the mouthbibition takes place under these circum- and museles of the face, and execute astances, and to follow the substance in its retrograde movement of a very strangepassage from one tis:ue to another ; this and bizarre nature.would at least be curious, if not useful; i The solution has now remained five orindeed FŒDEBA empleyed himself in the six minates in contact, with the mem-

partial investigation of the subject, and brane of the intestine, but do not see anyfollowed an imbibed substance from tissue appearancc of the symptoms which I haveto tissue, until he trased it at length to just mentioned being about to be pro-the hard part- and bones. duced; however, when you approach the

Palæenary transpiration, Gentlemen, muzzle of the dor, you cannot fail to re-acts not only on the serum and fluid parts ’ cognisethe odour of camphor, which issuesof the blood, but also in the removal of abundantly at each expiration; this isvarious extraneous substances which may enoagh to establish the fact of its ex-

have found their way into the circulation; imbibition through the pulmonary mem-this property of the pulmonary membrane brane, theugh I wished, at the same time,is one of high importance, we shall there- to show you an example of its poisonousfore endeavour to establish its existence effects on the animal economy. You have

by direct experiment, the best, indeed a similar phenomenon taking place in theThe only sure support, which a physielo- human subject when a lavement call-

gist can give to any assertion conceruing taiaing camphor has been admiaistered ;the functions of any part or organ. Odo- the pecaliat odour of this substance taintsrous bodies sometimes are introduced into the breath for the whole cay after; somethe stomach, and thence flttfl a passage people are inclined to imagine that theinto the general mass of the cireulation. odoriferous principle ascends through theHow are they removed from the blood ? intestinal canal, stomach; and œsophagus,By means of the pulmonary surface, as to the mouth, and is thus discharged; butyou shall presently see. this theory is completely without founda-Some of these bodies are cmployed in tion, because a similar effect is produced,

medicine, we shall therefore select from no matter in what part of the body youamongst them ether, camphor, and phos- introduce the substance; if you place it inphorus, and show you how each substance, any cf the cavities, or inject it directlyafter having been mixed with the blood, into the veins, you have the same exhala-exhales its peculiar odoar in the pulmo- tion of the odoiiferous matter from the

nary transpiration. Camphor is a remedy lungs.which we have often occasion to employ having prcved the manner in whichill the form of lavement; no sooner is the camphor passes off from thecircuiation, wesubstance introduced into the rectum than shall procced, Gentlemen, to experimentit is taken up by the vessels of the part, with ether, and show how the odorousis carried into the mass of the blood, and matter of this fluid is likewise exhaledafter a very short time is found in the with the pulmonary transpiration. Wepulmonary transpiration, as I now proceed now inject a small quantity of etherto show you; at least you will find a strong through an aperture made in the thoracieodour of camphor discharged at each re- parietes of this dog; the fluid lias not

spiration which the animal gives. I now been introduced more than ten seconds,take some of this solution of camphor! and tie animal has fallen on the table as,’there is perhaps half : n ounce in this if suddenly struck with death ; this is asmall bottle), and inject it into the anus I species of intoxication which ether pro-of the dog before you, and in a few mo- duces when taken in any quantity, andments I expect you w ill have the charac- may be carried to such an extent as toteristie effccts produced. On the present occasion death in reality; the fact is, theoccasion we meet with a little embarrass- auimal before us, whenr I thought onlyment in performing this experiment, sim- dead drunk, is actually de rived of lift;

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vou may see a similar effect in certain in-di iduals who are habitually given to in-toxication, and on whom the ordinarystimuli have lost their force from too fre-quent repetition ; these people are in theha)it of exciting themselves by opium orether, which gives rise to a powerful andmost pernicious species of inebriety, andlays the foundation of serious disease. Butto return to our subject. Although the ani-mal is dead, you may satisfy yourselves ofthe truth of the fact I mentioned ; theodour of ether is quite strong when youapproach his mouth.

I shall now proceed to make a curiousexperiment, which proves, like the former,that substances introduced into the circu-lation escape by the lungs. This bottlecontains a small bit of phosphorus in a stateof solution. Phosphorus, you know, pos-sesses the peculiar property of enteringinto a state of combustion whenever it is

exposed to atmospheric air, and gives offa fine white vapour, the product of itscombustion. Now when we introduce a

portion of phosphorus, dissolved in oil,into the circulation of an animal, you willsee this white vapour exhaling with thebreath, and if the experiment were per-formed in a dark chamber, you wouldwitness the curious phenomenon of a

burning vapour issuing from the mouth,as if the animal breathed fire, accordingto the vulgar phrase, and would be con-vinced by ocular demonstration, that thesubstance exhales with the pulmonarytranspiration. Here is a strong dog: wehave previously exposed the jugular vein,and now proceed to inject about a scrupleof the phosphoretted oil into the vessel.In a few moments you will see the whitevapour of which I spoke exhaling from theanimal’s nose. This is rather strange;several minutes have elapsed since the in-jection was made, and I see no trace, asyet, of the vapour. Perhaps the oil has notbeen sufficiently charged. Let us heat theflask for some time, and try another sy-ringeful. I have repeated the injection,as you see, but have not succeeded in

producing the effect which I wished.

However, you can smell the phosphorusissuing with the animal’s breath, althoughvou cannot see it in the form of va-

pour, and the experiment sufficiently sup-ports those already made to prove themanner in which odorous bodies intro-duced into the blood are removed by themedium of the pulmonary membrane.

THE symptom in consumptive patients which wehave found chlorine most decidedly to relieve isdyspnœa. The freedom of breathing produced by it,was one of its most obvious effects, Sometimes itallayed congh. Sometimes it was too irritating foruse. C:ark on Tuberc. Phthisis in Cyc. Prac. Med.

CLINICAL OBSERVATIONS

ON

VARIOUS DISEASES,

BY

MR. WARDROP.

PROLAPSUS OF THE RECTUM.

IT is of the greatest importance in thepractice of medicine to distinguish symp-tomatic from primary affections, as suchdiscrimination at once points out the organto which our remedial means ought to bechiefly directed. Prolapsus of the rectumhas, I believe, been generally treatedmerely as a local complaint; but the his-tory and treatment employed in the fol-lowing cases prove, I think satisfactorily,that it is a secondary affection; and is,therefore, to be relieved, not only by localremedies but by those therapeutic meanswhich will restore a deranged state of theprimse vice.

1 was first led to form this opinion ofthe nature and treatment of prolapsus,from having frequently observed portionsor folds of the rectum protruded along withhemorrhoidal tumours in patients whosebowels had been irritable, or in whomthe natural functions of the intestinal canalhad been disturbed, the prolapsed por-tion of bowel disappearing whenever thesource of irritation was removed.

Case 1.—An unmarried lady consultedme about a very large prolapsus of therectum, which had afflicted her duringmore than eight years, and by which shewas prevented from walking and takingexercise, for the intestine could be keptup only while she remained in a horizon-tal position, as her bowels were alter-

nately relaxed and constipated. Beforeusing any local means, I prescribed a doseof calomel, with a view to correct the de-ranged state of the primæ vise. Afterhaving taken only two pills, composed ofa couple of grains of calomel with as muchof the antimonial powder and extract ofrhubarb, which brought away copiousbiliary evacuations, the bowel, to mysurprise, did not again protrude, so thatshe required no local treatment ; and up-wards of a year afterwards she informedme that the prolapsus had not recurred.

Case 2.-A lady, the mother of severalchildren, returned from India with herconstitution much debilitated; but shecomplained of no particular disease, exceptthat she was liable to a prolapsus of therectum, and the intestine protruded so