Dr. Hope has also made this pleasing experiment, after the manner of Hales--he has placed a forked branch, cut from one tree, erect between two others; then cutting off a part of the bark from one fork applied it to a similar branch of one of the trees in its vicinity; and the same of the other fork; so that a tree is seen to grow suspended in the air, between two other trees; which supply their softer friend with due nourishment.
Miranturque novas frondes, et non sua poma.
All these experiments clearly evince, that the juices of vegetables can occasionally pa.s.s either upwards or downwards in their absorbent system of vessels.
X. _Objections answered._
The following experiment, at first view, would seem to invalidate this opinion of the retrograde motions of the lymphatic vessels, in some diseases.
About a gallon of milk having been giving to an hungry swine, he was suffered to live about an hour, and was then killed by a stroke or two on his head with an axe.--On opening his belly the lacteals were well seen filled with chyle; on irritating many of the branches of them with a knife, they did not appear to empty themselves hastily; but they did however carry forwards their contents in a little time.
I then pa.s.sed a ligature round several branches of lacteals, and irritated them much with a knife beneath the ligature, but could not make them regurgitate their contained fluid into the bowels.
I am not indeed certain, that the nerve was not at the same time included in the ligature, and thus the lymphatic rendered unirritable or lifeless; but this however is certain, that it is not any quant.i.ty of any stimulus, which induces the vessels of animal bodies to revert their motions; but a certain quant.i.ty of a certain stimulus, as appears from wounds in the stomach, which do not produce vomiting; and wounds of the intestines, which do not produce the cholera morbus.
At Nottingham, a few years ago, two shoemakers quarrelled, and one of them with a knife, which they use in their occupation, stabbed his companion about the region of the stomach. On opening the abdomen of the wounded man after his death the food and medicines he had taken were in part found in the cavity of the belly, on the outside of the bowels; and there was a wound about half an inch long at the bottom of the stomach; which I suppose was distended with liquor and food at the time of the accident; and thence was more liable to be injured at its bottom: but during the whole time he lived, which was about ten days, he had no efforts to vomit, nor ever even complained of being sick at the stomach! Other cases similar to this are mentioned in the philosophical transactions.
Thus, if you vellicate the throat with a feather, nausea is produced; if you wound it with a penknife, pain is induced, but not sickness. So if the soles of the feet of children or their armpits are tickled, convulsive laughter is excited, which ceases the moment the hand is applied, so as to rub them more forcibly.
The experiment therefore above related upon the lacteals of a dead pig, which were included in a strict ligature, proves nothing; as it is not the quant.i.ty, but the kind of stimulus, which excites the lymphatic vessels into retrograde motion.
XI. _The Causes which induce the retrograde Motions of animal Vessels; and the Medicines by which the natural Motions are restored._
1. Such is the construction of animal bodies, that all their parts, which are subjected to less stimuli than nature designed, perform their functions with less accuracy: thus, when too watery or too acescent food is taken into the stomach, indigestion, and flatulency, and heartburn succeed.
2. Another law of irritation, connate with our existence, is, that all those parts of the body, which have previously been exposed to too great a quant.i.ty of such stimuli, as strongly affect them, become for some time afterwards disobedient to the natural quant.i.ty of their adapted stimuli.--Thus the eye is incapable of seeing objects in an obscure room, though the iris is quite dilated, after having been exposed to the meridian sun.
3. There is a third law of irritation, that all the parts of our bodies, which have been lately subjected to less stimulus, than they have been accustomed to, when they are exposed to their usual quant.i.ty of stimulus, are excited into more energetic motions: thus when we come from a dusky cavern into the glare of daylight, our eyes are dazzled; and after emerging from the cold bath, the skin becomes warm and red.
4. There is a fourth law of irritation, that all the parts of our bodies, which are subjected to still stronger stimuli for a length of time, become torpid, and refuse to obey even these stronger stimuli; and thence do their offices very imperfectly.--Thus, if any one looks earnestly for some minutes on an area, an inch diameter, of red silk, placed on a sheet of white paper, the image of the silk will gradually become pale, and at length totally vanish.
5. Nor is it the nerves of sense alone, as the optic and auditory nerves, that thus become torpid, when the stimulus is withdrawn or their irritability decreased; but the motive muscles, when they are deprived of their natural stimuli, or of their irritability, become torpid and paralytic; as is seen in the tremulous hand of the drunkard in a morning; and in the awkward step of age.
The hollow muscles also, of which the various vessels of the body are constructed, when they are deprived of their natural stimuli, or of their due degree of irritability, not only become tremulous, as the arterial pulsations of dying people; but also frequently invert their motions, as in vomiting, in hysteric suffocations, and diabetes above described.
I must beg your patient attention, for a few moments whilst I endeavour to explain, how the retrograde actions of our hollow muscles are the consequence of their debility; as the tremulous actions of the solid muscles are the consequence of their debility. When, through fatigue, a muscle can act no longer; the antagonist muscles, either by their inanimate elasticity, or by their animal action, draw the limb into a contrary direction: in the solid muscles, as those of locomotion, their actions are a.s.sociated in tribes, which have been accustomed to synchronous action only; hence when they are fatigued, only a single contrary effort takes place; which is either tremulous, when the fatigued muscles are again immediately brought into action; or it is a pandiculation, or stretching, where they are not immediately again brought into action.
Now the motions of the hollow muscles, as they in general propel a fluid along their cavities, are a.s.sociated in trains, which have been accustomed to successive actions: hence when one ring of such a muscle is fatigued from its too great debility, and is brought into retrograde action, the next ring from its a.s.sociation falls successively into retrograde action; and so on throughout the whole ca.n.a.l. See Sect. XXV. 6.
6. But as the retrograde motions of the stomach, oesophagus, and fauces in vomiting are, as it were, apparent to the eye; we shall consider this operation more minutely, that the similar operations in the more recondite parts of our system may be easier understood.
From certain nauseous ideas of the mind, from an ungrateful taste in the mouth, or from foetid smells, vomiting is sometimes instantly excited; or even from a stroke on the head, or from the vibratory motions of a ship; all which originate from a.s.sociation, or sympathy. See Sect. XX. on Vertigo.
But when the stomach is subjected to a less stimulus than is natural, according to the first law of irritation mentioned above, its motions become disturbed, as in hunger; first pain is produced, then sickness, and at length vain efforts to vomit, as many authors inform us.
But when a great quant.i.ty of wine, or of opium, is swallowed, the retrograde motions of the stomach do not occur till after several minutes, or even hours; for when the power of so strong a stimulus ceases, according to the second law of irritation, mentioned above, the peristaltic motions become tremulous, and at length retrograde; as is well known to the drunkard, who on the next morning has sickness and vomitings.
When a still greater quant.i.ty of wine, or of opium, or when nauseous vegetables, or strong bitters, or metallic salts, are taken into the stomach, they quickly induce vomiting; though all these in less doses excite the stomach into more energetic action, and strengthen the digestion; as the flowers of chamomile, and the vitriol of zinc: for, according to the fourth law of irritation, the stomach will not long be obedient to a stimulus so much greater than is natural; but its action becomes first tremulous and then retrograde.
7. When the motions of any vessels become retrograde, less heat of the body is produced; for in paroxysms of vomiting, of hysteric affections, of diabetes, of asthma, the extremities of the body are cold: hence we may conclude, that these symptoms arise from the debility of the parts in action; for an increase of muscular action is always attended with increase of heat.
8. But as animal debility is owing to defect of stimulus, or to defect of irritability, as shewn above, the method of cure is easily deduced: when the vascular muscles are not excited into their due action by the natural stimuli, we should exhibit those medicines, which possess a still greater degree of stimulus; amongst these are the foetids, the volatiles, aromatics, bitters, metallic salts, opiates, wine, which indeed should be given in small doses, and frequently repeated. To these should be added constant, but moderate exercise, cheerfulness of mind, and change of country to a warmer climate; and perhaps occasionally the external stimulus of blisters.
It is also frequently useful to diminish the quant.i.ty of natural stimulus for a short time, by which afterwards the irritability of the system becomes increased; according to the third law of irritation above-mentioned, hence the use of baths somewhat colder than animal heat, and of equitation in the open air.
_The catalogue of diseases owing to the retrograde motions of lymphatics is here omitted, as it will appear in the second volume of this work. The following is the conclusion to this thesis of_ Mr. CHARLES DARWIN.
Thus have I endeavoured in a concise manner to explain the numerous diseases, which deduce their origin from the inverted motions of the hollow muscles of our bodies: and it is probable, that Saint Vitus"s dance, and the stammering of speech, originate from a similar, inverted order of the a.s.sociated motions of some of the solid muscles; which, as it is foreign to my present purpose, I shall not here discuss.
I beg, ill.u.s.trious professors, and ingenious fellow-students, that you will recollect how difficult a talk I have attempted, to evince the retrograde motions of the lymphatic vessels, when the vessels themselves for so many ages escaped the eyes and gla.s.ses of philosophers: and if you are not yet convinced of the truth of this theory, hold, I entreat you, your minds in suspense, till ANATOMY draws her sword with happier omens, cuts asunder the knots, which entangle PHYSIOLOGY; and, like an augur inspecting the immolated victim, announces to mankind the wisdom of HEAVEN.
SECT. x.x.x.
PARALYSIS OF THE LIVER AND KIDNEYS.
I. 1._Bile-ducts less irritable after having been stimulated much._ 2.
_Jaundice from paralysis of the bile-ducts cured by electric shocks._ 3. _From bile-stones. Experiments on bile-stones. Oil vomit._ 4. _Palsy of the liver, two cases._ 5. _Schirrosity of the liver._ 6. _Large livers of geese._ II. _Paralysis of the kidneys._ III. _Story of Prometheus._
I. 1. From the ingurgitation of spirituous liquors into the stomach and duodenum, the termination of the common bile-duct in that bowel becomes stimulated into unnatural action, and a greater quant.i.ty of bile is produced from all the secretory vessels of the liver, by the a.s.sociation of their motions with those of their excretory ducts; as has been explained in Section XXIV. and XXV. but as all parts of the body, that have been affected with stronger stimuli for any length of time, become less susceptible of motion, from their natural weaker stimuli, it follows, that the motions of the secretory vessels, and in consequence the secretion of bile, is less than is natural during the intervals of sobriety. 2. If this ingurgitation of spirituous liquors has been daily continued in considerable quant.i.ty, and is then suddenly intermitted, a languor or paralysis of the common bile-duct is induced; the bile is prevented from being poured into the intestines; and as the bilious absorbents are stimulated into stronger action by its acc.u.mulation, and by the acrimony or viscidity, which it acquires by delay, it is absorbed, and carried to the receptacle of the chyle; or otherwise the secretory vessels of the liver, by the above-mentioned stimulus, invert their motions, and regurgitate their contents into the blood, as sometimes happens to the tears in the lachrymal sack, see Sect. XXIV. 2. 7. and one kind of jaundice is brought on.
There is reason to believe, that the bile is most frequently returned into the circulation by the inverted motions of these hepatic glands, for the bile does not seem liable to be absorbed by the lymphatics, for it soaks through the gall-ducts, and is frequently found in the cellular membrane.
This kind of jaundice is not generally attended with pain, neither at the extremity of the bile-duct, where it enters the duodenum, nor on the region of the gall-bladder.
Mr. S. a gentleman between 40 and 50 years of age, had had the jaundice about six weeks, without pain, sickness, or fever; and had taken emetics, cathartics, mercurials, bitters, chalybeates, essential oil, and ether, without apparent advantage. On a supposition that the obstruction of the bile might be owing to the paralysis, or torpid action of the common bile-duct, and the stimulants taken into the stomach seeming to have no effect, I directed half a score smart electric shocks from a coated bottle, which held about a quart, to be pa.s.sed through the liver, and along the course of the common gall-duct, as near as could be guessed, and on that very day the stools became yellow; he continued the electric shocks a few days more, and his skin gradually became clear.
3. The bilious vomiting and purging, that affects some people by intervals of a few weeks, is a less degree of this disease; the bile-duct is less irritable than natural, and hence the bile becomes acc.u.mulated in the gall-bladder, and hepatic ducts, till by its quant.i.ty, acrimony or viscidity, a greater degree of irritation is produced, and it is suddenly evacuated, or lastly from the absorption of the more liquid parts of the bile, the remainder becomes insp.i.s.sated, and chrystallizes into ma.s.ses too large to pa.s.s, and forms another kind of jaundice, where the bile-duct is not quite paralytic, or has regained its irritability.
This disease is attended with much pain, which at first is felt at the pit of the stomach, exactly in the centre of the body, where the bile-duct enters the duodenum; afterwards, when the size of the bile-stones increase, it is also felt on the right side, where the gall-bladder is situated. The former pain at the pit of the stomach recurs by intervals, as the bile-stone is pushed against the neck of the duct; like the paroxysms of the stone in the urinary bladder, the other is a more dull and constant pain.
Where these bile-stones are too large to pa.s.s, and the bile-ducts possess their sensibility, this becomes a very painful and hopeless disease. I made the following experiments with a view to their chemical solution.
Some fragments of the same bile-stone were put into the weak spirit of marine salt, which is sold in the shops, and into solution of mild alcali; and into a solution of caustic alcali; and into oil of turpentine; without their being dissolved. All these mixtures were after some time put into a heat of boiling water, and then the oil of turpentine dissolved its fragments of bile-stone, but no alteration was produced upon those in the other liquids except some change of their colour.
Some fragments of the same bile-stone were put into vitriolic aether, and were quickly dissolved without additional heat. Might not aether mixed with yolk of egg or with honey be given advantageously in bilious concretions?
I have in two instances seen from 30 to 50 bile-stones come away by stool, about the size of large peas, after having given six grains of calomel in the evening, and four ounces of oil of almonds or olives on the succeeding morning. I have also given half a pint of good olive or almond oil as an emetic during the painful fit, and repeated it in half an hour, if the first did not operate, with frequent good effect.
4. Another disease of the liver, which I have several times observed, consists in the inability or paralysis of the secretory vessels. This disease has generally the same cause as the preceding one, the too frequent potation of spirituous liquors, or the too sudden omission of them, after the habit is confined; and is greater or less in proportion, as the whole or a part of the liver is affected, and as the inability or paralysis is more or less complete.
This palsy of the liver is known from these symptoms, the patients have generally pa.s.sed the meridian of life, have drank fermented liquors daily, but perhaps not been opprobrious drunkards; they lose their appet.i.te, then their flesh and strength diminish in consequence, there appears no bile in their stools, nor in their urine, nor is any hardness or swelling perceptible on the region of the liver. But what is peculiar to this disease, and distinguishes it from all others at the first glance of the eye, is the bombycinous colour of the skin, which, like that of full-grown silkworms, has a degree of transparency with a yellow tint not greater than is natural to the serum of the blood.
Mr. C. and Mr. B. both very strong men, between 50 and 60 years of age, who had drank ale at their meals instead of small beer, but were not reputed hard-drinkers, suddenly became weak, lost their appet.i.te, flesh, and strength, with all the symptoms above enumerated, and died in about two months from the beginning of their malady. Mr. C. became anasarcous a few days before his death, and Mr. B. had frequent and great haemorrhages from an issue, and some parts of his mouth, a few days before his death. In both these cases calomel, bitters and chalybeates were repeatedly used without effect.
One of the patients described above, Mr. C, was by trade a plumber; both of them could digest no food, and died apparently for want of blood. Might not the transfusion of blood be used in these cases with advantage?
5. When the paralysis of the hepatic glands is less complete, or less universal, a schirrosity of some part of the liver is induced; for the secretory vessels retaining some of their living power take up a fluid from the circulation, without being sufficiently irritable to carry it forwards to their excretory ducts; hence the body, or receptacle of each gland, becomes inflated, and this distension increases, till by its very great stimulus inflammation is produced, or till those parts of the viscus become totally paralytic. This disease is distinguishable from the foregoing by the palpable hardness or largeness of the liver; and as the hepatic glands are not totally paralytic, or the whole liver not affected, some bile continues to be made. The inflammations of this viscus, consequent to the schirrosity of it, belong to the diseases of the sensitive motions, and will be treated of hereafter.