Part 11

The functions of the absorbents are not at the present day a subject of doubt with any anatomist; but the manner in which these functions are performed, are far from being so well agreed upon. The first idea has been to compare the action of the absorbents with that of capillary tubes. But if we reflect a little upon this action, it is easy to see that these phenomena are wholly different from those of inert, capillary tubes. I think that we never should be able to say precisely, how an absorbent orifice, being immersed in a fluid, takes it up, seizes its particles and makes them ascend in its tube. But what is undoubted in absorption is that the vessels derive this faculty from the vital forces which they have; that it is only the relation existing between the particular kind of organic sensibility with which they are endowed, and the fluids with which they are in contact, that is the immediate cause of the phenomenon. Do you wish numerous proofs of this? See the lacteals choosing only chyle from among the variety of matter contained in the intestinal canal; see the absorbents of the bladder and the gall-bladder leaving many of the elements of the urine and the bile, to take only the aqueous part of these fluids; see the cutaneous absorbents, the mucous ones of the bronchiæ, &c. selecting only certain principles from the air and leaving others. Often inactive for a long time, they immediately recommence action when any substances in relation with their sensibility are presented to them. Observe the fluids injected or effused into the cellular texture, they are taken up or left by the absorbents of this texture, disappear promptly, or remain and occasion suppuration, according as they agree with or are repugnant to their sensibility.

We cannot deny that in the natural state the sensibility of the absorbents has a particular type, to which certain substances are alone accommodated, and which alone on this account can be absorbed. The exercise of the organic sensibility then always pre-exists in absorption, as it does in secretion, nutrition, &c. Thus in the physical phenomena, the exercise of gravity always precedes the fall of heavy bodies. Thus the power of attracting is put into exercise before the motion of the planets takes place, &c. &c.

II. _Varieties of Absorption._

It follows from what I have said, that whenever the organic sensibility of the absorbents is altered in any way, absorption must necessarily experience a corresponding derangement; now this is what constantly happens. Serum often bathes for whole months the absorbent orifices, in dropsy, without raising their sensibility sufficiently to be taken up by them. Let any cause increase this property, instantly absorption takes place. Observe some indolent tumours which remain for a long time in the same state by the stagnation of their fluids, they are immediately discussed when certain medicines applied to them rouse the dormant sensibility of their absorbents. Discutients do not act upon the fluids themselves; they do not attenuate, or cut them, according to the vague language of physicians, but by changing the degree of force of the absorbents, they render them able to act. It is so true that it is in this way that different resolutions are effected, that often a slight degree of inflammation is previously necessary to their development; all surgeons know this. Desault did not consider most of the swellings of the testicles as an obstacle to the operation for hydrocele by injection. On the contrary it often happened, that after the irritation produced in the testicles by the surrounding membrane, the enlargement disappeared, which was only kept up by the want of energy in the absorbents.

The alterations of organic sensibility can diminish, increase, or variously modify this property. Let us cease to wonder then at the extreme variety of the absorptions; let us not be astonished, if many fluids, besides those ordinarily taken up, can pass into the blood by the absorbents; if the bile, the urine, the mucous fluids, which are usually rejected, can enter the circulation; if the blood effused in the cellular texture is taken up by these vessels. The forces of life impress, by their extreme variety, the same character on all the functions over which they preside.

Much has been said of putrid matters passing into the blood, and there serving as a cause for diseases. This infection of the blood has undoubtedly been exaggerated; but I am convinced that in many cases it is real. Why are the colour, consistence, odour, and nature of the excrements so very variable? If the same substances are always absorbed from the aliments, it is evident that the residue of these aliments would always be the same. Observe the innumerable varieties of the urine, the bile, the mucous fluids, &c. according to the difference of the principles that concur to form them. Why should not the chyle present the same variations? it would be the only fluid of its kind in the animal economy if it did not change under many circumstances. Now, whence can these changes come, if not from this, that the lacteals present numberless varieties in their organic sensibility, varieties, each of which admits only certain principles and rejects the others?

The absorption of the lacteals, which, in an ordinary state, introduces into the blood only nutritive substances, can then often be a way open for the admission of many morbific principles. Thus in the lungs, the vessels which take from the air the substances proper to colour the blood, often draw in principles injurious to their functions, according to the different alterations that their sensibility can experience.

In the ordinary state, the kind of organic sensibility and of tone of the cutaneous and mucous absorbents, shuts out all external substances that are hurtful. But when this kind is changed, the way can in an instant be open to them. Does not pus remain without mischief on the cellular texture, in most wounds? Let an imprudent application raise there a little the forces of the absorbents, it is taken up by them; the ulcer dries up; the pus passes into the blood; and then follows the whole sad train of the symptoms of re-absorption which commences.

We can say, that a thousand channels are incessantly open in our organs, to morbific principles. The organic sensibility, placed as a sentinel at their mouths, indicates according to the manner in which it is affected, to the insensible contractility when it is necessary to open or shut them.

It is exhalation that contributes to the formation of most tumours; it is absorption that serves for their cure.

If I were to run over the phenomena of absorption in the different ages, sexes, seasons and climates, I could show constantly the differences of organic sensibility always preceding the differences of this function. I shall speak of them in the different ages.

The causes that vary the natural type of the sensibility of the absorbents, are, as in all the other functions, direct or sympathetic; 1st, direct, as when by previous friction on the skin, we excite the absorbents, and force them to act, which they would not have done without this; 2d, sympathetic, as when the absorbents, feeling the affection of a distant viscus, increase or diminish their action, according to the kind of influence they receive. We have spoken of this phenomenon in the sympathies of the different systems.

III. _Motion of the Fluids in the Absorbents._

The fluids once absorbed on the different surfaces of which we have spoken, are carried by a successive motion to the common trunks, which transmit them to the black blood.

We know not the laws of this motion. It is evident from many observations formerly made, that it has much analogy with the motion of the venous blood; but it is also distinguished from it by some differences.

It appears to be in general more slow. The thoracic duct opened when it is full of chyle, does not throw out its fluid as far as a vein of the same size.

The motion of the lymph does not seem to be subject to a reflux in the neighbourhood of the heart, like the venous blood. For example, the venæ cavæ, jugulars, &c. are so much the more dilated, in proportion to the obstacles the lungs have opposed to the return of the blood. Now in injecting the thoracic duct, I have never observed between its dilatation and contraction, and the state of the pulmonary organ, any kind of relation. On the other hand, we never find this duct full of lymph, as we find the veins full of blood, when an obstacle has interrupted the motions of the fluid in the last moments.

How happens it, that in the reflux that produces the venous pulse of the jugulars, the blood does not enter into either absorbent trunk? The valves, arranged to prevent the entrance of that, which in a natural state, flows towards the heart, are evidently useless here. We can clearly attribute this phenomenon only to the relation existing between the orifice of these trunks and the black blood, as the orifice of the larynx, foreign by its vitality to external bodies, repulses every fluid but the air. Blood is never found in the thoracic duct.

There is in the venous blood an evident continuity of motion, from the capillary system to the heart; it is from this system that it goes, to be propagated, if we may so say, to that organ. The motion of the lymph, on the contrary, is incessantly interrupted by glands, each of which, as I have said, exhibits really in relation to the vessels that enter and go out of it, a small capillary system. At each gland the motion necessarily changes its impulse; now as the state of these glands is susceptible of many varieties, we can easily conceive, that the motion of the fluids circulating in the absorbent system, necessarily presents a great number of them; that it may be rapid in one part, very slow in another, regular here, there irregular, &c. Hence we must not be surprised if we find some absorbent vessels dilated, whilst those of the neighbourhood are hardly perceptible. There is indeed a kind of variety in the veins, but it always has its source in the origin of these vessels, and never in their course, as takes place in the absorbents.

The continuity of the venous blood and the frequent interruptions of the lymph should establish differences not only between the motions of the two kinds of vessels, but also in the composition of the fluids. The first is necessarily everywhere the same; the second may vary at every gland, and take new modifications at each of those through which it passes.

I should be disposed to think that the insensible contraction of which the small capillary system of each gland is capable, would aid the motion of the lymph, by diminishing the course that this fluid must take, without a new impulse, from the origin of the absorbents to the black blood, if these organs were wanting. In fact, we know that in the extremities where there are much fewer glands, there are more frequent effusions than in the trunk where the absorbents pass through them at every instant; I speak of those effusions which ought evidently to be attributed to the want of circulation of the lymph, as those arising from compression, too long standing, &c. and not those that depend on an increased exhalation, like those after organic affections.

We see, from what I have said thus far, that we have only a few disconnected views upon the motion of the lymph; that of the veins, though still requiring much research, is yet more known; but in order to give a perfect knowledge of these subjects, the first especially, many experiments and much further labour are necessary.

IV. _Of Absorption in the different Ages._

In the fœtus and in childhood, absorption relative to nutrition is not in proportion to exhalation. Many substances remain in the organs, but few go out, hence there is growth.

But little is known of the differences which the internal absorptions of synovia, serum, fat, marrow, &c. then present.

The external absorptions appear to be more active, for we know that contagions are taken with much more facility in the first age. We know not however whether the skin and mucous surfaces then constantly introduce more foreign substances into the body, or if they are only more disposed to introduce them.

We are deficient in positive data as to the state in which absorption is found in childhood. To judge of it however by that of the lymphatic glands, it would appear that it was very energetic. In fact these glands are in proportion much developed; they appear to be the seat of very active functions; they have a peculiar life more developed than afterwards, hence a greater disposition to diseases. We know that until puberty, or rather until the end of growth, they are the seat of many affections which entirely disappear after that age, and lessen the numerous series of those to which we are exposed.

This double circumstance, 1st, the precocious and proportionably great development of the lymphatic glands in childhood; 2d, their very great disposition to diseases, indicates certainly remarkable activity in their functions; for it supposes a great development of the vital forces; now these vital forces being more developed ought necessarily to preside over more energetic functions. See in fact the organs whose functions we know, which are on the one hand much developed in childhood, and on the other much disposed to diseases; the functions of these organs are more active. Thus the brain and nerves being more developed, have more sensibility; thus the vessels with red blood have an activity of nutrition, in proportion to their size, &c. In youth, it is when the genital organs are more developed and they become more exposed to diseases, that their functions are greater. Examine all the organs and their functions, you will see that a general law of the economy is, that these three things, 1st, great development; 2d, greater disposition to diseases; 3d, greater activity of functions, are constantly united. Now when these two first exist in the glands of the absorbents, we ought to conclude that the third is there also, though we are not certain of it, since, from what I have said, we are ignorant of the uses of these small organs. Grimaud has considered them, it is true, as essential to nutrition; he even calls the nutritive system the combination of these glands and the cellular texture, a gratuitous supposition, which is not proved. All that we know upon this point, is that on the one hand nutrition, and the development of these glands on the other, are very great in the fœtus. But does it follow from this, that the first phenomenon proceeds from the second? Undoubtedly not; no more than because the brain, the liver, &c. are early developed in the fœtus, and nutrition is very active, they should be considered as the agents of this function. Besides, nutrition is a function that has no particular organ for its centre and agent. Each organ is itself the machine which separates from the blood or the fluids that enter it, the nutritive materials that are suitable for it, and afterwards appropriate them to itself. The muscle separates its fibrin, the bone its phosphate of lime, &c. But one common and central organ does not elaborate these nutritive materials, as one common viscus moves the blood, as one central organ presides over sensibility, &c.

As to the anatomical state of the absorbents in the fœtus and childhood, we can know but little; I do not know that any author has injected them comparatively in this age and in the adult. I have but one fact upon this point, it is that the lacteals, examined in an experiment upon two young dogs, who had only left off sucking eight days, appeared to me larger in proportion than at a more advanced age. I will make one remark that has often struck me; it is that the size of the animal has much less influence than would be thought upon the diameter of these vessels. For example, an adult dog, twice as large as another, has not by a great deal, vessels of double size. Accident led me to examine them the same day, three years since, upon two large grey-hounds, that were among the dogs brought to me, and upon one of those vulgarly called cur dogs; they were nearly equal in all three; this struck me.

We know but little of the different revolutions that absorption undergoes in the ages that succeed infancy. Only there is no doubt that puberty is the limit of this kind of predominance which the lymphatic glands enjoyed in the economy. The age of their diseases is then passed; often even these diseases, heretofore beyond the reach of art, are spontaneously cured. The predominance of the genital organs which succeeds to this and some others, those of the sensitive-organs, &c. seems to destroy the germ which this first supported.

Soemmering has described in a particular work the part that the absorbents perform in the different diseases of the adult and the other ages. This part has appeared to me to be often very difficult to be known, notwithstanding what he has said of it. I refer however to his work on this point.

In old age, nutritive absorption continues very active; for it is that which decomposes the body, which takes from it the substances that nourish it, and which consequently withers and dries the organs.

The external absorptions, on the contrary, are feeble; the skin takes with great difficulty the different contagions, as I shall say in treating of this organ; the mucous surfaces absorb slowly; but little chyle passes into the blood in proportion to what enters it in the adult. The two absorptions, the nutritive and the external, are exactly reversed at the two extreme ages of life; the second is superior to the first in infancy, the first predominates in old age.

As to the internal absorptions, as those of synovia, of the serous surfaces, of the cellular texture, &c. I should think that they predominated in old age, and that to this was to be attributed the numerous serous effusions which happen at that age, and which we observe in dead bodies. We have not however upon this point so good data as upon the other two.

V. _Preternatural Absorption._

We can understand two things by this expression; 1st, the absorption of fluids different from those naturally taken by the absorbents, as that of effused blood, &c. I have already spoken of this absorption; 2d, that which takes place in the cysts which are developed contrary to the natural order in the economy. Now this last exhibits a very singular phenomenon, when compared with preternatural exhalation. It, in fact, takes place with difficulty; it is rare that you see the fluids of encysted tumours enter suddenly the circulation by absorption, either in whole or in part, as this very often happens in the serous collections of the peritoneum, which, without being cured, have many alterations of increase and diminution. What physician has not observed that the urine flows more as the abdomen becomes flat, and that it is suppressed when it is filled?

Observe on the contrary, that exhalation is renewed with great facility in encysted tumours; that if we empty them and do not remove their cysts, they are soon reproduced, as I have said. Is it that the absorbents are not developed in proportion to the exhalants in these tumours? I know not; but the fact is not less certain; observation of diseases proves it every day.

SYSTEMS PECULIAR TO CERTAIN APPARATUS.

GENERAL OBSERVATIONS.

The former part of this work has been devoted to researches upon the systems common to the structure of all the apparatus, upon the primitive systems, which form if we may so say the nutritive parenchyma, the basis of all the organs, since there is hardly any one of these organs in which the arteries, the veins, the exhalants, the absorbents, the nerves and the cellular texture do not enter as a more or less essential part. Each is at first a texture of these common parts, then of other peculiar parts which particularly characterize them.

The systems that will now be examined are not so generally extensive in the animal economy. They belong only to some particular apparatus; thus the osseous, the animal muscular, cartilaginous, and fibrous systems are especially destined to the apparatus of locomotion; thus the serous, mucous, and organic muscular systems enter especially into the digestive, respiratory and circulatory apparatus; thus the glandular system forms the apparatus of secretions, thus the cutaneous system enters principally into the external, sensitive apparatus, &c.

All the systems that remain to be examined are then much more insulated, perform a much less extensive part than those of which we have been treating. Confined to certain apparatus, they are unknown to the others, and have an independent life of their own, whereas the primitive systems everywhere mingle their vitality with that of the other organs, into whose composition they enter; most of them have a kind of existence and external forms which distinguish them from these last. The different parts which compose each, are almost always insulated, not connected with each other; the bones, the muscles of animal and organic life, the cartilages, the fibro-cartilages, the medullary organs, the glands, the serous membranes, the hair, &c. exhibit this insulation in a remarkable manner. Each portion belonging to these different systems, has always between it and the other portions of the same system many intermediate organs, which are of a very different nature, and which consequently belong to other systems. There are hardly any except the cutaneous, fibrous and mucous systems, which are everywhere continuous in their different parts; yet this last has no communication between that portion of it which is spread upon the digestive and respiratory apparatus, and that which belongs to the urinary and genital organs.

We have seen on the contrary that the primitive systems are everywhere continuous, having no interruptions in them. The cellular, the arterial, the venous, the absorbent, the nervous are so arranged, that if it were possible to remove all the organs they enter, and leave them alone, they would form a complete whole, formed differently according to the different systems. The exhalants can also be considered as everywhere connected, as we have seen. Suppose on the contrary that the organs intermediate to the bones, the cartilages, the fibro-cartilages, &c. should be removed, all the parts of these systems would immediately be separated, and you would not have one continuous whole.

The order to be followed in the examination of these systems is of no importance; we shall place them in the following order, which will comprehend 1st, the osseous; 2d, medullary; 3d, cartilaginous; 4th, fibrous; 5th, fibro-cartilaginous; 6th, animal muscular; 7th, organic muscular; 8th, mucous; 9th, serous; 10th, glandular; 11th, cutaneous; 12th, epidermoid; 13th, and finally, the system of the hair.