Part 21

This texture comprehends, 1st, the chorion; 2d, that which is called the reticular body; 3d, the papillæ. The chorion is the essential part of the dermis; it is that which determines its thickness and form. The reticular body appears to be but little distinct from it. The papillæ arise from it also, but are more evident.

_Chorion._

The chorion is of a very variable thickness. 1st. In the head, that of the cranium and that of the face exhibit an opposite arrangement. The first is very thick and also dense and compact, which is owing especially to the numerous hairs that go through it. The second, everywhere fine and delicate, is particularly so upon the eyelids and the lips. 2d. The chorion of the trunk is posteriorly and all along the back, of a thickness almost double that of its anterior part, where it is nearly the same upon the neck, the chest and the abdomen. I would except however that of the penis, the scrotum, the great labia and the mammæ, in which its delicacy is greater than any where else. 3d. In the superior extremities it is nearly uniform upon the shoulders, the arm and the fore-arm; on the hand it increases a little in thickness and more in the palm than on the back. 4th. This thickness is generally much more evident on the thigh and the leg, where there are more muscles, than on the arm or the fore-arm. On the foot, it increases as on the hand, less in the dorsal than in the plantar region, which is the thickest of all the parts of the dermoid system; which is owing principally in the natural state to the arrangement of its epidermis. We see from this, that though everywhere continuous, the chorion is very different in its different parts. The relation of its thickness with its functions is easily perceived on the hand, the foot, the cranium, &c. Elsewhere we cannot so well see the reason of these differences, which are notwithstanding as constant.

Woman has a chorion generally less thick than that of man; compared in all the regions, it exhibits in the two sexes a sensible difference; on the mammæ especially, it is much more delicate in woman. That of the great labia however is proportionally thicker than that of the scrotum.

In order to understand perfectly the intimate structure of the chorion, it is necessary to examine it at first on its internal surface, after having carefully separated it from the fatty cellular texture, to which this surface adheres more or less intimately. We see then that it is differently arranged according to the regions.

1st. On the sole of the foot and the palm of the hand, we observe an infinite number of white fibres, shining like aponeurotic fibres, which are detached from this internal surface, form upon it a kind of new layer, cross each other in all directions, leave between them, especially towards the heel many spaces of different sizes, that are filled with fat, separate more and more, and are finally lost in the sub-cutaneous texture, nearly as the fibres of the brachial aponeurosis insensibly disappear in the neighbouring cellular texture. Hence why when we dissect the palmar and plantar integuments, we experience the greatest difficulty in separating them entirely from the cellular texture which is interlaced with these fibres; hence why also these surfaces have not, on the parts which they cover, the mobility which many others exhibit.

The density of the cellular texture contributes also something to this arrangement which is essential to the functions of the foot and the hand, which are designed to seize and grasp external bodies.

2d. The dermis of the superior and inferior extremities of the back, of the neck, of the thorax, of the abdomen, of the face even and consequently of almost all the body, is distinguished from the preceding, because the fibres are much less distinct, and are not lost in the cellular texture by being as it were confounded with it, whence arises a remarkable laxity of the skin of these parts, and the very great facility with which it is dissected; in a word because the spaces between these fibres are much more narrow. These spaces appear like an infinite number of holes irregularly placed at the side of each other, containing most of them small fatty parcels of the neighbouring texture, and exhibiting, when these small parcels have been carefully removed, very evident vacuities. The fibres which form them, are sufficiently near each other, to make you believe at first view, that it is a surface pierced with an infinite number of holes, that has been applied under the skin. On the contrary, on the hand and the foot, towards the heel especially, it is a true net-work the spaces of which are larger than the fibres that form them; this is the reverse here. Be that as it may, these spaces in the internal surface of the chorion are very favourable to the action of tannin which penetrates the texture infinitely better from this side than from the opposite, because it insinuates itself into these numerous openings. I have had occasion to observe it in the human chorion which I have had tanned for the purpose. Chaptal has observed that the epidermis is a real obstacle to the action of tannin, and that on this account scraping is a preliminary operation essential to tanning, since it allows the skin to be penetrated on both sides; but even when thus scraped, it receives the tannin much more easily on the side of the flesh than on the opposite one.

3d. The chorion of the back of the hand and the foot, as well as that of the forehead does not exhibit these numerous openings on its internal surface; it is smooth and white, especially when it has been macerated a little. It is precisely the same as that of the scrotum, the prepuce and even the great labia. The texture of it is more compact, no space is left in it, so that though more delicate than that of the extremities and the trunk, it contains almost as much substance. As to the chorion corresponding to the hair and the beard, we see in it only the openings necessary for the passage of the hairs, and which are wholly different from those of which I spoke just now, which form real culs-de-sac, and do not pierce through the chorion.

Hence the internal face of the dermoid chorion exhibits three very distinct modifications. The first and last are seen to a small extent, whilst the second is almost general, with some differences however in the trunk, the extremities and the head. Besides, these modifications do not suppose a diversity of nature, but only of forms. Much separated and arranged in fibres in the first, the dermoid texture is compact and condensed a little in the second, and by this condensation renders the spaces less distinct. But there is a means of seeing them everywhere very well, where there is the least trace of them, and this is by maceration. This means also shows the dermoid texture best. In fact, when the skin has remained for some time in water, it softens, the fibres of its chorion separate, and their interstices become more distinct; then we see that the spaces exist not only on the internal surface, but that they extend into its texture which appears to be truly like a sieve in its whole thickness, so numerous are the spaces arising from the interlacing of the fibres.

These spaces do not terminate in culs-de-sac towards the external surface; they open upon this surface by many foramina which are very evident in a skin that has been macerated for a month or two, and which, in the ordinary state are almost imperceptible in some subjects, and very visible in others. Besides, in order to see them it is necessary to remove the epidermis; now as with the view of producing this effect immediately we commonly employ the action of boiling water or fire, the dermoid texture by this means acquires the horny hardening, and they become much less apparent, whereas maceration not only does not produce horny hardening of the skin, but it expands and dilates it, which renders these foramina very evident. In some parts of the skin and in certain subjects, we might then introduce the head of a pin into them; in others they are less evident. These foramina never pierce the dermis perpendicularly, all open obliquely to its surface; so that a perpendicular pressure tends to close them and bring their parietes in contact. I cannot compare their termination better than to that of the ureters in the bladder; hence why the hairs which go through them are never perpendicular, but oblique to the skin. We speak incorrectly when we say that the hairs are planted obliquely; their insertion in the bulb is perpendicular; it is in their passage through the chorion that they change direction.

Besides, these foramina are not vessels, but mere communications from the interior to the exterior through which pass the hairs, the exhalants, the absorbents, the blood-vessels and the nerves which go to the surface of the dermis; thus the subjacent spaces are only cells in which are contained the vessels of the glands and of the cellular texture. The dermoid texture should then be considered as a real net-work, as a kind of cellular texture, the cells of which very evident within, become less so on the exterior surface, with which all communicate to transmit to it different organs. The chorion is then the outline, the frame, if I may so say, of the cutaneous organ. It serves to lodge in its spaces, all the other parts which enter into the structure of this organ, and contributes to give them the form they are to have, but is wholly foreign to them.

What is the nature of this texture, which enters especially into the composition of the cutaneous chorion? I know not; but I think it has much analogy with the texture of the fibrous system; the following considerations support this analogy. 1st. On the heel, where the dermoid texture has the fibrous form of the irregular ligaments, it would be almost impossible to distinguish it from it, so uniform is the external appearance; it has the same resistance and density; the same sensation is experienced when it is cut with the bistoury. 2d. The dermoid texture becomes yellow and transparent like the fibrous by stewing. 3d. It melts gradually like it into gelatine. 4th. Like it, except the tendons however, it strongly resists maceration. 5th. Sometimes these two textures are identified; for example, the annular ligaments of the wrist evidently send elongations to the neighbouring dermoid texture. 6th. This texture can serve, like the fibrous, for the insertion of muscles; we see it in the face, where many of the fibres of the orbicularis of the lips and the eyelids, and almost all those of the eyebrows, find real tendons in the fibres of the dermoid texture. There is the same arrangement in the cutaneous palmar muscles.

All these considerations evidently establish many relations between the dermoid and fibrous textures. Yet they are far from being the same. To be convinced of this it is sufficient to observe how much their mode of sensibility differs, and how different also are their diseases; it seems at first as if there was no analogy between them in this double relation. Yet the line of demarcation is by no means as great as it appears to be. In fact the acute sensibility of the skin is not seated precisely in this white texture, which is interwoven so as to leave between its meshes the spaces of which we have spoken, and which we see especially on the surface adhering to this organ. The experiment mentioned in the article on the mucous system, and in which I irritated the cutaneous organ from within outwards, evidently proves it. It is the surface on which the papillæ are found that especially exhibits this vital property.

On the other hand morbid anatomy proves that the internal surface of the dermis, in which are especially found the texture and the spaces of which we have spoken, is entirely free from most cutaneous eruptions. This is no doubt true as it respects the small pox, the itch and many species of herpes; I have satisfied myself of it as to the vaccine vesicles, the miliary eruption, &c. &c. It is certain that in erysipelas, the external surface only of the chorion is coloured by the blood which enters the exhalants; thus the slightest pressure, causing the blood to flow back, produces a sudden whiteness which soon disappears by the return of the blood into the exhalants. It is this which forms the essential difference between simple erysipelas and phlegmon, in which not only the external face of the chorion, but its whole texture and the subjacent cellular one are inflamed. In measles and scarlatina, the redness is also very evidently superficial. These phenomena accord with those of injections; for if they succeed at all in children, the skin of the face and less frequently that of the other parts, becomes almost entirely black. Now this blackness is much more evident on the external than the internal surface of the skin, no doubt because more exhalants are found in the first than in the second, which the arterial trunks only traverse.

The preceding considerations evidently prove that the texture of the internal surface of the chorion, and even that of its interior, have a vital activity much less than that of the external surface; that this texture is disconnected with all the great phenomena which take place upon the skin, with those especially which relate to the sensations and the circulation; that it is in the papillæ that the first are seated and in the reticular body the second; and that it is almost passive in nearly all the periods of activity of this double portion of the dermis. Its functions, like those of the fibrous texture, suppose it to be almost always in this passive state; they are only to defend the body and to protect it from the action of external bodies. It is this which forms our real covering; thus its properties are well adapted to this use. Its resistance is extreme. It requires very considerable weight to tear very narrow strips of chorion, when it is suspended from them; drawn in various directions, these strips are broken also with much difficulty.

Yet this resistance is much less than when tannin is combined with the chorion. We know that when thus prepared, this portion of the skin affords the strongest strings we have in the arts. I know but two textures in the animal economy, which unite to such an extent suppleness and resistance; these are this and the fibrous texture; and this is a new character which approximates them. We have seen that it requires a very considerable weight to break a tendon, a strip of aponeurosis, or a ligament taken from a dead body. The muscular, nervous, arterial, venous, cellular textures, &c. yield infinitely more easily. If the dermoid texture had less extensibility, it might advantageously supply the place of the tendons, the ligaments, &c. in the structure of the body.

Since the chorion is foreign to almost all the sensitive and morbid phenomena of the skin, let us inquire then in what part of the dermis these phenomena are seated. These parts exist very evidently on the external surface; now we find on this surface, 1st, what is called the reticular body; 2d, the papillæ.

_Of the Reticular Body._

Most authors have considered the reticular body as a kind of layer applied to the external face of the skin between the chorion and the epidermis, pierced with an infinite number of openings through which the papillæ pass. I do not know how we can demonstrate this layer, which escapes according to the opinion of most of them, when the epidermis is detached. In order to see it I have employed a great many means, but no one has succeeded. 1st. Such is the adhesion of the epidermis to the skin, that in a sound state we can hardly separate them without injuring one or the other. Yet with the greatest precaution we see nothing mucous on the chorion when it is laid bare. 2d. A portion of skin cut longitudinally, especially from the foot where the epidermis is very thick, allows us to see very distinctly on the divided edge the boundaries of this and of the chorion; now nothing escapes from about the line which separates them. 3d. In ebullition in which the epidermis has been removed, nothing remains upon the internal surface, nor upon the chorion. 4th. Maceration and putrefaction, the latter especially, produce upon the chorion a kind of glutinous layer the instant the epidermis is removed. But this layer is entirely the product of decomposition. Nothing similar is met with in the ordinary state.

I believe, from all these considerations, that there is not a substance deposited by the vessels upon the surface of the chorion, extravasated, stagnant upon this surface, and representing there a layer in the sense in which Malpighi understood it. I believe that we ought to understand by the reticular body, a net-work of extremely fine vessels, whose trunks already very delicate, after having passed through the numerous pores with which the chorion is perforated, come and ramify upon its surface, and contain different kinds of fluids.

The existence of this vascular net-work is placed beyond a doubt by fine injections which change the colour of the skin entirely externally, without altering it much within. This is, as I have observed, the principal seat of the numerous eruptions most of which are really foreign to the cutaneous chorion.

We may then consider the reticular body as a general capillary system, surrounding the cutaneous organ, and forming with the papillæ a layer between the chorion and the epidermis. This system contains in most men, only white fluids. In negroes, these fluids are black. They have an intermediate tinge in the tawny nations. We know how much the shades vary in the human race. Hence the colouring of the skin resembles nearly that of the hairs, which evidently depends upon the substance existing in their capillary tubes; it is analogous to that of the marks at birth, that are commonly called nævi materni, and in which we never see a layer of fluids extravasated between the epidermis and the chorion.

Moreover, I think we know but little as yet concerning this substance, which fills a part of the external capillary system. It does not circulate in it, but appears to remain there till another replaces it. When we examine the skin of a negro, we see a black teint, and that is all. In maceration I have observed that this teint is sometimes removed with the epidermis, and that it sometimes remains adhering to the chorion. It is very evidently foreign to both, since both have the same colour in whites as in blacks. It is never reproduced, after it has been removed; for cicatrices are white in all people.

Is there in white people a white substance which, remaining in the external capillary system, corresponds to that of negroes, or does the colour of their skin depend only upon the epidermis and chorion? I have been tempted to believe that they also have a colouring substance, since the long-continued action of a powerful sun evidently blackens them. This circumstance has even made me believe that whiteness is natural to all men, and that there was but one primitive race which has degenerated according to different climates.

But in order to be convinced of the diversity of races, it is sufficient to observe, 1st, that the teint of the skin is but one of the characters which distinguish each race, and that many others are always united to it. The nature and form of the hair, the thickness of the lips and the nose, the width of the forehead, the degree of inclination of the facial angle, the whole appearance of the face, &c. are constant attributes which indicate a general modification in the organization, and not merely a difference of the dermoid system. 2d. White people become tawny in hot countries; but they never acquire the teint of the people of the country. 3d. Removed to cold countries in early age, or even born in them, the blacks always remain so; their shade hardly changes at all from generation to generation. 4th. Colour by no means follows temperature exactly; we see many varieties in the shades of people who live under the same degree of latitude, &c.

Every thing proves then that the colour of the skin is but an insulated attribute of the different human races, though it is that which is most striking to our senses, and that we should not attach to it a greater importance than to many others which are drawn from the stature, which is oftentimes very small, as in the Laplanders, from the broad and flat face, as in the Chinese, from the dimensions of the chest, of the pelvis, the extremities, &c. It is from the differences of the whole, and not from those of an insulated part, that the lines of demarcation should be made which separate the races. The European face and forms are in general the type with which we compare the exterior of the other nations. The ugliness or beauty of the human races are, in our way of considering it, measured by the distance which separates these races from ours. Such is in fact the force of habit with us, that we rarely judge in an absolute manner, and that every object which is much removed from those to which we are accustomed, is disagreeable to us and sometimes even disgusting.

Besides, the colouring matter of the cutaneous reticular body is more interesting to the naturalist than to the physician. What should particularly arrest the attention of the latter is the portion of the capillary system exterior to the skin in which the fluids circulate. In fact, besides the portion which is the seat of colour, there is evidently another that the white fluids constantly pervade, in which they are moved with more or less rapidity, and in which they continually succeed each other. It is from this portion that the exhalant pores arise which furnish the sweat; it is this vascular net-work which is the seat of erysipelas and of all the cutaneous eruptions that are foreign to the chorion.

The blood does not penetrate it in an ordinary state, but a thousand causes can at every instant fill it with this fluid. Rub the skin briskly, and it reddens in a moment. If an irritant is applied to it, whether it acts mechanically like nettles, the appendices of which penetrate the epidermis, or exerts a chemical action, like the frictions with ammonia, or the action of fire when a portion of skin is held too near it, instantly the sensibility of this vascular net-work is raised; it invites into it the blood which it formerly repelled; every part of a surface reddens in proportion to the irritation. If passion acts powerfully upon the cheeks, immediately a sudden redness is evident in them. All rubefacients exhibit moreover a proof of the great tendency which the sensibility of the superficial capillary system of the dermis has to place itself, if it be ever so little excited, in relation with the blood which in the ordinary state is foreign to it.