Part 9

I perceive that we cannot infer from what takes place in the intestines, what happens in the pituitary, palatine membrane, &c. because though analogous, the organization may be different. We cannot here as in the intestines examine the venous blood returning from the part; but, 1st, if we consider that in animals who have respired oxygen for some time, we see the palatine and pituitary membranes more red; 2d, if we reflect that the lividity of the different parts of this membrane, in those destroyed by asphyxia by the carbonic acid gas, depends not on the immediate contact of this gas upon the membrane, but upon the passage of venous blood into the arterial system, as my experiments have, I think, demonstrated; 3d, if we remark finally that in these circumstances the contact of the air does not change, after death, the lividity which the venous blood gives to the mucous membranes, although the skin be then much more permeable to every kind of aeriform fluid; we shall see that it is at least necessary to suspend our judgment upon the colouring of the blood in the mucous membranes, until further observations have decided the question.

The following experiment may also throw some light upon the subject. I have inflated the peritoneal cavity of several guinea-pigs with carbonic acid gas, with hydrogen, oxygen and atmospheric air, to see if I could effect through a serous membrane what I could not make succeed in a mucous; I have not, after these experiments, found any difference in the colour of the blood of the abdominal system; it was always the same as in the common guinea-pig which I killed for comparison.

I think however that I have remarked many times, both in frogs and animals with red and warm blood, such as cats and guinea-pigs, that the infiltration of oxygen into the cellular texture gives, at the end of some time, a much brighter colour to the blood, than that which this fluid exhibits in artificial emphysemas produced by carbonic acid gas, hydrogen and atmospheric air, in all which the colour of the blood scarcely differs at all from what is natural. But in other cases oxygen has had no influence upon the colour of the blood; so that notwithstanding having made many experiments upon this point, I am unable to give any general result. It appears that the tonic forces of the cellular texture and of the parietes of the vessels which are spread upon this texture, receive a very variable influence from the contact of the gases, and that according to the nature of this influence, the fibres crisping and contracting more or less, render these parts more or less permeable, either to the aeriform fluids that tend to escape from the blood in order to unite with that of the emphysema, or to this last fluid, if it tends to combine with the blood, which no doubt produces the varieties I have observed.

The red colour of the mucous system is analogous to that of the muscular system. It does not depend essentially on the blood circulating in the small arteries of this system. It arises from the colouring portion of the blood combined with the mucous texture, especially in the deep part of the organs; for at the origin of the mucous surfaces, this colour appears to be principally owing to the blood in circulation; in fact asphyxia does not render so livid the deep mucous surfaces, as it does those which are superficial and in communication with the skin. The black blood arrives immediately to these by the last arteries, and tinges them as we see. In syncope in which the heart being affected no longer sends blood into the arteries, we know that this portion of the mucous system becomes instantly white.

Besides the red colour of the deeper portions, can, like that of the muscles, be removed by repeated washing and frequently changing the water. Yet the water in which they have been washed is not as red as that used for the muscles.

The instant a mucous surface is plunged into boiling water, however red it may be, as that of the intestines and the stomach, it instantly whitens. The action of the nitric, sulphuric and muriatic acids produces in it also a sudden whiteness.

This colour of the mucous surfaces acquires a remarkable intensity in inflammation. The redness becomes then extremely deep on account of the quantity of blood that is accumulated in the capillary system. It is particularly in dysentery that the internal surface of the intestines exhibits this phenomenon in a striking degree. I ought however to observe to those who open dead bodies, that they never should lose sight of the original tinge of the portion of the mucous system they examine, since each of the divisions of this system exhibits in its shades remarkable differences. If the membrane of the bladder, the rectum, &c. is found as red as that of the stomach in its natural state, then pronounce that there had been inflammation; if the redness of the sinuses equals that which is natural to the bladder and the rectum, decide that inflammation had existed in them. There is, as I have said, a scale of colour for the mucous system. It is then essential to have an accurate knowledge of this scale, a type to which we can refer the inflammatory state in the examination of dead bodies.

_Exhalants._

Does exhalation take place upon the mucous surfaces? The analogy of the skin seems to indicate it; for it is well proved that the sweat is not a transudation through the inorganic pores of the cutaneous surface, but a real transmission by vessels of a peculiar nature and continuous with the arterial system.

It appears at first that the pulmonary perspiration which takes place upon the mucous surface of the bronchia, which has so much relation with that of the skin, which increases and diminishes according as this diminishes or increases, and the matter of which is probably of the same nature; it appears, I say, that the pulmonary perspiration is made at least in great part by the system of exhalant vessels, and that if the combination of the oxygen of the air with the hydrogen of the blood contributes to produce it, during the act of respiration, it is but in very small quantity, and it is the portion that is purely aqueous. Besides, this last hypothesis of modern chemists, contradictory to the production of all the other fluids thrown out by the mucous surfaces, appears to me ill adapted to explain the formation of this. When the same phenomenon is produced in many places, and the explanation that is given of it is applicable only to one, we should be suspicious of this explanation.

It should be observed in regard to the pulmonary perspiration, that the solution of the mucous fluid which lubricates the bronchia, in the air constantly inspired and expired, furnishes a considerable portion of this vapour which, insensible in summer, is very evident in winter, on account of the condensation of the air. The mucous juices are dissolved like every other fluid; for wherever there is atmospheric air, heat and moisture, there is evaporation. Here this evaporation is even a means which nature employs to rid herself, as I have said, of the mucous juices. If they are too abundant, as in a cold, then the quantity of air which serves as a vehicle to them, not increasing in proportion, it is necessary that there should be another mode of evacuation; this is expectoration which compensates for what the air cannot remove by solution.

The intestinal juice which Haller has especially considered, but which appears to be in much less quantity than he thought it, the œsophagean and gastric juices, particularly this last which has been supposed to be distinct from the mucous juices, are probably deposited by exhalation upon their respective mucous surfaces. But in general it is very difficult to distinguish with precision what belongs in these organs to the exhalant system, from that which is furnished by the system of mucous glands, which, as we have said, are everywhere subjacent to them. Thus we constantly see the mucous fluids of the œsophagus, the stomach and the intestines, mixing with the œsophagean, gastric and intestinal fluids.

As on the one hand the blood vessels ramify almost naked on the mucous surfaces, and as on the other these vessels are always the origin of the exhalants, it is evident, that these have but a short course to run to arrive at their surfaces; they are rather pores than distinct vessels. Hence why no doubt the blood has so great a tendency to escape by the exhalants; why consequently hemorrhages without rupture are so frequent in the mucous system; why this affection can be classed in the diseases of this system, &c. &c. No other, by the arrangement of the arteries, offers to the exhalants so short a course between their origin and termination. Often even, as I have said, we make the blood of these vessels ooze in the dead body through their exhalants.

_Absorbents._

The absorption of the mucous membranes is evidently proved, 1st, by those of chyle and of drinks on the intestinal surfaces, of the venereal virus upon the glans penis and the canal of the urethra, of the variolous when the gums are rubbed with it, of the serous portion of the bile, the urine and the semen, when they remain in their respective reservoirs. 2d. When, in the paralysis of the fleshy fibres that terminate the rectum, substances are accumulated at the extremity of this intestine, these substances often become hard, an effect probably of an absorption of the soft parts. 3d. There have been various cases in which the urine has been almost wholly absorbed by the mucous surface of the bladder, where there have been insurmountable obstacles in the urethra. 4th. If we respire, by means of a tube, the air of a large vessel filled with the exhalations of turpentine, so that these vapours can only act upon the mucous surface of the bronchia, the urine has the peculiar odour that always arises from the use of this substance, the exhalations from which have been introduced into the blood by the means of absorption, &c.

Whatever may be the mode of this absorption, it appears that it does not take place in a constant and uninterrupted manner, like those of the serous membranes, in which the exhalant and absorbent systems are in a regular and continual alternation of action. There is scarcely any but the chylous absorption, that of drinks, and that of the aqueous portion of the secreted fluids remaining in a reservoir as they come from their glands, that constantly take place. Nothing is more variable than the other absorptions. Under the same influence, the glans takes up or leaves the venereal virus; the internal surface of the bronchia sometimes admits and sometimes refuses admittance to contagious miasmata. There are more cases of retention in which the urine is not absorbed entirely, than there are where this absorption takes place, &c. &c. The innumerable varieties of the vital forces of the mucous membranes, varieties produced by those of the stimuli with which they are in contact, explain these phenomena. If these forces are raised or diminished a little, the absorption is altered, even that which is natural, as that of the chyle. Take a purgative; it contracts, shuts even the mouth of the absorbents of the intestinal canal; as long as the irritation continues, all the drinks that are taken pass off by the anus; at the end of four or five hours, the absorbents gradually recover their natural tone and absorption recommences. In these cases, the first discharges are only the intestinal matters, the others are the copious drinks that have been taken. There are many diseases in which, the sensibility of the chylous absorbents being too much raised, they are no longer in relation with the aliments, they take up with difficulty the residue of them, &c. Deficiency of action produces the same phenomenon; in absorption in fact it is a middle degree of sensibility of the organ which produces it, a degree below or above which it cannot take place.

All the mucous absorbents appear to go to the thoracic duct.

_Nerves._

I would remark that at all the origins of the mucous system, where the animal sensibility is very great and where it places us, like the skin, in relation with external bodies, cerebral nerves are distributed. The pituitary and palatine membranes, the conjunctiva, the mucous surface of the rectum, the glans penis, the prepuce, &c. exhibit this fact very evidently. There are hardly any nervous filaments coming from the ganglions in these different places.

On the contrary, this last species of nerves is the predominant one in the intestines, in all the excretories, in the reservoirs of the secreted fluids, &c. places where the organic sensibility is the most evident.

ARTICLE THIRD.

PROPERTIES OF THE MUCOUS SYSTEM.

I. _Properties of Texture._

Extensibility and contractility are much less in this system than they at first appear to be, on account of the numerous folds which it exhibits in the hollow organs during their contraction, folds which are developed only during extension, as we have seen. Yet these two properties become very evident in some cases. The excretories are capable of taking a size much larger than is natural to them. This is seen in the ureters in particular, which are sometimes found as large as an intestine. The ductus choledochus and the pancreatic duct have often also these dilatations. The urethra and the salivary ducts appear to be less extensible than the others. If they have ever so little obstacles from strictures, contractions, &c. they break rather than stretch; hence various urinary and salivary fistulas.

Hence there is, as we see, many varieties in the degrees of the extensibility of the mucous system; it is the same with regard to the contractility of texture. These two properties are besides capable of being put rapidly into action. We know that the stomach, the intestines, the bladder, &c. pass in an instant from a great size to extreme contraction. Their functions even suppose this rapidity, without which they could not be performed. The palatine membrane which lines the cheeks, exhibits the same phenomenon when the mouth is filled with air, aliments, &c. which are afterwards expelled from it.

When the usual fluids cease to pass through the mucous ducts, they remain in permanent contraction; this is what takes place in the intestines below a preternatural anus. I have seen in this case the cæcum and the rectum reduced to the size of a large quill. Yet there is never then an obliteration of their parietes, on account of the presence of the mucous juices, of which the patient always passes a certain quantity. The urethra, after the operations for stone in which the urine passes for a long time through the wound, and in the great fistulas in the perineum or above the pubis, the salivary ducts in wounds which affect them and through which the whole saliva is discharged, the nasal canal in fistulæ lachrymales, contract also more or less, but are never obliterated. We know that the vas deferens is often a very long time without having semen pass through it, and yet it remains open. This phenomenon distinguishes the mucous ducts from the arterial, which, when the course of blood is interrupted in them, change into ligaments in which every thing like a canal disappears. We ought not to lose sight of this phenomenon of all the mucous ducts; it proves the incorrectness of the practice of those who, thinking that at the end of some time it is impossible to re-establish, in fistulas, the natural way, think it necessary to make an artificial one.

The mucous tubes are not only not obliterated when they are empty, but when inflamed they do not even contract adhesions of their parietes, as so often happens in the serous cavities, in the cellular texture, &c. Observe how important this fact is to the great functions of life; what would indeed become of these functions, if in catarrhs of the intestines, the bladder, the stomach, the œsophagus, the excretories, &c. these adhesions were as frequent as they are in pleurisy, peritonitis, pericarditis, &c.

II. _Vital Properties._

Few systems live in a more active manner than this; few exhibit the vital forces in a higher degree.

_Properties of Animal Life._

Constantly in relation, like the integuments, with external bodies, the mucous surfaces have occasion for a sensibility which would enable the mind to perceive these relations, especially at the origin of these surfaces. Thus the animal sensibility is very much developed there. It is even superior in it in many places to that of the cutaneous organ, in which no sensation is as acute as those which take place on the pituitary membrane from odours, upon the palatine from tastes, upon the surface of the vagina, the urethra, the glans penis during coition. But without speaking of these exaggerations of sensibility, if I may so express myself, all the natural phenomena of the mucous surfaces prove this property in an evident manner; it is unnecessary however to pause for these phenomena.

I would only observe that this sensibility, like that of the cutaneous organ, is essentially subjected to the powerful influence of habit, which tending constantly to blunt the acuteness of the sensation of which they are the seat, brings equally to indifference the pain and the pleasure they make us experience, and of which it is the medium, as we know. 1st. I say that habit brings to indifference the painful sensations arising upon the mucous membranes. The presence of a sound in the urethra for the first time, is distressing the first day, painful the second, inconvenient the third, and insensible the fourth. Pessaries introduced into the vagina, bougies into the rectum, tents fixed in the nasal fossæ, and a canula kept for a length of time in the nasal canal, exhibit in different degrees the same phenomena. It is upon this remark that is founded the possibility of the introduction of sounds into the wind-pipe to aid respiration, and into the œsophagus to produce an artificial deglutition. This law of habit can even transform into a pleasure an impression at first painful; the use of snuff for the pituitary membrane and different aliments for the palatine, furnish well known examples of this. 2d. I say that habit brings to indifference agreeable sensations arising on the mucous surfaces; the perfumer, placed in an odoriferous atmosphere, the cook, whose palate is constantly affected by delicious tastes, do not find in their professions the acute enjoyments they give to others. From habit can even arise the succession from pleasure to painful sensations, as in the preceding case it converts pain to pleasure.

I would however observe that this remarkable influence of habit is only exerted upon sensations produced by simple contact, and not upon those produced by real injuries, as the tearing, the forced stretching, the cutting or pinching of the mucous system; thus it does not mitigate the pains caused in the bladder by pressure and by the tearing a stone occasions, or on the surface of the womb, of the nasal fossæ, &c. by a polypus, on that of the œsophagus or the wind-pipe by a sharp and uneven body accidentally lodged there, &c. &c.

It is to this power of habit over the sensibility of the mucous system, that must be in part referred the gradual diminution of its functions, which accompanies age. Every thing is stimulant in infancy, every thing is blunted in old age. In one, the very active sensibility of the alimentary, biliary, urinary, salivary surfaces, &c. contributes principally to produce that rapidity with which the digestive and secretory phenomena succeed each other; in the other, this sensibility blunted by habitual contact, connects but slowly the same phenomena.

Is it not from the same cause that arises this remarkable modification of the sensibility of this system, viz. that at its origins, as upon the pituitary, the palatine membranes, the œsophagus, the glans penis, the opening of the rectum, &c. it gives us the sensation of the bodies with which it is in contact, and that it does not give this sensation in the very deep organs which it lines, as in the intestines, the excretories, the gall-bladder, &c.? In the interior of the organs, this contact is always uniform; the bladder only knows the contact of the urine, the gall-bladder that of the bile, the stomach that of the aliments masticated and reduced, whatever may be their diversity, to an uniform, pulpy mass. This uniformity of sensation produces no perception, because in order to perceive, it is necessary to compare, and here the two terms of comparison are wanting. Thus the fœtus has no sensation of the waters of the amnios; thus, the air, very irritating to a new born infant, becomes insensible to it. On the contrary, at the beginning of the mucous membranes, the stimulants vary every instant; the mind can then perceive the presence of them, because it can establish approximations between their different modes of action. What I say is so true, that if in the interior of the organs, the mucous membranes are in contact with a foreign body, different from that which they are accustomed to, they transmit the sensation of it to the mind. A catheter in the bladder, sounds introduced into the stomach, &c. are examples of this. Fresh air, in great heat of the atmosphere, suddenly introduced into the trachea, carries an agreeable sensation over the whole surface of the bronchia; but habit soon renders us insensible to it and we cease to have the perception of it. Yet it is to be observed that when the intestines come out in preternatural inversions of the anus, their sensibility never becomes so acute as that of the palatine, pituitary surfaces, &c. &c. The absence of cerebral nerves no doubt has an influence upon this phenomenon.

The sensibility of the mucous system is much raised in inflammations; acute catarrhs are, as we know, very painful. The contact of bodies is then not only felt, but is very disagreeable. I would observe however that the sensibility never rises so high as it does in the inflamed cellular, serous, fibrous systems, &c. A phlegmon, a pleurisy, &c. compared with a catarrh, are sufficient to convince us of this. We may say that the organs least accustomed to feel in the natural state, experience in diseases the most acute sensations.

There is no animal contractility in the mucous system.

_Properties of Organic Life._

Organic sensibility and insensible contractility are very evident in the mucous system. They are constantly put in action in it by four different causes; 1st, by the nutrition of this system; 2d, by the absorption that takes place in it, either naturally or accidentally; 3d, by its exhalation; 4th, by the constant secretion of its glands. These two properties are the original causes of all these functions, the increase and diminution of which are truly the indices of the state of these glands. As a thousand causes continually act upon the mucous surfaces, as a thousand different stimuli continually excite them, especially at their origin, this state is incessantly varying like the functions that result from it.

The mucous system differs then from most of the others; 1st, in this, that the organic sensibility and the insensible contractility are habitually more exalted in it, on account of the more numerous functions over which they preside; 2d, in this, that they incessantly vary, on account of the variety of the stimuli. Observe in fact that, in the osseous, fibrous, cartilaginous, muscular, nervous systems, &c. on the one hand, these properties are put in action only by nutrition; and on the other, no stimulant being in contact with these systems, they always remain at the same degree.