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A
SERIES OF
ELEMENTARY LECTURES
ON THE
VETERINARY ART:
WHEREIN THE
ANATOMY, PHYSIOLOGY, AND PATHOLOGY
OF THE
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HORSE,
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ARE
ESSAYED ON THE GENERAL PRINCIPLES
OF
Jfte&ical gcfenct.
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veterinary surgeon percivall,
Of the Royal Regiment of Artillery.
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To watch, to scrutinize, to inqnire, is labour, and labour is pain. To confide,
to taKe for granted that all is well, is easy, is exempt from labour, and, to the great mass of mankind, comparatively delightful."—Mills' History of British India. ' Those who seek truth only freely expose their principles to the test, and are
pleased to have them examined."— Locke. |
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*e=s=
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LONDON:
- ■
PRINTED BJT JOHN HILL, BLACKFRIAHS J
f<V And published by
LONGMAN, HURST, REES, ORME, AND BROWN,
• Paternoster Row. 1823.
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ENTERED AT STATIONERS' HALL.
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TO THE
'Vtttvimvvi jHrtrical IS^amintng QommitUt,
AND TO THOSE
DISTINGUISHED TEJCHERS
OF HUMAN MEDICINE,
WHO,
WITH LIBERALITY UNPRECEDENTED,
Have gratuitously opened to
€f)e "Ftttvimvn Pupil,
THE
SOURCES OF HIS FUNDAMENTAL MEDICAL KNOWLEDGE,
THESE LECTURES
Are inscribed, in testimony of
RESPECT, ESTEEM, AND GRATITUDE,
By their most devoted Servant,
THE AUTHOR.
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a 2
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PREFACE,
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•dN elementary zeork on veterinary subjects, should it be
deemed worthy of a place among the many approved in- troductions to various other branches of science, has lit- tle need of commendation, and none of excuse, in making its appearance before the public. Too long have the mem-' bers of the profession experienced the inconvenience of not having by them some accurate synopsis of the scattered elements of their art; too long, indeed, have the medical profession in general looked forward to some scientific pro- duction of this nature. But, could we plead this pressing demand—this deside-
ratum in veterinary literature, as an apology for obtruding ourselves thus early upon public notice, it might still be regarded as an unqualified act in us, to attempt the ex- position of the principles of an art of which the prof essors themselves have only published on detached parts. Con- ceiving, however, that the present essays, (in the form of lectures,) concise as they confessedly are, might prove use- ful in the absence of more elaborate composition, and daily witnessing the pernicious influence of books on farriery, written by individuals unacquainted even with the rudi- |
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PREFACE.
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VI
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ments of the art they treat on, we have ventured, tiotwith-
standing the above acknowledged truth, we fear prejudi- cial to them in the minds of some, to lay them, in their present state, before the public. Having offered our reasons for undertaking a work, we
hope, at some future period, to be able to complete; it only remains to crave for it> that liberal examination, and in- dulgent censure, for which those eminent characters, to whose protection we have consigned it, are so universally and so justly esteemed: assuring them, that, however un- finished the superstructure may be found, the foundation has been laid in practical investigations, anatomical and pathological, in an ample field of observation and ejrpe- rience. |
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Royal Horse Infirmary, Woolwich,
May, 1823. |
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CONTENTS.
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Page
Introduction ••«•«...............................-....*<••■ ix LECTURE I.
OntheBlood ............................................. 1 LECTURE II.
On the Blood—Serum—Red Globules—Coagulable Lymph—Diseases of the Blood—Venesection................................ IS LECTURE III.
On the Arteries ........................................... 32 LECTURE IV.
On the Physiology of Arteries—Pulse.......................... 43 LECTURE V.
On the Diseases of Arteries—Inflammation.................... 56 LECTURE VI.
On Veins—Physiology of Veins —Diseases of Veins—Blood-spavin —Wounds of Veins a...................•................. 86
LECTURE VII.
On the Absorbents—Absorbent Glands.......,................ 107" LECTURE VIII.
On the Physiology of Absorbents—Diseases of Absorbents ........ 118 LECTURE IX.
On Cellular Membrane—Diseases of Cellular Membrane .......... 131 LECTURE X.
On the Brain and Nervous System—Brain—Nerves—Physiology of
the Brain and Nerves..................................... 144 LECTURE XI.
On Neurotomy—Diseases of the Nerves—Tetanus ..."............ 168 LECTURE XII.
On the Muscles—Tendons—Diseases of Tendons—Bursa? Mucosa?—
Diseases of Bursa; Mucosas................................. 196 LECTURE XIII.
On the Physiology of Muscles—Diseases of Muscles—Stringhalt—
Palsy .................................................. 216
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1
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CONTENTS.
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Vlll
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LECTURE! XIV. rage
On Glands—Secretion—Diseases of Glands .................... 251
LECTURE XV.
On Bones—Diseases of Bones—Exostosis—Marrow ............. 234
LECTURE XVI.
On Cartilage—Diseases of Cartilage—Ligaments and Joints—Dis-
eases of Joints—Ossification—Division of Bones—Prominences and Cavities of Bones........................................ 262 LECTURE XVII.
On the Skeleton—Spine —True Vertebra;—Cervical Vertebra?—Dor-
sal Vertebrae—Lumbar Vertebra?—Os Sacrum—Ossa Coccygis— Diseases of the Spine—Fracture and Anchylosis .............. 287 LECTURE XVIII.
Pelvis—Ossa Innominata—Sternum—Cosla?—Bones of the Fore Ex-
tremity—Scapula—Os Humeri—Radius et Ulna.............. 305 LECTURE XIX.
Carpus—Os Scaphoides—Os Lunare—Os Cuneiforme—Os Trapezium -—Os Trapezoides—Os Magnum—Os Unciforme—Os Pisiforme— Bones of the Leg—Os Metacarpi Magnum—Ossa Metacarpi Parva —Diseases of the Metacarpal Bones—Splint.................. 318 LECTURE XX.
Os Suffraginis—Ossa Sesamoidea—Os Corona?—Diseases of the Pas- tern Bones—Ringbone—Os Naviculare—Os Pedis--Diseases of the Navicular and Coffin Bones............................ 330 LECTURE XXI.
Bones of the Hind Extremity.—Os Femoris—Patella—Tibia et Fi-
bnla—On the Tarsus—Astragalus—Os Calcis—Os Cuboides—Os Cuneiforme Magnum—Os Cuneiforme Medinm—Os Cuneiforme Parvum—Os Metatarsi Magnum—Diseases of the Bones of the Hock—Spavin.......................................... 343 LECTURE XXII.
Bones of the Head—Bones of the Cranium—Ossa Frontis—Ossa
Parielalia—Ossa Temporum—Pars Squamosa—Pars Petrosa—Os Occipitis—Os Sphenoides—Os Ethmoides.................... 359 LECTURE XXIII.
Bones of the Face—Ossa Nasi—Ossa Unguis—Ossa Malarum—Os-
sa Maxillaria Superiora—Ossa Maxillaria Anteriora—Ossa Palati —Ossa Spongiosa vel Turbinata, superiora et infenora—Vomer— Maxilla inferior vel posterior—Diseases of the Bones of the Head 368 |
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INTRODUCTION.
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The Veterinary Art, according toils present ac-
ceptation, comprehends a knowledge of the external form, as well as the internal structure and economy, of our principal domestic quadrupeds; their appropriate ma- nagement; the nature, causes, and treatment of their dis- eases ; and the art of shoeing such as require it. The horse, and his varieties—the mule and ass, the
dog, the ox, the sheep, the pig, and some others, come equally under the ministering hand of the veterinary sur- geon : the comparative value however of the horse, desig- nates him as the object of his primary, we had almost said his sole consideration ; so that the rest, regarded as another and an inferior class, have but little of his time or study devoted to them. The veterinary art, become a science, alone preceded
in practical benefit by that of medicine, of which it is a luxuriant and aspiring branch, has for its objects the pre- servation in health, and restoration from disease, of an animal nearest to man himself in the scale of animated |
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X INTRODUCTION.
nature; whether we contemplate his beauty, his worth,
or his general and extensive use. Perhaps no age, nor country, has so elevated the horse beyond the common level of the brute creation as this : he is housed, clothed, and fed, at a cost only exceeded by that appropriated to his master, to whose gains he is instrumental, or to whose diversions he is indispensable ; his life is watched with a peculiar care, and his loss too often irreparable. If the veterinary art be estimated as beneficial and important in exact ratio to the value of the animal to whose well-being all its objects are directed, surely at no antecedent period has it merited the same degree of encouragement as at the present: should we, therefore, not have been suc- cessfully engaged in our efforts to cultivate and improve it, let us hope, at least, that such attempts are deserving of commendation ! Had it not been for the fostering patronage of some of
the most exalted characters in this country, the veterinary art must still have lain prostrate at the feet of ignorance and superstition; no less a personage, however, than our magnanimous King himself, ever distinguished for pro- moting that which is nationally useful and beneficial, has deigned to raise it into importance and respectability, in appearing as the Patron of the Veterinary College. Were not this of itself full and sufficient testimony of the pre- sent consideration of our art, we might adduce that very respectable and honorable list of governors of the insti- |
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INTRODUCTION. XI
tution, the bare perusal of which will evince, that the
nobility, the talent, and the wealth of our nation, have subscribed to its protection, its advancement, and its dif- fusion. But let us descend a little into detail—we shall findj
by pure and plain matter of fact, that, prior to its being grafted upon the luxuriant stock of science, great num- bers of our horses became prematurely unserviceable : the natural consequence of which was heavy and continual national expenditure; not to glance at the ineffective state to which our cavalry and other horse departments were necessarily reduced. Let us take, by way of exam- ple, the present system of shoeing horses. In the course of a long experience we have ascertained, that, by a skil- ful performance of this branch of our art, we can prevent many of the diseases, and them the most formidable, to which the foot of the horse is liable ; enable horses to go with ease to themselves, and safety to their riders; and preserve them to use to a much longer period than here- tofore. On the other hand, to sketch a picture of the me- lancholy effects resulting from the practice of shoeing in the hands of professionally unscientific persons, when the horses belonging to the Honorable Board of Ordnance were first placed under the superintendance of veterinary surgeons, numbers of them, highly valuable in other re- spects, were cast for death purely because their feet were incurably diseased. Thrush, and its sequel canker, corns, |
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INTRODUCTION.
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Xll
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grease, aud all those varieties of disorganization induced
by mal-treated inflammation of the parts within the hoof, consigned multitudes of them to the knacker's knife : whereas, since the eye of science has controled the hand of the smith, we will venture to assert, that not a single horse has been lost to the service from either of the above- named diseases; arid that at the present day the three first —viz. thrush, canker, and corns, are almost unknown ; and the last of so rare occurrence, that there are not ad- mitted into the Infirmary a dozen cases in the course of the year. We might bring forward here many—very many other instances of the benefit, not more obvious than great and permanent,. the country has experienced from the practice of our art under the direction of those acquaint- ed with its principles : but we trust that the one here ad- duced, which a reference to recorded statements will at any time evince the truth of, stands in need of support from no concomitant, nor lacks confirmation from any corroborative evidence. To the breeder—to the proprietor of a large stud*—
to the gentleman of the turf—and to every individual who feels an interest in the well-being of his horse, the veteri- nary art cannot but appear in a most favorable light. The first, by enabling him to trace out the perfections and * By the word stud is popularly and here meant, a collection of
horses simply. |
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INTRODUCTION. XH1
imperfections of male and female, by developing the na-
ture of those diseases to which each may be disposed, and by informing him what are and what are not ingenerate, it renders competent to produce, by certain unerring laws, an improved and matchless progeny; to the second it is both useful and profitable, in teaching him the means of prevention, as well as those of palliation and cure, of dis- order in his stud ; the third it fills with renewed hope, in having restored to the goal of contention, his broken- down but celebrated racer; the last it contributes in no trifling degree even to the happiness of, in administering to those maladies which his old and favorite horse may have contracted in his service. To the enlightened practitioners of medicine of the
present day, we need say but little to convince them, that veterinary inquirers may, from time to time, by extensive opportunities in comparative anatomy, add something to the general fund of medical knowledge ; and that, so far, they may now and then consult veterinary works with ad- vantage. Indeed, so much analogy is there throughout, between the structure and economy of the horse and those of the human subject, and so alike are the chief phenomena of pathology, that the surgeon has but little to do to become the veterinary surgeon, though the con- verse of this, unfortunately for the latter, by no means obtains. And where is the surgeon who would not him- self direct the treatment of his sick or lame horse, in pre- |
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xiv INTRODUCTION.
ference to calling in the village blacksmith?—a man
whose knowledge is necessarily confined to that of nail- ing the shoe to the foot ? He would not permit a shoe- maker to visit one of his own patients, why should he al- low the blacksmith to prescribe for his horse? The the- ory of medicine in the human subject, is the theory of medicine in the brute ; it is the application of that theory —the practice alone that is different: whether we pre- scribe for a man, or a horse, a dog, or a cat, the laws of the animal economy are the same in all, and one, and that an unerring system of principles, built upon ascer- tained and established truths, is to dictate our practice in all. We might as well, in reference to the principles of each, attempt to separate surgery from medicine, as insist that either of these arts, in theory, is essentially different from the veterinary : every day's experience only serves to confirm this—our belief; in shewing us how often the dis- eases of a horse arise from the same causes as those of a man, exhibit the same indications, and require a similar method of cure. Were this not true, how is it that the testimonial for practice—the diploma cf a veterinary sur- geon, owes its stamp of importance and indisputable qualification to the signatures of practitioners of human medicine ? Will it be said, that these distinguished cha- racters are, as physicians and surgeons, unacquainted with the principles of veterinary science? This is no new doctrine—it has not originated in our time : Vegetius, |
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INTRODUCTION. XV
fourteen hundred years ago, when he was collecting ma-
terials for his work, De Arte Veterinarid, wisely, not only consulted the veterinary surgeons, but also the phy- sicians of the day ; nam (inquit) mulomedicinse doetrina ab arte medicinse non adeo in multis discrepat, sed in multis plurimisque consentit. The advantages resulting to the veterinary surgeon from
a knowledge of the different branches of human medicine, can alone be duly appreciated by its possessor : without it, he is but ill prepared to meet the medical literati of the day ; with it, he stands as an effectual barrier to im- proper interference on the one side, and to the dissemina- tion of doctrines flimsy or absurd, on the other. The young veterinarian we would admonish to be very cau- tious how he admits empiricism into his counsel—how, in other words, he practises that which his judgment may condemn : pin your faith upon no man's sleeve, but look for yourself as you proceed, is inscribed on the di- rection-post which points out the road to professional ce- lebrity. To the old practitioner we would fain hint, that nothing is so effectual a barrier to advancement—nothing so prejudicial to the art, as to continue in the use of re- medies purely because they were the infallibles of those who went before : let him be wary how he vainly piques himself of his experience; for he who reposes himself on practice, to the utter exclusion of theory, we do not care what his experience may be, is but a dabbler in the |
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INTRODUCTION.
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XVI
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art, and one that tampers with the lives of animals unfor-
tunate enough to be placed under his care *. In order to convey some idea of the present state of
veterinary science, it may not be amiss to take a hasty re- trospective view of our art, from the institution of the Ve- terinary College. This establishment may be said to have had its origin in the Odiham Agricultural Society; who, in the year 1785, first occupied themselves about the im- provement of the veterinary art, then in a very neglected condition: it is M. Sainbel, however, who came over to England in the following year, with a view of pub- licly teaching it, and who afterwards became professor, whom we must regard as the founder of the College. We * We recall to memory here an anecdote so pertinent to this
part of our subject, that we cannot forbear relating it. A farrier who was subpoenaed on a horse-cause, was opposed, as evidence of the contending party, by a young veterinary surgeon. The son of Vulcan, who had from the beginning eyed his professional anta- gonist with all the spleen and self-sufficiency so peculiar to his sect on such occasions, as one of comparative ignorance, when put in competition with him, the possessor of grey hairs and venerable looks, during his examination by the counsel, to whom he was re- plying in a most haughty and assuming tone, was asked by the judge, "and pray, sir, how long have you been a farrier?" to which our hero, astonished that his lordship had not heard of his professional fame, nor of that of his progenitors, answered, " how long a farrier, my lord ! I was horn a farrier, my father before me was a. farrier, and so was my grandfather ! ! !" |
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INTRODUCTION. XVH
may consider this, therefore, as the epocha of scientific
farriery in England; though, long before, there had been much written on the subject, particularly by the French, who, for a considerable time anterior to this, led the way in vetennary pursuits; which only required selection and arrangement, by a person of good discriminative talent, and sound medical knowledge, to convert it into materials fully sufficient for laying down the rudiments of veteri- nary science. To the lot of Mr. Coleman, the suc- cessor of M. Sain eel, and present professor to the College, fell this gratifying task : what professional fame this gentleman has acquired in its acquittance, or with how much respect and esteem he is looked up to by the members of the institution for the services he has ren- dered it, need not be the theme of our pen. Seeing, then, that there was much useful, though imperfectly digested matter to be obtained from the perusal of works on far- riery *; and that to this was to be added all that bad any relation to the art in comparative anatomy, physiology, chymistry, human surgery and medicine, which were at that time, and have been ever since, making rapid strides * From a long list of French authors we may adduce, Sojlley-
sel, Bourgelat, La Fosse, Vitet, and Sainbei, as excellent sources of practical information : among numerous of our own wnters on farriery, &c. Blundeville, Markiiam, Newcastle, onapE) Gibson, Bracken, Bartlett, Osmer, Clarke, and Stubbs are the principal contributors. b
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XV111 INTROnUCTION.
in advancement, we shall find that our art was suscepti-
ble of very considerable improvement, in a very short space of time; and that we ought not to be at the pre- sent day, remembering that this happened thirty years ago, so young and inexperienced in the practice of it as many seem inclined to believe. It is now quite time that we were acquainted with the anatomy and physio- logy of the horse, so far as our practice demands; and it is to be hoped that we are making daily progress in our pathological knowledge: though this last is a branch of comparative slow growth, and one that is peculiarly shy of bringing forth fruit. We shall, at ano- ther time, prosecute an inquiry into the existing state of veterinary science in this country ; consider the national means provided for its improvement and diffusion, in the establishment of the College; analyze the system of education therein pursued, comparing it with those now adopted at the principal continental veterinary schools, and with that originally proposed by M. SA1NBEL ; ascertain what progress has absolutely been made, notice the dis- coveries, and endeavour to trace each to its respective and proper source ; and offer such hints and suggestions for the further benefit and advancement of our art, as strike us not to be unworthy the attention—nay, serious consi- deration of those more immediately concerned in the welfare and promotion of this very useful branch of ge- neral knowledge. |
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INTRODUCTION. XIX
It is far from our intention here to enumerate the "dis-
coveries" that have been made, even in our own time; suf- fice be it for the present to observe, that, with the power- ful aid of our cotemporaries in medicine, whose path is our nearest way to perfection, we are rapidly effecting a complete revolution in the veterinary art. We have had, and we still have, great obstacles to contend with:—pre- judice, envy, obstinacy, and ignorance; we hope, how- ever, to find none of them insurmountable; on the con- trary, in process of time, as we advance in knowledge and importance, to tread them one and all under foot. Let us act towards one another as become the respecta- ble members of a liberal profession, engaged in one com- mon cause, whose promotion is the interest and the be- nefit of us all—let us go hand in hand, and unanimously and resolutely oppose the incursions of that individual who would sell our present rank and prospective prefer- ment to fill a private purse ; while we unsparingly lavish our praises and our honors upon him, who, in being a real and unsophisticated friend to our art, contributes to the welfare and advancement of every one of us. Although we abstain from, indeed our limits will not
admit of our making mention of the progressive improve- ment the art has undergone, even since the foundation of the College, we shall take a hasty review of the principal literary productions of the professors and members of the institution. b2
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XX INTRODUCTION.
Charles Vial de Sainbel, the founder of our
College, now no more, if we are to repose faith on what he wrote, and on what he had but time to lay the foun- dation stone of, had great and important designs indeed in view, to the aggrandizement of veterinary science. His career, however, was of so short duration, that he has only left us—besides an excellent and unpractised plan for the education of eleves veterinaires—a work, translated into English, containing some very pithy Observations on the Art of Veterinary Medicine; an Essay on the Propor- tions of Eclipse; another, which obtained a prize giveu by the Royal Society of Medicine, on the Grease and Watry Sores on the Legs of Horses; a third, oh the Glan- ders; and a few short Observations on the Cholic, or Gripes. That Sainbel, had he lived, would have pro- ceeded on sound principles, may be inferred from his fourth observation on the veterinary art. " The object of this art is therefore not only congenial with that of hu- man medicine, but the very same paths which lead to a knowledge of the diseases of man, lead equally to a know- ledge of those of brutes. An accurate examination of the interior parts of their bodies, a studious survey of the ar- rangement, structure, form, connexion, use, and relation of these parts, and of the laws by which they are intended to act, as also of the nature and property of the various foods, and other agents, which the earth so liberally pro- vides for their support and cure ; these form in a great |
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INTRODUCTION. XXI
measure the sound and sure foundation of all medical sci-
ence, whatever living individual animal is the subject of our consideration." First in the catalogue of works of more modern vete-
rinary writers, in volume and importance, presents itself that of Professor Coleman ; wherein the Structure, Economy, and Diseases of the Foot of the Horse, and the Principles and Practice of Shoeing, are treated of with great clearness and ingenuity : the descriptive part is well illustrated by several highly finished paintings. Messrs. Moorcroft, Bracy Claek, Goodwin, Budd, and Powis, have also written on this subject. Mr. Goodwin, whose is a good practical work on shoeing horses, has given us a synoptical display of the vari- ous methods adopted, in this branch of our art, by dif- ferent nations; and introduced some modification in the present practice of it; which, in our opinion, will be sootier or later carried into effect; even by the adherents to other systems; and may be so, we also think, without any concession of their present tenets. Professor Peall has published some Observations on
the Diseases of the Horse, and his Stable Management; unrivalled by any book of the kind, either for the practi- cal matter it contains, or the liberal and scientific style in which it is written. Mr. Bracy Clark has presented us with an inte-
resting Essay on the Pots of Horses and other Animals ; wherein the transformations, and other curious incidents |
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XXli INTRODUCTION.
connected with the natural history of that little animal,
are with much science and research developed to us. The same writer has published another Essay on the Gripes of' Horses; and, more recently, a work entitled, The Reformed Veterinary Pharmacopoeia. Mr. Sewell, assistant professor to the college, we be-
lieve every member of the profession will attest, has long and unremittingly exerted himself in the augmentation of veterinary knowledge; and, we feel pleasure in adding, with no ordinary success. Among other innovations in practice, of small comparative import, we must not lose sight of the operation, called neurotomy, the merit of which is the exclusive right of Mr. Sewell. It is illi- beral! it is false, to assert that it is not! But Mr. Se- well has treated the groom's oracle* with deserved contempt-------with silence. The following members of the institution have also
become authors; some of general treatises, others of es- says, dissertations, &c. the bare mention of whose names we must be content with here, or we shall extend these preliminary observations much beyond their prescribed limits: viz. Messrs. Boaedman, Lawkence, Wil- kinson, Shipp, Smith, Ryding, Feron, Burke, and Denny. * Treatise on Veterinary Medicine in four volumes, &c. &c. by
James White, late Veterinary Surgeon to the First or Royal Dragoons. Vide Vol. III. p. 148 of the 13th edition. |
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INTRODUCTION. XX1U
Science, then, may at length be said to have dawned on
the veterinary art—society has, now, long regarded it as one of adequate utility to merit its support and encou- ragement—the Veterinary College has been established thirty years, and has dispersed its members throughout the united kingdom. Notwithstanding all this however, had not others, under less favorable circumstances than our own, have been well received upon the arena of pub- lic decision, we should not yet have ventured to have made our appearance at the same tribunal. It has been said, and with much truth, that he who
would be of essential service to the profession as an au- thor, should take up the investigation of one subject, and confine himself to that alone : thus has medicine attained its present pre-eminence in this country. It appears to us however, that, before any science, or art, can make great progress, it is requisite that every member of it be furnished with a synopsis of the fundamental principles of that science, or art ; and that, for the want of such im- plements, many are deterred from lending their aid, who would otherwise prove very useful laborers in the vine- yard. To this end, it is not enough that these rules for their guidance be propounded to them once, or twice, or even thrice ; but it is absolutely necessary that there be some authentic records of them kept, accessible to every individual of the profession : so that the students may av»il themselves of them in the absence of their teachers ; |
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XXIV INTRODUCTION.
the members refer to them at pleasure; and the public
in general be informed of the pretensions of its practi- tioners, by a display of that knowledge which they are, or ought to be, in the possession of. No man supposes that his watch can be repaired at
the anvil, though there be those who send their horses to the blacksmith to be cured of their disorders : they know that this blacksmith is unacquainted with the mechanism of a watch, and yet they intrust a machine to him, to which, in point of complication of structure, a rattle bears more affinity to a watch, than a watch to it! Why then are gentlemen so blind? Is it that a horse is of less value than a watch ? No ! It is that the vile trash diffused in treatises on farriery, is so truly disgusting to a man of com- mon reflection, that he forms his opinions of the art by those he entertains of the book, and considers it specially adapted to the genius of his groom or coachman, or suit- ably lodged within the skullcap of his blacksmith or bell-hanger—below the dignity of a man of education, and incompatible with the habits of a gentleman! " Mi- serable animal I" says Sainbel, " bereft of speech, thou can'st not complain, when to the disease witli which thou art afflicted, excruciating torments are superadded, by the ignorant efforts of such men, who, at first sight, and without any investigation to lead them to the source of thy disorder, pronounce a hackneyed, common-placed opinion on thy case, and then proceed with all expedition |
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INTRODUCTION. XXV
to open thy veins, lacerate thy flesh, cauterize thy sinews,
and drench ihy stomach with drugs, adverse in general to the cure they engage to perform*." To those who may regard the veterinary profession in
other light than as one, not only deservedly established upon the basis of respectability, but, from its objects, necessarily requiring ability and a knowledge of medicine to practise with advantage, we would put the following questions of Vegetius; (a writer we have already quoted;) and then ask them, if these arguments, surely excellent, if not elegant of their kind, were tenable at that day, with how much more force and truth can we apply them at the present ? Quis aut nosse curas jumentorum erubescendum pu-
fet, cum optima jumenta habere gloriosum sit 1 Quis vituperationi det id posse curare, quod laudi ducitur pos- sidere ? Forsan ipsa opera mulomedicorum videtur ab- jectior, notitia aut ciirationis non solum honestissimis, sed etiam disertissimis convenit: ut provisione et ordinatione sollerti curatis animalibus et damnis careant, et volupta- tibus perfruantur. Highly respectable as every member of the law and di-
vinity professionally is, and great as the honors are con- ferred on some of the most eminent, yet do we find in- Vide Saijibel's General Observations on the Art of Veterinary
Medicine.- |
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XXvi INTRODUCTION.
stances, too numerous indeed, of chicanery and apostacy
in both these professions : shall we then brand the vete- rinary art with stigma because one who professes it swerves from that course which circumspection might, and honesty ought to dictate ? The man who barters his reputation for dirty pounds, shillings, and pence—be he who he may—whether he preside over or be a member of it, forfeits the confidence and good-will of a profes- sion he living dishonors, and dead leaves a name, a blot jn its history. That individual has ever appeared to us as the most
skilful and best practically informed veterinary surgeon, caeteris paribus, who is most familiarly acquainted with the natural habits of the horse, as well as those various states in which he is placed by art;—either in the stable, upon the turf, in the field, or upon the road: " A skilful horseman, and a huntsman bred;"
and for the same reason, that he is regarded as the most
able physician, who has well informed himself of the ha- bits of life and constitution of his patient. In the selection of a hackney, for example, we should estimate that man's judgment at little, who was not only a good horseman him- self, but who had not ridden a variety of horses of that denomination ; nor should we consult him in the choice of a racer, who was not perfectly conversant in the trials and performances of horses of various breeds, and differ- |
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INTRODUCTION. SXV11
ent shapes; neither would we give him credit for any
but fanciful knowledge of equitation, who could not set a sauteur in a school, or cross the country upon a well- trained hunter. Let it not be understood, however, that we coincide
with that system of education which would train up the 61eve vet£rinaire in a stable, or a blacksmith's shop, ra- ther than initiate him in the different branches of litera- ture: surely, the study of medicine in the horse involves nothing so ecurien in its nature as to render it necessary to be stalled for its attainment! The student of medi- cine receives clinical instructions, and is an attentive ob- server of the progress of disease ; but it is neither requi- site, nor advisable, that he should spend that time in the wards of an hospital, which he now, with such in- calculably greater ultimate advantages, devotes to classi- cal and other learning! Without a due share of practical knowledge, it is true, our medical acquirements are ever leading us into error; and this is the only excuse we can make for them who are eternally bewildering themselves in framing plans in the cabinet for the farrier to look through when they enter the forge. In fine, it appears that a happy combination of medical science with equestrian skill in the same individual, will eminently qualify him as a veterinary surgeon. Were the art intrusted to the first, U would, at no remote period, dissipate itself in specula- tion and refinement; and were it in the hands of the last, |
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XXV111 INTRODUCTION.
it would rapidly sink again into that abyss of ignorance
and blind humiliation, from which—and woe be to him who from sinister and selfish motives would again darken and enslave it—it is rising fast into the horizon of science. But to conclude these preliminary observations— With all that was known prior to the institution of the
College—with that vast accession of convertible science for which we are indebted to human medicine—and with what has since been added by later writers, we purpose to compile a regular course of lectures on the veterinary art; parts of which we shall submit from time to time, until the whole be completed, to the perusal of those de- sirous to acquire an elementary knowledge of it. For students we principally design them: should they, how- ever, be deemed worthy of the attention of others, we shall feel amply repaid for our time and application. The anatomical part of the work is taken from our own
dissections—without adherence to the details of others. The veterinary practitioner does not require so accu-
rate an anatomy as the surgeon: he has seldom to cut down on an artery; never to amputate a limb. There are some parts of the animal, indeed, of which a know- ledge would lead to little or no practical utility what- ever: such are many muscles of the back, loins, neck, and head—the minute structure of the brain and nervous system— the precise course of blood-vessels removed from external injury; and some others. |
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INTRODUCTION. XXlx
Our physiology we adapt to the popular doctrines of
the day. To compose our pathology, we avail ourselves of the
labors of those few who have written from their own ob- servations ; and we have copious notes of our own to re- fer to, as well as a large assemblage of records, collected by ourselves and others in the course of a very extensive practice of nearly thirty years duration, in the service of the Honorable Board of Ordnance. Such are the materials we have the use of iri the con-
struction of our work, and such are our pretensions to public notice : our aim is to lay down principles funda- mental to the attainment of a knowledge of the veterinary art. __________ Before we enter on the immediate consideration of
these lectures, it will be proper to sketch an outline of their contents ; and explain what we mean by the ana- tomy, physiology, and pathology of the horse. In order to obtain a thorough knowledge of any science,
it is expedient to commence with the most simple, and proceed progressively to the most complicated parts. This is the course pursued by our most eminent teachers of the anatomy and physiology of the human body; and it is that which we have observed in the compilation of these lectures. Were the term anatomy strictly confined to its deriva-
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XXX INTRODUCTION.
tion, it would simply imply the dissection of parts; but,
according to its present acceptation, we mean by it—a knowledge of the structure of the component parts of an animal, and of separating and distinguishing those parts from one another. Anatomy may be divided into human, and veterinary .-—the former being that which restricts its inquiries to the human species ; the latter, that which ex- tends them to all our domestic animals, from the horse, its special object, downwards. From a comparison of the two, we derive comparative anatomy. -By physiology, we mean a knowledge of the actions or
functions—the economy or use of parts. As parts, by performing different actions from those
which are natural to them, are altered in regard to their original structure, so we have a third division, termed pathology. In order to elucidate these objects of inquiry, let us
take some part of the body, and thus methodically exa- mine it: say, for example, the hoof. We describe it to be of certain relative dimensions, and definite shape; to be divided into crust, sole, frog, and bars; to be composed of horny fibres, either regular or irregular in their course; and to be firmly attached to the parts within : all this is comprised in its anatomy. Its physiology, is that of con- taining and protecting the soft, or sensitive parts ; of sus- taining the animal's weight, and preventing slipping; and of expanding in due ratio to the force with which the |
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INTRODUCTION. XXXI
foot is put down, and thus counteracting the effects of
concussion. By knowing its healthy appearances, we become acquainted with its morbid, or pathological con- ditions : we find it contracted, preternaturally upright, small, convex, flat, or concave. The constituent parts of the body may be disposed in
three classes. The first will comprehend the organs of locomotion:—the bones and muscles. The second, those subservient to nutrition and sensation:—the viscera, blood- vessels, and absorbents—and the brain and nerves. The third, those destined for the reproduction of the species : —the parts of generation in both sexes. Anatomy, then, may be considered to be a knowledge
of the materials, and of the manner in which these mate- rials are connected in the construction of the animal ma- chine. Its framework, that upon which all the other parts are distributed, to which they are attached, and by which they are sustained, is constituted of hard, inflexible parts, called bones: if an animal fracture one of the prin- cipal bones of the leg, its pillar of support being lost, the limb can no longer uphold the body. Bones, however, not only afford stability, attachment, and support to the other—the soft parts, but serve to contain the more im- portant of them, and defend them from external injury : such as the brain, the thoracic, abdominal, and pelvic viscera. By contrasting the skeleton with the living animal, we
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XXXli INTRODUCTION.
mark the proportion which the bony fabric bears to the
bulk of the whole body : we perceive that the bones, di- vested of flesh, form but an outline of the original animal. Now the flesh is divisible into a very considerable number of distinct portions, which anatomists call muscles; and these parls it is that we are to regard as the essential agents "of motion : the bones are the passive, these are the active locomotive organs. To the muscles, the limbs chiefly owe their bulk and form ; of them a considerable part of the trunk is composed ; and by them all the mo- tions of both are executed. They uphold the body while standing, move it from one place to another, and render it fixed at pleasure; they direct the eyes to the objects of vision, erect or depress the ears as befits the vibration of sound, and give motion to the jaws for the comminution of food : they are also the agents of respiration, and are concerned in a variety of ways with other important func- tions, a detail of which would be ill-timed in this hasty review of them. Were the limbs composed of but two, or three bones,
they would be but ill adapted to perform that variety and extent of motion which they now do, in transporting the animal from place to place ; on the contrary, we find them, most wisely, to consist of several, differing in size and shape, so arranged and accommodated as to act with facility, and surprising rapidity: to give strength, and ad- mit of speed, no less than one and twenty are found in |
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INTRODUCTION. XXX1U
the fore extremity. The ends of bones, shaped so as to
fit into each other, are covered by cartilage, better known by the name of gristle; and are fastened together by dense, fibrous cords, denominated ligaments; whose in- ternal surface is lined by a membranous bag, containing what is called joint-oil—in technical language, synovia. Thus is constituted a. joint: in the motion of which, the nice adaptation of the bones, and due tensity of their li- gaments, prevent dislocation ; the cartilages, like cushions of support, guard against concussion ; while the synovia is a true joint-oil for the lubrication of the whole. Next we come to take a view of those organs concern-
ed in the maintenance of life. In order to furnish nutri- ment to the system, the animal, irresistibly compelled by the sense of hunger, takes in from time to time a certain proportion of food ; which, after it has undergone tritu- ration by the teeth, and has been moistened by saliva, is conveyed by the esophagus, or gullet, into the stomach. Here the several matters of which it consists are reduced to a soft, uniform mass, called chyme; and this is further converted within the intestines, into which the stomach impels it, by the admixture of different juices; the two most remarkable of which are furnished by the liver and pancreas—the bile, and pancreatic fiuid. .At this time, a milky and highly nutritive essence separates itself, and Is absorbed by numberless capillary tubes, called lacteals, a,|d conveyed by them into the system; while the resi- c
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Xxxiv INTRODUCTION.
duary matters, feculent in their nature, continue their
route through the guts to be expelled at the anus. The blood, the nutritive fluid to the animal as the sap
is to the vegetable, is conducted to every part of the body by a system of vessels, named arteries ; whence it is re-conveyed to the heart by others, similar in composi- tion and distribution, called veins; and this perpetual motion of it, is what we denote by the term circulation. Having, however, once performed this circuit, wherein it has served the purposes of nourishment, growth, and reproduction, and supplied the various secretions—such as bile, semen, urine, and saliva, it is unfit for the like uses again, until it has been exposed to the influence of the air. This is effected in the lungs, and is the ultimate de- sign of respiration. Thus constituted—with the instruments of motion, and
the means of preserving and repairing itself—still does the machine require an active principle—a primum mo- bile—a spring that gives impulse to the whole, ere it can possess the power of self-operation. This alone re- sides in the brain and nervous system—the organ of sen- sation and motion; whose presence essentially distin- guishes the animal from the vegetable. By the faculty of motion, animals are enabled to perform certain actions; by that of sensation, they obtain a knowledge of what is passing around them. The only sense that pervades al- most all classes of animals, is that of feeling : the others, |
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INTRODUCTION. XXXV
which appear to be only modifications of it, in a more
exalted and susceptible condition, are by no means con- nected with their vitality. The eye is so constructed that it can feel the rays of light; and the ear so formed as to take cognizance of the vibrations of sound; buton nei- ther of these senses has life any dependance; for a blind horse is as much alive as one whose vision is perfect; and there are some animals in which sight and hearing are en- tirely wanting. Indeed, scarcely any parts of animals present greater varieties than the organs of sense : in the human subject, the power of feeling is inherent in an emi- nent degree in the tips of the fingers; in the horse, we find no proper organ of feeling—it is probably compen- sated for by the super-excellence of that of smell; and so exquisitely fine is this sense in the dog, that even the tracts of the light-footed deer are followed by him with a certitude truly surprising. The term of life of every animal being fixed, at a more
or less distant period according to its kind, it was neces- sary that it should be provided with means for the propa- gation of the species. Among the higher classes, gene- ration is the effect of the concurrence of the sexes; each of which possesses an assemblage of organs, mutually adapted to this end: but in the lower orders, the sexes are now and then combined in the same individual; or generation is performed without any copulative act at all. In the male, the testicles separate a peculiar fluid from |
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XXXvi INTRODUCTION.
the blood, known by the name of semen; and the chief
use of the penis is to conduct this fluid into the uterus or womb of the female; in order to excite in the ovum, therein contained, a disposition to growth and develope- ment. In one of two small glandular bodies, placed within the belly of the female, named the ovaries, is formed the ovum; whence, through a tube denominated the oviduct, it is transported into the womb : here the little embryo, exposed to the influence of the seminal fluid, gradually developes itself, acquiring the precise form and attributes of its parent; until the period of its consummation has arrived, when it is launched into the world to provide for itself. |
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VETERINARY LECTURES.
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LECTURE I.
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On the Blood.
xVCCORDING to the course which we observe in
the compilation of these lectures, the blood presents it- self as the first subject of our consideration; and with real advantages to the student is it made so by our teachers of human anatomy, whose arguments in favor of this method are so instructive, that we cannot pass them over here entirely unnoticed. The body is said to be composed of two orders of
parts—solids and fluids. Of the latter the blood consti- tutes the chief bulk; indeed it may be regarded as the matrix, if we may be allowed the term, out of which all the others, as well as the solids themselves, are formed and re-produced. But the fluids of the body differ from the solids, inasmuch as they afford, from the uniformity °f their properties, a composition of a more simple and intelligible kind—than is presented to us, by, perhaps, the least complicated of the latter ; a fact that might of itself |
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V.
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2 On the Blood
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induce us to treat of them in the beginning of the course.
Another and obvious advantage, however, resulting from such an arrangement, is this: that in investigating the properties of the fluids, it is seldom or ever necessary to advert to the solids; whereas, if we were to reverse this order, we should find ourselves often much perplexed to render our descriptions intelligible, for want of an ade- quate knowledge of the former, and more particularly of the blood ; so that, in fact, we may look upon a thorough acquaintance with the properties and uses of the blood, as, in a great measure, the ground-work of our future ana- tomical, as well as physiological acquirements. More- over, regarding the blood, in an anatomical point of view, as constituting a part of the body, it must indubitably be considered as by far' the most essential: at the same time, it has been so much submitted to observation and experiment, that we may safely say, none has received more splendid elucidations from the most celebrated writers on human medicine; and add, that few still pre- sent a wider field for future research. When we con- template the names of a Harvey, a Hallee, and a Hunter, and reflect on the time and labor these eminent physiologists bestowed on their investigations, relative to the nature, the uses, and the motion of this fluid, we shall be still further convinced of the importance of our pre- sent subject, and regard it as one having additional claims to our primary and profound consideration. Blood may be defined to be, a fluid circulating within
the heart, arteries, and veins of a living animal. From the uniformity of its appearance, it has received the name of an homogeneous fluid; and such indeed it appears to be, while circulating within its vessels in the living body: the lapse of a few minutes, however, after its |
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On the Blood.
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3
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detraction, presents to us a mass composed of dissimilar
parts, or one of an heterogeneous nature. The color of the blood is red in all warm-blooded
animals ; though it is said to vary in its shades of redness in different classes of them*. Of its doing so in dif- ferent parts of the same animal, we have full and fa- miliar demonstration : in the common domestic fowl, for example, some parts—'as the wings and breast, are white ; others—as the legs, of a faint and dusky red hue ; while the heart, liver, &c. present all the common appearances that the same organs do in quadrupeds. On the other hand, many animals, called cold-blooded, possess blood entirely colorless: e. g. in the insect tribe, it is thin, limpid, and transparent. Again, there are others in which a red blood circulates in those parts more imme- diately connected with life: such are fish, whose vital organs are red, though their muscles are perfectly white. Without further digression, however, to prove that color is not an essential property of blood, we may advert to some parts of the horse, which are wholly supplied with this fluid in a colorless form: the transparent parts of the eye are a familiar example of this, in which the vessels are too minute to admit of the entrance of the coloring particles. On the contrary, blood in some parts of the body is so intensely red, that its color approaches more to that of the Modena red, or purple—as is the case with that contained in the pulmonary arteries, and venous sys- tem in general; while in others, its hue is of the bright- est scarlet—of which the pulmonary veins and larger ar- * The blood of the horse is not so red, under ordinary circum-
stances, as that of the human subject; nor is that of the latter so high colored as that of the clog, so far as we have compared them. b 2
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f
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«
4 On the Blood. teries afford the best examples. To the dark-colored
portion, the name of venous blood has been applied; to the bright red, that of arterial: it will be seen, however, from what has been before stated, that these epithets are not in strict conformity to the laws of the animal economy. The shade of red, then, not only varies in the blood of dif- ferent species of animals, but in that of the same animal, from the darkest Modena, or purple hue, to a perfectly limpid brightness. With the exception of that flowing within the pulmonary vessels, the blood changes its co- lor, from the bright scarlet, or arterial hue, to the dark red, or venous, in passing from arteries to veins—a change, the intensity of which depends on the rapidity with which it circulates from one set of vessels to the other; so that, as might be expected, stagnation in any part will have a similar effect on it. Rest, therefore, or what is, in a measure, equivalent to it, tardiness of mo- tion, will be attended with an alteration in the appear- ance of this fluid. If, for example, you tie a cord around your arm, that part more remote from the heart, will be- come turgid, from distention of its vessels with blood; which (blood) will rapidly undergo a change, from a more or less bright red, first to a Modena, and ultimately to a dark purple, or black hue—changes solely referable to its detention by the ligature. Under extraordinary rapidity of circulation, the result, though not altogether the con- verse of the former, is still very different, inasmuch as the arterial character is preserved by the blood in its course through the veins ; and this appearance will be in pretty exact ratio to that of its augmented celerity. The com- mon operation of venesection affords a good illustration of this : when you first open the jugular vein, the blood which spirts out, is of a dark venous hue, but in a. short |
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Ou-Jhe Blood. 5
time, the stream assumes a reddish tint, and often, parti-
cularly when the orifice in the vein is large, becomes quite of the arterial character; a change simply owing to its quicker circulation from artery to vein, and its consequent accelerated flow in that vessel from which you are drawing it. Having before stated, that the con- verse of what generally takes place, happens in the pul- monary vessels, with regard to the color of the blood, it •will here be necessary briefly to explain this phenome- non : let us, however, remark by the way, that in no part of the body is the contrast greater between the two kinds of blood, than in these tubes. In the pulmonary arteries, its color is so dark, that it has not unfrequently been called by authors, black blood, though it is, in truth, only of the most intense Modena red ; while, on the contrary, in the pulmonary veins, nothing can exceed its beautifully bright red, or scarlet tint. Now, as the pulmonary arte- ries convey the blood to the lungs, and the pulmonary veins return it from them, it is evident tiiat this remark- able and sudden change must have been effected in those organs: physiology has demonstrated that it is so, and that it is to be ascribed to the air which they contain, and, farther, that it is a process essential to the support of the animal's life. Venous blood is unfit for the various pur- poses to which arterial is applied; it is, consequently, sent through the lungs in order to acquire renovated properties ; and these are made manifest to the eye of the anatomist, in the alteration of color. In the more perfect, or, as they have been denominated
in contradistinction to the others, the warm-blooded ani- mals, the blood is every where found, while circulating in the living body, to be of a certain degree of heat; and this Jt steadily preserves in its circulation through the inward |
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6 On the Blood.
parts of the body, uninfluenced by the surrounding tem-
perature*. In all unexposed parts, the heat will ex- ceed 100° of Farenheit's thermometer; it has been found however, by experiment, that this degree is not equally maintained in the more superficial situations of the body : what these variations are, we have but little to do with ; though they may be ascertained by the aid of the thermometer, at any time, with precision. But in the lower orders of animals, or such as are called cold-blood- ed, the heat of the blood corresponds with that of the medium in which they live. We are not, however, to suppose that the temperature of this fluid is never sub- ject to variation, even in perfect animals, for it is found to be much influenced in them by disease : e.g. in the hu- man subject, in whom the heat of the body is, in health, 9S", it has been known to rise to 110° during fever; and in all superficial parts, increased heat is one of the essential symptoms of inflammation. The weight of a given quantity of blood when com-
pared with a like volume of water, is nearly one-eleventh more—i. e. water being equal to 1000, blood is about 1090; but its specific gravity will be subject to varia- tion, according to the state of health of the animal from which it is taken: it will be greatest in such as are the strongest, and enjoy the most perfect health. * The heat of the horse's blood, while flowing into a basin, is
100°. If the bulb of the thermometer be introduced into the wound, the quicksilver will rise to about 101°. The temperature of the more superficial parts of the body will, in course, vary with that of the surrounding atmosphere. Mr. Hunter found, that the thermometer introduced into a wound two inches deep, made into the gluteal muscles of an ass, indicated 100°; and that the heat of the vagina was the same. The interior of the chest of the dog, he ascertained to be 101°. |
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On the Blood. 7
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For many reasons, it is impossible to form a correct
estimate of the quantity of blood contained in an animal; though, at first view, it appears no difficult task to arrive at such a knowledge. We have no means, however, of extracting the whole of this fluid from the body, or of correctly ascertaining what remains in it after death ; and though the following experiment may answer every prac- tical and useful end, still it is by no means conclusive as a nice computation: it is one that has been frequently made on the dog, in this instance we repeated it on an ass about six months' old. The weight of the animal being ascertained to be 79 lbs.
a puncture was made with a lancet into the jugular vein, from which the blood, which flowed in a very free stream, was collected. The vein having ceased to bleed, the ca- rotid artery of the same side was divided, but no blood came from itt in a few seconds afterwards the animal was dead. The weight of the carcase was now found to be 73 J lbs. consequently it had sustained a loss of 5Jlbs. precisely the measure of the blood drawn. It appears from this experiment, that an animal will lose about l-15th part of its weight of blood before it dies ; though a less quantity may so far debilitate the vital powers, as to be, though less suddenly, equally fatal. In the human sub- ject, the quantity of blood has been computed at about l-8th part of the weight of the body ; and as such an opinion has been broached from the results of experiments on quadrupeds, we may fairly take that to be about the proportion of it in the horse : so that, if we estimate the weight of a common sized horse at about 12 cwt. the whole quantity of blood will amount to 84 qrts. or 10S lbs, of which about 45 qrts. or 90 lbs. will commonly flow from the jugular vein prior to death ; though the loss of |
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On the Blood
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s
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a much less quantity will deprive the animal of life*.
It is well known, that young animals possess more blood than old, and that they will, perhaps on this ac- count, sustain greater bodily injuries, and bear larger hemorrhages; indeed they are wisely provided with such an excess, if we may so term it, in order that their growth may be promoted, and their several organs main- tained in a state of vigour: but in old, in which the body is gradually decaying, and the powers of life declining, the quantity of this fluid becomes reduced. Mr. Wilson, in bis Lectures on the Blood, Sec. says, that " Fat animals are found to possess less blood than leaner animals, and tame animals which are confined, less blood than wild ones." Some have formed speculations on the quantity con-
tained in the human body, from the losses occasionally sustained ; vague, however, must ever be such conjec- tures ; for it is found that blood to an enormous amount may be lost, in cases where hemorrhage, not copious or too long continued, returns at frequent intervals : thus in uterine and nasal hemorrhages in the human sub- ject, astonishing accounts have been published of the * Supposing a man to weigh 12 St. or 168 lbs. the quantity of
blood contained in his body may be rated at 21 lbs. or 2 galls. 2qrts. and 1 pint. Again, granting that a dog weighs 40 lbs. the amount of his blood will be five pints. These calculations are useful, and worth our retention, inasmuch as they serve to guide us in prac- tice, as to the probable extent to which we may, with safety, carry venesection in different animals. For instance, we may reckon the loss of a pint from a man to be equivalent to that of a gallon from a horse, or to four ounces from a dog, and vice versa; selecting in- dividuals from each class about the respective weights we have here ■<et down. |
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On the Blood. 9
total admeasurement of the collected daily discharges.
But in all these cases, we are to remark, that it is the gradual or occasional loss of it, and, consequently, the time given for its reproduction, (for new blood is made even while the old is escaping,) that enables these pa- tients to bear up against the debility ever attendant on such affections*. Animals, in fact, support losses of blood well or ill, according as the part, from which it comes, bleeds more or less freely, or as the hemorrhage endures for a longer or shorter space of time: on this principle it is, that a large orifice is in general to be preferred, in the detraction of blood for inflammatory disease, to a small one. There are some parts of an ani- mal that contain more blood than others : e.g. muscle possesses more than either bone or tendon, and is, conse- quently, redder; as color in the living body is, for the most part, dependant on blood. Parts much exert- ed are found to have more blood sent to them than others, which, though of similar structure, are less used : * " I have seen several quarts thrown up from the stomach in a few
hours, even by a very thin puny person : and, on the other hand, if we had not this proof, we should suppose that there could be but very little, when a few ounces will make a person faint. I have an idea however that people can bear to lose more by the stomach than by any. other way. Besides it becomes a matter of surprise how little is commonly Tound in the dead body: but I believe in disease it in some degree diminishes with the body, for more is to be found in those who die suddenly, or of acute diseases; and even in some who die of lingering diseases, as a dropsy, we have a con- siderable quantity of blood. The only way of accounting for this, Is, that in a common lingering illness there is less blood, and in a dropsy it coagulates less; for the strong coagulation squeezes out the serum which I imagine transudcs_after death, and is not ob- servable." Hunter on the Blood. 4 |
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On the Blood.
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10
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hence, the muscles of the legs of a fowl are red, but
those of the wing and breast nearly white. Blood, while circulating in its vessels, is always fluid;
were it not perfectly so, the transmission of it through numerous capillary tubes to different parts of the body, could not be effected. That blood is constantly kept in motion during life with-
in its vessels, is an opinion that has been handed down to us by the earliest physiologists ; but it was not until the timeof Harvey, that, what is now called, the circulation of the blood was discovered. Harvey demonstrated, that this fluid, which previously to his time was believed only to ebb and flow, was conveyed by one set of tubes to every part of the body, called arteries ; and by another, termed veins, returned to the heart, or source whence it came ; that, thence, it performed a second revolu- tion through the lungs, in order to be rendered fit for the various and important uses, it serves in its trans- mission over the body. So that, in truth, there may be said to be two circulations, the greater and the lesser : the former, meaning its course over the body in general ; the latter, that through the lungs. Two of the best, and at once demonstrative proofs of the circulation, are the simple experiments of putting ligatures around an artery and a vein : in the one case, that portion of the vessel will be full of blood which is next to the heart, while the opposite part will remain empty; in the other, the reverse of this will happen ; clearly demonstrating, that the blood is perpetually flowing in both sets of ves- sels, and, at the same time, shewing, that its current in each is in opposite directions. The blood, though fluid while circulating, possesses
a power of becoming solid—of converting itself into |
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On the Blood.
|
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II
|
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a glutinous mass, called a coagulum; by which property,
it is variously converted into materials for the growth, support, and repair, of every part of the body.— Bones, muscles, &c. are formed from it; the different organs of the body are kept in a continual state of tone by it; divided surfaces and fractured bones are glued to- gether and repaired by it; and lastly, all the secretions of the body, as urine, bile, saliva, &c. are furnished by it: moreover, by this power of coagulation, when extra- vasated from its vessels, are many dangerous bleedings ar- rested, which might otherwise prove destructive to life. To the indefatigable exertions of Mr. John Hdnter,
in the promotion of medical science, «re we indebted for those opinions which attribute to this fluid, while circu- lating in the living body, a vital principle. In his disser- tation on this subject, Mr. Hunter prepares the mind for the reception of so novel, and, at first view, so inconceiv- able a doctrine, by the following preliminary notice : " To conceive that blood is endowed with life, while cir- culating, is perhaps carrying the imagination as far as it can go ; but the difficulty arises merely from its being a fluid, the mind not being accustomed to the idea of a living fluid." And, at another place : " Our ideas of life have been so much connected with organic bodies, and principally those endowed with visible action, that it re- quires a new bend to the mind, to make it conceive that these circumstances are not inseparable. It is within these fifty years only, that the callus of bones has been allowed to be alive ; but I shall endeavour to show, that organization and life do not depend in the least on each other ; that organization may arise out of living parts and produce action, but that life can never rise out of, or de- pend on, organization." Mr. Hunteu then proceeds to |
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On the Blood.
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w
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show, that the principle of life may and does exist in ani-
mal substances devoid of apparent organization and mo- tion, in proof of which he instances the egg, as a fami- liar and striking illustration; which, he says, so long as it retains this principle, resists the influence of external agents—such as heat and cold, much longer than dead animal mat er. To support this fact, he made the follow- ing experiment: he put a new laid egg into 0 of Faren- heit's thermometer, and froze it—with a view of destroyr ing its preserving powers, and then allowed it to thaw. Next he put this egg, and another newly laid, into a cold mixture: the former was frozen seven minutes and a half before the latter. From this, and from other similar ex- periments, the author comes to this conclusion: "Thata fresh egg has the power of resisting heat, cold, and pu- trefaction, in a degree equal to many of the more imperr feet animals, which exhibit nearly the same phenomena under the same experiments; and it is more than proba- ble that this power arises from the same principle in both," In the next place, Mr. Hunter demonstrates, by
some ingenious experiments, not widely different from those just mentioned, an analogy between the coagula- tion of the blood and the contraction of muscle detached from the body. He reconciles the repugnant idea of life in a fluid al-
ways in motion, and often separated into many portions, by sajing, that all its parts are similar, and in perfect harmony with each other. ** Because blood is alive," con- tinues he, " it has the power of preserving its fluidity; were it not so, it would be, in respect to the body, as an extraneous substance. Blood is not only alive in itself, but is the support of life in every part of the body ; for |
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On the Blood.
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13
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mortification immediately follows, when the circulation
is cut off from any part." " Moreover," he says, " blood itself must be kept
alive ; because, while it is supporting the life of the so- lids, it is either losing its own, or is rendered incapa- ble of supporting that of the body. To accomplish all this, it must have motion, and that in a circle, as it is a continuance of the same blood which circulates, in which circle it is in one view supersaturated, as it were, with living powers, and in another is deficient, having parted with them while it visited the different parts of the body." Mr. Hunter also shows a striking coincidence be-
tween the coagulation of the blood and the contraction of the muscles, a phenomenon we know to depend on life, and one that he considers as the strongest proof of the existence of the vital principle. Animals killed by lightning, or by electricity, have
not their blood coagulated, nor their muscles contracted. Those that are hunted to death, exhibit the same appear- ances. In persons who die suddenly—as from blows on the stomach, or sudden gusts of passion, this strict ob- server remarked the same coincidence. " The natural deduction from all these facts and observations," says he, " I think is perfectly easy; it is impossible to miss it." Presuming from these data, that the blood, in common
with the solid parts, is possessed of what he calls the materia vita diffusa, Mr. Hunter now enters into an in- quiry of some length and ambiguity, through which we have neither time nor inclination to follow him, relative to the nature and disposal of this materia vita; in the course of which he says, adverting to where the living principle of the blood first begins, " I am rather inclined |
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On the Blood.
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14
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to think that the chyle itself is alive ; for we find it co-
agulates when extravasated; it has the same powers of separation with the blood; and it acquires its power of action in the lungs, as the venai blood does." This is a short but imperfect sketch of Mr. Hunter's
opinions concerning the life of the blood : to say the least of them, they are extremely ingenious, and are the pro- ducts of much cautious and laborious investigation, and, we must admit, as the offspring of so great a mind, well deserve our serious consideration. |
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LECTURE II.
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On the Blood.
Having treated of this fluid, in our last lecture, as
circulating in the body; we shall, in this, examine its properties when taken out. When blood is first received into a vessel, a halitus,
or vapor, emitted from its surface, is observable : a mir- ror held over the basin becomes obscured by it, and a peculiar odor accompanies its fumes, which is said to be more unpleasant in carnivorous than in graminivorous animals. We observed, in the last lecture, that blood, although
apparently, was not in reality, an homogeneous fluid ; for when drawn and allowed to remain at rest, it separates into two parts : a red solid portion, called crassamentum ; and a yellowish fluid part, called serum. This spontaneous separation of its component parts,
is called its coagulation : it takes place, in the blood of the horse, in the space of about twenty-five minutes; in that of the human subject, in seven or eight. These two parts differ in their relative quantities in
different animals, and in the same animal at different times, depending on the state of the general health of the |
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On the Serum.
|
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16
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subject from which the blood is taken : in some dis-
eases, and in weak subjects, the proportion of serum is considerably augmented. Richerand, in his Elements of Phi/siologij, says, that " in the human subject, the serum constitutes about one-half, or three-fourths of the fluid; the coloring matter and fibrina are in inverse ratio of the serum; and it is observed, that the more brilliant and red the color of the blood, the greater the proportion of the fibrous parts." In the healthy horse, the serum may be computed at about one-half of the whole quantity of the blood taken away. On the Serum.
Serum is a fluid of a deep yellow, or straw color, hav-
ing the appearance of being about the consistence of wa- ter; it is heavier, however, than that fluid, though the thinnest part of the blood, in consequence of its possess- ing soryie degree of tenacity. Though the serum be naturally of a deep yellow, its
color is subject to some variation in disease. In the hu- man subject, this has been frequently taken notice of in jaundiced persons, in whom it acquires a brown tinge from the admixture of bile; and in the horse, in which jaundice is comparatively an uncommon disease, we have remarked the same appearance. It has been asserted, that the proportion of serum, in
a given quantity of blood, constitutes one of the most material differences between the composition of this fluid in the horse and of that in the human subject: in the one, soon after it has been drawn, we discover the coagulum swimming in serum ; while the other consists of one uni- form congealed mass, whose surface is scarcely moistened by serous exudation. In order to form a correct esti- |
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On the Serum. 17
|
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mate, however, of the proportion of serum in a given
quantity of blood, it will be necessary to keep the mass for several days, and this we can commonly do without its becoming putrid; whereas the blood of the human subject will putrefy in the course of two days after it has been drawn, even at the temperature of 50": a want of such precaution has created much erroneous statement on this subject. If we draw a pint of blood from a horse in apparent
health, serum in the following quantities, at the intervals stated, will be separated. During the first five or six hours, very sparing exudation takes place; but soon after- wards, the coagulum becomes surrouuded by it; so that next day, twenty-four hours from its detraction, we may commonly pour off from five to six ounces. After this, its proportion daily becomes less: from one to two ounces are found in the vessel on the second day, from half an ounce to an ounce on the third, from three to five drachms on the fourth, about one drachm on the fifth, and a like quantity on the sixth; and on the seventh day generally, at the temperature of 50°, the mass is putrid. Now, if we sum up the media of these several quantities, we shall find that the serum amounts to rather more than half of the whole quantity of blood drawn; we may fairly take, however, half* as the average. It appears therefore, that the most essential differences
between our blood and that of the horse, are—first, that the latter possesses greater preservative powers against putrescency than the former, when extracted from the body ; and secondly, that the spontaneous separation of * " Le serum est un liquide aqueux, transparent, roussMre, et d'une
saveur salee, et dont la proportion la plus ordinaire est d'un tiers d la mmtii." Trait'c d'Anatomie Veterinaire, par Gikaiid- c
|
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On the Red Globules.
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18
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it, into its elementary or component parts, requires a
longer space of time : it is not true, that there actually exists any very marked difference between them in re- gard to the relative proportion of serum. If serum be exposed to 1.60° of Farenheit's thermome-
ter, it will be converted into a solid tremulous mass, the effect of coagulation; in which state, a little fluid oozes out from its sides, termed the serocity: the admixture of boiling water, of some of the mineral acids, or of alcohol, also coagulates it. The coagulum of serum is simi- lar in its properties to common white of egg, or, what is called, albumen: its serocity has been found by Dr. Bostock, (in his Analysis of Human Blood,) to consist of common mucus in conjunction with soda and some neutral salts. Serum, or a fluid very like it, is occasionally se-
parated from the blood in large quantities within the dif- ferent cavities of the body, constituting that disease known by the name of dropsy. Serum is supposed to be the menstruum, or solvent of all the secretions. The crassamentum, or cruor, is composed of two parts:
—the red globules and the coagulable lymph: to the for- mer the blood owes its color ; to the latter, its solidity and firmness. On the Red Globules.
The red globules, or red particles, as they have been
also called, constitute the coloring ingredient of the blood : they are commonly entangled in the coagulable lymph during its coagulation, though occasionally some arc mingled with the serum, tingeing it red. They form, pro- bably, the least important part of the blood; for in some animals, many organs of the body are supplied with this |
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On the Red Globules: 19
fluid without globules : e.g. in most fish the muscles have
no red blood, aud in the common domestic fowl we know that the muscles of the wings and breast are commonly white. In the human subject, and in the horse, there are also some parts that are supplied only with thin color- less blood, the best example of which is (as we mention- ed in the former lecture) the more transparent parts of the eye, where the blood-vessels are too minute, in a state of health, to admit of the passage of red globules; though, under certain morbid affections, they become augmented in size, and then readily allow of the circulation of the coloring particles : hence these parts, which were be- fore colorless and transparent, are now obscured and filled with red blood. In some animals this fluid is al- together without the red globules: none has been found in the blood of insects. It is to microscopical observations that we owe what
speculations have been offered in regard to the size and shape of these minute bodies; we say speculations, for, as yet, authors have not come to any determinate conclu- sions on this subject. From the extreme diversity of opinion of those who have endeavoured to ascertain the dimensions of a globule of human blood—one estimating it at ^5^TO Part °f a gram °f sand, while another computes it at 3-(/TO part of an inch, it is evident that much illusion has ever attended these inquiries. It appears neverthe- less well authenticated, that their size is not at all in proportion to the bulk of the animal; for their dimensions vary but little either in the ox, ass, cat, or mouse*; and in the skate it is generally believed that they are larger than in any other animal. No less discrepant have been the descriptions of au-
* Vide Wilson's Lectures on the Bbod, &c.
c 9, |
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On the Red Globules
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20
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thors as to their shape : some have compared them to
rings, others to flattened vesicles, &c. the opinion best received at the present day, is, that they are spherical; but, from being possessed of flexibility, occasionally un- dergo some alteration in form, during their progress through the smaller blood-vessels of the body. Though red when viewed in the general mass of
blood, the globules seen in small clusters, or individually, are yellow, or transparent. In order to explain the cause of these different shades, nothing more is requisite than to detach a drop, or two, of port wine within a glass ca- pillary tube, or of any other dark colored fluid, and it will be found, if held to the light, to be perfectly limpid and colorless ; or, if there be more than one, of a light- er and altogether different shade from that of the fluid from which they were taken : it is from this cause, then, that the blood, when distributed in the minute blood-ves- sels, is of a different hue from that in the trunks. The color of the globules is affected by atmospheric air: if you examine a clot of blood in a blood-basin, you find its upper surface, which has been exposed to the air, of a bright scarlet, hue, while the under, or that which has lain in contact with the basin, is of a dark Modena red, or purple ; but invert the coagulum, and the one will be- come dark by exclusion from the air, while that which was before purple, will acquire a scarlet hue from its influ- ence. In order to prove that this change is effected by the air, if you place dark colored, or venous blood in vacuo, its color will remain unaltered. To the same cause is ascribable that change of color which this fluid receives in the the lungs of the living animal. The red globules appear to be the most difficultly
formed of any part of the blood; so that a person who |
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On the Coagulable Lymph. 21
lias lost much blood from hemorrhage, looks pale for
some considerable time afterwards ; hence it is also, that butchers render their veal white, and delicate in appear- ance, by repeatedly bleeding calves while they are fat- tening. The quantity of these particles varies in different ani-
mals, and in different parts of the same animal. Those appear to have most that are in the best health, and per- form the utmost labor compatible with their strength; but in all, they abound in the different glands of the body, are more numerous in muscles than in sinews, or bones, and especially in those most exerted, which are consequently the reddest. We have before observed, that the globules do not
appear to be equally essential with the other constituents of the blood : their precise use is not known. On the Coagulable Lymph.
The coagulable lymph, sometimes described under
the names of jibrine, or Jibrma, and gluten, is that part to which the crassamentum owes its chief bulk, solidity, and firmness ; and is of greater importance in the ani- mal economy than either of the others. During the cir- culation of the blood it is perfectly fluid, and is so inter- mixed with the serum and red globules, that we have no means of separating it. When freed from the red globules and serum, by wash-
ing, maceration, &c. it is nearly white, or colorless. The coagulable lymph is a firm, tough, and elastic sub-
stance, of greater specific gravity than serum, exhibiting a fibrous texture very analogous to that of muscular ""re, hence its name of jibrine, orfibrina. its toughness, which is often extreme, is not apparent
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22 On the Coagulable Lymph.
till some time after its coagulation; for we have found,
that a coagulum will contract, or become smaller by squeezing out ^erum, even for a week, or more, after the blood has been drawn. We have before stated, that the blood soon coagulates
of its own accord, when taken from the body ; we shall now briefly point out how its coagulation is affected by various external agenls. It will coagulate sooner when drawn from a small orifice, or allowed to trickle down the neck, or if it be collected in a vessel with a broad ex- tended surface, or in one of a triangular form ; but if it be drawn from a large orifice, in a free stream, or be col- lected in a deep narrow vessel, its coagulation will be retarded. Heat, above ]25° of Farenheit, acids, alcohol, and alum suddenly coagulate it; and it will concrete sooner in the natural heat of the body than in any degree below it. Neutral salts altogether prevent its coagulation. Keeping the blood in motion, during its detraction, does not delay its coagulation; and if it be kept stirred, while fluid, with a wisp, the coagulum will assume a distinct fibrous appearance. Blood that has been frozen will not congeal. When the coagulation of the blood is from any cause
retarded, the red particles, being the heaviest part, gravi- tate to the bottom of the blood-basin; and, instead of being entangled uniformly in the substance of the coagu- lum, collect chiefly in its lower part; leaving the sur- face, and a portion below it, entirely without them, which, from the serum it contains, exhibits a yellow ap- pearance : to this part the name of buff, or size, has been given. This state of the coagulum may frequently be prognosticated, by touching the surface of the blood, a few seconds after it has been drawn, with the finger: if no |
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On the Coagulable JLymph. 23
red particles adhere to it, but it be moist with a yellow-
ish and perfectly limpid fluid, you may safely predict that the coagulum will be buffy. Blood coagulates in the body after death; though not
always; for in cases of sudden death, as in horses that die suddenly from hunting, or racing, or in hares that have been coursed to death, it remains fluid. The constituents of the coagulable lymph, are fibrine
or gluten, and albumen. Various attempts have been made to discover the cause
of the spontaneous coagulation of the blood : the fol- lowing are those that have been commonly assigned for it. Cold, from the change of temperature which the blood undergoes when drawn, was said to be one; if, however, it be received in the same degree of heat, to which it was exposed while circulating in the body, its concretion (far from being prevented, or even retard- ed) will be accelerated. Rest was said to be the cause of it; but, as we have before stated, it will coagulate though it be constantly stirred, or otherwise kept in mo- tion. Exposure to the air has been thought to account for it; and, certainly, the process appears to be in some measure assisted by it, although it is by no means the principal agent; for blood will congeal even in vacuo, though it requires a longer space of time. We concluded our former lecture with some remarks
in illustration of the doctrine of Mr. John Huntek, in regard to the principle of life being inherent in the blood : to this cause the same eminent physiologist at- tributed the coagulation of it. We then briefly stated, that, among other ingenious illustrations, this author re- marked the close analogy existing between the coagula- tion of the blood and the contractions of muscles ; which |
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24 On the Diseases of the Blood.
latter phenomenon is universally admitted to depend on
life ; having, however, already agitated this question, it will not be necessary to enter upon it again here. The coagulable lymph appears to be the most useful
part of the blood, if we may so express ourselves: it is one that is common to the blood of all animals. All the solids are formed from it:—their continual growth in the young animal, and reproduction in the adult, are effected by it. By its property of coagulation, wounds, or divided surfaces, are united ; the fractured extremities of bones are glued together; and the mouths of bleeding vessels plugged up, and hemorrhage put a stop to : but it would be impossible to enumerate all the various and important uses of this substance. On the Diseases of the Blood.
All diseases were formerly supposed to originate in a
morbid condition of the fluids of the body j from which notion, such incorrect ideas were formed of their nature, as Jed to a mode of practice, either indirectly injurious from its inertness, or want of efficacy, or positively per- nicious from its co-operation with the morbific agents themselves. The ancients supposed, that there was some peccant, or offending matter floating in the fluids, or, as they called them, humors of the body; and that nature, requiring the expulsion of this imaginary acrimonious matter, instituted a diseased action in the system for that purpose; which was occasionally to be promoted, but never suppressed, by the practitioner. To this doctrine, which is called the humoral pathology, the veterinary art has long been subservient; and, though it has been of late years in a great measure rid of such obscure tenets, still are the humors afloat among our crafty vulcanians |
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On the Diseases of the Blood. 25
of modern times, whose practice as often tends to exas-
perate, as to relieve, the sufferings of their unfortunate patients; however well adapted it may be, to impose on the credulity of their unsuspecting employers. The explosion of the humoral pathology has been fol-
lowed by a doctrine—that, although the blood in disease exhibited morbid signs, it was never diseased in itself; or, in other words, that it did not contain any morbific in- gredient. The principal arguments advanced in support of this opinion, are two : viz. first, that if it were diseased, as it flows to every part, the niorbid matter it contains, ought to create general, and not local irritation ; aud se- condly, that, if it were so in contagious diseases, we ought by means of inoculation with it, to produce the same ef- fects as arise from the introduction of the contagious mat- ter itself. In attacking the first of these positions, we would ask, if there be any disease which invades alike all parts of the body?—and why, on the contrary, so many seem to have a predilection for particular parts ? In the human subject, for instance, small pox and measles confine them- selves to the skin ; scrofula affects the absorbent system ; and the venereal disease, either the organs of generation, the throat, the skin, or the bones. Again, in the horse, far- cy is an affection of the superficial, not of the deep-seated absorbents; and glanders, one confined to the membranes, &c. of the nose ; and yet all these are, with the exception of scrofula, contagious diseases, in most of which, if not in all, probably, the circulating mass is contaminated. The second of these arguments admits of a more ready reply. -No one ever imagined that the morbific matter contained ln the blood, existed in so concentrated a form, as to pro- duce its effects by inoculation with a single drop of that fluid; no more than that the venereal virus, diluted |
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26 On the Diseases of the Blood.
with fifty or a hundred times its weight of healthy pus,
would convey the disease by inoculation with a fiftieth or hundredth part of such a mixture. In further illustration of this, we can, and do medically, not only without any baneful effect, but with manifest advantage, take minute quantities of substances of so poisonous a nature, that the old practitioners were altogether deterred from the use of them. This subject, however, has of late been put with- out the pale of disputation by actual experiment. Some years ago, at the Veterinary College, the blood of a horse affected with glanders (which is a contagious dis- ease, and one at all times readily communicable by in- oculation) was transfused into the veins of a healthy ass, previously prepared by copious blood-letting : in the usual space of time, the animal exhibited every symptom characteristic of glanders, of which it shortly died. Con- sidering the antiquity of the practice of transfusing blood, from the vessels of one animal into those of another, it is somewhat remarkable, that this fact has never been before demonstrated by experiment; for it is now nearly two centuries ago, since this operation was first attempted on dogs, and subsequently on men, with expectations of the most glittering description : like those who were so soli- citous about transplantation of teeth, however, the indivi- duals on whom it was practised, were occasionally seized with diseases of a malignant and dangerous tendency. The blood not unfrequently, in the human subject, exhibits, what are considered as, morbid appearances : whether this be the effect of what Mr. Hunter calls "contiguous sympathy—a real increase of animal life"— or, whether it arise from some variation in the relative proportions of its constituent parts, or be produced by some morbific matter contained iu it, we are not about to |
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On the Diseases of the Blood. 27
inquire. All we wish to impress here is, that, what is re-
garded as indicative of increased, if not diseased action in the vascular system of the human subject, is perfectly na- tural to that of the horse, in his domesticated state: if, therefore, you examine the blood of a horse in apparent good health, you expect to find it sizy. It has been, with great truth, remarked, by some of our best practi- tioners in human medicine, that an inflammatory diathesis is by no means essential to the production of buffy blood : an opinion confirmed by the appearances of horses' blood in health. We do not believe that this fact is universally known—we have searched the works of veterinary authors on the subject, with but little ad- vantage ; for they have either transcribed their accounts, which are for the most part erroneous, one from another, or borrowed them from human anatomy. Blood is said to be cupped, when the upper surface of
the coagulum, instead of being perfectly even, is concave, as if it had been scooped out, and the surrounding margin is elevated, and more or less inverted. This appearance in human blood, is commonly regarded as a mark of in- flammatory action, and one that, in combination with cer- tain febrile symptoms, imperiously calls for a repetition of blood-letting. But in that of the horse, it has been asserted, nothing of the kind ever takes place. In order to show, that, so far from this opinion being a correct one, cupped blood is by no means unfrequently met with in veterinary practice, and that it is occasionally seen in health*, (as often we believe as in disease,) as well as to * We had a remarkable instance of this, while engaged in some
experiments connected with this subject. A horse, to every ap- pearance in perfect health, was bled to one pound ; after which he was galloped (for the space of about twenty minutes) until he |
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On the Diseases of the Blood.
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28
|
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point out the space of time in which healthy blood co-
agulates, and the average proportion of serum contained in it, we have subjoined the following statement:— sweated profusely: while under extreme agitation, from the ex-
ertions he had been put to, another pint of blood was drawn, by unpinning the same orifice. The coagulum of the first par- cel of blood was sizy, tough, contracted, and deeply cupped: that of the last exhibited no signs whatever of buff, was extremely loose and flabby in its texture, so that on being handled it readily mingled with the serum ; and in a much shorter time than the first, went into the putrefactive state. This latter fact is intimately connected with what we have al-
ready advanced, regarding the non-coagulation of the blood after an animal has been coursed to death; since, had exertion been continued until the horse sunk under it, the blood would probably have remained wholly fluid; whereas, in this case, the animal be- ing only in progress towards that state—being only urged to a point from which he could recover, the coagulating powers of the, blood were merely diminished. |
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STATEMENT.
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30
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On Venesection.
One of the most powerful and efficacious means we
possess of subduing disease, is venesection, phlebotomy, or blood-letting. There is no remedy quicker in its ope- ration, nor any more beneficial in its influence, when pro- perly employed; at the same time, there are few more pernicious than it in the hands of rash and unscientific practitioners. We have two objects in view in taking away blood:
first, that of diminishing the momentum of the circula- tion ; and secondly, that of allaying the irritability of the nervous system. Though we can at all times fulfil the former indication, we do not so certainly effect the latter, by lessening the quantity of blood in the system ; for in some cases, the frequency of the pulse, which is depend- ■ ant on nervous irritability, will remain undiminished af- ter the removal of as much blood as the powers of the constitution can withstand. After having drawn blood for any inflammatory affec-
tion, there are certain signs, which may be pretty gene- rally relied on, that indicate the necessity of a repetition of the operation ; among the chief of which are, the un- abated hardness, and strength, combined with frequency of the pulse and the continuance of pain, or the symp- toms of it, in the part affected : the sizy or cupped state of the blood, combined with inordinate toughness of the coagulum, and a sparing exudation of serum, are also commonly believed to confirm this indication ; from what we have advanced, however, in regard to these occur- rences, it may fairly be questioned how far they are signs of disordered action. In drawing blood it is advisable—nay, sometimes indis-
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On Venesection.
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31
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pensable, if we wish to give speedy relief, to make a large
orifice in the vein, or artery, we may select for the pur- pose : by attending to this, we shall not only often ar- rest disease on a sudden, but absolutely prevent subse- quent weakness, by having occasion to take less away, in the aggregate, during its progress. Dr. Pember- Ton, in his very useful Practical Treatise on Various Diseases of the Abdominal Viscera of the Human Sub- ject, observes, in speaking of acute hepatitis,—" I find from numerous experiments made at my desire for this purpose by different surgeons, that when the orifice is such as to admit of eight ounces of blood to flow in three minutes, that then a patient under acute inflamma- tion will receive every benefit which is expected from the remedy. If it flows in a longer time he will receive less benefit, and under certain circumstances no benefit at all, or even absolute injury." |
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LECTURE III.
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On the Arteries.
Of blood-vessels there are two orders:—arteries and
veins; we shall make the first the subject of the present lecture. The arteries are elastic tubes, formed for the purpose
of conveying blood from the heart to every part of the body. These vessels were formerly supposed to con- tain and distribute air over the animal system, hence the name of artery ; an opinion that appears to have origin- ated from the circumstance of their being found empty after death. There pre only two arterial trunks, from which all the
branches of the body spring : these arise from the heart, and have received the names of aorta, and pulmonary artery : the first, by means of innumerable ramifica- tions, transmits blood over the body generally; the last only conveys it to the lungs. Arteries have been divided into sanguineous, and
lymphatic or serif"erous: those in which red blood ordi- narily circulates, compose the first class ; their minute ramifications, which are too small to admit the red glo- bules, the second. |
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On the Arteries. 33
The ventricles of the heart are the sources from which
all the arteries in the body have their origin, by means of the two trunks before mentioned. Generally speaking, these tubes take the nearest course
to the organs they are destined to supply. They are commmonly deeply seated, and run on the inner sides of the limbs rather than the outer, for the purpose of be- ing better protected from external injury : in passing over a joint, they are most commonly found upon its bending side, by which precaution any preternatural extension of them in the motion of the part, and consequent obstruc- tion to the circulation, are guarded against; and for the same reason, those of the lips, ears, and nostrils, take a serpentine course. There are some arteries whose ca- nals are extremely tortuous, in which it is thought the cir- culation is, by that means, retarded : in this number may be reckoned those of the brain, testicle, and uterus; there are probably other reasons, however, for such a pecu- liarity of course in the blood-vessels of these parts, with which we are not at present acquainted. The ramifications of the arteries may be compared to
the branches of trees, of which the aorta and pulmonary artery form the trunks; their various subdivisions, the branches. For the vessels into which they divide, like the trunks themselves, send off others of less diameter ; and these again, in their turn, become trunks to more mi- nute ramifications ; until, by repeated subdivision, tubes °f infinite number and extreme exility, are distributed over every part of the body. We find that arteries send off their branches in a some-
what different manner, according to their proximity 0 the heart, or source whence they receive their blood : •£• some, in the immediate vicinity of that organ, are D
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34 On the Arteries.
coming off at obtuse angles—as is the case with the pos-
terior cervical arteries; though most of them are leaving their trunks at right angles—of which the intercostals are ready examples; such, however, as are farther removed from the heart, arise at acute angles, as is abundantly ex- emplified in those of the extremities. The same hy- draulic laws, which regulate the motion of fluids through tubes similarly arranged out of the body, must be ad- verted to here, in order to explain the advantages derived from this mode of ramification in arteries. If we were to impel water into a tube of any kind, with which many others communicated at different angles, we should find that the fluid ran with more facility into such as took the same course with the trunk, than into others whose junction formed a right angle with it; but found its passage with difficulty into those branches running in an opposite direction from it. Thus it is with the arte- rial system, through which the blood is propelled by the heart to every part of the body: in order to equal- ize the force of the circulation within the different rami- fications, we find that those branches nearest to the heart, or pump, resist its too powerful action by being connected with the main trunk at obtuse angles ; while those re- motely situated from it, favor the influx of blood, and thus, in some measure, compensate for the diminution of propulsive power, rendered weak in them by their dis- tance from the heart. Notwithstanding this admirable contrivance, however, to abate the force of the circulation in those vessels connected with the larger trunks, it does not appear that the design is wholly fulfilled; for sur- geons in operating, on the human subject, on parts which receive their vessels immediately from the large arteries, are always particularly careful to arrest he- |
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On the Arteries. 35
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morrhage; on which account, they often tie branches in
the neck, which they would altogether disregard in the extremities. When the trunk of an artery splits into two, or, as we
anatomically express it, bifurcates, the conjoined area of its divisions is greater than that of the trunk itself; from which fact, anatomists, of late, have compared their cavities, taken in the aggregate, in form to a cone—re- garding the capillaries as the base, and the aorta as the apex of it: but if we take any branch singly, we shall perceive that its form is also conical; in this case, how- ever, the position of the cone is reversed—the origin of the vessel being the basis, its termination the apex. The smallest arterial ramifications, which, from their
extreme minuteness, have been termed capillaries, are so numerous that you can scarcely insert a pin into any part of the body without wounding one or more of them. Some structures possess a much more abundant supply of blood than others ; of course their blood-vessels must be proportionately more numerous ; hence, they are said to be more vascular: glands, which are secreting organs, are of this class ; muscles also possess considerable vas- cularity, in comparison with sinews, or cartilage. Arteries are said to have five modes of termination.
The first, and most common, is in veins. An artery having become of so small size as to acquirethe name of capillary, is reflected, and ends by continuity of canal in a vein, the commencement of which is equally minute; so that the distinction between the two at the point of union Is lost. Common injections furnish us with abundance of Proofs of this mode of ending:: every one knows, who Has been in the habit of injecting feet, that it is no un- common circumstance for the waxen composition, D 2
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\
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36 On the Arteries:
which is thrown into the pastern arteries, to re-
turn by the pastern veins; the same thing frequently happens in the testicle and head—indeed, in the course of dissection, we meet with numerous instances of it. The second termination is that by ajiastomosis: when
minute arterial branches meet and conjoin their canals, they are said to inosculate, or anastomose. The coats of the intestines well injected, present a surface of beautiful vascular network, in consequence of the very frequent in- osculation of their smaller arterial branches: anastomosis, however, is not wholly confined to the terminations of ar- teries, for we have, in the foot, several communicating arterial canals of large size. The great advantage de- rivable from anastomosis, is, that of preventing the possi- bility of the supply of blood being cut off from any part, in case of obstruction in the trunks going to it; for, it is evident, that the larger arteries, although they do not immediately communicate, must, under such circum- stances, still receive blood, by a retrogade circulation, from the inosculating ramifications. Pressure being one of the most frequent causes of obstruction, we discover at once, why the arteries of the foot should have been so liberally provided with anastomosing branches. Notwithstanding the inosculation of arteries must have
been known soon after the discovery of the art of injecting, it is not till of late years that surgeons have found out its importance as connected with operative surgery : the old practitioners were afraid of obstructing the cavity of one of these vessels, (by ligature,) lest mortification of the part, which it supplied with blood, might ensiie; now a- days, however, no such apprehensions are entertained in regard to, we may say, any part of the body. We have tied the posterior aorta of the dog, and many of the |
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On the A rteries. 37
larger trunks in the horse and ass, without the least ap-
parent inconvenience being sustained by those animals. In one of the anatomical schools at Paris, a human sub- ject was brought for dissection, in which the descending aorta was obliterated, but the circulation had been suffi- ciently well carried on by anastomosing branches ; and Sir A.Cooper has lately published the case of a man who had an aneurism of the iliac artery, in whom he tied this vessel a little above its bifurcation : a memorable in- stance of the vast importance now attached to arterial anastomosis. The third termination of arteries is in open mouths—
upon, generally, extended surfaces. The smallest visible branches of arteries are found to be extremely short; and though we cannot trace them to their ultimate extremi- ties, yet are we warranted in asserting, that they end in this way, from many facts and observations connected with the economy of the animal in health and disease. These extreme ramifications have been denominated exhalents, from the particular office they perform, viz. that of pouring forth the finer parts of the blood in the form of vapor : what is called the insensible perspir- ation, from the skin, is a secretion of this kind ; as are all those serous fluids, emitted upon the membranous sur- faces of the larger cavities of the body—the abdomen, thorax, &c. The numerous ramifications employed in the formation and repair of different parts of the body, are also probably of this description; and we believe, that the materials of which an animal is composed, are 8pewed forth from their minute orifices. rhe fourth termination is in small cavities, called cells,
°' which some parts appear to be wholly made up : the spleen and penis are commonly believed to be of this |
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On the Arteries.
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J 8
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kind—in these organs the blood is poured into cells,
from which veins arise that take it up again. The fifth and last termination is in the beginning of a
tube, called an excretory duct: these branches are deno- minated the secreting, or secerning arteries, in conse- quence of their having the power of separating some- thing from the blood of a total different nature from that fluid itself; which secretion is conveyed by the excretory duct from the gland, as fast as it is formed within it by these vessels. The secerning tubes are so minute, that they can seldom be traced, even if injected, with much accuracy. In the liver, from their extreme exility and pe- culiarity of distribution, they have been called penicilli: probably they may be demonstrated better in the kid- ney than in any other gland; in the substance of which we can frequently trace them into small excretory vessels, called the tubuli uriniferi. Most arteries are enveloped in a case of cellular mem-
brane, by which they are connected to the surrounding parts; and in some places this substance is so condensed as to give them a complete covering, commonly called a sheath—as happens with the carotid arteries; it is, however, only an adventitious tegument, and is not to be regarded as one of its proper coverings. An artery is composed of three tunics, or coats, con-
nected together by cellular membrane, all of which possess a certain degree of elasticity : the external or elastic, the muscular, and the internal, membranous, or cu- ticular coat. It is in the external covering of an artery that the pro-
perty of elasticity essentially resides, hence is derived the appellation of elastic coat ; a property, which it not only possesses in the living, but preserves in the dead animal. |
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On the Arteries. 39
This covering is peculiar to arteries ; so that any one
at all conversant in anatomy, easily recognizes a vessel of this class, not only from its peculiar whiteness, but from the tubular form it preserves, even after its removal from the body. This coat is said to be made up of con- densed cellular membrane, disposed in fibres which are seen running in every direction. It is much more abundant in the trunks than in the branches ; hence arises the greater difficulty of distinguishing the latter from veins, they being comparatively loose and flaccid: in the aorta it seems to be more than equal in substance to both the other coats. Being elastic in the longitudinal, as well as lateral direction, an artery may be stretched either by elongation, or expansion, and it will still re- cover its original form and dimensions : in fact, the action of this coat may be said to be, that of tending to preserve the natural shape and size of the vessel. If an artery, in the living body, be divided, the first gush of blood will be immediately followed by the retraction of its cut extremi- ties; and this recession of them into the surrounding cellular niembrane often renders it exceedingly difficult to find them : this, aided by other means which we shall here- after point out, becomes Nature's chief resource in the event of hemorrhage. Aware of this circumstance, sur- geons, when called to a case of wound from which there is dangerous bleeding, always make it their primary en- quiry, to ascertain whether the bleeding vessel be com- pletely divided, or not: in the latter case, it is generally proper to cut the undivided portion, so as_ to give the ex- tremities of the bleeding artery the power of retracting, ar»d afterwards to employ pressure, before ligature of it be "ad recourse to. We have succeeded in stopping alarm- |
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40 On the Arteries.
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ing hemorrhages from the internal pectoral, and sub-
maxillary arteries of the horse in this way. The second coat, placed immediately under the elastic,
is called the muscular. In its composition it is fibrous ; and its fibres are believed to be of the same nature, (for they appear to possess similar properties,) to those of the muscles themselves. They are best seen in the coats of the smaller arteries, which are thicker, in proportion to their calibre, than those of the large: these afford, many of them, pretty distinct traces of fibres, taking a circular course, and putting on the appearance of muscularity. That they are of this nature, is a fact Mr. Hunter first attempted to establish by the test of experiment: having bled a horse to death, he found, that the area of these vessels was considerably diminished—the aorta had lost about l-20th of its original breadth, while the radial artery was contracted to 1-half of its former dia- meter. The result of this experiment is perfectly con- sonant with what we have here advanced, and seems to confirm our observations from dissection, relative to the proportions of the elastic and muscular coats in the trunks and branches. Notwithstanding these facts, how- ever, the existence of a muscular coat has been by some denied ; who have maintained, that in the substance of an artery, which is entirely white, any thing like muscular fibre is indemonstrable : but we know that color is not essential to muscles, and that those that have it (for there are many colorless ones) obtain it only from the blood within them. We have, however, many proofs that ar- teries possess a power, which, from its effects, can be no other than muscular: among others, maybe mentioned the fact, of their action being occasionally increased, |
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On the Arteries. 41
Without any acceleration, or alteration, of the pulsations
of the heart: e.g. if a portion of the skin be inflamed, or if a stimulant be applied to it, we know that a blush will quickly appear upon the surface, owing to an unusual de- termination of blood to that part. Now, it is evident, that the action of the impelling powers must be aug- mented in order to produce this unnatural flow of blood to the part; and yet, if we examine the pulse, we are unable to detect any change in the general circulation ; consequently, it must be local—one confined to the ves- sels of the part itself; which would appear to be the re- sult of a kind of voluntary, or muscular power : by such reasoning alone, can we explain the act of blushing in the human subject. We stated before, that these vessels are found empty after death : this affords us an additional ar- gument in favor of their muscularity, otherwise they could not discharge their blood into the veins. There appears still to be some doubt among physiologists, whether the muscular coat be employed, or not, in the ordinary cir- culation. The third coat, or lining of the artery, is the membran-
ous, or, as it is sometimes improperly termed, the cuticu- lar. It is thin, but very dense; possesses much strength, but less elasticity than either of the others : that it is elastic, however, is proved from the circumstance of its never being thrown into folds during the contracted state of the vessel. Its internal surface is uniform, smooth, and polished, to allow of the free circulation of the blood ; while, from its density, it prevents exudation—an accident that never occurs in the living animal. The coats of these vessels are possessed of vascularity ;
or» m other words, have arteries, veins, and, it is thought, absorbents, entering into their composition. Their arte- |
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42 On the Arteries.
nes, which are very small, are called arteria arteria-
rum; their veins, vena venarum: the former arise from the neighbouring arteries—never from that which they supply. Absorbents, we believe, have never been seen entering their coats ; though Mr. Cruick- shanks, in bis Anatomy of the Human Absorbents, says, that he has seen the aorta, almost throughout its whole length, covered with them. Arteries possess but little feeling. Many of the larger
trunks indeed are surrounded with nervous filaments, and some, doubtlessly, penetrate their coats—of which the aorta and carotid arteries are instances: it appears, however, that the circulation will continue in vessels in which all sensibility is destroyed ; were this not the case, paralytic parts could not support their life. The only arteries having valves, are the aorta and pul-
monary artery, and they only at their origins from the heart: we shall describe the formation and use of a valve, when on the veins. |
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LECTURE IV.
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On the Physiology of Arteries.
.I_N our definition of an artery, we said, that it was an
elastic tube formed to convey blood from the heart to every part of the body. That this is the passage of the blood, experiment, as well as ocular demonstration, have long removed beyond the sphere of doubt: if you put a ligature on an artery, the vessel becomes turgid between the heart and the obstructed portion, but empty beyond it; and if you examine through magnifying glasses the transparent web of a frog's foot, the circulation in it may be readily seen. Considering the circulation, then, as a physiological truth—a point no longer contestable, and knowing that the blood flows from the heart, through the arteries, to the different parts of the body, we are na- turally led to enquire by what means its motion is effected. We are to look on the heart as the primary agent in the circulation: by its operation, which has been compared to that of a pump, blood is impelled into the channels of these vessels, to be by them conveyed and distributed over the system at large; whence it is returned to the |
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41 On the Physiology of Arteries.
heart by another set of tubes—the veins. Though the
principal cause of the blood's motion, however, is the beatings, or contractions of the heart, we are not to re- gard the arteries as the mere channels of its transmission —as, in fact, altogether passive: on the contrary, they contribute much to its current, and in what manner they do so, we shall now proceed to enquire. In order to be perfectly intelligible in our discourse
of the economy of these vessels, it will be necessary to revert to what we advanced in the last lecture, relative to their property' of elasticity—which was found to reside principally in the external covering, as well as to that of muscularity—which we endeavoured to prove was pos- sessed by some circular fibres, running between the outer and inner tunics. By the former, we stated, that the ar- tery was preserved of a cylindrical form, and determinate dimensions; and by the latter, that it had the power of contracting its natural calibre : moreover, we observed, that the property of elasticity was not dependant on life ; but that the peculiar nature of the muscular was such, that it owed its powers entirely to vitality. We men- tioned also, that all arteries were branches of one of two trunks, which arose from the ventricles of the heart: and this, we repeat, is an organ by whose operation these vessels are supplied with blood. Having premised these data, we trust that the principal causes of the blood's motion through the arteries will be made sufficiently ap- parent. Every artery in the body always contains a certain
quantity of blood, by which its cavity is completely filled : not, however, that this quantity is invariably the same, for it varies at every momentary supply from the heart; but, by the action of the elastic and muscular coats, the |
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On the Physiology of Arteries. 45
calibre of the vessel is constantly adapted to the con-
tained blood. It is, therefore, with truth asserted, that an artery is always full. At every beat of the heart, a certain portion of blood is thrown into the aorta, and pulmonary artery; (no matter which we take by way of illustration, for they both receive it precisely at the same time, and in the same manner;) which, being already in a state of plenitude, now become stretched from distention. The diameter of the vessel being increased by distention of its parietes beyond their tone, the elastic coat—the use of which is to preserve it of its ordinary dimensions, immediately exerts its counteractive force, in order to restore it to its origi- nal calibre. The muscular coat also, whose contractions will be excited by extension of its fibres, is probably at this instant called into action. What is the effect? By their united efforts, the column of blood, which has been thrown into the aorta by the heart, becomes displaced : it cannot regurgitate into the ventricle, for, as we have before stated, there are valves at the mouth of this vessel; its course, therefore, is necessarily into the first and larger branches that immediately come off from the trunk itself. A succession of similar phenomena takes place in the branches as in the trunks ;—they were full before, consequently the same over-distention happens, and gives rise to a similar repulsive effort of the elastic coat; which, assisted by the muscular, aids, in this man- ner, in the propulsion of the blood to the extreme parts of the body. It is not to be imagined, however, that these effects happen in succession in the different arteries ; on the contrary, the whole arterial system experiences dilatation, called diastole, and contraction, or systole, precisely at the same instant; hence the pulse, which is |
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46 On the Physiology of Arteries.
occasioned by the former, occurs in every vessel at the
same time. In this summary view that we have taken of the action
of these vessels in the circulation, we have not, nor shall we here, advert to the operation and influence of the heart: suffice be it to say, that the blood is principally circulated by its contractions, though writers on this sub- ject have by no means agreed to what extent its power is exerted. We have observed, that the artery, in resuming its state of systole, displaces a column of blood—and that it does this is evident, for blood of itself is incom- pressible : we have also asserted, that this column is im- pelled into other vessels ; its regurgitation being pre- vented by valves, and its advance, we may here add, aided by the enlarged space into which it flows, in conse- quence of the aggregate calibre of the branches exceeding that of the trunks. Thus far, then, we have considered the elastic coat as
being the chief agent employed in the circulation : indeed, from its prevalence over the muscular in the larger vessels, it has been regarded by some physiologists, as the only one employed in the natural action of these parts. If, however, we examine into the causes of the motion of the blood through vessels in the more remote parts of the body—in which we find the elastic property considerably diminished, while, on the other hand, the muscular has become proportionably augmented, we shall feel inclined to doubt, more especially when we take into our consi- deration the abatement of the heart's power in these ex- treme branches, that elasticity alone is equal to the effect. It has indeed been contended, that the heart is the only agent employed in the circulation : of such as maintain this opinion, it may be enquired by what means the blood |
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On the Physiology of Arteries. 47
is circulated in foetus formed without hearts ? Such 7m-
sus naturcz have been met with, in which (to reply to the above question) the circulating powers must have wholly resided in the muscular fibres of arteries. As far as ex- periment and observation have gone in the investigation of this subject, it is now generally believed, that the mus- cular coat is an auxiliary in the circulation ; and that it not only contributes to the efficiency of the elastic, but, in some vessels, exerts a force even superior to it. In the larger branches, its action will be simultaneous
with, and similar to, that of the elastic coat, with which it will restore the vessel to its former size, after its disten- tion with blood from the heart; but in the smaller ar- teries, it will predominate over the elastic, and further aid the principal circulating power, by contracting them beyond their natural calibre. So that, in the one case, it will co-operate with the elastic, in the other, it will op- pose it: and, if this be true, in the latter instance, the elastic coat will be employed in the dilatation, as well as contraction of the vessel. In the vicinity of the heart, then, the blood is moved
along its arterial channels, by the alternate extension and shrinking of the elastic, aided by the successive relaxa- tion and contraction of the muscular : more remotely from that organ, by the more forcible contractile efforts of the muscular, aided by the comparatively feeble action of the elastic coat*. * The following extract, from Dr. Thomson's valuable work on
inanimation, would induce us to regard the capillary arteries as more active and efficient agents in the circulation of the blood, than they are commonly believed to be. " The experiments and observations which I have just related (the application ofsti- mua—ammonia, to the minute vessels in the web of a frog's foot,) |
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On the Pulse.
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48
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Arteries convey blood from the heart to the different
parts of the body for a variety of purposes. We mentioned in our last lecture, that by blood the body was nourished, and its growth promoted—all which is effected by the open mouths of these vessels ; hence, they have been compared to a set of workmen, continually employed in conveying materials for the formation and repair of the animal machine. In some places they form bone ; in others, muscle; and in others again, tendon ; although the blood which they convert into these different parts, is, in all of them, precisely similar in its properties, being pumped into them at the same instant by the heart. In addition to this, however, the arteries produce all the se- cretions of the body : the hoof itself is nothing more than a secretion, which the coffin arteries furnish from the blood ; urine is separated from it by the emulgent arte- ries; and semen, by the spermatic. Inflammation, which is commonly a healthy process set up by nature to repair losses the body may have sustained by accident, or disease, consists in a change of action of the arterial system. On the Pulse.
By the alternate contractions and dilatations of the
heart and arteries, is produced that well-known motion of them, called their beating, or pulse. prove undeniably, I conceive, the existence of irritability in the
smaller or capillary arteries of cold-blooded animals, and conse- quently the possibility of irregular distributions of the blood in par- ticular parts of the body being produced, independently of the heart, by the vital, contractile, or irritable power inherent in even the minutest branches of the arterial system." Vide Thomson's Lec- tures on Inflammation. |
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On the Pulse. 49
At every injection of blood from the heart, the parie-
tes of the arteries are distended beyond their natural di- mensions—an effect only perceptible in such vessels as are tightly bound down to the adjacent parts, by the immediate touch, or compression of them; but if, as is generally the case, the artery be but loosely connected to the surrounding parts, then will its diastole become distinctly visible, in consequence of this sudden influx of blood displacing it, and, at the same time, somewhat contorting its canal. A vessel, under these circumstances, may be seen to advance a little, or leap from its place ; in consequence of being rendered serpentine in its course, by the gush of blood which the heart has just impelled into it; and it is from this cause, that such an artery produces that jerking sensation under the fingers, commonly called the pulse. We have a familiar in- stance of a similar effect taking place in injecting these vessels : if one of them happen to be excessively dis- tended with wax, it will, unless prevented by surrounding attachment, always be thrown into a serpentine form; and then it is not only stretched in a lateral, but also in a rec- tilineal direction. Again, if, in operating, you lay bare an artery that is but indistinctly seen, and tie aligature around !t, you will at once render it perfectly distinguishable, in consequeuce of the momentary jerks, and alterations of figure, it will undergo, from the impulse of the blood against the ligature. It is, then, precisely on this princi- ple, that we feel the pulse by making pressure upon an artery : by partially obstructing its cavity, we have a pe- cuhar sensation given to our fingers, called pulsation ; arising^ we repeat, from the impetus of the blood mo- mentarily ejected from the heart. Ihis pulsatory action does not pervade every part of
"E
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50 On the Pulse.
the arterial ramification : though its effect is said to be
visible in those branches which do not exceed 1-sixth of a line in diameter, yet does it cease altogether in the ca- pillaries ; so that the blood in the veins, which are still further removed from the heart, flows in an even and un- interrupted stream. In consequence of functional derangement of the cir-
culatory system being present, more or less, in almost all constitutional diseases, the pulse is regarded, to a certain extent, as an index of disease—as an important indica- tion of its nature and severity : it behoves us, therefore, to make ourselves well acquainted with the variations to which it is subject, and to know (as far as medical obser- vation has tended to distinguish them) the different mor- bid states of which they are the signs. At the same time, we are to bear in mind, that, like most other symp- toms of disease, it is not to be solely depended on— without a due consideration of all the circumstances of the case. In all animals, in a state of health, we find, what lias
been called, a standard pulse: i.e. that their heart and arteries pulsate a certain number of times within the space of a minute. In general, the larger the animal the slower the pulse: e.g. in the human subject, it is about 72, in the horse about 45, and in the dog about 90. But the standard pulse of different individuals of the
same species will vary; though not, generally speaking, with much latitude ; so that we should not deem a pulse of 65, or any number between that and 80, extraor- dinary in a man; nor should we pay any attention to one ranging between 40 and 50 in a horse : we have heard, indeed, and we think it likely, that the pulse of a tho- rough-bred horse is somewhat quicker than that of a |
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On the Pulse. 51
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korse of ordinary breeding. Again, the standard pulse
will undergo some variation at different periods of life : it is always more frequent in the young than in the full grown animal, and slower in the old : the pulse of a new- born infant is 140; that of a man at sixty years of age, 60; the pulse of a colt, six months old, is about 55 ; and we think it highly probable, (hat a proportionate diminu- tion attends old age. When the pulse, however, much exceeds in number
the standard, it is called a. frequent, or quick pulse: e.g. one of 55, 60, 70, or upwards, is of this description : the most frequent we recollect ever to have met with in the horse, was one of 120. Very simple causes, as well as most constitutional diseases, and more particularly those of the inflammatory kind, will accelerate the pulse : exer- cise, temperature, and alarm of any kind, are the principal ones. If, on the other hand, the number of pulsations in a minute be less than forty, it is denominated a slow pulse. This kind of pulse is, in general, an indication of disease in the brain; and is very commonly met with in the le- thargic, or sleepy stage of staggers. A remarkable in- stance of preternatural slowness of pulse, occurred in a horse to which we were giving black hellebore : we counted not more, at any one time, than 24 beats in a minute*. But the pulse, without any regard to its frequency, may
* A grey galloway, who had a chronic ulcerative affection of one
side of the sexton nasi, with tumefied submaxillary glands of the same side, took hellebor: nigr: rad: Siss : this produced consider- ate nausea, loathing of food, &.c.; accompanied with exceeding slowness of pulse, and great irregularity of it, which continued for about twenty-four hours ; the pulse, then, gradually rose to its na- tural frequency. E2
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51 On the Puke.
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vary in many respects from what is considered as its na-
tural, or healthy state. In the first place, it may be hard, or soft. Hard, if
the artery is beating with increased force, but with di- minished diameter; so that it feels like the vibrations of a tight cord under the'fingers: such is commonly the nature of the pulse when active inflammatory disease is present in the system. Not unfrequently, the artery is reduced to an extremely contracted state—conveying to your touch the sensation of a wire ; from which circum- stance, it has been called the small, thready, or wiry pulse : it is not uncommonly found in horses that are griped, or who labor under inflammation of the bowels ; in other cases, it is strongly characteristic of membranous inflammation, be it in whatever part of the body it may. A soft pulse is one in which the coats of the artery are,
from relaxation,preternaturally distended by blood, so that the vessel is more than its ordinary size : under these cir- cumstances, it is easily compressed by the fingers. In a strong pulse, as its name implies, the artery (of its
usual calibre) is beating with increased force; in a weak, with diminished: the former is frequently present during inflammation of the lungs, after the first bleeding; the latter, in such subjects as are much debilitated from disease. An oppressed pulse is one in which the elastic and mus-
cular coats of an artery are in such a state of extension, that they are unable to contract with their usual force upon the contained blood. In those sudden and severe attacks of inflammation of the lungs, to which young horses are especially subject, either from hot stables, or over-exertion, this is the condition of the heart and larger arteries at the commencement: hence nothing is more |
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On the Pulse. 53
common in these cases, than to find the strength, as well
as frequency, of the pulse increased after venesection; Jn consequence of the plethora of the vascular system being relieved by the evacuation. The pulse is said to intermit, when the intervals be-
tween the beats are of unequal duration : it is sometimes called an irregular pulse. There are several parts in an animal more convenient
than others for feeling the pulse. By applying the palm of our hand to the left side of a horse, immediately be- hind, and a little above his elbow, we perceive, more or less distinctly, the pulsations of the heart against the sides of the ribs; so that we may, pretty accurately, count them: we meet occasionally, however, with horses in which the motions of the heart are so indistinctly felt, (which generally arises from excessive fatness,) that we are compelled to repair to some other situation. If, therefore, we are sometimes foiled in our attempts to learn the frequency of the pulse by endeavouring to feel it at the heart, it is evident, that we should at no time estimate its strength, weakness, &c. from such a fallacious source. It is by the compression of an artery alone against some hard body—as bone, that we can at all accurately ascertain the state of the pulse, and perhaps no ar- tery is better adapted for this purpose than the submax- ]Hary, as it crosses the posterior margin of the lower Jaw: here we have an opportunity of including the vessel between our finger and thumb, and of making different degrees of pressure upon it, with a view of learning "*e force, as well as frequency, with which it is beating. lne temporal, carotid, and pastern arteries, are also, now and then, resorted to for this purpose. It demands, how- ever> sonie attention, and much varied practice, to acquire |
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54 On the Pulse.
that acuteness of feel—that tact, which guides the ex-
perienced practitioner in his prognosis, and at,once dis- tinguishes the man of science and observation, from the intermeddling bungler: to this end, there is no more ready way, than, first, to gain a perfect knowledge of the pulses of different horses in a state of health, and, after- wards, compare them with those of others variously af- fected by disease. In forming our opinion of the pulse, we are to be, in
some measure, on our guard against any accidental cir- cumstance that may tend to influence it: e.g. in the hu- man subject, it is well known that the appearance of the surgeon not unfrequently accelerates the pulse of the patient: alarm of any kind will similarly affect that of the horse. The sensation' of cold has a considerable effect on the pulse-—it has the power of diminishing the frequency of action of the heart and arteries : if a horse that has a pulse beyond the standard, (in regard to quick- ness,) be exposed to an atmosphere, the temperature of which is very considerably less than that from which he has just been removed, his pulse will be soon reduced in frequency, though it will beat with more force than be- fore ; hence it is, that cold is said to give tone to the or- gans of circulation ; and so, in truth, it does, by lessening their frequency, but augmenting their power of action. There are some medicines that, when introduced into
the system, diminish the celerity of the pulse : among those most efficacious in the horse, may be mentioned digitalis, and ivhite and black hellebore. By the use of digitalis, which, it is believed, operates on the heart and arteries through the medium of the brain, the pulse may be considerably lowered, and occasionally rendered inter- mittent. White hellebore has the same effect by causing |
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On the Pulse.
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55
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nausea—and this it does most effectually and safely,
when properly administered. Aloes will, very frequently, soon after its exhibition, occasion a refusal of food, from its producing some degree of nausea; but we have not re- marked, that it is attended with much alteration in the quickness of the pulse. Barytes, given in large doses, will cause the pulse to intermit. In most diseases the pulse becomes much more fre-
quent than in health ; and for this reason, one of our chief objects in the treatment, is to reduce it to its natural standard; or, when it continues excessively quick, the animal must, eventually, sink from exhaustion of its vital powers. Venesection is, as we mentioned when treating of the blood,' one of our most efficient remedies for this purpose ; aud exposure to cold is occasionally employed with the same view : there are two medicines, however,— digitalis and hellebore, which, when properly exhibited, will prove of the greatest utility to us in practice in ful- filling this indication. |
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LECTURE V.
i*^* ^sr^ **r<* ■**+ *<*+ «rVs* .#\/v rf\*N* ^r*r v\*s/«
0« rte Diseases of Arteries.
Every organic part of the body is liable to disease :
and disease may be defined to be, that change in a part which is characterized by alteration, or suspension of its functions, by pain, and by other well known signs col- lected from observation. Were we to say with some, that disease consists in any alteration from the healthy state, we should not only be perplexed in correctly de- fining what health is, but find ourselves compelled, in strict conformity with this opinion, to pronounce, at least, two horses out of three unsound. There scarcely exists a horse, that has exceeded five years old, the pe- riod of full growth iu this animal, that has not a splint*; but we do not consider the animal, on that account, even the less valuable, much more as unsound: unless the splint perceptibly alter the functions of the part, be painful, and so produce lameness; and then, it accords with our first definition, and comes under the head of dis- ease. Were we to attend more closely to this natural di- vision of health from disease, we should meet with less * A splint is nothing more than an osseous tumor upon the
side of the leg. |
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On hrftammalion. 57
difliculty in determining the soundness, or unsoundness
of horses; less frequently differ in our opinions on this point; and seldom have occasion to incite them who em- ploy us, to encounter the uncertainty of the law. The most dangerous diseases to which the body is sub-
ject, are those of the blood-vessels; for as the vascular system is of the utmost importance in anatomy and phy- siology, so are its diseases of the greatest consideration in surgery and medicine. In saying thus much, we allude to that condition of an organ, or of the constitution at large, implied by the word Iriflammation.
A part is said to be inflamed when it manifests the
following signs: 1st. increased redness; 2dly. szoelling ; 3dly. pain; 4thly. increased heat. Now we shall take up the consideration of these symptoms in the order they are here enumerated, and illustrate each by examples drawn from the most obvious and familiar occur- rences. We labor under considerable disadvantage in not
being able, generally speaking, to inspect the surface of an inflamed part in the quadruped : the hair effectually precludes all our attempts to expose its color. In some organs, however—in the eye, for instance, the redness is the primary symptom ; that by which we form our opinion of the intensity of the disease. Every one has seen the white of the eye bloodshot; and more close observers have remarked, that, under high inflam- mation, every now and then, small red vessels are seen traversing the transparent part of it; obscuring its bril- liancy, and thus impairing, or destroying vision. Pre- |
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58 On Inflammation.
cisely the same appearance is put on by the skin, or any
other part, when inflamed ; of the truth of which, .we have often an opportunity of convincing ourselves, by examin- ing the legs of horses denuded of cuticle and hair, from the application of escarotic blisters. Now to explain the cause of the redness. It is simply owing to the pre- sence of the red particles of the blood—they circulating in greater abundance in the smaller vessels of the in- flamed part, and being admitted into others which in health only convey the serous, or transparent parts of that fluid: a theory that admits of the readiest possible de- monstration. In the first place, we can often inject a part that has been inflamed during life*, although we could not have shewn its vascularity in a healthy condi- tion : secondly, if by any irritant, chemical or mechani- cal, we excite inflammation in a part of an animal, before transparent and colorless, it will so gradually assume a red hue, that we may actually detect the globules in their passage into vessels previously serous and invisible. The tumor attendant on inflammation, is referable to
two circumstances. It may simply be caused by disten- tion of the part, from dilatation of its vessels; or it may be dependant on the effusion of coagulable matter into the cellular membrane, and consequent expression of serum around it f, The tunica conjunctiva of the eye is the * We are not to expect invariably to find parts red in the dead
animal, though they have been the seat of inflammation during its life. " The redness of parts which have been slightly inflamed not unfrequently disappears after death, so that it is sometimes dif- ficult to discover the precise spot which, during life, had been the seat of inflammation." Thomson's Lectures on Inflammation. f" The swelling in inflammation is accompanied with a greater or
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On Injiarnmation. 59
best instance of the first: frequently, in violent opthal-
rnia, we see it swollen and wrinkled, when we evert the eyelids, to ascertain the degree of the existing inflamma- tion ; though, every now and then, this is dependant on vcchymosis*. Of the last, instances enough present them- selves, but the best we have is that of the disease called strangles: we hardly need advert to the swelling here—it constitutes the very essence of the affection itself, and is to be ascribed, in the incipient stage, to the effusion of coagulable matter and serum into the cellular membrane, between the branches of the lower jaw, and the skin of the throat. If we cut into the tumor in this state, we find the centrical and larger part of it, consisting of a so- lid mass, which has recently been found to be, the albu- niinous part of the serum in a coagulated form ; and the less degree of stretching or tension. In the earlier stages it seems
to be produced solely by the unusual influx of blood; but no very great increase can be produced by this circumstance alone. As the inflammation, however, proceeds, a quantity of serous fluid is usually poured out into the interstices of the cellular membrane, in the parts contiguou s to the seat of inflammation. Thisproduces a kind of swelling which pits under pressure of the finger, and is distinguished by the term cedema. In some cases, where the in- flammation runs high, the effused fluid is found tinged of a red co- lour. In other rare cases instead of serum, coagulable lymph, or, as it is now termed, the fibrin of the blood seems to be effused. When this happens, the swelling continues after every other mark °f inflammation has disappeared, and remains often during the whole of after life. Swelling and tension, therefore, seem to de- pend partly on the inflamed vessels being unusually distended with blood, and partly, perhaps chiefly, on the effusion of serum and other fluids into the surrounding cellular membrane." Thomson's ■Lectures on Inflammation. ■Ecchymosis is an effusion of blood from the vessels of the in-
flamed part. |
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60 On Inflammation.
surrounding parts to be filled with serum in a fluid state,
which appears to have been squeezed out from the sides of the coagulum. Even in this latter case, however, we do not mean to assert, that distention does not contribute to the tumefaction ; though very triflingly so, we appre- hend, when compared with what is the effect of effusion. Increased heat, next to be considered, is, too often, the only satisfactory test we have of deep-seated and destruc- tive inflammation : to disease in the foot indeed, it is al- most our only guide; for lameness itself is, generally speaking, but a fallacious symptom—at least, as far as it tends to direct us to the seat of disease. On this ac- count, heat is a sign that we should be nice in our ex- amination for; inasmuch as the acuteness of touch, on such occasions, not seldom distinguishes the practised ve- terinarian, from the closet inquirer on the one side, and the all-knowing farrier on the other. It may at first seem strange, that so great a man as
John Hunter, should have doubted that the heat of an inflamed part was actually increased; rest assured, however, that he did not do so from theory; on the con- trary, we find this opinion (as we know the groundwork of all his doctrine) to be the result of experiment, made under his own immediate observation. His words are, " As inflammation is the principal instance capable of producing local increased heat, I have taken the oppor- tunity of examining inflammations, both when sponta- neous and in consequence of operations. I have also made several experiments for that purpose, which are si- milar to operations, and cannot say that I ever saw, from all these experiments and observations, a case where the heat was really so much increased, as it appeared to be to the sensations." Mr. Hunter, in one experiment, |
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On Inflammation. 6l
having ascertained the heat of the rectum in the dog—
an«, in another, in the ass—threw up a solution of corro- sive sublimate; this excited a high degree of inflamma- tion, but, in neither case, was the heat increased more than one or two degrees. Indeed, in one instance, where "e had injected the same solution into the vagina of a young ass, after having remarked its natural temperature, which was 100", the thermometer fell, two hours af- terwards, to 99°, and continued so till the succeeding day, when it rose again to 100°: "This experiment," he says, " was repeated several times on the same ass, with the same result." There is much fallacy, how- ever, in these experiments ; for it is well known, that the interior parts of the body possess the power of main- taining an equalisation of heat, which will not be al- tered by placing the animal in a higher or lower tem- perature ; or, as it now appears, under the influence of inflammation. Had Mr. Hunter have made the exte- rior of the body the subject of his experiments, he would have found the heat of it not only perceptibly, but ac- tually increased under inflammation*. To prove this, we have nothing more to do than to ascertain the tempera- ture of any external part—say any part of the skin, for * As, indeed, he did in a patient on whom he operated for hy-
drocele : a thermometer introduGed into the cavity of the tunica va- ginalis, and kept in close contact with the testicle, indicated a tem- perature of 92°; next day, however, when inflammation had come on> it rose to 98J°.—"But even this," says Mr. Hunter, "was n°t equal, probably, to that of the blood at the source of the circu- lation in the same man." This experiment, and others that he maile, prove that the heat of an inflamed part never exceeds that ot the blood at the heart: in more or less approaching it, however, temperature of most external organs, under inflammation, be- comes very perceptibly and demonstratively augmented. |
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62 On Inflammation.
it will vary under different circumstances, and then ap-
ply a blister to it: the heat of it, as soon as the blister takes effect, will rise considerably; though, we believe, seldom, or never, become equal to that of the interior of the body. The cause of this increase of temperature is to be referred to the unusual flow of blood into the in- flamed part, combined with the accelerated circulation of it. The fourth symptom of inflammation is pain; one
which, like redness, though probably always present, we derive, comparatively with surgeons, but little advantage from, in ascertaining the precise nature and degree of ex- isting inflammation*. Increased sensibility is accompa- nied by increased irritability ; so that those circumstances which but little affect the part in health, produce ex- treme pain under inflammation : this will throw some light on the cause of pain—which we here refer, to ten- sion of the nervous texture, and possibly pressure on it, from tumefaction of the surrounding parts. Though the horse cannot be said to complain of pain, his expres- sions of it, to those acquainted with his habits, are often too well marked to pass unnoticed:—the hang- ing head—the drooping eyelids—-the pendulous lower lip—together with the gloomy aspect, and general torpor of the animal, strongly denote dull and continual pain: on the other hand, the wild and unnatural stare—the ge- neral irritability of frame—and his frantic, but unavailing * A remark of peculiar force in regard to inward inflammatory
affections. " Pain," says Dr. Thomson, " when conjoined with other constitutional symptoms, is one of the surest marks which we possess of the existence of inflammation in the internal parts of the body:" and, we may add, one of whose kind and seat the ve- terinary surgeon is too often painfully ignorant. |
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On Inflammation. 6.3
plunges for relief, we need not add, feelingly portray the
ao°ny he is in. In local inflammation, not of sufficient lntensity, nor importance, to affect the general health, we 'nay form some idea of the pain, by the degree of pres- sure the animal will bear upon the part without flinch- lng: for instance, in the adhesive stage of strangles, the horse very seldom evinces any great deal of tenderness, When we feel the tumor; but if we touch the swelling, ever so lightly, when the suppurative process is far ad- vanced, the animal suddenly snatches away his head, and requires the benumming aid of a twitch, before he will allow us to proceed in our examination. The terminations, or effects of inflammation, are of
four kinds: viz. adhesion, suppuration, ulceration and mor- tification. When the sides, or edges of a clean-cut wound are
brought together, and confined in contact by suture, plaster, or other means, they will commonly unite. Now, it was formerly supposed, that the blood itself, extrava- sated within the wound, was the bond of union in this case—that it coagulated, and glued the divided surfaces together : recent and more accurate examinations, how- ever, show that it is not the crassamentum of the blood, hut the coagulable part of the serum, which, from its re- semblance in its properties to albumen, has been deno- minated albuminous matter, that cements them : and this, now, in common medical language, is best known hy the name of adhesive matter. There is no such pro- cess as what Mr. Hunter called union by the first in- tention *: we know of no other mode of union than that "y adhesion. 'As extravasation arises from a rupture of a vessel, it is of ser-
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(54 On Inflammation.
Should the wound remain unclosed, or should loss of
substance happen in any part of the body, either from abscess, ulceration, or sloughing, adhesive matter'is still the repairing material; but, in these cases, it is effused in the form of little rounded eminences, at first yellowish, but afterwards red, in consequence of acquiring blood- vessels from the surrounding texture. This constitutes process of granulation. Now, there are some parts of the body more likely to
take on the adhesive inflammation than others : what are known as the serous membranes, are parts exceedingly dis- posed to this process. We often find the lungs glued to the sides of the chest, in horses that have died of acute inflammation of these organs, in consequence of the ar- teries of the pleura, (which in health furnish a fluid for its lubrication,) having effused adhesive matter : this is not near so common an occurrence in horses, however, as in the human subject. Now and then, we find adhesions among the intestines, and other abdominal viscera; for the peritoneum, like the pleura, is one of the serous mem- branes. It has been asserted, that the horse's skin is na- turally insusceptible of the adhesive inflammation : we believe, however, that both experiment and observation will evince the shallowness of such an opinion; and that vice in the re-union of that vessel; if there are more solids rup-
tured than a vessel, as in a fracture of a bone; it becomes a bond of union to those parts, and this may be called union by the first in- tention ; but the union is not that of the two parts to each other, but the union of the broken parts to the intermediate extravasated blood ; so that it is the blood and parts uniting, which constitutes union by the first intention." Hunter On the Blood. This is one of the few doctrines of Mr. Huutek's, which subse-
quent investigations have shewn to be erroneous. |
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On Inflammation. 6.5
11 is not to the want of healing powers, but to the means
we are compelled to employ to keep the parts in contact, as well as to the difficulty of managing our patient, that We are to ascribe our frequent failures;—but as we shall have occasion, in our lecture on the diseases of veins, to enlarge somewhat on this subject, we forbear to offer wore at present. The adhesive inflammation, though it every now and
then do mischief from not being checked, or kept within Proper bounds, is to be considered as a restorative, or healing process—one to which, in many instances, the preservation of life itself is owing. Without it, all acci- dents or operations must have proved eventually fatal: by 11 a broken leg is united, and rendered as strong, if not stronger than ever—albuminous matter effused, ce- ments the broken ends of the bone, and ultimately be- comes bone itself—or it glues the lacerated surfaces of muscles together, and is converted into new skin, should the old have been much injured, or destroyed. A bleed- ing vessel is only safely'and effectually plugged by adhe- sion ; for although the clot of blood within it forms the temporary cause of arrest of the hemorrhage, it is the ad- hesive matter, afterwards effused, that permanently seals tne mouth of the vessel. In fine, be what parts they way that are lost, adhesive matter is the material out of ^hich they are regenerated : gradually it assumes the "aUire of the substance defective, acquires vascularity and sensibility, and, at last, becomes a part of the solids 'hernselves. Suppuration consists in the formation of purulent
atter. Those arteries which, at another time, spew forth Utt»nous substance, take on here a different action, v |
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66 On Inflammation.
and pour forth a fluid of a cream-like nature, to which has
been given the name of pus—in vulgar language, matter. Now, in the human subject, the formation of pus (in ab- scess) is denoted by two remarkable alterations ; one af- fecting the part itself, the other, the constitution. With regard to the former, the pain in it, which during the ad- hesive process had been dull and uniform, as soon as the suppurative has commenced, becomes, what surgeons call, darting and pulsatory: this, combined with the ge- neral enlargement of the tumor, the elevation of its centre, the blush upon the skin, and last, and most characteristic, perceptible fluctuation, leave no doubt as to the state of the part; though the pus may be, and often is, deep- seated. Then, as to the constitutional symptoms—the formation of matter, if it be at all considerable, is gene- rally ushered in by a shivering fit; the pulse also com- monly undergoes some variation about this period. In the horse, generally speaking, we must content our-
selves with a cautious examination of the swelling itself. Should the case be one of external abscess, the increased hardness and tenderness of the tumor, the tensity of the skin covering it, together with its perceptible prominence, will indicate that suppuration is likely to ensue ; though the period of distinct fluctuation, is probably that alone at which we can safely offer an opinion. We are not going to contend that even extensive suppurations in the horse, are always preceded by shivering; but we think differently from him, who would assert that nothing of the kind ever happens : we have certainly seen young horses, having strangles, in whom something very anala- gous to a cold fit was present about the period of suppuration ; and that there often is an accession of fe- |
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Ou Inflammation. 67
brile symptoms—such as acceleration of pulse, quickened
respiration, and general heat of body, will, we suppose, not be doubted*. As there are particular structures in the body disposed
to take on the adhesive action under inflammation, so there are others in which a suppurative process almost always ensues. All mucous surfaces, generally speaking, are of this description : if a horse contract a catarrh, (which is an inflammation of the mucous membrane lining of the nose,) we have not adhesive matter, but pus discharged from the nostrils. Most wisely and provi- dently is it so ordained by nature; for had these parts been equally disposed to the adhesive process, every com- mon cold must have terminated in roaring—and occa- sionally proved destructive to life. Indeed, we some- times find that mucous surfaces do throw out adhesive matter; and they scarcely or never do so, without its being productive of some ill consequences: the interior of the trachea, for example, every now and then is coated with adhesive matter, giving rise to croup in the human subject, and roaring, or thick wind in the horse. It is from the readiness with which mucous membranes run into suppuration, that an opening into a joint is attended with so much danger to life : unless the cavity be speedily * During our pupilage, we remember that Professor Coleman
made no mention of fever in his lectures : we concluded, there- fore, that its presence was, and we believe is still, denied. In many, Judeed in most books of farriery, it is described. We are here close upon the confines of this very important, and interesting question ; we must, however, and we do so with some reluctance, inasmuch as its discussion would be opportune enough in this place, reserve what we have to say on it for another part of the course. |
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68 On Inflammation.
closed, general suppuration of it takes place, ulceration
ensues, and anchylosis, either partial or complete, is the ordinary event. Should we succeed, however, in pro- ducing early the adhesive process in the opening, we seal up the joint, and guard against these truly melancholy and irremediable consequences. Hitherto, we have considered inflammation, and its ef-
fects, as consisting in an increased action of the arteries : we have now to show, that it sometimes appears to give rise to altered function on the part of the absorbents. When parts are removed by absorption, without any, or proportionate deposition, they are said to ulcerate. It was formerly supposed, that ulceration could not hap- pen without suppuration ; but we now know, that the presence of pus is not necessary, inasmuch as it, now and then, takes place without it: the best example of this is aneurism— of which we have seen but one case in the horse, though it is a common disease in the human sub- ject. Suppuration is, however, generally a concomi- tant of ulceration ; and it would appear, that the pres- sure of the pus is the stimulus to the absorbents to act, as is well illustrated in a common abscess. Though, re- lative to this process, is this very curious fact—that ab- sorption always proceeds to the skin, and never internally; for if an abscess form between the abdominal muscles and the peritoneum, we believe that the matter will invariably make its way to the skin. Pressure however cannot, in all instances, be adduced as the cause of ulceration; for in glanders, a disease the very essence of which is ulceration, no such excitant is present. The fourth termination of inflammation is in gangrene,
mortification, or sphacelus. These terms are perhaps, strictly speaking, not synonimous; in common use how- |
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On Iitflammation. 69
ever, they are considered so, and as such we shall adopt
them here. Arteries, in which inflammation is gene- rated and supported often as a salutary process, now and then, from excess of inflammatory action, become the agents of destruction to the parts to which they are dis- tributed—even themselves the destroyers of their own vitality. Blood in undue quantities is impelled into a part by the increased action of its arterial trunks ;—the vessels of the part itself are rendered powerless by disten- tion ;—at length every channel becomes overloaded, blocked up, and unable to relieve itself;—and the part dies from obstructed circulation. Another cause of ob- struction, but a very rare one, is the adhesive process taking place in the interior of arteries, and obliterating their canals. You will not infrequently meet with accounts of mor-
tification in horses in books on farriery, or hear some of their followers of the present day assert, that a horse died as rotten, as a pear. But the truth is, that we have no instance of mortification in the horse—defining it to be, a total destruction of the powers of life—the death ol a part; at least, we have never seen, nor even heard oi one in which we could place any reliance on the judg- ment of our reporter. Horses who die of severe inju- ries, followed by high and extensive inflammation, sin! prior to the gangrenous stage, and they appear to do sc from excessive nervous irritation. The nearest approach to sphacelus, and one which we can adduce, if we can any. as an example of it, is that condition of the lungs where death has quickly supervened on acute inflammation of "lem: even here however, the parts cannot, correctly speaking, be called gangrenous. |
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70 On Inflammation.
Inflammation has been divided into several kinds, or
species. When its attack is sudden and violent, and its progress quick, it is termed acute; but when of a tardy, lingering, and milder nature, the epithet chronic serves to denote it. Again, inflammation may either be healthy, or unhealthy, a distinction that appears to relate to some peculiarity of constitution; or it may be simple or com- mon, or morbid or specific. -Any inflammatory affection arising from ordinary causes, is simple or common: those alone are morbid or specific, produced by parti- cular causes, and not under the power of ordinary re- medies. The causes of inflammation are generally ranked under
three heads:—the remote or predisposing; the occasional or exciting; and the proximate : we shall consider them in this order. That may, in a general light, be looked upon as the re-
mote cause of inflammation, which renders a part more susceptible of the action of the immediate or exciting cause; or which, in common medical language is said to impart a predisposition. Particular constitutions are said to be predisposed to particular diseases; and here the predisposition would seem to be inherent in the ori- ginal conformation, or contexture of parts : white-legged horses, we know, are predisposed to grease ; light ches- nuts, to disease In general; narrow chested, to pulmo- nary affections ; and large long-necked horses, to be- come roarers. As an external agent, inasmuch as heat is by far the most frequent exciting cause, cold ap- pears to be that which predisposes the oftenest: when we say, that a horse has caught a cold—by which we mean an inflammation of the membrane lining the air |
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On Iriftummation. 71
passages—we do not believe that cold has absolutely pro-
duced the disease, though it is named so from this cir- cumstance; on the contrary, we suppose that heat, in al- most all cases, has been the exciting cause*. The exciting causes of inflammation are various and
numberless : they may all, however, be reduced under two general heads. In the first class are comprehended all such as act by their stimulant, or Chemical properties :— heat, canlharides, turpentine, the mineral acids, the caus- tic alkalies, &c. The second class includes those whose operation is purely mechanical: as pressure, friction, wounds, bruises, fractures, &c. The proximate cause of a disease may be considered
as its essence;—that on which its presence depends—with- out which it could not exist—and by whose changes its nature must be perpetually altered. The opinions of the most distinguished medical men, have varied exceedingly in respect to this important subject; more perhaps than on any other with which we are acquainted. The ancient medical philosophers, unacquainted with the circulation of the blood, supported for a long time the doctrines of * It would appear from the following paragraph, that Dr. Thom-
son considers cold, in this case, as a direct excitant of inflamma- tion. " In some instances cold, or a diminution of temperature, seems to act more directly upon the parts with which it comes in contact. We have examples of this in the inflammation of the mu- cous membrane ofthenose, fauces, trachea, and bronchia,from the inhalation of cold air; and in the production of rheumatic inflam- mation from the accidental exposure of some part, or other of the body to cold. The application of cold, in the instances I have mentioned, seems to have somewhat of a directly exciting effect; and perhaps the same remark is still more applicable to the local cflects of cold in the production of the inflammation accompany- ing the state which is usually denominated frost-b?te." |
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72 On Inflammation.
fluxion and congestion*: these were exploded by their
more enlightened successors, who adopted in their stead, those of obstruction—first promulgated by the celebrated BoEEHAAVEf, and of spasm—the theory of the inge- nious Cullen %. Even at the present day, very eminent medical men are
divided in their opinions, relative to the state of the ca- pillaries under inflammation : some contending that they * By fluxion is meant a flow of the humours, or blood, to any
particular part; by congestion, a stagnation of them: both giving rise to inflammation. t Boekhaave thought, that the minute vessels were blocked up
from the thickness, or viscidity of the blood, in some inflamma- tions ; while in others, the same effect happened in consequence of the larger globules having been impelled into them ; which last he called an error loci. With regard to the first of these—viz. viscidity of blood, no such condition of it can be demonstrated : we believe that the blood in all parts preserves its fluidity alike. But, in re- ference to the second, we do not deny the fact; we believe that the globules are circulating within vessels, before impervious to them. His deductions, however, we cannot admit;—we consider the error loci, as he terms it, to bean effect, and not a cause of inflammation ; but that no obstruction whatever ensues, since the circulation is still carried on, though the part be inflamed. I Dr. Cullen's theory, like Boerhaave's, is one of obstruction ;
instead of attributing the cause of it, however, to the blood, he transfers it to its vessels: " The cause of obstruction,'' he says, " is spasm of the extreme arteries supporting an increased action in the course of them." Now, the very condition which we know to be an effect of inflammation, is pre-existcnt to the spasm;—viz. con- gestion ; so that spasm would be a consequence, and not a cause of it, as the error foci of Boerhaave's evidently is. But we have no proof that these vessels are in a state of spasm; and even if they were, are we sure that it would be productive of inflam- mation. |
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On Inflammation. 73
arc acting with diminished force ; while others maintain
that their action is preternaturally increased. Both par- ses admit, however, that blood is contained in the in- flamed part in an unusual quantity, and that these vessels are, consequently, dilated beyond their natural diameter : they also agree, in rejecting all idea of stagnation. It Would carry us very much beyond the prescribed limits cf this lecture, to enter into a detail of the facts, and in- genious arguments, by which each has supported its favourite theory: but with relation to the doctrines promulgated in our metropolitan medical schools, we be- lieve that the latter is the one more generally espoused. We would refer those who wish for information on this important subject, to Dr. Thomson's excellent work on Inflammation : in which, from some experiments that Were made on the frog's foot, whereby a state analogous to inflammation was induced, the author has come to the following conclusions: "First, that the velocity of the blood, so far from being always diminished in inflamed vessels, is often increased, particularly in the commence- ment of inflammation; and that this increase of velocity may continue in the capillary vessels from the commence- ment to the termination of that state. This increased cir- culation, I am inclined to believe, exists in a greater or 'ess desree in that state which has been denominated ac-
es tu'e inflammation. Secondly, that a diminished velocity
ln the circulation through the inflamed capillary vessels, "'ay take place in the very commencement of inflamma ll°n, and may continue during the existence and progress °' lhat state. Thirdly, that this diminished circulation in -•' e '"flamed capillary vessels takes place, however, more requently in the progress than at the commencement of 1,1 animation in healthy and strong persons; and that it |
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74 On Inflammation.
is probably a state which occurs in those inflammations
which have been denominated passive." ■ " If this view of the state of the circulation in inflamed vessels be just, it will follow that inflammation is some- times attended by an increased, and at others by a dimi- nished velocity in the circulation through the capillary vessels of the inflamed part; and consequently that nei- ther of these two states ought to be included in the defi- nition which we give of inflammation." Inflammation is treated either by constitutional, or lo-
cal means : we shall first consider the former. Constitutional remedies are required when any vital
or important organ is the seat of disease, which gives rise to sympathetic irritation in the system at large. Should the stomach, or intestines be inflamed, we know that the heart and arteries will pulsate with more than ordinary strength and frequency, and that other febrile symptoms will manifest themselves; which, unless checked by timely and proper means, may run on, with redoubled vio- lence, until the animal die from exhaustion. A punc- ture in the foot—a contusion on a bone*—or an open joint, will not unfrequently destroy life in this manner. Our principal constitutional remedies are such as act on the system by depletion: they are, in a general sense, comprised in the epithet, antiphlogistic. We possess no means so effectual for the relief of in-
flammation as venesection. Whenever the case is at all urgent, either from the magnitude or importance of the part inflamed, and the constitution and condition of your * We have seen two or three cases in which death has super-
vened from accidents of this nature, though the external wound has heen but slight. |
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On Inflammation. 75
patient are good, draw blood with freedom; and do this
as near to the seat of disease as circumstances will permit. Supposing the case to be one of inflammation of the la- minae*, lose no time in opening the inferior coffin "artery, and taking away three or four quarts of blood; an oper- ation that will not seldom arrest the disease in the onset : again, should the horse be the subject of staggers, speedily have recourse to copious venesection, from the jugular veins, whereby you detract blood from the vi- cinity of the brain, and gain the advantage of a local, as WeB as a constitutional effect f. We before stated, that blood in acute inflammatory disease should be drawn from a large orifice: we may add here, that the effi- cacy of the operation will commonly be greater the soon- er it is put into force. Of such value is this reme- dy in veterinary practice, that it is on many occasions the only one in which we place confidence for the cure ; indeed, there are some cases that will not admit of any thing else being done, that can have any effect in restoring the animal to health. It is not only our most important Cleans of cure, but that which of all others is most uni- Vcrsally adopted: a horse is seldom brought to us with any constitutional disorder whom we do not bleed; and with the greatest advantage do we do so, since almost all tne diseases we have to treat, essentially consist in acute "'flanimation. Vulgarly called, fever in the feet.
t V/e have no means of drawing blood from the part itself; ut we generally can (and should be continually on the alert in Practice to reap the advantage) take it from a vessel connected Wlt" il : a pint of blood let from an artery going to, or a vein im- mediately derived from the diseased part, is equal to half a gallon drawn from the sygto atlargc. |
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76 On Inflammation.
Though venesection is highly beneficial, generally
speaking, in violent inflammations, there are cases of a specific nature, in which it should be altogether omitted, or had recourse to with considerable caution ; inasmuch as we seldom have seen good result from it, and we are not sure that it has not been occasionally productive of harm. In the suppurative stage of strangles, bleeding is never necessary; nor, indeed, in the adhesive, unless we wish to avoid the formation of matter. In glanders, we have never witnessed any benefit from venesection: and we abstain from it commonly in the chronic stages of farcy. JsText in importance for the abatement of inflammation
comes purging. Though not so potent a remedy, it is one even of still more extensive adoption than blood-let- ting : for a case rarely presents itself, requiring our aid, in \vhich purgatives, in one form or other, are not impe- riously indicated; so valuable, indeed, is a purgative me- dicine to us, that, were we not in the possession of any, we might lay aside all other curative means, as insuffici- ent to establish the utility of our art. Aloes, almost the only medicine on which we can de
pend as a purgative for horses*, is to be administered in doses apportioned to the size and apparent strength of constitution of our patient, and to the impression we wish to make on the system. To a horse in health, under or- dinary stable management, we give about six drams f; to one with staggers, a disease in which there is much * We shall discuss this question at large, in our lecture On Pur-
gation, and Purgative Medicine. f R Aloes Vulgar. Ext. Pulv. 3vj. vel Ji.
01. Menth. Piper, gtt. xx.
Syrupi — q. s. ut ft. Bol. statim sumcnd.
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On ItifiaAmation. 77
l°rpor of the bowels, we would give twelve: but the
judgment of the practitioner will best determine the dose. Wow numerous the cases are in veterinary practice, cura- k'e by the administration of a single dose of purgative Medicine, and how important an article aloes is in our Pharmacopoeia, will best appear in the course of these •ectures. Should the first dose of aloes not take effect, it is sel-
dom safe to repeat it, in ordinary cases, under the space °f twenty-four hours—the period at which its operation commonly commences. Sometimes we exhibit aloes in a laxative form : with
this view, we give two or three drams, or from that to half an ounce*, once a day, or every other day, until purg- ing is produced. Now and then, an alterative medicine is compounded of it—the efficacy of which simply de- pends on a still smallerdivision of the aloes : we give one, and even half a dramf, once or twice a day, or every other day, according to the nature of the case. Calomel in large quantities will purge a horse : not
^variably however, for we have given it in half-ounce doses without its having been productive of even a laxa- t«ve effect. Let it be noted here, in respect to this Medicine, that it is one that cannot with safety be ad- ministered as a purgative, and, therefore, one which we never think of employing with that object—unless in * R Pulv. Aloes. Vulg. 3L vel 31J. vel 311).
Pulv. Glycyrrh. Rad. Jss.
Pulv. Zingib. ----- 31.
Syrupi-------------q. s. ut ft. Bol. omni die, vel om. alt.
die sumend.
T Ut supra. |
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78 On Inflammation.
conjunction with aloes*, whose operation it is said to
render more violent. It is a principle in physic—one a scientific practi-
tioner never loses sight of, that medicines which excite nau- sea, diminish, in a very perceptible manner, the power and frequency of action of the vascular system, and dis- pose the skin to perspiration. Now, veterinary surgeons bleed in inflammatory disease with good effect, and purge with good effect, and yet we are told, that they do not nauseate with good effect. The horse's fauces are so con- structed as plainly to demonstrate'that it was not intended he should vomit, as a man does ; and only one half of his stoaiach is susceptible of the operation of medicine : but, opposed to these facts, we have two others equally true, in practice ;—the one is, that when we excite efforts to vomit, no ill effects whatever result; and the other, that the greatest benefit is derived from nausea, a state we can at any time produce and regulate with equal certitude. The root of white heleboref is the medicine we have been in the habit of employing for this purpose for the last ten years, and we feel no scruple in adding, with the best ef- fects ;—it lowers and weakens the pulse, relieves the dis- tended vessels of the inflamed part, and promotes that smooth and glossy condition of skin, which is evidence- sufficient, in the horse, of our having excited diaphoresis : R Hydr. Submur. Si-
Aloes. Vulg. Pulv. 3 v. vel ^vij. Syrupi-----------q. s. ut ft. Bol.
-)■ Neither ipecacuanha, nor the tartarized antimony possesses
virtue as a horse medicine. Very large doses of them may be given—two ounces of the latter, without producing any apparent effect. |
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On Inflammation. 79
these are not fabricated reports—they are the result
or long experience and close observation, and such as we are not likely to concede to argument grounded upon any analogical or theoretical conclusions. The common dose *s a scruple* of the powdered root, once, twice, or thrice a day, according to the effect we are desirous of produc- Ing: during its exhibition we are frequently to examine the pulse with attention, in order that we may detect its influence on it as early as possible, and either omit its subsequent use altogether, or give it in smaller doses, or at longer intervals. The effeot of nausea is further indi- cated, by the horse's becoming suddenly dull and torpid ~-by his hanging his head down, or resting it upon the manger—by his refusing to eat, or drink—and by his froth- 'ug at the mouth : which last event is characteristic of ex- cessive nausea, and only precedes, should the medicine be carried further, distressing and unavailing efforts to vomit. Even this effect of it, however, is attended with no danger, and only requires a little time to subside. On the whole, next to aloes, it is the best medicine with which we are acquainted to combat acute inflammatory disease ; and the only one we are yet in possession of as a diaphoretic. Diuretic medicines, classed with those whose effect is
*° restore the suppressed secretions, while they act as evacuants, are serviceable in inflammation. Common turpentinef, resin, and soap are the remedies generally 'Hade use of to excite the action of the kidneys: con- joined in various proportions, or simply mixed with other ft Pulv. Rad. Veratri 9j. vel 9ij.
Pulv. I'lor. Anthemidis 5ss.
%rupi q. s. ut ft. Bol. bis terve die sumend.
-Te>ebinthi?M Vulgaris of the London Pharmacopoeia. |
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80 On Inflammation.
substances, perfectly inert, according to the fancy of the
practitioner, they form our common diuretic, or urine ball*. These balls should be given, in the generality of cases, about every other day; though sometimes they are required every day, and even twice a day, towards the decline of disease : their use is more especially indi- cated, where any dropsical depositions are left, we are anxious to promote the absorption off. If narcotic medicines are of service to horses, we have
yet to learn what they are, and in what cases they should be exhibited : we occasio»ally give opium, but never with a view of allaying pain and irritation, or procuring sleep. With reference to diet and regimen—generally speak-
ing, it is proper to substitute bran for corn, or beans; and feed with green meat, in lieu of hay, should it be in the spring, or summer season : unless the case be one of inflamed bowels, and then, probably, the animal should * R Terebinth. Vulgaris ,?ss.
Ol. Juniperi--------31.
Pulv. Glycyrrhizse q. s. ut ft. Bol. alternis diebus su-
m end us. Or the following:
R Resin. Flav. Pulv. ^ss. Saponis duri-----■ 3ij.
01. Carui-------- 3L M. ft. Bol. omni die sumendus.
f We would remark here, for the information of the young and
inexperienced practitioner, that the horse is an animal very suscep- tible of the action of diuretics; so that too large doses, but more especially the too frequent repetition of them, will never fail to in- duce a state of general debility, should they not be followed by ne- phritis. Let their effects, then, always be inquired into ; and, where we have occasion to administer them often, let the general health and condition of the horse be particularly attended to. |
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On Iiiflammalion. 81
be fed with fermented provender. Now and then the ap-
petite is so bad, that scarcely any food at all is taken: when this is the case, we should not allow the horse any other drink than what contains some nutritive ingredient; —-either water-gruel, barley-water, decoction of arrow root, or infusion of linseed, will commonly be preferred by him ; and prove an excellent panada until his appetite be restored. Sometimes it becomes necessary to drench him with one or other of these fluids, in order to support life, until the power or inclination return of feeding himself. With the exception of lameness, and some few other
cases, which require a stationary condition, what is called a loose box, is the best possible situation for a diseased horse: here he moves at pleasure, puts himself into that posture most easy to himself, and favorable to his cure, and experiences altogether an indulgence which we should by no means think lightly of in practice. In- dependently of this, however, it may happen that exer- cise becomes necessary; and when it is, let it be confined to that of walking: we know of no instance in which a sick horse is benefitted by trotting, or galloping; but we have met with many, where simple disorder has been converted by it into alarming and fatal disease. The local, or topical means we possess for the abate-
ment of inflammation, are few and simple. One of the most powerful is the application of cold: this reduces the temperature of the inflamed part, lessens its acquired, or morbid sensibility, and lowers the action of the arterial trunks connected w'ith it. The coldest water, or ice it- se"> may be employed for this purpose ; the first by means of cloths frequently renewed, the last by being "■closed in thick coarse bags. Few practitioners, how- everj put faith enough in cold water to employ it without G
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82' On Inflammation.
medication; and by far the most common addition to
it, is the superacetate of lead—in the proportion of about half an ounce to a quart; which gives it an as- tringent, and, some think, a sedative virtue : to this it is advisable to add about two ounces of distilled vinegar, in order to prevent any decomposition. As a wash which proves by evaporation still more refrigerent, at the same time that it possesses the astringent and sedative proper- ties of the former, we may combine spirits of wine with it*; or we may use simply spirits of wine and water -j*. With regard to the lead wash, it is by no means clear to us that it possesses any advantage, as an application to the skin of the horse, over common water; inasmuch as the preparation itself, even in ounce doses, taken into the alimentary canal, is perfectly innocuous. As a com- mon astringent lotion, the sulphate of zinc dissolved in water—half an ounce to a quart, is one of the best; or we may substitute common salt for the zinc, adding double the quantity : recollect, however, that, generally speak- ing, neither of these last is to be applied to a surface acutely inflamed ; for they both possess slightly stimu- lant, as well as astringent properties; and this gives them the preference in many chronic affections. Sometimes warm applications are to be preferred to
cold; but so undefined are the cases in which each is proper, that one practitioner will frequently employ the former, while another insists that the latter is more effica- * The liquor plumbi subacetatis saves much trouble in making
the Goulard lotion—about two tea spoonsful of it are sufficient for a pint of water. To make this an evaporating lotion add two ounces of spirits of wine. f R Spts.Vini. Rect. fiij.
Aq. Fontanas------lb.j. M. ft. Lotio;
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i
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On Inflammation. ■ 83
cious : in the generality of instances, we should use the
cold. Strangles, where we wish to promote the suppura- tive stage, is the only case which now occurs to us, in which most practitioners would order a warm bath, or a poultice, rather than a cold wash. Heat itself—dry heat, has the effect of exciting or increasing inflammation ; but when united with moisture, it diminishes inflamma- tory action, by exciting perspiration upon the surface, and consequent evaporation : so that its ultimate effects are, probably, not very different from those of cold. Bran is occasionally used for poultice ; but it is very inferior, on many accounts, to linseed meal *, which we now, therefore, always prefer. In cases of extravasation of blood from a blow on a
part, or where the cellular texture is filled with adhe- sive matter, and the inflammation that has given rise to it, is on the decline, what are called discutient lotions f —such as discuss the swelling by rousing the action of the absorbents, are often of service. Blisters, rowels or setons, rubefacients, sinapisms, and
the actual cautery, are remedies in the veterinarian's ca- talogue, whose operation is different from those already detailed. In regard to them all, we may lay it down as an invariable rule, that they are not to be employed to a * Pour as much hot water into a pan as you think sufficient for
the poultice you are about to make, and then stir in linseed meal, until the mass acquires a proper consistence. t What we are in the habit of employing is this:
R Ammoniae Muriat. ,f ss.
Spts. Vin. Tenuioris' ~) . „.....,..,. .
Aceti___________j swg. jviij M. ft.Lotio. or this,
R Liq. Ammon. Acet. | _ . „, ft T ..
c„, tT. _. J- sing, f vj. M. ft. Lotio.
&Pts. Vin. Rect. J 6 ° J
G 2
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• o
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84 On Irtfiammation.
part inflamed ; on the contrary, they do good by exciting
inflammation in a part itself free from it; though the nearer they are applied to that originally diseased, the greater benefit is likely to result. Some of them simply produce a determination of blood to the part they affect, and thus relieve (as we say, by derivation) the neigh- bouring inflammation : this is the case with what we may call rubefacients—though their effect as such is not ordinarily visible on the skin of the horse, and with si- napisms. Others—as blisters, rowels, and setons, not only inflame, but excite a discharge from the parts they are applied to, and thus act by evacuation, as well as re- vulsion : in addition to these more apparent effects, how- ever, they seem to lower the action of the vessels sup- plying the inflamed part, and work altogether a salutary influence, that we are not able probably well to explain. The effects of inflammation are best met with blisters,
and stimulants of various kinds. When the primary action has subsided, and an adventitious deposit remains, our object is to re-excite inflammation, with a view to its ul- timate removal. Blisters exceed in efficacy all other means for this purpose ; and though we occasionally make use of stimulants, and now and then of escharo- tics, we hardly ever succeed so well in the end. The actual cautery, (firing,) considered as the veterina-
rian's last resource, is one of his most potent, and when properly handled, one of his most effectual means to re- new inflammatory action, and excite absorption : it does the former by its immediate stimulating effects ; the latter, it commences by stimulation, but-promotes considerably afterwards by pressure, having the same effect as a tight bandage applied to the part. La Fosse appears to entertain the same empirical no-
tions about firing, as the common farriers do in this coun- |
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On Aneurism.
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So
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try : " Ce que les medicamens ne guerissent pas, le fer le
guerit: ce que le fer ne guerit pas, le feu le guerit: et ce que le feu ne guerit pas, il faut le regarder cotnme in- curable." On Aneurism.
An aneurism may be said to be, any tumor formed
upon an artery, so as to communicate with its interior. Aneurism, commonly as it is seen in the human sub-
ject, is so rarely met with in the horse, that we should not have thought it necessary to have made any mention of the disease, had there not been in the museum at this place, a very fine specimen of aneurism of the thoracic aorta. It is a-dried preparation, about the size of a com- mon pumpkin, perforated underneath by two large circu- lar apertures, through which it has discharged its contents into the chest. The sac is in many places extremely thin, and puts on internally, so far as we can examine it in its present state, the appearance of ulceration : but whe- ther it consist of an adventitious substance, or be a dila- tation of the coats of the vessel, (though we are much in- clined to regard it as the former,) it is not easy to deter- mine. In a word, all we know concerning it, is, that it was brought from the slaughter-house, and has been many years in our possession : as a preparation we think it valuable, being one of the few specimens to be met with of this disease *. * Writers, in general, have been silent on this subject: a further
proof of the rarity of these cases. Mr. Feron, in his Treatise en Farriery, has entered into some description of the nature of aneu- risms, without having particularized such as belong to the horse; So that we are at a loss to know whether he has had any cases of tne kind, and if so, what they were. |
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LECTURE VI.
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On the Veins.
The veins are those vessels which convey back to the
heart the blood distributed by the arteries to the different parts of the body. The veins commonly exceed the arteries in number, as
well as size; according to some writers, in threefold proportion: in some parts, however, they correspond in both these particulars to the arteries—as in the lungs; while, on the other hand, in others, they are manifold their number—of which the foot is the best example. There are ten principal venous trunks. Two, called
the venae cavaj, return the blood from the body generally to the right auricle of the heart: eight, denominated pul- monary veins, convey it from the lungs into the left auri- cle. In addition to these, there is a small vein, named the coronary, unconnected with any trunk, which empties itself into the right auricle. The veins, unlike the arteries, are divided into two or-
ders :—a superficial, and a deep-seated order. The for- mer take their course superficially, being commonly found immediately beneath the skin, hence sometimes called subcutaneous: the latter, of smaller size, for the most part |
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On the Veins. 87
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accompany the arteries; two of them, thence called venae
comites, are frequently found running with a single arte- rial trunk. The superficial and deep-seated sets have free communication, by means of anastomosing branches, with each other; of which the common operation of ve- nesection affords a good demonstration. If, for example, you are drawing blood from the shoulder of a horse, and you take up the other fore leg, you know that the blood will flow in a much freer stream, than if you allow the animal to favor the limb from which you are taking it; for, by making him exert the muscles of the bleeding leg, the blood is pressed from the deep-seated into the su- perficial veins. Veins take their origin in four different ways. The
first, and most common, is that from the termination of arteries, which we endeavoured to prove, when speaking of those vessels, was by direct continuity of canal. The second source from which they spring, is from the inte- rior of cells : the corpora cavernosa penis and the spleen are considered as instances of this. The third mode of origin is also from the internal surfaces of cavities, but which are called sinuses: these are much larger than cells, and are found within the layers of the outer membrane of the brain, called the dura mater. The fourth, and last venous root, is that from the termination of other veins; Well instanced in the vena porta?—a vein that supplies the liver with blood, (therefore somewhat similar to an ar- tery,) from the extreme ramifications of which other minute venous radicles proceed. All the veins iu the body ultimately conjoin so as to
*°fm ten trunks; which, as we have just stated, pour their blood into the auricles of the heart. Veins, although elastic in their composition, have not,
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On the Veins.
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88
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like arteries, a proper elastic coat. They have only two
coverings :—a muscular, and an internal or membranous coat. That these vessels are elastic, may be proved by simple extension of their substance, either in the dead, or living animal—the vessel will be found, after being stretched, to contract itself to its former dimensions: it would appear however, that they are more elastic length- wise than in their diameter; for we know that they do not, when empty, maintain their cylindric shape, nor preserve circular apertures when divided. The external or muscular coat of these vessels, is much
thinner than that of the arteries; and its fibres are less distinct, being only traceable by the naked eye in some few of them: no wonder, therefore, that its existence, by some anatomists, should have been altogether denied. But there are facts which seem to prove the presence of such a coat, however indemonstrable it may be by actual dissection. We frequently see the superficial veins after exertion, especially those of thorough-bred horses, distend- ed with blood : now, if in this condition the animal be al- lowed to remain at rest, and more particularly, if he be re- moved into a cold atmosphere, in the course of a short time, we shall no longer perceive the subcutaneous vessels equally numerous, nor those, still in view, equally turgid; from which it is evident, that the veins must have pos- sessed a power of contraction—or how could they have rid themselves of their redundant blood ? Again, in bleeding, we know, if pressure be made on the jugular vein for a short time previously to opening it, that the blood will gush out with considerable force, as soon as the lancet is introduced ; and this appears to arise from the elasticity of the vessel; for if the vein be examined after some blood has been drawn, we shall find that it has |
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On the Veins. 89
absolutely become smaller in its calibre^ than it originally
was ; a fact we cannot '.veil account for, unless we admit the muscularity of veins*. The second, internal, or membranous coat, is per-
fectly smooth upon its inner surface, dense and elastic in **S texture, and possesses more strength than that of an artery : we say this, because if you make a ligature ever so tight on a vein, you will not divide this tunic, un- less you cut through the vessel itself, as is invariably the case, when you draw one even moderately tight on an ar- tery. By its smoothness internally, it affords free and un- interrupted passage to the blood; and by its density, ex- udation is prevented. These vessels are furnished with their vasa vasorum ;
consisting of minute ramifications from the neighbouring arteries, and of small veins, called vena; venarum, which avoid emptying themselves into the trunk from the coats of which they return the blood. Nerves, and there can be no doubt absorbents, enter also into their compo- sition. Within the cavities of veins, are many semicircular,
loose, membranous projections, called valves : there is commonly but one, sometimes two, and at others three °f them, attached to the circumference of the vessel. In a section we took from the central portion of the jugular vein, eight inches in length, we found, on slitting it open, tvvo pairs of valves in the upper part, at the space of two "iches apart, and in the lower, three single ones—a tri- cuspid valve, whose edges were accurately adapted to Slumenbach says, that the muscular coat exists in the
iar§est trunks only. |
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go On the Veins.
each other: making altogether three sets of valves within
the space of eight inches of vessel. The valves are thin and semitransparent, and are by some authors considered as reflections of the internal tunic: Mr. Hunter con- tradicts this opinion however ; and says, that their struc- ture—what is totally different—is tendinous and inelastic. There are some veins in the body without valves—those of the brain, abdomen, and chest: the smaller venous ramifications are also of this construction; an exception familiar to those who have injected the veins of the foot, which is always done contrary to the course of the blood. It was the aforegoing discovery, that first led some physiologists to attribute to valves the function of sup- porting the column of blood, contained in the veins, in its passage to the heart: whether they serve such a pur- pose, or not, however, is to us of little importance; we shall, therefore, dismiss the question altogether without remark. One use of a valve, be it placed where it may— in a machine, or in a blood-vessel, is to admit of the pas- sage of a fluid in one direction, and to prevent its re- flux. Now, that the valves of veins perform this use, is at once proved by attempting to inject them contrary to the circulation of the blood; which, it is well known, we are unable to do, even by the employment of all our strength : so that a column of blood, in flowing back to the heart, having once passed a valve, (or set of valves) can never regurgitate, be the forco, tending to displace it in the vein, applied in what direction it may. Veins differ from arteries in the following particulars:
in having but two coats, and them so thin, that the color of the blood appears through them; in wanting suf- ficient elasticity to retain their cylindric form; in having |
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On the Physiology of Veins. 91
valves • in being more numerous, and, generally speak- -
Ulg> larger; in having no pulsation; and, lastly, in the tllr>ction they perform. There are certain peculiarities of the veins of some
Parts which it will be proper to take notice of. Some °f those about the head of the horse, are remarkably dif- ferent in their structure from the veins of other animals— they strike us at once as peculiar in having several sacculi, 0r pouches, along the course of their canals, formed by "•'atation of their parietes, which much resemble so 'toany aneurismal enlargements : there is commonly one, but sometimes two, of these found underneath the mas- seter muscle, on either side of the face. These venous reservoirs are probably of the same use to the animal as 'he sinuses of the dura mater—preventing any thing like interruption, or even retardation, to the return of blood ; ^hich, in consequence of the almost incessant action of tr,e posterior jaw of' the horse, more especially while grazing, (for he is an animal commonly found feeding,) ^'ght otherwise have been occasioned. On the Physiology of Veins.
Blood having been distributed by the arteries to the
uirterent parts of the body, and having furnished such ma- terials as from their nature they required, is returned by l"e veins again to the heart: so that the veins may be said 0 perform a subordinate function to the arteries. The arteries, as we before stated, have not only to convey lo°d throughout the system, but, by some unknown ear»s, to convert it into the various component parts of
e "°dy, as well as to separate the secretions from it;
lereas these tubes have nothing more to do, than to
ca«ry back to the heart the unexpended blood. |
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92 On the Physiology of Veins.
Now, it has long been a question among physiologists,
to what causes the motion of the blood in the veins was to be attributed ; for, when we recollect how distant many of them are from the heart, that the blood in them is flow- ing from a larger into a smaller space, (taking the compa- rative aggregate calibres of the trunks and branches,) and that it is, in many places, flowing contrary to its own gra- vity, we shall perceive that no inconsiderable force is re- quired for this purpose. By some, the vis-a-tergo, as it has been called, or the force of tiie heart from behind, has been supposed equal to the effect; while others, with more appearance of feasibility, have regarded the veins themselves as not altogether passive in its transmission. Indeed, if we consider the propellent power the left ven- tricle must possess, in order to move such a mass of blood through these tubes, so remote from its operation, and, at the same time, calculate the sum of resistance opposed to it, by the interposition of the capillary system, and va- rious other causes, we shall be inclined to seek further for agents of propulsion. On the other hand, we are not to reject the power of the heart altogether, merely because the blood flows with an uniform stream in the veins; for the absence of pulsation in them, is no proof that the mo- tion of the blood is not influenced by the contractions of the heart: the extreme division which this fluid undergoes in its circulation through the capillaries, and the tortuosity and complication of the numberless small veins, account for the regular and uninterrupted stream which we meet with in their larger branches. To prove that this is the explanation of the fact, if you open a vein that has free and direct communication with the extremity of an artery> the blood will flow from it with the same pulsatory mo- tion, as if the artery itself had been penetrated; but if the |
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On the Physiology of Feins. 93
ein De one of large size, remotely situated from any arterial
°H)munication, or if it be one that springs from the union
numerous capillaries, that smooth and even stream,
itli which the blood circulates in the trunks, will be ob-
servable here. Th ese facts, then, lead us to conclude,
nat the force of the heart is not sufficient of itself to pro-
Pel blood through the venous system.
■rrom the collected accounts of writers on this subject,
]t seems highly probable, that the blood, flowing in the Vems, receives additional momentum from the reaction of tne capillaries—which we spoke of in a former lecture : and that it is further urged on by some contractile force resident in these vessels themselves. That the blood is advanced in its course by the action of those muscles con- t'guous to veins furnished with valves, is, without doubt, "Well founded, as far as an occasional auxiliary is concern- ed, as the common operation of bleeding demonstrates ; ■°r it is in consequence of muscular pressure upon the veins about the head, that the motion of a horse's jaw ac- celerates the flow of blood through the jugular vein : as such, however, it cannot be ranked among the essential causes of the blood's motion in them. Although the blood hi the venous svstem for the most
Part flows without intermission, the large veins near the
fieart have a sort of pulsatory action excited in them ; so
"'at, at first sight, on laying them bare, we might suppose
neni to be the trunks of arteries : they pulsate, however,
*rom a different cause ; in consequence, of a portion of
'°od regurgitating into them, during the systole of the
uncles, there being no valves placed at their termination
llue heart, to prevent such reflux. This retrogade mo-
°n °f the blood may be observed in the vena? cavaj,
|
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94 On the Physiology of Veins.
jugular, and pulmonary veins; so that, in them, the
blood really appears to ebb and flow : a circumstance probably that led the ancients into error concerning its real course. We mentioned in a former part of this lecture, that
veins were more numerous than their correspondent arte- ries, and we adduced the foot as a good instance : an ex- amination of this organ furnishes us with some facts that seem to point out the utility of this disparity in their num- ber and size. We find that the sole and sides of the foot are parts crowded with these vessels, and we know that these parts are most of all subject to pressure, and, as a natural consequence, to obstructed circulation: this Na- ture has in a great measure prevented, by supplying them plentifully with veins, and those veins without valves; so that the blood may flow in every direction with equal fa- cility. For the same reason, are many parts furnished with superficial and deep-seated veins, and others with veins with no valves: in the former case, the actions of muscles are the chief cause of pressure ; in the latter, the motions of the viscera, as well as the variations of volume and site to which they are liable, have a similar ef- fect. There is one vein in the body whose distribution and
use are so different from any other, that it requires a dis- tinct consideration: we mean the vena portae, a ves- sel formed by the union of those veins that return blood from the organs of digestion. ,It supplies the liver in a similar way to what arteries do other secreting organs of the body; and, like them, separates a peculiar fluid from the blood ; so that, in effect, it is more properly of an ar- terial than a venous description. |
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On the Diseases of Veins.—Blood-spavin. 95
On the Diseases of Veins.
There is but one disease met with in the veins of horses, and that the result of external injury : we must, however, in comformity with custom, say a few words on a suppo- sed varix of these vessels, called Blood-spavin.
In the human subject, the veins of the legs now and
then become varicose; by which is meant, a dilatation of their coats in consequence of preternatural distention : under these circumstances, the valves in them perform but imperfectly their office ; the veins themselves become tortuous, bulge, and occasionally burst in various places, forming small tumors, or bloody ulcers, in the skin, which, from the appearance of the blood through them, are of a purple color. Such have many veterinary wri- ters* conceived to be the nature of blood-spavin—a dis- ease that has no existence but in the pages of their works. The horse, as far as our observations have gone, is not troubled with varix ; and we much doubt that the veins of this animal have ever become spontaneously varicose, though we have none whatever, that something like varix may have been produced in them, by the remedies com- monly recommended for the removal of a blood-spavin. We allude here to the use of ligature—a practice long ex- ploded by the scientific veterinarian. If ever you examine a horse said to have blood-spavin,
(for it is by no means a very common occurrence,) you will perceive a soft fluctuating tumor upon the inner and Bracken was the first who detected the fallacy of such an
opinion. |
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96 Blood-spavin.
fore part of the hock, in the course of the principal vein,
which is at that part superficially placed. At first view of it you are convinced from the unnatural prominence of the part, that there must be disease; and so there undoubt- edly is ; though it is not of that kind which its name so emphatically expresses. Dissection has fully developed its nature. There is placed here a little membranous bag, called a bursa mucosa; which contains in a natural state, a certain quantity of mucous fluid; from a too copious secretion of which, it happens, now and then, that this sac becomes distended, preternaturally enlarged, and in this condition constitutes a disease, called bog-spavin ; the nature of which will be hereafter more fully explained. The vein, passing immediately over this bag, compress- ed, and diminished in calibre by enlargement of it, can- not transmit blood, at this part, with the usual facility or quickness ; the consequence is, that a preternatural distention of it happens immediately below the tumid bur- sa, thence extending as low down as the first valve: and this has been mistaken for a varix, or some such thing, and denominated a blood-spavin. A blood-spavin, then, is purely a distention* of that
vein which passes superficially over the inner and fore part of the hock-joint; solely produced by, and conse- quently coexistent with, a bog-spavin. Be the cause of such obstruction, however, what it may, the same thing will happen : hence, if we tie this, or any other vein, we shall produce instantly, in truth, a blood-spavin, and pro- bably, by allowing the ligature to continue, in process of time, a varix. From what has been said about the nature of this sup-
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• We would call a varix a dilatation.
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On Wounds of Veins. 97
posed disease, it is obvious that the only remedy is that of
removin" the cause of obstructed circulation through the vein: how this is to be attempted, will be pointed out when we come to consider a bog-spavin. On Wounds of Veins.
It is of the ill consequences occasionally arising from
the common operation of bleeding, that we are now go- ing to treat. When the jugular vein is opened by a phleme, or lancet, and the necessary quantity of blood taken away, the edges of the cutaneous wound are brought together, and maintained in contact, by the insertion of a pin, about which is twisted a skein of common tow. Now, under ordinary circumstances, what happens in the closure of the wounded vein, is this. First, a coagulum is formed by the blood extravasated into the surrounding cellular substance, between the wound in the skin and that in the vein, by which the latter is so effectually plugged, that all further efflux is put a stop to. Then, from the lips of the orifice in the vein, in consequence of inflammation en- suing, adhesive matter is poured out; which, in the course of a few days, resembles in its texture the parietes of the vein with which it is continuous ; while, in the interim, the coagulum is daily diminishing, until, at length, it is wholly removed by a process of absorption. Lastly, the new-formed membrane, occupying the site of the punc- ture from the lancet, is with difficulty distinguishable from the coats of the vein themselves*. If, from the use of a bad or dirty instrument, from in-
expertness in the operator, from inattention to pinning up, * Vide an excellent paper on this subject by Mr. Travers, in the
first part of the Surgical Essays, by Messrs. Cooper and Travers.- H
|
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qq ' On Wounds of Veins.
from subsequent friction, or, may be, from irritability of
habit, any separation between the edges of the wound be permitted, so as to destroy union by adhesion, tumefac- tion of the neck, in the course of the Vein, frequently en- sues, and the horse is said to have an inflamed neck from bleeding. It is ever a most reprehensible practice to bleed with rusty, ill-conditioned phlemes, or lancets : both the lacerated wound they inflict, and the rust or dirt be- smeared by them upon its edges, are causes which pre- vent union, and dispose parts to take on unhealthy ac- tion ; the practices of striking phlemes with improper force, and of not holding them in a precise line with the course of the vein, are also censurable. Peculiarity of constitution has but little to do with mischief of this kind in the horse, however often it may be the source of it in the human subject. Another cause to which this acci- dent may be referred, is that of not neatly and carefully pinning up the neck. For this purpose, your pin should be small, and so inserted through the lips of the cutaneous wound, that it pierce them about the centre, and take sufficient hold to prevent the probability of its being torn out. This being done, and the blood sponged from the neck, it is an excellent practice to rack the horse up,so as to con- fine his head, for, at least, an hour, after the operation ; in which time a firm coagulum will have formed: should it happen that he has to go some distance after bleed- ing, this precaution may be taken with advantage, prior to feeding, even on his return home. For it sometimes happens, that horses—either from rubbing their necks after bleeding, from the pressure of the collar in draught, from friction by the rein of the bridle, or from some sud- den and violent movement of the head and neck, or even from hanging the head down for long—have fresh bleeding |
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On Wounds of Feins. S9
excited from the orifice ; and this may be so profuse, as,
if not arrested, to prove fatal: more commonly however the hemorrhage stops of itself, or a second pinning up is had recourse to; and it is this accident that frequently gives rise to an inflamed vein. Inflammation occasioned by one or more of the afore-
mentioned causes, attacks the internal, or membranous coat of the vein; and proves, if it be not soon subdued, a source of much troublesome disease in the neck; as every practitioner, who has seen these cases, is well aware of. The first appearance indicative of the ap- proach of this disease, is the separation of the cut edges of the integuments, which are commonly redder than Usual, and sometimes everted. Soon after, a little sa- nious discharge, at first tinged with blood, and afterwards mingled with pus, appears at the wound; the surround- ing skin becomes tumefied, tight, and hard; and the vein itself, above the orifice, feels like a hard cord under the fingers in its course to the head. As the disease advances, the secretion of pus becomes more distinct, (though in some cases the serous effusion still continues,) and the tumefaction of the neck increases, accompanied with ex- treme tenderness, which the animal fully evinces by flinch- ing from the least pressure. About this time, there is commonly some constitutional irritation—denoted by quickened respiration, frequent and strong pulse, refusal of food, sparing evacuations of foeces and urine, and general heat of body, n ore especially of the mouth. Under these circumstances, if the animal be not relieved, the head becomes enormously swollen on one side, ac- companied with more or less disturbance of the senso- num ; ancj to such an alarming height has the irritative fever m the system run, that even death itself has been h 2
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100 On Wounds of Veins.
k hown to happen, where the case was treated from the
first with all possible attention. In describing how this disease may terminate fatally, we have been recalling to mind the particulars of a case of a horse belonging to an officer of the royal artillery ; where a dirty phleme had been the exciting cause; but of which, unfortunately, there were no minutes made ; nor were the parts inspect- ed after death with sufficient care, to inform us to what extent the disease had proceeded. This is the only in- stance of fatality in the horse with which we are ac- quainted, though doubtlessly there are many others : in the human subject some cases are also related which have ended in death. We believe that this accident is more frequent among
horses than men ; and it has been asserted, that the dif- ficulty of producing union by adhesion is the cause of this : when we advert, however, to the means we are compelled to use to close the wound, to the too frequent non-obser- vance of all subsequent precautions, as well as to the un- tractable nature of our patient, it appears to us, that we shall find ample causes for its more frequent occurrence among horses, without ascribing it to this, which, we humbly submit, will not apply to the case before us*. If * In the Essay on the Wounds and Ligatures of Veins, to which
we have already, in a note, made reference, we find, as part of a communication from Mr. Coleman, the following;—" I have no doubt that inflammation of the wound sometimes takes place in con- sequence of the mode used to stop the bleeding; but I should ob- serve that the most simple wound through the integuments of horses is scarcely ever healed by the first intention.; and it is this disposition to suppurate and resist adhesive union, that is probably the most fre- quent cause of the external wound after bleeding not uniting by the first intention in horses, the same as in the human subject." That even a clean-cut wound through the skin of the horse, if it be ex- |
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On Wounds of reins. 101
it were to be referred to the insusceptibility of the horse's
skin to the adhesive inflammation, instances of it must happen much oftener than they do; not only from inat- tention to the animal after the operation, but even under the most judicious management: which, by the.bye, they seldom or never do. Let us ask any surgeon, what would be the effect of pinning up arms as we do the necks of horses? ^—and, more particularly, if his patient happened to be a maniacal one, by whom his injunctions to keep the arm at rest, and in a certain position, were altogether disregarded ? Could we make use of a proper fillet, or of adhesive plas- ter, and impress on our patient the necessity of keeping his head and neck still, lest he disturb the wound, we will venture to assert, that we should not have to complain of the powers of healing of the skin, nor of those of any other organized part of this animal. Why have we not in- flamed veins in the thigh, or the arm ? If they arise from defective healing powers, these cases ought to be quite as frequent as those of the neck ; whereas, they are compa- tensive, treated in the ordinary, slovenly, careless manner, seldom
heals by the first intention, we admit; but that the lips of the wound made in bleeding, unless they be afterwards separated by violence, rarely or never fail to adhere, is, to us, undeniable. No^ thing is more common, in the present improved state of veterinary surgery, than to close the incisions made in performing neuro- tomy, without any suppurative process: and could we preserve the nice adjustment of the divided parts, without the employment of suture, and other irritative means, we are of opinion that adhe- sion would invariably ensue. These facts, with what we have ad- vanced above, induce us to depart from the opinions contained in this citation: and we are the more anxious to express ourselves openly and intelligibly on the subject, inasmuch as we are differ- ing (and with all deference we do so,) with Professor Coleman, on, a point purely practical, and by observation alone to be decided. |
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102 On Wounds of Veins.
ratively rare in practice—to many, unknown : and one rea-
son appears to us self-evident;—because they are removed out of the way of external injury. As to the exciting cause of inflammation of the inner
tunic of a vein, various opinions have been offered. Ob- struction of its canal, has been adduced as one ; without foundation, however, for ligatures on the veins of horses are not attended with any inconvenience. Exposure of its cavity, has been introduced as another; but were this the cause, we should probably have fifty, or a hun- dred cases, where we now have but one. Inflammation in the vein would appear to be an exten-
sion, through continuity of substance, from that of the ex- ternal wound, which always precedes, we believe, though it is not invariably followed by, it—the textures are dif- ferent, but the same arteries send off vessels to both parts; and though this will not explain why inflammation is excited in the vein, it may serve to point out the best means of prevention :—the effectual and speedy closure of the external wound. We have observed, that this disease is sometimes con-
fined to the adhesive process—a thin ichorous discharge only shewing itself at the external wound; very common- ly, however, especially if the case be neglected, or mal- treated, abscess forms within the cavity, which now and then extends upwards for a considerable distance. In either case, the most common termination is the oblitera- tion of the affected vein ; or, as it is vulgarly expressed, the loss of it. Every one, in the course of his practice, has met with horses having no vein on one side. We shall now make mention of, and endeavour after-
wards to account for, a circumstance, which, at first view, appears so singular, that it has hitherto, we believe, |
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On Wounds of Veins. 103
baffled all attempts to explain it: viz. why inflamma-
tion of the jugular vein in the horse should extend itself towards the head—contrary to the course of the circula- tion, while the same disease in the human arm, invades the vein as it proceeds to the heart—corresponding to the passage of the blood. It appears, that although obstruc- tion be not the exciting cause of this disease, it is that which directs the course of it when produced; for, it is our opinion, it will invariably be found to proceed in that direction in which the vein is blocked up. Let us see how this will apply to the cases before us, and, first of all, take a view of what happens in the human arm un- der these circumstances ? It is either from the basilic, or cephalic vein, (two superficial venous trunks at the bend of the elbow,) that surgeons draw blood; which veins freely communicate with others, particularly the deep-seated, just below the part commonly punctured : in the event, therefore, of its canal, near the orifice, be- ing obstructed, the vein will not be choked up below, in consequence of the free anastomosis existing between it and the contiguous trunks ; in which the unimpeded cir- culation will preserve a continual flow of blood up to the obliterated part. But above the orifice no vessels of communication are found, nor can the blood take a retro- gade course from the axilla; consequently, there is no- thing to prevent that portion of it—that contained in the upper part of the vein, from forming a clot. From the human arm let us advert to the horse's neck. It is from the jugular vein (the internal jugular of the human sub- ject) that we extract blood commonly in the horse ; a Ve'n of large size, and the only one, with the exception of the vertebral, which returns the blood from the head and neck : the horse has no external jugular vein, If, then, |
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104 On Wounds of Veins.
this vein be obliterated at the part we bleed, whether is
the upper or the lower portion of it more liable to ob- struction ?—to the formation of a coagulum ? The lower part will not, for, having once emptied itself, (and this it will do probably even by gravitation,) no fresh supply of blood can be sent to it: but the upper, on the contrary, being full, must remain so ; there being no communicat- ing channels by which the blood can be carried off. Here, then, we have an exception to the principle laid down by surgeons, relative to this accident: viz. that ob- literation is always found next to the heart. Knowing that the same cause, under the same circumstances, will al- ways produce the same effect, we would resolve this ap- parent anomaly in the laws of the animal economy, by saying, the same cause is operating under different cir- cumstances. Subsequent inquiry and experiment have fully borne us
out in this solution of a mystery, apparently the more ab- struse the more it was investigated by the laws of pa- thology ; for we are ready to confess, that our theory was framed before our hands were busied in experiment. It naturally suggested itself, that, if our explanation was correct, other veins similar in their distribution and com- munication to the cephalic or basilic of the human sub- ject, when inflamed, would swell towards the heart. Re- ference to our own cases proved the fact, and subsequent inquiries among our friends have corroborated it: both the saphena and plate veins of the horse, when inflamed, tumefy upwards; and the reasons are obvious—they need not repetition*. » The rarity of these cases, and the interest this question has
excited in the profession, induced us to follow up our inquiry by |
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On Wounds of Veins. 103
The mode of treatment found to be most successful by
veterinary practitioners, is, in some respects, very differ- ent from what surgeons are in the habit of adopting. If the tumefaction and induration, in the course of the vein, have extended to the head, a blister is by far the best ap- plication, without any regard to fomentations, evaporating lotions, &c. which are only of use in the more incipient stages. At the same time, you should produce a slough, and excite the adhesive action in the vein, by the intro- duction of some caustic, or of the actual cautery : the lat- ter is by far the preferable remedy. In the use of it we avoid all force—the mere searing of the sides of the wound is all that is required; our objects being to pro- the still less fallacious test of experiment. It was proposed, that
these and other veins should be inflamed by irritation—in fact, that' they should be placed, as nearly as possible, under the same circum- stances as the jugular, when so affected from the cut of the phleme. We found it somewhat difficult to induce a suppurative condition of these veins, though we employed for the purpose rusty lancets, escharotics of various kinds, ligatures, and frequert separation and friction of the external wound; but, perhaps, some of these means in another case, (for we have not had an opportunity of repeating our experiments) might succeed. An intimate friend of ours, Mr. Cherry, Veterinary Surgeon at Clapham, to whom we had communicated our ideas on this subject, made several attempts to inflame the inner tunic of veins by passing pack-threads through them ; but in no one instance did he succeed—the ligatures, on the fifth day, were ulcerating their way out, and the interior of the veins presented no change but a very slight thickening of the lin- ing membrane : there was no blush whatever perceptible. The results of these experiments, which, we must confess, were by no means so satisfactory as we could wish, favored our theory: we would rather that others should pursue some such tract of investi- gation however, than hastily receive that which is still matter of debate. |
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106 On Wounds of Veins.
cure a free opening, and a discharge of healthy pus. The
introduction of the cautery, without the application of a previous or accompanying blister, we have frequently ob- served to be followed by aggravation of the disease—ar-r resting the discharge, and thereby considerably augmenting the tumefaction : we, therefore, seldom or never separate the cautery from the blister, though the latter may, in course,often be made use of without the iron. Could weex- tract blood from the part itself, much benefit, doubtless- ly, would ensue ; but it is rarely necessary to draw it from the system, unless the. constitutional irritation run high. Purgatives in full doses are always proper; and the sub- stitution of bran for corn is a good regimen. There is one circumstance regarding the treatment of inflamed necks, which is not held in proper estimation by the ma- jority of practitioners; and that is, the position and motion of the head and neck : by keeping the head constantly ele- vated, and as immoveable as is compatible with the ha^ bits of the animal, we contribute much towards the abate- ment of the existing inflammation. |
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A
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LECTURE VII.
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On the Absorbents.
There is a vascular system in an animal body, which,
from a knowledge of its being employed in absorbing, or taking up substances, anatomists have called the absorb- ent: it is altogether distinct from the arterial and venous systems, though it differs from them, as we shall hereaf- ter learn, more in regard to its economy than its struc- ture. The absorbent vessels are, comparatively speaks ing, of late discovery; if we take into our calculation their general distribution, and extensive use in the animal constitution. These vessels were formerly supposed to be of two
different kinds; hence they received the names of lac- teals and lymphatics: appellations that have not been laid aside, though more recent experiments have shown, that there exists no real distinction between them, either in relation to structure, or function. The lacteals were first discovered. They were seen, first of all, upon the sur-r face of the viscera of the abdomen, in animals opened soon after a full meal, containing a fluid similar to milk 111 Us appearance : a circumstance implied in their name. Not long after, others of a similar description were found |
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108 On the Absorbents.
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in various parts of the body ; which, from being filled
with a thin, transparent, watery fluid —lymph, received the name of lymphatics. These vessels are now divided, according to their relative situation, into superficial and deep-seated absorbents : the former are plentifully distri- buted under the skin, and pierce it in prodigious num- bers ; the latter are commonly found accompanying the principal blood-vessels. The absorbents have but one principal trunk, called
the thoracic duct; which takes its course along the in-r ferior part of the spine, within the cavity of the thorax, and terminates in the left jugular vein, near its junction with the axillary : by it, all the absorbed fluids are re- ceived, and poured into the circulating mass. The absorbents, generally speakiug, run in company
with the principal veins, according as they are superfi- cially or deeply placed ; though, unlike them, they take a singularly tortuous course : if, therefore, we wish to find these tubes for the purpose of injecting them, we ought always to be guided in our search by the situation of the venous trunks. Hence, we know, in farcy, (a disease of the superficial absorbents,) that buds are commonly per- ceived upon the inside of the thighs, and may be traced in the direction of the vein from which we bleed. In their passage, the branches conjoin their canals, so as to form a set of tubes, less numerous, but of greater indi- vidual diameter; whose united area grows smaller as we approach the thoracic duct: by which construction, the course of the contained fluid is much accelerated. These vessels do not ramify alike in all parts; in some, they ex- hibit an arborescent appearance : e.g. the ramifications of the lacteals within the folds of the mesentery, much resemble the branches of a tree; in others, they form a |
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On the Absorbents. 109
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sort of network in their distribution: e.g. upon the sur-
faces of the lungs and liver. Like the blood-vessels, the absorbents anastomose in
every part of the body ; in consequence of which, the pas- sage of fluids through them is much facilitated, and all obstructions rendered harmless so long as any of the communicating branches remain pervious. Indeed, so provident has Nature been in regard to this principle of anastomosis, that an obliteration of the thoracic duct it- self, would not necessarily prove destructive to life; for Mr. Cruikshank has demonstrated a communication between the lacteals and lymphatics, by which the chyle might still be conveyed into the circulating mass; Ac- cording to this writer, anastomosis takes place not only between the smaller branches, but between the larger trunks, and even the glands themselves. In all animals, the structure of which has been ex-
amined, we believe that absorbents exist; they are found, however, in greater abundance in some parts of the body, of the same animal, than in others : this appears to be the case in the mesentery, lungs, and lker ; while none have hitherto been discovered in the brain, though, from what we know of the composition and economy of that organ, \ve have no reason to doubt their presence there. If we believe that a fluid is continually poured into the lateral ventricles, we must admit that absorbents exist in order to prevent its accumulation: an effect never met with in health, though it occasionally happens in disease. Mr. CrtjiKshank, who has bestowed much pains in the com- pilation of his work on the Anatomy of the Absorbing Ves- sels of the Human Body, says, that " the lacteals are three *f not four times more numerous than the arteries and Veins," and, that "in the extremities of the human body, |
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On the Absorbents.
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no
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the superficial lymphatics are vastly more numerous than
the cutaneous veins—fourteen trunks frequently accom- panying one cutaneous vein:" and further, that "the deep-seated lymphatics are at least double the number of the arteries they attend." The absorbents arise from five different sources. First;
they proceed from the interior of the villous coat of the intestines. To be satisfied of this mode of origin, we have only to kill an animal about three or four hours after a copious meal, and lay open the abdominal cavity; and we shall perceive the mesentery streaked with numerous white lines, which may be traced into as many small white specks upon the inner surface of the intestines; which specks, or spots, are the mouths of so many lacteals. If the parts are dissected, and steeped in spirits of wine, the chyle in the lacteals becomes inspissated: so that, in this way, you may make a very elegant preparation of them, and examine them with much more facility. From the microscopical observations of Mr. Cruikshank, and others, it appears that these vessels arise by small orifices belonging to short radiated branches; and that many of these unite to form one absorbent trunk—one lacteal. The second mode of origin is that from the interstices
of the cellular membrane, or rather, from the interior of its cells: by throwing quicksilver into them, in some parts, the absorbents become immediately injected—as is the case when any is poured between the membranous envelopes of the testicle. In addition to this proof, however, we infer their existence in the cellular mem- brane from a well known fact, which could not otherwise be satisfactorily explained. We mentioned, when on the arteries, that many of their minute branches were called exhalents, in consequence of emitting, in the form of |
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On the Absorbents.
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Ill
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vapour, an aqueous fluid into the cellular membrane •
and that, although this secretion was constantly going on, there was no accumulation of it, excepting under some circumstances connected with disease. It is evident, therefore, that there must be a proportionate absorp- tion ; and we know of no other means by which such a pro- cess can be effected, but by the mouths of these minute vessels. The third source from which they spring, is the large
cavities of the body : viz. those of the belly, head, and chest: in them, there is also an exhalation from the ex- tremities of the arteries, which requires to be continually imbibed by those of the absorbents. Fluids injected into the bellies of living animals, are soon afterwards im- bibed by these vessels, in which alone they have always been detected: Mr. Chuikshank says, that "of six pints of warm water (thrown into the belly of a dog) after six hours not more than four ounces remained." The fourth place of origin is from the surface of the
skin ; of which we have demonstration from injection, as well as ample proof deduced from various phenomena exhibited in the economy of this part. If an injecting pipe be inserted under the cuticle, or scarf skin, of the scrotum, and the quicksilver be allowed to extravasate, numbers of these vessels will be filled : independently of this however, were it not for the presence of absorbents, how could we explain the operation of mercurial ointment; which, we know, when rubbed upon the skin of the hu- man subject, will produce the same effects as if it had been taken into the stomach ? We shall have occasion to illustrate this more fully, iu treating of the physiology of these vessels. The fifth and last origin, is that from the interior of an
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On the Absorbents.
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i 12
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excretory duct*: where they appear to have been distri-
buted for the purpose of preventing the duct from burst- ing, by relieving the distention it is occasionally s.ubject to, from some obstruction in its canal. When this hap- pens in the hepatic duct, bile is absorbed into the system, giving that yellowness to many parts of the body, seen in the disease called jaundice ; for it has been found by ex- periment, that if the duct of the liver be tied, the absor- bents of that organ become shortly afterwards filled with bile ; and any pressure on it, or other cause of obstruc- tion, would of course have a similar effect. Some make mention of a sixth origin of the absor-
bents:—from the extremities of arteries; which they instance by saying, that if you throw quicksilver into the spermatic artery, it will fill the absorbents of the cord : this is certainly true—we have preparations demonstra- tive of it, but it is an event most probably referable to extravasation of the metalic injection ; for, as we have just stated, if mercury be simply thrown under the mem- branous coverings of the testicle, (without seeking for vessels underneath,) the absorbents will be as completely injected, as if we had inserted the pipe into one of their ramifications. After all, however, that has been said about the different modes of origin of the lymphatics, we are compelled to acknowledge, that their orifices have never been seen : in consequence of their extreme minute- ness, as well as from the transparency of the fluid they contain, they have hitherto eluded the observation of our most diligent anatomists—they are supposed to be similar to those of the lacteals. * A tube, by means of which, the secretion of a gland is convey-
ed into the organ destined for its reception, |
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On the Absorbents. 113
The principal termination of these vessels is in the tho-
racic duct; which, we before mentioned, was to be con- sidered as the trunk of the absorbent system. It is placed beneath the spine, commencing in its lumbar region, where it is formed by the junction of three large absor- bent vessels:—one of which is the main trunk of the lac- teals; the others are branches of considerable size, form- ed by the union of absorbents coming from either of the hind extremities. The thoracic duct at its origin is somewhat larger than elsewhere, which dilated portion of it has received the name of receptaculum chyli: in its course along the spine, it is first placed to the right, and then to the left side of the aorta, and ultimately ends in the left jugular vein, near its junction with the axillary. There is on the opposite side of the neck an absorbent trunk, of comparatively small size however, in which the absorbents from the right side of the head and neck, and from the off fore extremity terminate: this empties itself into the right jugular vein. It is thought, that an absorbent has three coats :—an
elastic, a muscular, and an internal or membranous; but these tunics are so extremely thin and pellucid that they cannot be separately demonstrated. If you distend one of these vessels with quicksilver, and then make an open- ing into it, the metallic injection will be ejected with such a degree of force as to lead you to suspect that the vessel must have contracted, or it could not so suddenly have emptied itself, and recovered its original calibre : and it ls evident, that to elasticity alone can be ascribed such a contractile power in the dead body. -Anatomists, in general, believe that these vessels have
a muscular coat, though they rather infer its existence from the well-known functions that they perform, than 1
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114 On the Absorbents.
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from any proofs of its presence afforded by dissection :
some however assert? that they have seen fibres, closely resembling muscular, in the thoracic duct of the horse, which vessel, they tell us, possesses contractile powers; and if this be true, we may fairly conclude, that its nume- rous ramifications are similar to it; though their minute- ness and the semi-pellucid nature of their coats, render it perhaps impossible for us to detect any distinct arrange- ment of fibres. One of the best arguments in favor of their muscularity, is the degree of irritability they are said to shew on the application of stimuli to them : e.g. if an absorbent be touched, either in the living or recently dead animal, with any stimulant, it will be seen to contract on its contents, in the same way that muscular fibres are known to do; or if a lacteal be emptied by. puncturing it, or by making pressure upon it, it will be immediately filled again ; and, to all appearances, from the impulsion of fluid into it by the communicating ramifications. Like arteries and veins, the absorbents possess an in-
ternal coat, but it appears to be one of a much denser and stronger texture ; for, in injecting these vessels, you will find that a single trunk will of itself support a very heavy column of quicksilver, and that the vessel will still contain the metal, though the exterior coat be cut through. Valves are exceedingly numerous in this system of ves-
sels ; though they are very irregularly placed, being found in some absorbents in great numbers, while in others they are comparatively scarce. We observed, when on the veins, that, according to the opinion of Mr. Hunter, the valves in them were not to be regarded as continuations of the lining membrane, and Mr. Cruikshank, we find, thinks, that they differ in structure from it in the ab- sorbents : he says, in allusion to this part of our subject, |
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On the Absorbents. 115
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"It never struck me as a good argument, that because
one substance was seemingly continued from, or went into another, it was therefore the same kind of substance." These valves are situated in pairs, and we not unfrequently find three or even four pairs within the space of an inch : there are no absorbents without them. If you examine a distended absorbent, you perceive that it is knotty, or irregular in its canal: this appearance is owing to the valves, which are placed in pairs at every joint, or coi> traded part of the vessel. The small abscesses in farcy assume that remarkable appearance called buds, in conse- quence of the valves intercepting the diseased portions of these tubes*. The valves perform the same office in absorbents as
they do in veins : viz. that of preventing any retrogade motion of the circulating fluids, and, it is thought, that of sustaining in part the weight of their column, by frequently intercepting it. In support of this hypothesis, Mr. Cruik- shank says, "that the thoracic duct in horses has few valves, compared with the same duct in monkeys, where it is quite crowded with them :" but by subsequent re- searches into comparative anatomy, he was by no means well borne out in this opinion. Absorbents have their vasa vasorum. The above wri-
ter mentions, that he has injected in quadrupeds the ar- teries on the coats of the lymphatic vessels, and seen them ramifying very elegantly through their substance ; and he goes on to say, " these arteries must have their corres- ponding veins, and I can have no doubt of their being at- * The valves do not appear to be diseased in farcy, when the
lining membrane presents a surface of ulceration: another, and to us a conclusive proof, of the difference of texture of these parts. I 2
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On the Absorbent Glands.
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116
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tended with lymphatics." Without taking the trouble,
however, of attempting to inject these vessels, we caii frequently demonstrate their vascularity, when they are in a state of disease—as in the inflammatory stage of far- cy prior to suppuration : hence we find, that they in no wise differ in this respect from arteries and veins. Nerves also, in all probability, enter into the texture of
an absorbent; for we are informed by the same writer, that the thoracic duct is surrounded by nervous filaments. It would appear, however, from some experiments relat- ing to absorption, that these vessels can perform their action without the nervous energy. On the Absorbent Glands.
Small glandular looking bodies are found in various
parts of the body,commonlylooked upon as appendages to this class of vessels—as forming a part of the absorbent sys- tem, with which they are so generally connected. Though these organs are called glands, we have no reason for con- sidering them as such : indeed, much doubt is still enter- tained by anatomists as to the real nature and use of them. They are commonly of an oval figure ; and vary in size,
from the bulk of a small pea to that of a walnut. There are very many of these glands in the mesentery, through which the lacteals are passing : also in the loins, upon the inside of the thighs, in the breast, and under the jaws, every practitioner knows, that the kernels, as they are called, in farcy, are occasionally found. These glands are for the most part of a reddish color in their substance ; though, in exception to this, there are a few at the roots of the lungs which put on a dark blue, and sometimes black appearance. From the number of these small bo- dies in various parts, the circulation in the absorbent sys- |
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On the Absorbent Glands.
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117
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tem is not likely to be much impeded by obstruction of
one, or even a cluster of them ; for, as many have no immediate communication, morbific virus commonly af- fects but a limited number of them. The lymphatic glands are enveloped in separate cap-
sules, loosely connected to the surrounding parts by cel- lular membrane. We do not know precisely in what the minute structure of a lymphatic gland consists ; though the opinion of its being cellular—i. e. made up of small cavities, or cells, seems to be the best received among modern anatomists. Mr. Cruikshank observes, that " In quadrupeds it is very easy to demonstrate the cellu- lar structure : both in asses and horses, the glands on the mesentery are most distinctly cellular:" many of these cells communicate one with another. An absorbent, prior to piercing the substance of one of them, divides itself into several branches, called vasa inferentia, from the cir- cumstance of their dipping into, and terminating in, these cells, into which they are supposed to deposit their con- tents. Other similar ramifications, arising from the op- posite sides of them, by which the fluids are again taken up, have received the name of vasa efferentia. To these, by some, a third set has been added under the appella- tion of vasa circuita, which pass over the exterior of the gland without having any communication with its cells: these vessels (if such exist) appear to be useful in giving passage to the fluids into other glands, in case of any ob- struction in that over which they ramify. The lymphatic glands are very vascular—they possess
numerous arteries with corresponding veins, which latter vessels are without valves*. It appears that their nerves are of very small size, and but few in number. Vide Crwxkshank, on the Absorbing Vessels of the Human "Body.
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LECTURE VIII.
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On the Physiology of the Absorbents.
Absorption was formerly supposed to be a pro-
cess carried on by the veins, to which the absorbents them- selves were regarded as appendages; an opinion that maintained celebrity until the time of Mr. John Hun- ter : he it was that first proved, by many ingenious and well-conducted experiments, that this function was prin- cipally, if not entirely, performed by the absorbent system. He first demonstrated, that the lacteals, and not the me- senteric veins, absorbed and conveyed certain fluids from the cavity of the intestines into the circulation. By inject- ing milk, and other fluids colored and scented with vari- ous substances, into the bowels of an animal, he found that the lacteals were uniformly filled with them ; while, on the other hand, the mesenteric veins either remained empty, if the circulation was stopped in them by tying the mesenteric arteries, or contained blood, when no liga- tures were used, which exhibited no tests whatever of any admixture of the injected fluids. With regard to the economy of the lymphatics, although
we cannot demonstrate their functions with equal certi- tude by experiment, we may infer it to be similar to that |
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J
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Oh the Physiology of the Absorbents. 119
of the lacteals, from the many phenomena relative to the
healthy and morbid actions of the body, which we could on no other principle than that of a process of absorp- tion, satisfactorily explain. We said, in the foregoing lecture, that the lymphatics arose from every part of the body, and that their trunks were more numerous than those of the arteries and veins taken collectively ; we have no right, therefore, to argue from their minuteness, their in- capability of performing the functions ascribed to them. Mr. Hunter, to whose labors we are indebted for
much information on this subject, was first induced to be- lieve that absorption was performed by the lymphatic vessels, from an attentive observance of different facts connected with disease, which he found inexplicable on the, then, more current opinion of the veins being the channels of absorption. This acute physiologist first re- marked, that poisons, said to be absorbed and conveyed into the circulating medium by the veins, did not take the course of those vessels, but, on the contrary, might be traced along that of the lymphatics. The venereal virus, for example, which is commonly absorbed from the glans penis, produces effects in the groin, by creating irritation in the absorbent glands there ; and they, iii consequence, swell, become hard and painful, and form, what is called, a buboe. Now, this is not the course of the veins, but of the absorbents ; which indeed may frequently in this disease be felt, or even seen, running along the dorsum penis into the glands in the groin : and that these vessels are not veins, but absorbents, may be proved by the fact, lhat if the swollen glands be extirpated before the poi- son has passed beyond them, the disease will be as effec- tually eradicated, as if the specific itself had been admi- nistered. Again, if a horse be innoculated with glandered |
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120 On the Physiology of the Absorbents.
matter in the nose, in the course of three or four days an
ulcer will be seen at the place of innoculation, accompa- nied with one or more small tumors under the jaw : in this instance, although the disease appears to take the course of the superficial veins, dissection has demonstrated that those vessels are in a state of health, and that it is the lym- phatics alone, with the glands in which they terminate, that are affected. From a consideration of the above facts then, it appears undeniable, that these vessels are, as their name imports, the channels of absorption ; and that no such function can be assigned to the veins, as far, at least, as the actual inspection of parts warrants such an asser- tion : still it is light to remark, that there are writers of the present day who think that the veins participate in this process. In some instances, the virus conveyed by these vessels
and poured into the blood, contaminates the whole circu- lating mass: the experiment we related when on the blood, relative to transfusion, seems to put this opinion out of the reach of doubt. The absorbents not only possess a power of imbibing
fluids, but even of taking up the hardest solids themselves, of which we see daily examples in the disappearance of bony tumors: exostoses, in the form of splints, spavins, and ringbones, are removed, on this principle, by the effect of blisters; and strangles we have all seen, prior to sup- puration, give way to absorption. But another and more striking instance, is the removal of extravasated blood : if a man gets a black eye, which is nothing more than an effusion of blood under the skin in consequence of a rupture of some small blood-vessels, we know that the swelling will gradually diminish, and slowly lose its black or blue tinge, until, at length, the part resumes |
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On the Fhyuolooy of the Absorbents. 121
{and it does so by a process of absorption) its natural size
and appearance. Parts of the body that have lost their vitality, are detached and thrown off in the form of sloughs by an act of absorption : these vessels erode, as it were, such particles of living matter as are in immediate contact with the dead, and the latter is ultimately cast off by gra- nulations, which spring up from the living surface under_ neath. It has been observed, that new or recently form- ed parts are absorbed with more readiness than old. On no other principle than that of absorption, can we
explain the well-known action of mercurial ointment rub- bed upon the surface of the human skin ; the constitu- tional effects of which are nearly the same as if so much had been actually introduced into the stomach; though, in the one case, it is carried into the system by the lympha- tics; in the other, by the lacteals. We have made some trials of mercurial inunction on the skin of the horse, where it is uncovered by hair, but we have never been able to produce salivation, without the aid of the internal exhibition of some preparation of mercury; and calomel is the most effectual for this purpose. Tartar emetic also, a very small quantity of which will vomit a man when taken, has a similar effect on him by inunction. Physiologists had no sooner ascertained that the process
of absorption was the function of these vessels, than other inquiries were instituted to learn by what means solid matters were removed and conveyed by them into the circulation. Various conjectures have been formed on this curious process : some imagining that they had teeth, for the purpose of comminuting or breaking down the solids; while others thought that capillary attrac- tion, or suction, was the power by which this extra- ordinary function was performed. Others, with more |
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122 On the Physiology of tlie Absorbents.
plausibility, offer as their opinion, that all solid matters
are dissolved, or reduced to a state of fluid, prior to the absorption of them : bone, for example, say they, prior to its being absorbed, is dissolved by the phosphoric acid contained in the blood; this opinion however, like the preceding, is purely hypothetical, nor indeed do we at present know how the process is effectuated. It would appear, from some facts, that the orifices of
these vessels possessed something like the power of selec- tion: e.g. poisons, generally speaking, will not be taken up by them, unless the surface of the skin be abraded. You may besmear any part of the skin with the matter of farcy and glanders without infecting the animal; and we have several times rubbed it upon the pituitary membrane without contagion : but if you produce the least abrasion of the surface, the absorbents almost invariably imbibe tin virus. .Again, the lacteals have other fluids than chyle pre- sented to their mouths ; both bile and pancreatic juice flow over their orifices, and yet these fluids are never de- tected in their canals. It is now well known, that absorbent vessels will take
up gases in contact with the surface of the body, though doubt still exists as to the absorption of fluids : hence mercurial fumigation in the human subject causes saliva- tion, and yet it appears that mercury in a state of solution in water will not produce it. A similar result has been observed from some experiments made with spirits of tur- pentine : if the hand be immersed in this fluid, and care be taken not to inhale its fumes, no absorption of it ap- pears to happen; but let a person inhale the vapors of it, and its presence can be demonstrated in the urine, with as much certainty as if it had been introduced into the sys- tem through the medium of the alimentary canal. It |
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On the Physiology of the Absorbents. \'2S
still remains to be decided, and it is a question replete
with interest to the veterinary surgeon, whether we have any infectious disease in the horse—any that may be com- municated by the inhalation and absorption of noxious vapors : we know, that glanders and farcy are contagious, but whether we can pronounce them to be communicable by the breath, or susceptible of being engendered by a polluted atmosphere, seems as yet undetermined: at least, we believe, that we shall find advocates both pro and contra. With a view of ascertaining whether nutriment could
be supplied to the system by means of the absorbent powers of the skin, emaciated persons, labouring under disease of the organs of deglutition, having been first ac- curately weighed, have been put into baths consisting of nutritious fluids of various kinds, such as milk and soup : these patients however derived no benefit from the ex- periment, nor did they receive any augmentation of weight but what was satisfactorily accounted for without any re- ference to absorption. Under such circumstances, how- ever, although the lymphatic vessels refuse to take up nutriment presented to them in the form of extraneous matter, they are actually nourishing the body—by convey- ing its adeps into the blood : hence the cause of the ex- treme emaciation of these people is explained, as well as the sustenance which the body appears to receive (for it essentially does not) from the very sparing quantity of the ingesta. And now that we know why extreme pain long continued, or any other cause of defective appetite, should throw an animal so rapidly out of condition, and leave him so debilitated, we shall not feel surprised at a horse, who has simply picked up a nail in the foot, wast- ing away in flesh, however fat he might previously have |
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124 On the Physiology of the Absorbents.
been ; for the pain caused by this accident is often so ex-
cruciating, that not only does all desire for food leave him, but even death itself occasionally ensues. The matter absorbed, having once entered the orifices
of these tubes, is propelled, it is supposed, by the action of the muscular tunic, through their various ramifications into the receptaculum chyli, where a commixture of the chyle, from the lacteals, and lymph, from the lymphatics, takes place; which fluids are, in union, poured by the thoracic duct into the left jugular vein, to be circulated with the general mass of blood. It is not improbable, that the passage of the absorbed fluids is somewhat assist- ed by the occasional pressure to which these vessels are subjected, in almost all parts of the body. The lymphatics, like the arteries, are constantly in ac-
tion, but their function, as we have seen, is very differ- ent ; for they are removing the various materials of which the body is composed, and re-conveying them into the blood, from which they were originally formed: hence the latter vessels have, and not inaptly, been regarded as a set of workmen employed in depositing new materials, while the absorbents have been compared to others who are clearing away the rubbish and worn-out parts, and carrying them back to the general elaboratory; where they are either decompounded, and in part again ren- dered fit to serve some purpose in the animal economy, or cast off altogether as excrementitious. This change is continually, and almost imperceptibly, going on in every animal body; but the processes of deposition and absorption do not bear the same relative ratio at all ages : in the young animal, for instance, in which the body has not attained its full growth, the arteries deposit more than the absorbents remove, hence the increase of every |
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On the Physiology of the Absorbents. 125
part is accounted for ; but at the time of puberty, when
an animal has arrived at perfection of growth, these two orders of vessels are nicely balancing their operations ; while in old age that of the absorbents predominates, and the animal experiences a gradual decay of the pow- ers of his constitution. We are to consider the lympha- tics, therefore, as the means of removing that which is superfluous or noxious, and the lacteals, as the channels for the conveyance of nutriment; at the same time, how- ever, that these vessels serve such important ends in the system, they sometimes prove, as we shall hereafter ex- plain, the vehicle of its infection, and even, now and then, of its destruction. We have various means of exciting the action of the
absorbents. Many medicines are employed for this pur- pose ; some of which appear to possess a specific ac- tion over them, while others operate through the medium of the excretories of the system. In the human subject, one of the most powerful is mercury, employed in various forms : to such an alarming extent, indeed, may this re- medy be carried, that the gums will uicerate, or be absorbed, and the teeth loose and drop out, from its in- fluence : and even the jaw-bone itself has been known to become carious during its improper administration. Hence, one of the most ready means surgeons possess of dispersing a tumor, is the inunction of it with mercurial ointment; and in this case, the medicine has little or no local effect, but produces absorbtion principally from its influence on the absorbent system. Strong diuretic and purgative medicines increase the
action of the absorbents ; for under their operation, it appears that these vessels are excited to do more than ordinarily, in order to repair the losses sustained by the |
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126 On the Physiology of the Absorbents.
constitution during the continuance of such evacuations :
hence it is, that these are among the best remedies we can employ in dropsical affections. How often.do we see swelling of the legs removed by a dose of physic, or the use of a few diuretic balls; and a similar effect is well observed in watery farcy, in which strong doses of aloes and calomel, combined with diuretics, are the most ready and efficacious means we can adopt to reduce that enor- mous tumefaction of the limbs, so alarming a symptom in this disease. Exercise, while it accelerates and strengthens the cir-
culation of the blood, proves a stimulus to the absorbent vessels; of which we have ample proof in the diseases above mentioned, not to notice the numberless instances we have of it, more particularly in the autumnal season of the year, in horses whose legs are filled in the morn- ing, but become fine as soon as they have been walked out for a short time. Friction also tends to promote absorbtion. Merely
hand-rubbing the legs will frequently reduce common dropsical accumulations in them; indeed, it seems to have the same effect as gentle exercise has—accelerat- ing the circulation, facilitating the return of blood through the veins, and, at the same time, increasing the action of the absorbents. In the human subject, mer- cury, but a short time ago, was almost always introduced into the system, for the cure of the venereal disease, through the medium of the absorbents of the skin: in this case, friction is necessary to impel the ointment through the pores of the cuticle, at the same time that it rouses these vessels into action. In some instances, pres- sure alone will effect a diminution in the size of a swollen part: hence, the constant application of a tight bandage |
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On the Physiology of the Absorbents. 127
to an enlarged leg, will often reduce it; and with the
same view, some old practitioners recommend that sheet- lead be bound tightly upon the leg for the removal of splints. In the human subject, digitalis, when internally admi-
nistered, both from its nauseant and diuretic effects, proves a stimulus to these vessels: we are not prepared to say whether its use be attended with similar good ef- fects in the horse. Absorption is augmented by the application of stimu-
lants to the surface of the skin: this fact is best shown in the use of blisters to those kinds of tumors we are not able to discuss by other means : need we mention windgalls, and a variety of exostoses. Now let it be observed here, that the first effect of a blister is to excite the action of the arteries, so that the swollen part is ren- dered absolutely larger than it was before ; but its ulti- mate one is to provoke that of the absorbents, which im- mediately set about the removal of the swelling. Heat, whether it be combined with moisture or not,
will cause absorption; though its modus operandi ap- pears to be different according to the means which we employ in its application, as fomentation and the actual cautery plainly show us. Physiologists are not agreed as to the use of the ab-
sorbent glands in the animal economy. It has been sup- posed, that the lymph, in passing through them, expe- riences a more perfect union, or combination of its ele- ments, or, in other words, undergoes a process of assimi- lation, or animalization, and that this renders it fit for commixture with the general mass* of blood : the fact of the venereal virus in the human subject, although conta- |
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128 On the Diseases of the Absorbents.
gious if taken from a chancre, being quite innocuous
when obtained from an ulcer in the throat, is advanced in support of this hypothesis; it may be urged, however, against it, that there are some substances which do not appear to undergo any change in their passage into the system. On the Diseases of the Absorbents.
The absorbent vessels, and their glands, are liable to
become inflamed from two causes:—from simple ir- ritation, and from the external application of various poisons. In horses, they are seldom diseased from the first cause, though we have seen them thus affected : if, for example, any irritant of an active nature, be applied to the membrane lining the nose, so as to cause some corrosion of its surface, you will have corded absorbents and tumefied submaxillary glands, the effects of ulcera- tion in the nostrils, putting on altogether the appear- ance of glanders ; but differing essentially from that dis- ease, inasmuch as it will soon subside from the use of common depletive remedies. In the human subject, this kind of irritation is very common, in consequence of these vessels being much more susceptible of injury than in horses : merely tying the shoe too tight, will not very un- frequently disease the whole limb, by inflaming the ab- sorbents ; which appear like so many red lines upon the surface of the skin, taking their direction to the groin, where the absorbent glands, called the inguinal, are also commonly enlarged. In men, they inflame less frequently from the absorption of poison than from common irrita- tion ;—not so in horses; in them, the introduction of poi- sonous matter into the system,isthe chief source of disease |
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On the Diseases of the Absorbents. 130
of the absorbents, and their glands; of which we have,
but too frequently, fatal instances in the destructive ra- vages of glanders and farcy. We might, a priori, have supposed, that these vessels
were diseased, at least in function, in all cases of dropsi- cal accumulation ; otherwise, the fluid would have been taken up by them in the same ratio in which it was effused by the arteries; far from being owing to defective ab- sorption however, these vessels are actually enlarged in their calibre under such circumstances, and have, in reality, been performing more than they ordinarily do. The chief cause of this disease appears to be increased action, combined with diminished power in the circulat- ing agents—the heart and arteries; by which more blood is thrown into the capillaries than can be returned by the veins. Bleeding, therefore, in such affections, is generally a good practice, as it tends to abate the quickness of the pulse, at the same time that we are making use of the remedies before enumerated, to rouse the absorbents into still greater action. But in farcy, which is a disease of the absorbents themselves, the dropsy commonly attendant, is probably owing to defective absorption, in consequence of obstruction in these tubes. The absorbent glands of the mesentery are by no
means unfrequently diseased : indeed so common is this disease in the ass species, that we meet with it often in apparent good health. There is an affection of the same nature to which scrofulous children are very sub- ject ; in whom it is known to be present during life, by Preternatural enlargement, tension, and hardness of the belly^ accompanied with more or less disorder of the bowels, and marks of general ill health. Here we might conclude our remarks on this hitherto uninvestigated K
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130 On the Diseases of the Absorbents.
subject; had not an extensive range of practice afforded
us opportunities of deviating from the trodden path of generalization, and of coming to something determinate about a disease, with which we have only been made analogically acquainted. In almost all the cases we have met with, (and they
have been pretty numerous,) in which dissection has shown general disease of these parts, loss of condition has [been a marked and uniform symptom during life, accom- panied with some perceptible change in the appearance of the excrement—though this may be only occasional— and with more or less irregularity in the discharge of it. These symptoms, which may be said to constitute the first stage, are succeeded by others not less characteristic of a disease, that, if it be extensive, and the horse young, is not unlikely to end in death. Irritation of bowel su- pervenes, probably giving rise to a dull and heavy pain, so that the horse lies down during most part of the day, manifests considerable depression of spirits, loses his ap- petite, and continues to fall away : about this time his pulse becomes frequent—we have known it to rise to 100°—his breathing is in some degree quickened, and other signs of constitutional disturbance are present. The case is now alar-ming—the practitioner is ignorant of its ntfture—and the animal unrelieved, dies in a state of extreme emaciation. Seeing, then, that this is the com- mon course of a malady we have not devoted that atten- tion to which, every one who has his profession at heart will coincide with us, weought to have done, we shall con- elude this lecture by admonishing veterinary practitioners against inattention to diseases denominated chronic; of which this is one of the most important*. • These glands, when diseased, are met with in a variety of
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LECTURE IX.
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On Cellular Membrane.
V^ELLULAR membrane is the general connecting
medium, if not a constituent, of every part of the body. states. The common appearance is what is called schirrus; but
even this is extremely variable, as to the precise nature of the change the gland has undergone. Without any attempt to trace the progress of this and other morbid changes, much less to couple them with their diagnostic symptoms, which present medical sci- ence, even in the human subject, does not admit of, we subjoin descriptions of several specimens of this disease now in our mu- seum. No. 2. A cluster of mesenteric glands, having a lobulated appear-
ance, attached by aloose fold of mesentery to the duodenum. Alto- gether they are about the size of a hen's egg, firm and solid through- out, and exhibit a yellowish inorganic texture within: all the glands connected with the small intestines were similarly diseased. The case was fatal. 3. A mesenteric gland enlarged and schirrous. The change
this has undergone, is of a scrofulous nature: its central part con- tained a curdly cheesy matter, such as is found in parts so diseased ln the human subject. 94. Several cancerous mesenteric glands, belonging to the large
■ntestines. They contained considerable collections of curdled pus, which, by ulceration, had discharged itself into the gut. Death ensued. |
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On Cellular Membrane.
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132
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By it the coats of arteries and veins are knitted together,
as well as loosely connected to the surrounding parts; and these vessels, together with almost all other parts, are found to possess much of it in their ultimate compo- sition. The various membranes of the body, by mace- ration, or boiling, may be entirely resolved into cellular membrane; though it exists in them in so dense and compact a form, that its general character is much altered: even bones themselves, by being long steeped in diluted muriatic acid, may be converted into a soft substance, which appears to be chiefly cellular membrane ; and we know, that it unites the minutest jibrilla of muscles, so as to form fasciculi, and by continued union of them, a complete muscle. There are two kinds of cellular membrane in the body:
—one, from its net-like tissue, is called the reticular; the other, from containing adeps or fat, the adipose. We shall first speak of the reticular membrane. The reticular membrane varies somewhat in its quan-
116. Specimens of two schirrous mesenteric glands of very large
size: when taken from the horse, each weighed 14 lbs. Internally they consist chiefly of schirrous deposit; an unhealthy-looking pus was discharged from them in some places; and here and there are depositions of bone. Their peritoneal covering is considerably thickened, indurated, and altogether altered in texture: it may, in some parts, be with propriety called cartilaginous. The case proved fatal. 151. Thickened and tuberculated mesentery, with cancerous
glands. In the subject from which this preparation was taken, the mesentery and its glands presented a sheet of scrofulous disease. Some of the glands were in an enlarged and schirrous state; others contained a curdled and bloody pus; in addition to which the me- sentery itself was studded with hard, white, solid tubercles. This case ended in death. ^^H |
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On Cellular Membrane. 133
tity in different parts of the body: upon the ribs, and
more especially about the breast, it is abundant and loose in its texture ; but upon the belly, and about the head, it is dense, and so short, that we can scarcely pinch up the skin, or insert a rowel, though we effect either with the utmost facility in the chest, or under the jaw. Al- though the quantity of this substance depends in some measure, as we shall hereafter find, on the condition of the animal, it is always plentiful in parts possessed of much motion : hence, we find it long and loose in the scrotum, (where it invests the testicles,) upon the inside of the elbow and thigh, and under the jaw ; and in the human body, we always find it thickest—most con- densed, in parts exposed to pressure, more especially in the palms and soles. The reticular membrane is made up of fibres, inter-
woven and disposed in such a manner as to form innu- merable cells, or small cavities : and this it was, that first gave rise to the name of cellular membrane. These cells have a free communication with each other; a fact demonstrated by occurrences of the most common and familiar kind : who has ever seen the carcass of a calf inflated by the butcher, in order to give the veal a fatter aud whiter aspect, will need no farther proof. There are many phenomena, however, connected with disease, which verify the same thing : in emphysema, (a swelling of the skin from the admission of air through a wound communicating with the cells of this membrane,) the air very commonly diffuses itself over the whole body; and a w°und in the chest, or one at the point of the elbow, is m°st likely to be attended with this appearance. Again, in anasarca, (an effusion of water into this substance,) or m ecchymosis, (an extravastion of blood ;nto it,) the fluids |
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134 On Cellular Membrane.
invariably, after a time,occupy the most depending parts :
hence the tumefaction of the legs, breast, and belly, in the first of these diseases, more than that of any other parts. Into the cells of this membrane, during life, is poured
forth a serous fluid, in the form of vapor, by the exhalent extremities of the arteries ; (which we formerly described as terminating upon the surfaces of these minute cavities;) from the evaporation of which, that peculiar odor, so constantly perceived in flaying an animal recently dead, is emitted. The reticular membrane does not put on the same ap-
pearances in all places:—it is, in most structures, opaque, but there is one part where texture is so extremely fine and delicate, that it is perfectly transparent: we mean the eye, in which there is a Cellular bag, called the tunica v>trea> through which the rays of light pass with- out the least interception. These cells possess a certain degree of elasticity: if, for instance, we include a por- tion of skin between our finger and thumb, it will suddenly recoil on being liberated, and recover its original situa- tion ; a circumstance principally attributable to the elas- tic property of the subjacent cellular membrane. This membrane is not very vascular : the blood-vessels
found ramifying within it, are chiefly distributed to other and neighbouring parts; so that, when violent inflamma- tion is excited in it, sloughs of it not uncommonly take place ; and this happens when we introduce any caustic under the skin ; the core which comes out, being chiefly dead cellular membrane. Absorbents appear to exist in great numbers in it; for if we but extravasate quicksilver nntier the skin, in some parts of the body, it will find its way into many of these vessels. Although tlus part is not |
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On Cellular Membrane.
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135
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very sensible in a state of health, it becomes so in dis-
ease : the simple introduction of a probe into the cavity of an abscess, is a sufficient proof of it; there can be no doubt, therefore, but it possesses nerves. The adipose, or fatty membrane differs from the reti-
cular in two material points of structure : first, in its cells being perfectly circumscribed cavities, i. e. such as have no communication whatever with each other; and se- condly, in containing, instead of vapor, fat; which, at the temperature of the living body, is oil. Knowing this then, you will at once discover why the adipose membrane should have entire cells : had they resembled those of the reticular, what must have been the consequence ? The oil, or fat, like the water in anasarca, would have gravi- tated to the most depending parts, and have accumulated in such prodigious bunches about the legs, that progres- sion must have become irksome, with great difficulty per- formed, or altogether impeded: on the contrary, as the fat is at present disposed, the animal carries it about with the utmost comparative ease. We have said, that adeps is met with in the form of oil in the living body ; and in the human subject, and those animals that feed on flesh, called carnivorous, it retains much of its oily nature after death ; but in horses, and other graminivorous ani- mals, it concretes, and exhibits that appearance we are all so well acquainted with by the vulgar name of fat. From exposure to the air fat becomes firm and hard:
though if we break it into pieces, it still shews that it is every where intersected by pieces of skin or bladder, which, in fact, are nothing more than the membranous Cells containing it. About the kidneys, the adeps, which in fat animals is deposited there in considerable quantities, assumes a whiter and harder aspect than in other parts, |
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] 36 On Cellular Membrane.
for which reason it is commonly called suet. In many
parts of the body, there is little or no fat ; and when we reflect on their nature and functions, we are .persuaded that its presence must have proved extremely inconveni- ent to them : the eyelids, for instance, had they been loaded with fat, could not have moved as they now do; nor could the penis, so constucted, have answered the purposes for which it was designed. Young animals have more fat than old, anil have it deposited more upon the superficial parts of their body; in fact, the young of almost all the different species of the higher animals are enve- loped in fat; well instanced, in the infant, the puppy, and the kitten. But it is not so with the foal, the calf, and some few others, which immediately after birth have the power of following their dams, in search after food : fat to them would have proved burdensome, without an- swering the same useful purposes, for which nature seems to have given it to the young of most other animals. We frequently see very fat young horses—indeed most of the three and four years old horses, purchased of dealers, or of the breeders, have considerable depositions of fat be- tween the skin and abdominal muscles ; or, to express ourselves in the jockey's phrase, are "fat upon the rib." The prodigious bulk that beasts, fed for the purpose, will attain, is almost incredible : a prize ox has weighed two hundred stone* ; and a prize sheep, forty stone*. In the human subject also, we have had astonishing instances of corpulence : Lambert weighed fifty-two stonef. In re- spect of the latter, it has been remarked, that fat people do not in general live to a great age. As the cells of the reticular membrane are filled with a serous exhalation f A stone is 8 lb. f Horseman's weight, 14 lb, to the stone.
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On Cellular Membrane. 137
from the terminations of the arteries, so we believe those
of the adipose to be with fat: we have no anatomical proof of the existence of any distinct gland for the pur- pose, but we suppose it to be a secretion from the arterial ramifications distributed over their interior. In almost all animals that are healthy, copious food of a nutritive kind, and privation of exercise, will increase the deposi- tion of fat; but in the human subject, and, indeed, in many quadrupeds the spirits appear to have very con- siderable influence over this secretion. We see num- berless examples of people, who appear to enjoy the best bodily health, and yet are constantly meagre, though their food and habits of life tend to an opposite state ; and we may occasionally observe horses and dogs, particularly circumstanced, in which, from their natural leanness, or poorness upon the rib, something of a mental nature would appear to operate ; indeed, it is a well known truth, that if you separate a horse of an irritable disposition from others, with which he is accustomed to be stalled, he will fall away in condition, in consequence of, what is vulgarly called,fretting from being alone; and so much does this act of segregation affect some, that we have known them even refuse their food. Those horses are commonly the fat- test that are fed on easily digested food—as bruised corn aud chopped hay, and that have little or no exercise : a fact well appreciated by the horse-dealer, whose horses are fine, and fit for sale, but incapable of fatigue. Constitutional diseases, generally speaking, extenuate
the body, and more particularly those of the acute or painful kind ; hence, the irritation caused by a simple puncture in the foot, will, if it be of long duration, induce a state of emaciation: under such circumstances, the ab- sorbents are supposed to act with more than ordinary |
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138 On Cellular Membrane.
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effect, and to take up the adeps from the interior of its
cells. It has been supposed, that fat is placed near the surface
of the body, in order to defend the more internal parts of it from cold: this opinion, however, is not a very tenable one, when we consider the many facts connected with the subject. It has been thought to, and probably does in some measure, facilitate the motion of various parts. That it gives great beauty, not only to the hu- man form, but to that of horses, and other quadrupeds, no one will deny : it fills up many inequalities of surface the bones and muscles would otherwise present; the unsightliness of which we witness but too many in- stances of in half-starved cattle. But the principal use of fat seems to be, that of serving as a store, from which the animal can derive nourishment, when debarred of it from other sources ; as if Nature, all provident, whenever She has more chyle than is required for the immediate supply of the animal economy, lays it up, as bees do honey, to nourish the system, in part or wholly deprived of aliment by accident or disease : in no other way can we explain, why it should diminish in quantity when the animal takes little or no sustenance, or account for the extreme emaciation apparent before death caused by starvation. We have slready stated, that cellular membrane not
only varies in quantity in different parts of the body, but that it exists every where in more or less abundance, ac- cording to the condition of the animal; a fact we may, at any time, obtain full demonstration of by dissection ; though we need scarcely trouble ourselves so far, for the inspection of fat and lean stock, will of itself afford us am- ple conviction. The addition of cellular substance is al- |
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On Cellular Membrane. iSQ
ways attended with a proportionate deposit of fat, which
is not merely confined to subcutaneous situations, but pervades the texture of parts, and more especially of the muscles : a horse, under such circumstances, is said to be gross, to have flesh loose and Jlabbt/, and to be soft, and unfit for work. Young horses recently brought up to London for sale, or others just taken from grass, or that have been fed on soft meat in the stable, and little exercised, are all fat and^Vic to the eye, but not in condition for work. The common and simple manage- ment that such "horses require, to put them into condition for regular work, is to give them nothing but dried proven- der of the best kind ; to exercise them gently at first, and exert them more by degrees ; and occasionally administer moderate doses of aloes, by way of emptying the bowels, and exciting the powers of absorption, in order to get rid of some of their superabundant fat. By these means, we disencumber the muscles of their useless cellular and adi- pose matter, reduce the weight of the carcass, and im- prove the wind : in fact, we put the animal in a fit condi- tion to go to hard work, or, in common language, season him. In order to prove that such changes will take place in the composition of his body, let us only recall to mind, for a moment, the difference between the flesh of the stall-fed ox, preparing for the butcher, and that of the beast daily yoked to endure hard labor: reverse the states of these animals, however, and you will soon render the one fit for the knife, whose flesh before was hard and black; while the other wiil every day lose his elasticity and plumpness of feel, until his muscles become firm and hard, and altogether without fat. But the horse, in comparison with other beasts, may be said to possess but little adi- pose matter—he is an animal not equally disposed to be- |
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140 Diseases of the Cellular Membrane.
come incapacitated from such a cause; for, though we
every now and then see horses enormously fat, we never hear of one whose legs are overpowered by the weight of his body, or that cannot support himself under ordinary exertion; instances of which are always to be met with among pigs, oxerij and sheep. Not only do horses pos- sess less cellular substance in their composition than these animals, but some species appear to have it natu- rally either in much less quantity, or of a more dense and compact texture than others: the thorough-bred horse, for instance, exhibits, in this respect, a very different structure from the cart-horse; in him the skin, the muscles, and even the bones themselves, are less in vo- lume, much closer in texture, and appear altogether to be composed of finer and more compact materials. We may discover a similar, though less obvious difference in the contexture of the greyhound and the bull-dog : and we may even find very evident traces of the same thing, in the component parts of a delicate female, when com- pared with those of a robust and vigorous athlete. Diseases of the Cellular Membrane.
In this place, abscess is commonly considered. An
abscess may be said to be, a collection of pus within a cavity formed by the cellular membrane. In the formation of abscess, the adhesive inflammation
almost always precedes the suppurative; so that adhe- sive matter, and probably a little serum, are first depo- sited, producing a consolidation of the cellular substance; and this afterwards becomes the nidus for pus, by glu- ing the membrane tightly to the skin on one side, and to the muscles on the other : hence arise the swelling and induration in strangles, prior to the effusion of matter. |
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Diseases of the Cellular Membrane. 141
In this stage, the swollen part feels hard, hotter than usual,
and the animal flinches from pressure; which symptoms denote the continuance of inflammation, and its progressive course into the suppurative stage, unless it be put a stop to by the timely administration of our resolvent remedies. The suppurative process having commenced, at first only a little purulent matter is deposited in the centre of the tumor, by the mouths of those vessels which before ef- fused lymph: this, by its pressure, excites absorption of the inner contiguous layer of adhesive matter, a process that now keeps pace with the secretion of pus internally; until, at length, the swelling, before diffused and hard, is converted into one perfectly circumscribed, soft, and fluctuating. At this time, in the human subject, if the abscess be of large size, there is usually a fit of shivering, followed by some degree of fever; and in young horses, we may often discover something of the same kind, du- ring the progress of strangles, when the collection of pus is considerable. There being now no interposition of substance between the contained matter and the skin, ul- ceration of it ensues ; so that the integument covering an abscess becomes extremely thin, and always more so at its most prominent part; where, in common language, it is said to point: at this time, surgical interference gene- rally evacuates the abscess, though, if it- be left alone, it will discharge itself by a small opening at the spot where it points, and, in this way, it is said to burst. With regard to the progress of abscesses in general, they mostly make their way to the surface, so as to evacuate themselves by the skin: there are however instances, in which the different outlets of the body, as the alimentary canal, and trachea, become the medium of its ejection. But should pus be effused underneath parts, which, from their |
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142 Diseases of the Cellular Membrane.
vital powers being com paraiively weak, do not readily
ulcerate, it will diffuse itself over a larger surface, in- stead of taking a direct course to the skin : hence it is, that purulent matter collected under tendinous struc- tures, dissects its way among the muscles, and makes inroads and sinuses in various directions, unless free vent be given to it by incision. In like manner, if pus form under horn, a part wholly inorganic,—as in quittor, ulceration will give it issue by some circuitous route ; for (and the reasons are obvious) no absorption of the horn can take place : this at once explains, why we are so solicitous about discharging matter collected un- derneath the horny sole—lest it might occasion ulcera- tion of the sensible laminse, and present itself at the co- ronet, under the form of quittor. It is generally a good maxim, to make an opening into
an abscess as soon as the maturation of it is complete: let it be understood, however, that no harm will result from a contrary mode of treatment; for it is now univer- sally believed, that no ill consequences are to be appre- hended from the absorption of pus. How often do we see strangles suppressed without any apparent ill effect! —indeed, it is the best practice, if proper evacuants be at the same time administered : we say this in opposition 1o a budget of prejudice, founded on ignorance, and a stub- born adherence to erroneous tenets. But in some cases, and more especially in abscess of the foot, we should dis- charge the pus, however small in quantity, as soon as its presence is ascertained : otherwise, as we have already shewn, much mischief is likely to ensue. There are three modes of opening an abscess at pre-
sent adopted in veterinary practice: viz. by incision, by the actual cautery, and by seton. Each of these operations |
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Diseases of the Cellular Membrane. 143
has its advantages, and may be preferred according to
the nature of the case, as we shall find when we come to treat of particular abscesses. Fomentations and poultices are occasionally of service in promoting the processes of suppuration and granulation; but in the generality of cases, from the inconvenience with which their use is almost always attended in the horse, not to say the fre- quent impracticability of employing the latter, we do not have recourse to them : stimulants, more especially blis- ters, will best promote the suppurative state, and as for the process of granulation, that needs little or no assis- tance from art; except where there is any destruction of ligamentous, cartilaginous, or bony parts. The most troublesome cases of this kind are those termed poll-evil, and fistula: it is so seldom, however, that any thing like skill dictates the practice of the farrier, that we are not surprised at the tediousness and frequent incurableness of these diseases. |
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LECTURE X.
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On the Brain and Nervous System.
X HE brain, with the situation and general appearance
of which we are all more or less familiar, is that soft white mass which fills the cavity of the skull. In no animal is the cranium so large, in relation to the face, as in man; in none therefore is the brain, whose magnitude is al- ways correspondent with that of the skull, of proportion- ate bulk. In horses, this organ is but small when com- pared to the size of the body; though there are some differences (quite unimportant in an anatomical point of view) in the dimensions, as well as form, of the heads of horses of different breeds*. The brain is divided into three portions, all of which
* " The brain of the shark does not weigh 3 ounces although the
animal itself is generally 300 lbs. weight. The brain of the sheep, with respect to the whole weight of the body, bears the proportion of 1 to 150. In a dog the proportion is less: it is as 1 to 100. As we ascend in the general scale of rational beings, the magnitude of the brain bears an increased and strongly marked proportion to the size of the system in general. In the African, it is as 1 to 54. In an European, as 1 to the 50th part of the system altogether." Saumarez's System of Physiology, |
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On the Brain and Nervous System. 145
are continuous in substance : the cerebrum, so large that
it occupies at least 3-fourths of the interior of the skull; the cerebellum, or little brain; and the medulla oblongata. That portion of medullary substance which extends from the brain through the whole length of the spinal canal, is called the medulla spinalis, or spinal marrow. No viscus in the body is so well defended from external
injury as the brain : on every side it is enclosed by bony walls, well constructed to make great resistance, and more especially so at those parts where external violence is likely to be received. The interior of the skull is variously fur- rowed and indented by the more projecting parts of the organ, to which, in every particular, its figure is nicely adapted ; for it is by the shape of the brain that that of the cranium is moulded, inasmuch as the formation of the one precedes that of the other. The relative situation of the divisions of the brain, differs in the horse from that of the corresponding parts of the brain of the human sub- ject; though both organs, in regard to the bones of the cranium, are similarly lodged : e.g. the cerebrum, which forms the upper and anterior portion in the human sub- ject, constitutes the lower and auterior in the horse; while the cerebellum, which in the former is placed be- low and behind the cerebrum, in the horse is placed a- bove and behind it. This difference, however, is but ima- ginary, being entirely referable to the position of the head ; for if we place the horse's head upon a table, so that it rest upon the branches of the lower jaw, we shall find no difference whatever in the relative situation of these parts. The brain has three coverings, called its membranes, or
meninges; the dura mater, the pia mater, and the tunica arachnoides. Of these, the exterior is the dura mater; which, though called a membrane, is of a dense, tough, h
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146 On the Brain and Nervous System.
and inelastic texture, being chiefly made up of tendinous
fibres. It is so firmly adherent, by means of numerous little processes, to the sutures of the cranium, that it is with difficulty we separate them, afterhaving sawn through the bone; and this union is further strengthened by blood- vessels, which pass between it and the internal table of the skull; for, in truth, this membrane is supplying the place of an internal periosteum. There are several broad expansions, similar in texture to the dura mater itself, stretched across the cavity of the skull; the chief use of which seems to be, to prevent one portion of the brain from resting upon, or compressing another: there are also some canals, or sinuses, within the folds of this mem- brane, which, like so many reservoirs, receive the blood as it flows from the veins coming from the interior of the brain. Upon its inner surface it is smooth, being lubri- cated by a fluid furnished by its blood-vessels : it has no other connection with the subjacent membraues, although it lies closely applied to them, than it has with the brain itself;' and that is, through the medium of the many small veins terminating within its folds. The blood-vessels of this membrane, though not numerous, are of sufficient magnitude to admit easily of injection: it is a good illus- tration of the truth of the remark, " that the capillaries are not abundant in fibrous texture." By some the pre- sence of nerves is altogether denied to it; though there are writers who are inclined to believe, that they have seen something like nervous filaments in its texture : in a sound state, we are pretty certain that it possesses no sensibility ; for it may be cut, or irritated in various ways, without giving the animal any apparent uneasiness. The pia mater is that membrane which closely enve-
lopes the substance of the brain, dips down between its |
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On the Brain and Nervous System. 147
convolutions, and adheres to its surface by numberless
minute blood-vessels, easily lacerated by stripping it off ■with the forceps. It differs altogether in its texture and appearance from the dura mater; presenting a smooth surface exteriorly, but a rough and villous one next to the brain, and being composed of a beautiful network of blood- vessels, united together by a delicate cellular tissue : it is, in fact, the immediate source from which the brain de- rives its blood, and, at the same time, the medium through which the unexpended blood is returned to the sinuses of the dura mater. The third membrane has, from its extremely thin and
delicate texture, been compared to the spider's web, in allusion to which the name of membrana arachnoides has been given to it. It is placed between the two others, closely adheres to the pia mater, and separately invests the cerebral eminences and depressions, without, like that membrane, insinuating itself between the convolutions j from which circumstance, it is, with pains, demonstrable in some places about the base of the brain. Though there can be no doubt but it possesses organization, hitherto the most successful injections have not shewn any blood-vessels in its substance. Of its use, we dare not speak : physiologists are unable to say for what purpose so delicate and transparent a structure is here interposed. From the vascular connection which subsists between
the scalp, upon the exterior of the skull, and the dura mater, upon its interior, we have at once an explanation of that apparent anomaly in pathology, viz. that external injuries of the skull frequently induce symptoms of in- flammation of the brain, or its membranes : in the human subject, such wounds are always considered, on this ac- count, as dangerous, and, indeed, it not very unfrequent- £ 2
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148 On the Brain.
ly happens that they prove mortal. Though we have
never seen a case of this description in the horse, there does not appear to be any good reason' why we should not be cautious how we make or treat wounds of such a nature. A fluid, differing from serum in its properties, though
like it in appearance, is occasionally effused between the dura mater and tunica arachnoides, or, more commonly, underneath the latter membrane, (as well as within the substance of the brain itself,) constituting a disease, term- ed hydrocephalus: it rarely happens in horses, but in the human subject, and more especially in children, it is by bo means an unfrequent cause of dissolution. On the Brain.
We have already given an outline of the situation and division of this organ ;—we shall now make some general observations in regard to its structure. If a vertical sec- tion is made of any part of the brain, we perceive that its interior presents two substances of different colors: the out- er of these, of a dirty greyish hue, is called the cineritious, or cortical part; the inner, which is white, and of which the chief bulk of the. organ is composed, the medullary. The cortical part is not always the outer; in some places, the relative disposition of the medullary and it, is reversed ; it is that, however, in which the blood-vessels of the or- gan are most conspicuous; for, in consequence of being closely invested by the vascular pia mater, it receives the numerous ramifications of arteries transmitted by that membrane for the nourishment of the interior parts of the brain. On the other hand, in the medullary por- tion, the blood-vessels, which in health only convey the colorless parts of the blood, are so minute that they es- |
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On the Brain. 149
cape notice; unless, occasionally, here and there, when
it has heen inflamed, the bloody specks upon its divided surface, denote the division of those that have become of sufficient magnitude to admit the red globules. By the investigations of the best anatomists, the brains
of animals appear to be of a fibrous nature ; and in many parts of the human brain (which is larger than that of any other animal) the disposition and course of its fibres have been traced : such inquiries, however, have, unfor- tunately, not led to any elucidation of the sensorial func- tions, nor are we aware that they have been attended with any advantageous result in regard to its pathology. After all, the truth is, that the intimate structure of this or- gan is still unknown to us. With regard to the cineritious, or cortical part, there is much reason to believe, that it is almost wholly constituted of the ramifications of blood- vessels of extreme exility; from which, others, still more minute, are distributed to the substance of the medulla. It is here worthy of remark, that in no instance does
Nature so invariably present us with the same structure and arrangement of parts as in this viscus : in almost every other in the body, we can discover some little va- riation, in this respect, in different subjects; but in the brain, the same uniform appearances ever present them- selves on dissection : so intimately united do structure and function seem to be in*this organ. The cerebrum is divided into two halves, called hemispheres, each of which is formed of parts precisely similar, in every par- ticular, to each other; so that, in fact, every part of the organ may be said to be double, i. e. its two halves are constituted of several small portions, which are not only perfectly alike in structure, but are of corresponding |
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On the Nerves.
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symmetrical forms and dimensions: a remark that not
only applies to the brain itself, but one that holds good with regard to the spinal marrow. An animal, therefore, has, to all intents and purposes, two brains; and, proba- bly, for the same reason that he has two eyes, two ears, and a double tongue. The arteries which supply the brain, are the two ver-
tebrals, besides two other considerable branches from the carotids, called the internal carotids: its blood is returned from the sinuses of the dura mater by the vertebral and jugular veins. It is on the supply from the vertebral ar- teries, however, that this organ mainly depends, for the preservation of that energy essential to the support of life ; for if ligatures be put on these vessels, the animal speedily dies; whereas both the carotids may be tied without occasioning any apparent ill effects. On the Nerves.
The nerves are soft, white, fibrous cords, proceeding
from the brain and spinal marrow to all parts of the body. From the brain issue ten pairs of nerves, called the ce-
rebral ; and from the spinal marrow, thirty-^ix, denomi- nated the spinal: making, altogether, forty-six pairs of nerves in the body. In some animals, among which may be ranked the
horse, the nerves, in generat, are larger than those in the human body; though the brain of the latter far exceeds in bulk the same viscus in the quadruped. " The spinal marrow," says Rich era nd, " and the nerves, in the dif- ferent animals furnished with them, are larger in propor- tion to the brain, according as the animal is more distant from man in the scale of animation." . |
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On the Nerves. 151
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At their origin, the nerves are covered by the dura
niater, and a membrane similar to, if not a continuation of, the pia mater; but the tunica arachnoides cannot be distinctly traced upon them: these coverings, however, seem to proceed only to a short distance, for if we exa- mine the vagina, or sheaths, in which they are afterwards inclosed, we shall find them to be nothing more than con- densed cellular membrane. It is to this covering that the compactness and density of a nerve are chiefly owing; when deprived of it, but a slight degree of pressure will destroy its texture : indeed, there are some nerves whose pulpy nature would subject them to perpetual contusion and laceration, were it not for the protection afforded them by this compact cellular envelope. The substance of the nerves, like that of the brain, is
fibrous. Their fibres, which are connected together by cellular membrane, take a serpentine course, as may be seen by a close examination of the numerous white lines upon their surface ; so that if we unravel a nerve, we shall find it to be made up of an infinite number of jibrilla, or filaments, the minutest of which still retains a serpen- tine form. Some have imagined that these fibrils are tu- bular ; others, that they are cellular; but, in truth, we must confess ourselves still unacquainted with the inti- mate structure of the nervous system. It has been ge- nerally supposed, that nerves were inelastic in themselves, and that any extension, or contraction, they admitted of, arose from the elasticity of their component cellular membrane; Sir E. Home, however, has proved, by some ingenious experiments, that they possess a power of re- traction when divided in the living body; a circumstance which, of late, cannot altogether have escaped the obser- vation of those, who have performed the operation oineu-* |
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On the Nerves.
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152
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rotomy *• This retraction does not seem entirely to de-
pend on any inherent contractility of tissue, otherwise ex- tension of the nerve would be a necessary preparative ; on the contrary, it happens under the most complete state of relaxation ; an effect that will not take place in the dead subject under similar circumstances. A nerve is said to have two extremities:—a cerebral,
and a sentient: the former is that part by which it is con- nected with the brain, or spinal marrow; the latter, that by which it terminates in the various structures of the body. It has been usual to say, that the nerves arise, or have their beginning, from the brain, though it would ap- pear, from some recent investigations into their composi- tion andfunctions, that we might, with equal propriety, re- gard them as deriving their origin from the organs to which they are said to be distributed, and as ending in the senso- rium. Supposing, however, that they do issue from the brain, there still remains some difference of opinion re- specting their beginning, or roots. By some it is thought, that they are not continued from the substance of this organ, but are merely attached to its surface; though there are nerves which we certainly appear to trace be- yond the superfices—into the interior of it, as is the case with the optic ; so that although it is customary, for the sake of anatomical detail, to assign certain parts of the brain as the beds or origins of certain nerves, we are still, in truth, ignorant of the manner in which their original or radical fibres are disposed. It would appear, from many familiar facts, the result of experiments and patho- logical observations, that the nerves distributed to one side of the body, arise from the opposite side of the |
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* Vide Lecture XI.
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On the Nerves. 153
brain; and if this be true, there must be somewhere a de-
cussation of them : if an injury be received on the left side of the skull, the right side the body will become pa- ralytic; an effect that would not happen, unless there was a ready communication between one side of the brain, and the nerves of the opposite side of the body, by means, in all probability, of direct continuity of fibre. If one column of the spinal marrow be cut through, the animal will become paralytic, not on the opposite, but on the same side; a fact, which, although it at first view ap- pears contradictory to what we have just stated, in truth tends to confirm this opinion : for the medulla spinalis is composed of two columns, the fibres of which decussate each other in the same manner as those of the nerves are supposed to do. The nerves, generally speaking, soon after their origin,
form various communications with others in the vicinity; in many parts, by such frequent intercourse, that a kind of nervous net-work is formed, to which the term plexus is applied : some nerves, however, pass directly from the brain to their destinations, without either receiving, or giving off any communicating ramifications—such are the optic and olfactory. In their course, the nerves ge- nerally proceed in straight lines to the parts to which they are distributed; deviating only, like the arteries, for their own safety, or for some wise and evident purpose. Sometimes they run with the blood-vessels, sometimes alone : we commonly find a nervous trunk, and in some places two, accompanying the principal arteries and veins of the extremities. The branches of the rrerves, for the most part, come off at acute angles : those springing im- mediately from the trunk, send off others of smaller size. |
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154 On the Nerves.
until filaments of such minuteness are formed, as to be
invisible to the naked eye. The twig-like ramifications of nerves end in two dif-
ferent ways : either by inter-communication—which is si- milar to the anastomosis of arteries, or by sentient extre- mities within the substance of those organs to which they are distributed. In the retina, a part of the eye entirely composed of the expanded termination of the optic nerve, an extremely delicate tissue, of a pulpy consistence, and semipellucid yellowish appearance, is observable; from which, it has been conjectured, that the extremities of other nerves may be somewhat similar: but, to confess the truth, we do not know what form they actually as- sume—we think it very probable, that their mode of ter- mination may vary according to the nature and texture of the part in which they are expended. The nerves are very unequally distributed to different parts: the organs of sense, the skin, muscles, and mucous membranes are plentifully supplied with them; the serous, fibrous, and medullary membranes receive but few ; and none have yet been detected in either cartilage or tendon*. A ganglion is a little knot or swelling upon a nerve, per-
fectly natural to it. We find them in various parts of the body; more especially about the neck, chest, and abdo- men. From the fact of their being peculiar to those nerves which run to parts possessed of involuntary motion, they have been regarded as the means whereby such functions * And yet the granulations of these parts possess sensibility, of
which we have recently had a very marked instance, in the case of a broken knee. The horse never failed to snatch up the leg, every time the granulating edges of the extensor tendon were touched with the probe. |
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On the Physiology of the Brain and Nerves. 155
are supported ; hence those nerves of the eye which are
dispersed upon the iris, have them, while others going to the muscles of the organ, whose actions are under the in- fluence of the will, are without them : the opinion, there- fore, to say the least of it, is an ingenious one, though this is insufficient proof to establish it. On the Physiology of the Brain and Nerves.
The brain, in a physiological point of view, is to be
regarded as the primary organ of sense'—the sensorium; as the seat of perception, in which cognizance is taken of all impressions made on those organs to which nerves are distributed; and as the source of volition, or the part from which the will is transmitted along the nerves to the organs of voluntary motion. If the brain of an animal is severely injured, or diseased, a state of general insensibi- lity is induced, and the body rendered incapable of mov- ing itself: it does not follow, however, that all feeling be lost, even though the brain itself be removed, for the spinal marrow alone has been found capable of preserv- ing a degree of sensation. That a violent blow on the head, or pressure from any cause, no matter what, upon the brain itself, will deprive an animal of sensation and voluntary motion, we have frequent opportunities of wit- nessing in horses suffering from the effects of severe falls more especially from falls backward, upon the vertex, in the act of rearing; from which accident, it is not uncom- mon for them to remain for several days perfectly sense- less ; all attempts to rouse them proving ineffectual: you may c.ut or burn them, hold a lighted candle to the eye, or discharge a pistol close to the ear, and every part will remain as motionless as if the animal was dead. In op- |
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156 On the Physiology of the Brain and Nerves.
position to this, there are particular morbid conditions of
the organ, in which its functions are preternaturally ex- cited : inflammation is, perhaps, the most common cause of this derangement; hence it is that we account for the extreme irritability of horses in the mad stage of stag- gers, and the uncommon degree of force with which they exercise their muscular powers, during the continuance of the paroxysm. Though sensation and voluntary motion are so exclusive-
ly cerebral functions, that they cannot be duly perform- ed unless direct communication be kept up with the sen- sorium, in a perfectly sound and impressible state, it is different with regard to those motions that are involun- tary. When a horse becomes stunned from a blow, or during the lethargic stage of staggers, although sensation and the power of locomotion are nearly, or quite lost, still does the heart beat, the chest expand, and the alimentary canal continue to digest food. An admirable instance to show how needful Nature has been in the preservation of life, even during the disturbance of organs more imme- diately its source and seat: for had these parts been sub- ject to the same laws as govern the motions of the limbs, death must have supervened on every accident of this de- scription : whereas, now, life is supported, while the brain is recovering from the effects of the mischief. It is a curious fact, that, although the brain is the or-
gan of feeling, there is one part of it, apparently of itself, devoid of sensibility ; viz. the cortical, or cineritious por- tion ; which has been cut, torn, taken out, and otherwise injured, in the living animal, without causing any very evident marks of pain ; and this will appear the more ex- traordinary, when we consider that but little pressure upon its surface will instantly occasion violent and dan- |
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On the Physiology of the Brain and Nerves. 157
gerous effects. Also the medullary matter may be
pierced to a certain extent, from the surface of the cere- brum, without much inconvenience; and even a little of it may be removed without any ill consequences : we must be exceedingly cautious, however, in making this experi- ment, not to penetrate too deep into its substance, or the shrieks of the agonized animal will soon inform us of the extreme sensibility of its interior parts. Instances have occurred in the human subject, in which patients have lost, or had removed, from time to time, large portions of the cerebrum, without any apparent derangement at the time, or subsequent disturbance of the intellects. Concussion of the brain, a very frequent accident in the
human subject, though comparatively a rare one in the horse, produces symptoms very like those arising from immediate compression of the organ. In violent degrees of it, the patient is rendered perfectly insensible, though, in less severe cases, only stupor and partial paralysis en- sue : in either case, it is a disease never unattended with danger, and one which very frequently terminates in death. Violent injury, or disease of one side of the brain, de-
prives parts of the opposite side of the body of the pow- er of motion, and, but not always, of sensation : paralysis, or palsy, is the general term used to denote this affec- tion, though it is sometimes.specified by the word hemi- plegia. This state is commonly induced by pressure upon the brain, or spinal marrow, either the effect of the depression of a piece of bone upon its surface, or by the effusion of blood, or pus, upon or within its sub- stance ; we are, therefore, in such cases, not to apply our remedies to the paralysed parts, but to seek for the cause whence the nerves of these parts take their origin. The extent of paralysis will depend on the nature of the |
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158 On the Physiology of the Brain and Nerves.
cause, but chiefly on the part affected : if, for example,
only a single nerve be compressed, or injured, those or- gans which it exclusively supplies, will be rendered para- lytic ; but if it be the spinal marrow, then all those parts receiving nerves posterior to the seat of injury will be affected; and should the mischief be anterior to the origin of the phrenic nerve, in the neck, the diaphragm will be palsied, and death ensue. In wounding the brains of living animals, in various
ways, experimenters have generally found, that convulsions seized that side of the body on which the sensorium was injured, and paralysis the opposite : when, however; one column of the spinal marrow was divided, the parts on the same side were paralysed, but the others remained un- affected. There is one circumstance, connected with the phy-
siology of the brain, about which much has been said by such writers as have noticed it in the course of their experiments, without having, in a satisfactory manner, en- tered into an explanation of it. When we lay bare the brain of a living animal, we perceive (especially if we put our hand upon it) an evident rising and falling of the sur- face—alternate states of inturgescence and subsidence. Thus far, the subject admits of ready exposition: these motions simply depend on the diastole and systole of the heart, with which they are perfectly synchronous—the sudden influx of blood into the large arteries at its base, produces its elevation, while its depression is the effect of the momentary cessation of action in the injecting powers. But there are other motions to which this organ is subject; and the confusion of these with the for- mer, has probably tended to create the contention among authors respecting the causes of them : experiment, how- |
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On the Physiology of the Brain and Nerves. 159
ever, our only safe guide in these matters, shows that the
latter, which are but occasional, aud consequently irre- gular, are dependant chiefly on respiration, though they may be influenced by any thing that tends to accelerate, retard, or impede the reflux of venous blood. In order to convince ourselves that the brain is af-
fected by respiration, and that this is the common cause of alteration of its volume, we have only to observe the fontanels of children, or inspect the brains of living ani- mals, exposed for that purpose. How far we are to regard the brain and nerves as con-
cerned in the production of animal heat, yet remains to be determined : it is a question that has excited consider- able interest of late, in consequence of some truly inge- nious experiments of Mr. Brobie's. When all connec- tion was cut off between the brain and respiratory organs, by severing the head of an animal from the body, this gentleman found,* that, (respiration being artificially supported,) although the blood appeared to undergo the usual changes, and the respired air its ordinary alterations, the heat of the body diminished; and diminished, not- withstanding the circulation of the blood was kept up to its natural standard : more, however, we forbear to say on the subject, until we have occasion to speak of the phy- siology of the organs of respiration. The nerves, we may consider, as so many cords of com-
munication between the brain and the several organs of the body, by which the two grand functions—sensation and volition, are supported. If the nerves going to any voluntary part—say the fore leg, be cut through, the limb 18 not only deprived of its sensibility, but of all power of voluntary motion : you may prick, or injure it in any way, and the animal is perfectly unconscious of your doing so; |
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] 60 On the Physiology of the Brain and Nerves.
and even if he were, he could not move the leg, for the
muscles will now no longer obey the will. Not, how- ever, that the nerves themselves possess any power of motion, though they are to be regarded as the indispensa- ble agents of the brain in all such movements as are re- gulated by volition. In like manner, though the nerves be the organs by means of which parts are endowed with sensation, they of themselves, unconnected with the brain, are wholly devoid of feeling : you may prick, or cut, for example, the extremity of a nerve, whose communication with the sensorium is cut off, without the animal's even knowing that you are touching it; but you have only to irritate the opposite end, and you give rise to instanta- neous convulsions. Precisely the same thing happens if the nerves be tied, or otherwise compressed : you may cut or burn the parts to which they are going, apply light to the eye—if it be the optic nerve, or sound to the ear—if auditory, and no effect whatever, will, in either case, be produced. The functions of volition and sensation, are, in them-
selves, entirely unconnected ; i.e. they may subsist inde- pendently of each other—one will remain where there is a total absence of the other. Cases of paralysis in the human subject often occur, in which the lower extremi- ties retain their feeling, though the patient has lost all power of moving them : the reverse of this has also been noted. The nerves going to the organs of sense, possess a
power of being acted on by peculiar stimuli: e.g. the nerve called the optic, which is distributed to the inte- rior of the eye, receives the impressions of the rays of light, and transmits them to the brain, where perception of a peculhr kind is created, and the result is vision ; in |
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On the Physiology of the Brain and Nerves. 161
like manner, the vibrations of sound affect the auditory
nerve, which is spread over the internal parts of the ear; odors of all kinds are perceived by means of the olfactory nerves, belonging to the nose; while the tongue, through the medium of nerves called the gustatory, is endowed with the faculty of tasting: moreover, in the human sub- ject, the extremities of the fingers have a power of feel- ing, distinct from that of common sensibility. All these organs however have, in common with every other part of the body to which nerves are given, what is called or- dinary sensation; and this may remain unimpaired, though the proper sense of the part is entirely lost. If, for example, we are deprived of vision, by some disease or injury of the optic nerve, our eye is still affected by such stimuli as act on parts possessed only of common sensation—like them it can feel heat and cold; in like manner, though we be deaf, yet are our ears not de- void of ordinary feeling ; nor is our nose deprived of its general sensation, because a common catarrh may have destroyed its power of smelling. The reverse of this however will not apply: no part that has lost common feeling, is in the least affected by its appropriate stimulus ; nor is one set of nerves having a specific susceptibility, influenced by the peculiar excitant of another. For ex- amples, no part of our body is endowed with that pecu- liar faculty of feeling which resides in the points of the fingers; or, in the horse, in the extremity of the nose: the eye is not affected by the sound of a cannon, nor the ear by the most intense light; the tongue cannot smell, nor can the nose inform us of the sense of taste. The agent producing sensation, is not, generally
speaking, in direct contact with the extremity of the nerve: when we feel any thing, the nerves of our fingers M
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162 On the Physiology of the Brain and Nerves.
do not touch the body felt, for the cuticle (which is itself
an insensible part) is interposed ; through which, conse- quently, we ascertain the physical properties of a sub- stance, in a similar manner to what we do, though more imperfectly, through a thin glove. This covering appears to be necessary, to defend the sentient extremities of the nerves from the action of those external stimuli, which, were they allowed to come in immediate contact with them, would be productive of acutely painful sensations : hence we find the delicate expansions of the olfactory nerves upon the pituitary membrane, always besmeared with mucous, to them a sheath of defence against pungent odors, or other irritating matters. If the trunk of a nerve be in any way irritated, the sen-
sation produced in it, will be transmitted through its va- rious branches to the parts to which they are distributed : if, for example, the ulnar nerve, which passes over the el- bow, be compressed, or accidentally struck, we know that a peculiarly unpleasant feeling will be experienced in the little and ring fingers, in which parts its ultimate ramifi- cations are dispersed. So curious is this phenomenon, that if the nerve be irritated even after its division, still will the effect be felt, the same as if it were conveyed along the undivided branches: hence it is, that persons after having undergone the operation of amputation, of- ten complain of a pain in their hand, or foot, though the limb be absolutely in another room. When we speak of our feet, or hands being asleep, that well-known ting- ling sensation in them, is the effect of the nerves of the part recovering their sensation, which has, for a longer or shorter time, been suspended, in consequence of com- pression of the trunk, or branch, from which they spring. |
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On the Physiology of the Brain and Nerves. 163
Nerves deprived of those coverings which Nature has
provided for them as a shield or defence from external agents, acquire extreme sensibility: hence the pain of a blistered surface, and the excessive irritability of an in- flamed mucous membrane. The mere exposure of their trunks, in a denuded state, however, is not attended with painful sensations, or even the touch of them under such circumstances ; but if they be pricked, cut, or otherwise injured, convulsions immediately ensue : nothing can il- lustrate this better than the operation of neurotomy*—■ we detach the nerve from its surrounding connections, and clean it, with little or no apparent inconvenience to the animal, but no sooner does the bistoury wound its me- dulla, than his struggles remind us of the acute pain we are inflicting. Connected with our present subject is a curious phe-
nomenon, physiologists have characterized by the term sympathy; about which little else is known, than that certain effects, with many of which we are all more or less acquainted, are referred to such a source. Not only will one nerve that is, from any cause, unnatu- rally affected, give rise to a similar condition of its fellow of the opposite side of the body, but derange- ment in one set of nerves in a particular organ, will occasion more or less disturbance in those of another, with which they have not the least communication, nor apparent relation. In the optic nerves, the first of these cases is well exemplified: how often do we see— nay, we generally prognosticate, that when one eye has become the subject of opthalmia, the other will be, sooner or later, also inflamed. If ahorse receive a punc- |
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* Vide Lecture XI.
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]64 On the Physiology of lite Brain and Nerves.
ture in the foot, simple as the wound is, yet will it often
increase the irritability of the heart so much, that the pulse will rise to twice or thrice its ordinary quickness,, and the animal at length sink from sympathetic fever: and this is the more surprising, when we recollect, that large flesh wounds, or even the division of the nervous trunks themselves in the legs, are comparatively trifling accidents. Nothing is more common in the human sub- ject, than for disease of the testicles to excite vomiting; and in susceptive females, merely beholding an unpleasant sight, or perceiving a disagreeable odor, will now and then have a similar effect. Breathing itself is a natural sympathetic action ; for an animal is first compelled to respire in consequence of experiencing an uneasy sen- sation in the chest; (probably owing to congestion of blood there;) though it seems afterwards to be car- ried on through the influence of habit. Perhaps in no instance is the action of sympathy better illus- trated, than by observing what happens between that part of the throat, called the epiglottis, and the muscles of expiration; if the former be irritated, the latter will be immediately thrown into convulsive action : in com- mon catarrh, to this part, being inflamed, even air itself becomes an irritant; hence cough is generally an accompanying symptom, and one that is always aggravated by the respiration of cold air. For the same reason, horses cough when the weasand is tightly com- pressed between the finger and thumb, a practice com- mon with our horse-dealers. In disease we have nu- merous and striking examples of the influence of sym- pathy ; indeed, its effects are more or less observable in all constitutional affections. In the disease called stag- gers, the symptoms of which indicate more or less disturb- |
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On the Physiology of the Brain and Nerves. 165
ance of the cerebral functions, the exciting cause is very
frequently overdistention of the stomach, the brain itself being only sympathetically affected : and again, what is more common than to say>" a horse is looking unhealthy in his coat," or more demonstrative of ignorance than not to know, that the cause of it is not to be sought after in the skin, but in the alimentary canal. The nerves then support sensation and volition in the
body, and its different sympathetic affections, as well as the peculiar functions of the several organs of sense: how far they are employed in the generation of animal heat, we repeat, we have still to learn. In man, who holds the first place among animated beings, the brain is not only to be considered as the seat of sensation, and the source of volition, but as the organ of the mind—the part in which all those intellectual powers, for which he is so pre-eminently distinguished, reside. Not, how- ever, that the actions which support life are greater in him on this account; on the contrary, they are known to be weaker; for, we find, in proportion as the sensorial functions are few and limited, so, in general, are the powers of animation strong, and the restorative means great: hence it is, that a polypus, one of the simplest animals in nature, may be cut iu two, and both parts will survive and grow again, and produce two distinct polypi; , and hence it is, that the living powers of the foetus are greater than those of the adult, although it can neither see, nor hear, nor smell, nor taste. Such, indeed, is the in- fluence that the mental operations have over the corporeal in man, that there is no animal equally subject to disease, or in whom its ravages are so extensive and insupportable: We may yet go further, and say, that those persons whose |
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166 On the Physiology of the Brain and Nerves.
passions are easily moved, present us always with the
most unfavourable aspect under disease; a remark made long ago by those engaged in the practice of medicine. How, or in what manner, the functions of the nervous
system are carried on, is a mystery which physiology has not hitherto unveiled to us: though this, like other inex- plicable phenomena, has not wanted speculative opinions, some of which probably have tended to elucidate, though they have one and all failed to unravel the secret. Some have contended, that the nerves were so many
vibratory cords, and that impressions were conveyed along them by an oscillatory motion, or vibration of them ; others have thought that they were hollow, and trans- mitted a certain fluid, with astonishing rapidity, through their canals; while physiologists of more recent date, seem inclined to resemble the nervous functions to the phenomena of electricity, more especially to that species of it now known by the name of galvanism. From a multitude of experiments, the reproduction of
nerve has been so fully demonstrated, that no one at the present day is sceptical of the fact. Whether, or not, its precise original tissue be renewed, it is not worth our while to enquire ; suffice be it to observe, that the nerve is re-instated in its functions, which, to all appearances, are carried on with as much celerity and regularity as ever. An old experiment, but one that sets this question at rest, is, that if the nerve which forms one of the par vagum, or eight pair, be cut through in the horse on one side only, no inconvenience is perceived to result; but if the pair be divided, the animal becomes immediately con- vulsed, and expires. If, however, there be an interval of two, or three months between the division of these |
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On the Physiology of the Brain and Nerves. 167
nerves, the animal not only survives, but appears to expe-
rience from the last operation, as little annoyance as he did from the first: a circumstance that cannot fail to convince us of the fitness of the regenerated portion of nerve, of the opposite side, as a substitute for the original formation. Veterinary practice, however, has of late adduced so many instances of the reproduction of injured nerves, that no member of the profession can harbour a doubt on this point: were it not, indeed, for this power of Nature to re- store parts to their pristine condition, we should not have to recur to the operation of neurotomy, in those cases where a portion of nerve has been once excised. If a nerve be simply divided, union of it ensues, and
consequently sensation returns, in about two months; but if a portion of it (say an inch) be excised, and the di- vided ends allowed to retract, union and restored sensa- tion cannot be timed : we have known them to be pre- sent at the expiration of two years; and we have heard of some few cases in which no signs of their return have ever been noticed. In these cases, after a short interval, the retracted ends are formed into little, hard, round knobs, having a cartilaginous feel, and possessed of ex- treme sensibility. They vary in size, from that of a pea to a hazel nut; so that it is not uncommon, when neu- rotomy has been performed at the fetlock, to perceive them formed into little prominences under the skin ; which, in some horses, are the seat of sudden, dropping lameness, in consequence of being struck, in going, by the opposite fore foot*. * Though the question of the regeneration and consequent re-
solution of function of a nerve simply divided, no longer remains undecided in our mind, we submit the following extract from Mr. |
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LECTURE XL
<*v#- **+*-s*+ *** +*r *w *+* ^srv <*^^ *v*
-
Ow Neurotomy.
^Neurotomy —for so we take the liberty to name
an operation, hitherto called, (and we cannot help thinking Swan's valuable practical work on this subject*—one grounded
on experimental inquiry, in further confirmation of this, to us at the present day, an important point. " It will be seen from these experiments, in the first place, that after a division of a nerve, the extremities of the divided portions (retract,) become enlarged and more vascular, but especially the upper portion; and coagulable lymph, having the appearance of white of egg, is effused, which soon becomes vascular. In a few days the coagulable lymph from each portion becomes united, and anastomosis forms between the blood-vessels; the coagulable lymph gradually assumes a firmer texture, and the number of the blood-vessels diminishes, and the newly formed substance appears to contract, like all other ci- catrices, so as to bring the extremities of the divided portions nearer and nearer to each other. It is difficult to determine from an experiment on the limb of an animal the exact time at which the nerve performs its functions. In eight weeks after the division of the sciatic nerve, I have observed a rabbit to be in some degree improved in the use of its leg, but at |
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* A Dissertation on the Treatment of Morbid Local Affections of Nerves:
to which the Jacksonian Prize was adjudged by the Royal College of Surgeuiis. |
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■ On Neurotomy. 169
with equal impropriety,) sometimes nerving, sometimes
unnerving, consists in the division and excision of a por- tion of nerve, with a view of allaying pain, and relieving lameness. If the withdrawal of pain not to be assuaged by other
means;—if the restoration of an incurably lame horse to a state of comparative soundness ;—if one, or both, we say, be considerations of importance, the first on the score of humanity, the last on that of interest:—then neurotomy will take the lead of modern discoveries in veterinary science. As an emanation from that institution to which the veterinary art, as an useful branch of natural know- ledge, owes its rise and progress in this country, it is our duty to regard this operation in a favorable light: when we find, however, that the professed objects of it are no less than those we have here represented, with how much more exultation should we, as veterinarians, hail the dis- closure of such a valuable addition to our present prac- tice. Such, we cannot entertain a doubt, are the opinions of its zealous promoter; such we believe those of its nu- merous advocates to have been ; and sucli would they have continued to be, had they faithfully followed the in- the end of eighteen weeks it was not perfect. When the nerves of
the leg of a horse have been divided just above the foot, they are sufficiently restored to perform their functions in a very great de- gree in six or eight weeks ; but it must be observed that these •nerves are only formed for sensation, and it is very different with the nerves of voluntary motion"—" the re-union is sometimes accom- plished by granulations." " Secondly, I would observe, that punc- tures and partial divisions of nerves heal in the same way as when there has been a total division; and that, even on the first inflic- tion of the wounds, the functions of the nerve are very little im- paired.'' |
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170 On Neurotomy.
structions of him, who first taught them this improve-
ment in their art. Who this was, we need scarcely mention-at so ad-
vanced a period from the first promulgation of the dis- covery ; indeed did we not imagine that we should be ac- cused of a dereliction of what is due to that gentleman from the profession at large, and of esteem on our own part, we should think it unnecessary to state, that to Mr. Sewell, assistant professor to the veterinary college, be- long the merit, and the reward, resulting from its almost universal adoption. The most flattering testimony our discoverer could possibly have received, are the futile at- tempts that have been made to usurp the authorship of his production; the most solacing, the unequivocal marks of approbation conferred on it by a committee of the governors of that institution, which is not a little be- nefitted by the very extensive practical application of it. We shall, in the first instance, take a view of the opera-
tion itself—looking into its merits and demerits—explain- ing how it relieves, and in what manner it should be per- formed, and then consider its applicability in practice. Knowing that the nerves, as agents of the brain, convey sensation to and from every part of the body, and that one of the best and most obvious proofs that such is their use, is simply the division of them, at first, it might seem perfectly natural, that we should resort to such an oper- ation to remove pain, which, in fact, is nothing more than preternaturally acute sensation : we must recollect how- ever that the nerves have other functions to perform, and some, perhaps, with which we are not hitherto acquainted, and that the division of them is not effected without lesion to other parts—considerations, possibly, that have hi- therto much restricted surgeons from similar attempts on |
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On Neurotomy. 171
the human subject. It was not to be expected, however,
that some experiments of this kind would not be made on horses ; and, accordingly, we find that long ago, at the veterinary college, some, consisting in simple division, Were instituted; but the result proved fruitless : and we ourselves divided the nerves of the arm for lameness in the foot, in the year 1812, without being aware that the experiment had been previously made. All this does not detract one single iota from the praise due to Mr. Sewell; on the contrary, it contributes to enhance the value of his production, and to shield it from the scurrilous attacks of dabblers in the art: for however correctly some may insist, " that it is not a discovery," We contend, that it embraces all the advantages of any one of modern date, and reflects so much the more credit on its author, inasmuch as it has been raked from among many rejected and valueless gewgaws of the present day. It may now be asked, why we did not succeed ? Purely because our knowledge of the distribution of nerves was defective, and therefore practically of no use to us : we thought we had divided all the nervous trunks of the arm, and consequently had paralyzed the leg and foot; but, in truth, we had not done so much to produce that effect, as if one of the pastern nerves only had been severed; for there were others left uncut, to carry on sensation, and thwart the sole object we had in view : such errors does an imperfect anatomy lead us into. For aught we know, the nerves may have been divided many years ago, but if this be an argument against the operation, why should we still adhere to the same principles in our practice of shoeing, when so many said-to-be new and valuable systems are offered to our notice at this day ? Many of the improve- ments in shoeing have been received with as much fer- |
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127 On Neurotomy.
vor for their promotion as ever neurotomy was, but few
have borne even the test of argument, and much fewer that of experiment: neurotomy, on the other hand, after the severe ordeal it has passed through, is still practised by those who have not expected from it more than was held out in the first instance, but have steadily persevered in it as an useful addition to their catalogue of remedies. Mr. Sewell never hoped eodem collyrio mederi omnibus, but contented himself with adopting it as a last—an only resource ; so that an pis aller he can incur but little cen- sure for having practised it; and he may, and not seldom, have the gratification to see the prematurely worked-up hunter rescued from the slaughter-house, and restored to the service of his compassionate master. Our object in performing this operation, is to destroy
sensation ; and in doing this in the foot, we have not found, that the growth and uses of that organ, so far as its preservation in health goes, sustain impairment: we believe that every part remains in statu quo, so long as the whole be preserved from the effects of external vio- lence ; and, under certain circumstances, we think that the organ itself is even benefitted by the change. We know also for certain, that the formation of horn conti- nues undiminished*. Notwithstanding these facts, how- ever, there is an argument against neurotomy, which we cannot altogether refute, though we shall endeavour to deprive it of some of its main supports; and that is, that if the nerves of the foot are, comparatively speaking, of so little use, as from this statement they would appear to be, why is it so plentifully furnished with them, • * It has been remarked to us, that more horn is in some cases
produced after this operation. |
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On Neurotomy. 173
it not being in the horse the organ of feeling? This
operation has certainly taught us one, if not two impor- tant uses of nerves to the foot, which did not occur to us before: viz. that they (the nerves) are the safeguards of that organ in health, and, if we may be allowed the ex- pression, its nurses in disease ; they inform the animal when the foot is impaired, and warn him that it will be still farther injured by being made use of:—pain is the consequence of injury, the limb is favored, and the dis- ease in it arrested simply from repose ; so that it now and then subsides without medical aid. But in the insensible foot, the reverse of this is the case : the disease is aggra- vated by the animal's using the part as he would were it perfectly healthy ; (he being totally unconscious of its pre- sence ;) and a destruction of the organization of the foot, if not the loss of life itself, may happen in consequence of a comparatively trifling accident. Withal, however, this is not so formidable an objection as one would at first imagine; for, regarding the horse as an animal im- mediately under the superintendance and management of man, the keeper of him in health, and his attendant in disease, it is not to be expected, that any malady would remain long in a part so often examined as the foot, with- out being detected ; which, in fact, is tantamount to our being informed of it by the animal himself. Do such horses go with that natural ease and freedom
that others possess ?—in other words, is there any differ- ence in the action of a horse that has been so treated ? We have always thought, and we still believe, that the
animal loses a something, probably a kind of feeling which affects his tread sufficient to inform his rider, that his feet are not what they originally were; for there can- not be a doubt, (and this is one of the happiest instances |
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174 On 'Neurotomy.
in confirmation of it,) that the horse feels the ground upon
which he treads ; and so far, we contend, the foot is the organ of feeling. We do not pretend however to restore organization ; we do good by still more impairing that -which remains : like the mechanic who cannot imitate the exquisite workmanship of his master, we are content to save the machine, imperfect as it is, from total destruc- tion, by the removal of that which appears to be incom- patible with its present operation. Having thus canvass- ed two objections, which, to us, appear to have more weight than any, or even all others, that can be urged against the operation; we shall, or we shall overstep our limits, dismiss this part of our subject, by saying—that, whatever they be, they do but in a small degree deserve no- tice, when contrasted with the benefit resulting to a horse crippled and useless, and of no value to his possessor. The place of operating has now become a subject of
dispute: some prefer the fetlock, the part first deter- mined on ; others, above it; others again, operate above the joint on one side, and upon, or below it on the other. Mr. Sewell, and all who follow his directions, choose now the sides of the large pastern bone—below the fet- lock, for the operation*. We have performed it in all these different situations; but as our cases have been very inferior in number and variety to those of the assist- ant professor, we rather submit to his opinion than ven- ture one of our own. Mr. Sewell's object in excising the large pastern nerve, is to preserve sensation around * Should the fetlock be the seat of lameness, (which, by the bye,
it rarely is so as to require the operation,) we must divide the me- tacarpal nerves ; taking care to cut off the communication of the anastomosing branch. |
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On Neurotomy. 175
the front of the foot—a part, in general, free from dis-
ease : and this is now fulfilled, since the nerve that goes thither, is a branch from the metacarpal. The operation is by no means difficult to him acquaint-
ed with the anatomy of the part. The horse being cast, and properly secured, and the affected limb extended and placed in a convenient position for the operator, an in- cision, about 1| inches long, is to be made upon the side of the large pastern bone, opposite to, and in the direc- tion of, the large pastern nerve ; then, having cut through the cellular substance, so as to lay bare the trunk of this nerve, (anteriorly to which, and in contact with it, lies the artery, which must be carefully avoided,) raise it with a tenaculum, and divide it by the introduction of a probe- pointed bistoury, as high up as the external wound will admit: lastly, clean it from surrounding adhesions, and detach it from the continuation of the trunk below, so as to excise a portion about 3-fourths of an inch in length. The operation requires to be performed on each side, there being two separate trunks below the fetlock; and, of course, on both legs, should both be affected. To close the wound, we rather employ adhesive plaster than su- ture, with straps of which the pastern may be encircled, if the hair be closely shorn off: where suture is preferred, the interrupted is the best, and about three or four stitches are sufficient. The legs should be bandaged* after the operation, and the horse not allowed to lie down during » We commonly dip the bandages, previously to applying them,
lr» the saturn wash. It is also a good practice, to give a dose of Physic, and keep the horse, during his confinement, on bran, in- stead of corn. We may observe, that, in many cases, the bandages 0I% are sufficient. |
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17G On Neurotomy.
the first night, or be moved for the three or four following
days, lest the parts be disturbed, and union by adhesion defeated. Though the operation admit of very extensive and di-
versified application, its subjects have been from the first represented to be, what all subsequent experience has shewn they ought to be, horses incurably lame; by which we mean, cases that will not admit of relief by any other means. Had those who so enthusiastically listened to Mr. Sewell in the first instance, but attended to this short and simple precept—one that, not a little to his pre- sent satisfaction, he has forcibly inculcated all along, they would not have lost the confidence of their employers, nor have reaped so short a harvest, nor have brought the operation itself, within their sphere of practice, into early disrepute. Surely, if any thing can convince us of the truth of what we have just advanced, it is the unde- niable fact, that, while many others have exploded neuro- tomy from their practice, in consequence of the nume- rous failures they have experienced, Mr. Sewell now performs it with redoubled confidence, seeing that he seldom meets with an unsuccessful case. And this has arisen, in the greatest measure, we repeat, from a mal- selection of subjects; though there are, doubtlessly, faults in operating on, as well as in the management of these horses, to which we may ascribe the unfortunate is- sue of many untold-of cases. To our esteemed friend, Mr. Sewell, with whom we have had some very inte- resting communications on this subject, we are indebted for many truly valuable and incontrovertible facts rela- tive to neurotomy; some of which we shall now submit to the consideration of those, hitherto led astray by false |
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On Neurotomy. 177
representations, or who may have been deterred from
operating for want of more authentic and more extensie information. Mr. Sewbll has operated on upwards of five hundred
horses ; and the general result of the practice shows, that in about eight cases out of ten, full and complete success has manifested itself, so long as the horses have remained under his care ; for want of proper subsequent treat- ment, however, and attention to his directions, some few out of this number have turned out unfortunately. Lest, then, our adversaries accuse us of cloaking, or wishing to compromise that which, to them, may appear a very serious and even insurmountable objection, we will tell them, once for all, that instances are not, nor ever will be wanting of failure, and of failures such as some have thought proper to depict, as the dreadful effects of a cruel operation. But even the simplest operations may be the forerunners of dangerous disease, if the subjects of them are neglected, or mis-treated ; and, knowing this, should we find that horses of this description have been regu- larly hunted during whole seasons, indiscriminately used as hackneys, and put to work in coaches and post chaises upon the pave, or roads equally hard and uneven, all which is in direct incompliance with the instructions re- ceived by their owners, are we to feel surprised at some unfortunate issues, or to decry the operation on their ac- count ? But to shew how far many of these animals are relieved, and how great are the advantages reaped by their possessors, Mr. Seweu has received the following, gratifying communications, accompanied with the assur- at>ce, that many horses operated on, performed as well as eyer they had, when they were in a state of soundness. In a Manchester caravan several of these horses ran, in N
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178 On ISeurotomy.
heavy draught, for upwards of two years, at the rate of
six miles an hour, between London and Bamet: said to be one of the most laborious stages on that road. A postmaster, who had had several of his horses ope-
rated on, sold them at the expiration of the season of employ, (during which time they had been in regular work with others,) and informed Mr. Sewell, that he received from ,£18. to £15. for each, though he valued none of them at more than £S. prior to the operation. Also in the "York and Lay ton coaches, some have run
for more than two years, (in the course of which time they have travelled many thousand miles,) with perfect satisfaction, and no little profit to the proprietors, after having been given up as utterly useless, and destined to slaughter. To pass from these reports, which may serve as in-
stances of what such horses are capable, and of the space of time we may calculate to continue them in laborious employ, and, above all, in work attended with much con- cussion and occasional contusion of the joints and sensi- ble parts of the foot, and to take a still more pleasing view of the practice of neurotomy, let us, for a minute, inquire if any and what benefit has accrued to the army from it \ And we can state here, that the veteriuary sur- geons of several regiments of cavalry, both at home and abroad, are ready to testify, that many horses, belonging to their respective regiments, have been retained in the service, and thereby the expence of purchasing others saved, in consequence of having been subjected to neuro- tomy. In none, perhaps, has it been more successfully practised abroad, (and to the credit of their veterinary surgeons be it said,) than in the 12th Lancers, and 18th Hussars. Soon after the disembarkation of the latter re- |
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On Neurotomy. 179
giment from the continent, an order was received to
draught and sell about one hundred of their ineffective horses: after the selection had been made, it was remark- ed, that not one of the horses that had been operated on appeared among the non-effectives. In the Royal Artil- lery, out of three that have been neurotomized, a very fine horse has recently been cast, who would otherwise have been sold two years ago, the period of his being subjected to the operation : during this time, therefore, he has been serving in the place of one that must have been purchased of the dealer*. In the Hanoverian cavalry also neurotomy has been
practised; and we are informed that it continues to be so with success. These facts, collected from quarters to which access is
open to us all, leave, we should presume, no doubt in the unprejudiced mind of its application in a military point of view, and of the policy of such a practice as a mea- sure of public economy : indeed, " did it but render horses serviceable for one campaign only," as one of our most distinguished generals of cavalry observed, " it should still be considered as of national utility." We find by reference to Mr. Goodwin's New System
of Shoeing, (page 89,) that neurotomy has been introduced into the king's stables ; and we have understood from that gentleman, that the royal establishment has, in se- veral instances, derived peculiar advantages from it: we say peculiar, for here it has restored horses of such value, that their loss could not easily have been repaired. Mr. * In the dragoons, horses of this description have been trans-
ferred, either in consequence of reduction, or departure for India, from one regiment to another: this was the case in the 13th Light Dragoons. N2
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ISO On Neurotomy.
Goodwin is at issue with Mr. Sewell as to the place
of operating; and we are inclined to believe, that the latter gentleman attributes some of the failures .parti- cularized in his publication to this circumstance: but, from the inferiority in number, and consequent variety of our cases, when compared with those of the assistant pro- fessor, we have no doubt Mr. Goodwin will, with us, see the propriety of conceding a point we must at present contend under such manifest disadvantages. Our discoverer has not probably yet ascertained to
what extent neurotomy may, one day or other, prove beneficial: he tells us, that he himself, by operating in the usual manner, averted a locked-jaw from a horse in which tetanic symptoms had shewn themselves from dis- ease in the foot; and we will leave it even to his oppo- nents to say, whether the two following remarkable in- stances of its good effects, (the one Mr. Sewell's own, the other communicated to him by a very respectable practitioner,) do not evince the truth of this assertion. It was found, that a mare, given up as a breeder in con-
sequence of being incurably lame, was not visited by the ordinary periodical astrum for the male; but that the venereal desire returned in due season, as soon as she had undergone this operation. No doubt, it was the ha- bitual pain the animal felt, that deprived her of healthy and natural feelings; and if this was the theory of the operator, we highly commend him for it, and consider the thanks of the breeder due to him for so valuable a hint. Last of all, we will venture to affirm, would the neuroto- mist think of handling his knife in a case of this kind; and we will ask Mr. Sewell himself, flattering as that gen- tleman's views may have been when he first practised the operation, whether such a prospect had ever presented |
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On Neurotomy. 181
itself, as to render the barren female, "by it, again suscep-
tible of impregnation ? The other case we allude to, scarcely less worthy of
mention than the former, to which indeed it bears much analogy, is this. A stallion of some celebrity, a crip- ple before, in consequence of lingering and continual pain in his fore feet, became at length so reduced in condi- tion, and lost so much of his wonted energy, that all desire for the female left him; so that mares brought to him in the season for covering, were taken away again unnoticed. It was suggested, that neurotomy be per- formed ; and the suggestion proved not only most cre- ditable to its author, but happy in its result; since the horse was reinstated by it in good health, and again ena- bled to perform his copulative functions with all his ac- customed vigour. Some have had recourse to neurotomy, and we think
justifiably, in canker. Supposing the case to be inveter- ate, and there be found, as there almost always are, con- siderable trouble and difficulty in applying the dressings, we would, without hesitation, recommend the practi- tioner to divide the nerves going to the foot: pain being removed, the animal will make pressure upon the dis- eased parts, and thereby much accelerate the healing process. Lastly, we may make mention of a case which has
opened the door for the introduction of neurotomy into human surgery : whether the practice suggested itself from its high veterinary repute, or not, we will aot pretend to say; but as the case is a novel one, we have subjoined the particulars of it in a note *. The subject of this operation was a man who had a large,
sP°ngy, bleeding ulcer of the leg, attended with such excruciating |
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182 On Neurotomy.
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It would answer no end to detail here individual cases,
whether fortunate or unfortunate in their issue : our de- pain that not only was he deprived of rest at night, but was often obliged to get out of bed. At length, from profuse hemorrhage and excessive pain, the case became so alarming that there was little prospect of saving life, unless the limb was amputated. The patient worn out by the terrible anguish he endured, resolved to make this sacrifice, but, says Mr. Swan, "knowing that the branches of the external popliteal or fibular nerve were the princi- pal cause of the pain, from their connection with the ulcer; I de- termined first to give him the chance of saving his limb by cutting out a portion of the nerve.'' This operation—neurotomy—was per- formed in the way we have here recommended, and the edges of the wound brought together with adhesive plaster and bandage. After the nerve had been divided, the pain in the ulcer entirely ceased, and he had no feeling on the top of the foot when it was touched. Two days afterwards sensation became perfect again in the upper part of the foot. On the third day there was pain in the ulcer, which he referred to the tightness of the bandage: it went off again. Eighth day, wound united by the first intention. After the operation he never had any spasms in the limb, nor any of the violent pain which followed the course of the sciatic nerve, and caused so much suffering. His state was rendered much more com- fortable by the operation, but he at all times suffered pain from the connection of the saphenus nerve with the ulcer. Though he ap- peared to improve in health for a time, subsequent exfoliations were followed by such a decline of it, that amputation became ne- cessary two months after the operation. After this, he continued in good health for three months; when he caught cold and died of pneumonia. On dissection of the limb, the nerve that had been divided was enlarged and much thickened: the nerves in the vi- cinity were also enlarged, and received some new branches from the divided extremities of the other; " and I think it not improba- ble," says our author, " that some other branches forming a me- dium of communication between the divided portions of nerves, might have been destroyed in the dissection."—"Whether the new branches had much power in conveying the nervous influence, I cannot determine. About a fortnight before the amputation of the |
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On Neurotomy. 183
Auctions must be made from the largest collection of well
authenticated facts, by them alone our opinions adopted, and by them aione those opinions maintained. We are not to listen to this, or to that individual, whose practice, however successful, has been comparatively limited, to pay attention to any theoretical doctrine, or to lend an ear to the pleaders of humanity; but we are to pursue that course, which their experience has pointed out, on whose veracity and judgment we can rely, and who have a professional reputation at stake. The greatest difficulty we encounter, is a judicious se-
lection of subjects : and here the investigation of the na- ture, seat, and duration of the lameness, and the proba ble event of such an operation, are, above all other con- siderations, to be attended to. But, be the case what it may, observe, we do not propose neurotomy for the in- curably lame, but restrict it to the incurably lame and use- less horse; though, where but one leg is diseased, and under some particular circumstances where both are, we may and do deviate from this general course : like the surgeon who refuses to operate for cataract before his patient has lost all useful vision, by thus limiting our views, we shall never incur reproach, even though a failure be the result. Furthermore, we would lay down the following rules
for guidance in practice : — 1st. Any kind of chronic lameness about the foot, or
coronet, with the exception of that arising from pumice- feet, may require the operation. limb, I pressed on the part where the nerve was divided, and the
Patient said he felt it quite down the leg." Observations on some points relating to the Anatomy, Physiology and Pathology of the Nervous System, by Jos. Swan, Member of the Royal College of Surgeons, &c, |
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184 On JScurotomij.
Ind. Should inflammation be present in the foot, pas-
terns, or fetlock, it is always to be reduced prior to the operation. 3rd. If we suspect ulceration of the joints—of the li-
gaments, tendons, or articular cartilages, we should not operate; since neurotomy will aggravate the disease, by enabling the animal to make use of parts, unfit, in their present condition, to bear either pressure, or motion. 4th. Neurotomy succeeds best in those cases in
which lameness is accompanied by an alteration in the form and texture of the hoof, (pumice-foot excepted,) and where all previous disease has terminated in this : indeed, to some horses lame from anchylosis, partial or complete, it seems often to convey permanent be- nefit, by inducing them to exert these parts more, and thereby obtaining, in process of time, some small degree of useful motion in joints before stiff and im- moveable. Mr. SeWell finds, that in cases of entire section of a
nerve, sensation returns in about two months ; but in others, in which a portion of nerve has been excised, that the period of restored feeling can by no means be foretold : in one of Lis own horses, he ascertained that there was no sensibility in the foot even at the expiration of three years ; and in some others, after a longer interval, the or- gan appeared to be wholly destitute of it. The cast horse belonging to the Royal Artillery, of which we have lately made mention, evinced as much feeling as any other would have done, whenever we pricked, with a pin, either of his fore feet: this was after an elapse of two years. Whether lameness invariably returns with the restoration of sensation, is a question we cannot |
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On Neurotomy. 185
decide—it must so much depend on the nature of the
case *. Mr. Swan, from whom we have both in this and the
last lecture taken the liberty to transcribe on this subject, says, in relation to this part of it, " that when a portion of nerve has been removed, the restorative process is set up in the same way as when there has been merely a division of the nerve ; but the extremities of the divided portions afterwards present such appearances, as to lead to a sup- position that the nerve will never again be restored." This had almost induced Mr. Swan to believe so, when the case of a horse occurred to him, that had un- dergone neurotomy; in which the lameness returned in six months after the operation. But as lameness might have proceeded from other causes, independently of dis- ease in the foot, its return is not to be attributed, without a minute inquiry into the nature of the case, to the resti- tution of feeling. So far from agreeing however with Mr. Swan's informant—that'■ this is not usually the case where so large a portion of nerve has been re- moved," we believe that in the generality of instances sensation is only lost for a time ; but to this time we can- not at present set precise limits. How far the process may be accelerated by irritation from disease in the foot, vve do not know—in truth, we do not very clearly see the connexion between them. We cannot refrain, before we close this subject, from
again enforcing attention to that injunction which is to direct us in the selection of subjects. The incurably lame and useless horse, is him alone for whom we recom- *t appears to be less likely to return in cases of contraction,
than in affections of joints. |
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186 On the Diseases of the Nerves.
mend it; our object being to render an animal service-
able during the remainder of his life, who, otherwise, must have been given up, as utterly valueless', for slaugh- ter. None who have given the subject of neurotomy the least reflection, could conceive that the operation was ever intended to supercede other remedies ; the very nature of it is such, that, as a dernier resource, it is only appli- cable to adesperate and hopeless case; and if it succeed in restoring one of this description, it is of more value and consideration to us, than if it was only applicable to such as we can relieve by other and simpler means. In con- cluding, let us remark, that we do not recommend such horses being raced, hunted, or put to amj other extraordi- nary exertions: they may be driven in harness, and are more especially qualified for four-wheeled carriages, or leaders in others ; in short, for situations where no weight is incumbent upon the body. In this point of view—its objects being thus circum-
scribed, we dare prophecy, that neurotomy will be known as long as the veterinary art :—it has hitherto stood the test of this capricious age, and weathered out the storm of discordant opinion;—it has ranked high in the estima- tion of its more enthusiastic advocates;—it has fallen into disgrace and comparative dread with those who have misapplied.it;—it has now to rise to a certain point in the scale of veterinary surgery, where it will remain in despite of all future controversy. On the Diseases of .the Nerves.
The nervous system is much more subject to derange-
ment of function, than to disease of structure; we un- derstand so little however about its physiology, that we must necessarily be much in the dark in our theory |
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On Tetanus. 187
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of its diseases : in truth, we know little of them but from
their effects. Perhaps the most painful affection to which the human body is liable is tic doloreux; one that is generally believed to be a disease of the nerves, though, by some writers, the seat of it is referred to the brain; since no alteration of structure is ever perceptible in the nerves of the affected parts. One of the most for- midable, as well as most incurable diseases of veterinary nosology, is that which we are now going to consider. On Tetanus.
We have ranked tetanus, or locked-jaw, among the
diseases of the nerves, in order that its effects may be better understood ; though human nosologists, in gene- ral, treat of it as a cerebral affection, confessing however, one and all, that its real nature is still wrapped in ob- scurity. Instead of accompanying them into the depths of conjecture, as to the proximate cause of this fatal ma- ladv, it will be more consistent with our present views, to detail the symptoms by which it is known, examine the apparent causes that induce it, and offer such reme- dies, by way of treatment, as our own experience, and that of some skilful practitioners, have shown to be most effectual. Tetanus consists in a spasmodic contraction, more or
less general, of the muscles of voluntary motion, and espe- cially of those that move the lower jaw : hence the vul- gar name for it of locked-jaw, and the technical one of trismus. An animal labouring under this disease, has little or
no power over his muscles ; so that he either moves the af- fected parts with considerable difficulty, or, in consequence of the severity of the spasm, is unable to move them at |
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188 On Tetanus.
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all. Its attack is commonly gradual. The horse
first evinces a degree of inflexibility of the neck, in mov- ing his head, which is, in the course of a day or two, succeeded by so much rigidity of it, that he is unable to turn his head to either side, without at the same time moving his body and fore legs. The groom complains, that the animal does not eat with his wonted appetite, and that he either cuds his food, or appears to have some difficulty in swallowing it: this leads to an examination of the jaws, which are found either much restricted in their motions, so that you can only open the mouth to a cer- tain extent, or completely locked—inseparably closed: under whicli circumstances, all your efforts to sunder them prove fruitless, so obstinately are the incisor teeth maintained in contact by the powerful spasmodic action of the masseter and temporal muscles. The eye is com- monly the next object of attention: if, in efforts to elevate the head, we perceive the haw projected over the cornea, we may at once pronounce the case to be tetanus, though, as yet, no other parts than those we have named appear to be affected; and we have known one case in which the symptoms made no further progress—but gradually sub- sided, as if from the timely administration of our reme- dies. Most commonly, however, the disease advances, attacking other muscles iu irregular succession, and with different degrees of severity. The limbs now, should they have escaped spasm in the primary stage, become so stiff, that progression is either rendered aukward and unnatural, or altogether impeded: in severe cases, both fore and hind legs are stretched out in different directions under the trunk, so as rather to resemble, in their position, the four props of support of a common form, than the limbs of a living animal. At this time, the back and loins |
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On Tetanus.
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189
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are shrugged up; the tail is elevate and tremulous; the
hair on end ; the ears erect; the eyes wild, and turned askaunt; the nostrils expanded ; and the countenance al- together displays a degree of eagerness and anxiety not easily mistaken : in short, the poor animal exhibits a truly impressive and pitiable aspect, too characteristic of the state he is in to admit of the shade of a doubt. The spasm is not constant—it remits at intervals, so that the animal experiences some periodical mitigations of his painful malady : indeed, this explains that tremulous, qui- vering motion of the tail, so remarkable in this disease. In consequence of the diaphragm being occasionally
affected, respiration becomes unnatural: the motion of the flanks is quicker than ordinary, and is generally at- tended with some irregularity. The involuntary muscles, however, do not appear to be much influenced in teta- nus ; so that the pulse in the beginning is only either a little quicker than common, or remains altogether undis- turbed ; though towards the latter stages it will become accelerated and small, and sometimes irregular: and in respect to the bowels, though they be confined, then- torpor is by no means such as would indicate spasm. But the pulse, though unaltered by the disease, acquires commonly such extreme irritability, that, if the animal be agitated, or alarmed in any way, it will often, on a sud- den, beat with twice or thrice its former celerity, and then subside, with the alarm, into its natural state. In this country, we should say that tetanus was a more
frequent disease among horses than in the human sub- ject : it is one of the most dreadful in the catalogue of those of the latter ; and, if we may argue from the general analogy 0f the cases, none that we know of seems to pro- duce equal suffering in the former. |
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190 On Tetanus.
This is a disease of uncertain duration. It commonly
lasts for a few days, or a week, or two, and then, unless it previously end in death, gradually subsides; it may however be protracted much beyond this period : in either case, when the animal recovers, the spasms leave him slow- ly, and by degrees ; so that it is often a very considerable time before he regains the perfect command of his mus- cles. When the attack has been severe, it leaves the horse much debilitated and out of condition. Tetanus may arise from one of two kinds of causes: it
may be a consequence of local injury; or it may be in- duced by some agent, whose iufluence appears to be on the system at large ; and this has given rise to the division of it into symptomatic, and idiopathic. In the human subject, this disease is more commonly produced by wounds, especially of tendinous structure: thus a punc- tured hand, though it be a part remote from the brain, has frequently been the forerunner of a tetanic affection ; and it has been remarked by surgeons, that tetanus origin- ating from such cause, is more likely to prove fatal, than when it appears to have been spontaneous. In the horse we may often trace it to this source; and we are inclined to believe, that lesion of tendinous structure is most fa- vorable to its production : whether this be true, or not, tetanus often supervenes on the operations of nicking and docking, and on punctures in the foot; though doubtlessly, as in the human subject, injuries of parts of a total different nature may give rise to it. In the ge- nerality of cases, the disease makes its appearance after the wound has healed. With regard to idiopathic tetanus, or that which appears without any very apparent cause, we have not the same well-authenticated testimony for referring it to sudden change of temperature, as writers on |
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On Tetanus. 191
human pathology can adduce : they have found it to be
a disease more prevalent in hot than in cold climates, and one of rarer occurrence in Scotland than in England ; and they have ascertained, that the most frequent cause of it in warm countries, is the application of cold to the sur- face of the body when heated. Notwithstanding even these facts, however, medical men are by no means agreed in referring it to such a cause ; for if alternations of heat and cold induced it, we ought to have more frequent in- stances of it in this country. As far as our own observa- tions have gone, horses in stables and at grass, both in summer and winter, are the subjects of it; we cannot, therefore, under such circumstances, agree with those who attribute it to cold; and we regard their opinions as still more hypothetical, who ascribe its origin to worms*. We are very far from knowing what plan of treatment
is recommendable in this disease: it most frequently baffles every mode of practice ; though, now and then, it yields to a class of remedies, which, on repetition in si- milar cases, proves totally inefficacious ; whereas some- times the animal recovers, though nothing, or, (what is tantamount to nothing,) some inert remedies only be made use of. In those cases where symptoms of tetanus have followed nicking or docking, if the attack be recent, and still in an unconfirmed stage, we would most decid- * At the Veterinary College, have lately been met with two fa-
tal cases of tetanus, in which thecuticular coat of the stomach was extensively eroded ; in one, indeed, few or no vestiges of it remain- ed—the surface every where presented ulceration of the internal c°at, and the muscular was twice or thrice its ordinary thickness. In one horse the disease was idiopathic; in the other, the sequel of a wound in the arm: in both, it was believed, that nothing but aloes had been administered. |
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192 On Tetanus.
edly recommend that the extremity of the dock be cut
off with a sharp docking-iron, so as to make a new and clean wound, or even that the tail itself be removed —should it have arisen from nicking: in such cases, however, as are marked by considerable advance of the disease, little benefit, we fear, is to be expected from these means. In cases of punctured wounds, or others in which the external opening is but small, it is generally proper to enlage the outlet, by making a free incision; in doing which, it has been a laudable object of practice, in the human subject, to cut off all communication between the injured part and the brain, by dividing the nerves*. The actual cautery, and some of the most active caustics, may also occasionally be had recourse to with the same view. Should we not succeed in subduing the approaching spasms by the fulfilment of this—our first indication, viz- the removal of the exciting cause—of which indeed there is but too much apprehension, we are to proceed, without delay, to the general or constitutional treatment. While our knowledge of the proximate cause, or nature of this disease, remains clouded in so much obscurity, we are not to expect to institute a mode of practice grounded upon strictly scientific principles: most of our remedies are purely empirical, or such as have suggested themselves from the different views that practitioners of human me- dicine have taken of it. Some who have, and properly enough, regarded it as a spasmodic affection, have pre- scribed such medicines as are called antispasmodics, of which class opium is the chief: it has however failed in the majority of cases. Camphor and assafcetida have been * We have made mention of a tetanic attack being averted in
the horse by having timely recourse to this operation; but we are not in possession of the particulars of this case. |
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On Tetanus,
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193
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conjoined with it sometimes, but, and for obvious reasons,
with no good effect; for both these medicines are totally inefficacious in the doses in which they are commonly ex- hibited. The cold bath, or what is the same in effect, the affusion of cold water, and the removal of the horse into the open air, should he have been attacked in the stable, has had some very staunch advocates, to whose opinion we would gladly subscribe, did not the result of our practice forbid it: all we have to observe further about the expe- riment, is, that we have failed in every instance in which the plan, usually recommended, has been adopted. Ve- nesection has frequently appeared to confer considerable benefit; and though, like all the others, it has in too many cases failed to give relief, we should be inclined to place more dependance in this, than in any individual re- medy with which we are acquainted ; and in saying thus much, we think we are borne out in practice: indeed the supporters of the use of the cold bath themselves, seldom put much confidence in the sanative effects of cold with- out the accompanying use of the lancet. We would carry this practice further than is commonly recommended, and more especially in those cases where the pulse indicated any thing like inflammatory action in the system. Ano- ther remedy, in our humble opinion, only inferior in im- portance to the former, is the application of a blister to the skull, and whole length of the spine : for this purpose, let the hair be closely shorn from the skin covering the forehead and vertex, from the sides of the neck, di- rectly opposed to the cervical vertebrae, from the lateral parts of the withers, and from the ridge of the back and loins, as far as the tail; having done which, apply a pretty thick layer of the common blistering ointment to o
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194 On Tetanus.
the surface. In the course of ten or twelve hours, whe-
ther it have taken effect or not, clean the skin with hot water, and repeat the ointment; and this should be done, from time to time, as occasion may require: our object being to inflame these parts, and keep up from them a continual discharge*. In addition to these operations, we must procure evacuations from the bowels ; and no medicine will insure this effect so well, as from one to two drams of calomel, combined with eight, ten, or twelve of aloes; according to the size of the horse, and the exi- gence of the case : and this we are to take care to admi- nister as early as possible, lest the jaws become so fixed, that both food and medicines are inadmissible. Should this already have taken place, we may try to give a larger dosef of aloes in solution, and aid its operation by the fre- quent exhibition of copious glysters composed of this me- dicine in any emollient menstruum. A loose stall, or a well-ventilated box of large size, in which he can turn about loose without inconvenience, is the preferable ha- bitation for the animal. Should his jaws be so locked as to render mastication either very irksome, or altogether impossible, attempts to drench him with water gruel, or * At the veterinary college, it has of late been the practice to
insert setons in the neck, back, and loins, in addition to the blister, for our own part, we prefer the frequent repetition of blisters, f Not less than two ounces according to this formula: R Aloes Vulg. Pulv. ,fij. vel .f iij. Potassas Subcarb. ^i. Acaciffi Gummi f iss. Aqua? Ferventis ft j. Solve, etadde Spts. Vini rectificat. Jjj. |
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On Tetanus. 195
other nutritive fluid, should be frequently made, in order
to support him under the worst stages of this awful ma- lady. When the progress of the disease, from its onset, has not been rapid; when the spasm is not universal; and when its duration has become considerably protract- ed ; we may cherish some faint hopes of the animal's re- covery : under circumstances the reverse of these, how- ever, we may look forward to speedy dissolution. |
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o 2
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LECTURE XII.
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On the Muscles.
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M
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USCLES are bundles of fleshy fibres, abundantly
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distributed over an animal body, for the purpose of pro-
ducing motion of its several parts: muscle andjlesh, in fact, are synouimous terms. The chief bulk of an ani- mal is made up of muscle: every motion of his different organs, both external and internal, is either directly or in- directly effected by means of muscle; all his power of action resides in muscle; even the preservation of life it- self is dependant on muscular motion. We are not prepared to state the number of muscles in
the horse ; nor would such a knowledge prove of any uti- lity to us: that in the human subject is estimated at about five hundred. Muscles have been divided, according to the course
and disposition of their fibres; first, into rectilineal or straight, as the rectus abdominis, and sartorius ; second- ly, into half, and complete pennif'orm, as the vasti, and rectus of the hind extremity; thirdly, into radiated, as the obliquus internus abdominis, and serratus magnus ; fourthly, into hollow, as the bladder, intestines, and heart. |
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On the Muscles.
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197
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Muscles have received various names,according to their
shape, use, attachment, course, comparative size, &c. thus, we have the rhomboideus, trapezius, and quadratus, so called from their figure; the levator, depressor, ex- tensor, and flexor, from their different uses; the supra et infra spinati, the intercostales, and sterno-maxillaris, from their situation and attachments ; the obliquus, rec- tus, and transversalis, from the direction of their fibres; the maximus, medius, minimus, magnus, parvus, longus, and brevis, from their comparative size ; the semitendino- sus, and semimembranosus, from their composition. Our best writer on veterinary anatomy, Stubbs, has adhered, in his description of these parts, as nearly as possible, to the nomenclature made use of by human anatomists ; and there are so many forcible objections to any deviation from this procedure, that we shall at all times adopt it, unless forbid by palpable inconsistency. In describing the attachments of a muscle, it is found
convenient to divide it into three portions, to which differ- ent names are assigned. That extremity from which it arises, commonly connected to some fixed, or very limit- edly moveable part, is called its origin, or head; the other, implanted into the part to be moved, the insertion, or termination of it; while the portion intermediate—be- tween its head and termination, receives the name of body, or belly. Muscles are composed of two substances altogether
different, both in regard to their structure and use. The chief part of a muscle, (of some the whole,) is consti- tuted of fleshy fibres, whose color, commonly red, is wholly dependant on the quantity of blood they contain ; for if these red fibres be steeped, but for a short time, in water, they may be rendered perfectly white. Indeed, |
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198 On the Muscles.
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redness is by no means essential to these organs, for many
of them are entirely colorless ; which we have instanced in the stomach, the bladder, the intestinal canal, and the muscular coats of arteries; and yet these parts are simi- lar, both in structure and economy, to the red and larger muscles of the body. We know also, that in many fish, the muscles are white; and we have a good specimen of the same, in those of the breast and wings of our com- mon domestic fowl. The fleshy part of these organs, we have said, is
fibrous; and their fibres are disposed in packets or bun- dles, called fasciculi, which run in lines parallel to one another, and are connected together by cellular mem- brane. At first sight, these fasciculi, or fleshy packets, appear to be of large size ; but if we proceed to unravel them, we shall find that the fibres of which they are made up, are composed of numerous fibrilla, or smaller fibres, and that they themselves are so many fasciculi: these again, by prosecuting the examination, will be found to be divisible into others still more minute; so that, in truth, the ultimate fibre of a muscle cannot be discovered. The fasciculi fare much larger and coars- er in some muscles than in others: e. g. in the glu- teus maximus, a muscle of the buttock, their texture is extremely coarse, whereas in the small muscles of the eye it is remarkably soft and fine ; and even the cellular membrane, by which they adhere together, varies some- what in its tissue in these parts. It is for this reason, that some joints, and also parts of joints, of beef, mutton, 8cc. are much tenderer, and better flavoured than others ; and therefore commonly preferred for the table. The fibres of what are called the involuntary muscles,
are in general of finer texture than those of the voluntary, |
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•
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On the Muscles. 199
as well as shorter, and extremely irregular in their course:
e.g. the heart is composed of strong and red, but by no means coarse fasciculi, which, from running in all direc- tions, enable it to contract its sides with considerable effect; and the bladder and stomach are furnished with muscular fasciculi, pale, and slender, and alike differently disposed. _ Various conjectures have been offered, from time to
time, as to the ultimate structure of these minute fibres ; but physiologists have not as yet come to any definite conclusions on the subject. It is generally admitted, that they resemble in composition the fibrine of the blood, that they are disposed in straight lines in regard to one another, and that they are inelastic; for though muscles appear, when stretched, to possess some elasticity, it is a property they owe to the cellular membrane connecting their fasciculi together, and not one inherent in their com- ponent fibres. The opinions, that their primitive fibrillar are the continuations of the extremities of nerves—that they are composed of cells, or hollow tubes, or vesicles, are now altogether rejected; as well as the suppositions of their being, in figure, globular, rhomboidal, &c. The fleshy part of a muscle is extremely vascular.
Though small, its arteries are so numerous, that some authors have thought that the blood which they contain, not only served it for nourishment, but had some share in the performance of its functions. Their veins are pro- portionally abundant. Their nerves are small, and ramify extensively in their
substance : lymphatics also have been seen in them in considerable numbers. Muscles however are not very sensible parts : when cut, in experiments on living ani- mals, although their fibres contract as soon as divided, |
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200 Oil Tendons.
and appear to shrink under the knife, we never find any
very considerable pain evinced by the animal at the time; and, in amputation, surgeons have remarked, that their patients, generally speaking, complain but little after the division of the integuments. On Tendons.
Tendons are to be regarded as parts of, or appen-
dages to muscles. They were formerly supposed to be made up of fibres continued from the fleshy part, more closely compacted; this opinion, however, though, at first view, plausible enough, has been withdrawn, since their composition and texture have become the subject of more accurate examination. It is now ascertained, that tendons, though fibrous, are, unlike muscles, chiefly con- vertible into glue by long boiling; and that their fibres, in many instances, are taking a different direction alto- gether from those of the muscles to which they belong: the most obvious distinction, however, between muscle and tendon, and one which sets this question at rest, is that of function, as we shall hereafter have occasion to point out. The fibres of tendons are white, glistening, and inelas-
tic, and possess but little vascularity when compared with those of muscles : hence arises their disposition to slough —not a very uncommon effect of injury to them in the human subject, even as high up as their origin from the muscles. Nerves cannot be traced into them, and animals express no pain when they are injured*: but the theca, * Although tendons appear to have no feeling in health, they are
(or at least their granulations are) very sensible in disease : we have shown this by pricking and cutting the extensor tendon, divided, or |
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On Tendons.
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201
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or sheaths investing them, possess sensibility; and it is:
from this circumstance, that inflammation from sprains of these parts, is productive of so much pain. Absorbents in tendons are very scarce; for which reason, ulceration in them is an exceedingly tedious process : so that if mat- ter be poured forth under a tendinous fascbia, unless we discover its presence in time, and give it free issue by puncture, it will burrow among the muscles, or other soft parts, and produce extensive mischief; whereas, had it been collected under the skin, ulceration of the integu- ment would have readily discharged it, without any surgi- cal assistance. Tendons are of different forms'—either round, flat, ex-
panded, or bifurcated—and are continued from the bellies of muscles to bones, and other parts, into which their fi- bres are implanted. They are, in general, enveloped in thin membranous, or cellular sheaths; though in some parts they have theccE of similar composition to themselves; as is the case with the tendo perforans, which, at the fetlock, is enclosed within a theca formed by the tendo perforatus. The use of tendon is to connect muscles to those parts
destined to be moved by them. Sometimes it serves to give greater strength to them at their origin. In some places, more particularly in the extremities, by occupying less space, tendon preserves the symmetry of parts, and allows of more extensive action : for this reason, we sel- dom see any thing but tendon passing over a joint. Were it not for such an admirable and convenient substitute for muscle, the legs would be as thick as the arms and thighs, Partially so, in cases of broken knees: the animal withdraws the
hmb as often as this experiment is made, and commonly evinces considerable feeling—we have had occasion to make this remark already, in a former lecture. |
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202 On the Diseases of Tendons.
and consequently not only very unsightly, but incapable
of many of those movements which they now perform with the utmost facility. Afaschia is an expansion, commonly of tendinous
structure, which serves to bind down the muscles, chiefly of the extremities, and prevent displacement of them when in action. If a man have to raise a heavy weight, he fre- quently makes use of some artificial bandage around his arm, by which he finds his muscles so supported, while in action, that he is enabled to perform the labor with less effort: this explains the chief use of faschia. On the Diseases of Tendons.
Tendons are subject to inflammation in consequence
of sprains. Those of the flexor muscles of the fore legs are commonly the seat of this injury : in them it is described, in most works on farriery, under the head of " sprain, or clap, of the back sinews." In investigating the na- ture of this accident, we wish to confine ourselves to the injury sustained by the tendons themselves, and not complicate it with that of many other parts in the vici- nity, which, the least reflection will show, may, and very often do partake of it in severe cases of this kind. What is called a sprain, or strain of the flexor tendons
of the leg, does not, in the generality of cases, consist in any preternatural extension of those parts, but in a lace- ration of that cellular membrane which connects them to- gether, and of which the thecae for them is composed, in their passage between the knee and fetlock-joint. We do not mean to contend, that in the worst accidents of this kind the tendons may not be stretched, and even partially ruptured ; but we would reject the accounts of writers al- together, in reference to their being torn asunder, as wholly |
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On the Diseases of Tendons. '203
unsupported by the actual inspection of these parts, and
thus far disbelieve that a horse was ever broken dozen. Professor Peel, who has no competitor as a veterinary pathologist, in his work on the Diseases of the Horse, says, " I am strongly inclined to believe that the rupture of the back sinews in horses, is a very rare occurrence in- deed, although I am far from denying the possibility of such a circumstance." In the human subject, it is true that the tendon of the heel is not unfrequently broken ; but only reflect, for a moment, on the comparative size and strength of the tendo achillis and the gastrocnemii muscles, and then turn your attention to the flexor mus- cles and tendons of the horse ! Moreover, in dancing or jumping, the gastrocnemii of one leg are often absolutely sustaining the weight of the whole body ; but do the flex- ors of a horse ever do this?—muscles that are not even believed to be concerned in progression. Lastly, we have appended 2 cwt. to the tendo perforans without rupturing it. From these facts, then, and from some others that might be adduced, we would even deny the possibility of rupture of the flexor tendons in a sound and healthy con- dition. As laceration of the cellular membrane must, in most
instances, be accompanied, not merely by extension, but by rupture of its blood-vessels and nerves, the immediate effect of this accident will be more or less extravasation of blood; and this accounts for the swelling, and (by its pressure upon the injured nerves) for the tenderness, of- ten perceptible soon after it has happened: we some- times meet with cases, however, in which we cannot dis- cover tumor, or tenderness ; but in them lameness seldom appears prior to the supervention of inflammation. When the sprain has been violent, extensive tumefaction of the |
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204 On the Diseases qf Te/idoits.
back part of the leg immediately ensues, attended with
considerable pain—if we may estimate it by the limping gait of the animal, as he is led to the stable : quickly after inflammation supervenes—the parts become hot, more swollen, tense, and exquisitely sensitive; and the horse projects the limb a little, stands tottering with it upon the toe, and keeps the heel elevated. About this time, the system sympathizes from the extreme pain in the part, and symptomatic fever is ushered in :—the horse grows dull and languid, his flanks heave, his pulse becomes ac- celerated and strong, and his mouth feels hot and dry; and to such an alarming degree may these symptoms in- crease, that, if the animal be not in some way or other re- lieved, even death itself may step in, and put an end to his sufferings. Sudden and violent exertion of any kind, and more es-
pecially at a time when the animal is unprepared for the shock, is the exciting cause of this disease : racers, hunt- ers, and such horses as are ridden hard on the road, are the most common subjects of it. Hard galloping upon boggy ground—unexpectedly leaping into a blind ditch— or setting the foot on a sudden in a rabbit hole, frequent- ly produces it. Perhaps the improper use of thin-heeled shoes, and the imposition of more weight than, from age or conformation, the animal is able to carry, may now and then have the same effect. The treatment of a slight sprain is very simple. If the
leg be but little swollen, and the lameness inconsiderable, the use of some refrigerent, or evaporating lotion*, with a well applied bandage, will be all that is required ; or— * Either the Liquor. Plum. Subacet. Dilut.; or that in com-
bination with Vinegar, or Spirits of Wine.—Vide Lecture V. Local Treatment of Inflammation. |
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On the Diseases of Tendons. 205
a practice some prefer, immerse the leg in spring water,
and let the horse stand up to the knee in it for several hours in the day, using the bandage and cold wash only during the night. When there is much heat, swelling, and tension of the leg, however, our treatment of the case must be more active. In the first place, we are to draw blood to the amount of from four to six pounds; and this we can always do, with as much effect as locally, by removing the horn at the toe and puncturing the anterior coffin arte- ry, or opening the cephalic, or saphena vein, according as it is the fore or hind leg affected. We should also at this time exhibit a full dose of purgative medicine*- Emollient applications are here to be preferred to cold : fomenting the leg with warm water, or, what is more effectual, steeping it in the same manner as that in which we have recommended the use of the cold, will tend much to the reduction of the inflammation, and con_ siderably alleviate the animal's sufferings. When the heat and tenderness have much abated, we prefer immer- sion in cold to warm water, or have recourse to the evapo- rating lotion and bandage ; taking care, however, not to apply the bandage tightly, until the animal can bear mo- derate compression of the leg with the fingers. Rest is in- dispensable : it is an erroneous practice to turn horses into loose stables at the onset of this disease ; though it is of great service to them when the inflammatory action has subsided ; which you may determine on by the feel, and by the animal's walking sound. Nothing is more common in aggravated cases, than for
* R Aloes Vulgar. Ext. 3vij.
Ol. Carui gtt. xl. Sympi q. s. ft. Bol. for ahorse 0/ordinary size. |
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20(5 On the Diseases of Tendons.
much obstinate swelling and induration to remain after we
have entirely suppressed the inflammation. Tumefaction in the beginning is simply the effect of a coating of adhe- sive matter, filling up the cellular substance between the tendons and the skin ; as soon as the case has turned chronic, however, a gradual change takes place—the effu- sion becomes organized, and firmly adherent to, and con- tinuous with the surrounding parts, whose nature, ulti- mately, it partakes of; gluing the whole together into one solid mass, tightly binding down the skin, and more or less impeding the motions of the ligaments and tendons: and now we perceive why horses continue lame, and some- times irrecoverably so, after all heat and tension have dis- appeared. In order to remove this adventitious deposit, we may first try some discutient*; and, at the same time, if the season permit, turn the animal into an open pad- dock for a few hours in the course of the day. Should this thickening, however, not readily give way, the applica- tion of a blister, and its repetition about every fortnight, or three weeks, will generally promote absorption of it. In old, or prematurely-worked-up roadsters, hunters, and racers, w hose legs have failed from repeated and aggravat- ed injuries of this nature, we should, generally speaking, after having reduced the existing inflammation by the use of some of the aforementioned remedies, make frequent use of blisters : we wish to enforce this, in order that time may be given to the parts to recover their wonted condi- tion and tone, while we are assisting them to do so, by refraining from all further violence, and exciting the ab- * R Amnion. Muriat. ^ss.
Acid. Acetos—Spts. Vin. Ten. ana f vijj. M.
Some to be rubbed upon the le,g; and a bandage wetted with it,
kept tightly applied. |
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On the Diseases of Tendons. 207
sorbents to remove the interstitial effusion. The com-
mon practice in these cases, more particularly with farriers and gentlemen horse-doctors, is to fire and blister. Now, we will not ask these individuals—but we will put the question, seriously and conscientiously, to any veterinary surgeon, whether these remedies are required at the same time—whether there is such an affinity between a red hot iron and an ointment made of cantharides, corrosive sub- limate, and lard, that the first can on no occasion be had recourse to, without being followed up by the last ? With the intention of gaining a clear view of this important sub- ject, it is desirable that we should be made acquainted with the modus operandi of the actual cautery, which appears to us to have been in part overlooked. First, the cautery extinguishes the life of the part to which it is immediately applied; secondly, as a direct and powerful stimulant, it excites inflammation ; thirdly, eschars appear—the dead parts scale off; fourthly, furrows, where the skin is defi- cient, remain to granulate and cicatrize : there is also more or less interstitial effusion. The fourth and last effect of the cautery will explain its ultimate and most beneficial operation—as a bandage; for Nature here does not form new skin—no ! that would be an expensive and tedious process ; but She contracts the cauterized edges of the old to restore its integrity, and, in doing so, braces the parts underneath with much more effect than we could by the best contrived bandage. Seeing, then, that excessive sti- mulation and perpetual pressure are the principal effects of the actual cautery, and knowing that those of an es- charotic blister are excessive stimulation and serous ex- udation from the surface*, we cannot discover, we repeat, the intimate relationship between them. For the present, * Vide Lecture IX.
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208 On the Diseases of Tendons.
we will leave the subject here—we fear, we have said
enough to kindle the wrath of those whose opinion we will not ask, if not to raise up in arms against us some of our veterinary colleagues : influenced however by a desire to improve our art, while we avoid all unnecessary torment in the practice of it, we trust that no misconstruction will be coupled with our motives. We are not to make use of the cautery so long as blis-
ters seem adequate to this end; (which indeed we have very commonly found them to be;) and when we do, we are not to handle it as if its efficacy was in direct ratio to the depth to which the skin is scored : a mode of prac- tice in great repute among farriers, and one as tenaciously persisted in, we lament to say, by many veterinary sur- geons. The performance of this operation in such man- ner as to make the lines penniform, commonly called dia- mond, or feather firing, "has," as Professor Peel justly remarks, "nothing but its fancifulness and antiquity to recommend it," for, in our opinion, it evinces but little of the dexterity of the operator, and much less of his professional judgment. Without again agitating the question of the propriety,
or necessity, of simultaneous firing and blistering, we may contend, however curative it may be, that the practice is dangerous, and therefore impolitic. No man ever fires and blisters his horse all fours without a remote chance of killing him. Two cases of the kind have occurred to us, in one of which, indeed, only the fore legs were operated on ; but we have had several others related to us: the horse refuses his food, the legs become enormously swol- len, inflammatory fever supervenes, sometimes the kidneys are highly stimulated, and the poor animal dies in the height of irritation. In hunting and racing stables this |
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On Bursa Mucosa. 209
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occurrence is not very uncommon ; though it is mostly
veiled in some flimsy narrative, by which the proprietor and practitioner in attendance alike escape a merited re- primand. But the practice is so general, and the case, it would appear, so well denned in which it is proper, that even if the owner of the horse should not prescribe him- self, the representations of the groom are seldom unavail- ing ; so that many hunters and racers are thus inhumanly tortured once a year, whether they require it or not, not only with a view of remedying present mischief, but of preventing that which is to come! We would here suggest to the practitioner a plan,
which, if properly pursued, will prove of no inconsider- able service in all cases of lameness from sprains, or lace- ration of the fibres of the flexor muscles, or tendons. It consists simply in the elevation of the heel by some addi- tional substance, either of a temporary or permanent kind, to the heels of the shoe. In all cases likely to prove pro- tracted m the cure, we should recommend the shoe being removed, and raised by calkins at the heels to the extent of about an inch ; in others of less severity, the practitioner will be best able to form his own contrivance. Should a high-heeled shoe have been long worn, we must not di- minish its thickness at the heel suddenly, nor succeed its application by the immediate use of a common one. On Bursa Mucosa.
The bursa mucosae are small membranous sacs con-
taining fluid, interposed between certain parts moveable upon each other, to facilitate motion. They may be considered as appendages to muscles,
or rather their tendons ; for it is between tendons and the parts over which they pass, that we commonly find them: p
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210 On the Diseases of Bursa Mucosa.
hence they exist in great numbers in the extremities; ei-
ther between the tendons themselves—as between the flexor tendons of the legs ; or between the tendons and their thecae—as in those of the hock, fetlock, and knee ; or between tendons and cartilaginous surfaces—as between the os naviculare and tendo perforans, and within the cap of the hock; or between tendons and joints—as in the knee, shoulder-joint, and stifle. Sometimes we find them placed under the fleshy part of the muscle, in order to enable it to glide smoothly over some cartilaginous sur- face : e.g. under the antea et postea spinati of the fore extremity, and the gluteus maximus of the hind. These bursas are formed of thin tendinous sacs, lined
by a delicate membrane similar in its texture to the syno- vial membrane of a joint; which, like it, secretes and contains a viscid fluid, resembling in appearance the white of egg. They are connected to the surrounding parts by cellular membrane, so that (as they are circumscribed) they may, by a nice dissection, be wholly detached ; and indeed they are occasionally, by operation, excised al- together, in consequence of being diseased. In a physiological point of view, the bursas may be re-
garded as so many small, distinct capsular ligaments; and being, for the most part, situated between firm and un- yielding substances, moveable upon one another, they fa- cilitate motion by preventing friction, and preserve these parts from the injurious effects of it. On the Diseases of Bursa Mucosa.
These parts, both in the human subject and in horses,
are very frequently diseased : indeed, so common are these
cases in veterinary practice, that, perhaps, we are oftener
called on to treat them in one part or other, than any other
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On (he Diseases of Bursa Mucosa. 211
individual local affection. Different names have been
used to denote this disease, though the nature of it is pre- cisely the same in all, according to the situation of the af- fected bursa, or bursa;: e.g. if those about the fetlock joint are diseased, it is called wind-galls; if those about the hock, thorough-pin, or bog-spavin; or, if it is that within the cap of the hock, capped hock. Now and then, we meet with puffy swellings precisely of the same na- ture upon the knee; but to these no specific appellation has been given, in consequence, probably, of their being of comparative rare occurrence. If we inquire, by dissection, into the nature of this dis-
ease, we shall find that it consists in the distention of one or more of these tendinous sacs with an albuminous fluid, resembling synovia. Inflammation is first excited in the membrane lining the bag, the effect of which is an accu- mulation of its secretion : this, in course, preternaturally distends the cyst, and thus the disease in question is pro- duced. These encysted tumors may, and do form in some parts, without our being aware of their existence, until they have acquired a certain size, which will depend on their relative situation : as soon as they are large enough to make their appearance externally, they are known as puffy swellings, possessing elasticity, and a sense of fluctuation when compressed by the fingers. Oc- casionally these swellings grow to an enormous bulk, and then commonly interfere with the functions of parts to which they are contiguous. They are, in the first in- stance, like healthy bursa;, perfectly circumscribed—have no communication with any other cavity; it frequently happens, however, that wind-galls and thorough-pins of long duration, from internal absorption, open into the ca- p 2
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212 On the Diseases of Bursa Mucosa.
vity of the joint. The fluid contained in them also under-
goes some alteration during the chronic stages. These tumors are commonly the result either of some
injury to ligamentary or tendinous structure, or of impro- per usage of these (as yet imperfectly formed) parts : over- weighting, immoderately riding, or injudiciously breaking young horses, are among the most common forerunners of this disease. In horses more advanced in life, repeated acts of violence to these parts from long and forcible ex- ertion—from what is known as hard work, is the most common cause of them ; though sprain, or other injury, may occasionally produce them. Sometimes they arise from blows; the best instance of which is the capped hock. As the bursa? mucosas are not very sensible parts in
health, we do not find that pain, or lameness, (the effect of pain) is a common symptom of disease in them : in those cases, however, where the magnitude of the swelling is such as to interfere with the motions of contiguous parts, lameness may result from that cause alone. Remedies of various kinds have been from time to time
recommended for the cure of wind-galls. In the human subject, the treatment of a ganglion (for so the swelling is called) is exceedingly simple: if it be of small size, merely giving the part a sharp blow with a book, or some such thing, in order to rupture the sac, and extravasate its contents into the adhering cellular membrane, where in the course of a short time it will be absorbed, is all that is necessary: but in horses, their size and situation gene- rally preclude the probability of success by these means. Puncturing them, or laying them open in order to re- move the cyst by excision, or to destroy it by the intro- duction of caustic, has been recommended by several old |
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On the Diseases of .Burses Mucosa. 213
writers*: knowing, however, as Osmer appears to have
done, the nature of these swellings, we are somewhat sur- prised that he should have condemned all other remedies, for the introduction of one, not only very difficult, in many instances, to put into practice, but at all times more or less hazardous, from the intimate connection, if not com- munication, which these swellings so commonly have with the cavity of a joint. If either of these operations is ever to be performed, it should be attempted in some part remote from a joint. Setons are objectionable for similar reasons. As our principal object in the treatment of these affec-
tions, is to remove an eyesore, (for, as we have before mentioned, they do not often occasion lameness,) those means commonly used to promote the action of the ab- sorbents, have been had recourse to by most of the old practitioners in farriery. Pressure, either by means of sheet lead, or a bandage, is one of the most common; friction, by means of hand-rubbing, another : both, how- ever, have generally been accompanied with the applica- tion of some evaporating or discutient lotion, to which the good effects have been chiefly attributed. And if the swelling be recent, and more especially if there be any concomitant inflammation of the parts in the vicinity, we cannot do better than apply a linen bandage, kept con- stantly wet with some mixture of a stimulating and discu- tient kind f: even here, however, we believe, as much de- pends upon the proper application of the bandage—nice-? * Vide Bracken, Osmer, Taplin, and others.
t R Amnion. Muriat. 53s. Spts. Vin. rect.—Acid. Acetos. ana Jvj. M.
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214 On the Diseases of Bursa. Mucosa.
ly adjusting the turns of it to the irregularities of the leg
—as to the lotion itself. This practice will seldom suc- ceed in discussing the swelling, however effectual it may prove in the removal of the lameness : we are, conse- quently, to have recourse to other and more powerful means, if we be desirous to excite absorption of it. The use of stimulants of various kinds, is generally now re- sorted to : as the 01. Origani, and Liquor Ammoniac, ei- ther separately, or in combination with some inactive in- gredients. But of this class of remedies, blisters are by far the best: indeed to their use we should at once be- take ourselves, if we wish to obtain a speedy removal of the tumor; and either frequently repeat them, or keep up a discharge from the surface by means of some stimulat- ing unguent. Last of all, we may employ the actual cau- tery, when other attempts to disperse it have proved inef- fectual : a few longitudinal lines, lightly drawn upon the surface of the swollen part, will often promote the further absorption of its contents, when blisters cease to have that effect; but, then, it will require that the animal be turned out for about a month afterwards. Though these affections have been here viewed as dis-
ease, we must not close this lecture without observing, that we rarely find it necessary to treat them : they seldom occasion lameness, and are not often attended with in- convenience. A windgall, if it be recent, and we dislike the appearance of it, may be got rid of : but it is ever prudent not to disturb those of older date. A capped hock is certainly a great deformity, and, as such, should invariably be treated ; a thorough-pin, or a bog- spavin, is of less consideration as a blemish: like wind- gall, they are all to be removed by proper and timely |
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On the Diseases of Bursa, Mucosa:. 215
means, but commonly resist remedy, and may be regard-
ed as permanent defects, when of long or uncertain du- ration. We shall have occasion to make some further re- marks on these local affections, when our attention is engaged by the parts with which they are immediately connected. |
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LECTURE XIII.
On the Physiology of Muscles.
IN a former lecture, we stated, in our definition of a
muscle, that all the motions of the body were either di- rectly or indirectly the effects of muscular action. Now, though we are by no means warranted, from our anatomical knowledge, in taking up so extensive a position, still the inability of any other known power to produce such phe- nomena as happen in the moveable parts of the body, even where a fibrous structure is indemonstrable, leads us to conclude, that muscular fibres must exist, although they be so minute as to escape microscopical observation. Without prosecuting this abstruse question, we shall en- deavour, in the present lecture, to point out some of those laws and phenomena at different times disclosed by phy- siologists, in the course of their inquiries after the myste- rious causes of muscular motion. Muscles in the living body possess the power of short-
ening themselves, so as to bring nearer to each other their points of origin and insertion : a power expressed by the term contraction, or, from its peculiarity of self-action in these organs, self-contraction. A muscle during contrac- tion, at the same time that it is rendered shorter, becomes |
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On the Physiology of Muscles. '217
thick and hard, and appears to swell : to convince our-
selves of these facts, we have only to grasp the fore part of our arm completely extended, and then flex the fore arm to its utmost; and we shall feel the biceps flexor cu- biti, (the muscle performing this action,) which was at first but indistinct, relaxed, and soft, become turgid, firm, and rigid under our fingers. Notwithstanding these changes, however, it has been ascertained, that there is no absolute augmentation of its bulk ; for if the arm be im- mersed in a vessel completely full of water, when all its muscles are relaxed, no superflux of the fluid is occa- sioned by throwing them into action. The color of a muscle is not altered during contraction. But muscles may be in action without being able to
contract their extreme parts : as, for example, when we are attempting to lift a heavy weight, and are unable to effect it, all those muscles which would have contracted had the weight been raised, are still in strong action during our efforts to accomplish it. A muscle will -act with more or less force according to the nature of the function we intend it to perform : if we prepare the muscles of our arm to lift a heavy weight, and in raising it find, contrary to our expectation, that it is very light, the hand, with the weight, will be involuntarily elevated, with a sudden jerk; and something of the same kind happens, when, in descending a staircase in the dark, we unthinkingly step down two stairs instead of one, or vice versa. Under ordinary circumstances, a muscle cannot remain long in a state of contraction—its fibres must be relieved by in- tervals of relaxation: if we hold a weight out at arm's length but for a short time, we experience an uneasy sen^ sation in the muscles of our arm, the effect of fatigue in them, and this will continue to increase tintil we find our- |
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218 On the Physiology of Muscles.
selves no longer capable of sustaining it; but if we lay
down the weight, and rest the arm for a time, and then raise it as before, we shall find ourselves as able to sup- port it as in the first instance. Relaxation, therefore, is a state necessary for the recovery of muscles from fatigue, or the re-acquirement of that which enables them to con- tract as before. Even the heart itself has its momentary relaxations. It is curious to observe, when a muscle has continued long in action, how its numerous fasciculi will relieve each other, by alternate contractions and relax- ations ; which, as the fatigue becomes greater, occur in more frequent and irregular succession, producing that quivering motion so remarkable in a part whose strength is nearly exhausted. A muscle, having performed its office, relaxes; and
when relaxed, is completely passive: its belly becomes again soft, the swelling of it subsides, and its fibres may be readily elongated; in which condition it may be said to be at rest. Thus the biceps, which we employ to bend the arm, having done so, relaxes; though its fibres remain shortened, until the arm is straightened again by the action of the triceps extensor cubiti. No alteration is observable in the tendons, either
during the contracted or relaxed state of a muscle : they appear to be, as it were, substitutes for cords—to con- nect muscles to the parts intended to be moved, without impeding, from their volume, the motion of those joints over which they pass. If a nerve be cut through, the muscles to which it is
distributed become paralytic; or if that nerve be com- pressed from any cause—as from ligature around it, the same effect is produced : but if it be irritated, violent contractions of them, called convulsions, ensue. In like |
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On the Physiology of Muscles. 219
manner, compression or division of the medulla spinalis,
paralyzes all those muscles whose nerves are given off from it posteriorly to the section, or part compressed, and irritation of it convulses them ; consequently, the more anteriorly along the spine this experiment is made, the greater the number of muscles influenced by it: if it be before the origin of the phrenic nerve, the diaphram is rendered paralytic, respiration arrested, and the animal dies. The motions of these organs have been divided into
voluntary, involuntary, and mixed. Of the first class are those of the muscles of the extremities, head, neck, and tail; of the second, those performed by the muscles of respiration; and of the third, the actions of the heart, blood-vessels, and abdominal viscera. The brain being the centre of all muscular motion, it is along the nerves that the will, or the requisite stimulus to action, is conveyed to the voluntary muscles: we will, for example, to bend our arm, and it is done; but if the nerves be cut through going to the muscles employed in bending it, we may will or wish to eternity, and no effect will be produced. It is somewhat different, however, with the mixed order of muscles : we may breathe twenty times in a minute, or we can make a hundred inspirations in that time, but We cannot suppress respiration altogether; for in spite of our most resolute determination to hold our breath, We soon experience so uneasy a sensation in the chest, that we are compelled to desist from the attempt. On the contrary, respiration is going on, without any remis- sion, in such a manner that we are generally uncon- scious of it, unless our attention be immediately directed to it by auy incidental circumstance ; so that the actions performed in breathing, are strictly what they are said to |
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220 On the Physiology of Muscles.
be—mixed, or in part voluntary, and in part involuntary.
The motions of the heart and arteries, and those of the abdominal viscera, are entirely out of the limits of volun- tary influence : and most wisely is it so ordained, other- wise we should possess full discretionary power to ter- minate our lives, by having control over the motions of the heart, and be in continual hazard of forfeiting our existence from inattention to them. It is observed, that muscles increase in size and
power, in proportion to the exertions they are in the habit of performing : hence is it, that the arms of black- smiths are so well marked by fleshy prominences, and the calves of the legs of porters so much larger than those of others; and for the same reason, thorough-bred horses that have been in training, are admired for that plump- ness and cleanness of their muscles by which the trainer knows that they are in condition to go to work. The power of muscles is much greater than we could have had any conception of, from a bare consideration of their texture and uses : though we have frequent opportunities of witnessing the astonishing feats of strength which horses and other animals are capable of, we seldom con- trast them with the physical powers producing them. The immense burthens imposed upon the backs of little half-starved asses, with which they trip along without ap- parent inconvenience; the high fence and extent of ground over which a horse will project himself and his rider; and the mere elevation of the tail—which is often as much as a powerful man can effect with both hands —are familiar and striking instances of the force that these organs are capable of exerting. We are not to imagine, however, that muscles act to
the greatest advantage in the different movements of the |
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On the Physiology of Muscles. 221
body ; on the contrary, there is often much expenditure
of force, resulting from their situation and attachment, in relation to the parts to be moved, being unfavorable to their mechanical operation : and this, in most instances, arises from their being connected to bones near to the centre of motion, and having to raise a weight at the extremity of a long lever, or from their terminations being implanted into them at unfavorable angles. The ex- tensor and flexor muscles of the leg, which have chiefly to overcome the resistance opposed from the weight of the pasterns and foot, though they are inserted near to the top of the cannon, instance the first; while the proper extensor and flexor of the foot, which are tied down at the knee, and fixed at sharp angles into the cof- fin bone, serve to demonstrate the latter. If muscles were inserted in parellel lines with the bones, no motion whatever could be produced : they act with more effect in exact ratio, cateris paribus, as their insertions approach to right angles ; hence the extreme force with which the gastrocnemii extend the hock in progression % On the other hand, there are certain peculiarities of
conformation in the parts to be moved, and of arrange- ment in the moving powers, which conspire to the fa- vorable action of muscles. In the instance we have just adduced, the mechanical advantage afforded by the protuberance of the os calsis, is very great: the same adaptations of structure are observable at the elbow, by means of the olecranon ; at the knee, through the in- * Knowing this, we discover an important use of the navicular
hone, not adverted to by writers on the foot:—to increase the angle of insertion of the flexor perforans, and to add so much the more power to it, in its action on the coflin bone. |
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222 On the Physiology of Muscles.
terposition of the os trapezium*; and, we may add, in the
foot, by means of the os naviculare. The pulley, ano- ther mechanical power, is one, it is not improbable, that first suggested itself from attention to the construc- tion of the animal machine: the trochlearis muscle of the eye is a beautiful instance of this; the flexors of the pasterns and foot in the hind extremity are also, in their course over the hock, imitative of the same structure. Even the enlargements at the extremities of bones much assist the muscles in their operation, by making wider angles with their insertions. The contractile force of muscles is so great, that in the
human subject the tendons, and even the bones them- selves into which they are inserted, occasionally give way : we have already shewn that the tendo achillis is some- times ruptured by the action of muscle, and a fracture of the patella from the same cause is by no means an unfre- quent accident. But in the dead subject, the tendons are stronger than the fleshy parts of muscles: appending weights to them when taken out of the body will demon- strate this—the muscle will invariably break first. Profes- sor Peel mentions an instance of fracture of both the pas- tern and coffin bones, from leaping : but we apprehend, that this accident was occasioned by the sudden imposi- tion of the weight upon these parts, and not by any muscular force. The power of a muscle is not in exact ratio to its size,
but depends on its texture, or organization, and the de- gree of excitation it receives from the brain : thus it is * By strange perversion of language, this bone is called, because
it is said to correspond, in situation, to one of the same name in the human subject, os pisiforme. |
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On the Physiology of Muscles. 223
that thorough-bred horses, in which both these circum-
stances seem to combine, are often stronger than cart horses whose limbs are very considerably larger. The astonishing rapidity with which the contractions
and relaxations of the muscles can be effected, is well ex- emplified in the motions of the limbs of the fleetest race- horses; in which Hallek conceived, that the elevation of the leg was performed at speed in -^v of a second. The extent of motion that a muscle is capable of pro-
ducing, bears some proportion to its length ; though there are mauy exceptions to this : hence many of those of the fore and hind extremities, and neck, when they con- tract, cause the parts moved—the feet and head—to de- scribe the segment of a large circle. Muscles of great length however are always weak, when compared to others—short and thick, and whose points of attachment are near together : but these last possess, generally speak- ing, but a very limited action. Haller, in investigating the all-wise designs of Nature, in the construction and ar- rangement of these organs, observes, that " all the con- trivances of human skill end in this, that the moving power passes through a large space, while the resistance describes a small one. In the human body, on the contrary, the effect to be produced is, that the resist- ance should describe a large, and the power a small arc of a circle." It would be productive of no advantage, and taking up
time to little purpose, to make mention of the specula- tions of physiologists about the cause of muscular mo- tion ; for after all that has been said and written on the subject, writers of the present day confess, that we are still ignorant of the grand secret on what it depends: by way of briefly summing up, however, the results of their |
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224 On Ike Physiology of Muscles.
investigations, we shall conclude with a paragraph ex-
tracted from Dr. Rees' Cyclopedia. "Our knowledge concerning muscular motions (says the writer of a scienti- fic article on this subject under the head of muscle) amounts to this, that certain physical changes are pro- duced in the fibres under the action of certain causes : these changes we call contraction and relaxation. When we say that a muscle acts by virtue of its irritability, con- tractile power, or contractility, we merely denote this fact, and express the phenomena in a general word : we know no more of this irritability, what it is, or how it is brought into exercise than we do of attraction, or the force by which the phenomena of dead matter are regu- lated." In our last lecture we observed, that muscles in a na-
tural state were not possessed of great sensibility, a fact that admits of ready proof by experiment; though, that there may be a feeling created in the voluntary muscles approaching to pain, in consequence of over exertion, which we call fatigue, every one is sufficiently aware of: under disease, however, the muscles often become the seat of acutely painful sensations, as we shall hereafter have occasion to notice. All muscles act either in obedience to the will, or from
the application of natural, mechanical, or chemical sti- muli. The voluntary muscles perform their functions under the influence of volition; by them an animal is enabled to exhibit all the phenomena of voluntary mo- tion, of which locomotion, the will of producing sound, or the voice, and the prescribed power over the organs of respiration, constitute the varieties. But these organs may also be excited to contract after their communica- tion with the brain is cut oft", by application of certain |
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On the Physiology of Muscles. 23.5
substances of an extraneous nature, denominated stimuli :
the mere contact of any foreign body will generally cause contractions in a muscle though its nerves be divided, or even after it be removed from the body. This property, apparently inherent in the muscular tissue, and not de- pendant on nervous influence, (in which respect it essen- tially differs from common sensibility,) is known by the names of irritability, tone, and contractility: it is one not only resident in voluntary, but possessed by involuntary muscles; for these last may be thrown into action by or- dinary stimuli, though their communication with the brain be cut off, more forcibly, and for a greater length of time after all signs of vitality have disappeared, than the for- mer. The heart has been found to retain this incompre- hensible property of self-action the longest after death. This organ, though taken out of the animal, and laid upon the table, will continue to pulsate, and may be made to exhibit signs of life, by pricking or wounding it, or the use of chemical stimuli, or electricity, longer than any other, and after all attempts to excite action in the volun- tary muscles have proved fruitless: hence it has been emphatically designated the ultimum moriens. The involuntary muscles, during life, are set in action
by what are called natural stimuli—such as are peculiar to each individual set of organs : the heart and arteries, for instance, are stimulated by blood, the stomach by food, and the bladder by urine. Other fluids than blood, thrown into the blood-vessels, disturb the heart's motions; some—as atmospheric air, suspend them altogether; and if blood be introduced into the bladder, it induces con- vulsions of that viscus. In fact, these several organs may experience derangement of function, either from the con- dition of their excitable part (which is commonly a fine |
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226 On the Physiology of Muscles.
membrane) being altered, or from some variation in the
properties of the substances applied to them. If the blood, for example, be inflamed, or otherwise changed in its nature, it may derange the functions of the heart; or urine of an altered composition may disturb the na- tural action of the bladder. On this principle it is, that aloes, which is a chemical, if not a mechanical stimulus to the intestines, produces purging ; and that white hel- lebore excites efforts to vomit, though it has little or no effect after it has passed out of the stomach, being no more efficacious as a cathartic, than aloes is as an emetic ; and both probably might be introduced into the bladder without exerting any specific action on it. The degree of irritability of these parts, or their aptitude for impres- sion by certain stimuli, will vary from numerous and dif- ferent causes; among which we may mention, the nature of the tissue itself, the species of animal, its age, sex, and temperament. We all know that a thorough-bred horse is more irritable than another; and some peculiarity in the texture of his different organs is, probably, the most rational way of accounting for it: his pulse, we have un- derstood, is generally quicker than that of one of inferior blood. Why will one horse purge from three drams of aloes, and another require an ounce to produce the same effect ? These, and a host of other phenomena, we can only explain by saying, that the irritability of organs and textures not only varies in its degree in different indivi- duals, but in the several parts of the same animal at dif- ferent times. With regard to the influence of the brain and nerves on
the muscles, we have already stated, that the functions of the voluntary muscles are regulated by the will; but what the nature of the excitation is that they receive from the |
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On the Diseases of Muscles. 227
brain by the will, or by certain stimuli, we know no more
than we do about muscular motion itself. The same chain of connexion conveys a something to the involun- tary muscles, equally unknown. Of what, in fact, hap- pens between the stimulus and the part stimulated, we are quite ignorant—we can go no further than view, with at- tention and admiration, the phenomena resulting from their reciprocal action, and with a knowledge of them we must rest content. That the same medium of communication conveys a
something to the involuntary muscles, though equally un- discoverable, not less essential to their natural action, will appear from very many facts collected from experiment. If the nerves going to the stomach are cut through, digestion becomes imperfect. Paralysis of the lower extremities is occasionally accompanied with retention of the urine and faeces. Division of the nerves called the par vagum, proves fatal, by destroying the functions of respiration and circulation. And if you remove the brain of an ani- mal altogether, though the heart continues to contract for a certain length of time afterwards, its action may be sud- denly arrested by dropping a little laudanum upon it; and then all subsequent attempts to re-excite it have no ef- fect : opium being known to have the power of annihi- lating the nervous energy. On the Diseases of Muscles.
The most common morbid affection of these parts is spasm or cramp; one which may be said to consist in a continued contraction of a muscle, or of some of its fibres. Assuming that what we have advanced be correct, as to the manner in which muscles are acted on in a natural state, it will not be difficult for us to comprehend the na- Q 2
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228 On the Diseases of Muscles.
ture of this affection. If the spasm be in a voluntary
muscle, its contractions, before obedient to the will, are excited either in opposition to it, or without its con- currence ; if in an involuntary one, either the stimuli are in excess, or the irritability of the muscle increased, so that it is preternaturally affected by the ordinary stimuli: in both cases the spasm is succeeded by relaxation, and does not recur until induced by fresh excitement. A dreadful instance of spasm occurs in tetanus, in which often all the voluntary muscles are more or less affected ; it may, however, be confined to a few, or even to one muscle, of which we recollect to have seen two or three instances at the veterinary college. These horses were lame from a rigidity, the effect of spasm, of the adduc- tores muscles upon ihe inside of the thigh. That spasm is attended with severe pain, we may infer from the symp- toms attendant on cholic or gripes—a disease that con- sists in spasmodic contractions of the muscular coat of the small intestines: the common attacks, however, that almost every one has had of cramp in some part or other of his body, has probably informed him of the kind, as well as degree of pain felt by the animal on such occa- sions. We have already made mention of the manner in which
spasm is induced in explaining its nature. The most common cause of excessive irritability is inflammation, either in the organ itself, or in the general system, in which condition of parts common stimuli occasion un- due and irregular contractions; hence tetanus seems to be generally induced under an inflammatory diathesis, and cholic is a common attendant of inflammation of the bowels. We may also adduce in illustration of extra- ordinary excitation producing spasm: the gripes may |
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On Strhighatt. 229
be often traced to some offending matters taken in,
and perhaps nothing more frequently occasions it, than cold water drunk at a time when the bowel is in an irri- table state. The remedies usually had recourse to for this malady,
called antispasmodics, may be classed under two heads: those which act by diminishing the irritability of the part; and those that relieve by producing such an impression as renders it insusceptible of further stimulation, while their effects remain. Opium and other narcotics rank among the first: stimulants, aromatics, and certain other substances compose the latter;—among which the essen- tial oils of turpentine, juniper, carraway, aniseed, and thyme—alcohol, ammonia, and Eether—assafanida, and camphor—ginger, and numerous others of the same kind, are those commonly made use of. A class of remedies, however, that may be considered as a third—one whose operation is more certain and effectual, generally speak- ing, inasmuch as it tends to afford permanent benefit, is that which removes the cause of irritation, As this is in- flammatory action in the greater number of cases, we are at no loss to account for the good effects of venesection : or if it be in gripes, for the salutary operation of purga- tives, which remove the offending substances from the alimentary canal. But we shall postpone what we have further to say on this subject, until spasm of the intes- tines comes under our immediate consideration. On Stringhalt.
We reluctantly enter on this subject, since it must be
confessed, we have had but few opportunities of observ- ing its progress, or of examining into its causes with the satisfaction we could wish. We need give no descrip- |
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230 On Stringhalt.
tion of the action, or peculiar gait of a horse said to have
stringhalt: the greatest novice easily detects it, and sel- dom fails to make objections to purchase an animal thus affected. Mr. Feron*, one of the few writers who has noticed stringhalt, says, " I am convinced, however, by long experience and observation, that stringhalt, as it is called, is no disease, therefore can require no remedy." And in another place, " Indeed in Spain, France, and Germany,-if is esteemed extremely graceful in their riding schools, or manege, particularly when there is a stringhalt in both hind legs." This writer has, however, admitted it to be a disease, to the full scope of the word, in the very outset of his description by defining it to be " an involuntary convulsive motion of the muscles, which ex- tend or bend the hock." In some particulars, stringhalt bears some affinity to what in human medicine is called chorea; we do not mean, however, to assert that they are essentially the same disease, much less do we imagine that a similar mode of treatment would have any good effect: all we wish to infer by such an analogy is, that they are both spasmodic or convulsive diseases, in which the will has lest more or less of its control over certain voluntary muscles. Not unfrequently, when the animal has lifted his hind leg from the ground, which is always done with a convulsive twitch, the fetlock nearly approaches the belly, and, by some other remarkable irregularities in its action, before the foot can be replaced upon the ground, (which it seldom is in the most advantageous position,) displays such unnatural movements as to.convince us that volition has but little power over it during its suspension. Some- * A Complete Treatise on Farriery, <§c. by I. Fekon, Veterinary
Surgeon, 12th Light Dragoons. |
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On Stringhalt. 231
times this irregular action is confined to one leg, but we
believe that it is more commonly seen in both. It is seldom or never removed. Such writers as offer any opinion of its nature, suppose
it to be a muscular affection, mistaking, we conceive, the effect for the cause. We choose rather to refer its seat to the spinal marrow, or to the nervous trunks passing between it and the affected muscles ; an opinion we were first led to adopt, from having observed a broken-backed horse exhibit all the characteristic signs of stringhalt, which, in this case, was clearly only an accompanying symptom of the former disease. It was stated in the fore- going part of this lecture, that section, or compression of the spinal marrow, paralyzed muscles, and that irritation of it convulsed them : now, we know that many cases of broken-back terminate in palsy ; and, if this be true, why should not others be productive of stringhalt*—since the one arises from compression, while the other is merely the result of irritation ? It is not, however, necessary that a broken-back be present, for any other cause of irrita- tion, we apprehend, would induce this disease. Horses are very subject to injuries of the loins—much more so than vve seem to be aware of—from being suddenly stopped or turned, or from being overweighted about those parts; accidents that are but too seldom detected, since they may not be severe enough to constitute broken-back, though they may so far disturb the nervous functions as to cause stringhalt. Should the injury, or the consequences of it, be confined to one side, then only one column of the mar- row will be affected, and but one leg convulsed: the na- ture and extent of disease in it, will perhaps determine the degree of stringhalt. Such is our theory of a disease whose nature, we be-
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232 On Palsy.
lieve, has up to this time remained unexplained : whether
we have taken a correct view of it, experiment and special attention to these cases in future, can alone decide. We have long had it in contemplation to attempt to induce stringhalt by artificial means; and we intend, as soon as an opportunity presents itself, to institute some experi- ments for this purpose. We so seldom know any thing of the origin and pro-
gress of these cases, and, even if we did, they have gene- rally endured so long, that it would be labor lost to treat them. Should however a recent case present itself, in a horse of value enough to render his recovery an object of consideration, we may pursue such means as have been recommended in the equally hopeless one of broken-back. On Palsy.
Paralysis, or palsy, consists in a loss or diminution
of the power of motion of some parts of the body, either with or without impairment or deprivation of sensation. Jn the human subject, it seldom happens that both these faculties are affected alike : palsied parts are seldom void of common feeling; though instances have occur- red, but we believe they are very rare, of the total absence of sensation, in which the power of motion has remain- ed. In horses, the hind extremities are most subject to paralysis, in consequence of the greater frequency of dis- ease of the spine about the back and loins—commonly the result of external violence, as from casting; and it is not an uncommon termination of broken-back. Should this affection have come on suddenly, and be the effect of accident, either of the nature afore-described, or a fall upon (he head, we are to ascertain, if it be practicable, whether there be compression upon any medullary part, |
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On Palsy. 233
from a driven-in portion of bone ; in which case, its ele-
vation or removal is indispensable : it may be owing to an extravasation of blood, however, and here we should also be warranted in trepanning, supposing that we could determine on the precise spot that received the blow, and the symptoms resisted all other remedies. Venesection, strong cathartics, and blisters kept open, or frequently repeated, are the only means in our power, (without the operation,) likely to relieve, or remove the symptoms: should the case be a protracted one, and manifest some favorable changes, we may occasionally confer much sub- sequent benefit by the insertion of setotis. |
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LECTURE XV.
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On Bones.
Bones are the hardest and most inflexible parts
entering into the composition of an animal: like the framework of a building, they give strength and support to all the others, which, in contradistinction to them, have been called the soft parts. In the full grown animal the bones are perfectly white ;
but in the foetus they exhibit a bluish cast, from their blood-vessels being comparatively of large size, and the blood showing itself through their imperfectly ossified sides: the bones of the former may be said to possess much earth, and but little blood; those of the latter, a large quantity of blood, and but little earthy matter. In very old animals they turn yellow, and have a peculiarly greasy feel; a circumstance owing to the transudation of the marrow contained within them. If we make a section of a bone, we shall find it to be
of much less solidity and compactness of structure in- ternally ; and to put on, as we approach its centre, a spongy and fibrous texture, easily broken down by the in- troduction of a common scalpel: this substance in the long bones of the extremities has received the name of |
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On Bones.
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235
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cancelli; in those of a flatter and thinner make, of diploe.
Why bones should not have been formed solid through- out, we can assign sufficient reasons. In the first place, being hollow, they are considerably lighter, and therefore require less power to move them ; and in the next, they are stronger—as may be proved at any time by making the following experiment. Take two glass cylinders of equal length and diameter, the one solid, and the other hollow, and place their extremities upon pedestals, of any description, and, in this situation, append weights to their centres : the solid one will break from a less weight than the tubular. Bones by being hollow, also present a more extended surface for the attachment of muscle, and afford a convenient repository for the marrow. Bones by calcination, or by long boiling*, undergo
some changes in their composition : they lose much of their original compactness of texture, exhibit a porous or cellular appearance, and become lighter, whiter, and ex- tremely brittle. If we examine them, in this condition, a little more closely, we shall perceive that they are fibrous throughout, and that their walls only differ from the inte- rior parts in the greater compactness of these fibres; for though the shell of a (more especially calcined) bone appear to be composed of several lamella;, or plates, yet do these, in fact, consist of fibres so disposed as to form separate layers. The shell of the bone, then, its most compact and hardest part, is made up of several lamellae, which, after burning or long boiling, may be chipped off in the form of thin scales ; and these plates are rivetted together by numerous little bony fibres, running in, a * More expecially in Papin's digester, in which the water is
heated beyond the boiling point. |
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236 On Bones.
transverse direction ; which, from this circumstance, have
been named the daviculi, or nails. According to this disposition of the fibres, it is evident, that something like a network composes even the hardest parts of a bone ; and, if we might be allowed to compare this with the reticulated structute within it, we should say, that the shell itself was nothing more than a more compacted cancelli. What would appear to amount to a develope- ment of this structure, is a minute inspection of the can celli of a long bone : these, in the middle, where the shell is thick and strong, are few and spacious, but abundant and close at the extremities, where the walls are extreme- ly thin ; as if the shell at either end had parted with its internal lamellae to form the cancellated structure within. We shall find it to be pretty universally the case, that where a bone grows large and protuberates, its shell becomes proportionately extenuated, being chiefly ex- pended in forming medullary or cancellated struc- ture ; on this account, the largest is the weakest part of the bone, though, in truth, it contains as much substance as where the wall is of twice, or thrice the thickness. This remark not only applies to different parts of the same bone, but with singular force to the bones of different animals of the same species: take, for ex- ample, sections of equal length of the metacarpal bones of the cart-horse and the thorough-bred ; and the latter, although much exceeded in diameter by the former, will weigh just as much, and be not only more compact and firmer in appearance, but absolutely stronger. This will serve to shew cause for the prodigious strength possessed by slight spindle-shanked blood-horses, and their superio- rity over others, in this respect, which are much larger, and much coarser in their texture ; and not only weaker, but |
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On Bones.
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237
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softer in their nature: and this is probably one of the
happiest illustrations of a remark that we might extend through a long range in the animal kingdom. In the very young animal, the bones are solid throughout—not exhibit- ing any cancellated appearance ; and even in the old, there are many flat bones which become so thin as to have lost all traces of diploe. Within the cells of the cancelli are found numerous little membranous bags, full of an oily fluid, called marrow, of the nature and uses of which we shall have occasion to speak in the concluding part of this lecture. In addition to the hard—the earthy part, of which we
have been speaking, bones consist of an animal substance of the nature of cartilage ; to demonstrate which, we have nothing more to do than to steep them, for a lime, in some weak acid : by degrees they will lose their hardness and brittleness of texture, and be converted into a soft flexible substance, retaining the form of the original bone; and this, by further maceration, or by boiling, may be resolved into jelly, or glue. While a bone owes its color, brittle- ness, and strength to the earthy matter it contains, it is in this, its cartilaginous part, that its vessels ramify—that its living principle, in fact, may be said to reside : the earth is nothing more than a deposition from the mouths of ar- teries, disposed in a way we have already described ; the interstices of which are filled up, in the recent bone, by this, its animal part. In the human subject, there is a disease surgeons call mollities ossium, in which the bones become so soft and flexible, in consequence of a deficiency of earthy matter, as actually to bend under the superin- cumbent weight, and give rise to considerable distortion : when this disease—or something probably of the same nature—occurs in children, they are denominated ricketty, |
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On Bones.
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238
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the deformities of which are too well known to require
description here. We have seen mis-shapen foals with considerable distortions of the legs, chest, and hips; in which, as the deformity happened after being dropped, it probably arose from deficiency of earthy matter in the bones, or some irregularity in the ossific process : in this animal, however, nature generally removes such defects during growth, a fact the experienced breeder well knows how to estimate, in keeping his crooked foals with a view of their growing straight. Bone, though it appear to be inorganic to the more su-
perficial observer, admits of its vascularity being demon- strated with nearly the same facility as any other part of the body. That it possesses numerous arteries, is proved by injection ; for if, in the young animal, we throw melted size colored with vermilion into the principal artery of a bone, minute vessels may be distinctly seen ramifying throughout its substance. But in the course of our dis-t sections, we are often enabled to trace vessels of consi- derable size into the substance of the larger bones, through foramina in their walls: one of them, larger than the rest, commonly enters about the centre of the long bones of the extremities, to which the name of medullary artery is given, from its sole distribution to the medullary struc- ture. Were these demonstrative proofs wanting, however we have others from which we might infer, with equal certitude, the existence of blood-vessels in these organs. If a bone in the living animal is sawn through, blood is seen oozing from its divided ends, or should the parts have been previously injected, the appearance of injection upon the sawn surfaces, affords abundant evidence of its vascularity. An experiment physiologists have been in the habit of considering as conclusive on this subject, |
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On the Diseases of Bones. 239
is that of feeding a pig, or other animal, with madder—
a substance which will retain its color during the process- es of digestion and assimulation: in a short time the bones of the animal, previously white, become red, in con- sequence of being tinged with the madder ; which effect, say they, could not have happened in other than organized structure *. It appears that bones are not sensible in their natural state, though they are unquestionably so when inflamed : in the operation of amputation, in the human subject, for instance, the patient does not complain of any pain while the surgeon is sawing through the bone; and as to the vulgar idea, that all the feeling resides in the marrow, it is hardly necessary to observe, that it is without foundation : the membrane composing the cells may pos- sess sensibility, but the fat, or marrow, being a secretion, cannot feel any more than the saw itself. In the bones of some animals absorbents may be injected in considerable numbers, in consequence of their not having valves—as in fish ; but, though they are probably equally numerous, in those of quadrupeds we cannot demonstrate them; we only infer their presence from many phenomena which we notice relative to these parts, both in health and dis ease. If such were not the case, we could not account for their being tinged with madder, nor explain the pro- cess of sloughing in bones, termed exfoliation—in which the dead portions are separated from the living, and cast off in the form of scales. On the Diseases of Bones.
Though the horse be not obnoxious to those specific diseases of the human subject so often attended with mor- |
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* Of late another explanation has been offered.
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240 On the Diseases of Bones.
bid affections of these parts, he is an animal of all others
the most liable to have ossific disease excited in his frame from external injuries of various kinds, and from exces- sive exertion. Bones are subject to nearly the same dis- eases as the soft parts of the body : inflammation in them may terminate either in the effusion of adhesive matter, in suppuration, or in mortification. If a bone be fractured, it will be again united by a sort of adhesive or albuminous substance, called callus, poured forth from the arteries of the opposed broken extremities ; which, in a short space of time, will be converted into bony matter, and effect a re-union as strong as any part of the original bone. This kind of inflammation however, which commonly affects the external or periosteal surface of the bone, is one that may be, and most frequently is, induced by injury to li- gamentous structure ; from which it extends to the bone itself. Abscesses sometimes form within the shell of a bone, but more commonly in its interior: in these cases, additional osseous matter is deposited upon the exterior of the bone, in order to enable it, during the ul- cerative stage, to sustain the superincumbent weight, (which it otherwise could not do, in consequence of being weakened by internal absorption,) through some part of which a small opening is made, by ulceration, in order to discharge the collected pus. Something similar to this takes place in the process of exfoliation, sometimes called necrosis. When a piece of bone has lost its vitality—best known by its turning black—absorption is immediately set up for its removal, during which time new bone is de- posited around it, lest the old might give way from the pressure of the parts above; and in this, after a time, holes are made by ulceration for the discharge of the dead bone, by small and separate pieces: so that, in fact, a bone dur- |
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On Exostosis.
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241
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ing exfoliation, is little or not at all diminished in strength,
and knowing this, we are not apprehensive of fracture, though the animal make use of the limb during the pro- cess. In the same way then in which a slough, or core, is first
detached from the surrounding vital soft parts, and after- wards cast oft' by the subjacent granulations, so dead bone is separated from the living j a process surgeons have of late years, from a vigilance to the operations of Nature, thrown much light upon : it is, as might be expected, however, one of slow advance, and one that requires a long time for its completion. On Exostosis.
Ah osseous tumor originating from a bone, is call-
ed an exostosis: such is a splint, a spavin, a ring-bone, &c. Though these are the more familiar instances of the disease, there is, perhaps, no bone in the body that has not beer, seen, one time or other, thus affect- ed : we have now specimens before us of exostoses of the spine, ribs, pelvis, bones of the haunch, thigh, shoulder, arm, leg, and a considerable number of the pas- tern, coffin, and navicular bones; a few of the lower jaw ; and one, as large as a hen's egg, projecting from the orbi- tar portion of the frontal bone, and so placed in front of the orbit, as to render almost useless the eye on that side. Perhaps no animal is more the subject of this disease than the horse; and as it very often proves a source of permanent lameness, we should, by making our- selves well acquainted with its nature, endeavour to arrive at a knowledge of the best means of treating it. Sir A. Cooper, from whose excellent practical essay
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242 On Exostosis.
on this subject* we have derived much valuable informa-
tion, divides exostosis, in reference to its seat, into two kinds, periosteal and medullary; and, again, as to its na- ture, into cartilaginous and fungous: but it is to that kind only which is situated between the shell of the bone and the periosteum covering it, that we have to attend in ve- terinary practice. From the very accurate observations of the distinguished surgeon just mentioned, who calls a tumor of this nature, cartilaginous exostosis of the perios- teum, " it originates in an inflammation of the periosteum, and of the corresponding part of the bone ; and a depo- sition of cartilage, of a very firm texture, and similar to that which forms the nidus of bone in the young subject, adheres to both these surfaces. The periosteum adheres to the external surface of the swelling, and the swelling itself is attached still more strongly to the surface of the bone; it continues afterwards to be secreted as the car- tilage increases in bulk; for it appears that between the periosteum and bony mass, cartilage is constantly secret- ed, which constitutes the exterior surface of the tumor. Thus, on dissection, we discover, 1st. The periosteum thicker than natural; 2nd. The cartilage immediately below the periosteum ; and, 3rd. Ossific matter deposited within the cartilage, extending from the shell of the bone nearly to the internal surface of the periosteum, still leav- ing on the surface of the swelling a thin portion of carti- lage unossified." ** When the accretion of these swellings ceases, and the
disease has been of long standing, they are found to con- sist, on their exterior surface, of a shell of osseous matter, * Surgical Essays, by Messrs. Cooper and Tiuvers. Part I.
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