8IN0P81 OF THE COURSE OF LECTURES ON GENERAL AND HUMAN PHYSIOLOGY, IN THE JTctD-^amp0l)tre JtleMcal jhtstitution, (DARTxMOUTH COLLEGE.) BY E. R. PEASLEE, A. M., M. D., PROFESSOR OF ANATOMY AND PHYSIOLOGY IN DARTMOUTH COLLEGE, AND OF ANATOMY AND SURGERY IN THE MEDICAL SCHOOL OF MAINE. HANOVER :jf £ &tjty PRINTED AT THE DARTMOUTH PRESS. 1848. Entered according to Act of Congress, in the year Eighteen Hun- dred and Forty Eight, by Edmund R. Pkaslee, in the Clerk's office of the District Court of the District of New Hampshire. TO THE MEDICAL CLASSES OF DARTMOUTH AND BOWDOIN COLLEGES. Gentlemen, Since the limited time allotted to my departments does not allow a full diicusgion of all the topics included in the course I had prepared in Physiology, the following Synopsis of the 1st part of it (including General Physi- ology and the Organic Functions) has been compiled for your use; in order to make apparent the natural relations of the pretermitted subjects, and the order in which they should be investigated, as your future leisure may permit. I uniformly devote more time to the Animal Functions; and therefore have not extended this compilation over that part of the course. E. R. P. PROF. PEASLEFS SYNOPSIS OE LECTURES, ON GENERAL. AND HUMAN PHYSIOLOGY. PART 1st. GENERAL PHYSIOLOGY. PRELIMINARY CONSIDERATIONS. But two classes of objects in the material world—organized and non-organized. Object of the Natural Sciences—do. of Biology— define the term. Its subdivisions, Physiology and Pathology—define them. The vast extent of the field presented to the Physiologist—the sub- divisions of Physiology—General and Special—Vegetable—Animal —Comparative. Psychology, a division of Physiology. Physiology, the basis of Pathology—is indispensable to an acquaint- ance with Medical Science—A safeguard against the various forms of Quackery. Hygiene—Definition—Relation to Physiology. Subdivisions of Pathology—General and Special—Nosology—Ae- tiology—Semeiology—Diagnosis—Prognosis—these constituting the Science of Disease. Relation of Pathological Anatomy to Pathology. Therapeutics—define—not a branch of Pathology—General Ther- apeutics—Special do. Define the term " Indication." The Science of Medicine includes what ? The Institutes of Medi- cine ; define the term. Rational Medicine, do. Schedule showing the order in which the various branches in the curriculum of Medical studies should be pursued. General plan of the course of Lectures which follows. ORGANIZATION. Define the term—Distinction between organized and non-organized bodies—External form—not always distinctive—Relative solidity— latter increases with age—Great degree of softness essential to the highest functions—Organized bodies are said to resist chemical action (decomposition)—this not the fact; are affected by it more rapidly than most inorganic bodies—The true distinction in this respect. Neither organized nor non-organized bodies have any inherent tenden- cy to decomposition. Establishments at Bordeaux, &c, prove thie, Both are acted upon by external agents. 1 4 SYNOPSIS OF LECTURES. Chemical composition of organized and non-organized bodies dif- fers—this one reader. :;f their more ready decomposition. Inorganic matter is homogeneous—organized bodies not so. Indi- viduality of former resides in each molecule. Still, only seventeen of the 55 Chemical elements are found in the whole vegetable and animal worlds. Composition of Cellulose, the basis of vegetable structures. Do. of Proteine the basis of animal tissues. Vegetables may derive the elements entering into their composition from inorganic matter—animals cannot. Vegetables moreover lay up a store of nutriment for animals in the form of de- posites and secretions; Avithout which animals would perish. Organized bodies manifest vital phenomena ; non-organized not so. Distinguish between Properties, Forces, and Phenomena. LIFE. The usual definition—explains nothing. We know nothing of its f ^sence ; must infer its nature from its phenomena. Distinguish be- tween Vitality and Life. What is a law in natural science? Laws do not govern or vrodvee phenomena. The laws the Physiologist developes are no less abso- lute than others—e. g., those of Astronomy. How are they to be discovered ? Each science has its ultimate facts—define. Physiol- ogy has its own. Illustrated. THE VITAL STMULI. The action of certain external agents necessary to the manifesta- tion of Life—specify them—Specific effects of Oxygen as a vital stim- ulus—do. of Nutriment—of Water—of Heat—Light—Electricity. Physiological inferences from preceding facts. Pathological effects from abnormal action of each of the vital stimuli. Therapeutical in- dications in each case. The true vital actions must not be mistaken for others common to living bodies and to inorganic matter. Must exclude first the pure- ly physical acinous—second, the purely Chemical actions. 1st. NON-VITAL ACTIONS IN LIVING BODIES, A. The physical—Endosmosis—Capillary Attraction—Elasticity. B. The chemical actions—manifested by vegetable cell-germs—also in animal and vegetable excretion?—in Digestion, &c. &c. Pathological effects of abnormal action of the physical forces— Therapeutical indications. Rule for the administration of Saline Dir.r<;Jcs and Cathartics. Singular effects of Sulphuric Acid on Endosmosis—-do. of Hydrochloric Acid. Pathological effects of excessive or diminished action of the Chemical force, e. g., Indigestion, Vesical Calculi, &c. Therapeu- tical Indications. SYNOPSIS OF LECTURES. 5 2nd. PECULIAR AND VITAL ACTIONS IN LIVING BODIES. Two phases of Vital Force—1st, Organic, or Plastic Force—man- ifested by all living Bodies. 2d, Dynamic Force—manifested only by animals. A. Organic Force—(cell-life)—the only phase of Vital Force mani- fested by the Vegetable World. Its objects, Nutrition and Repro- duction. Is manifested by cells—We are unconscious of its opera- tions. Organic Force manifests itself in five ways—1st, in developing cell-wall—2nd, separating contained fluid from Blastema—3d, pro- ducing other endogenous or exogenous cells—biotransformation of cells into the tissues—5th, Germinal vesicle determining the type of the future being. Shall Ciliary Motion be added ? No one species ever developes another—Equivocal Generation— Even a new species appearing to be produced under peculiar cir- cumstances, no proof of it. B. Dynamic Force—developed by organs, (Nervous and Muscular Systems,)—We are conscious of its effects—Is of two kinds, Mus- cular and Sensory, Its results generally are objective—those of the Organic Force, subjective. Yet the Organic and Dynamic Forces are mutually dependent— the latter affording the conditions for the exertion of the former. Only the Nervous Tissue and the Muscular, (striated and non- striated,) manifest Dynamic Force. Repose must follow Dynamic exertions—not so Organic, unless excessive. Organic precedes Dynamic Force in order of developement. Give order of de- velopement of Dynamic Force. Sensation is last—Does Foetus in Utero possess it ? Physiological and Pathological relations of the Organic and Dynam- ic Forces. Therapeutical Indications. Stimulants and Narcotics affect the Dynamic Force ; Tonics and Alteratives, the Organic. Caution in the use of Stimulants—do. of Narcotics for infants, why ? Action of Digitalis—Cantharides—Ergot—Aloes—Strych- nia, &c. Recapitulation of preceding views. Tabular Classification of the three kinds of Forces manifested in Living Animals. VITAL PROPERTIES. Define the term—1st, Irritability—define—common to plants and animals—2d, Contractility—define—is a property of muscular fibre. Mobility—is common to plants and animal—its relations to Contrac- tility. Distinguish between vital and mere physical Contractility. 3d, Sensibility—define—depends on nervous system. Sympathy. (Vital Affinity and Vivification—Paine.) Pathological slates of the above properties. Irritation. Spasm— Paralysis. Hyperesthesia—Anaesthesia, &c. 6 SYNOPSIS OF LECTURES. ANIMAL PHYSIOLOGY. PRELIMINARY TOPICS. Classification of Animal Kingdom—General characters of each class—Place of Man in the Animal Scale—Did the whole race originate from the same parentage ? STRUCTURE OF ANIMALS. Solids and fluids—their ratio in the human body. Fluids dimin- ish as age increases. Fluids divided into two classes—Blood, including Chyle and Lymph, {incipient Blood) ; and the Se- cretions. Water constitutes the greatest portion of them all— forms about four-fifths of adult human body—Ilumoralism. The Solids are the aggregate of the Organs (define)—the Tissues, of the Proximate Elements—and these, of the simple Chemical Elements. A. Chemical (simple) Elements. But seventeen found in the whole Animal Series. But fifteen enter into the structure of the human body—Specify them. Some add Iodine, Bromine and Arsenick. The four most abundant, and found in most of the Organs. Whence are each of these fifteen elements derived ? (See Diges- tion.) Organs and Tissues in which these Elements are found in the hu- man body : 1. Sulphur—always with Albumen and Fibrine— also in hair and nails—as Sidphuric Acid with bases in urine, and Lime, in Chondrine. Pathological Relations. 2. Phos- phorus—in Albumen and Fibrine—forms one-thirtieth of solids in brain—as Phosphoric Acid with Lime in bones—Pathologi- cal Relations—Spontaneous Combustion, as explained by Tre- viranus. 3. Chlorine—in form of Hydrochloric Acid, in gastric fluid—Chloride of Sodium and Potassium in blood and bile— Chlorine compounds in milk, saliva, Synovial fluid, urine and cutaneous perspiration. 4. Sodium—always as Soda, (Carbon- ate, Phosphate, Sulphate, Hydrochlorate and Lactate,) in va- rious fluids, e. g. blood, mucus, saliva, bile, milk ; in muscle and bone. 5. Potassium—always as Potassa—very minute quan- tity—much more abundant in plants than animals—Hydrochlo- rate ia the blood, bile, sweat, milk, urine—The Phosphate, in the brain. 5. Calcium—always as Lime—Carbonate and Phos- phate, largely in the bones—sparingly in the muscles and brain. 7. Magnesium—always as Magnesia—the Phosphate in milk, blood, and the brain—and in bones. 8. Silicon—always as Sil- ica—very sparingly in hair—in urine—abounds in plants. 9. Iron—in blood of all red-blooded animals, and pigmentum ni- grum—traces of some of its salts in the gastric fluid (Kane)— SYNOPSIS OF LECTURES. 7 its relations to respiration ; Liebig's Theory (See Respiration.) 10. Manganese—a mere trace in hair. 11. Fluorine—Fluor- ide of Calcium in very small quantities in human bones, (Von Bibra.) By what Organs are these 15 elements respectively eliminated from the human body, in the metamorphosis of the tissues ? (See Secretion.) Tabular view of the tissues and organs in which each of the 15 elements are found in the human body, and the kind of force Avith which they are associated. B. Proximate (compound) Elements. 1. Proteine compounds (quar- ternary) Albumen, Caseine, and Fibrine—Hasmatosine and Globuline—2d, Gelatinous compounds—3d, Ternary com- pounds—Elaine, Stearine, and Margarine—4th, Secondary com- pounds. 1st. PROTEINE COMPOUNDS. Remarks on Proteine, the assumed compound radical of this class —its chemical composition—easy decomposition of all its com- pounds—why ? Its importance as the basis of all animal tissues —The Binoxide of Proteine—The Tritoxide—forms much of the "buffy coat" in Inflammations—Alkalies dissolve it—Pa- thological inference—Proteine always combined with Sulphur or Phosphorus or both, in the Proteine compounds—The latter found (except Caseine) in their simplest state in the blood. All the Proteine compounds derived originally from Vegetables, e. g. Vegetable Albumen, Caseine and Fibrine. A. Albumen—two varieties, Ovalbumen and Seralbumen—Their Formula; and combining numbers; showing their relation to Proteine—two forms of Albumen, soluble (fluid) and insoluble (solid). Chemical relations of Albumen to Mineral Acids, (except Phospho- ric)—to Vegetable Acids (except Tannic)—to Alkalies, (exists in blood serum as Albuminate of Soda)—to Metals—Bichloride of Mercury—The Albumen of one egg neutralizes 4 grains of it —to Alcohol—Effects seen in wet preparations of brain, &c.— to Creasote—Phosphate of Lime—Acetate of Lead—should not be applied to ulcerations of the Cornea. Other Phosphates and Sulphates found in Seralbumen—also Chlo- ride of Sodium. Physiological relations of Albumen—same to animals as that of starch to vegetables—the starting point of all animal tissues—is changed into fibrine before becoming organizable. Derived originally from the Vegetable kingdom—combined with starch and gluten usually in vegetables—in what part of them found? Why is cabbage a proper article of diet in Diabetes ? In what tissues and organs is solid Albumen found normally in the Human Body ? Associated with sensory Dynamic Force. s SYNOPSIS OF LECTUKES. Fluid Albumen normally found in the blood only (Lymph and Chyle) and serous secretions, and humors of the eye—In blood, acts endosmotically on all watery solutions in contact with the vessels. Pathological relations of Albumen—Solid Albumen forms some malignant growths—indications. Fluid Albumen in dejections in Asiatic Cholera; and those produced by Hydragogue Ca- thartics—in Pus—in morbid serous effusions—in Urine (Bright's disease, &c). Action of Mineral Acids in colliquative dis- charges. How detect the presence of fluid Albumen ; e. g., in Urine. Effects of certain classes of Remedies explained—The Albumen in the Blood is probably not acted upon by Chemical Agents, while the Blood is yet circulating. The action of Astringents— Styptics—Mineral tonics—Arsenic—Bichloride of Mercury— Alcohol—Creasote. B. Caseine—Found, in animals, in milk only—milk contains no Al- bumen—Chemical composition like that of Albumen except it contains no Phosphorus. Chemical relations of Caseine—identical with those of Albumen, except, 1st is not coagulated by Heat—2nd is coagulated by all acids and by Alcohol (Kane). Surpasses Albumen in rendering soluble the Phosphates of Lime and Magnesia. Caseine peculiar in coagulating from contact of certain membranes —Various explanations. Physiological relations—Caseine always converted into Albumen in the stomach of the young Mammal; then into Fibrine. C. Fibrine—the only organizable material from which all animal tis- sues are formed—Albumen and Caseine (both non-organizable) are converted into this before forming a part of the living body. Chemical composition—identical with Ovalbumen (Mulder)—dif- fers slightly from this (Dumas)—Combining number. Two forms, Fluid and Solid—Fluid exists only in living Blood (Lymph and Chyle) and exudations from it, e. g., in Inflamma- tion. Is solid in every other case, even in the blood after it is taken from the vessels. Exists most abundantly in muscle. Is associated with motor Dynamic force. Chemical relations very important—unlike Albumen is, then, co- agulated by mere rest—on this spontaneous action depends the coagulation of the blood—Fibrine kept fluid by Caustic Potash, Sulphate of Soda, Nitrate and Carbonate of Potassa, Chloride of Sodium, Phosphoric and Acetic Acids. Fibrine inferior to Albumen in uniting with Phosphates of Lime and Magnesia. Physiological relations of Fibrine—Difference between coagulum of Albumen and of Fibrine—best seen in " buffy coat" and in- flammatory exudations, why ? Describe the appearance of the fibrillation in these cases—Inflammation not essential to fibril- lation—Membrane lining egg-shell—chorion of human embrvo. " Coag'liable Lymph." is what? Synonymes. SYNOPSIS OF LECTURES. 9 Coagulation of Fibrine a vital act—Fibrillation the first step ; or- ganization succeeds—Fibrine is then Albumen vitalized. Fibrillation in a fibrinous exudation cannot go on to Organization, unless the exudation remains in contact with the living tissues. Circumstances in the living tissues favoring the process, and the subsequent Organization; 1st, thin layer of exudation; why? 2d, A plane surface—3d, Perfect rest of that surface. Table showing the relative chemical composition of muscular fibre, False membrane, and Mucus. Pathological relations of Fibrine—FluidfoxmdL in Inflammatory ex- udations ; and some dropsical effusions ; Solid, in heart and large vessels after death,and in false membranes—and in some tumors. Action of alkalies to prevent false membranes—of Calomel do. do. &c.—Why false membranes most common on serous surfa- ces ? Why sometimes on mucous surfaces ? Croup (pseudo- membranous Laryngitis). Three causes preventing coagulation of blood after death, 1st, Fer- ments, e. g., malignant Typhus, Glanders, &c, 2d, Retained ex- cretions, &c,—Scurvy and Purpura—Indications in these dis- eases—Asphyxia—Indications. 3d, Violent shocks, &c, e. g., Lightning—Blows on epigastrium, &c. Why does not coagulation ensue in these cases ? Singular cases of delayed coagulation, in disease. Tabular view of the tissues and organs in which Albumen and Fi- brine are found; both in the solid and the fluid state, and both in health and disease. Globuline and Hsematosine. (See Circulation.) 2nd. GELATINOUS CONSTITUENTS OF ANIMAL STRUCTURES. Probably derived from Proteine compounds—Found in animals alone—Are but two ; Gelatine and Chondrine. 1st. Gelatine—Its chemical composition, and combining number— Of less easy decomposition than Proteine compounds—two forms, solid and fluid—The fluid does not exist as such in the human body; is, like Proteine, obtained artificially,how? Does exist naturally in some fishes. Its two commercial forms. Chemical relations of Gelatine—to warm water—dilute acids, and alkalies—to Alcohol and Ether—to Tannic acid—Use in the arts —Test for the presence of Gelatine in solution—Gelatine is of neutral reaction—contains Phosphate of Lime, &c. Physiological relations of Gelatine—-Is abundant in the tissues of young animals—Is derived probably from Albumen—Herbivo- rous animals must derive it from vegetable Albumen, Caseine, &c—Its power of Gelatinizing—explain—Jellies are what ? In what tissues is Gelatine found in the hnman body ? Is generally associated with mare physical force, viz. Elasticity, &c. Action of Tannic acid as an Astringent. 10 SYNOPSIS Of LECTURES. 2d. Chondrine—In chemical composition approaches nearer the Pro- teine compounds than does Gelatine—Its formula and combining number—More easily decomposed than Gelatine. Seem3 to be an intermediate stage in the conversion of the Proteine com- pounds into Gelatine ; explain. Chemical relations of Chondrine—Similar, generally, to those of Gelatine; but, it is not precipitated by Tannic acid; and is pre- cipitated by Acetic acid, Alum, Acetate of Lead and Proto-Sul- phate of Iron. Physiological relations of Chondrine—Is found in all cellular car- tilages, and there alone, whether temporary or persistent—not found in fibro-cartilages—When temporary cartilages are con- verted into bone, their Chondrine is converted into Gelatine. Analogy of Chondrine in animals to Sclerogen in plants. Why is Chondrine replaced by Gelatine in the bones? 3d. TERNARY COMPOUNDS (FATTY CONSTITUENTS) OF ANIMAL P,< 1DIES. Are three ; Elaine, Stearine and Margarine—Elaine is fluid (above 65 deg.) and holds the others in solution—The three thus combined form most animal fats—Human fat contains no Stea- rine. Relation to these of the compound radical, Glycerine. The formation of soap. Formula of Margarine—is soluble in Alcohol and Ether—Do. of Elaine. Physiological relations of these compounds. An animal supplied with either of the three may produce the others. Three uses of the fat consumed in our food. 1st. As fuel for the re- spiratory process, (See Digestion.) 2d. Is deposited as adipose tis- sue. 3d. Enters into composition of certain organs. In the brain it constitutes about one-third of the whole solid matter ; but the fat of the brain is a nitrogenized compound, as the three compounds above, and adipose tissue, are not. Abundance of red fat (Cerebrol) in the vesicular matter of the brain. Emaciation produced by intense ac- tion of the brain ; or by deficient sleep. 4th. SECONDARY ORGANIC COMPOUNDS. Seven may be mentioned—Urea, Uric (formerly Lithic) acid, and Cholesterine (see Secretion), Ptyaline, Pepsine (see Digestion), Sugar of milk, Lactic acid (see Secretion). Tabular view of the preceding Elements of Animal Structures, associating each with the kind of force, whether vital or otherwise, of which it is the instrument. SYNOPSIS OF LECTURES. 11 THE TISSUES FORMING THE ORGANS OF ANIMAL BODIES. HISTOLOGY. Define—Classification of the tissues. A. Elementary Tissues—1. Simple membrane, and its modifications; Epithelium—Walls of Primordial cells, and those of pigment and fat-cells, &c. 2. White Fibrous tissue. 3. Yellow fibrous (Elas- tic) tissue. 4. Osseous tissue, and its modifications. Physical properties associated with each of these four tissues. B. Gompound Tissues. 1. Binary; Cartilage—Muscular fibre- Nerve tubes—Areolar tissue—Fibrous tissue (so called) e. g., fibrous membranes, &c. 2. Ternary; Mucous membrane—Serous and Synovial mem- branes—Skin—Fibro-Ciiitilage. ' Vascular tissue,' and ' Glandu- lar tissue,' are not distinctive phrases. When are tissues termed " Extra-vascular." The characteristics and peculiar functions, vital or otherwise, of each of the above tissues. HISTOGENY. Define—All the tissues (except simple membrane) formed origi- nally from Cells; hence, Cytogeny, or cell-development, is first to be considered. The discoveries of Schwann—modified by recent investigations. Two ways (or three) in which cells originate in animals—The Cy- toblast; Nucleus; Nucleolus; Cytoblastema or Blastema, &c. 2. How are these cells transformed to form the various tissues? Doubts as to the absoluteness of this law—The best authorities at the present time, respecting the formation of each of the com- pound tissues before mentioned, and in their order. THE ANIMAL ORGANS FORMED FROM THE PRECEDING TISSUES. Define the word ' Organ'—do. ' Apparatus'—do. ' Morphology'— Classify the organs in the human body. Development—define—The three layers of the Germinal mem- brane, Serous, Vascular, and Mucous—The organs developed in each—explain at length. Is the Nervous or the Vascular system first developed ? Trace the development of the different parts of the Nervous sys- tem. Do. do. do. Vascular system. Do. do. do. Alimentary, and Urino-genital Apparatus. FLUIDS IN ANIMAL BODIES. A. Blood, (See Circulation), Chyle and Lymph, (See Digestion and Absorption.) B. Other Fluids, (See Secretion)—Humoralism and Solidism. (p. 6.) CONCLUDING REMARKS. On Vitalism—The Chemical doctrines—The Chemico- Vital Theory. (Consult p. 4 and 5.) 2 12 SYNOPSIS OF LECTURES. PART II. SPECIAL (HUMAN) PHYSIOLOGY. PRELIMINARY TOPICS. The Functions—define the Phrase. What is a function ? Three great objects of the functions in man. Hence three divisions; Nutritive, Reproductive, and Functions of Relation, or Animal Functions. The Nutritive and Reproduc- tive constitute the Organic or Vegetative Functions. The table below indicates the classification, and the order of con- sidering the Functions, which will be adopted. The Organic functions are manifestations of the Organic force. (See p. 5.) But certain Dynamic actions are preliminary to each of them, to afford the necessary conditions for the action of the Organic force. The Animal Functions are manifestations of the Dynamic Force, (p. 5.) Still the Organic force is in- directly essential to these. Illustrate the mutual relation of the Organic and Dynamic functions, (p. 5.) Classification of the Func- tions of the Human Body. Organic Functions. Animal Functions. ' Functions f Digestion > a of Haema- < tosis. fe Absorption. Circulation. Respiration. Nutrition and ) Assimilation. ) Secretion. Reproduction. {Reflex. Instinctive. Voluntary. Sympathy of organs and parts. Sensation. {External. (Internal. SYNOPSIS OF LECTURES. 13 CLASS 1st. ORGANIC FUNCTIONS. A. NUTRITIVE FUNCTIONS. Are two subdivisions, Functions of Haematosis, (Sanguification); and of Nutrition proper, including also Secretion. The former subdivision includes what? (Table p. 12.) I. FUNCTION OF DIGESTION. Define the word—Digestion peculiar to Animals; Absorption be- ing the first Nutritive function in Vegetables. The organs indispensable to Digestion are a Stomach affording a Gastric fluid, and a Liver affording Bile. Relation of these two organs in the lowest animals. Morphology of the Digestive Apparatus in the whole Animal se- ries. Infer—is man naturally carnivorous, exclusively or in part; or a phytophagous animal ? Proper Digestive organs in man are the Stomach, Duodenum, and Liver. True function of the parts of the Digestive Apparatus above and below these. Peculiar structure of the Stomach and small Intestine. A. Dynamic actions preliminary to Digestion. 1st, Mastication, se- curingalso Insalivation—2d, Deglutition—3d, Dynamic motions of Stomach itself and Duodenum. Explain the importance of each. Physiological inferences. The facts observed by Dr. Beaumont respecting the formation of Chyme in the Stomach. Infer—eat slowly—let the food be of proper temperature. B. Secretions essential to Digestion. Saliva; Gastric Fluid; Bile; Pancreatic Fluid; Mucus. 1st, Saliva—Quantity in 24 hours. Has alkaline reaction ; (buccal Mucus is acid). Its chemical composition (Dr. Wright). The salts contained in it. Ptyaline—its properties. Microscopical appearance of Saliva. Donne's experiments. Physiological relations of Saliva. 1. Dissolves Proteine compounds, and Mucus (Enderlin)—Converts Starch into Sugar—how? Absorbs Oxygen in abundance—Other effects (Dr. Wright). Pathological relations of Saliva. Is acid in acute Rheumatism, Irritation and Inflammation of the Stomach, Mercurial Saliva- tion, Aphthae, Pleuritis, Encephalitis, Intermittent Fever, Amen- orrhoea and other uterine affections (Donne). Contains less water than usual in Inflammations. Tartar on the Teeth formed from its Phosphate of Lime and Magnesia. It may also become bilious, fatty, or sweet. 14 SYNOPSIS OF LECTURES. Effects of habitually ejecting the Saliva. Its importance in acid states of the Stomach. Are sedentary men more liable to Dys- pepsia than females equally sedentary ? 2d, The Gastric Fluid—Its physical properties—Chemical compo- sition—Contains a trace of Iron (Simon)—Has an acid reaction, from the presence of Hydrochloric acid (Dunglinson) and Lac- tic acid (Dr. R. D. Thomson). The former acid is derived from common salt (B.tJones). Some assert a Chloride, and not Hydrochloric acid, exists in Gastric fluid. Does acetic acid also exist in Gastric fluid ? MM. Bernard and Barreswil deny the existence of the bi-phosphate of Lime, &c.; but they experi- mented on dogs. The Gastric Fluid contains an organic compound called Pepsine. (p. 10.) This is, like Ptyaline, analogous to Albumen. Both a Hydrochlorate and an Acetate of Pepsine exist in Gastric Fluid. Remarkable solvent effects of these two salts on the Proteine compounds; how explained ? Physiological relations of the Gastric Fluid. Its precise effects, in forming Chyme, upon 1st, the Proteine compounds in our food; 2d, on Gelatine ; 3d, on Gum and Sugar; 4th, Fatty matters; and lastly, resins, woody fibre, elastic tissue, &c, &c. The pre- cise portion of the effects just alluded to, produced by the acids in the G. Fluid—do. do. do. by the Pepsine. Effects of render- ing this fluid alkaline (Barreswil). The acids dissolve the food; how does the Pepsine produce its effects ? (Wagner, &c.) The Gastric Fluid is not secreted while the stomach is empty. Its quantity proportional to the wants of the body ; not to the amount of food taken. Inference. Effects of stimulating condiments. Effects of over-eating not at once developed. Temperature of stomach must be 100° that Digestion may occur. Effects of iced articles of diet, &c. The Gastric fluid possesses antiseptic properties. It is produced by the vital force—itself mainly producing, apparently, chemical effects. Artificial digestion with natural Gastric Fluid succeeds; not so, with artificial Gastric fluid. Experiments of Wassmann, Wagner, &c. Relations of Saliva, Gastric fluid, and Pancreatic fluid, (Barreswil). Chyme—its properties, physical, and chemical. Action of the Py- lorus. How long does the food remain in the Stomach before being converted into Chyme ? Table showing the difference in digestibility of different articles of diet, (Beaumont). Pathological relations of the Gastric fluid. Effects of an excessive- ly acid state of it. What acids most frequently generated in dis- ease ; and the cause of each. Indications. Causes of an alka- line state of the Gastric Fluid. Indications. Effects of an ha- bitual use of Alkalies in excess. Bile mixed with the Gastric Fluid, in the stomach, impairs its digestive powers,(Pappen- heim)—should act after the Gastric fluid. SYNOPSIS OF LECTURES. 15 Dyspepsia; Apepsia or Indigestion—owing to a multiplicity of causes. The true cause is to be ascertained in each case. Food itself produces irritation of stomach, &c, if Gastric fluid is not secreted, e. g. in fevers, &c. Gas sometimes secreted in great quantities in stomachic disease; its composition, (Simon). Action of Hydrochlorate of Iron, in atonic states of the 'stomach— of other tonics, &c, &c. 3d, The Bile—Its physical properties—Chemical composition is very complex. (See Secretion.) Has an alkaline reaction, from the Soda it contains. Hence Chyle is alkaline, while Chyme is acid. Sources of the Bile—Quantity during 24 hours. Are three essential components of the Bile, 1st, alkaline elements —2d, the resinous—3d, the Calorific. Explain. Physiological relations of Bile. 1st, The Alkaline portion renders soluble the fat in the Chyme, and converts the latter into Chyle. 2d, The Resinous, excites the Dynamic (peristaltic) actions of the Intestines; and is discharged in the faeces—(the other two ele- ments are reabsorbed)—3d, The Calorific elements (fat, sugar, «fec.) conduce to maintain the animal heat; how? (p. 16.) Bile is indispensable to Chylification, as shown by Schwann—hence found in all animals. Unlike the Gastric fluid, Bile is constant- ly secreted. Does not enter Duodenum while empty. Use of the Gall Bladder. Why not found in many of the Herbivora ? Chyle—its properties—has never been chemically analyzed. Com- parative analysis of Lymph and Chyle in lower animals (Dr. G. O. Rees). Do. do. of Chyme and Chyle of the horse (Tiede- mann and Gmelin). Three kinds of contents of the Duodenum ; the residual matter in the centre of the canal. Pathological relations of the Bile. In Cholera it contains an ex- cess of Resin, (Hermann)—Remarkable diminution of this el- ement in fatty degeneration of the Liver, (Thenard). In Phthisis it contains very little fat, (Chevreul). In icterus the Biliverdin (coloring matter) is enormously increased, (Scherer). Cholo- lithi are composed principally of Cholesterine. Effects of non-secretion of Bile on Digestion ; on alimentary canal. Other effects (see Secretion). Substitution of ox-gall in some cases. What are Cholagogues ? Action of Alkalies in Icterus, Duodenitis, &c. Pathological relations of Liver and Stomach; to be remembered in cases of disordered digestion. 4th, Pancreatic fluid—Similar to Saliva in physical and chemical properties; and in being most abundant in the Herbivora. En- ters the Duodenum with the Bile. Is it more than an accessary Salivary secretion? 5th, Intestinal Mucus—by what secreted ? Physical properties— Chemical do.—TTas an acid reaction—Microscopic appearance —Chemical analysis of (pulmonary) mucus, (Nasse). 16 SYNOPSIS OF LECTURES. Physiological relations. Mucus is secreted on whole alimentary canal; hence mixed with food, chyme, chyle, and residual mat- ters. Probably aids the Gastric fluid in some degree. Is not the latter a more highly elaborated mucus, from the peculiar Gastric follicles ? The mucus also shields the membrane. Is mostly if not wholly ejected with the faeces. Functions of the infra-duodenal portions of the alimentary canal in relation to Digestion ; and to Defecation. How long is the residual part of the food in passing the whole length of the ca- nal? Defecation a dynamic function (see Reflex motion). Pathological relations of Mucus—Not always distinguishable from Pus—Both sink in water when pure; intestinal Mucus always does. The Microscope will not distinguish them, unless the Mu- cus be perfectly health}'. But Pus contains Albumen ; healthy Mucus does not. In Dysentery, intestinal Mucus becomes red (Simon). Is increased in irritation of alimentary canal—Indi- cations. Hydragogues are what—do not merely increase Mu- cous secretion ; what other effects ? Opiates diminish it—Ef- fects of this diminution on Digestion, Defecation, &c. The course of the Chyle from the Duodenum, &c, into the Circu- lation. (See Absorption.) REMARKS ON ALIMENT--HUNGER--THIRST. Our food contains, A. Nutritive (Azotized) Elements ; Proteine and Gelatinous compounds, (p. 7, 9.) B. Non-nutritive (non-azotized) Elements; includ- ing (I.) Residual (indigestible) matters; woody fibre, resins, &c.; (II.) fat, sugar, &c. (Calorific Elements.) A. The Nutritive Elements afford materials for (1st) the original structure of the organism, and its future growth; (2d) for re- pairing the loss constantly occasioned by the exertion of the Or- ganic force; and the more rapid waste produced by the Dynam- ic force (in the Nervous and Muscular Systems). Proofs of these two propositions. The quantity needed must be propor- tionate t'o the activity of all the functions. B. (I.) The Residual matter, 1st, distends the stomach and aliment- ary canal—2d, excites their Dynamic actions; then leaves the body, as the faeces. Importance of both these effects. Inference in respect to purely nutritious food. (II.) The Calorific Ele- ments (non-nitrogenized) aid in maintaining the animal heat; hence the term. (See also Bile, p. 15.) They do not repair waste; hence will not sustain life, unless the Nutritive Elements be added. Proofs of the preceding assertions. Pure starch, gum, sugar, oil, fat, &c, are merely Calorific. (F?.t is in a slight degree nutritive, p. 10.) The Proteine compounds, whether of vegetable or animal origin, are purely nutritive, and indirectly Calorific. In Carnivorous animals their own tissues finally be- SYNOPSIS OK LECTURES. 17 come Calorific elements—explain. Their natural activity se- cures the necessary Metamorphosis. In what proportion should the Nutritive and Calorific Elements be combined in the food of adults ? (R. D. Thomson.) In food of infants ? e. g. milk. Why do children need proportionally more of the nutritive elements; sedentary adults, less ? Arrow-root, &c, as an exclusive article of diet for infants. Alcohol, Ether, and Essential oils (diffusible stimulants) are mere- ly Calorific. Inferences. The Calorific Elements should have a direct ratio to the amount of oxygen consumed in Respiration; the Nutritive, to the amount of exercise (Dynamic waste). Dietetic Habits of Es- quimaux. Alcohol not used in so great excess in tropical cli- mates. Inactivity of natives of ditto, and the corresponding pe- culiarities of diet; contrasted with those of Arctic regions. We must change our diet, if we change climate—how ? Table showing the proportions of the Nutritive and Calorific ele- ments in some of the most common articles of diet. (R. D. Thompson.) A given quantity of a mixed diet equal to about five times as much purely animal food. Why ? Effects of a deficiency of Calorific elements in our food. Proxi- mate cause of death in starvation (Chossat). In great emacia- tion, they must be taken if there is no appetite even; why ? Must be perfect repose in such cases. Effects of an excess of these elements. Effects of a deficiency of the Nutritive elements—Do. of an excess of do. No absolute rules as to amount of food required per diem, can be given, why ? Estimated daily average of solid and liquid aliment. Cornaro's daily allowance for 58 years. Remarkable cases of gluttony. * Our food must contain inorganic substances also. Refer to the 15 chemical elements in the human body, (page 10, A.) Specify the kinds of food, and the other sources, whence each element is derived. Neither of these unimportant because existing in small quantity. Analogies in support of this proposition. The neces- sity of variety in our aliment. No single article, except, per- haps, eggs, and milk, can long sustain life ; nor these, in adults. Water also as indispensable as food, 1st, as a vital stimulus, (p. 4,) 2d, to dissolve gum, sugar, and other soluble substances entering the stomach in our food. Hunger—the sensation prompting us to take food into the stomach. Its seat—and precise medium. Why located in the stomach ? Why so immediately appeased on taking food ? Distinguish be- tween Hunger, Artificial appetite, and Morbid Do. Thirst—the sensation prompting us to drink (water). Where lo- cated, and why ? Proximate cause of natural thirst (explain)— hence best satisfied by water; and invariably thus satisfied by Ls SYNOPSIS OF LECTURES. the lower animals. Artificial thirst—Morbid thirst. Thirst a more imperative sensation than hunger. Inference. How long can life be sustained without taking water into the stom- ach? How long without food of any kind? Children perish sooner thus, than adults—the emaciated sooner than the corpu- lent—why? Remarkable cases of abstinence from food and drink. Reptiles, &c, naturally take food but seldom, e. g. Boa constrictor. Pathological states of above sensations. Demand for food increas- ed by any drain on the economy, e. g. suppuration, lactation, Diabetes, &c. Bulimia—Depraved Appetite—Anorexia. Cau- ses of each—The last produced by mental emotions; by pro- tracted Inanition—Indications. Excessive thirst in febrile diseases, &c.—various causes—Indications. Do. Do. in Chole- ra—do. after taking salt food, how explained? After taking spiced condiments, &c. II. FUNCTION OF ABSORPTION. Structure of the Lymphatic or Absorbent System. Found only in the Vertebrata. A. Absorption of the Chyle from the Alimentary Canal, by its Lym- phatics, called Lacteals. Lymphatics never commence with open extremities—how commence the Lacteals ? Where com- mence, the Stomach having none. How does the Chyle enter the Lacteals? (Goodsir.) Trace it thence till it becomes mixed with the Blood. Changes it under- goes in its passage. Subsequent changes. How the white cor- puscles of Chyle to be accounted for ? How the red, in the Tho- racic duct ? Chyle (and Lymph) is incipient blood; analogous to the true blood of the white-blooded animals. Absorption is a vital action; Endosmosis not so. (p. 4, A.) The Lacteals absorb alimentary materials only; others may enter them by Endosmosis, e. g. medicinal substances. But latter principally enter the veins of stomach and Alimentary canal. Is this a true absorption ? But even the Lacteals do not absorb all the alimentary materials which enter the circulation. Water, saccharine solutions, &c, pure albumen and fibrine, may at once enter the veins of the stomach (Bouchardat & Sandras). The fat, and the Proteine compounds not thus disposed of, are absorbed by the Lacteals. Is the above action of the stomachic veins a true absorption, or mere Endosmosis ? The analogous vessels alone absorb, in the Invertebrata. B. Absorption from all other free surfaces, by their own Lymphatics. All these Lymphatic vessels contain Lymph—Its properties (p. 15, 3d). Whence its white corpuscles? Proportion of fibrine in Lymph and Chyle. Do. of Albumen and water in do.— Two sources of Lymph. Causes of circulation of Lymph and Chyle. SYNOPSIS OF LECTURES. 19 The Lymphatic an appendage to the Venous system. Why then so completely isolated from the latter, except at the two terminal points of the Lymphatic system ? Why no need of the Lymphat- ic system in the Invertebrata ? Lymphatics of these surfaces, like the Lacteals, absorb alimentary materials—1st, Lymph, and 2d, any such material upon those surfaces. Life may be sustained by nutritive baths. These vessels also admit water and foreign matters, like the lacteals. Those of skin more superficial than the veins; the reverse true of the lungs and alimentary canal. Inference. Endermic med- ication. Probably no medicinal substance deficient in all the 15 elements (p. 17) enters the circulation through the Lacteals; nor through the other Lymphatics unless in exceptional cases; the veins receiving such materials. How explain the appearance of pus in the Lymphatics ? C. Appendages to the Absorbent system. 1st, The spleen—found only in the Vertebrate animals also. Its supposed function in aid of Haematosis (Carpenter). Its office as a " Diverticulum " to the Liver. 2d, The Supra-renal Capsules—probably appendages to the Ab- sorbent system during fcetal Life (See Secretion). Probable function of the Thyroid body. The Thymus—(See Respira- tion.) Recapitulation of the principles established in respect to the two preceding functions—and practical applications. The Chyle and Lymph are converted into Blood on arriving in the capillaries of the lungs. Hematology the next topic. THE VITAL FLUID (BLOOD). Called aap in vegetables, blood in animals. The distinction of white-blooded and red-blooded animals. Cold-blooded and warm-blooded do. Average quantity of blood in a healthy adult male—do. do. in a female—ratio of its weight to that of the body—What propor- tion of the whole amount of blood can be lost at once without fa- tal results ? At what ages is blood most abundant in both sex- es? (Lecanu.) Physical properties of human blood—Its specific gravity; less in the female. Microscopical appearance of blood while circulat- ing. What is the liquor Sanguinis ? The two kinds of corpus- cles seen floating in it. 3 20 SYNOPSIS OF LECTURES. Chemical relations of blood—Has an alkaline reaction—The fol- lowing table shows its complex chemical composition in the two sexes. (Becquerel and Rodier.) A. Blood of the Male. B. Blood of the Female. Water, - - (average) 779.0 - (average) 791.1 Blood corpuscles, (red) - 141.1 - 127.2 Albumen, - - - 69.4 - " 70.5 Fibrine, (and White corpuscles) 2.2 - (some say 2) 2.2 Free salts and extractive matters, 6.8 ... 7.4 fSeroline, 0.02 } - 0.02 Fatty J Cholesterine, 0.088 1 , fi - 0.09 . x g2 matters, 1 Phosphorized fat,0.488 f - 0.464 ' Saponified fat, 1.004 J ---- - 1.046 ---- 1000.1 1000.02 Remarks on above table—Varieties in the above proportions con- sistent with health. The following is the amount of mineral and saline matters in 1000 parts of the blood of both sexes. A. In Man. (6.499) B. In the Female. (7.695) Chloride of Sodium, (average) 3.1 - (average) 3.9 Other soluble salts, - - 2.5 ... 2.9 Phosphates, - - 0.334 - - - 0.354 Iron, ... - 0.565 - - - 0.541 Difference in composition of Venous and Arterial Blood. (Mag- nus, Simon, <&c.) Physiological relations of the blood. Is the source of all the solids, and the fluids (except Chyle). The precise uses and functions of each of the preceding constituents. 1st, The water in the blood—forms a large part of all the secre- tions. Is also the vehicle for carrying all the other constituents to the capillaries. (See also p. 4 and 17.) 2d, The Red (yellow) corpuscles. Their form, and average size. Are mere cells; the cell-wall and the nucleus are composed of Globuline, which differs not much from Proteine compounds. The fluid contents are composed of Haematine (formerly Hsema- tosine), containing the coloring matter of the blood. Differs from Proteine compounds in excess of Carbon, and has iron combined with it. Its formula. How much iron in the blood of an adult male ? Table showing the forms and sizes of the red corpuscles in the dif- ferent classes of animals. The red corpuscles have no apparent relation to the function of nutrition. Facts in support of this assumption. They have a direct relation to the respiratory process. Proofs. Are of course not found in white-blooded animals. For their relations to the process of respiration see the latter (p. 27). Are instru- synopsis of|lectures. 21 mental in sustaining the animal heat, by producing the metamor- phosis of the tissues; how ? (See Respiration.) Simon's views of the functions of red corpuscles not defensible, 3d, The Albumen—Its properties, &c. (see p. 7, A.) Is the pro- bable source of the Fibrine. 4th, The Fibrine—Its properties, &c. (see p. 8, C.) The only plastic element in the blood; the solids being formed directly from it. Is increased during last months of pregnancy, why ? 5th, The white (Lymph) corpuscles are directly associated with the fibrine. Some suppose they elaborate it from the albumen. Most abundant in blood of young animals. Exist in blood of all animals ; the red corpuscles do not. Inference. Their form, and size—latter varies little in the animal series. Their func- tion and that of the red corpuscles inferred from their different positions and movements in the vessels as seen under the micros- cope.^ Singular change in these positions, &c, in the capillaries of the lungs. (Wagner.) 6th, The salts. Their two-fold uses. Of the uses of the extrac- tive matters, nothing is positively known. 7th, The Fatty matters—enter into the composition of the brain, and of the Bile, &c. (p. 10.) How is the iron combined in the Haematine ? Liebig's views—Mulder's. The Coagulation of the blood—Is a vital act—Its cause (p. 9). What elements constitute the serum ? do. Crassamentum ? Time necessary for coagulation in health ? In what class of diseases does coagulation occur more rapidly ? Is least rapid in Inflam- mations, why ? What effects as to the color of the clot ? How explained ? The " buffy coat" is not distinctive of Inflammation. Contains white corpuscles in abundance; and tritoxide of Pro- teine (Mulder). Its proximate cause. May appear in Chloro- sis, Pregnancy, after hemorrhages, &c, why ? The " cupped " appearance; explain. Diagrams illustrating the form of the clot in health, in Inflammations, and in Chlorosis. (Dr. Williams.) PATHOLOGICAL CHANGES IN THE COMPOSITION OF THE BLOOD. These affect principally the Fibrine and the red (and white) Cor- puscles. The Albumen is diminished in Albuminaria (Bright's disease). The salts never vary much from 7 parts in 1000. 1st, A. Is excess of fibrine (Hyperinosis) and white corpuscles in all acute Inflammations. Most increased in Pneumonia (and acute Rheumatism). Variation in its amount in different de- grees of inflammation. White corpuscles form much of the buf- fy coat. B. Is a diminution of fibrine (Hypinosis) and white corpuscles in idiopathic fevers; in tvphoid, is sometimes only 0.9 in 1000 parts. 22 SYNOPSIS OF LECTURES. 2d, Is an excess of red Corpuscles in Plethora—a diminution in Chlorosis (and other Anaemic states) after Hemorrhages, &c. Action of Iron in such diseases. 3d, The solids generally of the blood are diminished (Spanaemia) in the Cyanoses, (Anaemia, Hydraemia, Schrophulosis, Chloro- sis, Scorbutus) and in purpura hemorrhagica, malignant typhus, plague, &c, &c. The specific gravity is often very low in preg- nancy ; why ? Indications. 4th, Foreign substances found in the blood in disease. E. g. Urae- mia—Melitaemia—Cholaemia—Piarhaemia— Pyohaemia — Ani- malculae sometimes found in diseased blood. (Simon.) III. FUNCTION OF SANGUIMOTION (CIRCULATION). A motion of the vital fluid is found in all plants and animals ; A true circulation (explain), only in animals possessing a heart and distinct aerating organs, (p. 25.) Theories held previous to the discovery of the circulation by Harvey; Sanguimotion having been already admitted. Trace the Circulation from the point to which the Chyle and Lymph have been followed, (p. 16.) Objects of Sanguimotion are two fold: 1st, To secure the passage of the blood through the capillaries of the respiratory organs (Aeration). 2d, To carry it thence into the general capillaries (Nutrition and Secretion) and back. Morphology of the Sanguimotory Apparatus in the Animal series. The Sanguimotory Apparatus of man. 1st, The Heart—its structure—its development (p. 11)—Capacity of its cavities—its motions—do not depend on nervous system; proofs—but are modified by it. Is its Diastole an active move- ment ? The sounds of the heart; to be studied distinctly from its motions. The cause of each. (Cruveilhier, &c.) Neither the auriculo-ventricular valves nor the pericardium elicit any sound in health. Pathological modifications of the natural sounds—other abnormal sounds. The diseases indicated by the latter; Endocarditis— Carditis—Pericarditis—Valvular disease—Anaemia—Mere Pal- pitation—Hypertrophy—Atrophy—Dilatation—Softening, &c, &c. 2d, The Arteries—their structure—how modified in the smaller and terminal (explain) arteries ? Their contractions and dilata- tions are affected, but not produced, by the nervous system. Proofs. SYNOPSIS OF LECTURES. 2:1 3d, 7he Capillaries—their structure—walls contain non-striated muscular fibre. Their size varies in different parts. Table showing their average size in different organs (Muller). The same capillary varies in different circumstances—specify them. Are differently distributed in different organs—illustrate this by diagrams, (Todd & Bowman, &c.) No reason nor necessity for admitting the existence of " vasa serosa." 4th, The Veins—their structure—contain some muscular fibres— their aggregate capacity compared with that of the arteries— how explained. In how long a time may all the blood possibly pass through the heart ? Why so rapid a motion of the blood ? Hering's ex- periments. Does not the blood move more rapidly than the mo- tions and capacity of the cavities of the heart can account for ? The Pulse—its cause—its velocity, (Dr. Young)—distinguished from its frequency. Table showing the normal frequency of the pulse at different epochs of life. Is more rapid than in Hip- pocrates' time. Table showing rapidity of pulse in different ani- mals. The frequency of the pulse affected in health by age, sex, [temperament,] mental state, time of day, and state of digestive system, muscular exertion, (position, &c.) (Dr. Guy). Explain at length. Individual peculiarities in respect to character of the pulse. Inferences, physiological and pathological. Varieties of pulse in disease—1st, Simple varieties—Frequent; quick; slow—Regular; irregular; intermittent—Hard ; soft— Large (full); small, &c. 2d, Compound varieties; Jerking; bounding; vibratory; thrilling; wiry, &c. Some of the above depend on the state of the heart, some on arteries; others on both. Refer each to its cause. In what diseases is the pulse diminished in frequency ? Pathological inferences. Indications. Physiological relations of the Sanguimotory apparatus. Each part produces its own sanguimotory effects; these four links consti- tuting the whole chain of the Circulation. Each part moreover controls the motion of its own contained blood, provided the part a tergo does the same; explain. 1st, The Heart—does not (normally) alone propel the blood through the Capillaries into the veins. Explain. Proofs. Its actual muscular force (Carpenter). Precise sanguimotory effects of the Heart. Is merely the fly-ivheel of Sanguimotion in the animal series; explain. Proofs. 2d, The arteries—the sanguimotory powers of the larger class de- pend more on their physical than their vital properties ; explain. Not so with the smaller and terminal arteries; they differing in structure and function. These latter supplied with nerves, like the heart, and larger arteries; hence their tonicity affected by 24 SYNOPSIS OF LECTURES. even mental emotions. But this tonicity exists independently and may be excited independently of the nervous system. What then the precise sanguimotory powers of the arterial system. Proofs of the views suggested. Effects of increased tonicity of arteries—diminished do. 3d, The Capillaries—Their vast physiological and pathological im- portance—(See objects of sanguimotion, p. 22.) They alone nor- mally control the motion of their own contained blood. Proofs from comparative Physiology, &c. This a vital force. The physical theory of capillary circulation (capillary attraction), and the chemical, (Prof. Draper) not tenable. Why do not capilla- ries and larger vessels alone carry on Sanguimotion in the high- est as well as in the lower animals ? The Pulmonary veins, left heart (explain), and arterial system, merely form a canal for carrying the blood from the pulmonary to the general capillaries; the Venous system, right heart, and pulmonary arteries, another to return it to the pulmonary capil- laries again. For effects produced on the Blood in the pulmonary capillaries, see Respiration; do. do. in general capillaries, see Nutrition, and Secretion. Local determination of blood produced by capillaries alone (and terminal arteries)—Heart can possess no distributive power; ex- plain. How reconcile effects of mental emotions on the capilla- ry circulation (e. g. blushing, the draught, &c.) with the idea that they are not supplied with nerves of any kind ? Positive facts confirming this idea. Pathological states of the capillary circulation—Congestion; define —Inflammation: how distinguished from Congestion? How the latter from Local determination, (Vascular turgescence.) For other elements of Inflammation, see Nutrition. Effusion ; Ex- udation ; Extravasation ; define and distinguish. For effects of morbid states of the capillaries and their contents, see Nutrition, Secretion, and Respiration. 4th, The Veins—not merely passive conductors of their contents —contractile power proved by their structure and by direct ob- servation of the larger trunks. Other forces aiding their feeble sanguimotory powers. The respiratory pulse. The veins liable to congestion, why ? Which parts of body most liable, and why ? Hence veins liable to enlargement, called Varix; arteries, from different causes, to Aneurism. Peculiarities of circulation in different parts and organs. That of the brain not entirely different from that of other organs. (Todd & Bowman.) Recapitulation ; and practical applications. Distinguish the Dy- namic Sanguimotory forces from the organic do. resident in the capillaries. SYNOPSIS OF LECTURES, IV. FUNCTION OF AERATION (RESPIRATION). Aeration indispensable to life in all plants and animals. Respira- tion not so. The former alone is an organic function ; the lat- ter an ammal (dynamic) function, affording the conditions for the former in the higher animals. Explain at length. The objects of Aeration are 1st, The decarbonization of the Blood. 2d, The oxygenation of the Blood. The aerating structure is essentially the same in all living organ- isms. Explain. Morphology of the Aerating Apparatus in the animal series—a Respiratory apparatus existing only in breathing animals. The Respiratory apparatus in man; including the aerating do. (pulmonary air cells.) The Larynx—Trachea — Bronchi; Structure of each, &c. A. RESPIRATION. The objects of respiration are 1st, (Inspiration), to carry pure at- mospheric air to the aerating structure. 2d, (Expiration), to return the air vitiated by its contact with the air cells, to the atmosphere. Both these (Respiratory) movements subservient to Aeration, 1st, Inspiration. The muscles concerned in this movement. How many inspirations per minute (average) in health. Ratio be- tween respiratory movements and the pulse. Modified in dis- ease—Pneumonia—Hysteria—Typhoid fever, &c. 2d, Expiration—follows inspiration. Is a passive movement, in- spiration is active; explain. Ratio of duration of the two res- piratory movements. How modified by disease ? Forced expi- ration—muscles concerned in it. Modifications of the respiratory movements in diseases. Increas- ed—diminished—null, &c. Diseases in which these modifica- tions occur. Inspection of the thorax, &c. The sounds developed by the respiratory movements. Ausculta- tion—define. 1st, Healthy respiratory sounds—describe. They vary in different parts of thorax, why ? Where is natural Bron- chial respiration heard, &c, &c. 2d, Morbid sounds. A. Modifications of natural sounds—specify them. B. Unnatural sounds, (rales, ronchi)—specify them. States of the respiratory apparatus indicated by these sounds. (For modifications of vo- cal sounds in diseases of respiratory organs, (see Voice, &c.) Per- cussion—define. Physiological relations of the Respiratory movements. Depend directly on the nervous system. (See reflex motion.) Hence increased by stimulants; diminished by Sedatives. Their pre- 26 SYNOPSIS OF LECTURES. cise object as subservient to Aeration. The winds take the place of these movements in plants. The air is drawn into the lungs, how? in reptiles it is forced in—explain. The inspired air passes less and less rapidly as it approaches the air-cells; more and more rapidly as it returns. The air inspired is not expelled by the next expiration. Explain. A quantity always remains in the air cells. How much air inspired (average) at a time? The terminal bronchial tubes (explain) control the pas- sage of the air through them into the air-cells, as the terminal arteries do that of the blood into the capillaries. Analogies in structure as well as function. The Spirometer. What is cough ? its final cause in health. The respiratory movements also indicate our mental emotions; and our corporeal states—Laughing—Sighing—Weeping— Yawning—Sneezing, &c. Pathological relations of respiratory motions. Some have been at- luded to above. Will be too frequent in sthenic diseases; too slow in asthenic. Specify their modifications in diseases of the chest—e. g. Pneumonia, Pleuritis, Bronchitis, Hydrothorax, &c. May be excessive: or diminished tonicity of terminal bronchi; the former relieved by narcotic inhalations, the latter by stimu- lants. Dyspnoea—Emphysema—Asthma—two kinds. Cough, as a pathological sign. B. AERATION. Is performed by the air cells. Their structure—how clustered round the terminal bronchi ? How communicate with each oth- er? Their average size. Size compared with the capillaries distributed upon them. How the latter distributed to secure aeration of blood in them from both sides ? Computed number or air cells in both lungs. (Rochoux.) Aggregate surface pre- sented by them to their contained air, compared with external surface of body. Distance of air in them from blood in the ca- pillaries. Peculiar position of red corpuscles in pulmonary ca- pillaries. (Wagner.) Objects of Aeration both indispensable to vital action, (p. 25.) 1st, Removal from the blood of carbonic acid, (Decarbonization), formed: A. from molecular decomposition (organic waste) and the still more abundant dynamic waste, (in Muscular and Nervous systems). See p. 16, A. B. from combustion of Calorific elements of our food ; and of the portion of the Bile formed from them. (p. 15,3d.) Proofs of the elimination of carbonic acid thus assumed. Different composition of venous and arterial blood in this respect. Com- position of inspired atmospheric air; do. of the expired air. Proofs of the derivation of this carbonic acid from the sources above mentioned. SYNOPSIS OF LECTURES. 27 The quantity of carbonic acid eliminated in any given time varies with the following circumstances; 1st, The temperature of the air—greater in a cold atmosphere. 2d, Muscular action—increased during exercise—least of all during sleep. 3d, State of Digestive function—greater after a full meal. 4th, Size of the body—males eliminate much more than fe- males. But children more proportionally than adults, why ? Illustrate the preceding propositions ; specify the reasons. Table showing the amount of Carbon (contained in the Carbonic acid) excreted from the lungs of males and females of different weights and ages, in 24 hours. (S.charling.) Remarks. The average in active adult males not less than 9 oz. (Troy) of Car- bon per diem ; corresponding to 32-J-oz. of Carbonic acid, which contains 23^,- oz. of Oxygen. The expired air also contains the Halitus from the Lungs—its source—its composition—often impregnated with odorou3 sub- stances, medicinal, or otherwise—illustrate. Causes of a fetid breath. The 2d Object of Aeration is Oxygenation; i. e. combination of Oxygen with the Blood. Proofs of this combination from ana- lysis of expired air, &c, &c. Amount of Oxygen consumed in 24 hours, varies with the circumstances above-mentioned in res- pect to the carbonic acid—repeat them. Give the reasons. Why the Oxygen consumed and Carbonic acid excreted always directly proportional ? But Oxygenation and Decarbonization are not necessarily and im- mediately associated as cause and effect; latter may continue for a time if another gas than Oxygen be inspired. Infer; carbon- ic acid exists as such in venous blood, and is not formed in the pulmonary capillaries by the direct union of the inspired oxygen with carbon. Still the expired carbonic acid must have been formed from carbon in the blood combined with Oxygen previously inspired. The oxygen appears to be directly united with the blood as follows: 1st, With the red corpuscles. Unites with their iron, how (Lie- big)—with their other constituents (Mulder). Consequent change in their color and form, variously accounted for. (Dr. Rees, &c.) Are thus "carriers of oxygen" (explain), which they give up in the general capillaries to produce the " meta- morphosis (decomposition) of the tissues," (molecular and dy- namic waste.) Why are they not needed in the white-blood- ed animals ? 2d, With the various elements constituting the liquor sanguinis, probably; to elaborate them more highly. Little known on this subject. Oxygen certainly combines with the white blood of the animals just alluded to. It forms tritoxide of Proteine, &c. (Mulder.) With the Hydrogen of the decomposed tis- 4 SYNOI'MS OF LECTURES. sues, it forms water; e. g. in halitus of lungs, &c, &c. But especially it unites with the carbon in the blood, from whatev- er source derived (p. 26, A, B.) and forms carbonic acid, to be excreted in the expired air (Decarbonization). Experiments with other gases than oxygen indicate that the simul- taneous consumption of oxygen and elimination of carbonic acid gas are owing to Endosmosis merely. Specify the experiments alluded to. Law of the mutual diffusion of gases by Endosmo- sis. Confirmed in the process of Aeration; 1174 parts of Oxy- gen being replaced by 1000 parts of Carbonic acid gas in the expired air. Other gases than Oxygen cause the Exosmosis of Carbonic acid for a time ; why not permanently ? Carbonic ac- id gas itself if inspired, will not admit of this Exosmosis at all, why? Since but 1000 parts of the 1174 of Oxygen, reappear in the ex- pired 1000 parts of carbonic acid, 174 parts (or 15 per cent.) are consumed in the formation of water, &c, as above, and in vi- tal combination with the organic constituents of the blood. The formation of water and of carbonic acid appears to be a mere chemical action, here as elsewhere. The oxygen in the blood not all derived from the atmosphere. An additional quantity results from the decomposition of the tis- sues, and of the Calorific elements of the food. Remarks on its final destination. Physiological relations of the Aerating process. A. The objects of Oxygenation are: 1st, To produce the decomposition of the tissues (see Oxygen as a vital stimulus, p. 4)—the oxygen being carried into the general capillaries by the red corpuscles. 2d, To combine with, and aid in elaborating the organic ele- ments of the blood. Thus Aeration is the final function of Hsematosis (p. 12) ; explain. 3d, To combine with the Carbon in the Blood, whencesoever derived (3 sources, p. 26) and convert it into Carbonic acid. N. B. Not all the Carbon in the Blood any more than all the Oxygen, is employed to form Carbonic acid. A quan- tity of both enter into the composition of the secretions, e. g. Bile, &c. 4th, To convert the free Hydrogen in the blood (its source, p. 27) into water. Thus the products of Aeration are car- bonic acid and water. Some of the Oxygen also forms Sul- phuric and Phosphoric acids, by combining with the Sul- phur and Phosphorus of the food,and the decomposed tissues. All the above results are attended by the development of heat; all but the 2d are apparently instances of pure chemical ac- tion. (See Calorification, p. 30.) But the Dynamic re- sults accompanying the first are purely Vital. (See Mo- tion and Sensation.) SYNOPSIS OP LECTURES. 29 B. The object of Decarbonization is merely to remove from the blood the carbonic acid just accounted for; this being an Excretion. (See Secretion.) Why must oxygen then be constantly entering the blood ? Why the carbonic acid constantly leaving it ? Mere non-decarboniza- tion more rapidly fatal than non-oxygenation; proofs. Infer- ence. Effects of carbonic acid gas in inspired air—Do. of de- ficiency of Oxygen—do. of increase of do. Necessity of venti- lation, illustrated. Most common errors in this respect. The aerating process modified by difference of climate—explain. Ef- fects on aerating organs. Inferences. Indications. Is the Nitrpgen in the inspired air affected by the Aerating pro- cess? The following are always directly proportional to each other: The dynamic activity, dynamic waste, amount of oxygen con- sumed, quantity of nutriment required, amount of the red cor- puscles in the blood, activity of Respiration and the Aerating process, amount of carbonic acid eliminated from the lungs, and the natural temperature of the body. Explain at length. Inferences. The skin also is to some extent, an aerating organ—Proofs. In- ferences. State of the Aerating process during the Hyberna- tion (explain) of animals. Remarks. Function of the Thymus body. (Dr. Simon.) Pathological states of the Aerating process : 1st, Total suspension of Aeration, called Asphyxia. Effects of non-decarbonization on the pulmonary capillaries. Explain at length. Why is the right heart full and the left empty after death from Asphyxia ? Why a liability to Pneumonia during recovery from it ? Its most common forms—Hanging—Drown- ing—exposure to charcoal fumes (carbonic acid gas)—Indica- tions. 2d, Deficient Aeration (gradual and partial Asphyxia). Effects on pulmonary capillaries. Why produce pulmonary congestion ? serous effusions into the air cells ? Pneumonia ? general lividi- ty (venous congestion) ? dilatation of right heart ? muscular de- bility ? torpor of intellectual faculties ? coldness of the body ? &c. Why produce fatty degeneration of the Liver ? do. of the Kidneys ? Why predispose to Phthisis ? All these effects may result from: A. Impure air—Indications. B. Deficient Respiratory movements; e. g. in affections of Me- dulla Oblongata, or general nervous debility (typhoid, &c, &c.)—Indications. All gases (or vapors) but Oxygen, if inspired produce abnormal ef- fects ; inducing 1st, Deficient (or null) Oxygenation, and its con- sequences, diminished strength, sensibility, consciousness, &c.— and 2d, partial or total non-decarbonization also, (Asphyxia) and 30 SYNOPSIS OF LECTURES. its eff'ects,(e.g. pure hydrogen, carbonic acid ga.s&c.) Some va- pors also act at the same time directly on the Nervous system as Stimulants or Sedatives. E. g. nitrous oxide gas ; &c. Effects of inhalation of Sulphuric Ether, &c, explained. Here is A. deficient Oxygenation ; Proofs—B. an increased evolution of Carbonic acid (MM. Ville and Blandin)—C. a Sedative effect on the Nervous system. Why the effects so rapidly induced, and so transient ? Why ig oxygen the best remedy if Etheriza- tion be carried too lar? Why do differences in the temperature of the ethereal vapor, vary its effects ? Rules for its safe admin- istration to annul pain. (Dr. Snow.) CALORIFICATION. Define the term—This Sub-Function common to all living bodies ; hence its result is properly termed Organic (not Animal) Heat. Table showing the natural temperature of various kinds of vegeta- bles (Paine). Remarks. Their heat is greatest during develop- ment of organs of Fructification—also great during germination of seeds. In both these cases, much Oxygen is consumed. Table showing the natural temperature of the various classes of animals; birds having the highest. Have Arctic animals of the same species the highest temperature? Illustrate. The natural temperature of the human body—slight varieties in different climates. Table illustrating this (Dr. J. Davy). If suddenly reduced to 79° in healthy adults, death is inevitable. The evolution of the Organic Heat is apparently a result of the performance of all the Organic Functions ; especially Oxygena- tion, (formation of Carbonic acid and water, &c, p. 28) and the conversion of fluids (blood) into solids (Nutrition). The first appears a purely clmnical source of heat; the 2d a vital one, and not the mere extrication of latent caloric. The increase of heat sometimes occurring after death indicates a chemical cause; at least not a vital. Organic heat does not de- pend on the nervous system (certainly not in plants); but is modified by it just so far as it primarily modifies the organic functions. Calorification has been said to be itself the last func- tion to fail; how explain this apparent fact. The Organic heat has been classed with the secretions (Paine). Organic heat varies then with amount of oxygen consumed; and the other proportionals on page 29th—why ? Hence varies with time of day (Chossat), season of the year (Edwards), and other circumstances under Oxygenation (p. 27). Explain. Calorific power is feeble in infants; and in old age, why ? How the great heat developed by insects (white-blooded) accounted for, they having no " carriers of oxygen ?" All very young animals have feeble Calorific powers; the more so the more helpless at birth. Average temperature of new-born infants (Roger). The calo- rific powers of animals in the state of Hybernation. Refer to SYNOPSIS OF LECTURES. •"> 1 ol the Calorific Elements of the Food (p. 17). Does animal diet excite organic heat more rapidly than vegetable (Paine) ? Physiological relations of the Calorific process. Importance of the Organic Heat (see Heat as a Vital stimulus, p. 4). Is also a sensation of Heat not connected with this, depending on a mor- bid state of the sensory nerves—Mere sensory heat does not af- fect the thermometer; organic heat does. Most animals confined naturally to particular climates, why ? Man maintains nearly a uniform temperature, whether in a climate with a temperature of 130° (India) or —70° (Arctic regions). Can also withstand a much higher artificial temperature. Ex- periments of Blagden, Chabert and others. Afrigorific process is established to neutralize the heat in such cases; explain—the heat of the body being increased not more than about 6°. How many degrees depressed by extreme cold, short of fatal effects? Proximate cause of death from exposure to cold. Extreme tol- erance of cold in the Zincali (Borrow). The skin also is a calorific organ—experiments of Becquerel and Breschet. Mere dryness of the skin increases the apparent or- ganic heat—explain, (fevers, &c.) Physiological objects of Dress. Common errors in this respect. Pathological states of the Calorific process. Much of the heat felt in some diseases is merely sensory. Organic heat is increased in Fevers (108° to 113° in typhoid, Piorry); how explained by Dr. Christison—in Inflammations—in Pneumonia blood was 113° (Piorry)—Phthisis, (114°, Do.)—Scarlatina, (106°, Dun- glinson)— Tetanus, (110°, Prevost.) In the uterine system is sometimes 120° (Granville)—Hot stage of intermittent (109°, Craigie)—Injuries of spinal cord, or spinal nerves. Accession of facial Neuralgia. Explain. The organic heat is diminished in cold stage of intermittents (to 74°, Dr. Phillip)—in debilitated states of the nervous system, implicating the respiratory movements, or indirectly affecting the organic functions (specify)—Affections of the Brain—Para- lyzed limbs (70°, Earle)—Injuries of great sympathetic (78°.8, Chaussat)—Apoplexy—temperature rises after death, very uni- formly (Dr. Cheyne). Asiatic Cholera (78°)—Icterus (96°.40) —Diabetes (Do). Organic Heat diminished in Etherization (Blandin). The ordinary range of temperature in disease in adults is 95° to 107° (Andral)—in infants 74°.3 to 108°.5. (Roger.) Chilliness experienced by patients is often mere sensory cold. The proximate cause of death from starvation is nomcalorification, (Chossat.) Infer the importance of external heat, and of stim- uli (calorific elements, though the stimulants also excite the res- piratory movements directly) in extreme inanition, &c (p. 17.) 32 SYNOPSIS OF LECTURES. Death from starvation occurs in birds when 40 per cent, of their weight has been lost (Chossat). Most of this burned a3 fuel; explain. Remarks on the correlations of the preceding Functions of Haema- tosis—Effects of Bloodletting on the function of Absorption—on action of Heart and Arteries—on Respiration—and Aeration. Have disposed of the 1st object of Sanguimotion (Aeration, p. 22); now follows the 2d (Nutrition and Secretion). Have seen how Blood is formed; next how is it disposed of. SUBDIVISION II. NUTRITION PROPER, AND SECRETION. Secretion implying Separation of certain elements from the Blood, the 1st stage of the Nutritive process may be included under that designation. The 2d cannot. (See below.) But the proper secreting function of the glands depends on their peculiarities in respect to Nutrition. In this view Nutrition in- cludes Secretion. (See Secretion, p. 36.) V. FUNCTION OF NUTRITION (AND ASSIMILATION). Nutrition is the Function which foru:s the tissues from the Plasma (define); whether we consider: 1st, Their original formation from cells, (Development, p. 11). 2d, Their increase in amount, (Growth). 3d, Their apparently permanent condition in the healthy adult, (Balance of repair with the dynamic and organic waste). Are two stages of the Nutritive process: 1st, Separation (Secretion) of the required elements in the Plasma, (Exudation (p. 24) of Plasma; Plasmexhidrosis). 2d, Conversion of the exuded Plasma into the several tissues, (Organization of Plasma). Each tissue has the power of appropriating the required elements of the Plasma to itself and thus repairing its loss, (Assimilation). Both of the above are vital processes. Proofs. Influenced by Nervous system ; not dependent on it. Proofs. The organs and parts concerned in the Nutritive process are the general Capillaries and the inter-capillary spaces, (Explain). Organization occurs in the latter. (For mere Sanguimotory function of the capillaries, see p. 24th, 3d.) Specify the phenomena of waste and repair: 1st, How are the existing tissues destroyed (p. 27)? The ele- SYNOPSIS OF LECTURES. 33 ments resulting from their decomposition, how disposed of? (See difference in Arterial and Venous blood, p. 23, and sour- ces of Lymph, p. 18, B.) How these elements eliminated from the Blood; except the Nitrogen ? (See Aeration.) How the Nitrogen do ? (See Secretion.) 2d, The waste is repaired by A. Plasmexhidrosis. Does not imply rupture of Ca- pillaries; Extravasation does—explain. What if the Exudation be slightly excessive ? (Sources of Lymph, p. 18, B.) B. Organization of Plasma. Explain at length. The Liquor Sanguinis alone affords the Plasma; proofs—the red Corpuscles produce the waste (p. 27). Hence Oxygen and Nu- triment (waste and repair) should be proportional (see also p. 29. B). Physiological considerations. The vast importance of this Func- tion. The rapidity of waste and repair vary at different ages— explain. Activity of nutrition varies in particular organs at dif- ferent periods of life; e. g. Liver, Thymus body, &c, in the Foe- tus. Particular parts and organs remain undeveloped till a par- ticular period of life; explain. Constitutional peculiarities in the Nutritive Function. How long (average) is the whole adult human body in being removed and recomposed, by waste and Nutrition ? Each tissue and organ selects not only its appropriate materials from the blood; but also particular non-nutritive (e. g. medici- nal) substances contained in it. This a fundamental principle in Therapeutics. E. g. Local effects of Lead—Arsenic—Iodide of Potassium—Balsam Copaiba. Even peculiar morbid states of blood itself affect particular parts; illustrated by symmetry of cutaneous diseases, &c.—explain. The activity of the nutritive process varies with, 1st, Activity of circulation of the part, within healthy limits. 2d, Exercise of part. Blustrate these two propositions. Rea- sons. The Reparative Process (explain) is merely a modification of the Nutritive, adapted to the requirements of the part. How differ from common Nutrition ? Has no necessary connexion with In- flammation ; is even opposed to it in its results. Proofs. Here the Exudation is plastic; in Inflammation, caco-plastic. Ex- plain. Modifications of the Reparative Process (Dr. McCartney). A. Adhesive Process. Explain at length. B. Modelling Process. do. do. C. The true Suppurating Process, (Union by Granulation)— The last follows Inflammation; the others not. (For charac- ters of true Pus see works on Pathology.) 34 SYNOPSIS OF LECTURES. Pathological states of the Nutritive Process. A. Disturbed Equilibrium of waste and repair. I. Diminished Nutrition (Atrophy). 1st, From cessation of repair (waste continuing); no nutri- ment being consumed, e. g. Fevers (there being Anorexia) —Starvation; here emaciation is very rapid. Birds lose /y of their weight before they die thus (Chossat). 2d, From inadequate repair, though food is taken; it not be- ing converted into Plasma, e. g. in Phthisis; Tabes Mes- enterica, &c, or any disease implicating either of the Func- tions of Haematosis. Bad diet (or in too small quantity) alone may lead to this result. 3d, From increased waste, the ordinary repair continuing; e. g. in case of any drain on the system—Lactation ; Dia- betes ; Suppuration; excessive exhaustion of Nervous sys- tem, &c. Individual peculiarities under this head. Local atrophy may result merely from diminished circulation through the part; hence often results from pressure, disuse of part, (e. g. paralyzed limb) &c. Illustrate. The Ulcer- ative process is allied to local atrophy. Explain. It has no necessary relation to Inflammation ; nor to Ulcers—Ex- plain. II. Increased Nutrition (Hypertrophy). General Hypertrophy, •and that of the muscular system merely, not a morbid Ijjjate ; while general atrophy is so. Causes of the former. Individ- ual peculiarities in this respect. General H. cannot be pro- duced at will beyond a certain extent in each individual; Plethora alone results from an excess of food in such cases. Local Hypertrophy of most internal organs is a morbid state ; e. g. of Heart, Bladder, Liver, Brain, &c. But may still pro- duce salutary effects in the circumstances; e. g. final cause of Hypertrophy of Heart, and of Bladder, generally. Important then to know the normal size and weight of each organ. Ex- ternal Hypertrophy may be removed by pressure, (e. g. of mamma,) why? B. Abnormal state of 1st stage of Nutrition {of Plasmexhidrosis). Is excessive in Inflammation; no Plasma being needed in the state of the part. Signs of this excessive Exudation in an ex- ternal part; Pain, Heat, Redness, and CEdema. But these are not distinctive of Inflammation. Proofs, &c. Specify all the other elements of Inflammation in connexion; both local and general—and its essential and accidental characteris- tics. Inflammation is always a morbid process. Contrast it with the Reparative which is never so. How is the excessive Inflammatory Exudation disposed of? 1st, Is absorbed by Lymphatics of the part (Inflammation ends in '■ Resolution.") SYNOPSIS OF LECTURES. 35 2d, Produces death of the part, (do. ends in Mortification.) 3d, Is decomposed, (Softening) and must be removed by Ulcer- ation, &c. Afterwards the injury is repaired by the Granu- lating process. 4th, Becomes imperfectly organized (Induration, False mem- branes, &c.) ; the exudation being always caco-plastic. C. Abnormal state of 2d stage of Nutrition ( Organization). 1st, Tuberculosis (including Schrophulosis). Exuded plasma is Caco-plastic, and Tubercles instead of the proper tissues are formed. Characters of tubercle. Produce no morbid effects (unless it be mechanically from their mass) while retaining their vitality (crude tubercles) ; on losing it they soften, and finally produce ulceration, now being " foreign bodies " (ex- plain). Peculiarities of the Plasma leading to the formation of Tubercles. This may result from 1st, Food deficient in quality or quantity. 2d, Deficient activity of functions of Haematosis. Explain. Why tuberculosis often retarded by Pregnancy ? 2d, Abnormal growths. A. Non-malignant—tumors, &c, of various tissues, Classify them. B. Malignant Growths—their peculiarities. Classify them. Why children peculiarly liable to Inflammatory diseases ? and to Tuberculosis? Indications. Why their diseases so rapid in their progress ? Effects of Bloodletting on the Function of Nutrition—on its modi- fications, especially Inflammation. Have seen how the Blood is converted into the Solids. Next, how are the various Fluids formed from it ? VI. FUNCTION OF SECRETION. This, as a distinct Function, separates from the Blood all the Flu- ids of the body, except Lymph and Chyle (p. 11, B). How dis- tinguished then from 1st stage of Nutrition (p. 32). The secreting structure essentially the same in all cases; cells alone actually secreting (p. 5, A). But secreting organs, assume va- rious forms; glands, crypts, follicles, &c, define. Hence same gland varies much in different animals; while its secreted fluid is very similar in all. Illustrate. The secreting power of each individual cell producing the pure Se- cretions (see below) is identical with its Nutrition; and is a pure- ly vital function. Those producing the Excretions apparently possess also a physical or chemical force (p. 4, A, B). Explain at length. Secretion modified by, but not dependent on, the Ner- vous System. Proofs. Secretion is then the result of the peculiar Nutrition of the secret- 5 36 SYNOPSIS OF LECTURES. ing surface. Every free surface of a vascular structure must se- crete, why ? Secretion is arrested by the opposite states of Congestion and Hyp- aemia (explain) of the secreting organ. Illustrate. Hence all the secretions changed in Anaemia, &c. The objects of Secretion are: A. To separate from the Blood, fluids containing elements dele- terious to the Organism (the Excretions). B. To separate fluids destined to perform important offices in the body (the Secretions). Difference between Secretion and a Secretion—Double meaning of the term Excretion; as a sub-function, it denotes the dynamic actions necessary to remove an Excretion from the body, e. g. Defecation, Micturition, &c. The Excretions cannot long be retained in the body without injury, why ? the Secretions are always retained, and finally reabsorb- ed—explain. Non-secretion (retention in the Blood) of the for- mer, produces general disorder; do. of the Secretions, merely lo- cal do.; why ? Attention to the Excretions of the highest Ther- apeutical importance. The Secretions are fluid in all animals ; why ? the Excretions vary in form to suit the requirements of the case; e. g. solid urine of serpents and some sea-birds ; and carbonic acid gas from the aerating organs of all animals. Table showing by what organs the 15 elements in the body (p. 6, A) are directly separated from the Blood. They are all finally removed from the body by the five emunctories; the Lungs, Skin, Urinary passages, Liver, and Alimentary canal; the last removing the Hepatic Excretion, and the intestinal Mucus, in the Faeces. A. THE EXCRETIONS. How distinguished from the Secretions ? Are normally produced only on mucous surfaces and the skin; explain. In disease they may be formed on other surfaces; e. g. pus in cavities, or on a granulating surface, &c, Every free vascular surface becomes an aerating organ if exposed to the air; proofs—and thus pro- duces an Excretion. The principal deleterious elements eliminated in the Excretions are the Carbon, Hydrogen and Nitrogen of the decomposed tissues. The Excretions themselves are Bile, the cutaneous Perspiration, Carbonic acid, Urine, and intestinal Mucus. Carbon and its compounds enter largely into the first three; nitrogen into the Urine. The Faeces are an Excretion only so far as they con- tain Bile and Mucus; the residual matters in them never hav- ing entered the blood. Of these, three are Excretions merely; viz. Urine, Perspiration, and Carbonic acid—all having an acid reaction. Two are both Excretions, and Secretions (explain), i. e. mixed Excretions, viz. SYNOPSIS OF LECTURES. 37 Bile, and intestinal Mucus—both having an alkaline reaction (Simon). But buccal Mucus is acid (p. 13, B); gastric fluid (see p. 16, top) is uniformly so. All the true Secretions, (if Gastric fluid is classed with the mixed excretions,) have an alkaline reaction. 1. Carbonic acid gas ; secreted by the Lungs, Skin, and any in- ternal membrane brought into contact with the air; e. g. that lining bones of birds, &c. Refer to the subject of Aeration, p. 26 to 30. IF. Intestinal Mucus—its properties, and its uses as a Secretion (see Digestion, p. 15,5th). All mucus but that of the alimen- tary canal appears to be a Secretion merely, and like other Secretions is Alkaline. The fluid portion of mucus (micros- copically examined) is always alkaline (Simon). Inference. For the objects, as a Secretion, of the Gastric fluid, see p. 14. Its excrementitious elements, like those of the intestinal mu- cus, are doubtless of small amount, and are excreted in the Faeces. III. The Bile. Its chemical composition, according to Berzelius —Thenard—Demarcay and others. Formula of its princi- pal organic element, Bilic acid (Bilin, Picromel, Choleic ac- id)—do. of Cholesterine. These abound in Hydrogen and Carbon. Biliphaein, Biliverdin, and Bilifulvin. Morphology of the Biliary Apparatus in the animal series. Structure of the human Liver, according to Kiernan. Its great size in the foetus, how accounted for ? Uses of the Bile (p. 15). The Alkaline elements are reabsorb- ed as a mere Secretion, after converting the Chyme into Chyle. The Calorific are likewise carried with the Chyle into the Blood, though previously separated from it as an ex- cretion. In the Blood these elements (principally of Carbon and Hydrogen) are converted by the Aerating process into Car- bonic acid and Water (p. 28, 3d, 4th); the Organic Heat is thus, in part, maintained (do. 4th); and finally these compounds are excreted by the Lungs, Skin, &c. (p. 29, B.) The Resinous portion of the Bile alone is not re-absorbed; act- ing as a stimulus to the dynamic powers of the alimentary ca- nal, and then being excreted in the faeces. It forms about ^7 of the Bile (Thenard), and is associated with the Biliphaein. Physiological relations of the Bile. The Calorific Elements Avhich enter the Meseraic veins from the Alimentary canal, (e. g. sac- charine matters, &c.) are carried by the Vena Portae to the Liv- er, and the Bile secreted; when the blood thus purified passes on to the right heart. The Hydro-carbon of the Bilic acid; &c, is subsequently "burnt" by the Aerating process. Results (p. 28). But the fatty Calorific Elements, being carried through the Lartcah, &c, to the right heart, are consumed as above, with- 38 SYNOPSIS OF LECTURES. out having traversed the Liver (Carpenter). Distinguish then between Calorific elements of the food and those of the Bile. Thus the Liver is associated with the Lungs and Skin as an elim- inator of Carbon. The reciprocal relations of the three. How varied by changes of climate ? Explain at length. Liver and Lungs in inverse ratio, in respect to size, in the various animals ; why ? (e. g. liver large in reptiles, small in birds, &c.) The Liver the only eliminator of Carbon in the body of the Foe- tus. Why none other needed ? Why this required ? Sources, composition, and uses, of the Meconium. For relations of Bile to Digestion, &c, see p. 15. Pathological relations of the Bile (see also p. 15). Effects of its non- secretion on the organism generally. Do. do. on the pulse—and on Nervous system. Account for these effects. Is non-secre- tion more deleterious than reabsorption of the Bile (e. g. from obstruction of gall-duct) ? Why ? General indications in both cases. All the Bile is discharged in the Faeces in certain morbid states— specify. Precise change of structure called " fatty degenera- tion" of the Liver (Bowman). Why Phthisis often produce it? Why gradual Asphyxia produce excess of Bile ? Why excess of Calorific elements in the food in warm climates produce He- patic disease ? Why deficient action of Liver lead to portal congestion ; and Ascites ? Morbid changes in composition of Bile (see p. 15). IV. CUTANEOUS PEHSPIRATION (SWEAT). Is constantly secreted—Sensible and insensible, define. Its spe- cific gravity (Simon). Its chemical composition (Anselmino). Its solids amount to from 1\ to 2 per cent; chloride of Sodium being the most abundant. What other salts ? Has an acid re- action, owing to free acetic, and lactic acids. Its odor is pecu- liar in different tribes of men, and different individuals; and in the two sexes. But the odor proceeds from the sebaceous secre- tion which must be distinguished from the Perspiration. Structure of the Skin; especially of the Perspiratory Apparatus (Glands and Pores). Aggregate length of latter in human body, 28 miles (E. Wilson). They are not found in the skin of the Dog? Amount of insensible Perspiration (average) per diem is 29 oz; do. exhalation (Halitus) from Lungs (water nearly pure), 18^ oz. (Seguin.) The solids in the former amount to about 2^ ounces; the remainder is mostly water acidulated as above. But much of the water given off from the Skin, is a mere Exhala- tion (Evaporation) and is not secreted by the Perspiratory glands. This a mere physical phenomenon, occurring in some degree at the lowest temperature, and even after death (Edwards). (So is the Exhalation from the Lungs.) The maximum is exhaled dur- ing digestion; the minimum during meals. Increased by a warm, SYNOPSIS OF LEC1URES. 39 dry, light atmosphere. It thus becomes the Frigorific process (p. 31.) Is diminished by a moist, dense, calm atmosphere. Hence varies with season of year, &c, &c. Is greatly increased in certain debilitated states of the system; e. g. after hemorrhage, and in colliquative sweats. How explain these ? Indications. No peculiar exhalent vessels exist. The skin also gives off Carbonic acid, and Nitrogen gases (Collard de Martigny); the former, as an Aerating organ (p. 29, B). The skin is more efficient in this respect than the lungs, in the frog. (Edwards.) The quantity of Nitrogen exhaled from the Skin, in man, is about 100 grains daily (Carpenter). Physiologiccd relations of the Skin. 1st, Is associated with the Liver and Lungs, as an emunctory of Carbon. 2d, Do. with the Kidneys, as an eliminator of Nitrogen. 3d, With the Lungs and Kidneys to remove water from the Blood. There is also a reciprocal relation between its exha* lent action and that of alimentary canal; e. g. diarrhoea pro- duced by a chill, &c. The antagonism of the exhalations from Skin, Lungs, Alimentary canal, and Kidneys—explain. Therapeutic inferences. Importance of maintaining the healthy action of the skin. Means of securing this result. Naturally more active in the female than in males equally sedentary ? The Perspiratory secretion affected by the Nervous system; e. g. in opposite ways by mental emotions. How explained ? The exhalation also thus affected; how explained; but far more by physical causes. Diaphoretics; some principally increase the secretion—others the exhalation. Specify. In what diseases indicated. Severe physical pain often a Diaphoretic, why? Why is exercise so ? Warm water ? &c. Pathological relations of the Skin. Total inaction of it produces death (Fourcault) in lower animals. Diminished do. produces diseases of Lungs—of Liver—and of Kidneys (Albuminuria). Latter sometimes a sequel of Scarlatina, why ? So is Ascites, or Anasarca, why ? Infer; maintain a due action of the skin in diseases of all these organs. The febrile symptoms in the Ex- anthemata an effect, merely; explain. Do. in part, in Burns and Scalds. The Dryness of skin in idiopathic fevers, how ac- counted for (p. 36, top)? Importance of daily ablutions in all febrile diseases. Excessive perspiration after cold stage of in- termittents; how explained. How " critical sweats." The ex- ploded idea of " peccant hnmors " thus discharged. What is a "cold." What the state vulgarly called, being "melted?" In- dications. Abnormal states of the Perspiration in Diseases (Simon). 1st, Change of odor. In Scabies is a mouldy odor—sweet in Syph- ilis—acid in Rheumatism and Gout; like musk, in Jaundice: 40 SYNOPSIS OF LECTURES. like sour beer, in Scrofula; like fresh brown bread, in intermit- tents. But these distinctions depend very much on the observ- er. 2d, Change in composition. Excess of Acetic acid, in Hectic (Prout), acute Rheumatism, and confinement after parturition. Excess of Lactic acid, in acute Rheumatism, Gout, Scrofula, Rachitis, and some Cutaneous eruptions. Is excess of Ammonia after attacks of Gout (Anselmino); in putrid and typhus fever (Berend). All putrid sweat probably contains free Ammonia. The Chloride of Sodium was increased in a case of Dropsy (Prout); the Phosphate of Lime in gouty and urinary concretions. The sweat is Alkaline in certain nervous diseases. 3d, Abnormal constituents of Sweat. Albumen, in a critical sweat in a case of acute Rheumatism (Anselmino); in gastric, putrid, and hectic diseases, and in patients moribund (Stark). Blood, in scurvy, putrid fever, and typhus icterodes. Uric acid, in gout (Mark); in a case of vesical calculus (Wolff). Urate of Soda, in gout, and stone. Biliverdin, and Bilin, in Jaundice, &c. Uro-erethin, in a fever patient (Landerer). Blue perspiration, in abdominal disease (Dr. Bleifuss); in hysteria and hypochon- dria (Michel). Fat, in colliquative hectic sweats. Much of the preceding needs confirmation. 4th, Foreign substances in the Sweat; especially medicinal. The following have been detected in it. Quinine, Sulphur, Mercury, Iodine, Iodide of Potassium, Asafoetida, Garlic, Saffron, Olive oil, Rhubarb, Indigo, Prussian blue, and Copper. V. URINE. Consists of water holding certain solids in solution. These vary from 36 to 67 parts in 1000, according to amount of fluids (wa- ter) taken; and much more in disease. Is almost entirely solid in some animals (p. 42). Morphology of the Urinary Apparatus throughout the animal se- ries. Structure of human Kidney, and other parts of Urinary Appara- tus. Surrenal capsules in the Foetus—their probable uses. Specific gravity of Urine (average) —varies with relative amount of solids in it; hence what circumstances increase it ? and di- minish it ? The Urometer. Average quantity of Urine per diem, 45 oz. (Simon); the fluctua- tions being greater however than of any other excretion. Vari- ations according to age; season ; state of skin, &c. Average is however very nearly the same in the same person. Is a very complex fluid, containing 19 or more constituents besides water. Its chemical analysis, by Berzelius—Lehmann—Bec- querel, &c. Its acid reaction owing to its free lactic and carbon- ic acid. Here follows Simon's Analysis. SYNOPSIS OF LECTURES. 41 Water, - Urea, - - - 12.46 Uric acid, - - - 0.52 Lactic acid, and Alcohol extract, 5.10 Spirit Extract, - - - 2.60 Water Extract, & Vesical Mucus, 1.00 Lactate of Ammonia, - 1.03 Chloride of Ammonium, - 0.41 " Sodium, Sulphate of Potassa, Phosphate of Soda, - " Lime and Magnesia, Silicic acid, ) Organic ) compounds, 12.98 10.14 963.20 o ► W36.80 CO *J 5.20' 3.00 -g 2.41 J- ^11.19 0.58 a trace Berzelius and Marchand find also Sulphate of Soda about 3.18, and Biphosphate of Ammonia 1.6. Liebig denies the existence of Lactic acid. Traces of peroxide of iron, and fluoride of Cal- cium are found in urine. Also carbonic acid gas in solution (Si- mon.) Of the solids (the only peculiar part of the Urine) about ^ is com- posed of fixed and Ammoniacal salts ; and the remainder of Or- ganic compounds, principally the Secondary (p. 10). A. The Salts; (Fixed and Ammoniacal)—the most abundant (see table); are more of the alkaline and earthy phosphates, than in the blood. Some salts precipitated on mere cooling of the Urine; others require its evaporation. Urinary "depos- its ;" define. Two kinds, Saline and Organic. The phosphates held in solution by the acids of the Urine; hence alkaline state of it produces phosphatic deposits, the most common of the sa- line. Peculiarities and tests of these deposits. The salts are derived from the decomposed tissues, and the ele- ments of the food; (especially the unassimilated) ? They ap- pear to enter the uriniferous tubes with the water, as a mere Exhalation (p. 38). The Sulphates and Phosphates result from the waste of Nervous system; hence increased by violent exer- cise ; especially the former (Simon)—and the latter by mental exertion. Illustrate. The Chloride of Sodium varies, with the food, from 29 to 116 grains per diem. The bases of the Sulphates and Phosphates enter the stomach in combination with vegetable acids, e. g. citrate, tartrate, &c. These are decomposed (how ?) and Sulphuric and Phosphoric acids replace them. How these two acids formed ? Thus the Kidneys eliminate much of the Oxygen of the decomposed tis- sues, &c. (p. 28.) Explain the action of the above vegetable acids as " Refrigerants." B. Organic Compounds, (see p. 10.) These are totally unorgan- izable; and most assume a crystalline form after the Urine is excreted. They abound in Nitrogen. The most important is 42 SYNOi'MS OF LECTl/RES. I. Urea—varies from 12 to 50 parts in 1000; average 32 (Dr. (r. Bird)—being from * to \ of all the solid residue. Is the simplest of all organic compounds. Its formula. Contains more than twice as much Nitrogen as Proteine, with less than \ as much Carbon. Form of its crystals. Urea is derived from, 1st, the decomposed tissues—principally the Gelatinous? (Dr. Prout.) 2d, azotized diet; principal- ly the unassimilated portions ? Urea may be increased absolutely by violent exercise (to 45 parts in 1000) why? and by purely animal food (to 52 parts) why? If diet is exclusively vegetable, may fall to 10 or 12. The average absolute amount excreted by males daily is 432 grains —do. by females 294 grains (Lecanu). Children proportion- ally more ; very aged persons less—why. The Urea is relatively increased, as are all the solids, when but little water exists in the Urine, and vice versa—the specific gravity, in former cases, being high. If the latter condition obtains, and the quantity be normal, there must also be an ab- solute increase of the solids; though the Urea alone may, or may not, be increased. Tests of Urea, microscopic, and chem- ical. II. Uric (formerly Lithic) Acid—average 1 part in 1000 of Urine (Bird); and little more than \\ per cent, of all the solid residue. Liable to great increase in disease. Is kept in solution by the Soda in the Urine (for 10,000 times its weight of water is necessary to dissolve it). Hence any other acid combining with the Soda (even Carbonic) precipi- tates it, e. g. in Pneumonia, &c. Indications. So does a diminution of the Soda—Indications. Form of its crystals. Uric acid and its salts forms the most abundant organic uri- nary deposits. It forms vesical calculi also. Its tests, chem- ical and microscopic. With Ammonia, forms the almost solid Urine of serpents and carnivorous sea-birds, to the entire ex- clusion of Urea. In carnivorous Mammalia we find Urea, but no Uric acid nor Urates. Formula of Uric acid. Contains much more Carbon and Oxy- gen than Urea, and also much Nitrogen. Is derived, proba- bly, like Urea, from the decomposed tissues (the albuminous, Prout,) and the azotized elements of the food. But is not in- creased by exercise and animal food proportionally with the Urea. Has no constant ratio in quantity to the latter. Urea derived from Uric acid by oxydation of the latter (Leibig)— objections to this view. This subject needs farther investiga- tion. Average quantity of Uric acid excreted per diem by males 13.09 grains, or 1 to 32 of Urea (Bird)—Do. do. in females 10.01 grains; or 1 to 29. In disease the quantity varies more than that of the Urea. SYNOPSIS OF LECTURES. 43 III. Hippuric acid is a constituent of Urine (Liebig) in small quantity. Replaces the Uric in the Herbivora. Benzoic ac- id converts the insoluble Urates into the soluble Hippurates; hence of great value in preventing Uric acid deposits; have also removed gouty concretions, i. e. Urate of Soda (Dr. Ure). Effects of Phosphate of Ammonia in latter class of cases, ex- plained. Hippuric acid is soluble in 400 times its weight of water—its formula. Richest of all organic compounds in carbon, except Bile. Its probable source (Dr. Bird). Is increased in tor- pidity of the Liver ? Of the other Organic constituents, Lactic acid forms about 1.5 parts to 1000 (Lehman and Marchand). Liebig endeavors to prove that another anonymous organic compound has been mistaken for it; while free Lactic acid does not exist in the Urine. The epithelium sca'es, and the mucus in Urine proceed from the urinary passages—explain. Are two coloring matters in the Urine, 1st, A yellow tint, Hce- maphcein (Simon) identical with the coloring matter of blood- serum. 2d, A rose, red, or even purple, tinge, Purpurine (Uro-erethrin, Simon). The elimination of the preceding organic compounds, is a vital action (secretion); that of the salts and water, apparently not so. Still the quantity of the latter is indirectly affected by vital force; it is even by the nervous system—explain. Extractive matters ; very little known respecting them. Form about 10 parts in 1000 of Urine (Lehmann and Marchand). Reduced to 5 parts by a purely animal diet; increased to 16|, by a purely vegetable do. Physiological relations of the Kidneys—of great importance. Are associated with the Skin and Lungs as eliminators of excess of water from the Blood—with the former moreover, as emuncto- ries of Nitrogen and certain salts; with the Skin, Lungs and Liver, in excreting Carbon—explain. They also eliminate much Oxygen. Hence the complicated antagonism of these organs— explain. Great changes in the Urine from diet. Specify. Purely vegeta- ble diet may render it alkaline. The Sulphates always increase and diminish simultaneously with the Urea (Simon). How explain this fact ? In regard to specific gravity, must distinguish the Urina potus, U. cibi, and U. sanguinis (explain)—last only can be relied on. Pathological relations of the Urinary excretion. Of vast interest and importance. Effects of total non-secretion of the Urine—of diminished secretion—Indications. Retention and re-absorption less deleterious than non-secretion. 6 44 SYNOPSIS OF LECTURES. For the whole subject of Urinary Deposits, their Pathology and Treatment, consult Dr. Golding Bird's valuable work. Brief directions to be followed in Uroscopy. Urine becomes alkaline in diseases of Bladder, accompanied by ex- cessive secretion of mucus, why ? Hence Phosphatic deposits ensue. Indications. General indications in diseases of the Kidneys—Nephritis and Al- buminuria, &c. Morbid changes in composition of the Urine, may be classed as fol- lows : 1st, Excess or diminution of one or more of the normal constitu- ents of the Urine. 2d, Absence of a normal constituent. 3d, Presence of abnormal substances, e. g. Albumen, Blood, Chyle, Fat, (with or without Caseine,) Biliphaein, Bilin, Su- gar, Carbonate and Oxalate of Lime, Pus, &c. For the particulars under these heads, and the precise composition of the Urine in different diseases, see Simon's Chemistry of Man. (Art. Urine.) All unassimilable substances entering the Blood, are removed by the Kidneys, in their original, or in a modified condition. For a list (by Dr. Day) of the various substances that have thus been detected as abnormal constituents of the Urine, see Simon as above, p. 550, &c. Diuretics—remarks upon, at length. Uncertainty of their opera- tion in certain diseased conditions. Thus, while the Functions of Haematosis (p. 28, A. 2d) make pure Blood, that of Secretion keeps it so, by eliminating the Excre- tions. B. THE SECRETIONS. Repeat their characteristics (p. 36, and 37). Many of them of less practical importance than the Excretions, and will be briefly considered. The following order and classification (slightly varied from Dr. M. Paine) will be adopted. On Serous membranes; including Synovia. Serous Fluid's \ ^ Areolar tissue. | Of the foetal membranes. I II. Lachrymal Fluid The Aqueous humor; Liquor Cotunnii, &c. ( Saliva. ILL Digestive Fluids. 1 Pancreatic Fluid. ( Gastric do. (and Bile.) IV. Mucous Fluids. { On the various mucous membranes. SYNOPSIS OF LECTURES. 45 Fat of Adipose tissue. Marrow of Bones. V. Fatty Fluids. <( Sebaceous fluid of Skin and Glans Penis. Fluid of Meibomian Glands; and Cerumen of I VI. Fluids secreted by the Sexual Organs. the ear. iSemen; and fluid of Vesiculae seminales. Fluid of Prostate; and do. of Cowper's glands. Catamenial fluid. B. Of the J Germinal do. (i. e. of Ovum.) Female. j Liquor Amnii, (see I.) [ Milk. I. SEROUS FLUIDS. The simplest of all the secretions—have the lowest specific grav- ity—resemble the Blood serum, physically and chemically ; but are not identical with it, nor all of same composition. Consist principally of water holding Albumen and salts (Chloride of So- dium the most abundant) in solution. Are never exposed to the atmosphere. Found on all surfaces moving upon each other, however small, even in the meshes of the Areolar tissue. Their object always (except C and D of this class) and almost solely, to diminish friction. Are probably rapidly secreted, and re-absorbed equally so. A. Fluids of proper Serous membranes—Structure of latter (p. 11, B. 2)—specify them. Normal quantity of fluid on a serous membrane. Chemical composition of that secreted by the Peri- toneum (Heller). Synovia—its peculiarities. Chemical composition. Its uses. B. Fluid of Areolar tissue. Structure of Areolar tissue (p. 11, B). Composition of this fluid (Heller). Fills the areolae of this tis- sue. Its uses. C. Liquor Amnii. Its specific gravity. Average quantity at, term. Chemical composition, (Mack, and Colberg). Its physio- logical relations. The Vernix Caseosa—its analysis (Dr. Davy). Its origin. D. The Aqueous Humor of the Eye. By what secreted ? its amount. Chemical analysis (Berzelius). Uses of this fluid, in Vision. If lost by a wound, is very soon restored—explain. The Vitreous humor contains a little more Albumen (1.6 in 1000) and common salt, than the Aqueous. The Crystalline Lens abounds in Albumen (244 in 1000) and Crystallin, a kind of Ca- seine (Simon), (122 in 1000); with a little fat, and common salt. Uses of these structures in vision. The Liquor Cotunnii, and Liquor Scarp ce of the Labyrinth of the Ear, have never been analyzed ? Their uses. 46 SYNOPSIS Oh LECTURHS. Physiological relations of Serous secretions. Some of them are secreted after death, i. e. after somatic death; the secreting cells still retaining their vital powers for a short time. But may not this be a mere post mortem Effusion ? Re-absorption ceases at death before secretion, why? sometimes even ceases before death; illustrate. Effects of diminished secretion of these fluids. Increased quantity in any serous cavity, may depend on increased secretion or di- minished re-absorption—explain. Pathological relations, &c. Abnormal accumulations of these flu- ids constitute Dropsies; e. g. (Class A) Ascites, Hydrocele, Hy- drothorax, Hydropericardium, Hydrocephalus, Hydrorachis, Hy- drops Articuli, &c.—(B) Oedema, Anasarca. These accumulations may result: A. From excessive Secretion; from irritation of the secreting membrane, produced by tubercles, Ovarian tumors, or previous disease, e. g. Inflammation, &c. Sometimes a serous mem- brane seems to perform a vicarious action (explain) with an emunctory when rendered inactive by disease; e. g. Ascites in Granular degeneration of the Kidneys, &c. Here the pe- culiar excretion of the Kidneys (Urea) is found in the serous fluid. Other cases of this kind. Serous Effusions (p. 24, 3) may result from mere relaxation of the tissues; also from venous congestion (p. 38,1. 24). They may also be dependent on a peculiar composition of the Blood. Explain. B. From diminished Re-absorption. This probably always fol- lows the previous condition, why ? or may alone produce the effect. Any interruption of the circulation, e. g. from debility, pressure of tumors, venous congestion, &c. may prevent re- absorption. Hence, dropsy a symptom in organic disease of Liver, Heart, Kidney, Ovary, &c, and in exhaustion from pro- tracted diseases, especially Phthisis; (explain.) Indications according to the proximate cause in each case—explain. Un- certain action of Diuretics administered to remove Ascites, &c.; how explained. Serous Secretions, how modified by Inflammation of Serous membranes ? Its peculiar effects on these membranes them- selves, (p. 9.) Serous accumulations in abnormal positions; Serous Cysts, &c. Serous surface itself must be removed; or the cavity oblit- erated; how? II. LACHRYMAL ELUID. Structure of the Lachrymal gland; its ducts. This secretion in- termediate between Serous and Mucous fluids—explain. Its physical properties. Chemically, it resembles the Aqueous Hu- mor (Fourcroy and Vauquelin); the principal solid (are but 1 SYNOPSIS OF LECTURES. 47 per cent, in all) is Chloride of Sodium. Hence the expression " briny tears." Uses of this secretion—Effects of its non-seeretion; do. of ex- cessive do., (Epiphora). Is affected by mental emotions, of vari- ous kinds. How explained ? III. The Fluids aiding Digestion have already been considered; Sa- liva (p. 13)—Gastric Fluid (p. 14)—Pancreatic do. (p. 15)—Bile (p. 15 & 37). IV. All the Mucous Fluids (except of alimentary canal) seem to be pure Secretions. (See p. 16 & 37.) V. FATTY FLUIDS. Found, (except Adipose tissue and Marrow), on external surfaces; and are evaporated in great part, (not re-absorbed.) Peculiar adaptation of such fluids to free external surfaces. For chemi- cal constitution of fatty organic Elements, see p. 10. A. Adipose tissue (fat)—its peculiarities (p. 11). How is fat se- creted ? Size and arrangement of fat cells. Their secreting function and their nutrition, identical;—explain—(see also p. 35.) The several uses of the Fat. Average quantity in adults, in pro- portion to whole weight. Difference in the sexes, and at diffe- rent ages, in this respect. Individual peculiarities. Instances of excessive secretion of Fat (Polysarcia)—Do. of an opposite character (Marasmus). Peculiarities of tribes, and of nations even, in these respects—illustrate. The secretion of fat liable to sudden fluctuations in amount. This first disappears during sickness, (and starvation) being also first to reappear during convalescence ; why ? Sometimes is a pro- gressive and somewhat rapid emaciation (absorption of fat) dur- ing the first few days of convalescence—how explained (see p. 17 and 18) ? Do corpulent persons endure privation of sleep better than the lean? Fat is often found in abnormal positions; e. g. fatty tumors, of va- rious kinds. These always non-malignant. Its normal quantity often increased in internal organs, constituting fatty degenera- tion ; e. g. of Liver, Kidneys, and Lungs. All these indicate diminished Aeration by the Lungs; hence present in Phthisis, &c, &c. (Guillot)—see also p. 29, 2d ; and 38. B. Marrow of Bones. Not found in young bones; why ? Not in those of birds of flight, why ? Uses of the marrow in human bones. C Sebaceous fluid of the Skin—Structure of the Sebaceous folli- cles. Fluid differs in different parts of the body; proofs. Odor of perspiration principally derived from it (p. 38). Glandulae odoriferas of axilla (Horner)—do. of glans penis. 4S SYNOPSIS OF LECTURES. Chemical composition of this fluid (Esenbeck); contains Stearine, Albumen (each 242 in 1000); Phosphate of Lime (200 in 1000), &c. Uses of sebaceous fluid. Effects of its non-secretion, or its entire removal from the skin. Is changed in certain diseases—explain. Is affected by mental emotions ? D. Meibomian fluid. Structure of Meibomian glands. This fluid is intermediate between mucous and fatty fluids; consisting of mucous matter and fat (Simon). Uses of this fluid. Effects of non-secretion, and of vitiated secre- tion. Indications. E. Cerumen of the Ear. Its physical properties. Chemical com- position (Simon) ; contains fat, albumen, epithelium scales, &c.; but no chlorides nor phosphates soluble in water. Its uses. Why its disagreeable odor ? Effects of non-secretion; do. of change in its character. Indications. VI. FLUIDS SECRETED BY THE SEXUAL ORGANS. All the fluids of the Male, and Milk also, are re-absorbed, if not excreted from the body ; if excreted, are absorbed by another individual—this being the final cause of their secretion; ex- plain. The Catamenial secretion is immediately excreted ; or if retained, is not reabsorbed—the Germinal fluid is also to be excreted either at once, or at the end of gestation. Explain. Both these secretions have peculiar physiological relations, and are in these respects sui generis. A. Fluids of the Male. 1st, Semen—Minute structure of human testis. Physical pro- perties of semen—Appearance under the Microscope—Des- cribe the Spermatozoa. Their different forms and size3 in the various classes of animals. Are they actual animalculae ? Chemical composition of Semen (John) ; the water (y% of the whole) contains Phosphate of Lime, Chloride of Sodium, &c, and a substance resembling Mucus. Uses of Semen—is the germ-vivifying agent (see Reproduction). Average quantity excreted at a time. Much affected by men- tal states; explain. Age at which the secretion is first pro- duced ; do. when it ceases. Ruinous effects of habitually ex- cessive excretion of this fluid. Remarks on the habits pro- ducing this result. How best removed ? How remove their effects ? Why matrimony produce a cure, while illegitimate indulgence cannot? Proofs of this proposition. 2d, Fluid secreted by Vesiculce Seminales is probably Mucus. Structure and uses of the Vesiculae—not found in all animals, why ? The Prostatic fluid has never been analyzed—resem- bles Mucus. Its uses. Structure of the Prostate. Probable uses of the fluid secreted by Cowpers glands. SYNOPSIS OF LECTURES. 49 B. Fluids of the Female. Have all a mutuaUrelation, and all'a direct relation to the Function of Reproduction. The Catame- nial and Germinal fluids are produced simultaneously "with, each other;—the Milk subsequently, but never at the same time. The Mammary gland sometimes vicariously];(explain)^secretes the Catamenial fluid, but never during lactation. 1st, Catamenial fluid. By what secreted ? A periodical secre- tion ; explain. Physical characters—Chemical composition (Simon, and Denis) ; compared with blood. Does it contain any fibrine (Simon; Day) ? Average quantity secreted at each period—Affected by mental states, &c. Average age at which the secretion appears; and ceases. Effects of climate, social position, &c, in this respect. Duration of each period. All the Mammalia have the Catamenial discharge : proofs. Dif- ference in the period, in each species ; the term of gestation always being a precise multiple of it—illustrated. Will this apply to individuals, as well as different species ? This fluid is peculiar in the following respect*. 1st, It is rather an extravasation (capillary hemorrhage) than a secretion, in respect to the manner of its production, and its composition— explain. 2d, It has not, like other secretions, a definite use; farthor than to aid in the excretion of the detached (but un- impregnated) ova, and the uterine and vaginal mucus, which is always combined with it. 3d, It has sometimes an acid re- action (Rindskopf). 4th, Is immediately excreted, unlike the other proper secretions ; though it does not remove a deleteri- ous element from the blood, like the proper Excretions. Physiological relations, Sfc. The effects of the periodical discharge of this fluid appear to be precisely those of an habitual hemor- rhage. Explain. It relieves the periodical Hyperaemia of the Uterus and its appendages; which appears to be its primary ob- ject. The following seem the ultimate facts: 1st, A reproductive nisus (explain) recurs in the ovaries and uterus at each period, ac- companied by a state of hyperaemia of these organs. 2d, The ovaries produce germs (ova), and the Uterus pours out an or- ganizable fluid {\evy nearly pure blood). 3d, This relieves the hyperaemia, and aids the excretion of the ova, &c, if not im- pregnated—or becomes organized into one of the foetal mem- branes, (explain) if the ovum is destined to undergo farther de- velopment in the Uterus. Proofs of this view. The appearance of the Catamenial discharge is therefore merely a sign of the previous development of a germ; though its absence does not always disprove such development—explain. In ordi- nary menstruation, then, this is a mere habitual hemorrhage in its results and effects. In impregnation it finally becomes an organized membrane. This sometimes also occurs in cases of Dysmenorrhoea—explain. Ordinarily the mixture of vaginal 50 SYNOPSIS OF LECTURES. mucus with its fibrine, destroys the coagulability of the latter; hence fibrine not usually detected in the Catamenial discharge. The development of a germ (ovum) renders impregnation possi- ble ; and, with the sign above-mentioned, and a simultaneous de- velopment of all the sexual organs, mammary glands included, constitutes Puberty. Other interesting moral changes which characterize this epoch in the female. Pathological relations, fyc. Effects of non-secretion of the Cata- menial fluid. 1st, May not appear at the usual age, or cease before the usual ppoch, because no ova are developed. Here the cause of non- development (some insidious disease perhaps, or mere debili- ty) requires attention ; not the Amenorrhoea. 2d, Sudden suppression of the discharge, from exposure to cold, shocks to the nervous system, &c. Here the consequences are those of the sudden arrest of an habitual hemorrhage; and from the extensive sympathies of the organ implicated, may suddenly be even fatal. Indications. Action of Emmenagogues—Tonics are the only valuable ones in the 1st class of cases above; the Sediluvium, Venesection, Ca- thartics, &c, &c, in the last. 2d, The Germinal Fluid—i. e. the fluid contained in the germ, or Ovum. See structure of ovum, p. 53. 3d, The Liquor Amnii—secreted within the Uterus by the foetal membranes. See Serous secretions, p. 45. 4th, Milk—Structure of the Mammary gland. The characters of Milk vary at different periods of its secretion. A. Colostrum (define)—Its physical and microscopical charac- ters—its peculiar corpuscles (Donne). Chemical composi- tion—Has more of all the solids than ordinary milk, except Caseine. Its peculiar effects on the infant. For how long time secreted? B. Ordinary Milk—Its physical properties^Microscopical do. Specific gravity. Consists of water holding in solution sugar of milk, caseine, and certain salts; and in suspension, an oily matter (cream). How does butter differ from cream? How separate each of these four constituents ? Human milk retains its alkaline reaction longer than that of lower animals (5 or 6 days even). The following is Clemm's analysis of Milk, 9 days after delivery. Water,..... 885.818 Butter, .... 35.316 Caseine, - 36.912 Sugar of Milk, and Extractive matter, - - - 42.979 Salts, of various kinds, - 1.691 ,J?lid ♦ H4.182 constituents. 1000. SYNOPSIS OF LECTURES. 51 But composition varies in females of different temperament—spec- ify (L'Heritier)—Do. from long remaining in the breast. Chang- es produced by diet; poor diet may reduce the solids to 86 in 1000 (Simon); the sugar and caseine being hardly changed at all, while the butter is very much reduced. Composition also varies with the time subsequent to delivery ; being least Case- ine and most Sugar at first; while the butter constantly varies. Last is also diminished by any cause producing active Aeration, why ? Milk returns to its colostral character at the end of about a year—Inference. 1. The oily portion of the Milk (cream) containing the Butter, consists principally of Elaine and Stearine (p. 10, 3d), and al- so contains Butyrine (its formula) which yields butyric, ca- proic and capric acids. 2. The Caseine of woman's milk is less easily coagulated than that of the cow's, and is less in quantity. Even mineral acids and the acetic, often fail to precipitate it, but rennet al- ways slowly effects this. Properties of Caseine, &c. (p. 8.) 3. The Sugar of Milk (p. 10) is nearly identical, chemically, with starch, and like it, converted into true sugar by Sulphu- ric acid. Its formula. Is converted by any ferment (p. 9) into Lactic acid; e. g. by rennet, or the Caseine itself, if de- composing. This acid then precipitates the caseine, how ? Much less sugar in cow's milk than in woman's. Hardly a trace of sugar in that of the Carnivora, why ? 4. The Salts of human Milk are nearly identical with those of the blood; being more phosphates—1st, (Insoluble) Phosphate of Lime, and Magnesia, Carbonate of Lime, and a very little Phosphate of Iron, &c.—2d, (Soluble) Chloride of Sodium and Potassium, Chloride of Calcium, Carbonate of Soda, Sul- phate of Potassa, &c. (Simon.) Physiological relations, &c. Is sole nutriment of infant during first months after birth. Its perfect adaptation to this end; most of all secretions, resembles blood in composition—and con- tains the nutritive and calorific elements in the required propor- tion (p. 17, top). Explain the uses of its various constituents to the infant. How make for the infant, a substitute for woman's milk, from that of the cow ? How vary this for adults; why ? This secretion modified in quantity, and quality even, by mental emotions; how explained ? The " draught." Pathological relations of this fluid. Effects on the female, of non-secretion of milk, after delivery. Do. of retention in the breast, and partial re-absorption. Do. of ex- cessive lactation ; their Protean character. Do. on the infant, of prolonged lactation. How long (average) should lactation continue ? Milk is sometime? secreted by the male (Prof. Dunglinson). Chan- 7 52 SYNOPSIS OF LECTURES. ges induced in the Milk by diseases, by mental emotions, &c., &c.; see Simon's Chemistry of Man, p. 337, &c. Certain medicinal substances are eliminated in the milk, especially saline compounds; also oxyd of zinc, tris-nitrate of bismuth, &c. But vegetable cathartics, do not enter it; as castor-oil, senna, colocynth, &c. Therapeutical inferences. But certain remedies have been detected in the Urine of the in- fant, which cannot be in the mother's milk—e. g. mercurial med- icines, Iodide of Potassium, &c. But Herberger detected the latter in milk also. For the characters of the Lochial secretion, see the best modern works on Obstetric Medicine. VII. FUNCTION OF REPRODUCTION. GENERAL REMARKS. The preceding Functions secure the development, &c, of the in- dividual; this, the perpetuity of the species. Are various modes of effecting this in the animal series. 1st, The Gt?nmiparous—explain and illustrate. 2d, The Fissiliparous— " " Neither of these requires the distinction of sex, nor distinct Reproductive organs. 3d, The Sexual mode—explain. Three varieties: A. Hermaphrodism (explain); and seZ/"-impregnation; illus- trate. B. Do. — still 2 individuals are required, and effect a mutual impregnation. C. Sexes in distinct individuals, and two of opposite sexes necessary for impregnation. This mode requires a germ-producing organ, the Ovarium in the female; and in the male, the Testis, secreting the germ- vivifying fluid (the Semen). All animals of distinct sexes are Oviparous, or Viviparous. Explain. The Oviparous may expel the Ova, (1.) before they come into con- tact with the male fluid (e. g. fishes and some reptiles); or (2.) soon after (e. g. birds). In both cases merely an Oviduct (ex- plain) is superadded to the Ovary in the female. In the 1st case, the male organs are merely the Testes with their excretory ducts extending merely to the surface of the body; in the 2d the latter must be extensible beyond the surface—for in (1) actual copulation does not occur; in (2) it is indispensable to repro- duction. r In Viviparous animals the excretory canal in the male must also be extended for the same reason. Here the phenomena of the Reproductive process always occur in the following order • SYNOPSIS OF LECTURES. 53 1st, Development of ova by the Ovary of the Female. 2d, Their vivification by the male fluid during Copulation (Co- 3d, Subsequent development internally, of the vivified ovum, or Embryo, (Gestation). 4th, Final expulsion of the developed embryo, or Foetus, (Par- turition). These successive stages require in the female 1st, The Ovaries— 2d, (Fallopian tubes) passages from them into 3d, A Uterus, in which the embryo becomes fully developed. 4th, A canal thence to the exterior—the Vagina. These remarks apply to all the Mammalia. REPRODUCTION IN THE HUMAN SPECIES. Structure of the Reproductive organs of the male (see also p. 48). Do. do. of the Female. Functions of each organ. I. The part performed by the Male towards Reproduction consists merely (1) in producing the Semen, and (2) so excreting it dur- ing coitus as to effect its contact with one or more mature ova. This last is a dynamic action (see Reflex Motion) ; usually ac- companied by vivid sensory impressions also; but not necessari- ly even by consciousness. Coitus always, with the male, a voluntary act. The term " impregnation " is applied properly to the female; and Fecundation or Vivification to the ovum— explain. The Spermatozoa are the fecundating portion of the Semen (p. 48). Their number in a drop of this fluid. How and where do the Spermatozoa come into contact with the ova ? How long a time necessary for this after their excretion ? II. The Female has the following parts to perform: A. The development of Ova. B. Conception—define—as a result of coitus. C. Intra-uterine development of the Embryo (Gestation). D. Final expulsion of foetus; (Parturition, or Delivery). Each of these will be separately considered. A. Development of Ova. Occurs with the Catamenial discharge, at Puberty (p. 50). The structure of the ovum, according to Wagner, Dr. Barry, Bischoff, and others. Its size, contained fluid, &c. Are ova matured and discharged with each catame- nial discharge ? " Corpora lutea," define—Distinction of true and false. B. Conception—a mere passive result of coitus, so far as the fe- male is concerned (explain). Does not necessarily imply a consciousness of the latter even; which is therefore not necessa- rily voluntary in the female. Proofs. What are the circum- stances essential to conception ? Hence impossible to distinguish, at once, a fecundating from a non-fecundating coitus. Early signs of Conception (Pregnancy). At what time during the Cat- \ SYNOPSIS OF LECTURES. amenial cycle is conception most frequent ? Researches of Dr. Ritchie, Raciborski, &c Changes occurring in the ovum immediately after fecundation. How long in traversing the Fallopian tubes ? and what force produces this result? Changes meantime occurring in the Ute- rus to prepare it for the reception of the Embryo. Extra-ute- rine foctation ; Super-foetation—define. C. Gestation—its duration (p. 49). Causes extending its ordinary duration (Earl Spencer)—Its shortest duration compatible with life of the foetus. Usual period of " quickening " (define). Why may not conception occur during gestation ? What is abortion ? Miscarriage, «fec. ? Structure and functions of the foetal membranes—the Liquor Am- nii (p. 45, C). Structure of the Placenta—its peculiar connec- tion with the Uterus—its Functions. Can the mental states of the mother directly affect the foetus ? Explanation of cases seeming to prove this to be the fact ? For the whole subject of Development of the Embryo and the Foe- tus in Utero, see p. 11. (Baer, Lee, &c.) Monsters (define) how accounted for. Geoffroy St. Hilaire's the- ory of arrest of development. Illustrate at length. D. Parturition—a dynamic function (see Reflex motion). Its av- erage duration. Ratio of male and female births; how account- ed for ? For the Mechanism, and the practical bearings of this function, consult the standard works on Obstetric Medicine. After Reproduction is completed, the female still provides nourish- ment for the infant—Lactation. For the properties of Milk and other topics under this head, consult p. 50, &c. Recapitulation of all the Organic Functions, showing their corre- lations and mutual dependence; and their relations to the Ani- mal Functions next to Be'-diScupsed. END OF FIRST PART,