Life and death

by A. Dastre

Secondary Organization in Organs.—That is why, as we said above, the secondary organizations of the economy exist:—the digestive apparatus which prepares the food and enables it to pass into the blood, into the lymph, and finally into the liquid medium which bathes each cell and constitutes its real medium; the respiratory apparatus which imports the oxygen and exports the gaseous excrement, carbonic acid; the heart and the circulatory system which distributes through the system the internal medium, suitably purified and recuperated. The organization is dominated by the necessities of cellular life. This is the law of the city, to which Claude Bernard has given the name of the law of the constitution of organisms.

Death by Lesion of the Major Organs. Vital Tripod.—Thus we understand what life is, and at the same time what is the death of a complex living being. The city perishes if its more or less complicated mechanisms which look after its revictualling and its discharge are seriously affected at any point. The different groups may survive for a more or less lengthy period, but progressively deprived of the means of food or of discharge, they are finally involved in the general ruin. If the heart stops, there is a universal famine; if the lungs are seriously injured, we are asphyxiated; if the principal organ of discharge, the kidney, ceases to perform its allotted task, there is a general poisoning by the used-up and toxic materials retained in the blood.

We understand how the integrity of the major organs,—the heart, the lungs, the kidney,—is indispensable to the maintenance of existence. We understand that their lesion, by a series of successive repercussions, involves universal death. We always die, said the doctors of old, because of the failure of one of these three organs, the heart, the lungs, or the brain. Life, they said in their inaccurate language, depends upon these as upon three supports. Hence the idea of the vital tripod. But it is not only this trio of organs which maintain the organism; the kidney and the liver are no less important. In different degrees each part exercises its action on the rest. Life is based in reality on the immense multitude of living cells associated for the formation of the body; on the thirty trillion anatomical elements, each part is more or less necessary to all the rest, according as the bond of solidarity is drawn more or less closely in the organism under consideration.

Death and the Brain.—There are indeed more noble elements charged with higher functions than the rest. These are the nervous elements. Those of the brain preside over the higher functions of animality, sensibility, voluntary movement, and the exercise of the intellect. The rest of the nervous system forms an instrument of centralization which establishes the relations of the parts one with the other and secures their solidarity. When the brain is stricken and its functions cease, man has lost the consciousness of his existence. Life seems to have disappeared. We say of a man in this plight that he no longer lives, thus confusing general life with the cerebral life which is its highest manifestation. But the man or the animal without a brain lives what may be called a vegetative life. The human anencephalic foetus lives for some time, just as the foetus which is properly formed. Observation always shows that this existence of the other parts of the body cannot be sustained indefinitely in the absence of that of the brain. By a series of impulses due to the solidarity of the grouping of the parts, the injury received by the brain affects by repercussion the other organs, and leads in the long run to the arrest of elementary life in all the anatomical elements. The death of the whole is then complete.

Doctors have therefore a two-fold reason for saying that the brain may cause death. The death of the brain suppresses the highest manifestation of life, and, in the second place, by a more or less remote counter stroke, it suppresses life in all the rest of the system.

Death is a Process.—Besides, the fact is general. The death of one part always involves the death of the rest—i.e., universal death. A living organism cannot be at the same time alive and a cemetery. The corpses cannot exist side by side with the living elements. The dead contaminates the living, or in some other way involves it in its ruin. Death is propagated; it is a progressive phenomenon which begins at one point and gradually is extended to the whole. It has a beginning and a duration. In other words, the death of a complex organism is a process. And further, the end of a simple organism, of a protozoan, of a cell, is itself a process infinitely more shortened.

The very perfection of the organism is therefore the cause of its fragility. It is the degree of solidarity of the parts one with another which involves the one set in the catastrophe of the rest, just as in a delicate piece of mechanism the derangement of a wheel brings nearer and nearer the total breakdown. The important parts, the lungs, the heart, the brain, suffer no serious alteration without the reflex being felt throughout. But there are also wheels less evident, the integrity of which is scarcely less necessary.

The Solidarity of the Anatomical Elements.—The cause of the mortal process—i.e., of the extension and the propagation of an initial destruction—is therefore to be found in the solidarity of the parts of the organism. The closer it is the greater do the chances of destruction become, for the accident which has happened to one will by repercussions affect the others.

Now the solidarity of the parts of the organism may be carried out in two ways; there is a humoral solidarity and a nervous solidarity.

Humoral Solidarity.—Humoral solidarity is realized by the mixture of humours. All the liquids of the organism which have lodged in the interstices of the elements and which soak the tissues, are in contact and in relation of exchange one with another, and through the permeable wall of the small vessels they are in relation with the blood and the lymph.