Advice to the people in general, with regard to their health

by S. A. D. Tissot

§ 425. All these Examples, and many others of cruel Deaths, from swallowing noxious Substances, demonstrate the great Necessity of an habitual Caution in this Respect; and give in their Testimony against the horrid, I had almost said, the criminal Imprudence, of People's amusing themselves with such Tricks as may lead to such terrible Accidents; or even holding any such Substance in their Mouths, as by slipping down through Imprudence or Accident, may prove the Occasion of their Death. Is it possible that any one, without shuddering, can hold Pins or Needles in their Mouths, after reflecting on the dreadful Accidents, and cruel Deaths, that have thus been caused by them.

§ 426. It has been shewn already, that Substances obstructing the Passage of the Gullet sometimes suffocate the Patient; that at other Times they can neither be extracted nor thrust down; but that they stop in the Passage, without killing the Patient, at least not immediately and at once. This is the Case when they are so circumstanced, as not to compress the Trachæa, the Wind-pipe, and not totally to prevent the swallowing of Food; which last Circumstance can scarcely happen, except the Obstruction has been formed by angular or pointed Bodies. The Stoppage of such Bodies is sometimes attended, and that without much Violence, with a small Suppuration, which loosens them; and then they are either returned upwards through the Mouth, or descend into the Stomach. But at other Times an extraordinary Inflammation is produced, which kills the Patient. Or if the Contents of the Abscess attending the Inflammation tend outwardly, a Tumour is formed on the external Part of the Neck, which is to be opened, and through whose Orifice the obstructing Body is discharged. In other Instances again they take a different Course, attended with little or no Pain, and are at length discharged by a Gathering behind the Neck, on the Breast, the Shoulder, or various other Parts.

§ 427. Some Persons, astonished at the extraordinary Course and Progression of such Substances, which, from their Size, and especially from their Shape, seem to them incapable of being introduced into, and in some Sort, circulating through the human Body, without destroying it, are very desirous of having the Rout and Progression of such intruding Substances explained to them. To gratify such Inquirers, I may be indulged in a short Digression, which perhaps is the less foreign to my Plan; as in dissipating what seems marvelous, and has been thought supernatural in such Cases, I may demolish that superstitious Prejudice, which has often ascribed Effects of this Sort to Witchcraft; but which admit of an easy Explanation. This very Reason is the Motive that has determined me to give a further Extent to this Chapter.

Wherever an Incision is made through the Skin, a certain Membrane appears, which consists of two Coats or Laminæ, separated from each other by small Cells or Cavities, which all communicate together; and which are furnished, more or less, with Fat. There is not any Fat throughout the human Body, which is not inclosed in, or enveloped with, this Coat, which is called the adipose, fatty, or cellular Membrane.

This Membrane is not only found under the Skin, but further plying and insinuating itself in various Manners, it is extended throughout the whole Body. It distinguishes and separates all the Muscles; it constitutes a Part of the Stomach, of the Guts, of the Bladder, and of all the Viscera or Bowels. It is this which forms what is called the Cawl, and which also furnishes a Sheath or Envelopement to the Veins, Arteries, and Nerves. In some Parts it is very thick, and is abundantly replenished with Fat; in others it is very thin and unprovided with any; but wherever it extends, it is wholly insensible, or void of all Sensation, all Feeling.

It may be compared to a quilted Coverlet, the Cotton, or other Stuffing of which, is unequally distributed; greatly abounding in some Places, with none at all in others, so that in these the Stuff above and below touch each other. Within this Membrane, or Coverlet, as it were, such extraneous or foreign Substances are moved about; and as there is a general Communication throughout the whole Extent of the Membrane, it is no ways surprizing, that they are moved from one Part to another very distant, in a long Course and Duration of Movement. Officers and Soldiers very often experience, that Bullets which do not pass through the Parts where they have entered, are transferred to very different and remote ones.

The general Communication throughout this Membrane is daily demonstrated by Facts, which the Law prohibits; this is the Butchers inflating, or blowing up, the cellular Membrane throughout the whole Carcase of a Calf, by a small Incision in the Skin, into which they introduce a Pipe or the Nozzle of a small Bellows; and then, blowing forcibly, the Air evidently puffs up the whole Body of the Calf into this artificial Tumour or Swelling.

Some very criminal Impostors have availed themselves of this wicked Contrivance, thus to bloat up Children into a Kind of Monsters, which they afterwards expose to View for Money.

In this cellular Membrane the extravasated Waters of hydropic Patients are commonly diffused; and here they give Way to that Motion, to which their own Weight disposes them. But here I may be asked—As this Membrane is crossed and intersected in different Parts of it, by Nerves, Veins, Arteries, &c. the wounding of which unavoidably occasions grievous Symptoms, how comes it, that such do not ensue upon the Intrusion of such noxious Substances? To this I answer, 1, that such Symptoms do sometimes really ensue; and 2, that nevertheless they must happen but seldom, by Reason that all the aforesaid Parts, which traverse and intersect this Membrane, being harder than the Fat it contains; such foreign Substances must almost necessarily, whenever they rencounter those Parts, be turned aside towards the Fat which surrounds them, whose Resistance is very considerably less; and this the more certainly so, as these Nerves, &c. are always of a cylindrical Form.——But to return from this necessary Digression.

§ 428. To all these Methods and Expedients I have already recommended on the important Subject of this Chapter, I shall further add some general Directions.