A Collection of Chirurgical Tracts

by William Beckett

I. A Consumption, in general, is a wasting of all the solid parts of the Body, for want of a due Distribution, or Assimilation of the Nutritious Juices.

By some learned Men this is observed to be the Endemical Distemper of England; and indeed our Weekly-Bills at once declare both the Strength of the Disease, and the Weakness of the Medicines wherewith it’s Cure hath been hitherto attempted. Besides, that which seems to justify this Observation, is the pernicious Custom of the Inhabitants of this island, who immoderately and unseasonably indulge their Appetites with several sorts of Meats and Drinks, whereby the Tone of the Stomach is so vitiated, as that it cannot perfectly ferment and volatilize the Chyle, which is commonly the internal procatartic Cause of most Distempers among us, and consequently of Consumptions from those Distempers, from whence comes a Colliquation of the Chyle in Lienteries and Dysenteries, tormenting Cholic and Iliac Pains, hypocondriac Melancholly, hysteric Fits, scorbutic Twitches, troublesome Catarrhs, sluggish Passage of the Chyle thro’ the milky Veins, scrophulous Tumours and Inflammations of the mesenteric Glands, spasmodic Contractions or Convulsions of the Nerves, preternatural Fermentation of the Blood and Spirits, Cachexies, Atrophies, Obstructions, Fevers hectical, inflammatory and putrid, Exulcerations of the Lungs and Marasmus, with many other Diseases, whence come they originally and for the most part, but from the Weakness, ill Habit and Indisposition of the Stomach?

Now the proper Action of the Stomach is Chylification; for tho’ the Meat we take into our Mouths receives some Alteration there in Mastication, by the fermenting Juice that flows from the salivatory Glands, together with the acrimonious Particles, and fermentaceous Spirits of Liquors which we drink, yet it is not turned into a thick white Juice, ’till it hath passed down thro’ the Oesophagus, or Gullet, into the Stomach, where by the help of it’s Fibres it is closely embraced, and mixed with specific fermentaceous Juices, separated by it’s inner Coat, and impregnated by the Saliva, then by a convenient Heat there is made a mixture of all; for that the fermentaceous Particles entering into the Pores of the Meat, do pass thro’ agitate and eliquate it’s Particles, dissolving the whole Compages, in which the purer parts were intimately united with the Crass, and making them more fluid, so that they make another form of Mixture, and unite among themselves into the resemblance of a milky Cream, after which together with the thicker Mass with which they are yet involved, by the Constriction of the Stomach they pass down to the Guts, where by the Mixture of the Bile and Pancreatic Juice they are by another manner of Fermentation quite separated from the thicker Mass, and so are received by the Lacteal Vessels, as the thicker is ejected by Stool.

After the purer part of the Chyle hath been thus strained thro’ the narrow and oblique Pores of the milky Veins, by the continual and peristaltic Motion of the Intestines, it is yet farther attenuated and diluted with a very thin and clear Lympha from the Glands of the Mesentery to expedite its passage thro’ those numerous Meanders into the common Receptacle, from whence by the constant Supply of such like Lympha from the small Glands of the Thorax, it is safely conveyed thro’ the Ductus Chyliferus Thoracius, subclavian Vein, and the Vena Cava into the Heart.

The Chyle now mingled with the Blood, passeth with it thro’ the Arteries of the whole Body, and returns again with the Blood by the Veins to the Heart, undergoing many Circulations before it can be assimilated to the Blood; for every time the new infused Chyle passeth thro’ the Heart with the Blood, the Particles of the one are more intimately mixed with those of the other, in it’s Ventricles, and the Vital Spirit, and other active Principles of the Blood work upon the Chyle, which being full of Salt, Sulphur and Spirit, as soon as it’s Compages is loosned by it’s Fermentation with the Blood, the Principles having obtained the Liberty of Motion, do readily associate themselves, and are assimilated with such parts of the Blood as are of a like and suitable Nature.

After the Chyle hath been thus elaborated, it becomes fit as well to recruit the Mass of Blood, as to nourish the whole Body, seeing it consists of divers Principles and Parts of a different Nature; therefore, according to the various Use and Necessity of every part, and also that it may conform and fashion it self to the different Pores and Passages, it is severally appropriated; the most volatile and subtil part is separated in the Brain, and adapted to refresh the Animal Spirits, the glutinous to nourish the Body, and the sulphureous to revive the native Heat: And in it’s Passage with the Blood thro’ all the parts of the Body, all the Mass of Chyle that is capable of being turned into Blood is sanguified; the serous and saline part precipitated by the Kidneys, and evacuated by Sweats or insensible Transpirations, the bilious is deposited in the Liver, and the rest of its Excrements retire to the several Emunctories of the Body.

Thus it comes to pass by the wonderful Sagacity of Nature, such extraordinary Provision is made, that the purer part of the Chyle by these ways and means is more purified; and when it is thus purified and sublimed, it is more capable of reinforcing the Blood and Spirits, as also of corroborating the Tone of every particular Part: Whereas when the Chyle is sour and dispirited, the Blood necessarily becomes vappid, the animal Spirits which reside in the System of the Nerves are infected with a Morbid Disposition, and all parts of the Body begin to flag and waste. For indeed there is no other way to recruit the daily Expence of Blood and Spirits, but by a continual Influx of laudable Chyle into the Blood-Vessels, which Chyle is made by the Fermentative Juice of the Stomach, and this Fermentative Juice supplied from the Mass of Blood, so that there plainly appears to be a fixed Correspondence betwixt the Blood and the Chyle, and a necessary Dependance all the Humours in the Habit of the Body have on the Stomach; from whence it is reasonable to infer, That if the Chilifying Faculty of the Stomach be depraved, the Blood and Humours must necessarily sympathize therewith, and in a manner proportionable to the Distemper of this part.

II. The immediate Cause of a Consumption of the Lungs is store of sharp, malignant, waterish Humours, continually distilling upon the soft spungy Substance of the Lungs, stuffing, inflaming, impostumating, and exulcerating them, whereby their Action, which is Respiration, or a receiving-in and driving-out Air is depraved, as will more clearly appear by the following Description of these Parts. It will not be impertinent to our Discourse if we should usher in the Description of the Lungs, with a short Account of the Trachea, Aspera Arteria, or Wind-pipe.

III. The Trachea or Aspera Arteria is a long Pipe, consisting of Cartilages and Membranes, which beginning at the Throat or lower part of the Jaws, and lying upon the Gullet, descends into the Lungs, thro’ which it spreads into many Branchings, and is commonly divided into two parts, the Larynx and Bronchus; the Larynx is the upper part of the Wind-pipe, the Bronchus is all the Trachea besides the Larynx, as well before as after it arrives at the Lungs.

The Substance of the Lungs is soft, spongy and rare, curiously compacted of most thin and fine Membranes, continued with the Ramifications of the Trachea or Wind-pipe, which Membranes compose an infinite number of little, round and hollow Vesicles, or Bladders, so placed as that there is an open Passage from the Branches of the Aspera Arteria, out of one into another, and all terminate at the outer Membrane that investeth the whole Lungs: These little Bladders by help of their muscular Fibres contract themselves in Expiration, and are dilated in Inspiration, partly by the Pressure of the Atmosphere, and partly by the elastic Power of the Air, insinuating it self into these Vesicles thro’ the Windpipe and it’s several Branches: Their Lobes are two, the right and left, parted by the Mediastinum, each of which is divided into many lesser Lobules, according to the Ramifications of the Aspera Arteria; they have all sorts of Vessels that are common to them with other parts, as Arteries, Veins, Nerves, Lympheducts, but peculiar to themselves they have their Bronchia, or the Branches of the Wind-pipe, for bringing-in and carrying-out Air so necessary to Life, that we cannot Live without it: And when we consider their admirable Structure, (as well as the Structure of every individual part of our Body) how ought we to adore the infinite Wisdom of our Creator! Now when these small Vesicles or Bladders are replete with extravasated Serum, or purulent Matter, the natural Tone of the Lungs is so weakned, that we cannot enjoy the Benefit of free and full Respiration, hard, scirrhous Tumours and Tubercles are bred, attended with a dry and troublesome Cough, Oppression of the Breast, difficult and short Breathing, preternatural Heats, Exulcerations, and other deplorable Symptoms, according to the Degrees of Obstruction, and different Nature of the included Humours.