General Anatomy, Applied to Physiology and Medicine, Vol. 1 (of 3)

by Xavier Bichat

Contractility of texture always takes place in the cellular system when extension ceases. Thus in emaciation, in the resolution of dropsy and of tumours, the cells contract and lose a great part of the capacity they had acquired; in a wound which has affected the cellular texture as well as the skin, the edges separate, and a space remains between them owing to the contraction of the cells.

As we advance in life, this contractility takes place with less ease; youth is the period of its greatest energy; thus in consequence of great emaciation that takes place in old men, the skin is flaccid and wrinkled, because the subjacent cellular texture not having contracted, the cutaneous covering remains at some distance from the external organs and cannot lie close to them. In a young man, on the contrary, who has become emaciated, the skin is exactly applied to the organs, it preserves its tension; because the cells in contracting draw it with them; these form the external prominences. It is necessary to observe these prominences; in the face, with the folds of the skin, they form what are called prominent features.

II. Vital Properties.

The animal properties are not among the attributes of the cellular texture in an ordinary state; we can with impunity cut it, draw it in different directions or distend it with gas. An animal that undergoes these experiments gives no indication of suffering. If he feels any pain, it is from the nervous filaments that pass through the texture, and which may be accidentally irritated. In disease however, the sensibility is raised to such a point, that it may become the seat of acute pain; phlegmon is a proof of this.

The organic properties are very distinct in the cellular texture; fat and serum could not be absorbed there, if they did not make an impression that brings into action organic sensibility. I would observe concerning this property considered in the cellular system, that all substances have not an equal relation to it; among the animal fluids the blood, the lymph and milk do not raise it so high, when they are effused or injected there, as to prevent absorption, which takes place of them as well as of fat and serum. On the other hand this sensibility is so altered by the contact of urine, bile, saliva or other fluids destined to be thrown out, that inflammation is often the consequence, and prevents absorption. Among the foreign fluids injected water is absorbed. Wine and almost all other irritating fluids excite suppuration, and are thrown out with the pus that arises from them. We know that in the operation for hydrocele, abscesses in the scrotum are always the consequence of an accidental passage of the injection into the cellular texture. Experiments upon living animals agree perfectly with this fact; every other irritating fluid, diluted acids, alkaline solutions, &c. produce the same phenomenon.

Insensible organic contractility is clearly proved in the cellular texture, by the exhalation and absorption that take place there.

It has to a certain extent sensible organic contractility. We know that cold alone is sufficient to contract the scrotum in a remarkable manner; that as it is irritated or not, this part has various degrees of contraction and relaxation; now it appears to contain under the skin only cellular texture; the filaments of which, it is true, have a particular appearance and seem to differ in their nature from the filaments of the other portions of this system. This contraction to be sure is not to be compared to that of the muscles, but it is certainly the first degree of it; it is of the same nature, or rather it is a medium between this and those oscillations that cannot be described, which we designate under the name of insensible organic contractility, and others call tone.

Sympathies.

The relations of the cellular with the other systems are very numerous and multiplied; but oftentimes it is not easy to perceive them clearly. In fact, as it is disseminated in all the organs and contributes to the structure of all, it is frequently difficult to distinguish what belongs to it, from that which is an attribute of the parts where it is found. These relations however, become evident under various circumstances; in acute as well as chronic diseases, it is very susceptible of the influence of the affections of the organs. I do not here mean the alterations arising from juxta-position and continuity, alterations so common as we have seen, but those produced in parts of the cellular texture that have not any known relation to the affected organ.

In acute diseases which have their seat in a particular organ, as in the lungs, the stomach, the intestines, &c. the cellular texture is often sympathetically affected; it becomes inflamed, suppurates, &c. Most critical deposits arise from this real though unknown connexion between the affected organ and the cellular texture. Oftentimes it is the natural exhalation or absorption of this texture that is deranged in acute affections; hence the swelling, and dropsies that sometimes suddenly arise. I attended a man in the ward Saint Charles who, in consequence of great terror, had a sudden contraction of the epigastric region; a tinge of the jaundice, an indication of the affection of the liver by the emotion of the mind, spread in a few hours after over his face. In the evening he had great œdema of the lower limbs, an œdema produced, without doubt, sympathetically by the influence of the liver upon the cellular texture. This influence of the principal organs upon this system becomes especially remarkable in chronic affections, in the alterations of texture they experience. We know that most of the gradual diseases of the heart, the lungs, the spleen, the stomach, the liver, the womb, &c. have among their symptoms, in the latter stages, a dropsy more or less general, which arises from the debility created in the cellular texture. Medicine owes much to Corvisart, for being among the first to perceive that almost all infiltrations are symptomatic, that almost all consequently depend upon an influence produced by the affected organ upon the cellular texture. That comes on gradually then, which took place suddenly in the patient I mentioned just now.