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

by Xavier Bichat

I have then injected into the jugular veins of many dogs bile taken from the gall-bladder of other dogs which I opened at the same time. For the first few days they appeared to be weary, did not eat, were much altered, their eyes were heavy, and they were constantly lying down; but after some time they gradually regained their former vigour. I afterwards employed human bile in these experiments; the result was the same, except that many times, the animal had hiccough and vomiting some time after the injection. In one instance a dog died in three hours after the experiment; but it was because I made use of that extremely black fluid that is sometimes found in the gall-bladder instead of bile which resembles thick ink, and which appears to form a considerable part of those black vomitings that sometimes take place.

These experiments induced me to try some with the saliva, and I obtained the same result from them; only the languid state that succeeded the injection was less evident. I afterwards made use of nasal mucus suspended in a sufficient quantity of water, for it can hardly be dissolved in it. Finally urine itself was many times injected, not that which comes immediately from drink and is only aqueous, but that which is of slow formation. In this experiment the dogs have been sicker, but only one died, and that happened on the seventh day. I have many times repeated it, on account of that which I performed three years ago; the same result has always taken place, which makes me think that being but little used at that time to make experiments, I introduced by accident a bubble of air through the syringe, which is sufficient to produce the death of the animal.

A question then is evidently settled by the experiment. The secreted fluids, though destined to be thrown out in the natural state, can re-enter the circulation, without causing the death of the animal, which is only more or less affected according to the nature of the fluid injected. Whether the bile circulates or not with the blood in bilious fevers, I have not examined; but it certainly can circulate with it after having been absorbed in its canals. I do not doubt but that in purulent reabsorptions, the pus circulates in its natural state in the sanguineous system; I confess that I have not made experiments upon the injection of this fluid, but I intend to immediately.

We exaggerate every thing. No doubt the solids in which the vital forces are especially inherent, are particularly affected in diseases; but why should not the fluids be affected also? Why should we not seek in them causes of disease as well as in the solids?

There are cases in which these are primarily affected, and in which the fluids are so in consequence; thus in cancer, in the affections of the liver, the spleen, &c. in most organic lesions, the various yellowish, grey, brown and even greenish shades of the face, are an index of the consecutive alterations which the fluids experience in their colour and consequently in their nature.

In other cases the affection commences with them; as when the venom of the viper is introduced into the blood, as when reabsorption of pus takes place from external abscesses, or in phthisis, and as when there is absorption of various contagious principles. There is no doubt that the different substances which can be introduced with the chyle into the blood, may be the cause of various diseases. Is it not the blood which carries to the brain the narcotic principles which produce sleep? does it not carry turpentine and cantharides to the kidneys, mercury to the salivary glands, &c.? Inject opium, wine, &c. into the veins, and you will stupify the animal the same as if you had given them by the stomach.

Physiologists at one time were much engaged with the introduction of medicinal infusions into the veins of living animals. They circulated by these infusions purgatives, emetics and a thousand other foreign substances, the contact of which the blood bore, without occasioning any other accident to the animal than that of vomiting or alvine evacuations if they were emetics or purgatives, and a greater or less general derangement if they were other foreign substances which had no affinity with any particular organ.

The caustics, as the nitric and sulphuric acids and other very irritating substances, have alone caused death in these curious experiments of which Haller has given us a sketch, and which prove that various substances wholly foreign to the blood can circulate in it, and that it is a common mass in which are found many principles differing from each other, and which cannot be always essentially the same. In these experiments the most important part has been neglected, that of the infusion of the different animal fluids, particularly the secreted ones, and those also which are preternaturally produced in diseases. I think that the different reabsorptions would be much elucidated by the infusion of the various kinds of pus, sanies, &c. But we have already sufficient facts to convince us that the fluids and especially the blood can be diseased; that the various foreign substances mixed with it can act in a fatal manner upon the solids. In fact, every acrid, irritating matter, without being mortal, accelerates the action of the heart and produces a true fever, if injected into the veins. In all these cases, it is always necessary that the solids should act; for all the morbid phenomena suppose their alterations; but the principle of these alterations is in the fluids. They are the excitants, and the solids the organs excited. Now if there are no excitants, there is no excitement, and the solids remain unaffected.

Finally there are cases in which the whole economy both solids and fluids seem to be simultaneously affected; such are adynamic fevers, in which at the same time that there is a general prostration of the first, the second appear to be really decomposed.

Let us not exaggerate then medical theories; let us regard nature in diseases as she is in a state of health, in which the solids elaborate the fluids and are at the same time excited by them. There is a reciprocal action, every thing succeeds each other, every thing is connected together. Our abstractions hardly ever exist in nature. We usually adopt a certain number of general principles in medicine, and we accustom ourselves afterwards to deduce from these principles, as necessary consequences, all the explanations of diseases. There is in physical phenomena a regularity and uniformity which never deceive. In morals even, there is a certain number of principles acknowledged by all men, which direct them and regulate their actions; hence a constant uniformity in our manner of considering moral and physical phenomena; hence the habit of going always from the same principles in reasoning upon them. We have carried this habit into the study of the living economy, without considering that it incessantly varies its phenomena, that under the same circumstances they are hardly ever the same, that they are continually increased and diminished and have a thousand different modifications. Nature seems at every instant to be irregular, capricious and inconsequent in their production, because the essence of the laws which preside over these phenomena, is not the same as that of the physical laws.