[90] The state of the spleen in the dead body may become in some measure an index of the state of the circulation during the last moments of life. The swelling of it shows almost always the embarrassment of the circulation; and not only in an insulated system, such as that of the vena portæ, as Bichat considers it, but in the whole pulmonary system.
When any cause impedes the circulation in the capillaries of the lungs, it necessarily produces a stagnation of the blood in the divisions of the pulmonary artery, and by degrees the disturbance is felt even in the two venæ cavæ, but especially in the inferior in which the blood rises against its gravity. The blood accumulates in the principal branches; the veins of the liver and kidneys swell more or less; as to these organs themselves, the firmness of their texture hardly allows them to be distended, so they do not increase sensibly in size, or if this increase takes place, it is slow. It is not the same with the spleen; the looseness of its texture will admit a great quantity of liquid, and its size can thus be doubled or trebled in a very short time. It becomes then a kind of reservoir, in which is accumulated the blood which cannot pass through the lungs.
It may be objected to what we have just said, that oftentimes in phthisis the greatest portion of the lungs has become incapable of allowing the blood to pass, and that yet after death, the spleen is found in a natural state. But it should be recollected, that phthisical patients have, during the latter part of their lives, but very little blood, so that each portion sent by the right ventricle always finds a sufficient channel for it in the lungs.
[CHAPTER VII.]
OF THE INFLUENCE OF THE DEATH OF THE LUNGS OVER THAT OF THE BRAIN.
We have just seen, that in asphyxia, the movements of the heart are paralyzed, because its fleshy fibres are penetrated with venous blood. This fact should indicate the same to be the case with reference to the action of the brain. It is indubitably proved by experiment.
Whatever be the manner in which the pulmonary functions are interrupted, it is always the interruption of the chemical changes, which troubles the functions of the brain.[91] What I have said upon this point with respect to the heart, is exactly applicable to the cerebral mass: I shall not repeat it. It remains to shew by experiment, and the observation of diseases, that when the chemical functions of the lungs are put a stop to, it is the black blood which interrupts the action of the brain and that of the nervous system. In the first place let us examine our experiments.
I first began by transfusing into the brain of an animal, the arterial blood of another, that this essay might serve as a point of comparison for others. Open one of the carotids of a dog; tie the extremity towards the brain, and fasten a tube to that which is next the heart; then open the carotid of another dog, tie the extremity of the vessel next the heart, and fix the other end of the tube into that which is next the brain; then let the assistant, who meanwhile should have had his fingers upon the artery of the first dog underneath the tube, remove his compression, and the carotid of the second dog will be seen beating under the impulse of the blood injected from the heart of the first. This operation fatigues but little the animal which receives the blood, particularly if one of the veins be previously opened, to prevent too great a fulness of the vessels. It will live very well afterwards. This experiment has been often repeated, and always with the same results.
After this experiment, I opened the carotid, and the jugular vein of another dog, and after tying the extremity of the carotid next the heart, received the blood of the jugular into a warm syringe, and injected it into the brain. The creature appeared immediately to be agitated, breathed quickly, and seemed to be in a state of suffocation, similar to that of asphyxia. Its animal life became entirely extinct; the heart, however, continued to beat, and the circulation to go on for half an hour afterwards; at the end of which time the organic life was terminated also.
This dog was of a middle size, and about six ounces of blood were injected with a gentle impulse, for fear of that being attributed to the shock, which ought to have been the result of the nature and composition of the fluid. I repeated this experiment upon three dogs the same day, and afterwards at different times upon others; the result was invariable, not only as to the asphyxia of the animal, but even as to the concomitant appearances.
It might be thought that out of its vessels, and exposed to the contact of the air, the blood might imbibe a pernicious principle, or be deprived of that which is requisite for the maintenance of life. It might be imagined, that to this cause was owing the sudden death of the dog, on the injection of the brain with venous blood. To shew that this was not the case, I made a small opening in the jugular of a dog, to which I adapted a moderately warm syringe, and pumped the blood immediately from the vein.—It was afterwards thrown into the carotid: the symptoms were the same as the preceding, but less marked, and the death of the creature induced more slowly.—It is probable, then, that the air when in contact with the living blood without its vessels may alter it a little, but the essential cause of death is still the same.