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                           GENERAL ANATOMY,

                              APPLIED TO

                       PHYSIOLOGY AND MEDICINE;

                           BY XAVIER BICHAT,

       PHYSICIAN OF THE GREAT HOSPITAL OF HUMANITY AT PARIS, AND
                 PROFESSOR OF ANATOMY AND PHYSIOLOGY.

                      Translated from the French.

                        BY GEORGE HAYWARD, M.D.

         FELLOW OF THE AMERICAN ACADEMY OF ARTS AND SCIENCES,
               AND OF THE MASSACHUSETTS MEDICAL SOCIETY.

                       _IN THREE VOLUMES._

                             VOLUME III.

                            _BOSTON_:
                   PUBLISHED BY RICHARDSON AND LORD.

                       J. H. A. FROST, PRINTER.
                                 1822.




DISTRICT OF MASSACHUSETTS, _to wit_:

  DISTRICT CLERK'S OFFICE.

BE IT REMEMBERED, that on the seventeenth day of April, A.D. 1822,
in the forty-sixth year of the Independence of the United States of
America, _Richardson & Lord_, of the said District, have deposited
in this office the title of a book, the right whereof they claim as
proprietors, in the words following, _to wit_:

"General Anatomy, applied to Physiology and Medicine; by Xavier Bichat,
Physician of the Great Hospital of Humanity at Paris, and Professor of
Anatomy and Physiology. Translated from the French, by George Hayward,
M. D. Fellow of the American Academy of Arts and Sciences, and of the
Massachusetts Medical Society. In three Volumes. Volume III."

In conformity to the Act of the Congress of the United States,
entitled, "An Act for the Encouragement of Learning, by securing the
Copies of Maps, Charts and Books, to the Authors and Proprietors of
such Copies, during the times therein mentioned:" and also to an Act
entitled, "An Act supplementary to an Act, entitled, An Act for the
encouragement of Learning, by securing the Copies of Maps, Charts and
Books, to the Authors and Proprietors of such Copies during the times
therein mentioned; and extending the Benefits thereof to the Arts of
Designing, Engraving and Etching Historical and other Prints."

  JOHN W. DAVIS,
  _Clerk of the District of Massachusetts._




MUSCULAR SYSTEM OF ORGANIC LIFE.


This system is not as abundantly spread out in the economy as the
preceding. The whole mass which it forms, compared with the whole of
the other, which is more than one third of the body, presents in this
respect a very remarkable difference. Its position is also different;
it is concentrated, 1st, in the thorax, where the heart and œsophagus
belong to it; 2d, in the abdomen where the stomach and intestines are
in part formed by it; 3d, in the pelvis where it contributes to form
the bladder and even the womb, though this belongs to generation, which
is a function distinct from organic life. This system then occupies
the middle of the trunk, is foreign to the extremities, and is found
far from the action of external bodies, whilst the other superficially
situated, forming almost alone the extremities, seems, as we have said,
almost as much destined in the trunk to protect the other organs, as
to execute the different motions of the animal. The head contains no
part of the organic muscular system; this region of the body is wholly
devoted to the organs of animal life.


ARTICLE FIRST.

OF THE FORMS OF THE MUSCULAR SYSTEM OF ORGANIC LIFE.

All the muscles of the preceding system take in general a straight
direction. These are all on the contrary curved upon themselves; all
represent muscular cavities differently turned, sometimes cylindrical
as in the intestines, sometimes conical as in the heart, sometimes
rounded as in the bladder, and sometimes very irregular as in the
stomach. No one is attached to the bones; all are destitute of
tendinous fibres. The white fibres arising from the internal surface of
the heart, and going to be attached to the valves of its ventricles,
have by no means the nature of the tendons. Ebullition does not easily
reduce them to gelatine; desiccation does not give them the yellowish
appearance of these organs; they resist maceration longer than them.

It is in general a great character that distinguishes the muscular
organic system from that of animal life, that it does not arise from,
nor terminate in fibrous organs. All the fibres of this last are
continuous either with tendons, or aponeuroses or fibrous membranes.
Almost all those of the first go on the contrary from the cellular
texture, and return to it after having run their course. I at first
thought that the dense and compact texture which is between the mucous
membrane and the fleshy fibres of the intestines, the bladder, the
stomach, &c. was an assemblage and net-work of many small tendons
corresponding to these fibres, and interwoven in the form of an
aponeurosis; the density of this layer deceived me at first view.
Ebullition, maceration, and desiccation have since taught me, that this
layer, completely foreign to the fibrous system, should be referred, as
Haller has said, to the cellular, which is only more dense and compact
there than elsewhere. It is this layer, which I have designated, in
the cellular system by the name of the sub-mucous texture. Many fibres
of the system of which we are treating appear to form an entire curve,
which is not crossed by any cellular intersection; some layers of the
heart exhibit this arrangement, which is in general very rare; so that
there is almost always an origin and termination of the fibres, upon an
organ of a nature different from their own.

We can hardly consider in a general manner the forms of the system of
which we are treating; each organ belonging to it is moulded upon the
form of the viscus to the formation of which it contributes. In fact,
the organic muscles do not exist in distinct fasciculi, like those of
animal life; all, except the heart, form but a third, a quarter and
often even less in the structure of a viscus.

The greatest number has a thin, flat and membranous form. There are
layers more or less broad, and hardly ever distinct fasciculi. Placed
at the side of each other, the fibres are rarely one above another;
hence it happens that occupying a very great extent, these muscles form
however a very small volume. The great gluteus alone would be larger
than all the fibres of the stomach, the intestines and the bladder, if
they were united like it into a thick and square muscle.


ARTICLE SECOND.

ORGANIZATION OF THE MUSCULAR SYSTEM OF ORGANIC LIFE.

The organization of the involuntary muscles is not as uniform as that
of the preceding. In these all is exactly similar excepting the
differences of the proportion of the fleshy fibres to the tendinous,
of the length of the first, of the prominence of the fasciculi,
of their assemblage into flat, long or short muscles; in whatever
place we examine them, their varieties are in their forms and not in
their texture. Here on the contrary, there is in this texture marked
differences; the heart compared with the stomach, the intestines with
the bladder are sufficient to convince us of this. It is by virtue of
these different textures, that the contractility and sensibility vary
as we shall see in each muscle, that the force of the contraction is
not the same, and that life is different in each, whilst it is uniform
in all those of animal life. We shall now consider in a general manner
the organization of the involuntary muscles.


I. _Texture peculiar to the Organization of the Muscular System of
Organic Life._

The organic muscular fibre is in general much finer and more delicate
than that of the preceding system; it is not brought into as thick
fasciculi. Very red in the heart, it is whitish in the gastric and
urinary organs. Besides, this colour varies remarkably. I have observed
that sometimes maceration renders it of a deep brown in the intestines.

This fibre never has one single direction, like that of the preceding
muscles; it is interlaced always, or found in juxta-position in
different directions; sometimes it is at a right angle that the
fasciculi are cut, as in the longitudinal and circular fibres of
the gastric tubes; sometimes it is with angles more or less obtuse
or acute, as in the stomach, the bladder, &c. In the heart, this
interlacing is such in the ventricles, that it is a true muscular
net-work. From these varieties of direction, results an advantage in
the motions of these sorts of muscles, which, being all hollow can by
contracting diminish according to many diameters the extent of their
cavity.

Every organic muscular fibre is in general short; those which, like
the longitudinal of the œsophagus, the rectum, &c. appear to run a
long course, are not continuous; they arise and terminate at short
distances, and thus arise and terminate successively in the same
direction or line; no one is comparable to those of the sartorius, the
gracilis, &c. as it respects length.

We know the nature of their fibres no better than that of those of
animal life; but they appear nearly the same under the action of the
different reagents. Desiccation, putrefaction, maceration, ebullition,
exhibit in them the same phenomena. I have observed upon the subject of
this last, that once boiled, the fibres of both systems are much less
alterable by the acids sufficiently weakened. After being some time in
the sulphuric, the muriatic and nitric diluted with water, they soften
a little, but keep their original form, and do not change into that
pulp to which raw fibres are always reduced in the same experiment. The
last of these acids turns them yellow as before ebullition.

I have also made an observation as it respects the horny hardening
which is produced the instant ebullition commences; it is this, that it
is always the same whatever may have been the antecedent dilatation or
contraction of the fibres. The stomach which at death was so dilated
as to contain many pints of fluid, is reduced to the same size, all
other things being equal, as that which is contracted so as to be no
larger than the cœcum. Diseases have a little influence on the horny
hardening. The heart of a phthisical patient exhibited to me in the
same experiment this phenomenon much less evidently, than that of an
apoplectic.

The resistance of the organic muscular fibre is in proportion much
greater than that of the fibres of the animal muscular system.
Whatever may be the distension of the hollow muscles by the fluid which
fills them during life, ruptures hardly ever take place in them.

The bladder alone sometimes exhibits this phenomenon, which is
however very rare in it. In the great retentions of the urine, in
which ruptures take place, it is almost always the urethra that is
ruptured, and the bladder remains whole. We meet in practice with a
hundred fistulas in the perineum, coming from the membranous portion,
to one above the pubis. We find in authors many examples of rupture of
the diaphragm; we know of but few of the rupture of the stomach, the
intestines and the heart.


II. _Common Parts in the Organization of the Muscular System of Organic
Life._

The cellular texture is in general much more rare in the organic
muscles than in the others. The fibres of the heart are in
juxta-position, rather than united by this texture. It is a little more
evident in the gastric and urinary muscles. It is almost wanting in the
womb; thus these muscles are not infiltrated, like the preceding, in
dropsies; they never exhibit that fatty state of which we have spoken,
and which sometimes loads the fibres. I have not observed in these
fibres the yellowish tinge which the others often take, especially in
the vertebral depressions.

The blood vessels are very numerous in this system; they are found
in it even in greater proportion than in the other; more blood
consequently penetrates them. This fact is remarkable, especially in
the intestines, in which the mesenteric arteries distribute numerous
branches, over an extremely delicate fleshy surface. But I would remark
that this appearance is to a certain degree deceptive, as many of these
vessels only traverse the fleshy surface to go to the mucous membrane.
In the ordinary state they give to the gastric viscera a reddish tinge,
which I have rendered at will livid and afterwards brought back to
its primitive state, by shutting and afterwards opening the stop-cock
adapted to the wind pipe, in my experiments upon asphyxia.

The absorbents and exhalants have nothing peculiar in this system.

The nerves come to them from two sources; 1st, from the cerebral
system; 2d, from that of the ganglions.

Except in the stomach in which the par vagum is distributed, the nerves
of the ganglions predominate everywhere. In the heart, they are the
principal; in the intestines, they are the only ones; at the extremity
of the rectum and the bladder, their proportion is greater than that of
the nerves coming from the spine.

The cerebral nerves intermix with them, in penetrating the organic
muscles. The cardiac, solar, hypogastric, plexuses, &c. result from
this intermixture which appears to have an influence upon the motions,
though we are ignorant of the nature of this influence.

All the nerves of the ganglions which go to the organic muscles, do not
appear to be exclusively destined to them. A great number of filaments
belong only to the arteries; such is in fact their interlacing, that
they form, as we have seen, around these vessels a real nervous
membrane, superadded to their own, and exclusively destined to them.
I would compare this nervous envelope to the cellular envelope which
is also found around the arteries, and which is wholly distinct from
the surrounding cellular texture; thus it only has communications with
the nerves of the organic muscles, without being distributed to these
muscles. Besides as the nerves of the ganglions are always the most
numerous and essential in them, and as their tenuity is extreme, the
nervous mass destined to each is infinitely inferior to that which
is found in the voluntary muscles. The heart and the deltoid muscle
compared together, exhibit in this respect a remarkable difference.


ARTICLE THIRD.

PROPERTIES OF THE MUSCULAR SYSTEM OF ORGANIC LIFE.

Under the relation of properties, this system is in part analogous to
the preceding, and in part very different from it.


I. _Properties of Texture. Extensibility._

Extensibility is very evident in the organic muscles. The dilatation of
the intestines and the stomach by aliments, by the extrication of gas,
by the fluids that are found there, that of the bladder by the urine,
by injections that are forced in, &c. are essentially owing to this
extensibility.

This property is characterized here by two remarkable attributes; 1st,
by the rapidity with which it can be put into action; 2d, by the very
great extent of which it is susceptible.

The stomach and intestines pass in an instant from complete vacuity
to great extension. Artificially distended, the bladder becomes
immediately of a size treble, quadruple even of that which is natural
to it. It sometimes however resists, but this does not prove its
defect of extensibility; it is because the fluid injected irritates
it and makes it contract; the organic contractility in exercise, then
prevents the development of extensibility, as it sometimes cannot be
brought into action by stimulants in a muscle laid bare, because the
animal contractility in exercise in the muscle, forms an obstacle to
it. The muscles of animal life are never capable of this rapidity in
their extensibility, whether because they are intersected by numerous
aponeuroses which dilate but slowly, or whether because their layers
of fibres are very thick, two circumstances that do not exist in the
muscles of organic life. Hence a remarkable phenomenon that I have
observed in all cases of tympanites. When we open the abdomen of
subjects that have died in this state, without wounding the swelled
intestines, these immediately burst out, swell more, and occupy twice
as large a space as they were contained in in the abdomen; why? Because
the parietes of the abdomen being unable to yield in proportion to the
quantity of gas that is developed, this has been compressed in the
intestines during life, and expands immediately by its elasticity when
the cause of compression ceases. In dropsies in which the distension is
slow, the abdominal parietes enlarge much more than in tympanites. The
size of the abdomen would be double in this, if the extensibility of
the parietes was in proportion to that of the intestines.

As to the extent of the extensibility of the organic muscles, we can
form an idea of it by comparing the empty stomach which oftentimes
is not larger than the cæcum in its ordinary state, with the stomach
containing sometimes five, six and even eight pints of fluid; the
bladder contracted and concealed behind the pubis, with the bladder
full of urine from suppression, rising sometimes even above the
umbilicus; the rectum empty, with the rectum filling a part of the
pelvis in old people in whom the excrements have accumulated in it; the
intestines contracted with the intestines greatly distended.

It is to the extent of extensibility of the organic muscles and to the
limits placed to that of the abdominal parietes, that must be referred
a constant phenomenon that is observed in the gastric viscera; viz.
that in the natural series of their functions, they are never all
distended at the same time; the intestines are filled when the matters
contained in the stomach are evacuated; the bladder is not full of
urine in the digestive order, until the other hollow organs are empty,
&c. In general, that is an unnatural order in which all the organs are
distended at once.

There is for the organic muscles a mode of extensibility wholly
different from that of which I have just spoken; it is that of the
heart in aneurisms, and the womb in pregnancy. The first, for example,
acquires a size double, treble even sometimes in its left side, and yet
it increases at the same time in thickness. This size is not owing to
distension, but to a preternatural growth. The aneurismatic heart is
to the ordinary heart, what this is to the heart of the infant; it is
nutrition that makes the difference and not distension; for whenever
it is owing to this it diminishes in thickness as it increases in
extent; there is no addition of substance. Besides the aneurismatic
heart has not often the cause that distends it, for commonly in this
case the mitral valves allow a free passage to the blood; whilst when
they are ossified the left ventricle often remains in a natural state.
Moreover, the slow progress of the formation of aneurism proves that
it is a preternatural nutrition that has presided over this increase
of the heart. You would in vain then empty this organ of the blood
it contains, it would not contract and resume its dimensions, as the
inflated intestine does which we puncture to allow the air to escape.

In the womb there are two causes of distension; 1st, the sinuses
greatly developed; 2d, an addition of substance, a real momentary
increase of the fibres of the organ which remains as thick and even
more so than in the natural state. At the time of accouchement, the
sinuses immediately flatten by the contraction of the fibres; hence
the sudden contraction of the organ. But as on the one hand nutrition
alone can remove by decomposition the substances added to the fibres to
enlarge them, and as on the other, this function is exerted slowly,
after the womb has undergone the sudden contraction owing to the
flattening of its sinuses, it returns but gradually and at the end of
some time to its ordinary size. Extensibility is not then brought into
action in the womb filled by the fœtus, and in the aneurismatic heart;
these organs really become at that time the seat of a more active
nutrition; they grow preternaturally, as they have grown naturally
with the other organs; but these do not then experience an analogous
phenomenon, they become monstrous in comparison. The womb decreases,
because the motion of decomposition naturally predominates over that of
composition after accouchement, whilst it was the reverse before this
period. The aneurismatic heart remains always so.

These dilatations of the heart should be carefully distinguished from
those really produced by extensibility, as in the right auricle and
ventricle for example, which are found full of blood at the moment
of death, because the lungs which are weakened, not allowing it to
pass through them, compel it to flow back to the place from which it
came. There are but few hearts which do not exhibit in very various
degrees, these dilatations, which we have the power in a living
animal of increasing or diminishing at will, according to the kind of
death we produce. Two hearts are hardly ever of the same size after
death; many varieties are met with, and these depend more or less on
the difficulties which the blood experiences in the last moments,
in passing through the lungs. Hence why in the diseases of the
heart, there is no standard by which we can compare the morbid size,
especially if we examine the organ as a whole. In fact the distension
of the right side can give it an aneurismatic appearance, and a size
even greater than that of some aneurisms. If we examine the left side
separately, the error is more easily proved, because this side is
subject to less variations. But the principal difference consists
in the thickness. The power of contraction appears to increase in
proportion to this thickness, which arises from the substance added by
nutrition. It is this power which produces the great beating that is
felt under the ribs, the strength of the pulse, &c.


_Contractility._

It is in proportion to extensibility. It is often brought into action
in the ordinary state. It is in virtue of this property, that the
stomach, the bladder, the intestines, &c. contract, and acquire a size
so small compared to what they have when they are full. In general,
there is no muscle of animal life, which is capable of such extreme
contractions as those of organic life.

It should be remarked, however, that life, without having contractility
immediately dependant upon it, since the intestines, the stomach, and
the bladder contract after death when their distension is removed,
modifies it in a very evident manner. The causes even which alter
or diminish the vital forces have an influence upon it; hence the
following observation that all those accustomed to open dead bodies can
make. When the subject has died suddenly, and the stomach is empty, it
is much contracted; when, on the contrary, death has been preceded by a
long disease which has weakened its forces, the stomach, though empty,
remains flaccid, and is found but very little contracted.

We should consider the substances contained in the hollow muscles of
organic life, as true antagonists of these muscles; for they have
not muscles that act in a direction opposite to theirs. As long as
these antagonists distend them, they do not obey their contractility
of texture; when they are empty, this is brought into action. It is
not, however, upon this property that the mechanism of the expulsion
of matters from these organs turns, as aliments from the stomach and
intestines, urine from the bladder, blood from the heart, &c. It is
the organic contractility that presides over this mechanism. It is
difficult to distinguish these properties in exercise. One occasions
a slow and gradual contraction, which is without the alternation of
relaxation; the other, quick and sudden, consisting in a series of
relaxations and contractions, produces the peristaltic motion, those
of systole, diastole, &c. It is after the organic contractility has
procured the evacuation of the hollow muscles, that the contractility
of texture closes them. In death from hemorrhage from a great artery,
the left and even the right side of the heart send out all the blood
they contain; afterwards empty, they contract powerfully, and the
organ is very small. On the contrary, it is very large when much blood
remaining in its cavities, distends it, as in asphyxia. These are the
two extremes. There are, as I have said, many intermediate states.

The contractility of texture is, in the system of which we are
treating, in proportion to the number of fleshy fibres. Thus, all
things being equal, the rectum, when empty, contracts upon itself with
much more force than the other large intestines; the contraction of the
ventricles is much greater than that of the auricles, and that of the
œsophagus is much greater than that of the duodenum,