Chapter XVI: Section XXV: 15 (2)

It is very common in dropsies of the chest or lungs to have the difficulty of breathing relieved by copious sweats, flowing from the head and neck. Mr. P. about 50 years of age, had for many weeks been afflicted with anasarca of his legs and thighs, attended with difficulty of breathing; and had repeatedly been relieved by squill, other bitters, and chalybeates.--One night the difficulty of breathing became so great, that it was thought he must have expired; but so copious a sweat came out of his head and neck, that in a few hours some pints, by estimation, were wiped off from those parts, and his breath was for a time relieved. This dyspnoea and these sweats recurred at intervals, and after some weeks he ceased to exist. The skin of his head and neck felt cold to the hand, and appeared pale at the time these sweats flowed so abundantly; which is a proof, that they were produced by an inverted motion of the absorbents of those parts: for sweats, which are the consequence of an increased action of the sanguiferous system, are always attended with a warmth of the skin, greater than is natural, and a more florid colour; as the sweats from exercise, or those that succeed the cold fits of agues. Can any one explain how these partial sweats should relieve the difficulty of breathing in anasarca, but by supposing that the pulmonary branch of absorbents drank up the fluid in the cavity of the thorax, or in the cells of the lungs, and threw it on the skin, by the retrograde motions of the cutaneous branch? for, if we could suppose, that the increased action of the cutaneous glands or capillaries poured upon the skin this fluid, previously absorbed from the lungs; why is not the whole surface of the body covered with sweat? why is not the skin warm? Add to this, that the sweats above mentioned were clammy or glutinous, which the condensed perspirable matter is not; whence it would seem to have been a different fluid from that of common perspiration.

Dr. Dobson, of Liverpool, has given a very ingenious explanation of the acid sweats, which he observed in a diabetic patient--he thinks part of the chyle is secreted by the skin, and afterwards undergoes an acetous fermentation.--Can the chyle get thither, but by an inverted motion of the cutaneous lymphatics? in the same manner as it is carried to the bladder, by the inverted motions of the urinary lymphatics. Medic. Observat. and Enq. London, vol. v.

Are not the cold sweats in some fainting fits, and in dying people, owing to an inverted motion of the cutaneous lymphatics? for in these there can be no increased arterial or glandular action.

Is the difficulty of breathing, arising from anasarca of the lungs, relieved by sweats from the head and neck; whilst that difficulty of breathing, which arises from a dropsy of the thorax, or pericardium, is never attended with these sweats of the head? and thence can these diseases be distinguished from each other? Do the periodic returns of nocturnal asthma rise from a temporary dropsy of the lungs, collected during their more torpid state in sound deep, and then re-absorbed by the vehement efforts of the disordered organs of respiration, and carried off by the copious sweats about the head and neck?

More extensive and accurate dissections of the lymphatic system are wanting to enable us to unravel these knots of science.

VII. _Translations of Matter, of Chyle, of Milk, of Urine. Operation of purging Drugs applied externally._

1. The translations of matter from one part of the body to another, can only receive an explanation from the doctrine of the occasional retrograde motions of some branches of the lymphatic system: for how can matter, absorbed and mixed with the whole mass of blood, be so hastily collected again in any one part? and is it not an immutable law, in animal bodies, that each gland can secrete no other, but its own proper fluid? which is, in part, fabricated in the very gland by an animal process, which it there undergoes: of these purulent translations innumerable and very remarkable instances are recorded.

2. The chyle, which is seen among the materials thrown up by violent vomiting, or in purging stools, can only come thither by its having been poured into the bowels by the inverted motions of the lacteals: for our aliment is not converted into chyle in the stomach or intestines by a chemical process, but is made in the very mouths of the lacteals; or in the mesenteric glands; in the same manner as other secreted fluids are made by an animal process in their adapted glands.

Here a curious phænomenon in the exhibition of mercury is worth explaining:--If a moderate dose of calomel, as six or ten grains, be swallowed, and within one or two days a cathartic is given, a salivation is prevented: but after three or four days, a salivation having come on, repeated purges every day, for a week or two, are required to eliminate the mercury from the constitution. For this acrid metallic preparation, being absorbed by the mouth of the lacteals, continues, for a time arrested by the mesenteric glands, (as the variolous or venereal poisons swell the subaxillar or inguinal glands): which, during the operation of a cathartic, is returned into the intestines by the inverted action of the lacteals, and thus carried out of the system.

Hence we understand the use of vomits or purges, to those who have swallowed either contagious or poisonous materials, even though exhibited a day or even two days after such accidents; namely, that by the retrograde motions of the lacteals and lymphatics, the material still arrested in the mesenteric, or other glands, may be eliminated from the body.

3. Many instances of milk and chyle found in ulcers are given by Haller, El. Physiol. t. vii. p. 12, 23, which admit of no other explanation than by supposing, that the chyle, imbibed by one branch of the absorbent system, was carried to the ulcer, by the inverted motions of another branch of the same system.

4. Mrs. P. on the second day after delivery, was seized with a violent purging, in which, though opiates, mucilages, the bark, and testacea were profusely used, continued many days, till at length she recovered. During the time of this purging, no milk could be drawn from her breasts; but the stools appeared like the curd of milk broken into small pieces. In this case, was not the milk taken up from the follicles of the pectoral glands, and thrown on the intestines, by a retrogression of the intestinal absorbents? for how can we for a moment suspect that the mucous glands of the intestines could separate pure milk from the blood? Doctor Smelly has observed, that loose stools, mixed with milk, which is curdled in the intestines, frequently relieves the turgescency of the breasts of those who studiously repel their milk. Cases in Midwifery, 43, No. 2. 1.

5. J.F. Meckel observed in a patient, whose urine was in small quantity and high coloured, that a copious sweat under the arm-pits, of a perfectly urinous smell, stained the linen; which ceased again when the usual quantity of urine was discharged by the urethra. Here we must believe from analogy, that the urine was first secreted in the kidneys, then re-absorbed by the increased action of the urinary lymphatics, and lastly carried to the axillae by the retrograde motions of the lymphatic branches of those parts. As in the jaundice it is necessary, that the bile should first be secreted by the liver, and re-absorbed into the circulation, to produce the yellowness of the skin; as was formerly demonstrated by the late Dr. Munro, (Edin. Medical Essays) and if in this patient the urine had been re-absorbed into the mass of blood, as the bile in the jaundice, why was it not detected in other parts of the body, as well as in the arm-pits?

6. Cathartic and vermifuge medicines applied externally to the abdomen, seem to be taken up by the cutaneous branch of lymphatics, and poured on the intestines by the retrograde motions of the lacteals, without having passed the circulation.

For when the drastic purges are taken by the mouth, they excite the lacteals of the intestines into retrograde motions, as appears from the chyle, which is found coagulated among the fæces, as was shewn above, (sect. 2 and 4.) And as the cutaneous lymphatics are joined with the lacteals of the intestines, by frequent anastomoses; it would be more extraordinary, when a strong purging drug, absorbed by the skin, is carried to the anastomosing branches of the lacteals unchanged, if it should not excite them into retrograde action as efficaciously, as if it was taken by the mouth, and mixed with the food of the stomach.

VIII. _Circumstances by which the Fluids, that are effused by the retrograde Motions of the absorbent Vessels, are distinguished._

1. We frequently observe an unusual quantity of mucus or other fluids in some diseases, although the action of the glands, by which those fluids are separated from the blood, is not unusually increased; but when the power of absorption alone is diminished. Thus the catarrhal humour from the nostrils of some, who ride in frosty weather; and the tears, which run down the cheeks of those, who have an obstruction of the puncta lacrymalia; and the ichor of those phagedenic ulcers, which are not attended with inflammation, are all instances of this circumstance.

These fluids however are easily distinguished from others by their abounding in ammoniacal or muriatic salts; whence they inflame the circumjacent skin: thus in the catarrh the upper lip becomes red and swelled from the acrimony of the mucus, and patients complain of the saltness of its taste. The eyes and cheeks are red with the corrosive tears, and the ichor of some herpetic eruptions erodes far and wide the contiguous parts, and is pungently salt to the taste, as some patients have informed me.

Whilst, on the contrary, those fluids, which are effused by the retrograde action of the lymphatics, are for the most part mild and innocent; as water, chyle, and the natural mucus: or they take their properties from the materials previously absorbed, as in the coloured or vinous urine, or that scented with asparagus, described before.

2. Whenever the secretion of any fluid is increased, there is at the same time an increased heat in the part; for the secreted fluid, as the bile, did not previously exist in the mass of blood, but a new combination is produced in the gland. Now as solutions are attended with cold, so combinations are attended with heat; and it is probable the sum of the heat given out by all the secreted fluids of animal bodies may be the cause of their general heat above that of the atmosphere.

Hence the fluids derived from increased secretions are readily distinguished from those originating from the retrograde motions of the lymphatics: thus an increase of heat either in the diseased parts, or diffused over the whole body, is perceptible, when copious bilious stools are consequent to an inflamed liver; or a copious mucous salivation from the inflammatory angina.

3. When any secreted fluid is produced in an unusual quantity, and at the same time the power of absorption is increased in equal proportion, not only the heat of the gland becomes more intense, but the secreted fluid becomes thicker and milder, its thinner and saline parts being re-absorbed: and these are distinguishable both by their greater consistence, and by their heat, from the fluids, which are effused by the retrograde motions of the lymphatics; as is observable towards the termination of gonorrhoea, catarrh, chincough, and in those ulcers, which are said to abound with laudable pus.

4. When chyle is observed in stools, or among the materials ejected by vomit, we may be confident it must have been brought thither by the retrograde motions of the lacteals; for chyle does not previously exist amid the contents of the intestines, but is made in the very mouths of the lacteals, as was before explained.

5. When chyle, milk, or other extraneous fluids are found in the urinary bladder, or in any other excretory receptacle of a gland; no one can for a moment believe, that these have been collected from the mass of blood by a morbid secretion, as it contradicts all analogy.

---- Aurea duræ
Mala ferant quercus? Narcisco floreat alnus?
Pinguia corticibus sudent electra myricæ?--VIRGIL.

IX. _Retrograde Motions of Vegetable juices._

There are besides some motions of the sap in vegetables, which bear analogy to our present subject; and as the vegetable tribes are by many philosophers held to be inferior animals, it may be a matter of curiosity at least to observe, that their absorbent vessels seem evidently, at times, to be capable of a retrograde motion. Mr. Perault cut off a forked branch of a tree, with the leaves on; and inverting one of the forks into a vessel of water, observed, that the leaves on the other branch continued green much longer than those of a similar branch, cut off from the same tree; which shews, that the water from the vessel was carried up one part of the forked branch, by the retrograde motion of its vessels, and supplied nutriment some time to the other part of the branch, which was out of the water. And the celebrated Dr. Hales found, by numerous very accurate experiments, that the sap of trees rose upwards during the warmer hours of the day, and in part descended again during the cooler ones. Vegetable Statics.

It is well known that the branches of willows, and of many other trees, will either take root in the earth or engraft on other trees, so as to have their natural direction inverted, and yet flourish with vigour.

Dr. Hope has also made this pleasing experiment, after the manner of Hales--he has placed a forked branch, cut from one tree, erect between two others; then cutting off a part of the bark from one fork applied it to a similar branch of one of the trees in its vicinity; and the same of the other fork; so that a tree is seen to grow suspended in the air, between two other trees; which supply their softer friend with due nourishment.

Miranturque novas frondes, et non sua poma.

All these experiments clearly evince, that the juices of vegetables can occasionally pass either upwards or downwards in their absorbent system of vessels.

X. _Objections answered._

The following experiment, at first view, would seem to invalidate this opinion of the retrograde motions of the lymphatic vessels, in some diseases.

About a gallon of milk having been giving to an hungry swine, he was suffered to live about an hour, and was then killed by a stroke or two on his head with an axe.--On opening his belly the lacteals were well seen filled with chyle; on irritating many of the branches of them with a knife, they did not appear to empty themselves hastily; but they did however carry forwards their contents in a little time.

I then passed a ligature round several branches of lacteals, and irritated them much with a knife beneath the ligature, but could not make them regurgitate their contained fluid into the bowels.

I am not indeed certain, that the nerve was not at the same time included in the ligature, and thus the lymphatic rendered unirritable or lifeless; but this however is certain, that it is not any quantity of any stimulus, which induces the vessels of animal bodies to revert their motions; but a certain quantity of a certain stimulus, as appears from wounds in the stomach, which do not produce vomiting; and wounds of the intestines, which do not produce the cholera morbus.

At Nottingham, a few years ago, two shoemakers quarrelled, and one of them with a knife, which they use in their occupation, stabbed his companion about the region of the stomach. On opening the abdomen of the wounded man after his death the food and medicines he had taken were in part found in the cavity of the belly, on the outside of the bowels; and there was a wound about half an inch long at the bottom of the stomach; which I suppose was distended with liquor and food at the time of the accident; and thence was more liable to be injured at its bottom: but during the whole time he lived, which was about ten days, he had no efforts to vomit, nor ever even complained of being sick at the stomach! Other cases similar to this are mentioned in the philosophical transactions.

Thus, if you vellicate the throat with a feather, nausea is produced; if you wound it with a penknife, pain is induced, but not sickness. So if the soles of the feet of children or their armpits are tickled, convulsive laughter is excited, which ceases the moment the hand is applied, so as to rub them more forcibly.

The experiment therefore above related upon the lacteals of a dead pig, which were included in a strict ligature, proves nothing; as it is not the quantity, but the kind of stimulus, which excites the lymphatic vessels into retrograde motion.

XI. _The Causes which induce the retrograde Motions of animal Vessels; and the Medicines by which the natural Motions are restored._

1. Such is the construction of animal bodies, that all their parts, which are subjected to less stimuli than nature designed, perform their functions with less accuracy: thus, when too watery or too acescent food is taken into the stomach, indigestion, and flatulency, and heartburn succeed.

2. Another law of irritation, connate with our existence, is, that all those parts of the body, which have previously been exposed to too great a quantity of such stimuli, as strongly affect them, become for some time afterwards disobedient to the natural quantity of their adapted stimuli.--Thus the eye is incapable of seeing objects in an obscure room, though the iris is quite dilated, after having been exposed to the meridian sun.

3. There is a third law of irritation, that all the parts of our bodies, which have been lately subjected to less stimulus, than they have been accustomed to, when they are exposed to their usual quantity of stimulus, are excited into more energetic motions: thus when we come from a dusky cavern into the glare of daylight, our eyes are dazzled; and after emerging from the cold bath, the skin becomes warm and red.

4. There is a fourth law of irritation, that all the parts of our bodies, which are subjected to still stronger stimuli for a length of time, become torpid, and refuse to obey even these stronger stimuli; and thence do their offices very imperfectly.--Thus, if any one looks earnestly for some minutes on an area, an inch diameter, of red silk, placed on a sheet of white paper, the image of the silk will gradually become pale, and at length totally vanish.

5. Nor is it the nerves of sense alone, as the optic and auditory nerves, that thus become torpid, when the stimulus is withdrawn or their irritability decreased; but the motive muscles, when they are deprived of their natural stimuli, or of their irritability, become torpid and paralytic; as is seen in the tremulous hand of the drunkard in a morning; and in the awkward step of age.

The hollow muscles also, of which the various vessels of the body are constructed, when they are deprived of their natural stimuli, or of their due degree of irritability, not only become tremulous, as the arterial pulsations of dying people; but also frequently invert their motions, as in vomiting, in hysteric suffocations, and diabetes above described.

I must beg your patient attention, for a few moments whilst I endeavour to explain, how the retrograde actions of our hollow muscles are the consequence of their debility; as the tremulous actions of the solid muscles are the consequence of their debility. When, through fatigue, a muscle can act no longer; the antagonist muscles, either by their inanimate elasticity, or by their animal action, draw the limb into a contrary direction: in the solid muscles, as those of locomotion, their actions are associated in tribes, which have been accustomed to synchronous action only; hence when they are fatigued, only a single contrary effort takes place; which is either tremulous, when the fatigued muscles are again immediately brought into action; or it is a pandiculation, or stretching, where they are not immediately again brought into action.

Now the motions of the hollow muscles, as they in general propel a fluid along their cavities, are associated in trains, which have been accustomed to successive actions: hence when one ring of such a muscle is fatigued from its too great debility, and is brought into retrograde action, the next ring from its association falls successively into retrograde action; and so on throughout the whole canal. See Sect. XXV. 6.

6. But as the retrograde motions of the stomach, oesophagus, and fauces in vomiting are, as it were, apparent to the eye; we shall consider this operation more minutely, that the similar operations in the more recondite parts of our system may be easier understood.

From certain nauseous ideas of the mind, from an ungrateful taste in the mouth, or from foetid smells, vomiting is sometimes instantly excited; or even from a stroke on the head, or from the vibratory motions of a ship; all which originate from association, or sympathy. See Sect. XX. on Vertigo.

But when the stomach is subjected to a less stimulus than is natural, according to the first law of irritation mentioned above, its motions become disturbed, as in hunger; first pain is produced, then sickness, and at length vain efforts to vomit, as many authors inform us.

But when a great quantity of wine, or of opium, is swallowed, the retrograde motions of the stomach do not occur till after several minutes, or even hours; for when the power of so strong a stimulus ceases, according to the second law of irritation, mentioned above, the peristaltic motions become tremulous, and at length retrograde; as is well known to the drunkard, who on the next morning has sickness and vomitings.

When a still greater quantity of wine, or of opium, or when nauseous vegetables, or strong bitters, or metallic salts, are taken into the stomach, they quickly induce vomiting; though all these in less doses excite the stomach into more energetic action, and strengthen the digestion; as the flowers of chamomile, and the vitriol of zinc: for, according to the fourth law of irritation, the stomach will not long be obedient to a stimulus so much greater than is natural; but its action becomes first tremulous and then retrograde.

7. When the motions of any vessels become retrograde, less heat of the body is produced; for in paroxysms of vomiting, of hysteric affections, of diabetes, of asthma, the extremities of the body are cold: hence we may conclude, that these symptoms arise from the debility of the parts in action; for an increase of muscular action is always attended with increase of heat.

8. But as animal debility is owing to defect of stimulus, or to defect of irritability, as shewn above, the method of cure is easily deduced: when the vascular muscles are not excited into their due action by the natural stimuli, we should exhibit those medicines, which possess a still greater degree of stimulus; amongst these are the foetids, the volatiles, aromatics, bitters, metallic salts, opiates, wine, which indeed should be given in small doses, and frequently repeated. To these should be added constant, but moderate exercise, cheerfulness of mind, and change of country to a warmer climate; and perhaps occasionally the external stimulus of blisters.

It is also frequently useful to diminish the quantity of natural stimulus for a short time, by which afterwards the irritability of the system becomes increased; according to the third law of irritation above-mentioned, hence the use of baths somewhat colder than animal heat, and of equitation in the open air.

_The catalogue of diseases owing to the retrograde motions of lymphatics is here omitted, as it will appear in the second volume of this work. The following is the conclusion to this thesis of_ Mr. CHARLES DARWIN.

Thus have I endeavoured in a concise manner to explain the numerous diseases, which deduce their origin from the inverted motions of the hollow muscles of our bodies: and it is probable, that Saint Vitus's dance, and the stammering of speech, originate from a similar, inverted order of the associated motions of some of the solid muscles; which, as it is foreign to my present purpose, I shall not here discuss.

I beg, illustrious professors, and ingenious fellow-students, that you will recollect how difficult a talk I have attempted, to evince the retrograde motions of the lymphatic vessels, when the vessels themselves for so many ages escaped the eyes and glasses of philosophers: and if you are not yet convinced of the truth of this theory, hold, I entreat you, your minds in suspense, till ANATOMY draws her sword with happier omens, cuts asunder the knots, which entangle PHYSIOLOGY; and, like an augur inspecting the immolated victim, announces to mankind the wisdom of HEAVEN.

* * * * *

SECT. XXX.

PARALYSIS OF THE LIVER AND KIDNEYS.

I. 1._Bile-ducts less irritable after having been stimulated much._ 2.
_Jaundice from paralysis of the bile-ducts cured by electric shocks._
3. _From bile-stones. Experiments on bile-stones. Oil vomit._ 4. _Palsy
of the liver, two cases._ 5. _Schirrosity of the liver._ 6. _Large
livers of geese._ II. _Paralysis of the kidneys._ III. _Story of
Prometheus._

I. 1. From the ingurgitation of spirituous liquors into the stomach and duodenum, the termination of the common bile-duct in that bowel becomes stimulated into unnatural action, and a greater quantity of bile is produced from all the secretory vessels of the liver, by the association of their motions with those of their excretory ducts; as has been explained in