A treatise on the blood, inflammation, and gun-shot wounds / by John Hunter ; with notes by James F. Palmer.

  • John Hunter
Date:
1840
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the blood, inflammation, and gun-shot wounds / by John Hunter ; with notes by James F. Palmer. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    blood of all animals; but there is more of it, I think, in those ani- mals which have red blood ; perhaps it may bear some proportion of the animal, and is promoted by all those circumstances which are calculated to exhaust or carry off the living principle. But this explanation does not account for every circumstance, nor remove the specific objections which the author himself has urged against all such hypo- theses. It does not, for example, account for the coagulation of the blood in the vessels of mortifying limbs, or for the incoagulability of this fluid in cases of sudden death. With regard to the first of these objections, I think we may be allowed to suppose that the effects of sympathy extend to a considerable distance beyond the mortified parts, so that these parts, and particularly the great vascular trunks, are weakened and deprived of those full powers of life which are necessary to preserve the blood in a fluid state. Many analogous cases might be adduced to show that any one part of a system of organs being injured, the effect is partici- pated in by the whole; and I think we must refer to this principle, viz., to the sympathy which exists between the heart and its various prolongations, the great disposition which is manifested by the blood to coagulate during the ex- istence of syncope. With respect to the second objection which has been mentioned, I confess my inability to propose any hypothesis capable of explaining the variety of circum- stances under which the blood remains fluid after death. That it depends, as Hunter supposed, on the sudden and entire abstraction of life, or as Mayo has imagined, on a greater residual vitality in the solids of the body, are explanations diametrically opposed ; and totally irreconcileable, as it appears to me, with the diversity of circumstances under which this phenomenon is exhibited. The blood has been found uncoagulated in every variety of common and epidemic fever, and in almost every variety of local phlegmasia, in hanging, drowning, hydro- phobia, coup-de-soleil, lightning, blows on the stomach, overwhelming affections of the mind, intoxication, apoplexy, severe and mortal injuries of vital parts, and in most cases of poisoning ; and, as opposed to these, in almost every respect in overdriven animals, typhoid and low fevers, cholera, scurvy, death from putrid food or putrid inoculations, &c. The former for the most part are examples of the sudden extinction of life attended with all the signs of previous health, the latter of the gradual decay of life attended with all the evidences of previous de- bility. There requires, therefore, evidently some more general principle than has yet been discovered to explain these diversities. The chemical and physio- logical explanations are in this respect both on a par; they both equally fail, as theories, in explaining all the circumstances of the case. Mr. Hunter compared the coagulation of blocd to union by the first intention, and in a larger sense to the act of nutrition and organical formations; but this opinion, as I shall have occasion hereafter to show, does not seem to be sup- ported by any sufficient data. At present I shall content myself with remarking one striking difference, which is, that organized structures when once formed continue to live and to manifest an interior activity, whereas the blood when once coagulated undergoes the common changes of dead matter. The act of coagulation has also been compared to muscular contractility ; but it differs from this in two essential respects : first, in not being followed by any relaxation ; and secondly, in not being stimulated to action by any of those agents which are apt to excite muscular contraction. It is further remarkable that prussic acid and extract of belladonna, one of which is so fatal to life, and the other so destructive of muscular action, do not in the least prevent a strong con- traction of the coagulum; but according to my judgment, no other argument is required to subvert the physiological hypothesis, than the fact that blood which has been kept fluid for an indefinite period of time by common salt, may yet be made to coagulate by the addition of water. It is remarkable that blood may be kept fluid and of a bright arterial colour for many months, or even years, by this means, and yet retain its coagulating property.]