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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    cessation of the function of the lungs the blood cannot receive any benefit in passing through them. These actions and cessations are all dependent on life and the connexion of one action with another. It is upon the same princi- ple that the first effect of recovery is the act of breathing.* The following cases illustrate this still further. 1 bled a gentleman in the temporal artery, while in a fit of apo- plexy ; he breathed seemingly with great difficulty; the blood flowed very freely, and he continued to bleed longer than we com- monly find from the same wound, which made me suspect that the artery had lost some of its contracting power. The blood was as dark as venal blood ; he became somewhat relieved, and his breath- ing more free. About two hours afterwards we opened the same * [The cessation of the heart's action, in cases of asphyxia, would appear to depend, 1st, On the circulation of black blood through its substance, by which its irrita- bility is more or less impaired ; 2d, On the effects of black blood on the brain producing universal depression,— lowering still further the tone of the heart, and paralysing the muscles of respiration, as well as the pulmonary capillaries; 3d, On the insufficient supply of blood which is sent to the left side of the heart in consequence of the paralysis of the pulmonary capillaries. We may therefore trace a sort of reaction in a circle among the vital organs, each concurring towards the same effect. What is the exact order of their cessation, or the precise share which each of them has in producing the ultimate effect, is not easily assigned. In syncope the series of phenomena would appear to com- mence with an impression on the brain, which is propagated to the heart, and thence to the lungs ; but in asphyxia the first effect is probably felt by the heart, the second by the brain, and the third by the lungs. Goodwyn conceived that the heart ceased to act because the left side, being only arterio-contractile, was incapable of being stimulated by venous blood; but this idea was fully disproved by the experiments of Bichat, which render it cer- tain that the blood stimulates the ventricles not by its quality, but by its bulk. (Goodwyn on the Connex. of Life with Resp. pp. 82, 8',l; and Bichat, Sur la Vie el la Mart.) On the other hand, Bichat's theory that the heart is poisoned by its own blood, is disproved, first, by the experiments of Kay and Edwards, which tend to prove that venous blood contributes, although feebly, to support muscular irritability; secondly, by the post mortem appearances, which exhibit the right side of the heart and the whole venous system gorged with blood, while the left side is almost wholly empty, contrary to what might be expected, consider- ing that the left ventricle ceases to act first in ordinary death ; and thirdly, by the difficulty of accounting for the renewal of the contractions of the heart on the re- establishment of respiration. Resuscitation from asphyxia would, if Bichat's doctrine were true, be impossible, because the very power by which it must owe the restoration of its irritability would be destroyed; whereas by admitting that the heart retains a certain portion of irritability, it is not difficult to account for the renewal of its contraction as soon as the stagnation in the pulmonary capil- laries is removed. It would obviously be inconsistent with the object of these notes to enter en this subject more fully; at the same time it appeared necessary to guard the reader against the notion, that these actions, or cessations of actions, are all dependent on life abstractedly considered. The fact is, all the phenomena of asphyxia primarily arise out of the interruptions to those chemical changes which atmospheric air produces on the blood, in consequence of which venous blood is circulated through the system, and produces a series of effects which are plainly rapable of being analytically examined. (See Cyclop, of Pract. Med., art. Asphyxia, by Dr. Rojet.) ]