An experimental inquiry into the pathology and treatment of asphyxia / [John Eric Erichsen].

  • John Eric Erichsen
Date:
1845]
Catalogue details

Licence: Public Domain Mark

Credit: An experimental inquiry into the pathology and treatment of asphyxia / [John Eric Erichsen]. Source: Wellcome Collection.

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    in consequence of a want of power in the heart. This cause, which was much insisted upon by the earlier writers, appears to me to have had scarcely sufficient attention paid to it by several modern physiologists; more especially in estimating the influence of an obstructing cause in the capillaries on the cessation of the circulation. It will be unnecessary to do more than allude to the opinion of Goodwyn, that the circulation was arrested and the heart’s action brought to a stand in consequence of the venous blood be- ing an insufficient stimulus to the left cavities of that organ, as this doctrine received. a complete refutation from Bichat, who found that the injection of venous blood into the left cavities will stimulate them when their action is much depressed; and that blood of a perfectly venous character circulates for some time through the pulmonic and systemic capillaries before the heart’s action ceases. In hybernating animals, also, blood that is nearly of a venous character circulates without difficulty. Be- sides, were Goodwyn’s views correct, the left cavities of the heart and the pulmonary veins ought to be found after death distended with blood, which is not the case. The opinions of Bichat on this part of our subject are of the highest interest and importance. ‘This physiologist supposed, as is well known, that the cause of the cessation of the circulation in asphyxia was that venous blood penetrated into the tissue of the heart, weakening each individual fibre; and he states that he is convinced that if black blood could be made to circulate through the coronary artery, whilst arterial blood passes as usual through the cavities of the heart, that the action of that organ would cease as rapidly as when venous blood only penetrates into its tissue by the coronary arteries, after having passed through the left ca- vities of that organ. Thus, he says, it is only little by little, and after it has thoroughly penetrated into each individual fibre, that the action of this organ is lessened, and at last ceases ; in the other case, (according to Goodwyn’s view,) a sudden cessation of the heart’s action ought to ensue. It would appear that Bichat did not believe that venous blood was actually deleterious to muscu- lar contractility, but rather that it acted by the exclusion of arterial blood. He says, ‘le coeur cesse d’agir lorsque les phenomenes chi- niques du poumon sont interrompus parceque le sang noir qui penetre ses fibres charnues n’est pas propre 4 entretenir leur action.” He did not, however, regard the enfeebled condition of the heart as the sole cause of the cessation of the circulation in asphyxia. This he attributed likewise to an increase in the mass of the blood, owing to a retention in it of excrementitious matters, which in a healthy condition pass off by the different secreting organs. He also thought that there was a tendency to the ob-