This system, the name of which I borrow from the fluid that constantly lubricates it, and which is furnished by small glands inherent in its structure, appears everywhere in a membranous form; that of fasciculi is wholly foreign to it. In speaking of the mucous organs we shall designate them almost always under the name of membranes. Their study is a new object of research. Pinel has been among the first, who has perceived the necessity of considering them in a general manner as it respects diseases. I believe that I am the first who has regarded them generally in an anatomical and physiological view. Few systems deserve more attention; upon it take place all the great phenomena of digestion, respiration, secretion, excretion, &c.; it is the seat of many diseases. It should alone, in a nosography in which diseases are distributed by systems, occupy a place equal to that of many.
The mucous membranes occupy the interior of the cavities which communicate with the skin by the different openings this covering has on the surface of the body.Their number at first view is very considerable; for the organs in which they are reflected are very numerous. The mouth, the stomach, the intestines, the œsophagus, the bladder, the urethra, the womb, the ureters, all the excretories, &c. &c. derive from these membranes a part of their structure. Yet if we consider that wherever they are continuous, wherever we see them originate, by extending from each other, as they originated in the first instance from the skin, we shall perceive that this number must be wonderfully limited. In fact by thus describing them, not separately in each part, but at the same time in all those upon which they are continued, we see that they are reduced to two general surfaces, of which all the others are portions, and which, on account of the different parts to which they are distributed, can be called, the one gastro-pulmonary, the other genito-urinary. The first is found in the head, the neck and the abdomen. This last cavity and more especially the pelvis, contain the second.
There is also a small insulated mucous surface; it is that which enters by the openings of the nipples and lines the lactiferous tubes. But it is so small that it deserves but little attention; besides, what will be said of the two others will be equally applicable to it. It is then useless to examine it in a general manner.
The gastro-pulmonary surface penetrates into the interior by the mouth, the nose and the anterior face of the eye. 1st. It lines the first and second of these cavities, extends from the first to the excretory ducts of the parotid and sub-maxillary glands, from the other into all the sinuses, forms the conjunctiva, dips down into the puncta lachrymalia, the nasal duct, the sac of the same name, and is continued into the nose; 2d, it descends into thepharynx, furnishes an elongation to the Eustachian tube, then penetrates the internal ear and lines it, as we shall see; 3d, it dips down into the trachea and is spread upon all the air-tubes; 4th, it penetrates into the œsophagus and the stomach; 5th, it extends to the duodenum where it furnishes two elongations, one destined to the ductus choledochus, to the numerous branches of the hepatic and cystic ducts and the gall-bladder, the other to the pancreatic duct and its different branches; 6th, it is continued into the small and large intestines and finally terminates at the anus where we see it identified with the skin.
The second general mucous membrane, which we have called the genito-urinary, enters in man by the urethra, and thence is spread on the one hand upon the bladder, the ureters, the pelvis of the kidnies, the infundibula, the papillæ and the capillary tubes which open on their summit; on the other hand it goes into the excretory tubes of the prostate, into the seminal ducts, the vesiculæ seminales, the vasa deferentia and the branches with numberless windings that produce them.
In woman, this membrane is introduced by the os externum and penetrating on the one hand by the urethra, goes as in man upon the urinary organs; on the other hand, we see it enter the vagina, lining it, the uterus and the fallopian tubes, and afterwards becoming continuous with the peritoneum by the opening of these tubes. It is the only example in the economy, of a communication established between the mucous and serous surfaces.
This manner of describing the course of the mucous surfaces, by saying that they are elongated, dip down, penetrate, &c. from one cavity to another, is no doubt not conformable to the progress of nature, which creates in each organ the membranes belonging to this organ, and does not thus extend them by degrees; but our manner of understanding it is better adapted to this language, the meaning of which the least reflection will show.
In thus referring to two general membranes all the mucous surfaces, I am not only supported by anatomical inspection, but pathological observation has also furnished me with points of demarcation between the two, and points of contact between the different portions of membranes of which each is the assemblage. In the different descriptions of catarrhal epidemics given by authors, we frequently see one of these membranes affected in all parts, the other remaining sound; it is especially not rare to observe a general affection of the first, of that which extends from the mouth, the nose, the surface of the eye, into the alimentary canal and the bronchial vessels. The last epidemic observed at Paris, with which Pinal himself was affected, was of this character; that of 1761, described by Razou, had it also; that of 1752, described in the memoirs of the Society of Edinburgh was remarkable for a similar phenomenon; now, we do not see at that time a corresponding affection in the mucous membrane that is spread upon the urinary organs and upon those of generation. There is then here, 1st, an analogy between the portions of the first, by the uniformity of affection; 2d, a demarcation between the two by the health of the one and the disease of the other.
We see also that the irritation of any one point of one of these membranes, frequently produces a pain in another point of the same membrane, which is not irritated. Thus a calculus in the bladder occasions a pain at the end of the glans penis, the presence of worms in the intestines causes an itching of the nose, &c. &c. Now, in these phenomena purely sympathetic, it is very rare that the partial irritation of one of these two membranes affects with pain one of the parts of the other; there are however examples of it; such is the singular relation that exists, in mucous hemorrhages, between the membrane of the womb and that of the bronchia. If the blood ceases accidentally to flow from one during menstruation, the other frequently exhales it and thus as it were supplies its functions.
We ought then, from inspection and observation, to consider the mucous surface, in general, as formed by two great membranes successively spread upon many organs, having between them no communication except by the skin, which serves them as an intermediate organ, and which, continuing with both, contributes thus with them to form a general membrane everywhere, continuous, covering the animal externally, and extending within upon most of its essential parts. We can conceive that there should exist important relations between the internal and external portion of this single membrane; and that they do will be proved by further researches.
Every mucous membrane exhibits two surfaces, one adhering to the neighbouring organs, the other free, covered with villi, always moistened with a mucous fluid. Each deserves particular attention.
The adhering surface corresponds almost everywhere with the muscles, either of animal or organic life. The mouth, the pharynx, the whole alimentary canal, the bladder, the vagina, the womb, a portion of the urethra, &c. exhibit a muscular layer embracing on the outside their mucous tunic which is within. This arrangement coincides perfectly, in animals with a fleshy membrane, with that of the skin, which moreover approximates very near, as we shall see, the structure of the mucous membranes, and which, as we have seen, is everywhere continuous with them. This arrangement of the mucous membranes occasions them to be agitated by constant motions which favour wonderfully the secretion that takes place in them, the excretion which succeeds it, and the various other functions of which they are the seat. Theinsertion of this muscular layer exterior to the mucous system, is made, as we have seen, by this dense and compact texture which I have called the sub-mucous. It is from this texture, more compact than the rest of the cellular system, that the mucous surface derives its force. It is from it that the organ which it lines receives its form; it is this which supports and preserves this form; the following experiment proves it. Take a portion of the intestine; remove from any part of it this layer, as well as the serous and the muscular; then inflate it, after having tied it below; the air produces in this place a hernia of the mucous coat. Try afterwards another portion of intestine; deprive this, for a small space, of its mucous membrane and of this also; inflation will produce upon the serous and muscular tunics the same phenomenon that it did in the preceding on the mucous; then it is to this sub-mucous cellular layer that it owes the resistance with which it opposes substances that it contains. The same may be said of the stomach, the bladder, the œsophagus, &c.
The free surface of the mucous membranes, that which is continually moistened by the fluid from which they borrow their name, exhibits three species of wrinkles or folds.
1st. One inherent in the structure of all the laminæ of these membranes, is constantly met with, whatever may be their state of dilatation or contraction; such are those of the pylorus and the valve of Bauhin. These folds are formed not only by the mucous membrane, but also by the intermediate tunic of which we have spoken, which here has a remarkable density and thickness, and gives them solidity. The fleshy tunic enters even into their composition, and we see on the exterior, upon the serous surface, a depression that indicates their presence.
2d. Other folds, only formed by the mucous surface, exist also always in a state of vacuity or fulness, less evident however than this; they are owing to the circumstance that the mucous surface is much more extensive than those upon which it is applied, so that it is folded that it may not run a longer course; such are the valvulæ conniventes of the small intestines, the structure of which we see very well by cutting longitudinally one of these intestines. The edge of the section exhibits the fleshy layer and the serous surface in a straight direction, whilst the mucous layer describes a line resembling a loose thread.
3d. The last species of folds is as it were accidental, and is only observed during the contraction of the organ which is lined by the mucous surface that is the seat of it; such are those of the interior of the stomach, the great intestines, &c. In the greatest number of subjects brought to the dissecting rooms, these folds of which so much has been said as it respects the stomach, cannot be perceived in it, because the subject has died after a disease that has so altered the vital forces, as to prevent all action of this viscus; so that though it is frequently found empty, its fibres are not contracted. In experiments upon living animals, on the contrary, these folds become very evident, and may be demonstrated in this way; make a dog eat or drink copiously, open him an instant after and cut the stomach in the length of its great curvature; no fold is then apparent; but soon the viscus contracts, its edges are turned over and the aliments escape; the whole mucous surface is covered with an infinite number of very prominent ridges, which have as it were the form of cerebral circumvolutions. We obtain the same result by taking out the stomach of an animal recently killed, distending it with air and opening it afterwards, or by cutting it immediately in its state of vacuity and drawing it in opposite directions by its edges; it stretches, its ridges disappear, and if we cease to distend it, they form again immediately in an evident manner. I would observe on the subject of the inflation of the stomach, that by distending it with oxygen, we do not produce by the contact of this gas, greater ridges and consequently a stronger contraction, than by using for the same purpose carbonic acid gas. This experiment furnishes a result very similar to what I have observed in rendering animals emphysematous by different aeriform fluids. It follows from all that we have said upon the folds of the mucous membranes, that in the ordinary contraction of the hollow organs which these membranes line they undergo but a very slight diminution of surface, that they contract scarcely at all, but fold within, so that by dissecting them on an organ in contraction we should have a surface almost equal in extent to that which they exhibit during its dilatation. This assertion, which is true as it respects the stomach, the œsophagus and the great intestines, is not perhaps as entirely so with regard to the bladder, the contraction of which makes the ridges within less evident; but they are not sufficient to destroy the general law. It is also nearly the same with the gall-bladder; yet here we find another cause. The gall-bladder, alternately observed in hunger and during digestion, contains double the bile in the first case that it does in the second, as I have had occasion to see very often indeed, in experiments made for this object or with other views. Now, when the bladder is in part empty, it does not contract upon the bile that remains, with the force of the stomach when it contains but few aliments, or with the power of the bladder when it contains but little urine. It is then flaccid; so that its being distended or not has but a slight influence upon the folds of its mucous membrane.
Besides, in saying that the mucous membranes always exhibit, with some slight difference, the same surface in the extension and contraction of their respective organs, I intend to speak only of the ordinary state of the functions, and not of those enormous dilatations of which we often see the stomach, the bladder, and more rarely the intestines become the seat. Then there is no doubt, a real extension and contraction, which coincide in the membrane with those of the organ.
A remarkable observation which the free surface of the mucous membranes exhibits, and which I have already pointed out, is, that this surface is everywhere in contact with bodies heterogenous to that of the animal, whether these bodies introduced from without to nourish it have not yet been assimilated to its substance, as we see in the alimentary canal and in the wind-pipe; or whether they come from within, as we observe in all the excretory ducts of the glands, which all open into cavities lined by the mucous membranes, and transmit without particles which, after having contributed for some time to the composition of the solids, become heterogeneous to them, and are separated from them by the constant motion of decomposition which takes place in living bodies. Hence we ought to regard the mucous membranes as limits, and barriers, which, placed between our organs and the bodies that are foreign to them, defend them from the mischievous impression of these bodies, and serve consequently within, the same functions which the skin performs without, with respect to the bodies which surround that of the animal, and which tend incessantly to act upon it.
The organization of the mucous system and its vital properties are accommodated to this habitual contact of substances heterogeneous to the living economy. That which is a foreign body to the other systems, the cellular, the muscular, &c. is not so to this. Solid substances, the metals, stones, wood, &c. which introduced into our parts excite in them inevitably suppuration and an antecedent inflammation by their simple contact, pass with impunity over this, provided that their angles and asperities do nottear it; they only augment a little the secretion, as I shall say. We can swallow a ball of lead, of wood, &c. and pass it by the anus without inconvenience. All the irritating fluids without being caustic, that we inject into the great intestines in enemas, or that we swallow, would produce abscesses, &c. if they were forced into the cellular system, &c. Surgeons employ the term foreign bodies in too general a manner; that which is so for one system, is not for another. Foreign is, in this respect, a term of comparison which we should employ only after a knowledge of the peculiar sensibility of each system, and not after that of this property described in a vague manner.
The mucous system not only bears without danger the presence of all bodies that are introduced into the economy, but also when it goes out, it can be exposed with impunity to the contact of external stimuli. Observe what takes place in prolapsus of the womb in which the whole membrane of the vagina sometimes becomes external, in those inversions of the intestinal tubes that take place through preternatural ani, in prolapsus of the rectum, &c.; then the mucous surfaces serve really as integuments; now in these cases the surrounding bodies produce hardly any more pain on them than upon the skin. On the contrary, the instant a serous surface is laid bare, as for example in the operation of hernia, in which the intestine is suffered to come out, on account of an opening unfortunately made by the point of a bistoury, this surface inevitably inflames. All the cellular, muscular, nervous, glandular systems, &c. laid bare, exhibit the same phenomenon. There is no danger in opening the bladder as it respects the contact of the air, whilst there is much in permitting this fluid to penetrate into an articular cavity, a tendinous groove, a serous sac, &c. We know how much in the high operation for the stone, we fear to wound the peritoneum, how uncertain are the results of empyema on account of the contact of the airupon the pleura, &c. The dangers of the action of this fluid upon these surfaces have been perhaps exaggerated, but they are notwithstanding real.
If a fistula extends from the exterior of the abdomen into the intestines, its whole course is lined with callous bodies; these defend the cellular texture and the muscles through which the fistula passes. On the contrary, nothing similar appears upon the intestinal mucous surface, because its organization alone is sufficient to protect it. The urinary, salivary and lacrymal fluids never escape externally by artificial ducts formed in the neighbouring organs, without there are similar callous bodies in the course of these ducts; on the contrary, they pass with impunity over the mucous surfaces. Make in a limb a long and straight opening with a pointed instrument, and fix in it for a time a sound; a callous canal will be produced by it. Let a sound on the contrary remain in the urethra, no alteration of texture will result from it.
Let us conclude from these different considerations, that the mucous system with the cutaneous alone, is organized so as to support the contact of all external bodies, and not to be affected by their presence, or at least experience only an increase of secretion, which is in no ways dangerous. Thus these two systems form two boundaries, the one internal and the other external, between which are placed the organs foreign, by their mode of sensibility and by that of their structure, to the external bodies. To these boundaries the excitement of these bodies is limited; their influence does not go beyond. So long as they do not pass these boundaries, the other organs do not feel them. We might say that the acute sensibility which each of them enjoys, is a kind of sentinel that nature has placed on the confines of the organic domain of the mind, to inform it of whatever can injure it.
The mucous system presents two things to be considered in its peculiar texture, viz. 1st, a layer more or less thick which constitutes principally this texture, and which by analogy with the cutaneous corion, may be called the mucous corion; 2d, many small elongations which surmount it, and which are called villi or papillæ. As to the epidermis which covers it, I shall treat of it with the cutaneous epidermis. This texture has nothing similar to the substance that colours the skin, and which is between the papillæ and epidermis. We know in fact that negroes, as well as whites, have this texture of a bright red, which it derives from its vessels.
This portion of the mucous texture, which is the most important, and which constitutes the thickness, form, and even the nature of it, has a soft and spongy appearance. We might say at first view that it was a consistent pulp, with which the extremely dense cellular texture that is subjacent to it had been covered. This softness is a character which distinguishes it from the cutaneous corion, which moreover has by its intimate nature but little resemblance to it.
The mucous corion is very various as to thickness; it differs in this respect in each organ. That of the gums and the palate is the thickest of all. Then come those ofthe nasal fossæ and the stomach, then those of the small intestines and the gall-bladder, then those of the large intestines, of the urinary bladder, the urethra and the other excretories, until it begins at length to become so fine as to appear transparent like a serous surface when it is removed with care. Finally, the finest and most delicate is that of the sinuses of the face and the interior of the ear; the arachnoides is often coarser.
I have called the texture within the ear mucous, though all anatomists call the membrane of the cavities of this organ periosteum. In fact, 1st, we see it evidently continued with the pituitary membrane, by means of the elongation of the Eustachian tube. 2d. We find it constantly moistened by a mucous fluid which this canal serves to convey out, a character foreign to the periosteum, which, like the fibrous membranes, always adheres by both its surfaces. 3d. No fibre can be distinguished in it. 4th. Its fungous appearance, though white and soft, and the ease with which it is torn, are evident attributes of the mucous membranes. Every thing proves that the membrane of the tympanum, that of the meatus, &c. belong to the system of which we are treating. Thus in catarrhs of the pituitary membrane, and of that of the fauces, we most often find that the ear is affected; thus the ear is, like the mucous surfaces, the seat of hemorrhage, thus polypi arise in it, as in the nose and on the surface of the womb. We consider as a sign of deposition of pus in the ear, every purulent discharge coming from that cavity. But how can we conceive of a purulent collection in a part in which there is hardly any cellular texture, in a part wholly osseous? Besides the fibrous system, to which the periosteum of the tympanum belongs, hardly ever suppurates, as we know. Every thing then induces us to believe that these discharges are only the effect of a catarrh of the ear, a catarrh which is sometimes acute and sometimes chronic. I have moreover a recent and decisive fact upon this point; the body of a man subject to these discharges during life exhibited a remarkable thickness and redness of the membrane of the tympanum, but without the least trace of erosion. The ear suppurates like the urethra, the vagina, &c. it is not a new fluid which is formed by suppuration; it is that which naturally comes from the meatus which increases in quantity and comes through a preternatural opening of the membrane of the tympanum.
Diseases make the thickness of all the mucous surfaces vary remarkably. I have seen them many lines thick in the maxillary sinus, and nearly half an inch in the bladder. In great extensions of the mucous sacs, this thickness diminishes very much; it increases in their contractions. The stomach especially exhibits this phenomenon in these two opposite states.
The softness of the mucous corion is also very variable; in the nasal fossæ, in the stomach and the intestines, it is really a kind of organized velvet. The name of villous membrane is perfectly suited to it. On the contrary, at the origins of the mucous system, as in the mouth, upon the glans penis, at the entrance of the nose, it is a more dense and compact texture, approximating nearer in its nature to the cutaneous corion. I am persuaded that like this it might be tanned and be useful in the arts if it were in larger pieces, whilst I doubt if the action of tanning could produce an analogous phenomenon upon the mucous texture of the deep-seated organs. The softness of this would render it incapable of serving for external integuments. The least cause would be in fact sufficient to break and tear it. Its structure being different from that of the cutaneous corion is the reason that the variolus pustules never appear on it, whilst we often see them on the mucous surfaces near the openings of the skin, especially upon the tongue, the palate and the internal surface of the cheeks.
Exposed to the action of dry air, so that it may come everywhere in contact with it, it becomes dry and very thin, but preserves some resistance. In bladders inflated and dried, in the stomach, the intestines, &c. thus prepared, it is this texture which supports these organs, and which prevents them from becoming flat, though we permit the air to escape; it offers even a resistance, from which arises a kind of crepitation when we wish to bend them in various directions. To be convinced of this, it is only necessary to dry the mucous surface separate from the serous and muscular that correspond with it; these when dried remain pliable like the cellular texture, whilst the first has a kind of rigidity.
In the organs in which the redness of the mucous texture is slight, as in the bladder, the rectum, &c. it becomes transparent by drying. Where it is very red as in the stomach, it takes a deep tinge, which becomes even almost black if there had been an antecedent inflammation in it by which much blood had been accumulated; hence it appears that this fluid is the cause of the colour.
Thus dried the mucous surfaces are smooth; they lose their viscidity at least in appearance; their folds are effaced by adhering to the surface from which they arise; thus the valvulæ conniventes are marked in a dried intestine, only by a red line, without any apparent prominence. But if we macerate the intestines in this state, the folds form again and become visible.
Exposed to a moist air, or left with other flesh that will not allow it to become dry, the mucous corion putrefies with great ease; the odour that it then sends out is very fetid. I think the reason why the abdomen of dead bodies becomes putrid so soon is in part because it contains substances already in putrefaction, and also because the surfaces, in contact with these substances, and which by their vitality resisted before their action, then readily yield to them. If these substances were contiguous to aponeuroses, putrefaction would be much less rapid. The mucous system when putrid takes a greyish colour; and as the dense, subjacent cellular texture putrefies much less easily, we can then remove from it by the least pressure, the mucous corion, reduced to a putrid pulp, in which every trace of organization has disappeared, and which forms a real pap.
During life, gangrene of the mucous texture takes place in general less frequently than that of the cutaneous. The consequences of catarrh, compared with those of erysipelas may convince us of this; there are however cases in which death appears in this texture, whilst the surrounding ones continue to live, as in gangrenous angina.
Exposed to maceration, the mucous texture yields to it promptly. I think that next to the brain it is altered quickest by the action of water. It is then reduced to a reddish pulp very different from that from putrefaction in the open air. When we put the whole stomach to macerate, this pulp is detached, when the sub-mucous texture and the serous membrane have as yet undergone but little alteration.
Ebullition at first extracts from the mucous texture a greenish scum, very different from that which the muscular and cellular textures give when boiled. This scum which mixed with the whole fluid in the beginning of the boiling, disturbs it and renders it green at first, afterwards rises upon the surface where it has small bubbles of air mixed with its substance; it often even falls to the bottom of the vessel by its weight. Sulphuric acid changes the colour of it to a dull brown.
A short time before the water begins to boil, the mucous texture crisps and acquires the horny hardness like the others, but in a less degree however; hence why it is then wrinkled almost always in different directions. In fact, the sub-mucous texture upon which it is applied,contracting at that time much more than it, it must fold on account of its length; thus during life, when the fleshy coat of the stomach contracts, its mucous surface not contracting in proportion, produces the numerous folds of which we have spoken. The action of a concentrated acid crisping the sub-mucous texture more than the mucous itself, produces an analogous phenomenon. After having been a long time dried, the mucous texture, like however almost all those of the animal economy, does not lose the faculty of acquiring the horny hardness when it is plunged into boiling water; it exhibits this phenomenon, whether we expose it to it dry, or whether we do it after having first softened it in cold water. It is a means by which all the valvulæ conniventes may be made suddenly to reappear, which had disappeared by drying, and which form again the instant the intestine contracts. This experiment is very curious to witness.
When the ebullition has been a long time continued, the mucous texture turns gradually to a very deep grey, from the white which it had first become. It is not softer than in the natural state, but it breaks much quicker; the following experiment is a proof of it. If we draw the mucous corion, boiled for some time with the subjacent cellular texture, this last resists the most; so that it remains entire, whilst the mucous corion is broken in many places. This never assumes the gelatinous appearance of the cutaneous corion or the fibrous and cartilaginous organs when boiled and of the others which yield much gelatine. However by mixing a solution of tannin with the water in which this system taken from an adult has been boiled, I have seen an evident precipitate.
The action of the acids reduces to a pulp the mucous texture much sooner than most of the others. During life, all the caustics act much more rapidly upon it than upon the cutaneous, of which the thick epidermis is an intermediate organ which checks their tendency of combining with its corion. Thus the instant the nitric acid, a substance which common people almost always choose for their poison, as the practice at the Hôtel Dieu proves, thus the instant I say, that the nitric acid is in contact with the alimentary canal, it disorganizes it, it forms there a whitish eschar, which, when death does not take place immediately, as most often happens, is slowly removed and detached in the form of a membrane. We know that the lips gently rubbed with weakened nitric acid, become the seat of a troublesome itching, whilst that oftentimes though this acid may have acted upon the skin sufficiently to make it yellow, it does not suffer from it.
The softness of the mucous corion makes me presume that it is easily altered by the digestive juices, not that I confide in the experiments of Hunter, who pretended that these juices could act upon the coat that secretes them, but because in general I have observed that the textures like it yield very easily to the action of water in maceration and are also very easily digested. I have not however any experiment upon the subject, and we know that in the animal economy analogy is not always a faithful guide.
All the mucous surfaces, but especially that of the stomach and intestines, have the property of curdling milk, as have many other substances, especially the acids. Is it to this property that must be attributed a phenomenon which is constant during life, viz. the coagulation of milk that enters the stomach for digestion? or is this phenomenon owing to the mixture of this fluid with those which are secreted by the surface of this organ? I think that both these causes contribute to it at the same time; both separate produce in fact this phenomenon. Spallanzani has proved it as it respects the gastric juices. Every body knows that the mucous membrane dried, and consequently deprived of these juices, preserves the property of coagulating milk. Spallanzani has convincedhimself that the serous and organic muscular systems of the stomach are destitute of it.
Are aphthæ an affection of the mucous corion? do they belong to the papillæ? are they seated in the glands? are they a separate inflammation of these glands, whilst catarrhs are characterized by a general inflammation of a considerable extent of the mucous system? All these questions deserve to be examined. Pinel has perceived the void there is in morbid anatomy upon this point.
The peculiar kind of sensibility which the skin enjoys is attributed principally, as we know, to what is called the papillary body, which commonly is not easy to be demonstrated. The sensibility of the mucous membranes, somewhat analogous to that of the skin, appears to me to have the same kind of organization, which is perceived with infinitely less ease. The papillæ of this system cannot be called in question at its origin, where it dips into the cavities, in the commencement even of these cavities, as upon the tongue, the palate, the internal part of the alæ of the nose, upon the glans penis, in the fossa navicularis, within the lips, &c. Inspection is sufficient to demonstrate them there. But it is asked if the papillæ exist also in the deep-seated parts of this system. Analogy indicates it, since the sensibility is as great there as at their origin, though with varieties that we shall point out; but inspection proves it in a manner not less certain. I think that the villi with which we everywhere see them covered are nothing but these papillæ.
Very different ideas have been entertained of the nature of these villi; they have been considered in the stomach and the œsophagus as destined to the exhalation of the gastric juice, in the intestines as serving for the absorption of chyle, &c. But, 1st, it is difficult to conceive how an organ everywhere nearly similar, can perform indifferent parts functions so different; I say nearly similar, for we shall see that these papillæ exhibit differences of length, size, &c. without having any of texture or structure. 2d. What can be the functions of the villi of the pituitary membrane, of the internal coat of the urethra, the bladder, &c. if they have not relation to the sensibility of these membranes? 3d. The microscopical experiments of Leiberkuhn upon the vesicle of the intestinal villi have been contradicted by those of Hunter, of Cruikshank and especially of Hewson. I am certain that I have never seen any thing similar on the surface of the small intestines, at the time of chylous absorption; and yet it would appear that a thing of inspection could not vary. 4th. It is true that these intestinal villi are everywhere accompanied by a vascular net-work, which gives them a red colour very different from the colour of the cutaneous papillæ; but the non-appearance of the cutaneous net-work is owing to the pressure of the atmospheric air, and especially to the contraction which it occasions in the small vessels. Observe in fact the fœtus as it comes from the womb of its mother; its skin is as red as the mucous membranes, and if its papillæ were a little longer, it would resemble almost exactly the internal surface of the intestines. Who does not know moreover, that the vascular net-work surrounding the cutaneous papillæ, is rendered evident by fine injections, so as to change their colour entirely?
That in the stomach this vascular net-work continuous with the exhalants furnishes the gastric juice, and that in the intestines it intermixes with the origin of the absorbents, so that these embrace the villi, we cannot doubt after the experiments and observations of anatomists who have recently engaged themselves in investigating the lymphatic system. But this does not prevent the base of these villi from being nervous, and them from performing upon the mucous membranes the same functions thatthe papillæ do upon the cutaneous organ. This manner of regarding them by explaining their existence generally observed upon all the mucous surfaces, appears to me to be much more conformable to the plan of nature, than to suppose them in each place with different and often opposite functions.
Besides it is difficult to decide the question by ocular observation. The delicacy of these elongations conceals their structure, even from our microscopical instruments, agents from which anatomy and physiology do not appear to me to have derived much assistance, because when we see obscurely, each sees in his own way and according to his own wishes. It is then the observation of vital properties that should especially guide us; now, it is evident to judge by them, that the villi have the nature I have attributed to them. The following experiment served to demonstrate to me the influence of the papillary body upon the cutaneous sensibility; it succeeds also upon the mucous membranes. Remove the epidermis in any part and irritate the papillary body with a sharp stilet; the animal is agitated, cries out and gives marks of acute pain. Slide afterwards, through a small opening made in the skin, a pointed stilet into the sub-cutaneous cellular texture, and irritate the internal surface of the corion; the animal remains quiet and makes no noise, unless some nervous filaments accidentally struck make him suffer. Hence it follows very evidently, that it is upon the external surface of the skin that its sensibility resides, that the nerves pass through the corion without contributing to its texture, and that their expansion takes place on the papillary body. It is precisely so with the mucous surfaces. Observe that this circumstance coincides very well with the functions of the two surfaces, which receive by their free portion the action of external bodies, to which they are foreign by their adhering portion.
The papillæ exhibit very great varieties. On the tongue, in the small intestines, in the stomach and in the gall-bladder, they are remarkable for their length. The œsophagus, the large intestines, the bladder, all the excretory ducts have those that are less evident; these last especially and the urethra in particular, are almost smooth in their whole mucous surface. We can scarcely distinguish the papillæ in the frontal, sphenoidal, maxillary sinuses, &c.
These small nervous eminences are sufficiently distinct and separate upon the tongue. In the nasal fossæ, the stomach and the intestines, they are so near together and at the same time so delicate, that the membrane has at first view an uniform and smooth appearance, though it is covered with these elongations. Each papilla is simple; no bifurcation is ever observed at its extremity. All appear to have a pyramidal form, if we can judge at least by those which are the most evident.
Are they susceptible of a species of erection? It has been believed with regard to those of the tongue, which become erect, it is said, to perceive tastes, and with regard to those of the nose, which receive odours more efficaciously in this state of erection, which is in the sensitive phenomena on a small scale, what the erection of the corpora cavernosa is on a large one. I do not believe that any exact experiment can prove this fact. Moreover, it would be necessary then that the intestinal, vesical papillæ, &c. should be in permanent erection, since they are almost always in contact with foreign substances.
Besides the blood vessels, the exhalants and the absorbents which contribute to the structure of this system as to that of all the others, it exhibits also a common organ,which is found almost always separate elsewhere, but which is here especially designed for it. This common organ is of a glandular nature; we shall now examine it.
The mucous glands exist in all the system of this name. Situated beneath the corion or even in its thickness, they pour out incessantly through imperceptible openings a mucilaginous fluid which lubricates its free surface, and which defends it from the impression of the bodies with which it is in contact, and at the same time favours the course of these bodies.
These glands are very apparent in the bronchia, palate, the œsophagus and the intestines, in which they take the names of the anatomists who have accurately described them, and where they make in many places evident projections upon the mucous surface. They are less apparent in the bladder, the womb, the gall-bladder, the vesiculæ seminales, &c.; but the mucus that moistens them clearly demonstrates their existence. In fact, since on the one hand this fluid is analogous on all the mucous surfaces, and, on the other, in those in which the glands are apparent, it is evidently furnished by them, it must be secreted in the same way in those in which the glands are less evident. The identity of the secreted fluids supposes in fact the identity of the secretory organs. It appears that where these glands are hidden from our view, nature compensates for their delicacy by their number. Besides, there are animals in which, in the intestines especially, they form by their vast number, a kind of new layer, in addition to those of which we have spoken. In man this is remarkable in the palatine arch, in the pillars of the velum, on the internal surface of the lips, the cheeks, &c. &c. There is then this great difference between the mucous and the serous membranes, that the fluid whichlubricates one is furnished by secretion, whilst that which moistens the others is from exhalation.
The size of the mucous glands varies; those of the velum of the palate, those of the mouth, &c. are the largest; they become insensible in the greatest number of mucous surfaces. I dissected two subjects that died of a pulmonary catarrh, and in them the glands of the trachea and bronchia, which are, as we know, very apparent, were not enlarged; the membrane alone appeared to be affected. Besides, we do not yet know the injuries of these glands, like those of the analogous organs, which are more apparent from their size. They are in general of a rounded form but with many varieties. No membrane appears to cover them. They have, like the salivary glands and the pancreas, only the cellular texture for an envelope. Their texture is more dense and compact than these last glands; but little cellular texture is found in them; they are soft, vascular, and appear when opened very much like the prostate gland. I cannot say whether nerves penetrate them; analogy indicates it, for all the principal glands receive them.
We know but little of the composition of the mucous fluids, because in the natural state, it is difficult to collect them, and in the morbid, in which their quantity increases as in catarrhs for example, this composition is probably changed. We know that in general they are unsavoury, insipid, and but slightly soluble in water, in that even which is raised to the highest temperature; they become putrid with difficulty. In fact they remain a long time unchanged in the nose, exposed to the contact of a moist air; in the intestines, they serve, without danger to them, as an envelope for putrid substances, &c.; taken from the body and subjected to different experiments, they give results conformable to these facts. Allthe acids act upon them and colour them differently; exposed to a dry air, they thicken by evaporation, and are often even reduced to small shining laminæ. The nasal mucus especially exhibits this phenomenon. Fourcroy has given in detail the analysis of this mucus; he has also given that of the tracheal mucus. But we must not apply rigorously to the analogous fluids our knowledge of the composition of these. It is sufficient in fact to examine a certain number of these fluids, to be convinced that they are not the same in any two places, that more or less thick, more or less uniform, different in their colour, their odour even, &c. they vary in the principles that constitute them, as the membranes which furnish them vary in their structure, in the number and size of their glands, in the thickness of their corion, the form of their papillæ, the state of their vascular and nervous systems, &c. I am far from being certain that the gastric juice is a mucous juice; it is even probable that exhalation furnishes it, the glands of the stomach throwing out a different fluid by the way of secretion. But this assertion is not accurately demonstrated, and perhaps hereafter it will be proved that this juice, so different from the other mucous juices, is however one of them, and that its properties are distinct only because the structure of the mucous surface of the stomach is not the same as that of the other analogous surfaces.
The functions of the mucous fluids in the animal economy are not ambiguous. The first of these functions is to defend the mucous membranes from the impression of the bodies with which they are in contact, and all which, as we have observed, are heterogeneous to that of the animal. These fluids form upon their respective surfaces a layer which supplies, to a certain extent, by its extreme tenuity, the absence of their epidermis. Thus where this membrane is very apparent, as upon the lips, the glanspenis, at the entrance of the nose and in general at all the origins of the mucous system, these fluids are not very abundant. The skin has only an oily layer, infinitely less evident than the mucous of which we are treating, because its epidermis is very distinct.
This use of the mucous fluids explains why they are more abundant where heterogeneous bodies remain some time, as in the bladder, at the extremity of the rectum, &c. than where these bodies are only to pass, as in the ureters, and the excretory ducts generally.
Hence why when the impression of a body would be injurious, these fluids are poured out in greater quantity upon their surfaces. The sound which enters the urethra and remains in it, the instrument that is left in the vagina to compress a polypus, that which remains some time with the same view in the nasal fossæ, the canal fixed in the lachrymal sac to remove the obstruction, that which is introduced into the œsophagus to assist interrupted deglutition, always produce, upon the portions of the mucous surface that corresponds to them, a more abundant secretion of the fluid which is constantly poured out, a true catarrh. This is one of the principal reasons that renders it difficult to keep elastic sounds in the wind-pipe. The abundance of the mucus that is then secreted, by closing the openings in the instrument, renders frequent introductions necessary, and can even threaten the patient with suffocation, as Desault himself has observed, though however he obtained great advantage from this means, as I have shown in his surgical works. I ought even to say, that since the publication of the Treatise on the Membranes, I attempted to fix a sound in the air tube of a dog, and that the animal died at the end of some time, having the bronchia filled with a frothy fluid which appeared to have suffocated him.
It appears then that every considerable excitement of the mucous surfaces produces a remarkable increase ofaction. But how can this excitement, which does not take place immediately upon the gland, have so great an influence upon it? for, as we have said, these glands are always under the membrane, and consequently separated by it from the irritating bodies. It appears that it is owing to a general modification of the glandular sensibility, which is capable of being brought into action by any irritation upon the extremity of the excretory ducts, as I shall prove in the glandular system.
It is to the susceptibility that the mucous glands have of feeling the irritation made at the extremity of their ducts, that must be referred the artificial catarrhs with which Vauquelin has been affected by respiring the vapours of the oxy-muriatic acid, the mucous discharge that attends the presence of a polypus, of any tumour in the vagina, of a stone in the bladder, &c. the frequency of fluor albus in women who are immoderate in the use of sexual intercourse, the more abundant discharge of the mucus from the nostrils of those who take snuff, &c. In all these cases, there is evidently excitement at the extremity of the mucous ducts. I refer also to this excitement the mucous discharge that takes place, from stimulating the end of the nipple of a woman who does not give suck, the copious secretions which the presence of an irritating body produces in the intestines, secretions which especially furnish the matter of diarrhœas, the gastric derangements which succeed an indigestion that has allowed to remain on the mucous surface of the stomach substances not digested and consequently irritating; these derangements are in fact real catarrhs of the membrane of the stomach, catarrhs which most often are not connected with bilious turgescence. I could add many other examples of the mucous secretions increased by an irritation upon the surface of the membranes, at the extremity of the excretory ducts; these will be sufficient to give an idea of the others.
All these excitements produce a kind of inflammation, the peculiarity of which is to contract at first for some time the glandular ducts, and arrest the secretion, which they afterwards excite in great quantity. When the mucous fluids have flowed abundantly for some time, they gradually diminish though the cause continues; thus less mucus is discharged from the urethra in proportion after the sound has remained in it a month, than when first introduced; but almost always as long as the cause continues, the mucous discharge is greater than in a natural state.
Blisters are much employed in medicine on the cutaneous organ, to dispel, according to some, the morbific humour, and overcome, according to others, a natural irritation by an artificial one. Why should we not also in many cases irritate the mucous surfaces? why not act upon the pituitary membrane, upon the glans penis, upon the membrane of the urethra, upon the pharynx, &c. and especially upon the uvula which is so sensible? why, instead of epispastics upon the perineum and sacrum, should we not introduce a sound into the urethra for a paralysis of the bladder? Instead of acting in hemiplegia upon the cutaneous organ, I have already twice employed the following means; I have introduced a sound into the urethra, one in each nasal fossa, and at the same time, a surgeon irritated at intervals the uvula; the patients appeared to be much more excited than by blisters. Very strong purgative enemas and emetics prove the advantage of the excitement of the mucous membranes in this case. Would it not often be better in ophthalmia, to produce an artificial catarrh in the nostril of the diseased side, than to put a blister or seton in the neck? I have once tried it; it did not succeed; but the ophthalmia was of long standing; I propose to repeat these experiments at the Hôtel Dieu upon a great number of patients. I think that we might often in diseases make use of mucous excitements instead of cutaneous, with much more advantage, becausein the mucous system the contact of a body is sufficient, and it is not necessary to produce, by removing the epidermis, a kind of ulcer.
The mucous membranes by the continual secretion of which they are the seat, enjoy a principal part in the animal economy. We ought to consider them as one of the great emunctories by which the residue of nutrition constantly escapes, and consequently as one of the principal agents of the habitual decomposition which removes from living bodies the particles that, having for some time contributed to the composition of the solids, are afterwards to become heterogeneous to them. Observe in fact that the mucous fluids do not enter the circulation, but go out of the body; that of the bladder, the ureters and the urethra, with the urine; that of the vesiculæ seminales and the different ducts with the semen; that of the nostrils by the act of blowing the nose; that of the mouth, in part by evaporation and in part by the anus with the excrements; that of the bronchia, by pulmonary exhalation, which arises principally, as I shall say, from the solution of this mucous fluid in the inspired air; those of the œsophagus, the stomach, the intestines, the gall-bladder, &c. with the excrements, of which they often form in the ordinary state a part almost as considerable as the residue of the aliments, and which they even compose almost entirely in some cases of dysentery and fever, in which the quantity of matter voided is evidently disproportioned to that taken in, &c. Let us observe upon this subject that there are always some errors in the analyses of the fluids in contact with the membranes of which we are speaking, as in that of the urine, the bile, the gastric juices, &c. because it is very difficult and even impossible to separate the mucous fluids from them.
If we recollect what has been previously said upon the extent of the two general mucous surfaces, which is equal and even superior to the extent of the cutaneous organ,and if we afterwards consider that these two great surfaces are constantly throwing out mucous fluids, we shall perceive how important this evacuation must be in the economy, and of what mischief its derangement must become the source. It is undoubtedly to this law of nature which wishes to have every mucous fluid thrown out, that must be attributed, in part in the fœtus, the presence of the unctuous fluid of which the gall-bladder is full, the meconium which loads the intestines, &c. fluids which appear to be but a mass of mucous juices, which being unable to pass off, remain until birth, without being absorbed, upon the respective organs on which they have been secreted.
The mucous fluids are not the only ones that are thrown out, and are in this way excrementitious substances to the economy; this is the case with almost all the fluids separated from the mass of blood by secretion; this is evident as it respects the greatest part of the bile; probably the saliva, the pancreatic juice and the tears are also thrown out with the excrements, and their colour alone prevents them from being distinguished like the bile. I do not even know if, by reflecting on many phenomena, we might not attempt to establish as a general principle, that every fluid separated by secretion does not enter the circulation again, that this phenomenon belongs only to the fluids separated by exhalation, as those of the serous cavities, of the articulations, of the cellular texture, of the medullary organ, &c.; that all the fluids are thus either excrementitious or recrementitious, and that no one is excremento recrementitious as the common division implies. The bile in the gall-bladder, the urine in the bladder, the semen in the vesiculæ seminales, are certainly absorbed; but it is not the fluid itself which re-enters the circulation; it is only its most delicate parts, some of its principles which we do not exactly know, probably the serous and lymphatic part; this does not resemble the absorption of the pleura and other analogous membranes, in which the fluid re-enters the blood as it came out of it.
That which is certain on the subject of the excretion of the secreted fluids is, that I have never been able to produce absorption of the bile by the lymphatics by injecting it into the cellular texture of an animal; it produces there inflammation and afterwards suppuration. We know that urine effused is not absorbed and that it destroys every part it touches, whilst that effusions of lymph and blood are easily discussed. There is as it respects the composition an essential difference between the blood and the secreted fluids. The exhaled fluids on the contrary, as the serum, in this respect resemble it very much.
Another very evident proof that all the mucous fluids are designed to be thrown out, is, that when they have continued for some time in any quantity upon their respective surfaces, they create there a painful sensation of which nature relieves us by various means. Thus the cough, which is the constant result of an accumulation of mucus in the bronchia, serves to expel it; thus vomiting in gastric derangements answers the same purpose as it respects the mucous juices accumulated in the stomach, whose presence produces a weight and even pain, though the membranes be not affected. We cough at will, because it is the diaphragm and intercostals by which this function is performed; we do not seek in medicine for any means to excite it. But as we cannot vomit at will, and as the presence of mucous juices often by fatiguing the stomach, does not irritate it sufficiently to produce a contraction, art has recourse to various emetics. We know what a painful sensation of weight the continuance of mucus accumulated in the frontal, maxillary, sinuses, &c. occasions, when there is a catarrh of a portion of the pituitary membrane. The region of the bladder is forthe same reason, in catarrhs of this organ, the seat of a troublesome and even painful sensation.
In general, the sensation which arises from the presence of the mucous juices remaining too long and in too great quantity upon their respective surfaces, varies because, as we shall see, each part of the mucous system has its peculiar mode of sensibility; so that the pain is not the same in each, though produced by the same cause. I would only observe that this sensation does not resemble that which arises from the tearing or the acute irritation of our parts; it is an uneasy, inconvenient sensation, difficult to be borne. Every one knows that which arises from mucus accumulated in the nasal fossæ, when the nose has not been blown for a long time, that disagreeable one that accompanies gastric derangements, &c. Those who have a weakness of the lachrymal sac in which the tears, on account of this, accumulate during the night, wake up with a sensation of weight, of which they are relieved by evacuating the sac by pressure, if the puncta lachrymalia are open.
The mucous membranes receive a very great number of vessels. The remarkable redness that distinguishes them would be sufficient to prove it, if injections did not demonstrate it; this redness is not everywhere uniform. It is almost nothing in the sinuses of the face, in the internal ear, of which the membranes are rather whitish, and which appear so especially, because their extreme delicacy allows the bone upon which they are applied to be seen very distinctly. In the bladder, in the great intestines, in the excretories, &c. this colour, though still very pale, is a little more evident; it becomes very much so in the stomach, the small intestines, the vagina and in the pituitary and palatine membranes. In the gall-bladder we cannot distinguish it, because the bile always covers the mucous surface in the dead body.
This colour depends upon a very extensive vascular net-work, the branches of which, after having passed through the mucous corion, and ramifying there, divide and spread ad infinitum on its surface, embracing the papillary body and covered only by the epidermis.
It is the superficial position of these vessels and consequently their want of support on one side, that exposes them frequently to ruptures from considerable shocks, as happens on the surface of the bronchia from a severe cough, on that of the ear and the nose from a violent blow on the head. We know that hemorrhage of the mucous system bordering on the brain, is a common accident from concussions and wounds of the head. Hence why the least gravel makes the ureters bleed; why one of the signs of stone in the bladder is the passing of blood; why a blunt sound carefully introduced is so often withdrawn bloody from the urethra; why the least effort made with instruments carried upon polypi, into a fistula lachrymalis or into the nostrils, produces hemorrhage. I have already observed that we must carefully distinguish these hemorrhages from those furnished by the exhalants, and which do not suppose any vascular rupture.
It is also the superficial position of the vessels of the mucous system, which makes its portions visible, as the red edge of the lips, the glans penis, &c. often serve to show us the state of the circulation. Thus in the different species of asphyxia, in submersion, strangulation, &c. these parts are remarkably livid, an effect of the passage of the venous blood, which has undergone no change from the want of respiration, into the extremities of the arterial system.
The long continued exposure of the mucous system to the air, often makes it lose the redness that characterizesit, and it then assumes the appearance of the skin, as has been observed by Sabatier in treating of prolapsus of the womb and vagina, which, from this circumstance, have sometimes so misled some people, as to make them believe it a case of hermaphrodism.
An important question presents itself in the history of the vascular system of the mucous membranes, viz. whether this system admits more or less blood according to different circumstances. As the organs within which these membranes are spread, are almost all susceptible of contraction and dilatation, as we see in the stomach, the intestines, the bladder, &c. it has been thought that during the dilatation, the vessels being more expanded, receive more blood, and that during the contraction on the contrary, being folded up, as it were choaked, they admit but a small quantity of this fluid which then flows into the neighbouring organs. Chaussier has made an application of these principles to the stomach, whose circulation he has considered as being alternately inverse of that of the omentum, which receives during the vacuity of this organ, the blood which this when it is contracted cannot admit. An analogous use has also been attributed to the spleen since the time of Lieutaud. The following is what the inspection of animals opened during abstinence and at different periods of digestion, has shown me upon this point.
1st. During the fulness of the stomach the vessels are more apparent on the exterior of this viscus, than when it is empty. Within, the mucous surface is not more red, sometimes it has appeared to me to be less so. 2d. The omentum, less extended during the fulness of the stomach, exhibits nearly the same number of vessels, as long, but more tortuous, than when it is empty. If they contain less blood, the difference is hardly sensible. I would observe, that in order to distinguish this well, it is necessary to take care that in opening the animal, theblood does not fall on the omentum which presents itself, and thus prevent its state from being ascertained. This is besides a necessary consequence of the arrangement of the vascular system of the stomach. In fact the great stomachic coronary being situated transversely between it and the omentum, and furnishing branches to each, it is evident that when the stomach is lodged between the layers of the omentum by separating these layers, and this by applying itself upon it becomes shorter; it is evident, I say, that the branches which it receives from the coronary cannot be equally applied to it also. In order to do this, it would be necessary that they should go from one to the other without the intermediate trunk that cuts them at right angles; then, in distending, the stomach would separate them as it does the omentum, and would be lodged between them; whereas it pushes them before it with their common trunk, the stomachic coronary, and makes them fold. 3d. I am confident that there is no such constant relation between the size of the spleen and the emptiness or fulness of the stomach, and that these two circumstances coincide necessarily, and that if the first organ increases or diminishes under different circumstances, it is not always precisely the reverse of the stomach. I first made, like Lieutaud, experiments upon dogs to convince myself of it; but the inequality in the size and age of those that were brought to me, making me fear that I should not be able to compare their spleens correctly, I repeated them upon guinea-pigs of the same litter and size, and examined at the same time, some when the stomach was empty and others when it was full. I have almost always found the size of the spleen nearly equal, or at least the difference was not very sensible. Yet in other experiments, I have seen under various circumstances, inequalities in the size of the spleen and especially in the weight of this viscus; but it was indifferently during or after digestion.
It appears from all this, that if during the vacuity of the stomach, there is a reflux of blood towards the omentum and spleen, this reflux is less than it has been commonly said to be. Besides during this state of vacuity, the numerous folds of the mucous membrane of this viscus leaving it, as we have said above, almost as much surface and consequently as many vessels as during fulness, the blood can circulate in it almost as freely. It has no real obstacles but in the tortuous courses, and not in the obstruction, compression and choaking of these vessels by the contraction of the stomach; now this obstacle is easily surmounted, or rather it is not one as I have proved in my Researches upon Death. As to the other hollow organs, it is difficult to examine the circulation of the neighbouring parts during their fulness and vacuity, as the vessels of these are not superficial as in the omentum, and as they themselves are not insulated like the spleen. We can only then, to decide the question, see the state of the mucous membranes on their internal face; now this face has always appeared to me to be as red during the contraction as during the dilatation.
Besides I only give this as a fact without pretending to draw from it any consequence in opposition to the common opinion. It is possible in fact that though the quantity of blood may be nearly always the same, the rapidity of the circulation being increased, more of this fluid may consequently in a given time enter it when it is full; which appears to be necessary to the greater secretion that then takes place of the mucous fluids, a secretion excited by the presence of the substances in contact with the surfaces of the same name. For example, there is no doubt that there is three or even four times as much mucus secreted in the urethra, when a sound fills it, as when it is empty; now the blood must be in proportion.
The remarkable redness of the mucous system, the analogy of respiration in which the blood flows throughthe mucous surface of the bronchia the well known experiment of a bladder filled with blood and immersed in oxygen, by which means the blood becomes red, have induced a belief that the blood being separated from the atmospheric air only by a thin pellicle or some of the mucous surfaces, as upon the pituitary, the palatine, the glans penis, &c. assumed there a redder colour, either from getting rid of a portion of its carbonic acid gas, or by combining with the oxygen of the air, and that these membranes thus performed functions accessory to those of the lungs. The experiments of Jurine upon the cutaneous organ, experiments adopted by many celebrated philosophers, seem to strengthen this conjecture.
I tried the following experiment to ascertain this fact. I drew through a wound made in the abdomen a portion of intestine which I tied at one point, I afterwards reduced it, keeping out a small portion only which I opened and by which I introduced atmospheric air, which filled the whole portion situated on this side of the ligature. I afterwards tied the intestine below the opening, and reduced the whole of it. At the end of an hour, the animal being opened, I compared the blood of the mesenteric veins which arose from the portion of intestine distended with air, with the blood of the other mesenteric veins arising from the rest of the canal. No difference of colour was manifest; the internal surface of the distended portion of the intestine was not of a more brilliant red. I thought I should obtain a more evident effect, by repeating with oxygen the same experiment upon another animal; but I perceived no greater variety in the colour of the blood. As upon the mucous membranes which are ordinarily in contact with the air, this fluid is constantly changing and is agitated by a perpetual motion, and as in the preceding experiment it remained stagnant, I attempted to produce the same effect in the intestines. I made two openings in the abdomen, and drew out ateach a portion of the intestinal canal; having opened these two portions, I fitted to one the tube of a bladder full of oxygen and to the other that of an empty bladder; I afterwards compressed the full bladder, so as to make the oxygen pass into the other, by going through this portion of intestine, left in the abdomen that the heat might support the circulation in it. The oxygen was thus many times sent from one bladder to another, taking its course through the intestine, which, on account of its contractility is more difficult than it at first seems to be. The abdomen being afterwards opened I found no difference between the venous blood returning from this portion of intestine, and that which flowed from the others. The superficial position of the mesenteric veins, covered only by a fine and transparent layer of peritoneum, their size, if the animal be rather large, render this sort of comparison very easy.
I perceive that we cannot infer from what takes place in the intestines, what happens in the pituitary, palatine membrane, &c. because though analogous, the organization may be different. We cannot here as in the intestines examine the venous blood returning from the part; but, 1st, if we consider that in animals who have respired oxygen for some time, we see the palatine and pituitary membranes more red; 2d, if we reflect that the lividity of the different parts of this membrane, in those destroyed by asphyxia by the carbonic acid gas, depends not on the immediate contact of this gas upon the membrane, but upon the passage of venous blood into the arterial system, as my experiments have, I think, demonstrated; 3d, if we remark finally that in these circumstances the contact of the air does not change, after death, the lividity which the venous blood gives to the mucous membranes, although the skin be then much more permeable to every kind of aeriform fluid; we shall see that it is at least necessary to suspend our judgment upon the colouring ofthe blood in the mucous membranes, until further observations have decided the question.
The following experiment may also throw some light upon the subject. I have inflated the peritoneal cavity of several guinea-pigs with carbonic acid gas, with hydrogen, oxygen and atmospheric air, to see if I could effect through a serous membrane what I could not make succeed in a mucous; I have not, after these experiments, found any difference in the colour of the blood of the abdominal system; it was always the same as in the common guinea-pig which I killed for comparison.
I think however that I have remarked many times, both in frogs and animals with red and warm blood, such as cats and guinea-pigs, that the infiltration of oxygen into the cellular texture gives, at the end of some time, a much brighter colour to the blood, than that which this fluid exhibits in artificial emphysemas produced by carbonic acid gas, hydrogen and atmospheric air, in all which the colour of the blood scarcely differs at all from what is natural. But in other cases oxygen has had no influence upon the colour of the blood; so that notwithstanding having made many experiments upon this point, I am unable to give any general result. It appears that the tonic forces of the cellular texture and of the parietes of the vessels which are spread upon this texture, receive a very variable influence from the contact of the gases, and that according to the nature of this influence, the fibres crisping and contracting more or less, render these parts more or less permeable, either to the aeriform fluids that tend to escape from the blood in order to unite with that of the emphysema, or to this last fluid, if it tends to combine with the blood, which no doubt produces the varieties I have observed.
The red colour of the mucous system is analogous to that of the muscular system. It does not depend essentially on the blood circulating in the small arteries of thissystem. It arises from the colouring portion of the blood combined with the mucous texture, especially in the deep part of the organs; for at the origin of the mucous surfaces, this colour appears to be principally owing to the blood in circulation; in fact asphyxia does not render so livid the deep mucous surfaces, as it does those which are superficial and in communication with the skin. The black blood arrives immediately to these by the last arteries, and tinges them as we see. In syncope in which the heart being affected no longer sends blood into the arteries, we know that this portion of the mucous system becomes instantly white.