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dred pulsations in a minute, while not more than seventy II. Moving strokes may be exhibited in any other part of the sys- powers of
the sanguitem. The rapidity of the pulse is in this case usually in neous sysproportion to the degree of the inflammatory action *: and hence, if the system should labour at the same time under ten different inflammations in different parts or organs of a different structure, as glands, muscles, and membranes, it is possible that it may have so many different seats of pulsation taking place at such different parts at one and the same time, while all of them are at variance with the pulsation of the heart. Even where there is no inflammation such discrepancies in the pulse are occasionally to be met with, insomuch that Reil gives a case in which the heart, the carotids, and the radial arteries all pulsated differently t: and we can hence readily perceive why they should be more frequent and striking under the increased action produced by inflammation, and often, in a debilitated organ, more disposed to irregular action and particularly irregular contractile action in its capillaries.
We are, indeed, let a little into the mystery of this phæ- Capillaries nomenon by the curious fact that some of the arteries pos- P sess a higher degree of contractile power than others, tractibility
than the and that the capillarięs possess the highest measure allotted to any of them. " Indeed every fact”, observes Dr. Bos- arteries. tock, “ with which we are acquainted respecting the me- Confirmed chanism and functions of the sanguiferous system, lead y us to the same conclusion, that the large arteries are to be regarded as canals transmitting the blood from the heart, where it receives its great impulse, into the smaller branches; and that it is chiefly in these smaller branches that it exercises its various functions.”I We may hence Important see why the capillaries are, in many cases, so much sooner
vrases so much sooner effect of this
fact on inexcited than the larger canals, and exhibit so much more flammation.
• Exposition of the Principles of Pathology, &c. By Daniel Pring, M.D. p. 119. 8vo. 1823. + Memorabilia Clinica. Vol. 11. Fascic. 1-6. Hall. 1792.
Elementary System of Physiology. Vol. 1. p. 402. 8vo. 1824. . VOL. II.
II. Moving violence of action: a distinction of high importance in powers of
explaining the doctrine of inflammation, though it has the sanguineous sys- been less attended to by pathologists tban it deserves..
The hypothesis, therefore, of a vis à tergo, whether Hence the
dependent upon the heart alone, upon the arteries alone, of a vis à or upon a combination of the two, has by no means tergo unsatisfactory, proved sufficiently satisfactory, or been sufficiently sup
ported by evidence in respect to the entire circulation. soever derived.
Under no modification does it account for the flow of the blood through the veins. And in regard to the whole of the views which have been thus far examined, Mr. John Hunter, as I have already observed, was so extremely discontented that he placed no more stress upon one part or organ of the sanguiferous system than upon another; upon the heart than upon the arteries; or upon
the arteries than upon the veins; regarding the whole Further economy as the result of a sort of instinct, to which, as opinions of Mr. J. just noticed, he gave the name of a stimulus of necessity; Hunter. and which opinion he supported by making an appeal to
insects which have no proper heart; to worms, most of which have no heart whatever; and to monsters which have been born without a heart; whilst at the same time he contended that veins, at least the larger, exhibit, under certain circumstances, an expansile and contractile power as well as arteries. “I think it probable”, says he, “ that where there is an universal action of the vascular system, the action of the arteries and veins is alternate: that where the arteries contract, as in many fevers, the veins rather dilate, more especially the larger."*
And it is hence, again, highly probable that in this uniAction of versal action of the vascular system” the secernents or
extreme arteries take an important part, and, as has since been suggested by Dr. Pringt, operate by a kind of suction, which may be regarded as a vis à fronte... ;
Upon the whole we may conclude with Haller, that the heart exerts a very considerable degree of force in the general economy of the circulation, although it is
impossible to estimate its power with mathematical pre- II. Moving cision. And we may reasonably refer the first, or ar
the sanguiterial half of the general circuit of the blood to this force, neous sysif not alone, in conjunction with the aid contributed by tem the elastic and contractile tunics of the arteries them- Moving
power of arselves, whether pulsation be a result of these powers terial cir. alternately exercised, or of mere local pressure.
culation. It yet remains, however, to account for the second half, Moving or that which consists in the passage of the blood through power
" venous cirthe veins; and upon this subject there is one most im- culation. portant and elucidating fact, which, till of late, has never been in any degree brought forward in the course of the inquiry. It is this: that when the heart, by the contraction of its ventricles, has exhausted itself of the blood contained within it, a comparative vacuum must follow, Vacuum in
the heart and the blood from the venæ cavæ, or venous system at large, be sucked up into the right auricle. This inge- by its sysnious remark seems first to have been thrown out by Dr. tole Wilson : and Dr. Carson of Liverpool, taking advantage of it, has constructed a simple and beautiful theory of the projectile powers employed in the circulation, the general principle of which may be expressed in a few words. The heart is supposed to act at one and the General cirsame time in a two-fold capacity. By the contraction of culation
produced by the ventricles, it propels the blood through the arteries; the double? and by the dilatation of the auricles, it draws it up from power of the
heart acting the veins. It is at once, therefore, a forcing and a suc- as tion pump. The contraction of the heart, and conse- and suction
pump: quently its comparative vacuum, are supposed to be con- ass siderably assisted by the elasticity of the lungs, and the surrounding play of the diaphragm, which we had occasion to notice agency. at some length in our physiological proem to the preceding class, and the great resistance which they jointly afford to the atmospheric pressure; whilst this very pressure, applied on every part of the exterior of the animal frame, contributes in an equal degree to the ascent of the blood in the veins; for, as the column of ve
• Wilson's Enquiry, &c. pp. 9. 11, 18. &c.
II. Moving nous blood is perpetually girt on all sides, and cannot powers of fol the sangui
fall back because of the numerous valves with which the neous sys- veins are furnished, it must necessarily take an opposite
or ascending direction. Difficulties There are, nevertheless, numerous difficulties that yet to remain- remain to be explained ; such as the proportion of proexplained. jectile power furnished by the conducting pipes them
selves; by what means the want of a diaphragm is compensated in birds and reptiles which have no such organ; and what constitutes the projectile power in animals that have no heart, and consequently no double pump to
work with*. Communi- There is also another curious fact which physiology cation be. Lone
: has pointed out, but has never hitherto been able to exmote organs plain : and that is, a direct communication between redistinct from that of the mote or unconnected organs, apparently, by some other blood. channel than the circulation of the blood. Something Between the of this kind seems to exist between the spleen and the spleen and stomach. stomach, the former of which has been proved by Sir
Everard Home to receive fluids from the cardiac portion of the latter, though we can trace no intercourse of vessels: but the most extraordinary example of this kind
which at present we seem to possess, is the communicaBetween the tion which exists between the stomach and the bladder. stomach and bladder. For the experiments of Sir Everard Homet, and the
still more decisive ones of Dr. Wollaston and Dr. Marcet , seem to have established, beyond a controversy, that certain substances introduced into the stomach, as rhubarb or prussiate of pot-ash, may pass into the bladder without taking the course of the blood-vessels, and
consequently by some other channel ; a channel, indeed, This subject of which we know nothing. This is a subject well worth entitled to further in- studying: for if two organs so remotely situated as the quiry. stomach and the bladder be thus capable of maintaining
a peculiar intercourse; so other organs may possess a like
Diatribe Anatomico-Physiologica de Structurâ atque Vitâ Venarum ; à Medicorum ordine Heidelburgensi præmio proposito ornata. Auctore Henrico Marx. 8vo. Carlsrue 1822. + Phil. Trans. 1811, p. 163.
Ibid. p. 96.
and its im.
intercommunion; and by such means lay a foundation for II. Moving those numerous sympathies between distant parts which
the sanguiso often strike and astonish us. M. Magendie's hypo- neous systhesis that veins are absorbents will explain the facts in tem Sir Everard Home's experiments, but has no bearing upon that of Dr. Wollaston and Dr. Marcet.
The discovery of the circulation of the blood has given Doctrine of a great importance to the DOCTRINE OF PULSATION; for
pulsation, by the strength or weakness, the slowness or frequency, portance. the hardness or softness, the freedom or oppression, the regularity or irregularity of the beat of the artery against the pressure of the finger, we are now able to determine many momentous facts, relative, not merely to the state of the heart, but of the general system; and, in many cases, to prognosticate upon grounds which were altogegether unknown to the earlier cultivators of medicine. And on this account it is that the Greek physicians took but little notice of the pulse, which, even in the days of Celsus, was regarded as a res fallacissima. The pulse is influenced indirectly by the general state Pulse how
influenced. of the body, but directly by that of the heart, or of the arteries, or of both, or of the quantity of blood which the vessels have to contain.
In an adult male of good health, and not too corpu- Standard in lent, the common standard of the pulse may be fixed at ad seventy strokes in a minute: but it varies in different individuals from sixty to eighty, being greatly affected by Influenced the temperament, and partly by the habit of life. In the by tempera
ment and man of a high sanguine character it rarely sinks below idiosyncraeighty, and is often at ninety; and in the melancholic it sies. seldom rises above sixty, and sometimes sinks to forty. In some idiosyncrasies the discrepancy is so considerable, and complicated with other changes than those of frequency and tardiness, that there is no reducing them to any rule.
Lizzari tells us of a person whose pulse was not more Singular inthan ten beats in a minute *. Dr. Heberden says, he once stances. saw a person whose pulse, as he was told, did not num
• Raccolta d'Opusculi Scientifici, p. 265.