the cause of obstruction of the affected vessel is certainly involved in obscurity. The following is an account of the case: "A German of middle age, a strong, muscular man, fell down a steep stair when drunk, and sprained his right elbow-joint. On examination, there was found to be a great degree of swelling and tension of the soft parts around. There was no fracture or dislocation to be discovered, but the joint appeared looser than natural, as if some of the ligaments had been torn. Mr. Turner was surprised, on endeavouring to feel his pulse at the wrist, not to be able to discover any pulsation in the radial artery, neither could he detect any in the ulnar nor in any part of the arteries of the fore-arm. The pulsation of the humeral artery was distinct up to the bend of the elbow. Next morning, when sober, he complained of violent pain in the arm. The swelling and tension were rather increased. The absence of pulsation in the arteries continued. He was sent to the Edinburgh Royal Infirmary, and Mr. Turner did not see him for more than a fortnight after this. At that time the swelling and pain of the elbow-joint had almost entirely subsided. On examining the arteries of the fore-arm, no distinct pulsation was to be felt, and pulsation in the humeral artery could be distinctly felt to the fore-part of the elbow-joint, where it suddenly ceased. The fore-arm was pale, and the veins much smaller and more collapsed than those in the other arm, and when they were compressed they filled very slowly. Sensation and motion of the fore-arm and hand were perfect. The patient ultimately recovered perfectly." "Mr. Turner thinks that cessation of the pulse must be here accounted for in the same way as in the cases already related—that is, by rupture of the internal coats of the artery. The artery could not have been torn across, otherwise there must have been an extensive effusion of blood into the cel lular substance of the arm and fore-arm, of which there were no symptoms; nor could the pulse have been stopped by pressure from the effusion into, and consequent tension of, the parts surrounding the artery. Usually no such effect is produced, and the stoppage would not have been permanent, but the pulsation would have returned as the swelling and tension abated, as they began to do very soon after the accident." Even if rupture of the internal coats had been sufficient to cause obstruction in the artery, it is difficult to conceive how such an injury could have occurred in this case. The humeral artery might have been considerably bruised by the fall the man had, but mere bruising of an artery, unless with a sharp instrument like the teeth of a forceps,* is not sufficient to cause rupture of the internal coats, much less obstruction of the vessel. This is shown by my sixth experiment, where the right femoral artery, being raised on a copper spatulum, was bruised by striking it several smart blows with a percussion hammer without causing any rupture of the inner tunics; and also by my seventh experiment, where the left femoral artery of another dog was similarly treated, and with a like result. The only explanation I can think of is that, previous to the occurrence of the injury to the elbow, there may have been obstruction of the lower end of the humeral artery, which had until then escaped notice. * See Experiment VII. PART FOURTH. Chronicle of Medical Science. HALF-YEARLY REPORT ON PHYSIOLOGY. Licentiate of the Royal College of Physicians, Physician to the German Hospital. I. DIGESTIVE ORGANS. 1. BOULEY and TROUSSEAU: On the Effects of the Ligature of the Esophagus in Animals. (Brown-Séquard's Journal of Physiology, vol. i., p. 777, 1858.) 2. BROWN-SEQUARD: Remarks on the Phenomena Consecutive to the Ligature of the Esophagus. (Brown-Séquard's Journal, vol. i., p. 799, 1858.) 3. ECKHARD: On the Influence of the Irritated Sympathetic Nerve on the Secretion of Saliva. (See Sub. IV., Nervous System.) 4. FUNKE: On the Endosmotic Qualities of the Peptons. (See Sub. III.) IN July, 1856, Bouley stated before the Academy of Medicine, as the result of many experiments, that ligature of the oesophagus is by no means an indifferent operation, as Orfila had maintained, but that it causes very serious symptoms, and even death, and that the inferences drawn from experiments implying ligature of the oesophagus, can be accepted only with great discrimination. In consequence of this statement, the Academy named a commission, consisting of Bégin, Bouley, Jobert, Larrey, Renault, and Trousseau. The report of this commission, as communicated by Trousseau, contains the following inferences:-1. The application of a ligature round the esophagus constantly followed by certain symptoms, which require to be taken into consideration in toxicological researches. 2. The symptoms are more or less serious according to the amount of constriction of the oesophagus. 3. Permanent constriction is fatal in nine-tenths of the cases. 4. Death takes place in the majority of animals between the third and sixth day after the operation. 5. The symptoms characteristic of permanent ligature of the esophagus are those of extreme prostration. 6. The lesions produced by permanent constriction of the œsophagus, are inflammation of the nerves (accompanying the œsophagus), and of the adjacent parts, either with or without purulent deposits. 7. Temporary ligature of the oesophagus is fatal only in three per cent. 8. As a general rule, the effects are less grave in proportion as the ligature was kept on less long, and the constriction less light. 9. The phenomena produced by ligature of esophagus can lead to the supposition of poisonous properties in inoffensive substances. the oesophagus ought always to be taken into account in toxicological experi10. The possible effects of ligature of ments requiring the ligature of the esophagus. Brown-Séquard remarks that his experiments prove that mere irritation of the nerves of the oesophagus, without obstruction of the passage, cause the same symptoms as those produced by the ligature, though in a less degree; while the ligature round the œsophagus, after the previous section of the oesophageal nerves, is not followed by the phenomena described by Bouley and Trousseau, but only by those of starvation and of inflammation of the wound. Brown-Séquard ascribes some of the principal symptoms of the ligature to reflex action, and promises to prove this view in a future essay on the nutritive phenomena and reflex secretions. II. BLOOD; CIRCULATION; RESPIRATION. 1. BROWN-SEQUARD: Experimental Researches on the Physiological Properties of the Red and Dark Blood. (Brown-Séquard's Journal of Physiology, vol. i., p. 729, 1858.) 2. BERNARD: Two Memoirs of the Variations of Colour of the Venous Blood. (Brown-Séquard's Journal, vol. i., p. 649, 1858.) 3. DRAPER: On the Modifications of the Blood-globules in the Spleen. (New York Journal of Med., Sept. 1858; and Brown-Séquard's Journal, vol. i., p. 825, 1858.) 4. GERHARDT: Researches on the Dulness of Percussion from the Heart, and the Change of Place of its Limits in Healthy Persons. (Archiv f. Phys. Heilkunde, Jahrgang 1858, p. 489.) 5. VIERORDT: Law of Dependence of the Mean Durations of Circulation in various Species of Animals from the Mean Frequency of Pulsation. (Archiv f. Phys. Heilkunde, Jahrgang 1858, p. 527.) 6. FÜHRER: On some Outlets (Auswege) of the Circulation of Blood. (Archiv f. Phys. Heilkunde, Jahrgang 1859, p. 145.) 7. BROWN-SÉQUARD: Experimental and Clinical Researches on some Points concerning Asphyxia. (Brown-Séquard's Journal, vol. ii., p. 93, 1859.) S. VALENTIN: On Respiration after Suppression of Transpiration. (See On a former occasion* we have mentioned Brown-Séquard's researches on the physiological properties of the red and of the dark blood. The author has arrived at the following further inferences in connexion with the same subject:-10. In the nervous and contractile organs, the persistence of the possibility of recovering the vital properties after they had completely disappeared, is found to show the following increasing series-brain, spinal marrow, urinary bladder, intestinal canal, uterus, heart, iris, sensitive nerves, motor nerves, muscles of animal life. The limits, hitherto found, were for the brain of an adult dog, twenty-two minutes; for the muscles of animal life of a dog, six hours. 11. To the oxygen contained in the blood, the power of regenerating the vital properties of contractile and nervous tissues must be attributed. 12. The contractile tissues of the principal organs of the animal economy, at all events in vertebrata, can be stimulated by blood saturated with carbonic acid. 13. Blood saturated with carbonic acid also acts as an excitant on nervous tissues. Bernard has continued his researches on the change of colour of venous blood, derived from various glands, according to the physiological condition of the glands. The experiments which form the basis of the present essay have been performed on the submaxillary gland of dogs. The glandular nerve of this gland appears to come from the fifth pair, but in reality the greater portion of it is formed, according to our author, by the chorda tympani. Galvanization of this nerve, through which the function of the gland, and thus profuse secretion of saliva, is excited, causes the venous blood proceeding from the gland to become of a bright red colour, like the arterial blood; at the same time the quantity of blood flowing from the vein appears much increased, and occa↑ Ibid., p. 226, * Conf. this Journal, No. xliii. p. 225. 1858. sionally the motion of the blood is distinctly jerking. A similar result is obtained when the function of the gland is excited by means of substances placed on the tongue of the animal. During the state of rest, i.e., while the gland does not secrete, the venous blood issuing from it is dark. The opposite influence appears to be exercised by the filaments of the great sympathetic nerve, which accompany the glandular branches derived from the external carotid artery. Dissection of these sympathetic filaments is followed by a change from the dark colour of the venous blood into bright red, while the application of galvanism to the peripheric portion of the filaments renders the colour again dark, and diminishes the velocity of the circulation. Corresponding to these changes in colour and velocity, are changes in the diameter of the vessels. The glandular or tympanico-lingual nerve, as Bernard names it, renders the diameter of the capillary vessels larger; the sympathetic nerve, on the contrary, produces contraction. These two kinds of nerves are considered as being in constant antagonism, their contracting and dilating action is regarded as the cause of all the other phenomena; the physiological action of the nerves producing merely mechanical alteration, which necessarily induces chemical changes. The author dwells especially on the fact illustrated by these discoveries, that each organ or each portion of the body has, to some degree, its own circulation, influenced by modifications in the nervous action, but more or less independent of the general circulation. In the second memoir, Bernard gives us the result of his chemical examinations, made by means of the oxide of carbon, that the bright red venous blood contains in every 100 volumes 17-26 volumes of oxygen, while the dark venous blood contains only 6:40 volumes, the arterial blood yielding 19:46, i.e., only 2.2 more than the bright red venous blood. Finally, the author points out the apparent difference between the muscular and glandular system, with regard to the colour of venous blood, the latter being darker and more deoxidized in proportion to the increased action of the muscle, more red and less deoxidized in proportion to the increased action of the glands. The author is, however, inclined to consider our expressions, "functional action," and "state of rest," as not quite correct for the glandular system, the state of rest being, in fact, one of chemical activity, that of functional action one of principally mechanical activity. H. Draper supports Kölliker's view, that the spleen is an organ in which the destruction of blood-globules takes place. He arrived at this inference by microscopic examination of the blood of the splenic vein, compared with that obtained from the limbs. As we have not seen the original communication, we mention only, from the extract in Brown-Séquard's Journal, that the blood of the splenic vein contained among every 100 globules 83 of an altered shape, (retrogressive metamorphosis ?); while the blood from the limbs contained only 40 among 100. Gerhardt's researches made at the University Hospital at Tübingen show that-1. In healthy persons the change of position from one side to the other, causes considerable change in the position of the heart's apex; the greatest variation observed was 9 centimetres, or 3.51 inches. 2. During in- and ex-piration the heart moves together with the diaphragm, and also exhibits a movement round its axis when the respiratory movements are of great extent. 3. The change from the erect to the horizontal position produces little or no change in the position of the heart: this fact renders probable the exist ence of an apparatus which prevents locomotion under these circumstances. Vierordt publishes a considerable number of experiments performed on various animals, with the view to ascertain the connexion between the mean duration of the circulation of blood and the frequency of the pulsations of the heart. The result of these experiments appears to corroborate the laws propounded by the same author in his monograph, "On the Phenomena and Laws 231 of the Velocity of the Circulation of the Blood."* Vierordt had then drawn his principal inferences from the phenomena observed on the horse, the dog, the rabbit, and the goat. The experiments of the present essay were performed on one or more cats, rabbits, foxes, hedgehogs, dogs, squirrels, guineapigs, hens, geese, ducks, buzzards, ravens, and owls. It will be remembered, that the first law of circulation propounded by the author in the work alluded to was, "The mean duration of circulation of a species of mammalia is equal to the average time in which the heart completes twenty-six to twenty-eight pulsations." This law is corroborated by his present researches, the average figure for mammalia being 26-3, and, if we except the hedgehog (in which counting the pulsations was extremely difficult) 26.8. It is also shown that birds are subject to a similar law, the average figure for them being 29.0. Führer's elaborate article "On some Outlets (Auswege) of the Circulation of Blood," contains, besides original researches, the corroboration of very important communications made fourteen years ago by the late J. G. Lessing, in an essay hitherto almost unknown, bearing the title "On a Plasmatic Vascular System in all Tissues; but especially in the Bones and Teeth."† We are prevented from entering into the details of these researches, but cannot forego translating the principal conclusions arrived at by Führer. "The doctrine of the circulation of blood, as described in our handbooks of anatomy and physiology, as a circle complete in itself, in which the blood passes from one system of sanguiferous vessels into the other, requires the following alterations : "1. A portion of the capillaries becomes incorporated with the organs, to form an essential element of their tissue." (p. 201.) The author adduces as instances the spleen, in the parenchyma of which new capillaries are constantly formed; the iris and choroid, with their pigment-containing ramifications; the cornea, with its system of transparent tubes anastomosing with each other, which system, being adapted to the function of the cornea, is as essential to its nutrition as it is inseparable from its tissue. The tubuli of the teeth, and the cells (corpuscles) of bones, are adduced as other instances of the entrance of capillaries into the structure of organs and their various formations, according to their general texture and function. In cicatrices and in the productions of chronic inflammatory processes, we find tubular fibres communicating amongst themselves, which take their origin in sanguiferous vessels, and persist, under various appellations, as plasmatic (serous) vessels. In the connective tissue (areolar tissue, bindegewebe), and in the parenchyma of organs, a reticular structure is seen, presenting the appearance of nuclei, connective-tissue corpuscles, and fibres. These are plasmatic (serous) vessels, which, under normal circumstances, do not convey blood-globules, and have always been considered as essential constituents of the tissue. "2. A portion of the capillaries, and of their terminations, does not directly return to the sanguiferous vessels, but forms the lymphatic vessels." (p. 203.) The lymphatic vessels are considered as collateral passages to the veins. The doctrine of a separate system of absorbents, with an origin distinct from that of the veins, would, according to this inference, be incorrect. "3. Arteries, veins, and lymphatics possess a common capillary system, in which the terminations and origins of the various classes of vessels are connected among themselves by anastomosis. There is no real limit between lymphatic and blood-vessels." (p. 203.) The vessels called serous (plasmatic) vessels, are of intermediate nature, which, under strong pressure, admit blood, * Conf. this Journal, No. xlv., p. 230. 1859. + Mittheilungen aus den Verhandlungen der naturwissenschaftlichen Gesellschaft in Herold'sche Buchh. 1846. Hamburg, vom Jahre 1845. Conf. this Journal, No. xxvii., p. 253. 1854. |