Chapter XIV: Section II (9)

I would remark upon this subject that the anastomoses furnish the first proof of a truth which we shall soon demonstrate more in detail, viz. that in the great trunks, the blood is especially influenced by the heart, and that in the capillaries, it is exclusively by the vascular parietes. In fact it is because the vitality of the arteries is every thing for the motion of the last subdivisions, that the least alterations that they experience give rise to many engorgements that inevitably require anastomoses, which are extremely numerous at the end of the arterial tree. On the other hand, the vitality of the trunks having scarcely any influence upon the blood, it experiences but few obstacles in passing through them; there is less need then of anastomoses, which are in fact more rare there.

If the least cause, the least irritation produced spasm of the trunks, as they produce that of their last divisions, it would be necessary that they should communicate as frequently together. A fleshy texture in the great arteries, and vital properties analogous to the involuntary muscles, would have required inevitably these numerous anastomoses, because a variety of causes influencing these kinds of muscles, they can at any moment increase unnaturally their contraction, diminish their caliber and embarrass the progress of the fluids that traverse them.

_Forms of the Arteries in their course._

Many physicians of the present age have described each artery as forming a cone, the base of which is towards the heart, and the apex towards the extremities. If we examine a portion of it between the origin of two branches, whether after having injected it, or by cutting it perpendicularly when it is empty, or by measuring it when it is full of blood, we find it always cylindrical. Undoubtedly considered in its whole extent, it takes a conical form, the effect of its successive diminution by the branches it furnishes; but in this sense it is less a cone, than a series of cylinders successively joined to each other and always decreasing.

Considered in its general arrangement, the arterial system represents on the contrary, as I have said, a cone absolutely inverted, that is to say, having its base at all the parts and its apex at the heart; so that the aorta has a diameter less considerable in proportion, than that of the sum of all the branches. We have a proof of this by comparing a trunk with two branches that succeed it; these surpass it in diameter, and the relation being always the same in all the subdivisions, we conceive that the capacity of the arterial system goes uniformly increasing.

This relation of the trunks and the branches has been exaggerated however by mathematical physiologists, who attributed to the last over the first a predominance much greater than really existed. A cause of error upon this point may arise from measuring the arteries at their exterior after having injected them; in fact, the caliber of the trunks is greater, in proportion to their parietes, than that of the branches separately examined; that is to say, other things being equal, the aorta has parietes thinner in proportion to its cavity, than the cubital artery; hence, without doubt, why aneurisms are rare in the branches, and frequent in the trunks, especially when the diseases arise from a local cause; for if they are the effect of a general disease, oftentimes the little arteries, the radial particularly, are also affected; I have already seen two examples of it. This observation upon the proportions of the arterial parietes proves the impossibility of judging of the relations of diameter between the two, at least by examining them in the interior.

Besides, these relations are necessarily very variable, according as the vital forces which vary themselves so much, increase or contract the caliber of the small arteries; and in this point of view, this examination cannot have the importance that was attached to it by the ancients, whose works are filled with calculations upon this point.

III. _Termination of the Arteries._

After being divided, subdivided, and having the peculiarities we have just examined, the arteries terminate in the general capillary system. To point out where this system begins, and where the arteries end, would be very difficult. We can prove that there the blood ceases to be entirely under the influence of the heart, and circulates by the influence of the insensible organic contractility of the vascular parietes; but how can this line of demarcation be rendered evident to the eye?

Authors in treating of the termination of the arteries, have considered their continuity with the excretories, the exhalants, the veins, &c.; but it is evident that the general capillary system is between the arteries and these vessels. Thus I shall treat of their origin in speaking of this system, which is spread in all the organs, but has essential differences according to the different systems, under the relation of its continuity with the arteries. In fact, 1st. there are systems in which these vessels are distributed in great quantity, and in which consequently the general capillary system contains much blood; such are the glandular, the mucous, the cutaneous, the animal and organic muscular, &c. 2d. Other systems receive but few arteries, as the osseous, the fibrous, the serous, &c. and consequently have but little blood in circulation in that portion of the general capillary system that belongs to them. 3d. Finally the pilous, epidermoid, cartilaginous systems, &c. destitute of arteries, contain only white fluids in the division of the general capillary system that has its seat in them.

ARTICLE THIRD.

ORGANIZATION OF THE VASCULAR SYSTEM WITH RED BLOOD.

I. _Textures peculiar to this organization._

The red blood circulates, as I have said, in a membrane arranged in the shape of a great canal, variable in its form, extended from the pulmonary capillary system to the general one, and having every where the greatest analogy. At the exterior of this membrane, nature has added a fibrous coat for the arteries, fleshy fibres for the heart, and a peculiar membrane for the pulmonary veins. I shall speak here only of the arterial coat. The fibres of the heart and the membrane of the pulmonary veins will be examined, one in the organic muscular system, the other in the system with black blood. As to the internal membrane of the arteries, which is also that of the whole system with red blood, we shall examine it in a general manner.

_Peculiar Membrane of the Arteries._

This membrane is firm, compact, very apparent in the great arteries, less evident in the last divisions where it is insensibly lost. Its colour is usually every where the same. If the branches appear red in living animals, and the trunks yellowish, it arises only from the transparency of the one which allows the blood to be seen, and the opacity of the others. The colour of the arterial fibre is yellowish. However it assumes in certain cases a greyish appearance. I have often observed in arteries exposed to maceration, that it reddens in a very evident manner at the end of some days, or rather that it takes a rosy tinge, very analogous to that of the cartilages of the fœtus and of the fibro-cartilages of the adult, submitted to the same experiment. This result is however less uniform in the arteries than in those two systems, in which it is never absent. Sometimes the internal membrane reddens also, but never the external or cellular; on the contrary, the longer this remains in water the whiter it becomes. When the fibrous coat of the arteries has continued some time with this redness, it gradually loses it, if maceration is continued. This phenomenon is often more evident in the branches than in the trunks. For example, the arteries at the base of the cranium become red very frequently in the dead body, by remaining in the fluids with which this part is moistened. We see, in opening the cranium, this redness which does not belong to the blood left in the arterial cavities, as we may be easily convinced.

The thickness of the peculiar membrane of the arteries is very evident in the great trunks. It constantly diminishes; a circumstance that distinguishes it essentially from the internal membrane, which I have found almost as thick in the tibial artery as in the aorta. It has been thought that in certain arteries, as in the cerebral, the fibrous coat is entirely wanting. There is no doubt that in the vertebral and internal carotid it is thinner in proportion than in equal trunks situated in the muscular interstices; but by examining attentively these arteries, I have clearly distinguished circular fibres in them. Has the thinness of their parietes an influence upon the sanguineous effusions, which are, as we know, so frequent in the brain? I cannot say. These effusions take place only in the capillaries, the trunks are never the seats of them; now it is impossible to examine these capillaries. I have sought in vain to ascertain by injections the vessels torn in apoplexy. Besides, this hemorrhage does not resemble that of the serous membranes; it is not an oozing through the exhalants of the ventricles; for these cavities are very rarely the only seat of it. Almost always these effusions take place even in the cerebral substance, generally nearer the posterior than the anterior lobe. The cerebellum is rarely affected by it. When the tuber annulare becomes so, there are often small partial effusions there, separated by medullary partitions that remain uninjured.

As to the arteries of the other parts of the body, their peculiar membrane presents generally a pretty uniform arrangement. It has appeared to me however, that in the interior of the viscera, of the liver, of the spleen, it is rather thinner than in the intermuscular spaces, and even than in the muscles.

This membrane is composed of very distinct fibres, adhering to each other, easily separated however, arranged in layers, in such a manner that after having raised the cellular covering, we can without difficulty separate these different layers from each other; it is this that has made many authors believe that the great arteries were composed of a great number of coats. The fibres that form these layers are circular or nearly so; the external ones appear to be attached to the compact cellular texture that is contiguous. In fact, by raising this, a number more or less considerable adheres to it always in an intimate manner. As to the internal membrane, it does not appear to furnish any attachment; we raise it easily, without bringing with it any arterial fibres. The manner of the adhesion of these fibres with the compact neighbouring texture, appears to me to have great analogy with the origin of the organic muscular fibres, which are attached in a great number of places, to the sub-mucous texture.

When a branch arises from a trunk, the circular fibres of the last separate and form on each side a half ring, whence arises a complete one, which embraces the small rings formed by the circular fibres of the arising branch. These circular fibres go even to the eminence of the common membrane, which is seen within the arterial cavity and of which I have spoken; so that the whole thickness of the peculiar membrane serves as a support to their origin. But there is but little continuity between the two kinds of fibres. Those of the branch do not arise from those of the trunk; it is the internal membrane that serves to fix them together, as fibres of communication. Dissection shows easily these branches set at their origin in the ring which arises from the separation of the circular fibres. We remark this at the origin of the intercostals and lumbars upon the aorta, &c. When two trunks of an equal size go off, as the iliacs, the last circular fibres of the primitive trunk which they formed, interlace intimately with the origin of each of the two circular layers, that arise at the fork that separates this origin. Thus the last rings of the aorta cannot be separated from the first of each iliac.

There are no longitudinal fibres in the arteries.

What is the nature of the arterial fibre? Almost all anatomists have considered it the same with the muscular. But if we examine them attentively, it is easy to be convinced of their differences. The want of red colour does not establish these differences, since in man even, some parts really muscular, as the intestines, want this colour. But the muscular texture is soft, loose and very extensible; the arterial texture on the contrary is firm and solid, breaks before it yields. We can observe this, by tying an artery tight. The two internal coats are cut; the cellular alone is not, though the ligature is immediately applied to it; we observe, by opening the artery, a section corresponding with the thread, exactly similar to what a cutting instrument would have made.

I have often repeated this experiment, pointed out by Desault, upon the dead body, and upon living animals; the result which is very uniform, explains the frequency of hemorrhages after the operation for aneurism. There is undoubtedly no texture so brittle, if I may use the word, as the arterial, none consequently less proper to be embraced by ligatures. Why is it that this should be the only one in which it is necessary to apply them? This phenomenon alone would distinguish the arterial texture from the muscular. In fact, the preceding experiment, made upon a portion of intestine in which the fibres are arranged like the arterial, would produce a flattening, an approximation of these fibres, but would not cut them.

Moreover compare the properties of texture of the arteries with those of the muscles; compare their vital properties, by examining the articles in which I treat of these properties; compare their development, and especially the different morbid alterations to which the two are subject, and you will see that there is not a single relation in which they have the least analogy. The aneurism of the heart and that of the arteries have nothing in common but the name. In one there is a rupture of the arterial fibres, a dilatation of the cellular coat; in the other an unnatural increase, a real development of muscular fibres which preserve their appearance and their properties.

Notwithstanding the ease with which the arterial fibres are broken in cases of aneurism, they enjoy in a natural state a very considerable degree of resistance and force; another character that distinguishes them from the fleshy texture. The following are the proofs of this resistance, which takes place both transversely and longitudinally. 1st. If we tie the carotid artery above, and drive a fluid afterwards into it, great force must be employed to break its texture. The same thing happens when we force in air instead of a liquid. Frequently the efforts of a man are insufficient to produce a rupture; thus the force of the heart can never cause it suddenly; so that the formation of aneurisms takes place only from the long continued action upon the arterial parietes; I doubt whether these tumours can be formed, without a previous alteration of the arterial texture, by the force of the impulse of the blood alone against the weak parietes of the arteries. 2d. The resistance of these parietes takes place longitudinally also. If we draw in a contrary direction, the two ends of an artery and of a muscle, we effect with more difficulty the rupture of the first, when the dead body is the subject of this comparative experiment. But upon the living the effect is opposite; the vessel yields to a very strong action made upon it; it would be necessary that this action should be incomparably greater to divide the muscle. This difference arises evidently from the vital properties of the latter, which in this case contracts violently, whilst the artery can make no further resistance than from the nature of its texture. Besides, this longitudinal resistance to distension is less than the lateral resistance opposed to the injection; experiments prove it, and it arises without doubt from this, that no fibre, in the first case, is found directly opposed to the effort.

This resistance of the arterial texture, so different from that of the venous, is a necessary consequence of the situation of the heart at the origin of the arteries. In fact, this organ driving the blood with force into their tubes, should find there a force capable of resisting the greatest efforts of which it is susceptible, when its sensible organic contractility is raised to a high point. This is the great advantage of the arterial texture. What would become of the circulation and all the functions that depended upon it, if the least cause which increased the force of the blood could dilate the parietes of the arteries beyond the ordinary degree? It was necessary that their texture should render these parietes independent of the different degrees of motion of the fluid that circulates in them; whence it follows that a fleshy heart and resisting arteries are two things inevitably connected. If nature had doubled the energy of the heart, she would have doubled also the arterial resistance. On the other hand, they would have had but little resistance, if there had not been an agent of impulse at their origin; this is precisely what happens in the hepatic portion of the vena porta, which by its distribution is analogous to the arteries. Why is the pulmonary artery thinner and less resisting than the aorta? Because the right ventricle being less fleshy, is not capable of so great efforts.

From what has been said, it appears, that the external arterial membrane resembles the fibrous organs, which, as we shall see, are characterized by an extreme resistance. But if we observe on the other hand that this membrane can be broken, raised by layers and scales in dissection, that it is elastic and even dry, if I may so say, whilst the fibrous organs are compact, form a solid body, resisting, but softer and more elastic, we shall be convinced that this external membrane is exclusively peculiar to the arteries; that it has no relation with the other systems, but forms a distinct and separate texture in the economy. The structure with regular fibres, is the only circumstance that can, in my opinion, make us believe in the muscular nature of the arteries; but the ligaments and tendons are fibrous also; of what importance are the forms to the intimate nature? Now, can we say that this nature is the same, when the physical properties, when the extensibility and contractility of texture, when the vital sensibility and contractility are different?

Besides, the action of different re-agents upon the arterial texture, proves clearly how much it differs from the muscular. There are then general phenomena common to all the solids; but different peculiar phenomena that are distinctive. We may satisfy ourselves of this, by comparing the following article with that which corresponds with it in the muscular system.

_Action of different agents upon the arterial texture._

The action of the air by drying the arteries gives them a colour of a reddish yellow, very deep and even blackish in the great trunks, more clear in the smaller ones. Thus dried, the arterial texture is almost as hard as the cartilages in the same state, extremely brittle, breaking in the great trunks with a crackling noise, that is not perceived in any other animal texture. It is especially in this preparation, that we see how much the cellular covering of the arteries differs from their peculiar texture. This covering remains pliable; it is whitish when raised up separately. Immersed again in water, the arteries assume in part their natural arrangement.

In drying, the arterial texture loses but very little of its thickness; this is a phenomenon that distinguishes it from most of the other textures. It arises from the small quantity of fluid that is contained between its layers, a circumstance that appears to be owing to the absence of the cellular texture. In opening the arterial layers, the kind of dryness they exhibit is remarkable, when compared with the moisture in which the muscular fibres are immersed.

Exposed wet among other organs to the action of the air, the arteries putrefy with great difficulty. Their texture resembles in this respect that of the cartilages, the fibro-cartilages, &c.; it is like them for some time almost incorruptible; when it is left to putrefy by itself, it gives out an odour much less fœtid than that of other textures; there appears to be less ammonia disengaged from it. The absence of fœtor is also very remarkable in the water in which the arteries have been macerated, entirely separated from every neighbouring texture. By comparing this water with that in which muscles have been macerated, the difference is striking. An evident proof of the resistance of the arteries to putrefaction and maceration, is what is observed in the viscera, which have been a long time macerated or which are putrid, as in the liver, the spleen, the kidnies, &c. In both cases, in the first especially, these viscera are reduced to a kind of pulp; the arteries however have preserved their texture still hard, amid this general softening. By removing carefully the putrid substance, we can follow them even to their final ramifications. This method of seeing the arteries is easy, whether they are filled by injection, or left empty. In the living animal, these vessels are also infinitely less susceptible of putrefaction than the skin, the cellular texture, &c. An artery often passes through a mortified part without undergoing any alteration from it; this is frequently seen in gun-shot wounds.

At the end of a period, very different according to the degree of temperature, the arterial texture yields finally to maceration and putrefaction. In the first case, it softens gradually without changing colour, loses the adhesion of its fibres, and is ultimately resolved into a pulp almost homogeneous and greyish. In the second case, it becomes greyish at first, then is reduced also to a pulp, and when all the fluid part is evaporated, there is left a kind of coal wholly different from that which remains after the putrefaction of the muscles. In general, it requires much longer time to soften the arterial texture by maceration than by putrefaction; which shows the superiority of the action of the air over that of water, in the production of this phenomenon.

Exposed to the contact of caloric, the arterial texture curls up, contracts and exhibits the horny hardening in the highest degree. If the action of water is added to that of caloric, which produces boiling, the following is the result of it. 1st. Very little froth rises before ebullition, from the vessel that contains the arterial texture; we might say that this texture and the muscular present in this respect, two opposite phenomena in the economy; the small quantity of froth that arises from the first, is greyish. 2d. At the moment of ebullition, there is an evident horny hardening, less however than that of the nervous texture, more sensible in the direction of the diameters than in that of the axis; a hardening accompanying this horny hardening, and a yellowish tinge of the liquor. 3d. This state continues for half an hour or more, ebullition constantly going on. 4th. Successive softening; but at the same time a greyish tinge succeeding to the yellow colour; want of adhesion among the fibres, increasing as the ebullition goes on, so that they break with great ease. 5th. However prolonged may be the ebullition, the arterial texture is never reduced, like the fibrous, the cartilaginous, &c. to a gelatinous and yellowish pulp. The fibres remain as they are, in the same relation, with the same size, &c. The want of adhesion and the change of colour are almost the only phenomena they experience. 5th. The broth, produced by the boiling, is insipid and tasteless, a proof how few neutral salts the arterial texture contains.

The action of the concentrated acids curls this texture, afterwards softens it, finally dissolves it in the form of a pulp, yellowish by the nitric, and blackish by the sulphuric.

Most of the others have a less sensible action than these two. When they are diluted, there is no horny hardening at the moment the artery is immersed in them; but its texture is gradually softened, and can be broken with the least effort, as after boiling. It is never reduced to a fluid state, how long soever it may continue in the acid.

The alkalies, even the caustic, have but little action upon the arterial texture; immersed a long time in them, this texture remains almost untouched, loses but little by solution, cannot be broken as it can after being in the diluted acids, &c.

_Membrane common to the system with Red Blood._

I call that the common membrane which lines the arteries, the left side of the heart and the pulmonary veins. It can be dissected with ease upon these two last organs. To separate it from the arteries, it is necessary to cut through by a very superficial circular section, the external fibrous layer, raise this layer by laminæ from below upwards; we come then to the internal membrane, which adheres but little to the preceding, and can be detached from it in the form of a canal, of very great extent. It is distinct from it, 1st. by its extreme tenuity, and the transparency that results from it; 2d. by its white colour; for it appears yellow only by being applied to the preceding; 3d. by the entire want of fibres. It is smooth and with a uniform texture like the serous membranes, which we may be convinced of by holding it up to the light. Besides, it differs essentially from these membranes by a kind of brittleness that characterizes it; it is broken and torn by the least effort. The whole resistance of the arteries resides in their fibrous coat.

It appears that this membrane, though every where connected, has however some differences of structure in the different regions. 1st. It is evidently more delicate in the interior of the ventricle with red blood, than in the corresponding auricle and in the arteries. 2d. It yields in the heart and in the pulmonary veins, to dilatations much greater than those of which it is susceptible in the arteries, in which it would inevitably break, like the proper membrane, if the blood could produce as great differences of size in it, as it does in these organs. 3d. When we macerate the heart for some time, this internal membrane acquires in the auricle and upon the mitral valves, a very remarkable whiteness, and which is foreign to it in all the rest of its course. 4th. As to the action of the different agents, of the air, of water, of caloric, &c. it appears to me to be the same every where, and resembles precisely that upon the peculiar membrane. Only I have thought, that in the small arteries, the common membrane has the horny hardness more than this, which on this account wrinkles on the interior in different places, when a whole branch is immersed in boiling water; this does not take place in the great trunks.

It is evident from this, that though the common membrane of red blood, is every where continuous, it is not uniform in its structure; we shall have occasion to make an analogous observation for the different portions of the two general mucous surfaces.

The internal surface of this membrane is moistened in the dead body, by an unctuous fluid, that is found in greater or less quantity. Does this fluid exist in the living? does it serve to defend the arterial coat from the impression of the blood? It is difficult to determine. We know of no organ fitted to furnish it; it would arise from the exhalants, if its existence, as many authors have admitted, was real. It would be well to ascertain as to its existence, whether it was merely a transudation after death, analogous to that of the bile through the gall bladder, or the consequence of a little serum remaining in the arteries after the expulsion of the blood. What makes me suspect so is, that these arteries being deprived of blood, contract intimate adhesions on their internal surface; which their fluid ought to prevent, as that of the mucous tubes does, which should they cease to transmit their respective substances, as the excrements for example, the secreted fluids, &c. would never be obliterated because of this fluid.

It appears then that it is the membrane itself, and not a fluid that escapes from it, which serves to protect the artery; it can, in this point of view, be considered in relation to the blood, as a kind of epidermis. It is this, which by its folds contributes especially to form the aortic and mitral valves, and the different eminences at the origin of the branches, smaller branches, &c. The external surface, feebly united to the other membrane as we have seen, has not an intermediate cellular one. Notwithstanding this slight adhesion, no means, boiling water, maceration, putrefaction, &c. can detach one of these membranes from the other, as takes place in the periosteum from the bone, which, are naturally much stronger united; it requires always the aid of dissection.

What is the nature of this common membrane? I am entirely ignorant; though with a different appearance it has the greatest analogy with the preceding coat, in its properties. We cannot class them in any system. They form a separate texture in the economy, a texture that has properties entirely distinct.

When we dry the common membrane of the arteries by itself, it is infinitely more pliable than the other. It remains transparent, the other does not. As to the phenomena of the other re-agents, except the horny hardening, they are nearly the same.

This membrane is remarkable, in all the organic systems, for the singular tendency it has of being ossified in old age. I have been able to satisfy myself, that out of ten subjects, there are at least seven that have incrustations after the sixtieth year. These incrustations, having no connexion with the peculiar fibrous membrane, begin uniformly on the external surface of this, the most external part of which they attack; for there always remains over the incrustation a kind of pellicle that separates it from the blood, and which belongs to the membrane; the earthy substance is never immediately in contact with this fluid.

These incrustations do not follow any of the laws of ordinary ossification. The cartilaginous state rarely precedes them. The saline substance is deposited immediately upon the exterior of the common membrane by the exhalants. It is always in separate plates, more or less broad, that this exhalation is made; rarely the whole of the artery forms a solid continuous tube; so that the membranous portions remaining between the plates can be considered as serving for articular connexions, and that the arteries, thus ossified, are composed of many pieces moveable upon each other, and being able to a certain extent to adapt themselves to the circulating motion.

As long as these plates remain thin, the interior of the artery is as usual smooth and polished. But if many saline substances are deposited there, they then have a greater thickness and make a projection within. The fine pellicle that covers them and which is continued upon the artery, is broken; then they adhere only by their external surface to the peculiar membrane. Their circumference is unequal and rough. If there is a great number in the artery, the whole internal surface presents numerous asperities, produced by the rupture of this extremely fine layer of the common membrane that covers the osseous plates. This arrangement is particularly remarkable at the origin and even in the course of the aorta. I have noticed it frequently in the dissecting rooms. Since I have practised medicine in the hospitals, I have already opened three or four subjects that have exhibited this arrangement, in which the heart was perfectly untouched, but who died however with most of the symptoms that accompany diseases of that organ. The rupture of the fine pellicle when the osseous plates become large, arises from the remarkable brittleness that we have observed in the common membrane, of which it is an appendage. I have never seen these osseous plates entirely detached, and become loose in the artery.

All the parts of the arterial system are subject to ossification. It appears as frequent in the branches as in the trunks. We know how common it is to find the radial ossified, in feeling the pulse of an old person. The ramifications appear to be less frequently the seat of these incrustations, which never take place in the capillary system; a circumstance that would induce me to believe that the common membrane of the arteries does not extend to this system, but that it changes gradually into a different texture.

It is not only in the arteries that the common membrane of the system with red blood is penetrated with saline substance; this often happens to it in the heart, especially in the aortic and mitral valves. It is more rare upon the internal surface of the left ventricle and auricle and the pulmonary veins. I have had however examples of these last. This general disposition to ossification in its whole course, proves that its nature is every where the same, and that notwithstanding the differences pointed out, I have had reason to consider it in an uniform manner, from the pulmonary capillary system to the general; for as I have already observed, an identity of diseases supposes an identity of nature. It is the frequency of ossifications of this membrane in the heart of old people, which renders extremely frequent the intermission of the pulse at that age. The ossification of the origin of the aorta has an influence also upon the circulation, as I have ascertained; but that of the trunks, branches, &c. does not produce the least derangement.

The ossification of the common membrane of the system with red blood differs essentially from those that happen in other parts, in this, that it is, if we may so say, a natural phenomenon, whereas the others are accidental and often preceded by inflammation and engorgement. Thus these ossifications do not follow the progress of age; they happen in young people and in adults, as often as in old ones. Before old age, the ossifications of this membrane are observed also, but infinitely more rarely than at this age. The diseases of the heart which the ossification of the mitral valves accompanies and often alone constitutes, are a remarkable proof of this. A phenomenon has struck me many times upon this subject; such an ossification as an old man can live with very well, and which only makes his pulse intermittent, produces in the adult the most serious consequences. I have already opened many subjects, who had been affected with difficulty of breathing, frequent suffocation, cough, irregularity of the pulse, necessity of an erect position of the trunk, and in the later periods, infiltration, serous effusion in the thorax, spitting of blood, &c. and in whom I have found only ossification of the mitral valves, less than we see every day in the bodies of old people in our dissecting rooms. I confess that even this natural disposition to ossification in the common membrane of the system with red blood, had made me think that they had exaggerated a little the cases in which this ossification becomes, in the adult and even in the old man, when it is very strongly marked, the cause of that series of phenomena, whose assemblage forms the asthma of most physicians. But the practice of the Hôtel Dieu shows me every day, that these cases of ossifications, those of aneurisms and those of other organic affections of which the heart is the seat, form a class of chronic diseases almost as numerous as that of the chronic diseases of the lungs, to which generally were referred all the diseases of the chest, before the time of Corvisart.

II. _Parts common to the organization of the Vascular System with Red Blood._

_Blood Vessels._

The parietes of the arteries contain secondary arteries destined to their nutrition. These arteries come usually from neighbouring branches, sometimes from the artery itself, whose capillary divisions terminate in the texture of its parietes. The heart exhibits this arrangement. At its exit, the aorta sends off the coronaries which are spread upon the texture of this organ and upon the origin of this artery itself. The bronchials furnish the parietes of the pulmonary veins. In the arterial texture, in which it is especially necessary to examine the little arteries, they wind at first in the cellular texture exterior to the artery, they ramify there in a thousand ways, send some divisions to the neighbouring organs, but furnish a great number that penetrate the peculiar membrane, are interposed between its layers, leave filaments there and terminate before they arrive at the internal membrane. I have never seen, either by injections, or by opening in a living animal an artery in which I had first stopt the course of the blood above and below, as for example, the carotid, I have never seen, I say, the little arteries penetrating even to this internal membrane. To distinguish well without injections, the vessels of the arteries, it is necessary to choose on one hand a great trunk like the aorta, and on the other to take this trunk in a young animal that has been killed for the purpose by asphyxia; all the little arteries then are perfectly injected with a very black blood. Examine the arteries of the fœtus, especially if it has died by asphyxia at birth, you will be struck with the great abundance of blood vessels that its great arteries contain and which are sometimes as livid as in asphyxia.

The veins accompany every where the little arteries in the parietes of the arterial trunks, they follow nearly the same distribution. I have not seen them become varicose in the parietes of aneurismatic arteries, in as evident a manner, as in the tumours of many other textures of the animal economy.

_Cellular Texture._

The arteries have around them two kinds of cellular texture; one, which is very external, loose, fatty, full of serum, with distinct layers, unites them to the neighbouring parts, favours their motions, is in no way distinct from the rest of the cellular system; the other, firm, compact, not fatty, filamentous and not lamellated, forms the first of their coats. We have spoken in treating of the cellular system, of this particular layer that covers the arteries, which authors commonly call the cellular coat, which the ancients called nervous, on account of its whiteness, and which, analogous in every respect to the sub-mucous, sub-excretory cellular texture, &c. differs essentially from the preceding, as it differs from that which is in the interior, around or in the interstices of the organs.

These two kinds of cellular texture, the last especially, contribute to support the folds of the arteries; as when we have carefully dissected the peculiar coat, these folds entirely disappear. However when they are on one hand strongly marked, and on the other, are not subject frequently to disappear in yielding to the elongation of the parts, as in the internal carotid in its canal, I have observed that the arterial fibres are accommodated to these folds; that the fibres are more numerous on the convex side, than on the other, so that the thickness of the artery is exactly uniform, which it would not be without this inequality; for being more pressed on the concave side, these fibres would make the artery thicker at that place.

The cellular texture forms the first membrane of the arteries, and gives as we have seen insertions to the arterial fibres, but it does not extend into the interstices of these fibres; it is this that distinguishes essentially the layers of the arterial texture, from those of the muscular, venous textures, &c. I have never been able to discover the cellular texture there by any means that I could employ. Maceration, of which Haller has said so much, does not show any thing like it. When at the end of a very long time, the arteries finally yield to it, they exhibit only a kind of pulp, in which there is no cellular appearance.

In general, the resolution of the organs into cellular texture by maceration, exhibits a phenomenon much less extensive than is generally thought. It is the organic texture itself that forms the kind of pulp that is then obtained. As this texture varies in each system, the pulp of these systems, a long time macerated, varies equally; this undoubtedly would not happen, if, as Haller has advanced, the cellular texture was the only base, to which all the organs are brought by maceration. But let us return to the arteries.

Not only their fibres are not formed of cellular texture; but as I have said, they do not contain it in their interstices, a character in which it differs from all the other systems. The most careful dissection does not show it. When we separate the fibres from each other, we see, either that they are merely in apposition, or that they are held by little elongations of the same nature as themselves. I have said that this absence of the cellular texture is observable between the proper and common membranes of the arteries, though Haller has pretended the contrary.

I believe that this absence of cellular texture contributes much to the kind of brittleness that particularly distinguishes the arterial texture, and which, as I have observed, renders it the least fit of all the animal textures, to support ligatures without breaking. It is to this circumstance also that must be referred the difficulty, the impossibility even of arterial dilatations, of the formation of cysts by the parieties of arteries. There are never, we know, true aneurisms; when these tumours increase at all, the two membranes of the artery break and the cellular coat alone is dilated. Hence the necessity of the peculiar structure which distinguishes the cellular texture placed around the arteries, and gives it a resistance that it has not in most other parts. Authors are astonished at these ruptures which distinguish the dilatations of the arteries from those of all the other systems. If they had compared the texture of the arteries with that of the other systems they would have seen the reason of this difference.

We easily understand, after what has been said, why there is never fat in the arterial texture; why it is never infiltrated in dropsies; why it does not develop hydatids and cysts in its layers, why the different tumours, for which the cellular texture serves as a base, as we have seen, do not appear in the arteries, &c. When an artery has been wounded, either longitudinally or transversely, we do not see fleshy granulations arise from the edges of the wound; I do not know that surgeons have seen them in the operations for aneurisms. Never, in the numerous cases in which I have had occasion to cut the arteries, in animals, and then leave them free, after having interrupted the course of the blood, have I observed any thing like it. If an arterial trunk is laid bare, the cellular coat often furnishes these granulations; but we never see them, if this coat is removed.

_Exhalants and Absorbents._

Are there exhalants in the arteries? Nutrition undoubtedly supposes them; but it is not probable, as I have said, that they open upon their internal surface.

As to the absorbents, I thought for some time, that the absence of blood in the arteries, after death, arises from this, that their lymphatics preserving still the absorbent faculty for some time, take up the serum which is separated from the crassamentum. But lately experiments have undeceived me. I have enclosed blood, water, the fluid of dropsies, &c. between two ligatures made above and below on the common carotid, the body of which had been so managed on the exterior as not to break the vessels that come to it. At the expiration of a considerable time I have not discovered any diminution in the fluid. There had been then no absorption. I would observe that on account of the want of collateral branches, the carotid is alone proper for these experiments, and a variety of other analogous ones.

We know that the absorbents abound where there is cellular texture, and that they are wanting usually where there is none. It is probable then that the absence of this texture produces also the absence of these vessels.

_Nerves._

1st. The first tree of the system with red blood, receives almost exclusively cerebral nerves. We know in fact, that the par vagum is spread upon all the pulmonary veins, as well as upon the neighbouring vessels of the lungs, which hardly receive any from the inferior cervical ganglion. 2d. The middle portion of this system, that in which the heart is found, derives its nerves almost as much and even more, from the ganglions, than from the brain. 3d. The great tree with red blood, or the arterial, is almost exclusively embraced by the first class of nerves. We have said how these nerves go in this respect. The cerebral which accompany them, furnish hardly any filaments to the arteries. There is merely juxta position as we see it in the extremities, in the intercostal spaces, &c.

I cannot repeat it too much, that the constant relation of the arteries with the nervous system of the ganglions, deserves the attention of physiologists, because it is too general not to belong to some great object of the functions of the economy, though the object may be unknown.

ARTICLE FOURTH.

PROPERTIES OF THE VASCULAR SYSTEM WITH RED BLOOD.

What we have to say of these properties, will refer particularly to the arteries, as well as what we have said of the organization. In fact the fleshy parietes of the heart and the membranous ones of the pulmonary veins, possess properties that will be examined hereafter, and which differ from those of the arteries, on account of the difference of texture. As to those of the common membrane they are nearly the same in the whole course of the red blood, the organization differing but very little.

I shall consider the properties of the arteries only in the arterial texture and in the common membrane; for the cellular coat belonging to the system of that name, partakes of all its properties.

I. _Physical Properties._

Elasticity, which is obscure in most of the other animal textures that are characterized by a great degree of softness is very remarkable in the arteries; it is this that particularly distinguishes them from the veins. This elasticity keeps their parietes apart, though they may be empty. These tubes, with the cartilaginous, as the trachea, the meatus auditorius of the fœtus, &c. which are equally endowed with elasticity, are the only ones that keep thus open of themselves. All the others have their parietes applied to each other, when the fluid that runs through them does not distend these parietes.

It is to the elasticity of the arterial parietes that must be referred their recovering themselves when they have been flattened so as to obliterate their cavity, the sudden straightening of an arterial tube that has been bent, &c.

This property takes also an evident part in that kind of locomotion the arteries have upon the entrance of the blood. In fact, lay bare a tortuous arterial trunk in a living animal, you see the whole of it rise at each pulsation, leave the place it occupied, and straighten itself, particularly at its curves. At the moment the injection penetrates a very thin small subject, we perceive also through the integuments, a locomotion of all the tortuous branches of the face. Now it is evident that if the arteries were not of a firm and elastic texture, they would not thus obey the motion that is impressed upon them; besides, observe what takes place in the injection of the abdominal branches of the vena porta, which having no valves can be injected like arteries. Nothing similar to the locomotion of which I spoke is observed in driving the fluid into them. I have often made arterial blood circulate in the veins by the means of curved tubes, fitted to the vessels of a living animal, for example, by making the carotid and external jugular communicate; now, we observe clearly in the veins carrying the red blood, a kind of pulsation synchronous with the beating of the heart, and a distinct rustling noise, but not a real locomotion.

The locomotion of the arteries supposes three things, 1st, an agent of impulse, that communicates a motion more or less strong, to the blood contained in their interior; 2d, a tortuous arrangement which allows the blood in striking their parietes to straighten them; 3d, the firmness and elasticity of these parietes which facilitate this straightening. On the other hand, the parietes must not be too firm; thus the cartilaginous texture would be improper for this locomotion.

The elasticity of the arteries is as striking after death as during life; it is essential to distinguish it from contractility of texture. There are many distinctive characters, the following are the most striking; 1st. The contractility of texture takes place only when there is a want of extension of the arterial parietes, that is to say, when these vessels cease to contain the blood which resists their contraction, or when they are cut and afterwards left to themselves. On the contrary, elasticity requires for its exercise, a previous compression and is manifested by the sudden return of the parts to their natural state. 2d. Contractility of texture has a permanent tendency to contraction; we may say that all the parts that possess it are in a forced state; so that as soon as this state ceases, contraction takes place. On the contrary, elasticity has not this constant tendency to exercise. 3d. Every elastic motion is brisk, sudden, as quick to stop as to begin. On the contrary, every motion of contractility of texture is insensible, slow, continues often many hours and even days, as we see it in the retraction of amputated muscles, &c. 4th. Every organ in which there is contractility of texture, enjoys necessarily extensibility. On the contrary, this last property is not necessarily connected with elasticity, as we observe it in the cartilages of animals, &c. 5th. Elasticity is purely a physical property. Contractility of texture, without being vital, is only inherent in the organs of animals.

II. _Properties of texture. Extensibility._

The extensibility of the arteries may be considered, 1st, transversely; 2d, longitudinally.

The arteries have but little extensibility in the direction of their diameter. 1st. Whatever efforts are made to dilate them by injections of water, air, fat substances, &c. their caliber is rendered but little larger than natural. 2d. I have said that their texture is remarkable by a kind of brittleness, that when the blood distends them a little in aneurisms, this texture breaks instead of yielding, and that it is only the cellular coat, which, by the extensibility it has from the system from which it is derived, that is fitted to form the cyst that contains the blood. It is this that essentially distinguishes aneurismal from varicose tumours. 3d. If we tie superiorly the carotid artery of a dog, the blood pushed against the ligature that stops its course, reacts violently upon the parietes and yet the dilatation is hardly perceptible. We must not think however that the arteries do not yield at all. When the dilating cause acts slowly, it produces its effect to a certain determinate point, beyond which rupture takes place. The proof of this, is in the dilatation of the arch of the aorta, in that which true aneurisms present in their early stages, &c.

Longitudinally, the arteries are more capable of stretching, than they are transversely. We may be convinced of this, by drawing out these vessels, to place a ligature upon them in an amputated stump. By cutting upon a dead body a portion of artery, and drawing it in a contrary direction, it is evidently elongated. It is necessary in these experiments, to pay attention to the development of the folds. In fact, I have said, that this development of the folds performs a principal part in the elongation of the arteries situated in the parts that are dilated.

It is evident that in the extensibility in a transverse direction, it is the circular fibres of the peculiar membrane that especially resist; that on the contrary, in the extensibility in a longitudinal direction, it is the common membrane that opposes the resistance, since there are no longitudinal fibres. It is not astonishing then that the first kind of extensibility should be less evident than the second.

_Contractility._

It is necessary to consider it in a transverse and in a longitudinal direction.