Xavier Bichat

“ These properties are so inherent in bodies, that we cannot conceive of their existence without them. They constitute their essence and their attribute. To exist and to enjoy them are two things inseparable. Suppose that of a sudden they are deprived of them; instantly all the phenomena of nature cease, and matter alone exists. Chaos was only matter without properties; to create the universe, God endowed it with gravity, elasticity, affinity, &c. and to a part he gave sensibility and contractility. ”

“ We may say that by creating first the heart and the brain, and developing them much sooner than the other organs, nature wished first to establish the foundations of the organization of the two lives. For on the one hand, it is the brain which is the centre of animal life; it is to this that all the sensations are referred; it is from it that all the voluntary motions proceed. On the other hand, by sending the blood towards all the organs, the heart evidently presides over the circulation, the secretions, exhalations, nutrition, &c. which compose by their union organic life. ”

“ Shall I speak of the different tumours that are formed in the midst of organs, without their perceiving it, of the numerous excrescences that grow by their side without affecting them? Dissect a muscle under a suppurating cutaneous wound, or even a most obstinate ulcer; you will not often find it different from the rest, the skin only has been affected. No doubt the difference of vitality of two neighbouring organs is an essential cause of the insulation of their diseases; but the cellular atmosphere that protects them is also an important one. ”

“ What is observation worth, if we are ignorant of the seat of the disease? You may take notes, for twenty years, from morning to night at the bedside of the sick, upon the diseases of the heart, the lungs, the gastric viscera, &c. and all will be to you only a confusion of symptoms, which, not being united in one point, will necessarily present only a train of incoherent phenomena. ”

“ We should have a very inaccurate idea of the mixture with the blood of the foreign substances brought by the way of the intestines, the skin, or the lungs, for the purposes of sanguification, if we compared it to the mixture of inert substances, or chemical combinations. The blood enjoys, if we may so say, the rudiments of organic sensibility; and as the life which it enjoys places it more or less in relation to the fluids that enter it, it is more or less disposed to combine with them and to endow them with the life with which it is animated. ”

“ But it is the vital powers especially that distinguish one life from another. I have shown that one kind of sensibility and contractility belongs to animal life, and another to organic. Now as these vital properties are the principle of the functions, it is evident that the division of these properties demonstrates that that of the two lives is not an abstraction, but that it is nature herself that has fixed the limits, since she has made particular properties for each. ”

“ If you have made use of acrid or spicy aliments, to which you are unaccustomed, a general heat, a thousand different sensations of lassitude and heaviness, accompany digestion. Shall I speak of the various kinds of wine, and their effects, even to intoxication? Who has not a hundred times paid dearly for the pleasures of a repast by a general disorder, an universal agitation, a heat in every part during the whole time that the wine circulates with the blood? ”

“ 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. ”

“ Animal life is composed of the action of the senses which receive impressions, of the brain which perceives them, reflects, and wills, of the voluntary muscles and larynx that execute this volition, and of the nerves which are the agents of transmission. The brain is truly the central organ of this life. Digestion, circulation, respiration, exhalation, absorption, secretion, nutrition, calorification, compose organic life, which has the heart for its principal and central organ. ”

“ It is on this account that I have considered respiration as the link that connects animal with organic life, and have proved that a fœtus without a brain, or without something to supply its place, cannot live out of the womb of its mother. Every thing is connected, every thing is united in the animal economy. We live without and within in a distinct manner, but one life cannot be preserved as a whole, independent of the other. ”

“ It is a fault of all authors that they seek only for mechanical causes in all the phenomena of the circulation. Without doubt the course of the blood is a mechanical phenomenon; but the laws that govern this course are vital; it is the same as a bone that is moved by muscular contraction; the effect is the mechanism of the lever; the cause is vital.
The blood no longer passing through the ductus arteriosus, this closes immediately by its contractility of texture; it becomes a kind of ligament, which fixes to a certain degree the aorta and pulmonary artery in their respective position. ”

“ I am convinced that disease is not the only thing, that the cellular atmosphere of the organs serves to propagate, but it is also the means of communicating medicinal effects. Why is a blister often useless that is applied to a remote part in rheumatism, whilst one placed upon the skin that covers the muscle or the fibrous organ that is the seat of the disease, frequently produces a sudden effect? ”

“ So the vital property is the primum mobile to which we must ascend, whether we consider the phenomena of respiration, of digestion, of secretion, circulation, inflammation, fevers, &c.—In giving existence to every body, nature has imprinted upon it a certain number of properties, that particularly characterize it, and by means of which it contributes in its own manner, to all the phenomena that are developed, succeed, and continually connect themselves in the universe. ”

“ Who does not know that the cause of sleep, of exhalation, of absorption, of secretion, of vomiting, of diarrhœa, of retention of urine, of convulsions, &c. is oftentimes very far from the brain, from the exhalants, from the absorbents, from the glands, from the stomach, from the intestines, from the bladder, from the voluntary muscles, &c.?
How little soever we reflect on the sympathetic phenomena, it will be evident that they are only unnatural developments of vital forces which are called into action in an organ by the influence that it receives from those that have been directly excited. ”

“ I say in the first place, that the parenchyma of nutrition is the same for all the organs, and that it is an assemblage of red vessels, of exhalants, of absorbents, of cellular texture, and of nerves; these are the proofs. 1st. These different organs are met with in all the others, as I have observed before, anatomy shows them every where, between each fibre, each layer, each point, if I may so say; they are truly the common organs. ”

“ These layers have not the same thickness in all cases; quite dense when the cellular texture is contracted, they become, when it is distended with air or any other means, so fine and attenuated, that the mind cannot conceive that there is any thing organized in them. Their organization is real, however, though some have doubted it. What in fact is a texture that is nourished, inflames and suppurates, which is the seat of very distinct vital functions, and which evidently lives, if it is not an organic texture? ”

“ I observe that there is a great difference between animal sensibility and contractility; that in the first, the nerves are in certain cases the evident agents of communication between the organs that receive the impression and the brain that perceives it, but that in other cases, we know not the kind of relation; whilst in the second, it is always manifestly by the nerves that the brain communicates with the muscles, and that the organs can never execute a voluntary motion without the influence of the cerebral nerves. ”

“ Can we conceive that the cellular texture should be an agent for the communication of pain, which is insensible to it itself? Observe also that the parts that are the most abundantly supplied with this texture, as the scrotum, the mediastinum, &c. are not those that sympathize the most. The same is true of the blood vessels, which, by their nature, are not fitted to transmit animal sensibility, and which besides do not exist in all the organs. ”

“ The membrane of each filament is truly in every case a kind of covering that protects its medullary substance, in which the sensibility particularly resides. As to the cellular texture which enters into the composition of nerves, it has, as elsewhere, no connexion with this property. Hence why we can, as I have often done upon a living animal, separate from each other, with the point of a very delicate scalpel, the different filaments of a nerve of some size, of the sciatic, for example, when they have first been laid bare, without giving the animal much pain. ”

“ Each organ has as yet only its nutritive parenchyma, the parenchyma upon which nature has imprinted the form of the organ, that is to be developed there. In proportion as this outline is increased, the nutritive substances penetrate it, and then each organ, which until that time had been like the rest in its nature, and forming with them a homogeneous mass, begins to be distinct, and have a separate existence; each one draws from the blood the substance that is proper for it. This addition gives the attributes of thickness, of density, and of nature ”

“ Physicians consider abstractedly almost all diseases. When they speak of inflammation they describe the redness, swelling, throbbing and pain, as general attributes, always uniform. If of suppuration, they take for a general standard that of the cellular texture, in phlegmon, without thinking that it is only one of the modifications of suppuration and its product. The same may be said of gangrene, scirrhus, &c. Nothing is more vague and uncertain than the general ideas that are given concerning a disease; they scarcely agree in one or two of the textures. ”

“ Nutrition takes place in parts that evidently receive no nerves, as in the cartilages, the tendons, &c.; in paralyzed limbs also its alterations are always independent of those of the nervous system. Those people in whom this system is the most elevated, who are the most sensitive, are not those in whom nutrition is the most active. In no experiment, I believe, has any one been able to influence nutrition by acting upon the brain, the nerves, and the spinal marrow. ”

“ Who knows if the sensibility of the left auricle, stimulated and modified anew by the red blood, does not repel the black which tries to enter it by the foramen ovale? We see every day in the economy, fluids passing at the side of openings, without entering them, though they may be wide, for the sole reason that their sensibility is not in relation with these fluids. Why does the trachea convulsively reject all fluids and solids? ”

“ The opinion of Haller is founded upon a transudation truly mechanical, a transudation that easily takes place in dead bodies, but never in living. In fact, if we lay bare an artery of a living animal, separate it entirely from every thing else, and examine it ever so long, we shall discover no oozing of fat through its coats, though the blood circulates in it as usual. There is an infinity of arteries, spread in the cellular texture, through which fat never transudes, as we see in the scrotum, the eyelids, &c. ”

“ How weak appears the reasoning of many great physicians, when we examine it, not in their works, but on the dead body. Medicine was for a long time excluded from the circle of the exact sciences; it will have a right to be associated with them, at least in the diagnostics of diseases, when we shall every where unite to accurate observation, an examination of the changes our organs undergo. ”

“ Many organs are wanting, vary, are presented under a thousand various forms in their different classes; on the contrary, the ganglions are constant. In those species even in which the cerebral system is imperfect, that of the ganglions is complete in its organization. Animal life diminishes and is contracted in an evident manner in most insects, in worms, &c. and generally in animals without verterbræ. The brain and the nerves become less evidently marked in proportion as this life is less perfect. The organic is, on the contrary, almost in its perfection in these animals. ”

“ Another difference that distinguishes the ganglions from the brain as it respects development, is this, that in the fœtus, they are not, like it, of extreme softness. Their hardness is little inferior to what they afterwards possess in adult age.
In proportion as we advance from infancy, the organic nervous system begins to become predominant. It is towards the thirtieth or fortieth year that it appears at its maximum of action; it diminishes as we approach old age; it decays in part at this epoch. The nerves become greyish; the ganglions are hard, resisting and smaller. ”

“ If we strictly examine the immense series of living bodies, we shall see the vital properties gradually augmenting in number and energy, from the lowest of plants to the first of animals, man; we shall see the lowest plants obedient to vital and physical properties; all plants are governed only by these, which, in them, consist of insensible contractility and organic sensibility; the lowest animals begin to add sensible organic contractility to these properties, afterwards animal sensibility and contractility. ”

“ Sensible organic contractility, which, like the preceding, is not separated from the sensibility of the same nature, governs especially in a state of health, the movements necessary to digestion and the circulation of the great vessels, at least for the red and black blood of the general system, for the excretion of urine, &c. In the state of disease, all the phenomena of vomiting, of diarrhœas, and a great part of those numberless ones of the pulse, may ultimately be referred to a disorder of the sensible organic contractility. ”

“ 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. ”