Diathesis

“ All that can be said with our present knowledge in explanation of the influence of age is, that either an existing diathetic condition tends intrinsically to the development of the disease or that the diathesis is likely to be acquired at certain periods of life more than at other periods. ”

“ Upon the whole, the presumption of any affection being scrophulous, is to be formed by the presence of the marks of a scrophulous diathesis, and the absence of such symptoms and appearances, whether antecedent or present, which characterise inflammation of a different species, or make us suppose it to have taken place, whether this be simple or specific. ”

“ Following these are other important diatheses, widely spread but not universal, since they depend upon local exposure; while hesitation is expressed whether the malarial diathesis ought not to be regarded as primary or universal. These views involve the recognition of the doctrine of hereditary transmission, and indicate that we ought to study disease as being, not of recent origin, or in dependence solely upon existing influences, but rather as that in which many seek truthfully to "read the record of a long descent." ”

“ From the whole of these facts it follows that all the organs, and indeed every fibre of the body, are simultaneously affected by the matters habitually conveyed into the stomach, and that it is the incongruity of these matters to the system, which gradually forms that morbid diathesis, which exists alike both in apparent health and in disease. ”

“ A diathesis is a tendency toward disease, and many of these can be recognized in their incipience and differentiated in such manner that preventive measures can be employed and earlier changes limited and improved. ”

“ While, therefore, a calculus is only as urine precipitated and solidified, and this fluid only as calculous matter suspended in a menstruum, it must appear that the lithic diathesis is as natural and universal as structural disintegration is constant and general in operation. As every individual, therefore, may be said to void day by day a dissolved calculus, it must follow that its form of precipitation within some part of the urinary apparatus alone constitutes the disease, since in this form it cannot be passed. ”

“ The uric acid diathesis, and the oxalic acid diathesis, both the result of imperfect liver function, are among the most frequent causes of irritation of the kidneys, by which channel they are eliminated from the body. ”

“ Heredity exercises a marked influence upon the occurrence of rheumatism; unlike malarial disease, no climate or locality is immune from rheumatism; the many indications that a diathesis plays a chief rôle in rheumatism; the remarkable influence exerted by cold and dampness in the etiology of the disease. ”

“ In brief, the truth is that frequent or severe local irritation in any part of the body in an individual of the hysterical diathesis may act as the exciting cause of an hysterical paroxysm or of special hysterical manifestations. ”

“ If he be full blooded and robust it may be acute or sub-acute. Thus it often happens that at the very time when a man of rheumatic diathesis is in finest form, he is suddenly laid prostrate by the return of his foe. ”

“ By many writers it is believed to depend upon some form of auto-intoxication, the toxins being absorbed from the gastro-intestinal tract, and those who suffer are supposed to possess what has been called an "arthritic diathesis." ”

“ I know a citizen of Philadelphia, who has laboured under a consumptive diathesis near thirty years, who believes that he has lessened the frequency and violence of pulmonic complaints during that time, by a careful accommodation of his dress to the weather. ”

“ Have you not reason to explore and demand a deeper and more thorough anatomical knowledge of the diaphragm and its power to produce disease while in an abnormal condition, which can be caused by irritations, wounds or hurts, from the base of the brain to the coccyx? Remember this is an anatomical and philosophical question that will demand your attention to the mechanical formation, physiological action and the unobstructed privileges of fluids when prepared in the laboratory of nature, to be sent at once to their ordained destination, before such substances are diseased or dead with age. ”

“ For even as the dissection of healthy and well-constituted bodies contributes essentially to the advancement of philosophy and sound physiology, so does the inspection of diseased and cachectic subjects powerfully assist philosophical pathology. And, indeed, the physiological consideration of the things which are according to nature is to be first undertaken by medical men; since that which is in conformity with nature is right, and serves as a rule both to itself and to that which is amiss; by the light it sheds, too, aberrations and affections against nature are defined ”

“ At the present day the science of physiology has arrived at such a pitch of perfection that there is not a single secretion, tissue, or organ of the body, with the exception of the spleen, which has not been investigated, and the functions divulged and made so plain that it is quite divested of that apparent mystery which formerly enshrouded it ”

“ The cells, the special anatomical elements of the liver, the kidney, and the brain are reduced by atrophy and degeneration. At the same time, the conjunctive woof which serves them as a support develops, on the contrary, at the expense in a measure of the higher elements. For this reason the tissues harden. We know that the flesh of old animals is tough. We know in pathology that this is happening to the tissues. It is due to growth, to injury to the active and important elements, to the elements of support of the organs. ”

“ From all that I have said, it is evident that in the organs whose capillary system contains in part blood, and in part different fluids, the proportion of the first to the others is infinitely variable; that a thousand causes in a state of health, as in that of disease, by bringing to the organ more or less blood, can fill more or less its capillary system. ”

“ In addition to forming the organs, the tissues are also grouped in such a manner as to provide supports for organs and to form cavities in which organs are placed. The various cavities of the body are of particular interest and importance. The three largest ones are the cranial cavity, containing the brain; the thoracic cavity, containing the heart and the lungs; and the abdominal cavity, containing the stomach, the liver, the intestines, and other important organs (Fig. 2) . Smaller cavities serving different purposes are also found.
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“ Most fatal diseases, moreover, have their original seat in the viscera of one of the three great cavities of the body, and no disease originating elsewhere can become fatal, until, by sympathy or metastasis, some of those parts are deeply affected. To enlightened physiologists this statement presents but a series of familiar truths. To the groups of organs exclusively, then, I repeat, contained in the abdomen, the thorax, and the cranium, must we look as the main source of human character. ”

“ Great care in acute diseases is commonly taken that the third factor shall not turn the scale against the tendency to reversion, far less is expert systematic supervision as to this brought to bear in chronic disease, while in the diathetic there is as a rule worse than a fitful, or no care—the misjudged application of causes best calculated to increase and intensify the defect or taint in the blood. ”

“ Anatomy has been ever with me a favourite branch of my profession; and when a student, I never let slip an opportunity, time and material permitting, to improve myself in it by dissection. It was a passion with me; and whenever I met with a person extremely emaciated or finely developed, my anatomical eye would scan their proportions, and instead of paying them the usual courtesies of life, I would be thinking what glorious subjects they would be for museum preparations or dissection ”

“ The diaphragm separates the physical world from the animal one, just as the neck separates the animal world from the rational one, as Plato points out in the Timaeus. Primary matter originates in the physical world, and here is to be found the origin of existence. From here the seed is sent forth and the embryo produced out of the four elements. Here also God selected the parts which are used as offerings, viz. fat, blood, the caul above the liver, and the two kidneys. He selected neither the heart, nor the brain, nor the lung, nor the diaphragm. ”

“ All these conditions cannot remain after death. Hence, if we desire to form positive opinions concerning much which is unfolded by dissection, we must supply the defect by analogy. Thus, whenever, in any part of the heart or arteries, the cohesion between the internal membrane and the subjacent structure is manifestly lessened, and the membrane is unusually red at that part, we may regard these appearances as the vestiges of inflammation, without thinking that we go too far in so regarding them. ”

“ First, other congeries of glands occupy but a particular part of the system, or constitute a particular organ, as the liver, or kidneys; but those glands, which secrete the mucus, and perspirable matter, which are called capillaries, are of very great extent; they receive the blood from the arteries, separate from it the mucus, which lines every cell, and covers every cavity of body; and the perspirable matter, which softens and lubricates the whole surface of the skin, and the more extensive surface of the air-vessels, which compose the lungs. ”

“ The general character of tertiary manifestations may be stated as follows: They attack by preference the tissues derived from the mesoblastic layer of the embryo—the cellular tissue, bones, muscles, and viscera. They are often localised to one particular tissue or organ, such, for example, as the subcutaneous cellular tissue, the bones, or the liver, and they are rarely symmetrical. They are usually aggressive and persistent, with little tendency to natural cure, and they may be dangerous to life, because of the destructive changes produced in such organs as the brain or the larynx. ”

“ As the organs within which these membranes are spread, are almost all susceptible of contraction and dilatation, as we see in the stomach, the intestines, the bladder, &c. it has been thought that during the dilatation, the vessels being more expanded, receive more blood, and that during the contraction on the contrary, being folded up, as it were choaked, they admit but a small quantity of this fluid which then flows into the neighbouring organs. ”

“ In man and the other mammals (but only in these) this cœloma divides, when fully developed, into two different cavities, which are separated by a transverse partition—the muscular diaphragm. The fore or pectoral cavity (pleura-cavity) contains the œsophagus (gullet) , heart, and lungs; the hind or peritoneal or abdominal cavity contains the stomach, small and large intestines, liver, pancreas, kidneys, etc. ”

“ Thus there is neither any eye nor any motive organ engendered until the brain is produced, and the faculties preexist which are to see and to govern motion.
In like manner, as the pulsating vesicles serve as instruments for the motion of the blood, and the heart in its entire structure does the same, (as I have shown in the work on the Mo{411}tion of the blood,) urging the blood in a ceaseless round through every part of the body, we see that the blood must exist before the heart, both in the order of generation and of nature and essence. ”

“ The art of anatomical dissection consists in freeing the muscles, tendons, arteries, veins, and nerves from the surrounding fat and connective tissue which in the living body preserves and covers them.
It is absolutely necessary that the student should not only know from books, but actually see with his own eyes, and for a long period attentively observe the origin and course of every nerve, artery, and vein which in the whole body is capable of being dissected out. ”

“ He sees the various parts of this great system of life when preparing fluids commonly known as blood, passing through a set of tubes both great and small—some so vastly small, as to require the aid of powerful microscopes to see their infinitely small forms, through which the blood and other fluids are conducted by the heart and force of the brain, to construct organs, muscles, membranes and all the things necessary to life and motion, to the parts separately and combined. ”

“ If this position be true we are warranted and justified in the conclusion that the germs necessary to form blood vessels and other parts of the body must look to the liver for the fluids in which they would expect to construct in form and size. It seems to be nature's chemical laboratory, in which are prepared by receiving chemical qualities and quantities to suit the formation of hard and soft substances, which are to become the parts and the whole of any organ, gland, muscle, nerve, cell, veins and arteries. ”

“ When we say this fluid is composed of certain anatomical elements, as the plasma, red corpuscles, leucocytes and granules, we go a step further in the problem of vitality. When we say that certain nutritious principles are taken into this circulating fluid by means of digestion and absorption, and that by assimilation they are converted into the various tissues of the body, we think we have solved the problem, and know just the essence of life itself. ”