Viscera

“ I wish to impress the reader with these facts, for they formed one of the strongest indications for the use of the remedies which I adopted for the cure of this disease. It is [106] difficult to determine the exact state of these viscera in every case of bilious and yellow fever. Inflammation certainly takes place in some cases, and internal hæmorrhages in others; but I believe the most frequent affection of these viscera consists in a certain morbid accumulation of blood in them, which has been happily called, by Dr. Clark, an engorgement or choaking of the blood-vessels. ”

“ The mechanics of the abdominal wall are such that the muscles exert a firm pressure on the viscera and tend to prevent their downward displacement. Still, in the abdomen, as well as in the body generally, the anatomy is so arranged that there must be a suitable relationship between the attitudes of activity and those of rest, or, in other words, that the erect posture, in which the viscera tend to drop, must be alternated sufficiently with a position in which all strain is taken off the viscera and the tendency for them to drop is in abeyance. ”

“ Visceral injuries.—The frequent escape of the thoracic viscera from injury, putting aside the lungs which fill so great a part of the cavity, was very remarkable. I never saw a case in which I could assume injury to any of the posterior mediastinal viscera, although such may have occurred on the field of battle. An injury to the œsophagus, for instance, would almost of necessity be accompanied by wound of either one of the large vessels, even the thoracic aorta, or the spinal column. ”

“ The several viscera are influenced by this tendency in a varying degree in proportion as they themselves vary in weight. For instance, the stomach and the large bowel are probably the most variable in weight, since a quantity of material collects in them and passes along at a comparatively slow rate. The more or less fluid nature of the contents of the large bowel assists in its accumulation at certain points, as, for example, in the cæcum and in the middle of the transverse colon, while in the stomach the pressure is exerted on its convexity. ”

“ The Internal Organs, or Viscera (Figs. 304 and 305) .—The viscera (vis’se-ra) , as in most vertebrates, include the food tube and its glands; the lungs, the heart, and the larger blood vessels; the kidneys and bladder and the reproductive organs. The lower part, or gullet, is enlarged into a crop. It is largest in grain-eating birds. It is found in the V-shaped depression at the angle of the wishbone, just before the food tube enters the thorax. The food is stored and softened in the crop. From the crop the food passes at intervals into the glandular stomach. ”

“ After the seventh day, if the viscera be inflamed, we are to soothe them by cataplasms of linseed and raw barley-flour in oil and water. We are then to apply dry cupping or cupping with scarifications to the parts, and to the back part of the head and the spine. But, if the body be observed to be very squalid and hot, even if the fever remain, we must use baths of fresh water, and plentiful anointing, and give some thin and weak wine, in order to rouse the strength; we need not apprehend any mental alienation that will thereby be produced ”

“ The thoracic viscera are probably supplied partly through the branches of the inferior cervical and thoracic ganglia, and partly through the pneumogastric, the latter statement being disputed by Gaskell. The abdominal viscera are supplied partly through the splanchnic nerves, which are made up of fibres issuing from the cord in the fifth to the twelfth dorsal nerves inclusive, and partly through the pneumogastric. Thus the dorsal region of the cord is the origin of the majority of vaso-constrictor fibres in the body. ”

“ The third process is that of the viscera, the formation of which in the chick takes place after the trunk is cast in outline, or about the sixth or seventh day,—the liver, lungs, kidneys, cone and ventricles of the heart, and intestines, all become visible nearly at the same moment; they appear to arise from the veins, and to be connected with them in the same way as fungi grow upon the bark of trees. ”

“ Since we can have no knowledge of its seat, the pain is referred to some accessible part of the segment of the body in which it occurs. A gulp of very hot water, on reaching the closed sphincter muscle of the stomach—the valve which must open before it can pass from gullet into stomach—gives rise to pain which seems to have its seat in the skin over the lower end of the breast-bone. In the same way disease of the various viscera gives rise to pain and tenderness of areas of the skin of the segments of the body in which the nerves of the viscera join the spinal cord. ”

“ No one would easily believe how greatly the viscera are altered by disease, particularly in chronic cases, and how extraordinary the anatomical effects of prolonged sickness often are. Indeed, I am confident that the opening and thorough inspection of one dead body, which has been wasted by slow disease or by infection, is of more real service to the art of healing than the dissection of ten corpses of healthy criminals. ”

“ The visceral loop is still present in the form of a separate band, which innervates the branchiae, [207] osphradia, and viscera generally, forming a special genital ganglion in connexion with the reproductive organs. ”

“ The viscera are pressed down from above by the stricture and weight of clothing. The mobility of the organ renders it susceptible to change of position under these circumstances.
These conditions must be overcome, or treatment will prove futile. In most cases the uterus can be readily restored to its natural position. First remove the pressure from above, and then take the exercises prescribed on page 267. This will give room for the pelvic viscera, and strengthen the supporting muscles. [Pg 274] Nature’s recuperative powers are never more remarkably demonstrated. ”

“ From this source proceed two large veins, which branch into the fore-part and the back of the body, and which, spreading out in a series of branches, convey the vital blood by other smaller veins over all parts of the body. This is the only one271 among the viscera that is not affected by maladies, nor is it subject to the ordinary penalties of human life; but when injured, it produces instant death. While all the other viscera are injured, vitality may still remain in the heart. ”

“ There are several cases of complete transposition of the viscera on record. This bizarre anomaly was probably observed first in 1650 by Riolanus, but the most celebrated case was that of Morand in 1660, and Mery described the instance later which was the subject of the following quatrain:—
"La nature, peu sage et sans douse en debauche Placa le foie au cote gauche, Et de meme, vice versa Le coeur a le droite placa." ”

“ The size of the cavity of the thorax is constantly varying during life, with the movements of the ribs and diaphragm, and with the degree of distention of the abdominal viscera.
From the collapsed state of the lungs, as seen when the thorax is opened, in the dead body, it would appear as if the viscera only partly filled the cavity of the thorax, but during life there is no vacant space, that which is seen after death being filled up during life by the expanded lungs. ”

“ Even the tension of the pulse is not always a sufficient warrant to bleed, for in three days, in a fever which runs its course in five days, the disorganization of the viscera is so complete, that a recovery is scarcely to be expected from the lancet. The remedies which give the only chance of relief in this case, are purges, blisters, and a salivation. ”

“ The abdominal viscera may also be congested, but the blood generally remains fluid throughout the body, and is easily removed.
Strangulation.—In this instance the carotid arteries are generally ruptured; the heart, the lungs and the viscera, are usually congested. In death from suffocation the same symptoms are present. In cases of sunstroke, decomposition sets in very rapidly, and requires an immediate check; the lungs will frequently be found congested. ”

“ A lent fever, depending on some fixed cause of the bowels, must be cured by having regard to those causes some of which I shall enumerate”:—the first supposition being that the fever depends on phlegmons by congestion of “the liver, spleen, pancreas, or the mesentery”; the second, if it depends on extravasations in an equally comprehensive range of viscera; the third, “if it depends on an ulcer, then all vulneraries must be administered internally; but to speak truth, when the viscera are ulcerated, there remains but small hope of life” ”

“ Indeed, while it seems superficially an easy matter to refer any one of the simple instincts directly to some certain one of the viscera as the main or primary source from which its appropriate stimulation comes to the nerve centres, it is by no means easy to decide what one or more of the viscera, or of the other organs that are not commonly classed as viscera, will have no part in the matter. ”

“ There are diseases it cannot cure; and in several of those patients in this town, who first took the Digitalis by your orders, there was the most positive proof of the viscera being unsound. In these desperate cases it often procured a plentiful flow of urine, and palliated a disease which medicine could not remove. ”

“ Observe in fact that all the principal viscera, the heart, the lungs, the brain, the gastric viscera, the testicles, &c. limited by their serous covering, suspended in the middle of the sac that it forms, only communicate with the adjacent parts where their vessels enter; everywhere else there is contiguity and not continuity. ”

“ Mechanical Injury to Viscera.—This causes rapid death, more especially when the viscus injured, as the heart or medulla, is necessary for the immediate functions of life; injuries to other organs may not be followed by immediate death unless very severe and with great shock. A wound of the lung may not be followed by death for some time. ”

“ It must not be forgotten, however, that our viscera have also certain sensitive nerves and while these are not as closely distributed as those on the surface they are there and their presence is often a source of pleasure or at least of satisfaction, but may be the source {561} of poignant discomfort. ”

“ Severe blows, attended by general concussion, frequently give rise to rupture of the solid viscera, such as the liver and the spleen, causing death by hemorrhage. When the hollow viscera are ruptured, such as the intestines or the bladder, death ensues from inflammation. ”

“ When, in addition to the cavity being opened, viscera are penetrated, and death does not directly ensue from rupture of some of the larger arteries, the shock is not only very severe, but the collapse attending it is seldom recovered from up to the time of the fatal termination of the case. This is sometimes the only symptom which will enable the surgeon to diagnose that viscera are perforated. ”

“ The viscera—viz., the liver, kidneys, heart, lungs, etc.—are less commonly infested, and in these organs the cysts degenerate very rapidly. In animals which have been infested for a long time, the cysts may even have undergone caseo-calcareous degeneration, the liquid being absorbed and the lesions presenting the appearance of little oblong firm nodules. ”

“ The viscera of the animal occupy but a small part of the space within the shell, the cavity being mainly filled by a large quantity of watery fluid, whose density must be very near to that of the external sea-water. ”

“ The instructors demonstrated the viscera, which, with the muscles and other “soft parts” were removed piecemeal, and disposed of daily. Whitman’s tremendously realistic line, “What is removed drops horribly into the pail,” always takes me back to the dissecting room with its repulsive odours and its sorry sights. But our growing interest did much to mitigate the repellent features. ”

“ Part 7 Of the viscera some appear to be single, as the heart and lung; others to be double, as the kidneys; while of a third kind it is doubtful in which class they should be reckoned. For the liver and the spleen would seem to lie half-way between the single and the double organs. For they may be regarded either as constituting each a single organ, or as a pair of organs resembling each other in character. ”

“ The stomach in all these animals is single, just as it is single in all other animals that have teeth in front of both jaws; and their viscera are excessively small, as always happens when there is no bladder. In serpents these viscera are, moreover, differently shaped from those of other animals. For, a serpent's body being long and narrow, its contents are as it were moulded into a similar form, and thus come to be themselves elongated. ”

“ But the same power and force can be directed upon ourselves by ourselves, either upon an afflicted member of the body,—from brain to heel,—or upon the internal viscera, as in cases of dyspepsia, liver trouble, kidney difficulty, heart disease, cancer of stomach; above all, the pelvic viscera of either gender when disordered, as most are; gravid uterus, ulcerated, originating frequently in lacerated, vagina ”

“ Where the viscera, for example, are so constructed as only to be fitted for the digestion of recent flesh, it is requisite that the jaws should be so formed as to fit them for devouring prey—the claws for seizing and tearing it to pieces—the teeth for cutting and dividing its flesh—the limbs or organs of motion for pursuing and overtaking it—and the organs of sense for discovering it at a distance. ”