Colonial North America: Countway Library of Medicine

^Putrefaction Putrefaction is known universally to disengage the Air contained in animal Substances and from a fixed to change it to an elastic State - the whole body of an animal exposed to the Causes of Putrefaction after Death will commonly be immensely enlarged by the Action of this Process - this daily ^[?] happens where [animal?] is exposed to considerable heat & Moisture at same time - By this Enlargement of Surface, the Quantity of Matter remaining the same the specific Gravity of such Substances must be much diminished and become less than that of Water, if ^{[?] drowned Body} immersed in this fluid [?] during the putrid fermen= tation they will rise upon it's Surface - In this Way bodies that have been drowned usually rise after a few Days to the Surface of the Water an Effect [vulgerly?] [?] to the breaking of the [?] as it is called [?] plainly arising from the above Cause - Dr Boerhaave a [mistake ??] mentions his having been nearly suffocated by the bursting of the body of a [hughe?] Mastiff which had been putrefying in the Water and which had just risen to the Surface at the time he happened to be passing by - [??] are also [attended?] with a degree of [?]

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it was been called by some, Membrana communis Musculorum, tho' there is no Occasion for such a Distin= ction, as it is Cellular Membrane still. It has by some been reckoned amongst the Integuments - The only Places where it is not dispersed, are those Parts, which lie loose as the Bowels &c & it is not found in the Humours of the Eye but the Vessels, that run into the Bones appear to have cellu= lar Membrane & perhaps also the compact Parts of the Bone. The Reticular Membrane ^{is made up of an infinite Number of Communicating Vesicles or bladder, so it} may be inflated all over the Body as ^{in the common operation of} Butchers do ^upon their Meat, the Air gives it a Whiteness & thick= ness - ^{The Water in} An Anasarca arises from ^{is contained in} the loose Texture of the Cell^Reticular Membrane, being loaded with Water; wether from the Vessels [Vault?] in Absorption - too great Thinness of the Blood or too plentiful Secretions, is not known, but most probably it is from Exudation - The Legs are most affected, When the Pa= tient has been standing, because there is a free Communic= ation from Cell to Cell, & the Water by it's Weight presses downwards, which it is evident from thence may be dischar= ged by Scarifications, which need not be very large - [Blist?]= [ers?] also empty the Water, first by the Cutaneous Vessels, then by its soaking thro' the Skin, which being porous, the Water passes off by transudations. Effusion of Blood into the Cellu= lar Membrane proves also the Communication between the

by diping in Oil or Water, also from extracting the [?] or Jelly from Ivory or bone shavings by which means they are rendered [friable?]

3 That it is composed of Oil and Water ^{[unite?] withe Salt as a medium} by the vital Attri= tion, appears from the chymical Analysis of Bone & hair from the jelly of Bones of Ivory & hair - and fish Glue ^{with that of [?]} is sufficient to prove how well they are adapted to the [?]

This Earth and glue ^{or this [?] Earth or Clay} is continually supplied the ani= mal System to repair the Consumption made by the vital & voluntary Actions from Attrition & Abrasion and the whole Body is supposed ^{by Haller} to be entirely chan= ged in the span of about 3 Years

^{[??] Haller} The Fibres thus formed ^{as just described cellulous plates of Haller [?]} are universally ^generally considered as ^{some of} the most simple parts of the Solids, but Haller has described another kind of fibres differing from these in that they as he [?] himself [?] in breadth whereas the others [?] in Length and those he supposes are principally employed in forming what is called the cellular Membrane or Tela cellulosa ^{Cellular Membrane what} Cellular Membrane in general This he supposes ^concludes to ^be made up ^of both the Kinds of fibres just described together with a great Number of inorganical Plates compress into the form of Parti=

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Cells, as on the Outside of the Eye, or from a Blow on any Part of the Body, where a Vessel is broke, & the Blood effused with the Skin unhurt, likewise it is evident from a Thrombus, or Extravasation of Blood into the Cellu= lar Membrane near the Orifice of a punctured Vein. In an Aneurism the Artery being wounded, the Blood gets into the Cellular Membrane, & sometimes passes very soon over a large Surface of the Body - The late Duke of Graf= ton had a Vessel broke in his Head by a fall from his Horse & the Blood run along the Cellular Membrane, & in a Day or two all his Neck & Chest were quite black, as tho' they were mortified & had a dreadful Appearance - The Cellular Mem= brane may be inflated by an Emphysema even in a living Animal, & that from two Causes, External & Internal. 1^st From Wounds, Lacerations or Rupture of the Parts subser= vient to Respiration, as from a Rupture of the Trachea by an Ulcer in a Consumptive Habit, or from a Rib wounding the Lungs &c. An Emphysematous Tumour in any Part may be distinguished by its Sound, When struck with the Hand, & a peculiar Cracking of Air, & it's being pressed away more easily than Water. Emphysema from an internal Cause, as a Rupture of the Trachea &c is very hazardous. But from an external is not attended with much Danger. A remarkable Case happened to a Person, whom D^r. Hunter was called to attend

=tions by the muscular Actions so as with the two former to intercept a great Number of Cavities Cells or Vesicles between them ^{Whether any [parts?] of this Membrane or [??]} It is very certain that It is the cellular Membrane that contains the most simple ^{& least} unorganized fibres of the body and if any part of the animal Solids is to be considered as formed by a simple [Connection?] of the Glue and Earth without any regular Dispo= sition of Parts we might reasonably considered this substance in that sight many parts of the partitions between the Cells really appear to the Eye to be destitute of rectilineal parts, and Haller supposes them to be flattened into plates by the action of the moving Powers the most simple constituent parts of the body are certainly inorganic but whether any of the animal Solids are so is much to be ^{Cell Memb [?]} debated on the other [hand?] ^{read Adhesion &c I [?]} The cellular Membrane is a fine transparent delicate Web which has generally ^commonly been known by the name of Tela cellulosa & adipose Membrane and has generally been [?] of as one of the common teguments of the body a large stratum of fat is contained in that portion of this Membrane which lies immediately under the Skin, and this appears evidently to be contained within certain Bags or Vesicles [??] for the purpose of [?]ving this substance as it is separated from the body. In many parts of the body it is much found to contain but a very small Quantity of this substance & in others none at all This has given Occasion for suspecting that the

Abscess in the Cell. [Memb?]

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The whole Body was Emphysematous, except the Hands & Feet from a fall off a Horse, but what was a very favourable Circumstance, there was but little of this Emp= hysema internally, the Patient was so enormously swelled that the human Shape seemed to be quite destroyed, his Eyes were closed, the Skin greatly stretched, & he panted for breath. The Swelling was first pressed from his Eyes, whereby he was immediately able to see, a small Incision being then made the Air rushed out in a Blast. If this hat not succeded D^r. Hunter intended to have opened even into the Cavity of the Breast, if necessary, where the Wound first happened

2^d. Putrefaction also causes an Emphysema, for if flesh be thrown into the Water, it first sinks, but after some Time it rises to the Top, from this it is, that drowned Persons after a while rise up to the Surface. Putrefaction or something like it in living Bodies produces an Emphysema, & most in hot Wea= ther - Dry Mortifications in old People are ^attended without Emphy= sema not proceeding from Putrefaction but rather from a Stagnation. the Disorder among the black Cattle has been attended with the Emphysematous Symptoms both extern= ally & internally. ^{The Reason why Matter does not extend throughout the cellar Membrane will readi= ly appear} An Abscess is an Inflammation occasioned by an Obstruction in the Vessels, which are then overloaded the Parts [tumify?] & grow harder. Inflammations consolidate or unite Parts, as the Lungs & Pleura, & if the Inflammation

of the cellular ^membrane might upon be found to be different In different Parts, Hard Vessels are found to run upon the Surfaces of the Membrane though they have not been proved to enter into the [?] of the Partitions themselves 2 ^Adhesions Dr Hunter thinks it sufficiently ^{[Organic?] considered [morbid?] Adhesion has formed} evident that this Substance is organic from Experiments upon that particular part which constitutes the medium of Adhesions in the various parts of the Body; It is well known that on the Surface of this Membrane in all parts of the body a quantity of thin Vapour is perpetually transuding from the exhaling Vessels of the Surface of the body; the use of thin fluid, is obviously to [?] Parts in contact to slide freely upon each other without Injury to each other - if by means of the contraction of those Vessels or any other Cause [?]ing in the fluids this Vapour should cease to be thus deposited, an Adhesion would very shortly take place between the parts in Contact and this is universally the Case in very considerable Inflammations in any part of the body

On artificially separating those parts the connecting Medium is evidently of the same texture with the cellular Membrane above mentioned and by injections made into the neighbouring Vessels is fully proved to be vascular and in fact to be made up almost entirely of small Vessels - the same thing is true with Respect to the Cicatrix found upon wounds In the former Case the Lymphatic substance seems first to

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is not disposed, it suppurates, the over distended Vessels being broke, they spill out the Contents, a Cavity is formed, Matter is accumulated, & is also surrounded by the Inflamed Parts; the Reason why in an Abscess the Pus is confined to one Place, & does not run in from Cell to Cell, is that Inflammation unites the Parts together first there is a glutinous Adhesion, & then an Anastomo= sis of Vessels, & as the Matter diffuses itself, the Inflamma= tion goes before, hardens & unites the Parts, & prevents the Matter going forwards - There was a Case in George's Hos= pital of a Mortification, which as it advanced up the Leg, was continually preceded by an Emphysema, at last when it got up to the Groin, the Man died. There was also a Case, when the Scrotum being accidentally punctured with a Pin on fastening on a Poultice, a Blood Vessel was opened, & the Blood diffused itself over the Scrotum & Penis & put on the Exact Appearance of a Mortification. Suppu= rations tho' deep seated for the most part, open outwards, those being the least Resistance that Way, except where es= [?]ed with a strong Fascia, an Abscess opens itself either in the middle, or otherwise the Drain is generally depending by reason of it's working downwards, & by it's Weight dissec= ting the Cellular Membrane, & were not Surgeons someti= mes too Officious, it would be better - But Abscesses in the Abdomen, Thorax &^c are Exceptions to this for in those Cases,

[?]zed out from the Ends of the inflamed Vessels and this glutinous Substance being thus out of the Course of circulations ^afterwards soon [coagulated?] by Rest and thus formed the Adhesion between the parts in Contact This Adhesion is very frequently found to take Place after violent Inflammations of the Pleura, as in Pleurisies, or of the outer Membrane of the Lung, as in Peripneumonies, and I have had occasion to [?] that one fourth at least of all bodies that I have opened have been found with the Lungs adhering to the pleura whence it is [?] probable that even slight Degrees of Inflammation may produce this [species?] of cellular Membrane

^Callus In the latter Case, the formation of what is called the Callus of a wound it is evident that the generating Cause is the Acti= on of the Arteries upon the contained fluids gradually [?] the closed Extremities - and indeed from these contractions it is much to be questioned whether all parts of an animal being are not furnished with Vessels and fibres and are consequently organical ^{return 2 Pages}

Distribution

There is scarcely any part of the body but what appears to be made up in part at least of this cellular Membrane by [?]rating the Solids of the body most of them are found to be formed by a number of [?] or Layers of this Substance

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it generally finds less resistance inwards, & Matter always makes it Way out, where it finds the least Resis= tance of the Ribs, but often goes inward & kills the Patient Matter rather enlarges the Parts by distending, pressing or breaking them down. Matter in the Abdomen sometimes works outwards, but sometimes acts on the hollow Viscera, & gets into the Stomach & Intestines, when a Patient is seiz= ed with a Purging & Vomiting, & sometimes die. Matter is said to be made up of the Juices & Vessels themselves. One kind there is certainly, where there is no visible Destructi= on of Vessels, but a thick Matter, & yet nothing like Ulcerati= ons or Solids broken down, but from an [inspissated?] Juice of an inflamed Surface. It seems to be owing to a Transu= dation of the inflamed Parts, which tho' thin at first, yet by stagnating it becomes thicker & like Pus. In a Child, the In= testines were once laid bare, without any Ulceration of their Surface, which were gradually covered with Matter, that at first was thin & transuded. We have the same in the Inflammation of the Eye, & in the [Clap?] upon the Glands, & this is the Case in the Aptha or Thrush, The Sloughs of this Kind only & no Breach of the Parts. Inflamed Surfaces have the Property of giving or squeezing out a thick fluid