Part 25

We might, as I have said, make use of this remark, by producing in various glandular and other affections, artificial catarrhs, a disease which we can always produce on the mucous surfaces by the introduction of a foreign body. I have for some time past made much use of ammonia respired by the nose. Pinel prescribes it before the paroxysms of epilepsy. There are an infinite number of other cases in which it is very efficacious, as in some kinds of cephalalgia, in ataxic fevers, in certain apoplexies, in various comatose affections, &c. A blister does not act till the expiration of some time; it requires four, five, six hours even for it to produce an irritation. Who does not know that oftentimes in diseases in which the forces are much prostrated, it has no action on the cutaneous system? On the contrary, the excitement of the pituitary membrane by ammonia is always sudden on the one hand and always efficacious on the other. Its effect, it is true, is only instantaneous, but this is precisely its advantage; for in many cases a blister is only useful the moment it irritates the skin; hence the use of drying it immediately and reapplying it. The employment of ammonia or of any other strong stimulant upon the pituitary membrane, can be repeated every quarter of an hour, every five or six minutes or even every minute. If habit renders the patient less sensible to its excitement, we can replace it by another irritating substance, whereas we cannot thus change the cutaneous excitement by a blister. What I have said of the pituitary surface is applicable to those of the rectum, the urethra and stomach, on which we can in many cases apply in diseases excitements in a more advantageous manner than is done upon the skin by means of blisters.

Moreover, the character of the glandular life of which we are treating, is only an insulated modification of a character general to all the vital properties, a character which consists in this, that they are weakened in one place when they are raised in another. Hence why the great collections of pus, large tumours and dropsies are always attended with a weakness in the glandular action. It is upon this character that rests the use of vesicatories, setons, moxa, cauteries, &c. which do not act, as has been said, by evacuating the morbific matter, but by making the irritation of the diseased part cease by that which is produced elsewhere.

Fourth Character. Influence of climate and season on Glandular Life.

Another phenomenon is also derived from the preceding character, and it is one that may be likewise considered as characteristic of the glandular system; viz. that in general it is in greater activity in winter than summer, in cold climates than in warm. In fact, heat which expands the cutaneous system increases the action of it at the expense of that of the glands, and reciprocally cold which contracts it, by preventing the constant exhalation that is going on there, forces the glandular system to supply this action. Hence why the same fluid, introduced into the economy, goes out with the urine in winter and with the sweat in summer; why, if we wish to produce an immediate discharge of urine in summer, it is necessary to suppress the perspiration by the sudden application of cold to the surface of the skin, by descending into a cellar, or some other subterraneous place; so that in summer we can, after digestion, make the product of the fluids pass off with the urine or the sweat, according to the temperature of the atmosphere in which we digest; why teas and diuretics forbid the use of each other, and why a physician who should employ them at the same time would know but little of the laws of our economy; why most of the diseases that are attended with an immoderate discharge of the secreted fluids, are almost always characterized by a diminution of the exhaled fluids; why in some seasons diseases have a greater tendency to be characterized by sweats, and in others by urinary, mucous evacuations, &c. It is to the greater degree of the vital activity of the glandular system in the winter, that must then be referred the frequency of catarrhs, diseases most of which suppose an unnatural increase of its action, the greater facility with which the kidneys are influenced by cantharides, &c. Physicians should have these considerations particularly in view in their treatment. It is necessary to act more upon the glandular system in winter, and the cutaneous in summer, because each system is as much more disposed to answer to the excitements made upon it, as it actually is in greater activity.

Fifth Character. Influence of Sex upon Glandular Life.

Is the life of the glandular system more active in man than in woman? As it respects the glands destined to digestion, the secretion of the tears, the evacuation of urine, &c. there is but little difference in the two sexes. As to genital glands, man has testicles and the prostate; woman has mammæ, so that in this respect they seem to be equal. Observe however that the influence of the first upon the economy, is much greater than that of the second. It is from the womb that go forth in woman the irradiations which correspond with those which the testicles send to all the other organs.

ARTICLE FOURTH.

DEVELOPMENT OF THE GLANDULAR SYSTEM.

I. State of this System in the Fœtus.

Though the secretions are not active in the fœtus, the glandular system is in general much developed. All the salivary glands and the pancreas are larger in proportion than afterwards; the liver is enormous; and the kidneys have a size much greater in proportion than they have in the adult. The same probably is true of the mucous glands, though I have not made any very precise researches upon this point. The form is different in many; the kidney for example is evidently uneven, whilst afterwards its surface is almost smooth. The colour is not the same; this is particularly striking in the salivary and lachrymal glands. These glands which are white in the adult, have in the fœtus an extreme redness which they lose by washing, which is not owing to the blood circulating in their vessels, though there is much of it in their vessels, but it is really inherent in their texture. This colour is never as great in the pancreas, though its texture is nearly the same. The texture of the glands is extremely soft and delicate at this age, which is the case with all the parts. They are divided and yield with great ease, and their vessels, which are large, carry into them a very great quantity of fluid.

Then they are, if we may so say, in a state corresponding with that of remission in the adult; they secrete even less fluid, though they appear however to be in constant action. In fact, all the reservoirs would be insufficient to contain their fluids, if in a given time, as much flowed from them as after birth. Is this because the black blood, which then enters their parenchyma, is unfit to furnish the materials of the secretions? This may have an influence, and I have elsewhere imagined it, from the circumstance that this blood is unable to support many other functions. But the principal reason appears to me to be, that in the fœtus the nutritive motion of composition predominates evidently over that of decomposition, which is very inconsiderable. Almost every thing which arrives in the organs remains in them and continues to furnish the materials of the rapid growth which is then taking place in the body; now, the secretions being principally destined to carry off the residue of nutrition, must then be very inactive.

Besides, digestion does not introduce into the blood any of those principles which, being useless to nutrition, must on this account go out as they entered, that is to say without making a part of our organs; such are for example most of the drinks, which only pass into the mass of blood, and go out immediately with the urine.

The glands of the fœtus are then like the brain at that age; though much developed, they remain inactive; they are in the expectation of action.

II. State of the Glandular System during Growth.

At birth, the glandular system increases suddenly in energy; it takes a life which until then was foreign to it, and begins to pour out more fluid. It owes this change, 1st, to the difference of the blood which enters it, and which till then black and consequently venous, then becomes red and charged with principles that are new to it; 2d, to the general and sudden excitement carried to the extremity of all the excretories, by the aliments to those which open upon the canal that extends from the mouth to the anus, by the air to the mucous ducts of the bronchial and pituitary surfaces and to the lachrymal gland, by the various frictions of the extremity of the glans penis and even by the air which acts also upon it, to the kidneys and the bladder.

All the glands are so much the more sensible to this sudden excitement, as they are unaccustomed to it. Their sensibility, heretofore torpid, is roused; they feel the contact of the blood which enters them and which till then had made only a feeble impression upon them. This sensation is so much the more acute, as on the one hand the organic sensibility of the glands becomes more evident, and as on the other the red blood is a more powerful stimulus than the black; for, as I have already had occasion to observe, the blood that arrives in an organ produces two effects in it, one of which is to excite it, either by the motion it communicates, or by the contact of the principles it contains, and the other is to furnish materials for the different functions, as for exhalation, secretion, nutrition, &c. The first effect is common to all the organs which the blood enters; the second is peculiar to each.

I would observe however that many of the secretions are much less active during the first years, than they are afterwards; such are those of the salivary glands, the liver, &c. The kidneys being destined to throw out the residue of digestion, as much and more often than that of nutrition, are in a state of activity in proportion to that of the first function. The infant often passes urine, as he frequently voids excrements. It is not because many substances, returning from the organs which they have nourished, present themselves to the kidneys, to be thrown out by this part.

The affections of the glandular system are not the predominant ones in early age. 1st. It is not the parotids that are enlarged in the frequent swellings that take place in their neighbourhood, but it is almost always the lymphatic glands. 2d. We know that an excessive flow of bile, and the affections which arise from it, are then very rare. 3d. All the secretions relating to generation are absolutely nothing. 4th. In the same proportion in which the organic affections of the liver and the kidneys are common in the adult, are they rare in the infant. Then it is in what are improperly called lymphatic glands, in the brain, &c. that the morbid anatomist finds materials for his researches; for observe that the organs which are particularly in action in one age, are those which are most often attacked by acute and chronic diseases at that age, and that on the contrary they seem to forget those in which but little is done. 5th. Surgeons know that sarcoceles, hydroceles by effusion, varicoceles and all the diseases of the testicles are as rare before the period of puberty, when nutrition only is going on in these glands, as they are common in the subsequent years.

It appears that it is the mucous glands which are then the most commonly affected and are consequently in the greatest activity. The lachrymal glands are also very frequently in action. The infant weeps more often than the adult; we might say that all the passions which agitate this age have but one uniform mode of expression, and this mode is weeping. If the infant suffers, if he is jealous or frightened he weeps; if he is furious, he weeps because he is not very strong. This influence of the passions upon the lachrymal gland in the early years, seems to take place at the expense of the influence exerted upon the other glands. It is rare that fear or fright give to infants a sudden jaundice, or that they excite bilious secretions. At this age they do not pass water and void their excrements from fright as often as in the after ages; they have not the spasmodic vomitings that are so frequently occasioned by the passions of the adult; they do not become pale or red as much in anger; thus the countenance is not to the same extent the moveable picture upon which is painted the emotions of the mind. The eye does not sparkle in anger and is not expressive in friendship. It is the lachrymal gland which then most often serves in the face, for the expression of the passions. Observe that this expression is that of weakness and want of power, it is that of woman, who resembles the infant in so many phenomena. The feeble stag opposes his tears to the dogs, who seize upon him to devour him.

The glandular texture remains for a long time soft and delicate in the infant. At birth and in the fœtus, neither the liver nor the kidneys have the singular property of hardening by boiling. They remain during this experiment very tender and yield easily to the least impression. If the boiling be ever so long continued, they do not lose this character, which is gradually weakened as we advance in age, and which at this period makes the glands fit for some uses in our kitchens to which they are not so proper in the adult.

III. State of the Glandular System after Growth.

Puberty commences about the period that growth finishes. A gland till then inactive in man, enters suddenly into activity. The prostate follows it in its development. In woman the breasts swell, separate, and acquire in a short time a size which they would not have done in many years, if they had grown according to the same laws as in the preceding state. The other glands, far from being weakened, in proportion as these become stronger, increase their action also; they become stronger, and gradually lose the softness that characterized them in infancy; they moreover grow harder.

Till then composition had predominated over decomposition in the general nutritive motion. Then almost as many substances are constantly thrown from each organ, as enter its interior to nourish it. Now as the glands are the great emunctories which throw out the residue of nutrition, they then pour out more fluids in proportion than before.

During youth it is the genital glands which predominate over the others; they seem to be a centre whence go irradiations that animate the whole machine. We might say most often that they are, in the mechanism of our moral actions, the spring which puts every thing in motion.

As we recede from youth, the influence of the genital glands becomes weaker, because they are in less activity. Towards the thirty-sixth or fortieth year, it is especially the glands destined to digestion which predominate over the others, and among these the liver in particular seems to be in activity. Then the bilious affections are predominant; then the passions to which the bilious temperament seems to dispose us, more frequently agitate the mind. Ambition, hatred and jealousy are often the sad attendants of this age. These passions are then more durable. The levity of youth and the passions arising from the influence of the genital glands, which predominate at this age, had for a time suppressed these, or rather had prevented them from being developed. Then they remain alone, the others having escaped in smoke with the fire of youth. Then also the influence of the lively emotions of the mind affects especially the glands and the abdominal viscera. Then is felt that contraction at the epigastric region, the painful effect of the bad passions; jaundice occasioned by sorrow is then more frequent.

This age is that of the organic affections of the glands, of all the numerous changes of texture, of all the excrescences which destroying as it were the nature of these organs, transform them into bodies of a different texture. In infancy, leucophlegmasia is most often produced by an engorgement of those lymphatic bunches that are called glands, which resembles tabes mesenterica, the engorgement of the bronchial glands, &c. In the adult on the contrary, it is with the diseases of the liver, of the spleen, of the kidneys, that it is most often seen.

IV. State of the Glandular System in Old Age.

In old age, the glands become more firm and hard. Before that period even, the glandular system of animals ceases to be used at our tables. The liver, the kidneys, the spleen, &c. are mixed with the fleshy texture in common boiled meat, only to communicate to it some salts, some savoury principles that are foreign to this texture. They are not eaten, or at least they are not agreeable to the taste. The lungs which contain so great a quantity of mucous glands, do not afford a very digestible aliment except those of the calf; those of the ox are not brought to our tables, especially when the animal is old. I would observe upon this subject that the muscular and glandular systems are in an inverse order as it respects digestion, at least in the stewed state to which they are reduced for nourishment. In fact, the glandular system has not an agreeable taste and is not very digestible except in young animals, whilst at this age the muscular is insipid, and does not become savoury food till towards the middle of life.