The economy of the animal kingdom, considered anatomically, physically, and philosophically

발행: 1846년

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branches that ramified Over the externat sursace filled With tho injection ;biit in dissecting the Ventricles, and the lest especially, We saW the lacerti, columus and cordS of the internat sursace, beautis ully distended by the mercii , So that they Shone like silver, and presented the appearance of transparent tubules, Whicli although persectly sound, yetswealed ali over With minute drops of mercury, and when cut into, letout the mercury in large quantities. Ibid. , prop. 52.) The nerveS are applied to, implicateit With, and inserted iii, the coronary vesSelS in uWOnderfui manner. . . . But although it should not appear froin theiranatomy, that the nerves Surround the coronary vesseis With an ivied tWine, and are applied to, implicated Mith, and assived to them in fixhundred disserent Ways, and thus assist in the alternate protrusion Osthe blood from the externat to the internat paris, and from these to the interior paSSageS, neVeriheleSS . . . eXperiments Would mOSt olearly demonstrate that such is reatly the case .... Is We talle the heari os a man, d0g, or Sheep, We Shail find it generalty relaxed and saccid, or as it Were in a state Os diastole, With the coronary arteries and Velias Verylarge and conspicuous. And is me stightly moisten it on the oulside With boiling Water, and inject it With the sanie, We shali immediatelysee it pass froni diastole into Strong systole, and the externat coronary

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390. BoguΗΑΑvΕ. The heari has two coronaryJ arteries arisingsrom the storta just above iis semiiunar valves, and whicli running in oppOSite directions, serui one canes. This canal encircles the base os the heari, and sends Osr arterial branches, Whicli variousty anaStOmOSe With each other, and are sperit in innumerable minute tWigs, that 90urout a humor in the sortii of dew, and pervade the whole sursace of the beari, and together With the vetiis similarly distributed malle up nearlyali iis substance. A quantity of sat lies exterually between the VeSSelS. The coronary arteries undergo diastole While the other arteries of thebody are performing Systole. But the Veliis pour their blood parilyinto the coronary Velias, and SO toWariis the right auricle, opening be- tween ii and the right ventricle; parily, by particular orifices, into theright auricle and ventricte immediately. These vetiis are emptied While the other vetiis of the body are filled. Inst. Med., n. I 83.)391. WINALow. Besides the great common vesseis, the hearthas vesseis peculiar to itself, called the coronary arteries and vetus, be- cause their trutilis in a manuer crown the base of the heart. The coronary arteries are two in number, and arise froni the beginning of theaorta, after Whicli they Spread round the base of the heari, and send anumber of ramiscations into iis substance. The exterior course of the corona vetus is much the fame With that of the arteries, but they endpartly in the right auricle, and partly in the right ventricie. They like-Wise terminate, but in Amalter numbers, in the lest ventricte, by the venous ducis that open in the fossulae and lacunae belWeen the inequalities of the ventricies. Similar lacunae are Observed in the auricles betWeen theprominent lines bes rementioned.' And in the great bag of the lestauricle we find smali holes that suem to have the fame use. Os the two coronary arteries, for there are Seldoin three, one lies to the right, the other to the lest, of the anterior third of the circumferetice of theaorta. The right coronary runs in belween the base of the heari and the right auricle, ali the way to the flat sursace of the heari, constituting half the coronat circle. The lest coronary passes between thebase of the heari and the lest auricle; and bes ore it turiis on the base, it seniis down along the convex Sursace of the heari a principat branch

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in the interstice belKeen the VentricleS. Another principat branchissuos froni the union of the tWO arteriai semicircles oti the flat side of the heari, and running to the apeX, there meets the former branch. The corona veins are distributed exteriorly much in the Same maniter. Their trunk opens principalty into the right auricle by a particular ori- fide furnished With a litile semiiunar valve. All the coronary Veins and their ramifications intercommunicate, so that is Wo blow through asinali hole made in any one of them, having sirst compressed the auricles and large arteries, we Observe that the air s elis ali the vesseis, and the ventricies likeWise by passing through the venous ducis.V F. Anaf., Tr. de la Potirine, n. 70-73.)392. RUYsCH. Authors have given the name os coronary to the arteries that supply the Substance of the heari; and deservedly ; be- cause arising froin the root of the storta above the semiiunar valves, theysurround the base of the heart. But no one hitherio has perfectly delinealed their numerous os eis and divarications, so as to Shew them distinetly, . . . much less has any one delinented the arteries that spreadtheir innumerable twigs through the auricles : although these arteries, termed by me the auricular arteries of the heari, proceed from the coronary artery on both sides, and are distributed through the auricles in ali directions ; their usu being, to furnish the auricles With the quantity os arterial blood requisite sor nutrition and warmth. The bes rementioned coronary arteries, in their distribution through the heari's substance, furnish arterial blood not only to the heari and auricles, butalso to the tunics of the root of the trunk of the aorta; whicli factagain I have not Seen observed or delinealed by other authors. lat. Anat. iii.)393. The course of these vesseis is veli Ahewn in Ruysch's Figures: thus those Whicli are considered arteries, and whicli proceed nearly fromopposite fides of the storta, encircle, in the manner of a croWn, the whOle circumserence of the heari, both breadthwise, and longitudinalty fromthe baseJ to the apex, relaniting With each other to complete the circles . From eaoh of the trunks, shortly after their origin, a considerablebranch is reflected, Whicli runs over against the root of the aorta belOWlike a Subtense, and meets with the branch of the other fide, and giVes Osr another branch, whicli descends nearly along the Septum On thelest fide of the heari, and divides into two tWigs that unite With thes Ormer coronary artery. From the fame subtense at the right sidennother considerable branch passes down, besides Others stom the coronary triank itself, but ali of whicli intercommunicate. It is Worthy os notice, that froni the subtending arc os eis rise to the aorta itfel

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Os the Same subtense, a ramiscation passes to the right auricle, and n Similar ono froni the lest fide to tho lest auriclo ; but Whicli anastom0SeSat Some distance froin the aorta with the coronary artery, that, Hamely, Whicli surrouniis the heart. Epist. Anas. iii ., tab. iii., fig. I, 2, 3.)It is very destrable that the reader should examine RuySch'S Other Figures, Whicli Wili teach him more than any mere verbal deScription. See, ser instance, the figure representing the flat side of the heart Where it lies on the diaphragm , in Which two venous branches are delinealed, running Doui the opening in the right auricle, oue os Whicli stants ossio the artery before described, in order to gain iis fide, and the Other Passes doWn nearly froin the fame potnt to the sursace of the heari. Thes. Anat. iv., tab. iii., fg. l.) See also Eustachius, Tabul. Anai., tab. V., fg. 7, 8 Cologiae, l7l6 , exhibiting the ramiscations that ruit froni the right auricle to the body of the heart. In fg. 7, the

394. ΜORGAGNI. I have Sometimes noti 'ed a lOSs or Separation dissolutionem of the fibres' in the extreme border of the lunular orcreScentie ValVe, Whicli, varying in Sige, is prefixed to the coronaryVein; and I remember Once to have seon this valve disjoined froni themolith of the vein, or at any rate connected to it merely by cornua. Adver3. Anat. V., Anim. 22.) Fantoni apprehends that the blood muSt be Sent into the coronary arteries, rather by the contractiori of theaorta than of the heari, because those arteries are most conveniently

silualed for the reception of the blood driven bach by the storta, andalso because the blood sies With suci, force and rapidity froin the heartinio the arteriai trunk, that it seems impossibie for a portion eVer Sosinali to turn bach at the time of the heuri's systole into the coronaryarteries.' Ι should certainly be of the fame opinion, unleSS Ι Supposed the a rite trunk to be so fuit of blood, that by iis reaction the blood that is sent froin the heari is drivon forcibly against the fides of the trutili, as the diastole of the lalter Ahews,) and theres ore, as it Would

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orifices. Aud in this case We must assent to the learneu Boerhaave, Where he says, that the coronary arteries undergo diastole While theother arteries of the body are performing systole But although this,as I have stated it, appears to be the case at 1irsi Sight, yet perhaps Onclosor consideration it Will scarcely seem probabie, that in a matter of Such great moment, So great a variety should exist in disserent individuals. And we must also bear in minit, that as in one and the Same subject one orifice of the coronary arteries is somelimes found above, the other below, the horder of the valves, so the Same Variety muStbe admitted to exist in one and the sanie heari at One and the fame time. What then shall we say l We must adopi one or the Other of these statements ; and since the orifices of the coronary arterieS, in those cases Where they lie completely bellind the valves, can Scareelyadmit the bl od excepi during the heari's diastole, it is certain that Dature, in order to be consistent With herseis, must be presumed to have prescribed the fame conditions in ali instances ; and this the rather, be- cause although these arteries open above the valves, yet not only arethey, as Fantoni intimates, most conveniently situatest for the recep

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have depicted both orifices of these arteries above the horderS, and most of them have delinealed another orifice also at the fides of the valves. Ibid. , Anim. 26.)395. VERMEYΕN. The heari has vetus and arteries peculiar toitself, Whicli are called coronary, because they surround the base of thelieari like a crown : from Whicli crown they senil sinalter branches through the whole of the substance of the heart. The coronary arterieSare tWo in number. They arise from the beginning of the aOrta under the Semilianar Valves, and although they run to opposite regions of the heart, yet in their course they again meet, and inosculate to sermas it Were a single vesset. The larger orifice of the coronary vein is in the vena cava beside the right auricle; from this pollit the Vein runs tothe lest part of the heari, and at lengili terminates by various litilem ullis in the cavlty of the right auricle . . . . The branches proceed ings Om the coronary vetus and arteries tOWards the apex of the heari, anastomose With each other in disserent places the venous branches With the venous, and the arteriai With the arteriat so that osten it is impossibie to determine to What large branch the sin alter branches pro- perly belong; a circumstance Whicli Ι have elsewhere mentioned as occurring ali over the body, although nowhere is it so palpabie as in theheart. When I say that these vesseis are distributed through the whole substance of the heari, I mean to include that they supply the auricles

and below the right auricle, and also the pulmonary artery and VeinS, he injected tincture of sas on made With brandy into the lest coronaryartery. A portion os this tincture Was Without violence soon made topass through the branches of the coronary artery tuto the entire Substance of the lest auricle, as SheWn by iis inflation, tension, and yello color: and froin the substance of this auricle the tincture feli into iis cavlty, and So into the pulmonary vein and test ventricie, Without adrop passing into the right ventricie. This saet, he thiniis, proves that the lest auricle has no vetus, hecause is it had any, the tincture Would have run through them, and been transmitted into the right auricle and Ventricle through the vena cava, Where ali the vetiis of the body meet Pither proximately or remotely. He then made other injections Withthe Same tincture, at one time into the right, at another time into thelest coronary artery, and he saW the liquid pass respectively into theright Or test ventricle, not omitting also the right auriclo. Os the lest Ruricle Ue have atready spolien. Ho asterwards mund in the cavities of

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the heart whon macerat ed in Water, a great number Os particular passages terminating on the inSide of the Same cavities, Whicli passages hecalis fleshy ducis, and SVS that they are continuous With the arteries. He concludes frst, that the coronary Veiiis With their branches are en- tiroly superficiat to the heari, Which he further proves by the tincture ii octod tuto them not tinging iis inner substance. Secondiy, that thesuvetiis do not communicate immediately With the superficiat arteries of the heari, as do the vetiis in the liver, Spleen, and SOme other paris ;since the communication in the hestri is essected by the intervention of the fleshy ducis, Whicli proceed from the fides and extremities of the superficiat arteries of the heari, and reach to the fides of iis vetiis. 397. Vietissens stated, that ait these particulars were as weli Seen in the hearis of the ox and sheep, as in the heart of the human subjeci; and theresere I took an Ox's heari, and traced the pulmonary vein frona iis orifice toWards the lest auricle, and aster removing the sui, I soon met with a branch, Whicli arising immediately from the coronary Veiu, extended through the substance of the auricle; and on proceeding sur-ther, I discovered sive suci, branches in one subjeci, and eight in ano

ing arteriat twigs, arising directly froin the lest coronary artery, and lying near the vetiis, under the sal; but I cut them oss to get a betterview of the venous tWigs. Having seen and examined these, Ι pro- ceeded to trace the coronary Vein, and saw it at length, by a large branch, or litile trunk, enter the substance of the right auricle, and there divide immediately into two branches of nearly equat Sige, namely, into a right and a lest. From ab ut the place of division, but mores rom the right branch, two smali tWigs came ossi Whicli extendedthrough the substance of the auricie. But the larger branch immediately entered iis substance, and sending oss some twigs, opened into iis cmity by a considerable orifice, Whicli not only gave vent to liquid, butalso to a probe passed into the velit. Αnd through the sanie orifice IasterWards inflated the vein iiself, as weli as many of iis smali tWigs distributed through the lidari's substance. I also found two other Venous orifices in the cavlty of the fame auricle : these Were the Orifices os omets of the above vein, but whicli omets Ι could not weli See onaccount of the sulcated character of the auricle . . . . The lest branchsent iis branches far and wide through the substance of the auricle, and 80me of iis tWigs torminated in the cavlty of the auricle, otherS in

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tainly not destitute os vetus. . . . In the fame OX's heari, I fixed Uponthe largest branch of the coronary vein, Whicli lies nearly in the place Where the externat wali of the right ventriolo joliis in front With themiddie septum, and having tied the other large branches to prevent the injected liquid from passing at orice to the coronary vein, Ι threW in Mater through the grand branch, and it readily found iis Way to thecavlty of the right ventricte, and oscaped by the orifice of the dividet

places froni Whicli it issued, I operiod the right ventricle in the part Opposite to the course of the vein alluded to, test Ι should wound the large branches of the lalter, and the liquid finding an easter exit elSe- here, Should not pass to the ventricie. But notwith standing this, itescaped so largely froin the orifices on the inside of the ventricte, that there Was no seeing the places froni Whicli it came . I then inserted asinali iube, and blowing through it, the air came out With water in thesorin Of bubbles, and shewed the places excellently. The orifices from

laid with the internat membrano of the heari, whicli thus acted as a Valve ; others, instead of this valvular provision, were inserted obliquely. On dissecting some of the largor orifices from Whicli the v ater isSued, I saW at the fides of them a number of minute foramina, just asVietissens himself has described. In some of them there Were four Orfive foramina, in others DKer, ali of which b0yond doubt were orifices

Water Was thrown in, Ι could not observe more than ur orifices out os which either issued. I tried the fame experiments With the coronaryarteries, and Observed that water Or air sent into the Vein, passed into the cavlty of the ventricte, through the oriscos Whieli Opened there, Willi more read iness and in largor quantity than When sent into the artery. . . . Here I firSt remarhed, that the vein commonly known as thecoronary, Whicli opens With a Wide orifice in the region of the right Ruricle, near the foramen Ovale and the cicatrix thereos,) is almost en

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tery is constituted of tWο arterieS, Whicli ruit fro in their origin in opposite directions, and inoSculatin g, conStitute the more flender part of thebes re-mentioned arte , SO alSO the coronary Vein has in a manner twotruulis, namely, One that OpenS into the Vena cava Over against theauriclo, and one that terminateS in the caVity of the Same auricle . . . in which also some of the Sinalter branches likeWise terminate. . . . It is

ident there re from the preceding observations, that a Vast numberos vesseis open directly into the cavities of the ventricles and auricles, this at least is true With respect to the right auricle,) and indeed many more into the right ventricle and auricle than into the lest . . . . I conclude . . . that those fleshy ducis of Whicli VieuSSenS SpenkS , . . . are in reality Venous. I inserted a brisite into some of the litile orifices of these vesseis, With a vieW to ascertain their course, and cautiouStyremoving the fleshy substance of the heari, I sam the bristio deviate incertain places, and perserate the above Substance; While in other placesit Was stili lodged in certain exquisitely sne Vesseis, Whose course Icould trace no further in consequence of their curvatures. A vastnumber of the litile orisces Would not admit the brisile at all. . . . Ιam in no Way influenced by the experiments that Vietissens brings sor-ward to fhew that the inner substance of the heari is destitute os vetiis, because it is not colored by tincture of sasDon injected into the coronaryvein ; for When common Water is thrown into the lalter, it passes in large quantities, and by numerous ouileis, into the cavlty of the ventricie ;aud indeed much more eastly than When thrown into the coronaryarteries. It is clear, hoWever, that in theSe Vetris there are no ValVeS, sinoe liquids injected through the larger branch or trunk, pass readilyinto the smaller branches. From Whicli I conclude, that the blood in these vetus does not alwayS pursiae the Same course, but iSSues Out into the ventricies When these are emptied, but When they are silled, and unable to receive any more, this biood then runs aWay tuto the largerbranches of the coronary vein, and so is carried on through the trunk, to the Vena cava, or right auricle. Ibid., cap. ix.)

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398. ΤΗΕ coronary vesseis os both kiniis, arteriai as Woli asVenous, arise DOm the hestri itself, and nos sis in the begin- ning of the aorta. For there are litile columns and lacunae in the ventricles and auricles; there are fleshy ducis, and there are motive fibres.. The blood flows Dom the heari into the lacunae, especially under the columns; Dom the lacunae itis expressed into the fleshy ducis; Dom the soshy ducis into the

fibros; Dom the fibres into the coronary vesseis, both arteries and vetus ; Dom the coronary vesself, either through tWO foramina in to the aorta, Or through one large foramen into theright auricle, or through severat smali foramina into the fame :but the superfluous blood in the coronary vesseis runs back intotho lacunae and ventricleS. Ait these vesseis depend entirely on the action of the heari, in the stream of Whose motion both they, and the motives bres, and fleshy ducis, as Weli as the lacunae of the ventricles and nurietes, are set and disposed. From Whicli it sol lows, thatali the vesseis that occupy the sursace of the heari are VenOUS, the arteries corresponding to Whicli are in the substance of the

that the superficiat vesseis, commonly called coronary, performtheir diastolo whon tho hoari persorius systole: and in like manner that tho superficiat vesseis of the auricles, perserm their diastole When the auricles perform systole; and vice ver8α. But

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