Bartholinus anatomy made from the precepts of his father, and from the observations of all modern anatomists, together with his own ... / published by Nich. Culpeper and Abdiah Cole.

Chap. XIII. Of the Pancreas, or Sweet-bread.

THe Word Pancreas signifies All∣flesh,* 1.1 whereas this part should ra∣ther be call'd All-kernel, its Substance being wholly glandulous, loose it is and shapeless, three or four fingers long, somtimes six or seven, and more, cloathed with a thin Membrane from the Peritonaeum▪ and in fat Bodies, it seems all made of Fat, which o∣thers term dirty fat and moisture; some Calicreas the Sweet-bread or White-bread, and Lactes; because of its milkie whiteness and softness.

Its Situation is under the lower part of the Stomach, and the bottom there∣of,* 1.2 the Duodenum and Vena portae, as far as the Regions of the Liver and Spleen.

Now its Original is at the first Ver∣tebra* 1.3 of the Loins. In the middle its Parenchyma is white.

And it hath for Veins the Splenick* 1.4 Branch; for Arteries the left Branch of Arteria Coeliaca; for Nerves those of the sixt-pares bran∣ches, which go to the Stomach and Duodenum, and it hath also little Kernels.

Besides all which, it hath also another Passage which is membranous, and of a peculiar Nature by it self, spread out all along the Pancreas, somtimes in a strait Line, somtimes in a crooked Line, which hath been as yet described by no Anatomist, being first discovered at Padua, when I was there, in the year 1642. by John George Versungus, a very diligent Anatomist, but killed by cruel Fate; it is remarkeable for its Cavity, and the strength of the Walls thereof. I beleive Fallopius did not know it. He mentions indeed small Passa∣ges, ending into the Pancreas and Kernels next it; but because this passage is only one, he rather saw through a mist the milkie Veins, dispersed into the Pancreas of the Mesenterie and other Kernels. It is for the most part single, though the same Party had found it double running one by another in parallel Lines: A short one in the ordinary place, and beneath it a larger. The Orifice whereof opens widely into the Gut Duode∣num, near the Entrance of the Gal-passage, with which it is somtimes joyned by one and the same Mouth, but more frequently (as I found with the Author) by a different but neighboring Circle. The little Valve si∣tuate before the egress thereof, looking outwards, keeps the Probe from entring this new passage, being thrust in by the Duodenum. And therefore in a Living crea∣ture, being bound towards the Gut, it swells more and more, but beyond it is presently emptyed, if we be∣leive Jacobus Baccius, which is an Experiment hard to make for before that this passage which lies intangled and encombred can be freed, or bound, the Creature dies. From thence this passage creeps through the whole Body of the Pancreas, spreading out on both sides infinite little Branches, until by narrower but or∣derly disposed twigs, it goes by little and little straight forward, and is silently terminated towards the Spleen. But it goes not into the Spleen, although Folius hath assured me, that he hath observed it to go thereinto. Peradventure that was against Nature, nor seems it fea∣sible, because the Branches are first obliterated by an orderly defect, ere they touch the Spleen, and there is no cavity there about, though an eminent one towards

[illustration]

[illustration]

In this TABLE both the Body of the Pancreas together with the new Wirsungian Passage, as also the Vessels drawn there through to the Spleen, are expressed.

The XV. TABLE.

The Explication of the FIGURES.

FIG. I.

• AAA. The Pancreas dissected.
• BB. The new Passage found in the Pan∣crras.
• cccc. Little Branches of the said Pas∣sage.
• d. The Orifice thereof.
• e. The Orifice of the Choler-passage.
• ff. The Choler-passage.
• ggg. Part of the Gut Duodenum.
• HH. The Ramus Splenicus.
• II. The Spleenick Artery.
• K. A Portion of the Arteria Caeliaca.
• LLL. Anastomoses or Conjunctions of the Mouths of the Spleenick Vein and Artery.
• M. The Hemorrhoidal Branch of the Spleenick Vein.
• NN. The Body of the Spleen.
• OO. The Ingress of the Vessels in the Spleen.

FIG. II.

• A. The convex part of the Spleen.
• BB. The Spleens Membrane separated.
• C. The flesh of the Spleen, which is blackish.

FIG. III.

• AAA. The concave part of the Spleen which receives the Vessels.
• B. The spleenick Vein.
• C. The spleenick Artery.

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the Guts. In which Cavity (truly) there is no conspicuous Humor, save that a Probe being thrust in, is for the most part died with a yellow cholerick colour, the Walls thereof being coloured with the like tincture, so that Choler seems to be therein contained, by the ordinary Law of Nature, which Johannes van Horn like∣wise a Friend of mine saw at Venice, in a cholerick loos∣ness, the said Vessel being evidently full of Gall or Choler. And therefore this new found passages

Use, is not to carry Chylus ut of the Duodenum into the Spleen, bo use 1.* 1.5 It doth not reach to the Spleen. 2. A Valve hinders the Ingress. Nor doth it serve to carry Melancholy out of the Spleen, to which use serve the Capsulae atrabilariae, the black Choler boxes. Nor to carry fermentative Juyce unto the Stomach, as Horstius Junior ingeniously feignes, Because 1. Such Juyce is not bred in the Pancreas, which is a glandulous Body. 2. The way is more ready to that purpose, from the Spleen; this being a more troublesom and encom∣bred passage, for it would be troubled by meeting the Chylus in the Duodenum, and would be infected by the nearness of the Gall-passage. 3. Never any such Juyce seen in this passage. 4. Who will be bound that it shall be able to pass beyond the Pylorus? Nor is it to prepare Chylus, which Baccius affirmes to be found in living Creatures. Nor to nourish the Pan∣creas, seeing that Humor is therefore unfit, and the coe∣liack Arteries do that work, but for the common good. But how, or which way shall it return to the Liver? For he rightly denies it to the Spleen. Shall it return to the Duodenum, and from thence to the Mesentery? There would be an infinite Circulation. He shall not easily find it in living Anatomies; also he confounds the Pancreas with the large Kernel of the Mesentery. Nor finally does it send the Excrements of the Chyle to the Duodenum, as Licetus, Riolanus, and Vestingus conceive; for in this Passage no Chyle is seen, but yel∣low Walls. Moreover the refuse of the Chyle is al∣ready voided by stool, nor does the Chyle part with a∣ny new Excrement, till it undergo a new change in the Veins of the Liver. Now sure it is, that out of the

Pancreas it self, whose proper passage it is, and in which it begins, and is ended, somwhat is thereby voi∣ded into the Guts, and it doth as I conjecture.

1. Purge forth Choler, whether bred in the Digesti∣on of the Pancreas, or in the Spleen, for each of these are taken to be Auxiliary-Livers. And it is as it were the Bladder-gall of the Spleen, which is conveniently joyned by its mouth, to the other passage of the Livers-Gall-bladder, by the Duodenum, so that look what use the one affords to the Liver, the same the other may be supposed to afford to the Spleen. And to prevent our doubting, the Humor of Choler daubs the inside of this Passage. To which Opinion of mine, very many Learned men have asserted, though in some things they dissent.

2. To receive into it self the Excrements of Arterial Blood from the Heart and Spleen, though the neigh∣boring Branches of Arteria Coeliaca.

3. Riolanus counts it a profitable Use, that by this Passage, in vomiting, divers Humors are purged out, and the Redundancies of the first Region; and conse∣quently the fomenting Humors which maintain long∣lasting and malignant Feavers and chronical Diseases, and which lurks in the Pancreas, is this way voided forth. And I may well ad somwhat to this most lear∣ned Invention. That not only by Vomit, but also by stool, through the assistance of Choler-purgers, hot cho∣lerick Distempers may be by this Passage discharged, which burn the Mesentery, Spleen, Arteries, and Heart it self. And hence proceed cholerick stools in burning Feavers, and blood in a Dysentery or Bloody-flux, by reason of the large Inundation of Choler, continually flowing from hence into the Guts; which is so much the more hard to cure, by how much the Pancreas doth lie out of the reach of Medicaments, being deeply whelmed among the Bowels.

The Use of the Pancreas it self is, 1. To prop and support Vessels passing* 1.6 through the same, as the Branches of Ve∣na porta, of the Coeliack Artery, and of the Nerves: Especially the Ramus Splenicus. 2. To assist the Concoction of the Stomach, which is per∣formed in Heat and Moisture. 3. To serve as a cu∣shion under the Stomach. And therefore that old Wo∣man of Rome in whom it was become stoney, fell first into a continual Vomiting, afterwards into an Atrophy or consuming of flesh, and at last died thereof, as Pana∣rolus hath it in his Observations. 4. To suck out the wheyish Blood which slides along that way, and through help of the Kernels to purge it. 5. In sickly and melancholick Bodies, to perform the Office of the Spleen, which Riolanus shews from the Example of the most renowned Thuanus: Whose Pancreas or Sweet∣bread, did equal the Liver in amplitude and weight, yet was it wholly scirrhous; but his Liver hard and round as a ball, and full of Flegm like Potters-clay, and his Spleen was found so small, that it hardly wei∣ghed an ounce.

Notes

• * 1.1

  The Substance of the Pancreas.
• * 1.2

  Its Situation▪
• * 1.3

  Original.
• * 1.4

  Its Vessels.
• * 1.5

  Its Use.
• * 1.6

  The Use of the Pancreas.