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. III. Of the Diaphrag∣ma or Midriff.

The DIAPHRAGMA or Midriff, is* 1.1 so termed from distinguishing or se∣parating, some term it Praecordia be∣cause it is ordinarily stretched ou•• before the Heart, and Phrenes, because it being affect∣ed, the Mind and Sense are disturbed by reason of the Consent it hath with the brain, so that when the Mid∣riff is inflamed a Paraphrenitis or petty Phrenzy is cau∣sed. The Cause of this consent is very doubtful. Hippocrates saies, the Heart becomes foolish through blood flowing back unto the Heart and Midriff, from the multitude thereof, which foolishness makes it dull and nummed as it were, and that nummedness makes it Phrentick. But the more firm experience of latter Physitians, hath proved that the brain and not the Heart, is the seat of Madness. Aristotle attributes

[illustration]

[illustration]

The I▪ TABLE▪

The Explication of the FIGURE.

This Figure presents the External proper Parts of the Breast, also De∣lineates the Situation of the Midriff in the Body.

• A. The Pectoral Muscle in its proper place.
• B. The same out of its Situ∣ation.
• C. The Muscle Serratus ma∣jor Anticus, or Greater∣fore-side-Saw-muscle in its own place, being partly visible.
• D. The same out of its place.
• E. The Serratus anticus mi∣nor, lesser foreside-Saw∣muscle.
• FF. The Claviculae or Chanel bones.
• G. The Subclavian Muscle.
• HHH. The Intercostal, or Rib∣between Muscles.
• III. The Diaphragma or Mid∣riff.
• K. Part of the great descen∣dent Artery.
• L. An Hole for the Vena Ca∣va descendent.
• M. An Hole for the Gullet passing through the Dia∣phragma.
• nn. The Venae Phrenicae or Phrenick Veins so cal∣led.
• oo. The Phrenick Arteries.
• PP. The two Appendices or Appurtenances of the Diaphragma.
• QQ. The Muscles termed Psoas.
• RR. The Musculi Quadrati or square Muscles of the Loynes.
• SS. The internal Cavity of Os Ilium, or the Flanck-bone.

page ••••

prudence to the midriff, and when it draws out of the neighboring Liver and Heart Excrementitious Hu∣mors, the mind is thereby hurt, and the external Senses. Yet, Neither doth he solve the doubt, for many other parts draw like Humors, without causing madness; nor doth he unfold, how the Midriff im∣prints these ravings upon the Brain. The consent of Vicinity makes nothing to the purpose, because it is nearer other parts, nor society in the same Office, be∣cause the Lungs being diseased in a Peripneumonia, do not cause a Delirium; nor finally, the communion of Nerves and Vessels, because in the Inflammations of other Nervous parts no such thing happens; Ca∣strensis doth therefore necessarily flie to an occult con∣sent, peculiar to this part alone. Others term it Septum transversum the Cross-partition, because it goes cross, and divides the Body, and separates the middle belly from the lowermost. Some call it Cinetus, Dis∣septum, Discretorium, and the Greeks also call it Z••ne, Di••zoma, Perizoma, &c. Now it is a sin∣gular* 1.2 and peculiar kind of Muscle, hav∣ing an action and figure differing from all others.

Its Situation is overthwart, or across* 1.3 the body, and because it enclines a lit∣tle downwards, oblique.

Its Figure is circularly round, saving* 1.4 the long Appurtenances.

This Muscle is in Number only one, be∣cause* 1.5 of the unity of its Action common to both sides, but it is a great one. Meysso∣nerius saw a double Midriff at Lyons.

Its Magnitude answers the Diametral* 1.6 wideness of the lower Belly, which is

comprehended between the lower Vertebra's of the back and the Ribs. Hence great and whaley flesh, because they have longer and more Ribs then we have, have a larger midriff, creeping mean-while as far as to the extremities of the Ribs. For,

For it seems to arise from the Verte∣bra's of the Loyns, by two somwhat* 1.7 long fleshy parts (which cleave to the muscles of the Loyns, at the sides of the great Artery, and growing by little and little wider, about the lowest Vertebra's of the Chest they grow together, where this Muscle begins to grow Circular) and is fastned to the Chest round about, beingknit where it is fleshy to the extremities of the Ribs: though we should do peradventure more rightly, to make the beginning thereof, in its whole Circumference, as well from the Loyns as the Ribs, which Galen doth also somwhere insinuate: For see∣ing it could not be knit to the eleventh Vertebra, be∣cause of the great Artery, and the beginning of the Lumbal muscle, it is strongly inserted, by its two smal appurtenances to the Vertebra's of the Loyns.

Galen somwhere (whom Sylvius, Vesalius, Aqua∣pendens, Spigelius and many more follow) will have the middle of the Diaphragma to be the Head thereof, because the Nerves are there inserted, and the Centre in a Circle, upon which one point of the compass doth rest, while the other is carryed about, may be well taken for the Head of the said Circle. But as it is a peculiar muscle, in Situation, Action, Figure, Nobility, &c. so hath it somwhat peculiar in this point. But the beginning or Head cannot be in this Centre, because it is moveable, and the Ribs and Vertebrae of the Loyns, in respect thereof immove∣able. Moreover, the Nervous or Tendinous part, is the End of the muscles, and not their Head.

Its Substance is fleshy, in the mid∣dle* 1.8 Nervous and Membranous, where a Membranous Centre shews it self and a Nervous circle in stead of a Tendon, to which fleshy Fibres do run, from the Circumference of the Chest, as to their Centre. Whence necessarily the middle part of the motive muscle is Nervous, for otherwise it could not be mo∣ved. Secondarily, it helps to strength, in a perpetual motion, and in the suspension of the bowels which adhere thereunto; moreover it serves to secure the Vessels which pass through. To sustain the beating of the Heart, it was not to be strong, as Riolanus su∣spects, because 1. A soft part doth easily give way and yeild to a blow. 2. The point of the Heart doth not strike against the Midriff in its pulsation, for the Heart smites the breast when it is erected in the Sy∣stole, and is contracted at the sides; in the Diastole when it descends to the Diaphragma, it becomes soft and flaggy, and gives no pulsation.

Note that Wounds in the Nervous Centre of the Diaphragma, are by all accounted deadly, whether because a Nervous part being offended, doth induce a Convulsion, or because it cleaves to the Pericardium or Heart-bag and to the Liver, or because respiration perishes, and the Heart placed over the same is like∣wise hurt; for the Pericardium and Liver being hurt, do admit cure. A wound is more safely made in the fleshy Circumference thereof.

It is cloathed with a double mem∣brane, for strength. The upper is* 1.9 from the Pleura, to which the Peri∣cardium or Heart-bag is firmly fastned, and somtimes also the Lobes or Laps of the Lungs by little smal Fiberkies; the lower is from the Peritonaeum. Also it hath its proper substance, formerly descri∣bed.

It hath Holes: some being very excee∣ding* 1.10 little, and others great. Those very little ones are the Pores, through which vapors arise from the inferior parts. They are widned by the perpetual motion of the Diaphragma, not by Odours and Fumes, as Helmont believes. Otherwise, because the Membrane is thick, it hinders the drinking in of thick vapors, and will not let them ascend without the Vessels. Among the greater, there is one on the right hand, in the middle of the Nervous part, to give a passage to the Vena Cava: Another on the left hand greater and somwhat backwarder, for the letting through of the Gullet or Oesophagus with tw•…•… Nerves which go unto the Stomach. And where it arises about the Vertebra's of the Loins, there ap∣pears a division, for the through-fare of the great Ar∣tery, and the Vena sine Pari, or Vein without fellow. These wide holes do admit from the inferior parts, the passage of thick Vapors with the blood, which cannot be prohibited by the Diaphragma. Hence in the 29. Aphorisme of the fift Section 'tis said, in a Fruitful Women, her lower parts being perfumed, the scent goes up to her Nostrils.

As to its Vessels. It has Veins and Arte∣ries* 1.11 from the Neighbouring Vessels vena cava and Arteria magna, called Venae phrenicae: and sometimes from the Vena adiposa

Nerves are spred through its whole Substance, being▪ brought from the spinal marrow of the Neck, between the fourth and fift Vertebra: which is proper to this part, and common to no other internal part under the Channel bones, because according to the Conjecture of the renowned Hofman, it was not to lie open to ex∣ternal wounds or Blowes, least we should be masters of our own Life or Death. But instruments of death are every where obvious, which the Love of Life and Fear of God hinders us from makeing use of. Now they are carried through the Cavity of the Chest, and are propped up by the mediastinum. Other Anato∣mists have observed other Nervs passing that way from beneath, proceeding from the costal and sto∣machick Branches. And because the Nervs of the Diaphragma or Midriff are* 1.12 in their passage mingled with certain little twigs, which are spread abroad into the muscles of the Jaws and Lips; hence when the Dia∣phragma is smitten there arises a kind of Laughter, which is no real Laughter, but a counterfeit one such as they call Risus Sardonius the Sardonian Laughter, because the muscles of the Face suffering a Convulsi∣on at the same time, and the Jaws and Lips being moved this way and that way, the partie seems to laugh. Such was the laughter of Thycenis in Hippocra∣tes and of Agnerus in our Countryman Sarco his relati∣ons, who was cut asunder in the middle with a sharp sword: also of that man in Aristotle whose Midriff being in the fight pierced with a Dart, made him die laughing. Pliny relates as much of other Fencers, and Homer tells us that Juno laught with her Lips when her Forehead scowled.

Galen makes the Cause of the Sardonian Laughter▪ to be in the Musculus latus quadratus, the broad square Muscle. But it reaches not to the Lips, Laurentinus Po∣litianus, makes the spirits to be the cause of this Con∣vulsion, which because of the sense they have of some troublesome thing, run back to the upper parts. Man∣cinius will have the Heart to be widened, and the face drawn into the posture of laughing, by the hear which

is raised by tickling and wounds, because he will have the Heart to be the seat of Laughter, in defence of A∣ristotle whom Physitians have confuted. Riolanus has sometimes observed laughter to arise in the guelding of a man, which was the forerunner of a deadly Con∣vulsion; for which cause he condemns our reason drawn from the Nerves, not giving us in the mean time any better reason viz. why laughter should arise upon the wounding or hurting the nerves of the Mid∣riff and Privities, and not when any other nerves are wounded.

Its Use is 1 To help free Respiration; for violent respiration is assisted by the muscles* 1.13 of the Chest; the former Respiration Galen ••erms gentle or small, which depends only upon the Midriff, the other strong, the intercostal muscles assist∣ing thereto, a third sublime, where the Diaphragma, intercostal or rib between muscles, and muscles of the Chest do act all together. Birds indeed, though they breathe have no Midriff, but their breathing which is light and scarse perceptible, because of the lightness of their bodies, is performed by their Lungs and Chest. Contrariwise Fishes which breathe not have a Midriff, but membranous, to seperate one Belly from another. In the greater sort of Sea fishes of the whaley kind, I have observed a fleshy Midriff like that of Creatures which live on the Land.

Now the motion thereof is thus: when the Breath is drawn in, the* 1.14 Midriff is stretched, when it is blowne out, it is remitted or slack∣ned, contrary to the Opinion of Arantius and Laurentius. Of whom the latter will have the Midriff contrary to all other muscles to draw to∣wards its end, and he will have the fibres which run out from the Circumference of the Chest, to be equal∣ly contracted, and the ribs to be drawn to the nervous Circle, and so to cause respiration. But how can the membranous Centre of the Septum, draw the ribs to its self and contract the whole Chest unless haply be∣cause it is fastned to the Mediastinum. But I have ob∣served more then once in dissections of living Bodies, that the Midriff is stretched out, when the Creature draws in its Breath. For the Guts are driven down∣wards by the Midriff when the Breath is blown out, and they ascend again when the Breath is drawn in, which also any man without Anatomical Section, may perceive in himself, by laying his Hand upon his Bel∣ly. In Wounds of the Diaphragma, the Guts and Stomach, when the Breath is drawn in ascend into the Chest, which Paraeus twice observed, which differs only according to more or less, from the naturall course of breathing. Now the motion of the Midriff ought to be such, because the Chest when the Breath is drawn in, must be widened to receive and contain the Air and swoln Lungs; and contrarywise, when the Air is breathed out, the Chest ought to be straitned, because then the sooty vapours are expelled, and the Lungs flag and become small again, and therefore in the former case the Midriff is lifted up, and in the lat∣ter depressed.

Jo. Walaeus besides that motion, whereby the fleshy part gives way inwardly, has observed another moti∣on in the Diaphragma during the drawing in of the breath, whereby the fleshy part thereof being con∣tracted into it self, comes to have folds in it, so that one portion of the fleshy part is placed upon another: and he observed that this folding is chiefly about the Appendices or Appurtenances, and when the breath is strongly drawn in: and he conceivs that by this means the Midriff is the more shortened, and the Chest by the lifting up of the Ribs, more widened.

II. To assist the muscles of the belly, in their com∣pression, when they would force out the Excrements and the Child in the womb: for from above it thrusts the Guts downwards. Hence, according to the Ob∣servation of Platerus, when the belly is costive, Sneez∣ing and Coughing do help, because thereby the Mid∣riff and Dung conteined in the Guts, are driven down∣wards, because of the Strugling of the said Midriff and its bearing down, the Excrements of the belly and U∣rine come away of themselves in live Anatomies and in such as are put to death by hanging.

III. To distinguish the lower belly with the natu∣ral parts, from the middle belly with its vital parts, least from the Ignoble parts frequent vapours should ascend, to the parts more noble, as the Heart &c.

IV. According to Hippocrates, it is the Fan of the lower belly, which fannes and cooles the Hypocondria or parts under the snort ribs.

V. Others suppose it causes natural respiration, because it depends not upon our will and pleasure, and moves when we are asleep, and never so much as think of it, and by help thereof, Men in Apoplexies do for a season breathe. But Piccolhomineus does more rightly assign a voluntary motion thereunto, howbeit only when some necessity constrains, as in easing of the bel∣ly, pissing, and fetching of breath, because it is a Muscle of a nature by it self; but not a motion absolutely or simply voluntary, which is discerned in progression & apprehension, that is to say in going and handleing.

Its motion ceases in a strong Apoplexy, only trans∣piration does then remain: but in a light Apoplexy, we see the Diaphragma also moved with the Chest muscles.

Notes

• * 1.1

  The Diaphrag∣ma or Midriff, why so called.
• * 1.2

  What it is?
• * 1.3

  Its Situation.
• * 1.4

  Its Figure.
• * 1.5

  Its Num∣ber.
• * 1.6

  Magni∣tude.
• * 1.7

  An Head and Tail in the Midriff.
• * 1.8

  Its substance.
• * 1.9

  Its Membrane.
• * 1.10

  Its Holes.
• * 1.11

  Vessels.
• * 1.12

  Sardonian Laughter▪
• * 1.13

  Use.
• * 1.14

  How the motion of the Diaphragma is performed.