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. IV. Of the Pleura, Mediasti∣num, and Thymus.

THe PLEURA or Rib-coate, which the Greeks call Chitòn* 1.1 hupezocòs, or absolutely bumèn, is a membrane which on the inside cloathes the cavity of the Chest, hard and white, but in some pleuretick persons accor∣ding to Hippocrates, black and blew, whence it is that Practitioners conceive that this is affected in the Pleu∣risie, which notwithstanding is demonstrated to hap∣pen secondarily, by Manelphus, Cletus, Platerus, Zac∣chius, Vitaglianus, Benedictus. It is some∣what thicker and stronger then the Pe∣ritoneum.* 1.2 Ariseing from the Coats, which cover the intercostal nerves which proceed out of the Backbone, by means of which it is continued with the Coats of the Brain. And therefore it is thic∣ker in the Back, to whose vertebra's it cleavs as it were inseperably. Hofmannus will have it arise from the Breast-bone rather than the vertebra's of the Back, wherein he is out, as I have proved in my Animadver∣sions upon Hofman, and in my Anatomical Colledge. In diseases of the Chest, it becomes many times ten-fold thicker: though others say it is so attenuated in pleu∣ritick persons, that it can hardly be descerned. Fal∣lopius saw it of a thick callous substance, in a Dropsie

of the Lungs, and Platerus saw it in like manner swoln by a Scirrhous Tumor.

It is every where double, that the Vessels may be carryed within the folding thereof. The outer part which looks towards the Chest, is harder and thicker, the inner part be∣ing* 1.3 fastned to the Ribs is thinner. Between these the matter of the Pleu∣risie is often collected, and not only between the Pleura and Muscles. Ga∣len makes it to be single, and will allow it to be double, only about the Mediastinum. Riolanus ex∣plains that same Duplicature to mean its thickness, which cannot be shewed without tearing. The con∣trary whereto is manifest in the swoln sides of such as have the Pleurisie.

It hath its inner surface smooth, least it should by its roughness hurt the Lungs; its outer more rough that it might be the stronglyer fastned.

Somtimes it is found furnished with a little fat (as there is also now and then in the Peritonaeum) near the Vertebra's of the back, where the Vessels are grea∣ter then ordinary.

The Ribs also have their Periosteum or Membrane so called, which some call the third coat of the Pleura, and others Membrana Circumossalis the bone-about Membrane.

It hath very many Holes, the lower∣more* 1.4 of which I have reckoned up in the History of the Diaphragma, the upper are there where it affords passage to the Vena Cava, the Arteria aorta, the Wezand or Aspera arteria, the Gullet and the Nerves of the sixt Pare.

As for its VESSELS. It hath Veins from the solitary Vein or Vena fine Pari, and the upper Intercostal or Rib-between Vein; Arteries from the Intercostal or Rib-between Artery, and from the great Artery; Nerves, twelve in number, proceeding from the foreside of the Vertebra's of the Chest. And there∣fore wounds in this part are attended with most grie∣vous pains.

Its USE is. 1. According to Galen to plaster over the whole Cavity of the Chest and to render it smooth and even, that the Lungs migt not be hurt in their motion. 2. To cloath the Chest and its parts on the inside (even as the Peritonaeum affords coats to the parts of the lower Belly) and to constitute the Partition Membrane. Or,

MEDIASTINUM, Which is an of-spring of the Pleura, being a doubl•• Membrane; separating the Cavity of the Chest and the Lungs into two parts. For after that the Pleura having taken its Original a∣bout the Back hath ascended by the sides to the Brest∣bone, taking its course again towards the Back-bone, it is carried right out from the middle of the Brest to the Back. Being fastned on each hand to the sides of the Brest-bone, this Membrane is not obscurely dou∣ble, as is the Pleura, but visibly, being constituted of the Pleura doubled; and there seems at first sight to be as great a space between both, under the Brest∣bone, as the breadth of the Breast-bone comes to. But this is only in appearance and not really so; for that same Cavity under the Breast-bone, is then only caused, when the Breast-bone is in dissection, plu∣ckt from the Mediastinum, for before the Mem∣branes of the Mediastinum are most closely united one to another. Which it is strange that no Anato∣mist did observe before Ad Falcoburgius. After him, I have often made the Experiment, in grown persons and Children new born, in Land-beasts and large Sea-fishes; nor could I shew any Cavity betwixt the Mediastinum and Breast-bone, no not to the most expert Spectators, but I found the Membranes of the former sticking close by certain Fibres to the lat∣ter, which we forcibly separated with a Penknife. Which that it might be more apparent, the inwards of the Belly and the Midriff being taken away, I made it visible to the Eyes of all that were present. These things are to be understood of the lesser Cavity (to satisfie Riolanus who is my Adversary in this point) between the Membranes of the Mediastinum and the sternum: For the greater, wherein the ever∣moveing Heart is seated, no man in his right wits will ever deny. In this greater Cavity, or in this Duplicature•• if a wound inflicted on the foreside shall penetrate, lightly, so that the Heart settling beneath remain unhurt, it is sufficiently void of Peril and safe enough; which one unskillfull in Anatomy would pronounce deadly, But towards the Vertebrae, the Cavity grows narrow by little and little, and the Membranes meet together. But in the middle the Cavity is wider, and in the fore part of the said Ca∣vity, the Heart and Vena Cava are placed; in the latter part the Gullet, with the Stomach Nerves. If in this Cavity humors praeternaturally assemble and putrifie, they may safely be let out by boreing an hole in the Breast-bone, if we believe Columbus and Hofman∣nus, which Nicolaus Fontanus doth notwithstanding deny.

It is of a thinner and softer substance then the Pleura; and about the Vessels* 1.5 tis frequently full of fat like the Call.

For Vessels, it hath Veins and Arteries from the Dug-vessels and the solitary Vein or Vena* 1.6 sine Pari, applied inwardly to the breast∣bone, which being taken away they become visible: Also it hath its own proper Vein called Mediastana, which is somtimes one and large, other whiles dou∣ble and smal.

Also the Phrenick and Stomachick Nerves are car∣ryed through this Duplicature, and afford branches to the Mediastinum.

The use of the Mediastinum is, I. To* 1.7 divide the Chest into two parts, that one Division of the Lungs being hurt by a wound or otherwise, the other might perform its office.

II. To hang the Heart and Heart-bag dangling in so free a posture, as to strike against no part of the Chest.

III. To sustaine the Vessels running through the same, as also the Midriff in Mankind, least it should by the weight of the Bowels be drawn too much downwards.

The Thymus grows thereto in the Jugulum or Throat-pit the highest part* 1.8 of the Chest, whereunto in ordinary Anatomical Figures it is fastned, and hath its name from the leafe of time which it resem∣bles, not from Thumos the Mind, as if in disturbances thereof by passion, the blood and Spirit should work or grow hot within this Kernel, in the Vena Cava, as Riolanus interprets the meaning of the word; for the blood grows hot in the Heart, here it hath only a passage and tarries not, seeing few branches are dis∣cernable in the body of the Thymus, unless somwhat be left by the Arteries for Nutrition sake. In children and the Embryo in the Womb, less subject to passions, the Thymus is greater and more Numerous, in per∣sons of ripe years who are soon angry, we find it dried and co•…•…. Now it is a kernellish, soft, spungy, 〈…〉〈…〉 (some term it the Sweet-bread, be∣cause

[illustration]

[illustration]

The II. TABLE.

The FIGURES Ex∣plained.

This TABLE represents the Brest-bone cut off and lifted up, also the Mediastinum and the Lungs, with the Mid∣riff.

FIG. I.

• AAA. The inner surface of the Brest-bone and the Gristles interwoven there∣in.
• BB. The Dug-Veins and Arteries descen∣ding beneath the Brest-bone.
• C. The Glandulous Body called Thy∣mus.
• DDDD. The sides of the Mediastinum pluck•• asunder.
• EE. The distance between the two Mem∣branes of the Mediastinum which is caused by its forcible separation from the Brest-bone.
• F. The Protuberancy of the Mediasti∣num, where the Heart is seated.
• GG. The Lungs.
• HH. The Midriff.
• I. Cartilago Ensiformis, the Sword-like Gristle.

FIG. II.

• A. The left Nerve of the Midriff.
• B. The right Nerve thereof.
• C. The upper Membrane of the Midriff a little separated.
• D. The naked substance of the Midriff.
• E. The Hole for the Gullet to descend through.
• F. The hole or the Vena Cava.
• GGG. The Membranous part or Centre of the Midriff.
• HHH. The Portions or Appendices thereof, between which the great Artery de∣scends.

FIG. III. Represents that same Glandulous Body, seated by the Larynx▪

• AAA. The Glandules or Kernels which naturally breed upon the Larynx.
• B. A portion of the jugular Vein, out of which two smal twigs proceeding, do spread themselves through the substance of the Glandules or Kernels.

page 94

in a Calfe 'tis counted a dainty bit)▪ In a Child new born tis distinguished into a threefold Kernel sufficiently big. In grown persons, tis extenuated, its moisture being consumed by heat. Howbeit I have seen it large in great Sea-fish, from which many other Kernels were diffused on either hand, about the Mediastinum and sides of the Lungs.

Blood-conveighing Vessels do pass through this Thymus or Sweet-bread; howbeit in the substance thereof, being dissected, we cannot manifestly dis∣scerne any.

The use therefore of the Thymus is 1. To under∣prop those great Vessels which ascend that way, as the Vena Cava, Arteria magna, and their branches passing along to the Arms and Shoulder-blades. 2. Also for safeguard, as is usual, and that the Vessels may not be hurt by touching upon the bones. 3. That it may be as it were a cover and fence for the Heart, for I have seen it as a Bulwork to the Heart, which the Heart of a Child in the Womb stands in need of, be∣cause as yet it stirs not. And therefore it hath a large Thymus, as a Sturgeon also hath and other Crea∣tures which live in the Water, by reason of the exter∣nal cold.

Notes

• * 1.1

  What the Pleu∣ra is, and its O∣riginal.
• * 1.2

  Its Thickness.
• * 1.3

  The place of the matter which causes a Pleu∣risie.
• * 1.4

  Its Holes.
• * 1.5

  Its substance.
• * 1.6

  Vessels.
• * 1.7

  The use of the Mediastinum
• * 1.8

  The Thymus what it is?