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. IX. Touching the Lungs.

THe Lungs called i•• Latin Pulmones* 1.1 in Greek Pneumoe••'s or Pleumones, have their name from Respiration or drawing in and blowing out the Air: because they are given to Animals living in their Air and brea∣thing, but not to fishes which have neither Neck nor Voice.

They are seated in the Cavity of the* 1.2 Breast or Chest, which they fil, when they are distended.

They are divided into the right and* 1.3 left part by means of the Mediastinum: that one part being hurt, the other may* 1.4 yet perform the Office. Each of these parts is divided into two Lobes, Laps or Scollups, about the fourth Vertebra of the Chest, of which the upper is shorter then the lower; seldom is one part divided into three Lobes, as in Brutes; because a man goes bolt upright, Brutes looking downwards▪ nor by reason of the shortness of the Chest, could any thing lie between the Heart and the Liver, except the Mid∣rif. Yet oftentimes Piccolhomineus, Riolanus and my self, have after Hippocrates and Russus Ephesius obser∣ved three. Now the Lungs embrace the Heart with their Scollups as with certain Fingers.

Their shape resembles that of an* 1.5 Ox-hoofe. On the outside towards the Cavity of the Chest, the Lungs are Bossie or bun∣ching out, on the inside they are hollow, where they embrace the Heart.

Their Colour in the Child is red like* 1.6 that of the Liver: by reason of the nourishment is receives from its Mother; in grown persons tis yellowish Pale; somtime Ash-color'd: in such as have died of a long sickness blackish. In some persons healthy enough. I have seen them Party colored, like Marble. In that part where it is knit unto the Chest by Fibres, tis red, as in a Child in the Womb.

Tis Knit in the Fore-part to the Brest∣bone* 1.7 by the Mediastinum, behind to the Vertebra's; somtimes the Lungs at the sides grow to the Pleura by certain Fibrous bands, whence arises a lasting shortness of Breath. Now this Connexion doth frequently deceive Physitians, nor knowing or discerning Penetrating wounds of the Chest. Nicolas Massa conceives this Connexion profitable to the Heart, least it should be oppressed with the bulk of the Lungs, or the facility or breathing should be hin∣dred, and Riolanus saies he evermore found this a••••e∣sion. I have cheifly observed it about the lower Ribs. near the Diaphragma, least they should press and bear upon it. Others say the Lungs are bound to Fibres, that in the wounds of the Chest, they might follow the motion of the Chest, though with a weaker mo∣tion. Hippocrates in his second Book de Morbis calls it the Lungs slipt* 1.8 down to the side; and this comes to pass either from ones Birth, or after a Pleurisie, or by reason of Tenaci∣ous and clammy flegm interposing it self; o•• from some external cause, as negligent

Curing of a wounded or suppurated Chest. Also the Lungs cleave to the Heart, by the Vena arteriosa and the Arteria venosa.

The Substance in a Child in the Womb is compact and thick; so that* 1.9 being cast into Water it sinks, which the Lungs of grown persons will not do. But after the Birth, because it begins to be moved with the Heart, by heat and motion the Heart becomes light and soft, lax, rare and spungy; so that the Lungs will be easily raised and fall again, and easily receive the Air: Which may be seen by the use of a Pare of bellows in dead bodies. Helmont hath seen the Lungs hard and stoney, in an Asthmatical person, and Sal∣muth observes that little stones have been there gener∣ated in shortness of Breath. Also touching stones we have the Testimony of Galen, Trallianus, Aegineta.

The Lungs are compassed with a thin light Membrane, furnisht with many* 1.10 Pores which Pores are sufficiently visible, when the Lungs are blown up with a pair of bellows, and Job. Walaeus hath observed the said Pores in live Anatomies, as big as a large Pease. This way the Sanies or Corrupt matter of the Chest may Penetrate and come away by Coughing. This Membrane is pro∣duced from the encompassing Pleura. For when the Vessels enter into the Lungs, they devest themselves of their Coat, which grows out of the Pleura, which doth afterwards invest the Lungs.

The Vessels. The Substance of the Lungs is interwoven with three sorts of* 1.11 Vessels, which make not a little also for strength. Two proceed from the Heart, of which before: The Vena Arterialis and Arteria Venalis.

The third is proper, viz. The Trachea or Aspera arteria so called, of which in the following Chap∣ter.

If these Vessels be fretted asunder as in persons Phcisical, or having the Consumption of the Lungs, many times plenty of blood is cast forth, or some Cartilaginous substance; yea and the Vessels them∣selves of the Lungs intire, which I have seen, and Tulpius hath two examples. And oftentimes persons in a Consumption die suddenly, because the greater Vessels being fretted asunder, the Heart is strangled with blood issuing there from.

These Vessels of the Lungs are great, not so much because they wan∣ted* 1.12 much blood, for their substance is very smal, setting aside the Vessels, nor needed they so much blood as is sufficient to nourish the whole body; but they are great, because the greatest portion of the blood is car∣ryed this way out of the right Ventricle of the Heart into the left by those wide passages, for the more sub∣tile blood can find its way through the obscure Pores of the Septum. This passage is proved.

• 1. By the greatness of the vessels. For the vena arteriosa and the arteria venosa are most large. And because the former is a vessel which carries out of the Heart, it is furnished with the Mitre-fashion'd valves, which hinder the blood from passing out of the Lungs the same way; and the latter bringing blood out of the Lungs into the Heart, has the treble-pointed valves, hindring the blood from returning.
• 2. Great Quantity of Blood is continually sent by the Pulse of the Heart, through the vena arteriosa and thence through the arteria venosa unto the left ven∣tricle, which is further confirmed by Ocular Inspecti∣on.
• 3. By Ligatures in living Anatomies. For the Vena arteriosa swels towards the* 1.13 Heart; but near the Lungs it is empty; the Arteria venosa contrarywise, swels towards the Lungs, but is empty towards the Heart.
• 4. The left Ventricle of the Heart being wounded, or the Arteria aorta, great plenty of blood will issue, as long as life remains, till all the blood in the body be run out. And from what other place can it come, seeing so much is not contained in the Heart, but out of the Lungs through the Arteria venosa, which had drawn the Blood out of the Vena arteriosa by the Anastomoses.
• 5. In the Arteria venosa as well of a living as a dead Body, so much Blood is found, that it hath often hin∣dred me in my publick Dissections.
• 6. By the similitude of the Vessels one with ano∣ther. The Vena arteriosa carrying out of the Heart into the Lungs, is just like the Aorta in substance, largeness, neighbourhood, and Valves. The Arte∣ria venosa doth in like manner resemble the Vena cava by straitness of Connexion, substance of a Vein, Ear∣lets and treble-pointed Valves.

This Circulation through the Lungs* 1.14 is furthered, 1. By the widening of the Lungs when Air i•• drawn in, which being every where filled, the vessels are distended, as when they cease, the motion of the Blood is either retarded, or quite ceases. 2. By the Situation of the vessels of the Lungs. The Vena arteriosa is Disseminated in the hinder or Convex part of the Lungs, because it is strongly moved by the Pulse of the Heart, the Arteria venosa doth cheifly possess the foremore and hollow part, that the Blood might more readily slide into the Heart. In the Mid∣dest of which the Branches of the Wind-pipe are sea∣ted, that in the blowing out of the Air, they might receive sooty Exhalations from the Vena arteriosa, and in drawing the Air in, they might communicate the same to the Arteria venosa. 3. The anastomo∣ses, by which the vessels are joyned together, both the branches which joyn mouth to mouth (though in dead bodies they cannot be discerned by the Eye-sight) and the Pores of the Parenchyma which is light and Porous.

It is to be noted for the answering* 1.15 the objections made against this Circulation.

1. That the Lungs are not oppressed or burthened so long as they being sound, the Blood perpetually glides through by Peice-meal.

2. That the blood doth not drop out through the Pipes of the Wesand, because partly they draw in on∣ly Air or sooty Exhalations, and in no wise Blood of a thicker nature then they, unless they be preternatural∣ly fretted in persons that have the Consumption, part∣ly because nature never ceases to drive found humors through the passages ordained for them, and retains what is necessary, which would otherwise go out at the passages of the Body being opened.

3. Although the Lungs of Dead bodies are whitish, yet the vessels do manifestly transpire through the ex∣ternal Coat. The Parenchyma it self is frequently ful, in persons strangled with blood, in others it is found emptied, because in the Pangs of Death it is forcibly excluded.

4. In burning Feavers, both the Lungs are hot, and thereupon the voice is Hoarse and dry, and they are oppressed, as appeared in the Epidemical Feaver

which raged up and down this year, by which many were strangled.

5. It is no good judging of the healthy state of the Body, from the preternatural state thereof.

Very smal Nervulets from the sixth Pare are spred only through the Mem∣brane* 1.16 thereof (which if it be inflamed, a pain will be felt, and communicated to the side it self and to the Back) not through the substance of the Lungs, least by Reason of their continual motion they should be pained. Hence the Ulcers of the Lungs are without pain. Howbeit Riolanus allots very many Nerves to the substance of the Lungs also, drawn from the Implica∣tion and Contexture of the Stomach Nerves. I also have seen many spred abroad within the Lungs, pro∣ceeding from the sixt Pare, and alwaies in a manner accompanying the Bronchia or Lung-pipes, derived from the hinder part, and only a little twig conveig'd to the Membrane from the forepart.

What the Action of the Lungs is, Authors Question. That they never move at all is Helmonts Paradox, but serve only as a seive, that the Air may pass pure into the Chest, and that the Muscles of the Belly al∣one do suffice for Respiration. But that they are indeed and in truth* 1.17 moved, the cutting up of live bodies shews, and Wounds of the Chest, that they move long and strongly. Moreover that they may be moved, any one may try with a pair of Bellows. Finally, They ought to be moved, for otherwise both the Heart would ••e suffo∣cated, and the motion of the blood in the Lungs, would be hindred. The Muscles of the Belly do in∣deed concur, but secondarily, because they are not joyned to the Heart, and when they are moved Re∣spiration may be stopped, Yea, and when they are cut off in a living Anatomy, the Lungs are moved nevertheless. But whether they are moved by their own proper force, or by some other thing, is a fur∣ther Question. Averrhoes who is followed among the late writers by John Daniel Horstius, conceives the Lungs are moved by their own proper force, not fol∣lowing the motion of the Chest, for otherwise saies he we must grant that a violent motion may be perpe∣tual.

But we are to hold, that though the Lungs are the Vessel of Respiration, yet they are so not by doing, but by suffering. For they have no motive force of their own, as Averrhoes will have it (because at our pleasure we can stop our breathing, or quicken or re∣tard the same) nor do they receive the principle of their motion from the Heart, or from the blood rai∣sing them, as Aristole conceives, and his followers, For 1. The efflux of the blood* 1.18 out of the Heart, is made by the orni∣nary motion, but the Respiration is voluntary. 2. The Cause of the Pulse and Respira∣tion would be one and the same, and they would be performed at one and the same time. But thirty Pul∣ses answer one Respiration. 3. While we draw in our Breath strongly, and hold the air drawn in for a season, the swelling of the Lungs should compel us to let our breath go, because it lifts up the Chest, accor∣ding to their opinion. 4. The Blood of the Heart doth not abide in the Lungs by an unequal retention, so as to distend them, but it is forthwith expelled ac∣cording to nature. 5. When it tarries longest in dis∣eased Lungs, it makes shortness of Breath or difficul∣ty in breathing, but no Tumor. 6. In a strong Apo∣plexy, the motion of the Lungs ceases, the Pulse be∣ing safe and the Heart unhurt.

Nor are the Lungs raised up, by the* 1.19 air forced in, which when the Chest is lifted up, because it hath no other space whither it can go to, it is carried through the Aspera arteria or Wesand into the Lungs, as Falcoburgius and Des Cartes conceive, and Hogelan∣dius, Regius, and Prataeus who follow him: For 1. The air may easily be condensed, as may be proved by a thousand experiments, as by Cupping-glasses, Wea∣ther-glasses, Whips, Trumpets, Winds and infinite things beside; and therefore it may be most straitly compacted about the Chest, and compressed within it self, as well by the internal subtile nature of the air and dispersed by Atomes, easily recollected one with∣in another, as by the external impulse of the Chest, whereby it may more easily be condensed, then driven into another place. 2, By the motion of the Chest or such a like body, we do not see the lightest thing that is, Agitated. By an hole in a Wall all Chinks and Dores being closely stopped, our Nostrils being stopped, we may with our Mouthes draw air out of the next Chamber, to which it is not credible that the air moved by the Chest, can reach with a strong mo∣tion; and though air may penetrate into the Cham∣ber, through some chinks and Rifts, yet is it not in so great quantity, as to stretch the Chest so much as it ought to be stretched, in free Respiration. The same experiment may be made in a Glass or Silver vessel applied close to ones Mouth. 4. While I have held my Breath, I have observed my Belly to be moved above twenty times the while. But whether is the Air then driven? Must it not needs be, because all places are ful of bodies, that the air next the Belly is compressed and condensed? See more of this sub∣ject in my Vindiciae Anatomicae, and in a peculiar Dis∣course.

Therefore the Lungs do only follow the motion of the Chest to avoid Vacuum: And therefore only they receive the air drawn in, because the Chest by wide∣ning it self, fils the Lungs with air.

Now that the Motion of the Lungs* 1.20 arises from the Chest experience shews. For 1. If air enter into the Chest, being peirced through with a Wound, the Lungs remain immove∣able, because they cannot follow the widening of the Chest, the air insinuating it self through the wound, into the empty space. But the Chest being sound, the Lungs follow the widening thereof, to avoid Va∣cuum; as in Pipes, Water is drawn upwards, and Quittor, Bullets, Darts and other hard things are drawn out of body through the avoidance of Vacu∣um. 2. If the Midriff of a live Creature be peirced through with a light wound, Respiration is stopped, the Chest falling in.

But somwhat there is which hinders* 1.21 many worthy men from assenting to this cause of the Lungs motion, because after the Chest is perfectly opened, the Lungs are oftentimes moved along time, with a vehe∣ment motion. But according to the Observation of Johannes Walaeus, Franciscus Sylvius, and Franciscus Vander Shagen, that is not the motion of Constriction and Dilatation, which is the natural motion of the Lungs; but it is the motion of an whole Lobe up∣wards and downwards, which motion happens, be∣cause the Lungs are fasten'd to the Mediastinum, the Mediastinum to the Midriff, and the Lungs are also

seated near the Midriff: whence it happens, while the Creature continues yet strong, that either the Lungs with the Mediastinum are drawn, or by the Midriff driven, the Diaphragma or Midriff, not yet falling down nor loosing its motion, which I observe in con∣tradiction to the most learned Son of Horstius. Now that this motion proceeds not from the inbred force of the Lungs, doth hence appear, in that alwaies when the Chest is depressed, the Lungs are lifted up, being forced by the Midriff, which at that time rises a good height into the Chest; and contrarywise the Chest being lifted up, the Lungs are depressed. And because the Lungs are the Instrument of Respiration, Hence it hath these following,

Uses,

• I. According to Plato, Galen, and Abensinae, to be a soft Pillow and Cushion* 1.22 under the Heart.
• II. According to others who follow Columbus▪ to prepare and wellnigh generate the vital Spirits (which are afterwards to receive their perfection in the heart) whiles in them the blood is as it were Circulated, first boyling with the heat of the Heart, and afterwards settled by the coldness of the air.
• III. It hath more proper uses when it is Dilated, and when it is contracted.

When the Lungs are Dilated, they receive in the Air like a pair of Bellows through the Branches of the Wind-pipe.

I. To prepare Aire for the Heart, for the convenient nourishment of the* 1.23 lightful Spirit. For every quality of the Aire is not a friend to our Spirit, as is seen in such, as are kild with the smoak of Charcole, and the steam of newly whited Walls.

Helmont conceives that the Air is united to the spirit of the Heart, and that it receives a fermentation in the Heart, which accompanying the same they do both dispose the Blood to a total transpiration of it self, which is the reason why in the extremity of cold wea∣ther and at Sea, we eat more heartily, because the thinness of the Air disposes the blood to insensible transpiration. Backius is somwhat of the same mind, who conceives that by the moist and thin body of the Air, the blood is made apt to run, so as that it may be diffused into the smallest passages of the Body. Others ascribe both these effects to the abundance of Serosity in the Blood. Therefore Hippocrates saies that water is hungry; and we see that such as are given to drink, are enclined to sweat much, as also Scorbutick per∣sons.

II. To fan and cool the heat. For we see that the heat of our Bodies stands in* 1.24 need of somwhat that is cold, without which it is extinguished, as is apparent in such as stay long in very hot Baths, as the flame of a Candle in a close place, wanting Air goes out. And* 1.25 therefore the Lungs are called the Fan and cooler of the Heart, and the Fishes in the Water and other Animals that have but on Ventricle in their Hearts, are without Lungs, because they do not want such a cooling. As also Infants in the* 1.26 Womb, being fanned by their Mo∣ther, and the wide Anastomoses, have their Lungs without motion. Hence it is that having seen only the Lungs, you may judg how hot any Creature is; for Nature makes the Lungs the larger, by how much the Heart is hotter. Therefore the Lungs are not abso∣lutely necessary to Life, but serve to accommodate the Heart. For instead of Lungs a boy of Amsterdam four years old, had a little Bladder ful of a Membra∣nous wind, as Nicolas Fontanus a Physitian of that Citty doth testifie, which being guarded with very smal Veins, had its original from the Aspera Arteria or Wesand it self, whose office it is to cool the Heart. Who nevertheless died of a Consumption, because haply, his Heart was not furnished with a sufficient quantity of Air.

When the Lungs are contracted in Expiration, they do again afford us a twofold use. I. Sooty Ex∣crements do pass away through the same, being car∣ried out of the Heart with the blood, through the Vena Arteriosa. II. To make an articulate voice in Men, and an inarticulate sound in Beasts, by affor∣ding Air to frame the voice. And therefore Creatures that have no Lungs, are mute, according to Ari∣stotle.

Notes

• * 1.1

  The Reason of their Name.
• * 1.2

  Their Situ∣ation.
• * 1.3

  Division.
• * 1.4

  Into Lobes.
• * 1.5

  Their Figure.
• * 1.6

  Their Colour.
• * 1.7

  Connexion.
• * 1.8

  A certain Cause of long lasting Short-winded∣ness.
• * 1.9

  The Substance.
• * 1.10

  Membrane.
• * 1.11

  The Vessels.
• * 1.12

  Why the Lungs ••at•• so great Vessels?
• * 1.13

  See Tab. 4. of Book 2.
• * 1.14

  How Circulati∣on is caused in the Lungs.
• * 1.15

  Contrary objecti∣ons answered.
• * 1.16

  Why Ulcers of the Lungs are without pain.
• * 1.17

  Whence the mo∣tion of the Lungs proceeds.
• * 1.18

  Aristotles Error.
• * 1.19

  The Opinion of Falcobur∣gius.
• * 1.20

  The motion of the Lungs is proved to arise from the Chest.
• * 1.21

  An Observa∣tion in live Anatomies.
• * 1.22

  Its Use.
• * 1.23

  All kind of Air is not a friend to mans Spirit.
• * 1.24

  Our heat doth want a Cooler.
• * 1.25

  Why Fishes need no Lungs.
• * 1.26

  The Lungs of Children in the Womb move not.