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Exam Ref 70-768 Developing
SQL Data Models

Stacia Varga
Exam Ref 70-768 Developing SQL Data Models
Published with the authorization of Microsoft Corporation
by: Pearson Education, Inc.
Copyright © 2017 by Pearson Education Inc.
All rights reserved. Printed in the United States of America. This
publication is protected by copyright, and permission must be
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Although every precaution has been taken in the preparation of this
book, the publisher and author assume no responsibility for errors or
omissions. Nor is any liability assumed for damages resulting from
the use of the information contained herein.
ISBN-13: 978-1-5093-0515-5
ISBN-10: 1-5093-0515-7
Library of Congress Control Number: 2017938462
First Printing May 2017

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Contents at a glance
Introduction
Preparing for the exam
CHAPTER 1 Design a multidimensional business
intelligence (BI) semantic model
CHAPTER 2 Design a tabular BI semantic model
CHAPTER 3 Develop queries using Multidimensional
Expressions (MDX) and Data Analysis Expressions (DAX)
CHAPTER 4 Configure and maintain SQL Server Analysis
Services (SSAS)
Index
Contents
Introduction
Organization of this book
Microsoft certifications
Acknowledgments
Microsoft Virtual Academy
Quick access to online references
Errata, updates, & book support
We want to hear from you
Stay in touch
Preparing for the exam
Chapter 1 Design a multidimensional business intelligence
(BI) semantic model
Skill 1.1: Create a multidimensional database by using Microsoft
SQL Server Analysis Services (SSAS)
Design, develop, and create multidimensional databases
Select a storage model
Skill 1.2: Design and implement dimensions in a cube
Select an appropriate dimension model, such as fact, parent-
child, roleplaying, reference, data mining, many-to-many,
and slowly changing dimension
Implement a dimension type
Define attribute relationships
Skill 1.3: Implement measures and measure groups in a cube
Design and implement measures, measure groups,
granularity, calculated measures, and aggregate functions
Define semi-additive behavior
 Chapter summary
Thought experiment
Thought experiment answers
Chapter 2 Design a tabular BI semantic model
Skill 2.1: Design and publish a tabular data model
Design measures, relationships, hierarchies, partitions,
perspectives, and calculated columns
Relationships
Create a time table
Publish from Microsoft Visual Studio
Import from Microsoft PowerPivot
Select a deployment option, including Processing Option,
Transactional Deployment, and Query Mode
Skill 2.2: Configure, manage, and secure a tabular model
Configure tabular model storage and data refresh
Configure refresh interval settings
Configure user security and permissions
Configure row-level security
Skill 2.3: Develop a tabular model to access data in near real
time
Use DirectQuery with Oracle, Teradata, Excel, and
PivotTables
Convert in-memory queries to DirectQuery
Chapter summary
Thought experiment
Thought experiment answer
Chapter 3 Develop queries using Multidimensional
Expressions (MDX) and Data Analysis Expressions (DAX)
Skill 3.1: Create basic MDX queries
 Implement basic MDX structures and functions, including
tuples, sets, and TopCount
Skill 3.2: Implement custom MDX solutions
Create custom MDX or logical solutions for pre-prepared case
tasks or business rules
Define a SCOPE statement
Skill 3.3: Create formulas by using the DAX language
Use the EVALUATE and CALCULATE functions
Filter DAX queries
Create calculated measures
Perform analysis by using DAX
Chapter summary
Thought experiment
Thought experiment answer
Chapter 4 Configure and maintain SQL Server Analysis
Services (SSAS)
Skill 4.1: Plan and deploy SSAS
Configure memory limits
Configure Non-Union Memory Access (NUMA)
Configure disk layout
Determine SSAS instance placement
Skill 4.2: Monitor and optimize performance
Monitor performance and analyze query plans by using
Extended Events and Profiler
Identify bottlenecks in SSAS queries
Monitor processing and query performance
Resolve performance issues
Configure usability limits
Optimize and manage model design
 Skill 4.3: Configure and manage processing
Configure partition processing
Configure dimension processing
Use Process Default, Process Full, Process Clear, Process
Data, Process Add, Process Update, Process Index, Process
Structure, and Process Clear Structure processing methods
Configure Parallel, Sequential, and Writeback processing
settings
Skill 4.4: Create Key Performance Indicators (KPIs) and
translations
Create KPIs in multidimensional models and tabular models
Configure KPI options, including Associated measure group,
Value Expression, Goal Expression, Status, Status expression,
Trend, Trend expression, and Weight
Create and develop translations
Chapter summary
Thought experiment
Thought experiment answer
Index

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Introduction
The 70-768 exam is designed for Business Intelligence (BI)
developers and solution architects to test knowledge of a wide range
of topics related to the design, querying, configuration, and
administration of BI semantic models in Microsoft SQL Server 2016
Analysis Services (SSAS). Approximately half the exam covers
multidimensional BI semantic models, while the remainder covers
tabular BI semantic models. In addition, there are new development
and query language features available for tabular models developed
in SQL Server 2016, with which you should be familiar to
successfully pass this exam.
For multidimensional models, the exam focuses not only on the
steps required to design and develop the model in SQL Server Data
Tools (SSDT), but also tests your understanding of the supported
types of dimension models, the options for implanting measures,
and the configuration of properties to enable specific behaviors, such
as slowly changing dimensions and semi-additivity. It also covers the
usage of Multidimensional Expressions (MDX), both to query the
model and to embed business logic into the model in the form of
calculated measures, named sets, Key Performance Indicators
(KPIs), and additions to the MDX script.
The exam’s coverage of tabular models requires you to understand
how to import data into a model or use DirectQuery mode, and how
the implementation of DirectQuery mode impacts the model
development process. You must also know how to enhance the
model by defining relationships between tables, adding measures
and calculated columns by using Data Analysis Expressions (DAX),
configuring partitions, and setting properties of model objects.
Furthermore, you must know how to create KPIs from calculated
measures and how to use DAX to write analytical queries.
Additionally, the exam focuses on considerations related to
deploying and securing models and keeping them up-to-date by
choosing the appropriate processing options for specific scenarios. It
also requires you to understand how to use various tools to monitor
and troubleshoot performance of BI semantic models and identify
the necessary steps to take to resolve performance issues. Other
areas of focus include the deployment and configuration of Analysis
Services instances for memory management and scale-out scenarios.
To supplement your real-world experience with BI semantic
models, this book reviews the concepts covered by the exam by
using many different examples that you can follow yourself. To do
this, you must install the SQL Server 2016 database engine and
Analysis Services. For more information about SQL Server 2016
installation, see https://msdn.microsoft.com/en-
us/library/ms143219.aspx. You must also download and install SQL
Server Management Studio (SSMS) from and SQL Server Data Tools
for Visual Studio 2015 (SSDT) from https://docs.microsoft.com/en-
us/sql/ssms/download-sql-server-management-studio-ssms and
https://docs.microsoft.com/en-us/sql/ssdt/download-sql-server-data-
tools-ssdt, respectively.
This book covers every major topic area found on the exam, but it
does not cover every exam question. Only the Microsoft exam team
has access to the exam questions, and Microsoft regularly adds new
questions to the exam, making it impossible to cover specific
questions. You should consider this book a supplement to your
relevant real-world experience and other study materials. If you
encounter a topic in this book that you do not feel completely
comfortable with, use the “Need more review?” links you’ll find in
the text to find more information and take the time to research and
study the topic. Great information is available on MSDN, TechNet,
and in blogs and forums.
Organization of this book
This book is organized by the “Skills measured” list published for the
exam. The “Skills measured” list is available for each exam on the
Microsoft Learning website: https://aka.ms/examlist. Each chapter in
this book corresponds to a major topic area in the list, and the
technical tasks in each topic area determine a chapter’s organization.
If an exam covers six major topic areas, for example, the book will
contain six chapters.

Microsoft certifications
Microsoft certifications distinguish you by proving your command of
a broad set of skills and experience with current Microsoft products
and technologies. The exams and corresponding certifications are
developed to validate your mastery of critical competencies as you
design and develop, or implement and support, solutions with
Microsoft products and technologies both on-premises and in the
cloud. Certification brings a variety of benefits to the individual and
to employers and organizations.
 More Info All Microsoft certifications
For information about Microsoft certifications, including a full
list of available certifications, go to
https://www.microsoft.com/learning.

Acknowledgments
Stacia Varga There are many people behind the scenes who make
this book possible. Front and center on my mind are the people who
ensure that my words make sense grammatically and are technically
accurate. Thanks to Ike Ellis, Troy Mott, and Christina Rudloff for
fulfilling that role. Also, I’d like to thank Trina MacDonald and her
team at Pearson for ensuring the book production process runs
smoothly. Throughout my career, there have been many individuals
who have helped me fill in the gaps of knowledge about Analysis
Services. While writing this book, so many memories came to mind
reaching back to my start with SQL Server 2000 Analysis Services
long ago with Mike Luckevitch, Scott Cameron, Hilary Feier, Liz Vitt,
Scot Reagin, Dan Reh, and Denny Lee among others at the entity
that began as EssPro, merged with Aspirity, and later was acquired
by Hitachi Consulting. Most of all, my thoughts were with Reed
Jacobson who was my mentor in many ways, but in particular he
guided my deep learning of MDX and coached me during the writing
of my first few books. He is gone now, but definitely not forgotten.
Meanwhile, my wonderfully patient husband Dean Varga kept the
coffee pot warm and my world relatively peaceful so I could write
yet another book.

Microsoft Virtual Academy

Build your knowledge of Microsoft technologies with free expert-led
online training from Microsoft Virtual Academy (MVA). MVA offers a
comprehensive library of videos, live events, and more to help you
learn the latest technologies and prepare for certification exams.
You’ll find what you need here:
 https://www.microsoftvirtualacademy.com

Quick access to online references

Throughout this book are addresses to webpages that the author
has recommended you visit for more information. Some of these
addresses (also known as URLs) can be painstaking to type into a
web browser, so we’ve compiled all of them into a single list that
readers of the print edition can refer to while they read.
Download the list at https://aka.ms/examref768/downloads.
The URLs are organized by chapter and heading. Every time you
come across a URL in the book, find the hyperlink in the list to go
directly to the webpage.

Errata, updates, & book support

We’ve made every effort to ensure the accuracy of this book and its
companion content. You can access updates to this book—in the
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Important: How to use this book to
study for the exam
Certification exams validate your on-the-job experience and product
knowledge. To gauge your readiness to take an exam, use this Exam
Ref to help you check your understanding of the skills tested by the
exam. Determine the topics you know well and the areas in which
you need more experience. To help you refresh your skills in specific
areas, we have also provided “Need more review?” pointers, which
direct you to more in-depth information outside the book.
The Exam Ref is not a substitute for hands-on experience. This
book is not designed to teach you new skills.
We recommend that you round out your exam preparation by
using a combination of available study materials and courses. Learn
more about available classroom training at
https://www.microsoft.com/learning. Microsoft Official Practice Tests
are available for many exams at https://aka.ms/practicetests. You
can also find free online courses and live events from Microsoft
Virtual Academy at https://www.microsoftvirtualacademy.com.
This book is organized by the “Skills measured” list published for
the exam. The “Skills measured” list for each exam is available on
the Microsoft Learning website: https://aka.ms/examlist.
Note that this Exam Ref is based on publicly available information
and the author’s experience. To safeguard the integrity of the exam,
authors do not have access to the exam questions.
Chapter 1. Design a
multidimensional business
intelligence (BI) semantic model

Important Have you read page xiii?

It contains valuable information regarding the skills you
need to pass the exam.

A business intelligence semantic model is a semantic layer that you

create to represent and enhance data for use in reporting and
analysis applications. Microsoft SQL Server Analysis Services (SSAS)
supports two types of business intelligence semantic models:
multidimensional and tabular. In this chapter, we review the skills you
need to create a multidimensional database, whereas we explore the
skills necessary for creating a tabular model in Chapter 2, “Design a
tabular BI semantic model.” We start with the steps required to
physically instantiate a multidimensional database on an SSAS server.
Then we work through the steps to perform, and the decisions to
consider, for the two main objects in a multidimensional database,
dimensions and measures.
Skills in this chapter:
Create a multidimensional database by using Microsoft SQL
Server Analysis Services (SSAS)
Design and implement dimensions in a cube
Implement measures and measure groups in a cube
Skill 1.1: Create a multidimensional database
by using Microsoft SQL Server Analysis
Services (SSAS)
Before you start the development process for a multidimensional
database, you should spend some time thinking about its design and
preparing your data for the new database. You are then ready to set
up the database on the SSAS server and choose how you want SSAS
to store data in the database.

This section covers how to:

Design, develop, and create multidimensional databases
Select a storage model

Design, develop, and create multidimensional

databases
The design process begins with an understanding of how people ask
questions about their business. That is, you must decide how to
translate your business requirements into a data model that is
suitable as a source for a multidimensional database. Then after
loading data into this data model, a process that is not covered in the
exam, you proceed by creating a multidimensional database project
in SQL Server Data Tools for Visual Studio 2015 (SSDT).
During the development process, you create supporting objects
such as a data source and a data source view to define connectivity
to your data model and to provide an abstraction layer for that data
that you use for developing dimensions, measures, and cubes. As you
work through each step, you deploy each newly created object to a
multidimensional database on the SSAS server so you can test your
work and ensure business requirements are met.
Source table design
An online transactional processing (OLTP) database is structured in
third normal form with efficiency of storage and optimization of write
operations, or low-volume read operations in mind. An SSAS
multidimensional database is an online analytical processing (OLAP)
database that is optimized for read operations of high-volume data. If
you do not already have a data warehouse to use as a source for
your multidimensional database, you should design a new data model
in a relational database in which to store data that loads into SSAS.
Before you start the design of a new data model to use as a source
for your multidimensional database, you should spend time
understanding how the business users want to analyze data. You can
interview them to find out the types of questions they want to
answer with data analysis, and review the reports they use to find
clues about important analytical elements. In particular, you want to
discover the measures and dimensions that you need to create in the
new data model. Measures are the numeric values to be analyzed,
such as total sales, and dimensions are the people, places, things,
and dates that provide context to these values. In this chapter, you
learn how to develop a multidimensional database that can answer
the following types of questions, also known as the business
requirements, based on data for a fictional company, Wide World
Importers:
What is the quantity sold of items by date, customer,
salesperson, or location?
How many items are sold by color or by size?
How many items that require chilling are sold as compared to
stock items that do not require chilling (dry items)?
How many sales occurred by date, customer, salesperson, or
location?
What are total sales (with and without tax included), taxes, and
profit by date, salesperson, location, or item?
When reviewing individual transactions, what is the tax rate and
what is the unit price per item sold?
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Exploring the Variety of Random
Documents with Different Content
manner, that the matter secreted by each of them is found in a
fluid state in contact with that of the neighbouring organs, with
which it is agglomerated in hardening. Arranged in concentric
circles around a small cone, they produce a hollow cylinder;
extended in parallel lines upon a broad surface, they produce a
flattened lamina. Such is the manner in which the nails and the
hair are formed. We see from this that the epidermoid
productions grow, but are not nourished. The hair exhibits, it is
true, an internal cavity, filled with a coloured fluid, which appears
to be necessary for its preservation; but we can easily conceive
how an oily fluid may help to preserve it, by giving it suppleness
and thus preventing it from breaking. This fluid is poured into the
canal in which it is found, and it is not the hair which draws it in,
any more at least, than a capillary tube draws in the fluid into
which its extremity is plunged.
[21] The idea of endowing each texture with a peculiar kind of
sensibility in relation with its uses is one which pleases the
imagination. The ligaments are designed to oppose the separation
of the bones; they should remain insensible to every kind of
stimulus that does not tend to disunite these parts, and pain
consequently, should not be produced but from distension or
twisting. Unfortunately this supposition is not well founded, the
facts on which it rests were not accurately observed. It is very
true that in twisting these ligaments, the animal almost always
cries out, but it is because we at the same time stretch some
neighbouring parts endowed with sensibility. When this is
prevented and the experiment is made with proper precaution,
we can twist, distend or tear the ligament, without appearing to
give the animal any pain.
[22] So, as long as the fluid is retained in the artery, which is
easily done by means of ligatures, no pain is manifested; but
when the irritating substance is carried by the vessels to the heart
or to any other sensible part, we can easily conceive that the
animal must experience pain, for the irritant always produces its
effect, whether it be carried directly to the part or arrive there by
means of the circulation.
[23] These expressions dose, sum, quantity of sensibility are
incorrect, inasmuch as they exhibit this vital faculty under the
same point of view as the physical forces, as attraction, for
example; and as they present it to us as susceptible of
calculation, &c.; but, from a want of words for one science, it is
necessary, in order to make it understood, to borrow them from
the other sciences. There are expressions, like the words to
solder, to glue, to unglue, &c. that are used for the want of
others in the osseous system, and which really give very
inaccurate ideas, unless the mind corrects the sense.
[24] If the urine, during a perfect erection, does not go out of the
bladder, it is because the contraction of the muscles of the
perineum, and especially of the levator ani, prevents it. If these
muscles are relaxed, though the turgescence of the corpus
cavernosum and of the urethra remains the same, the urine flows
out without any other obstacle than what arises from the
contraction of the canal produced by the swelling of its parietes.
[25] These different excretory ducts do not exhibit in the
mammalia any contractility. There is no stimulus which can
produce it in them; I have tried them all in vain. In birds, on the
contrary, the ureters and the pancreatic and biliary canals are
contractile, and their motions, which return at intervals, are too
well marked to be mistaken. It appears that the contractility of
the excretory canals in the abdomen, is connected in these
animals with the absence of the diaphragm. We know in fact that
this muscle in the mammalia, assists by the pressure which it
exerts, the course of the secreted fluids, and renders useless the
existence of a peculiar motion in the canals which contain them.
If it be however pretended that this motion exists in them, but
that it is insensible, it must be allowed then, that it cannot
perform the office which is attributed to it, viz. that of obliterating
an opening often large enough to admit a quill. It is true, that if
the orifice of one of these canals be irritated for a long time, a
swelling of the membrane which lines it is sometimes produced,
and the opening is then really lessened. But in these cases there
is no occasion to be deceived; we see that this swelling is
produced at that point by the afflux of the fluids, as it would be in
any other part subjected to a similar excitement. Besides, it
should be observed that the obliquity of insertion of the excretory
ducts is alone sufficient to explain how the substances which pass
in front of their orifices are not introduced into them. In fact
these substances, at the moment of their passage, by the
pressure which they exert, tend to obliterate the opening of the
canal, by flattening its parietes against each other; it is thus that
the pressure of the urine, upon the inferior extremity of the
ureters, prevents this fluid from ascending towards the kidney.
The obliteration of the opening is but an accidental thing, and
most often is not even complete.
[26] It is not surprising, that a canal usually filled with the
excreted fluids should refuse to admit another which runs in an
opposite direction.
[27] All that is here said of the sensibility of the lymphatic
vessels, which makes them sometimes admit and sometimes
reject the effused fluids, is the more hypothetical, as it is not as
yet proved that these vessels are the agents of absorption. It
should be remarked, that the fluids that are supposed to be
absorbed by them, differ essentially in their chemical composition,
from the fluid that is usually found in their cavity. This fluid
besides varies but very little in its composition, though its
appearance is not uniformly the same; now, if it were the result
of the absorption of fluids differing from each other, its
composition ought also to vary as that of the chyle does,
according to the nature of the aliments.
Before the lymphatic vessels were known, the principal
phenomena of absorption were observed, and it was natural to
attribute them to the action of the veins. This opinion was
maintained for a long time after the discovery of the lymphatics.
Finally, towards the middle of the last century, Hunter being
engaged in examining these vessels, which he has done more to
make known than any other man, thought that they should be
considered as the agents of absorption, and this opinion was soon
generally admitted. If we look for the means by which he
overthrew the ancient theory, we are astonished to find that it
was by five experiments only. Harvey did not with equal facility
obtain the acknowledgment of the circulation, and perhaps there
does not exist a second example of an opinion, which was for a
long time established, being abandoned so readily. It should be
remarked, that physiologists had not yet recovered from the
surprise produced by the discovery of a system of vessels so
extensive, and yet for so long a time unknown; they were
impatient to know the use of them; the veins had already the
function of returning to the heart the blood brought by the
arteries; they thought it would not impoverish them too much to
deprive them of the faculty of absorbing, in order to enrich the
lymphatics with it. Of the five experiments of Hunter, two are
designed to prove that the veins do not absorb, the object of the
other three is to show that the lymphatics do.
In the first experiment he injected tepid water into a portion of
intestine, and the blood which returned by the vein appeared to
be neither more diluted nor lighter than before. We cannot
conceive how by mere inspection, it is possible to judge if the
blood contains a certain quantity of absorbed water, a quantity
which must be proportionably very small, if we consider the
whole amount of blood that passes through the mesentric veins
during the period necessary for the absorption of the fluid. Hunter
in the same experiment tied the artery which went to the portion
of intestine, and examined the state of the vein. It did not swell,
and its blood did not become aqueous. But after this ligature, did
the absorption continue to go on in this portion of intestine,
which still had no doubt lymphatic vessels? This the author does
not say. How moreover should he think that the vein could
continue its action when the artery was tied?
In the second experiment Hunter injected milk into a portion of
intestine, and was unable to discover this fluid in the blood of the
mesentric veins; but at the period in which this experiment was
made, mankind were very far from being able to detect in the
blood a very small quantity of milk, and at the present day, with
all the aid derived from chemistry, we can hardly discover in it a
small quantity which is mixed directly with it. These two
experiments prove then nothing against the absorption of the
veins; as to those which he brings forward in favour of absorption
by the lymphatics, they are not more conclusive. I shall content
myself with relating one of them. He injected, into a portion of
intestine that was empty, a certain quantity of warm milk, and
confined it there by two ligatures. The veins that came from this
portion were emptied of their blood by several punctures made in
their trunk. The corresponding arteries were tied. He then
returned the parts into the abdomen, and drew them out again in
half an hour. Having examined them with attention, he observed
that the veins were almost empty, and that they contained no
white fluid, whilst the lacteals were almost full of it. But was not
this white fluid that filled them chyle rather than milk? Was it not
there before the injection of this liquid? In order to ascertain what
takes place in the lymphatic vessels during absorption, we must
begin by examining the state of these vessels before the
experiment. But this is what Hunter did not do, and it is this that
renders his experiment of no value. It is not very astonishing that
he mistook the chyle for the milk, since milk has for a long time
been mistaken for chyle. Flandrin, Professor of the Veterinary
School at Alfort, has several times repeated this experiment of
Hunter; but he took care before the injection of the milk to
ascertain that the lymphatics contained no white fluid; and he
never found any in their cavity after the experiment. I have
myself many times performed this experiment, with the same
precaution, and I have uniformly obtained the same results as
those of Flandrin.
It would occupy too much time to examine all the reasons that
have been advanced for and against the absorption of the
lymphatics; I shall only relate some experiments I have made
myself; but I ought first to observe, that absorption undoubtedly
takes place in parts such as the eye, the brain, and the placenta
in which the most minute dissection has been unable to discover
any lymphatic vessel.
First experiment.—Four ounces of the decoction of rhubarb was
given to a dog, in half an hour after he was killed, and it was
found that more than half of the liquid had disappeared; the urine
evidently contained rhubarb, but the lymph in the thoracic duct
exhibited no trace of it.
Second experiment.—A dog swallowed several ounces of alcohol
diluted with water; at the end of a quarter of an hour, the blood
of the animal had a very distinct odour of alcohol, but there was
nothing of the kind in the lymph.
Flandrin made a similar experiment on a horse, to whom he gave
half a pound of assafetida mixed with an equal quantity of honey.
Six hours after, the horse was killed. The odour of the assafetida
was very perceptible in the blood of the veins of the stomach, of
the small intestines and the cœcum; but it could not be perceived
in the lymph.
Third experiment.—A dog was made to swallow six ounces of a
solution of Prussiate of Potash in water. In a quarter of an hour,
the urine very evidently contained some of the Prussiate; but the
lymph taken from the thoracic duct showed no appearance of it.
Fourth experiment.—I gave to a dog, in whom I had tied the
thoracic duct, two ounces of a decoction of nux vomica. The
effects of absorption were as rapid as if the duct had been open.
After the death of the animal I satisfied myself, that the duct had
been well tied, and that there was no other branch, as there
sometimes is, by which the lymph could get to the subclavian
vein.
I have varied this experiment by putting the poisonous fluid, into
the rectum, the sacs of the pleura and peritoneum. The results
have been uniformly the same.
Fifth experiment.—M. Delille and myself made an incision into the
abdominal parietes of a dog, who had been fed very heartily
some hours before, so that the lacteals might be easily seen, and
we then drew out a portion of the small intestine upon which we
applied two ligatures three inches from each other. The
lymphatics that went from this portion of intestine were full of
chyle and very distinct. They were all tied and cut. The blood
vessels were also tied and cut, with the exception of an artery
and a vein; the portion of intestine also was cut off beyond the
ligatures, and thus it had no communication with the rest of the
animal except by the vein and artery which were left. These two
vessels were dissected with the greatest care, and even stripped
of their cellular coat, lest there might be some lymphatics
concealed in it; we then injected into the cavity of this portion of
intestine a decoction of nux vomica, and we retained it there by
means of a new ligature. This portion of intestine, covered with
fine linen, was restored to the abdomen; six minutes after, the
effects of the poison were manifested with their usual intensity.
Sixth experiment.—M. Delille and myself separated the thigh of a
dog from his body, leaving only the crural artery and vein, which
kept up the communication between the two parts. These two
vessels were dissected with care, insulated to an extent of from
two to three inches, and even stripped of their cellular coat, for
fear it might conceal some small lymphatic vessel. Two grains of a
very active poison (the upas) were then inserted into the paw,
and the effects were as sudden and as intense as if the thigh had
not been separated from the body.
As it might be objected, that notwithstanding all the precautions
taken, the parietes of the artery or vein might still contain some
lymphatic, we varied our experiment so as to leave no doubt on
this point. The artery was cut entirely off, the communication was
reestablished between the two ends, by means of a leaden tube
introduced into their cavity, and fixed by proper ligatures. The
same was done for the vein. Thus there was no longer any
communication between the thigh and the rest of the body,
except by the arterial blood which came to the thigh, and by the
venous blood which returned to the trunk: the poison afterwards
introduced into the paw produced its effects in the ordinary time,
that is in about four minutes.
From these different experiments, it is right to conclude that the
minute branches of the veins possess the power of absorbing;
that they exert it on the surface of the mucous and serous
membranes, and in the interior of the organs; that the
experiments that have been quoted in favour of the absorption of
the lymphatics are inaccurate or incorrectly understood, and
finally that there is no proof that these vessels absorb any thing
but chyle.
Is it now necessary to refer to the venous branches this sensibility
that has been attributed to the ultimate ramifications of the
lymphatics? But this sensibility, as we have already said, would be
constantly in error; the absorbent vessel does not select one fluid
in preference to another; all are indiscriminately absorbed, even
the most irritating, those in fact whose action is sufficiently
powerful to destroy the vascular parietes. Besides, the
phenomenon then continues, when it is no longer possible to
suppose the existence of this sensibility. After death even, the
venous branches absorb still as they do during life, if they are
placed in analogous circumstances; and to do this it is evident,
that an internal current must be established, which resembles the
course of the blood. I shall now relate an experiment, which I
made on this subject, and which I selected from many others,
because it appeared to me to be very conclusive.
I took the heart of a dog that had died the day before; I injected
into one of the coronary arteries some water of the temperature
of 30 degrees of the centigrade thermometer. This water returned
easily by the coronary vein to the right auricle, whence it flowed
into a vessel or dish. I poured half an ounce of slightly acid water
into the pericardium. At first the injected water exhibited no sign
of acidity; but in five or six minutes it presented unequivocal
marks of it.
Absorption then can take place without the assistance of this
sensibility, as well as of this insensible organic mobility, which is
supposed to be in the ultimate vascular extremities, in the
absorbing mouths, as they are called. But do these mouths really
exist? Do the last capillary branches terminate abruptly with a
large opening on the surface of the membranes or in the texture
of the organs? Can the absorbed fluids pass through their
parietes as oxygen does in the lungs to arrive at the blood which
it modifies? We are unable to make experiments on these small
vessels, that are not cognizable by our senses; let us make them
on the large ones, and if they permit fluids, in which they are
immersed, to pass through them, for a stronger reason we may
suppose that it takes place in the capillaries, whose parietes are
so much more delicate and consequently more permeable. Now
we have confirmed by experiments what we had suspected; the
first attempts were made on dead vessels.
I took a portion of the external jugular vein of a dog; I stripped it
of the surrounding cellular texture; I attached to each of its
extremities a glass tube by means of which I established a
current of warm water through its interior; I then immersed the
vein into a liquor slightly acid.
It is seen by the arrangement of the apparatus that there could
not be any communication between the internal current of warm
water and the external acid liquor.
During the first minutes the liquid that I collected did not change
its nature; but after five or six minutes the water became
perceptibly acid; absorption had taken place.
The same experiment was repeated on veins taken from human
subjects; the effect was the same; it was the same also with the
arteries, but a little slower from the greater thickness of their
coats.
It remained to be seen if in a living animal absorption thus took
place through the parietes of a large vessel. I know that the
textures that were permeable after death, are almost all so during
life, though the contrary is generally believed. If we inject into the
pleura of a living animal a certain quantity of ink, at the end of an
hour, and often sooner, we shall find the pleura, the pericardium,
the intercostal muscles, and the surface of the heart itself,
evidently of a black colour. It is true that the signs of this
exudation are not always apparent. Thus after death, the
transudation of the gall bladder is rendered evident by the
colouring of the neighbouring parts. During life, on the contrary,
as fast as the colouring particles are deposited, they are absorbed
by the serous membrane which covers the surrounding parts, and
carried off by the sanguineous current which runs through this
membrane and the subjacent organs.
From these considerations we must believe that absorption may
take place through the parietes of the vessel during life as after
death. To be satisfied of this I made the following experiment:
I took a young dog of about six weeks old. At this age the
vascular parietes are delicate, and consequently more likely to
render the experiment successful. I laid bare one of the jugular
veins; I insulated it perfectly in its whole length; I stripped off
carefully every thing which covered it, and especially the cellular
texture and some small vessels that ramified on it; I placed it on
a card, that it might not be in contact with the surrounding parts;
I then let fall, on its surface and opposite the middle of the card,
a thick aqueous solution of an alcoholic extract of nux vomica, a
substance the action of which is very powerful on dogs; I took
care that none of the poison could touch any thing but the vein
and the card, and that the course of blood was free in the interior
of the vessel. Before the fourth minute, the effects that I
expected appeared, at first feeble, but afterwards with so much
power as to render inflation of the lungs necessary to prevent the
death of the animal. I repeated this experiment on an adult
animal of a much larger size than the preceding one; the same
effects appeared but slower, on account of the greater thickness
of the parietes; they began to appear in fact after the tenth
minute.
After satisfying myself with this result respecting the veins, I
thought I would ascertain if the arteries exhibited analogous
properties. These vessels are in a less favourable condition; their
texture is less spongy than that of the veins and with an equal
caliber, their parietes are much thicker. It was easy then to
foresee, that if the phenomenon of absorption showed itself, it
would appear much slower than in the veins; this was confirmed
in an experiment on two large rabbits, in whom I dissected
perfectly clean one of the carotid arteries. It was more than a
quarter of an hour before the solution of nux vomica passed
through the parietes of the artery. As soon as I saw the
symptoms of poisoning distinctly, I stopped moistening the
vessel; yet one of the rabbits died. In order then to convince
myself that the poison had really passed through the arterial
parietes, and that it had not been absorbed by small veins which
might have escaped my dissection, I carefully detached the vessel
that had been used in the experiment; I cut it open in its whole
extent, and I made those who assisted me taste a little of the
blood, that was still adhering to the internal surface; they all
perceived in it, and I did myself, the extreme bitterness of the
extract of the nux vomica.
To these experiments may be objected a fact that is observed,
which is, that absorption does not take place the same under all
circumstances; its activity is redoubled or diminished, according
to the state of some other functions. Thus during a paroxysm of
fever, a medicine, which would usually act with great effect, often
produces, when given in a double or treble dose, no perceptible
effect. Now if absorption, was a purely mechanical phenomenon,
would it undergo modifications in relation with those of the vital
functions? Without doubt it would; for these modifications of the
functions may introduce new physical circumstances favourable or
injurious to the production of a mechanical phenomenon. Thus in
the present case, the state of fever, by accelerating the circulation
distends with blood the arteries and the veins. The fluid that is to
be absorbed must pass from the exterior to the interior of these
vessels. Now it may be easily conceived, that the quantity of
blood which they contain must have a great influence upon the
production of the phenomenon by the greater or less degree of
tension of their parietes. This is moreover completely confirmed
by experiment.
We can, without producing a very great disturbance in the
functions, increase at pleasure the quantity of fluid which passes
through the blood-vessels, by carefully injecting into the veins
water the temperature of which is near that of the blood. An
artificial plethora is thus produced, followed by very curious
phenomena, of which I shall have occasion hereafter to speak.
One day while making this experiment, the idea occurred to me
of seeing what influence the plethora thus produced would exert
upon the phenomenon of absorption.
In consequence, after having injected into the veins of a dog of
middle size about a quart of water, I placed in the pleura a small
dose of a substance, the effects of which were well known to me.
These effects did not show themselves till many minutes after the
period in which they usually appear. I soon made the same
experiment on another animal with the same result.
In many other trials the effects showed themselves at the period
in which they ought to have appeared; but they were evidently
weaker and prolonged much beyond the ordinary time.
Finally, in another experiment in which I had introduced as much
water as the animal could bear and live, the effects did not
appear at all. I waited nearly half an hour for effects which
commonly show themselves in two or three minutes. Presuming
then that the distension of the vessels prevented the absorption,
I endeavoured to satisfy myself of it, by seeing if after the
distension had ceased, absorption would be any longer
prevented. In consequence, I bled the animal copiously from the
jugular, and I saw, with the greatest satisfaction, the effects
appearing as the blood flowed out.
It was proper to make the opposite experiment, that is to say to
diminish the quantity of blood, in order to see if absorption would
take place sooner. This took place in fact, as I thought it would;
about half a pound of blood was taken from an animal; the
effects, which did not usually appear till after the second minute,
showed themselves in thirty seconds.
Yet it might still be suspected, that it was less the distension of
the blood-vessels than the change of the nature of the blood that
opposed absorption. To remove this difficulty I made the following
experiment; a dog was bled copiously; the place of the blood
which he had lost was supplied by water at the temperature of 40
degrees of the centigrade thermometer, and a certain quantity of
a solution of nux vomica was introduced into the pleura. The
consequences of it were as prompt and as powerful, as if the
nature of the blood had not been changed; it was then to the
distension of the vessels that must be attributed the want or
diminution of absorption.
The consequences that may be deduced from the experiments I
have just related will acquire new force, if we connect with these
facts a multitude of pathological ones, which are every day seen;
such as the cure of dropsies, engorgements and inflammations by
bleeding; the evident want of action of medicines at the moment
of a violent fever, when the vascular system is powerfully
distended; the practice of certain physicians who purge and bleed
their patients before administering active medicines to them; the
employment of cinchona at the period of remission for the cure of
intermittent fevers; general or partial oedema from organic
disease of the heart or lungs, and the application of a ligature
upon the extremities after a puncture or a bite of a venomous
animal, to prevent the deleterious effects which are the
consequence of it.
On the whole, I think, it may be concluded from the preceding
experiments that the capillary attraction of the small vessels is
one of the principal causes of the absorption called venous. If the
lymphatics do not appear to enjoy in the same manner the faculty
of absorption, it probably arises not from the nature of the
parietes, the physical properties of which are nearly the same as
those of the veins, but from the want of a continuous current in
their interior.
In this note I have brought together the absorption of the gases
and that of fluids. This resemblance holds only as it relates to the
permeability of the textures by these two orders of bodies. As to
the cause of the absorption of the two, it cannot be the same,
since gases are not subjected to capillary attraction.[28]
[28] Note by the Translator of Magendie’s Additions.—In the
preceding note M. Magendie has not done justice to Mr. Hunter.
Without entering at all into the examination of the question,
whether absorption is performed by the lymphatics or the veins, it
is due to Mr. Hunter to contradict the assertion, that “he
overthrew the ancient theory by five experiments only.” He was
not a man who adopted his opinions loosely or on slight grounds,
and in the present case he performed between twenty and thirty
judicious and satisfactory experiments, in the presence of several
physicians and surgeons. It is true that these were performed on
five different animals only, but if the result were uniform, this
number was as good as five thousand or any other one that could
be named.
G. H.
(See Hunter’s Commentaries and Cruikshank on the Absorbents.)
[29] Those theories no doubt are very incomplete that are
borrowed from hydraulics, and probably will be so for a long time;
but it arises from this, that the science on which it is founded,
hydrodynamics, is still but little advanced. A great advance will
unquestionably be made in physiology, when we shall arrive at a
knowledge of the course of a fluid in a system of canals, which
have the same physical conditions as the system of arterial and
venous vessels. But it will be a long time before science will have
arrived at that point. Is it necessary for this to make no use, in
the explanation of the circulation, of the few facts which are
known upon the course of the fluids? Is it necessary to enter
entirely into the field of hypothesis, to suppose in the small
vessels a sensibility and a contractility which evidently do not
exist in the large ones? I cannot believe it, and I think even that if
this hypothesis should be true, and if there should be
demonstrated for the capillary vessels, those properties which are
attributed to them, and which would have an influence on the
course of the blood, we should then know but one of the
conditions of this very complicated problem, and this would not in
any degree do away the necessity of knowing all the mechanical
conditions.
[30] Even in reasoning according to the hypothesis of Bichat, and
admitting the existence of this organic sensibility, it would always
be inaccurate to say, that the contraction is uniformly in
proportion to the sensation. How is it to be known in fact? Since
this sensibility is not transmitted to a common centre, it might
very well be excited without our being informed of it by any
apparent effect. Sometimes also a very evident contraction would
correspond to the slightest excitement.
[31] The contractility in the different organs in which we can
observe it does not exhibit characters so striking as those which
Bichat here assigns to it, and the motions which he ranks in the
same class have the greatest differences among them. To be
convinced how little justice there is in this division, it will be
sufficient to trace the progress of the food, along its whole
course, to the interior of the digestive canal. The first act which is
presented to our observation is entirely voluntary; this is
mastication; the act which follows it is not so completely so.
Deglutition in fact can sometimes take place against the will, if a
body of a proper consistence is at the entrance of the pharynx.
We have but an imperfect control over the muscles of the uvula
and the velum palati, if we wish to move these parts separately;
we have perhaps less power still over the contraction of the
muscles of the pharynx, though they do not appear to differ from
the locomotive muscles, either in their symmetry, or in the
arrangement and colour of their fibres, or in the nerves which
they receive; nor finally do they differ in the sudden,
instantaneous contraction, wholly different from the slow
contraction, the vermicular motion of the stomach and intestines.
After having passed the pharynx, the alimentary mass enters the
œsophagus. The motions are there still under the influence of the
nerves; but they are not at all under the influence of the will. The
muscular layer which produces them has not the appearance, the
red colour of the voluntary muscles; but it still preserves
something of the sudden motion of their contraction. Hence we
see, that the motions of the œsophagus cannot be ranked either
among the motions of organic life, since they cease by the
division of the nerves, or among those of animal life, as they are
not under the influence of the will. It is remarkable also that
Bichat, who, in this and the following paragraph, announces the
characters of the different kinds of contractility, does not speak of
the œsophagus, whilst he offers as an example the motions of
the bladder, the heart, the stomach and the intestines.
When Bichat wrote this work, hardly any thing of the motions of
the œsophagus was known, except from the writings of Haller,
who made but four experiments on the subject. I wished to
observe them myself, and I have discovered many facts which I
think interesting; I shall relate them here as I described them in a
memoir read to the Institute in 1813. Before attempting to
ascertain what part the œsophagus took in the passage of the
food, it was proper to ascertain its state when it was supposed to
be at rest. In the first experiments, I noticed an important
phenomenon, and which hitherto had escaped the observation of
physiologists, viz., that the lower third of the œsophagus has
constantly an alternate motion of contraction and relaxation,
which appears to be independent of all foreign irritation. This
motion appears to be confined to the portion of the tube which is
surrounded by the plexus of nerves of the eighth pair, that is to
say, to about its lower third; there is no trace of it in the neck nor
in the superior part of the thorax. The contraction appears like a
peristaltic motion, it begins at the junction of the superior two
thirds with the inferior third, and is continued to the insertion of
this tube in the stomach. When the contraction is once produced,
it continues for an uncertain time; usually it is less than half an
hour. The œsophagus contracted in this way in its lower third is
hard like a cord powerfully stretched. Some persons whom I have
made feel of it in this state have compared it to a rod. When the
contraction has lasted the time I have just mentioned, the
relaxation takes place suddenly and simultaneously in each of the
contracted fibres; in some cases, however, the relaxation seems
to take place from the superior fibres towards the inferior ones.
The œsophagus examined during the state of relaxation exhibits
a remarkable flaccidity, which contrasts wonderfully with the state
of contraction.
This alternate motion is dependent on the nerves of the eighth
pair. When these nerves are cut in an animal, this motion entirely
ceases; the œsophagus contracts no more, but it is not in a state
of relaxation; its fibres without the control of nervous influence
shorten; it is this which produces, so far as the touch is
concerned, an intermediate state between contraction and
relaxation.
When the stomach is empty or half full of food, the contraction of
the œsophagus recurs at much longer intervals; but if the
stomach be powerfully distended by any cause, the contraction of
the œsophagus is usually very powerful, and continues for a
much longer time. I have seen it, in cases of this kind, continue
more than ten minutes; under the same circumstances, that is to
say, when the stomach is excessively full, the relaxation is always
much shorter.
If during the time of contraction, we wished, by mechanical
pressure made on the stomach, to make a part of the aliments
which it contained pass into the œsophagus, it would be
necessary, in order to accomplish it, to employ a very
considerable force; and often even we should not succeed. It
seems that pressure increases the intensity of the contraction,
and prolongs its duration. If, on the contrary, the stomach is
pressed during relaxation, it is very easy to make the substances
it contains pass into the cavity of the œsophagus. If it be a liquid,
the slightest pressure, sometimes even its own weight, or the
tendency which the stomach itself has to contract, will bring
about this result. When the stomach is laid bare and distended
above measure, fluid does not usually enter into the œsophagus,
because, as we have said, the distension of the stomach is a
cause which prolongs the contraction of the œsophagus.
The passage of a fluid in the œsophagus is usually followed by its
entrance into the stomach. Sometimes however the fluid is
thrown out. When it goes into the stomach, the œsophagus
contracts nearly the same as in deglutition, sometimes almost
immediately after it has entered it; at other times the œsophagus
allows itself to be considerably distended before it pushes it into
the stomach.
It was at the moment of deglutition that Haller observed the
motions of the œsophagus, and the description which he has
given of them is very accurate for the two superior thirds of the
canal; but the action of the inferior third is essentially different;
and this distinction seems to have escaped him. Haller says that
the relaxation of each circular fibre immediately follows the
contraction; and this is true of the portion of the canal situated in
the neck and in the superior part of the thorax; but it is not
accurate for the inferior portion, in which we see that the
contraction of all the circular fibres is continued long after the
entrance of solids or fluids into the stomach. At this moment the
mucous membrane of the cardiac extremity of the œsophagus,
pushed by the contraction of the circular fibres, forms a very
considerable projection into the cavity of the stomach. The
contraction usually coincides with the period of inspiration, when
the stomach is more strongly compressed; the relaxation takes
place most often at the time of expiration. When the aliments
have once entered the stomach, it is this contraction of the
inferior part of the œsophagus which opposes their return. The
resistance that is offered at the other orifice is not of the same
species. In living animals, whether the stomach be empty or full,
the pylorus is uniformly shut by the contraction of its fibrous ring
and the contraction of its circular fibres. There is frequently seen
in the stomach another contraction, at one or two inches
distance, which appears to be designed to prevent the aliments
from arriving at the pylorus. We perceive also irregular
contractions, beginning at the duodenum, and extending to the
pyloric portion of the stomach, the effect of which is to push back
the aliments towards the splenic part.
The aliments remain in the stomach long enough to undergo no
other modifications than those which result from their mixture
with the perspiratory and mucous fluids, which are constantly
found in it and renewed there. During this time the stomach
remains uniformly distended; but afterwards the pyloric portion
contracts in its whole extent, especially in the part nearest the
splenic portion, towards which the aliments are carried. Then
there is found, in the pyloric portion, only the chyle mixed with
some unchanged aliments. When there is accumulated in this part
a quantity of it, which is never very considerable, there is seen,
after a moment of rest, a contraction at the extremity of the
duodenum; the pylorus and the pyloric portion soon take part in
this motion, and the chyle is forced towards the splenic portion;
but afterwards the motion is in an inverse direction. The pyloric
portion, which allowed itself to be distended, contracts from left
to right, and directs the chyle towards the duodenum, which soon
passes the pylorus and enters the intestine. The same
phenomenon is repeated a certain number of times, then it
ceases, and commences again after some time. This motion,
when the stomach contains much food, is limited to that part of
the organ nearest the pylorus; but as it becomes empty, the
motion extends, and appears even in the splenic portion when
the stomach is almost entirely evacuated. In general, it becomes
more evident at the end of chylification.
The motion which produces the progression of the chyle in the
small intestines is very analogous to that of the pylorus; it is
irregular, made at variable intervals, it is sometimes in one
direction and sometimes in another, and sometimes appears in
many parts at once; it is always more or less slow, it produces
changes of relations in the intestinal circumvolutions, and it is
entirely beyond the influence of the will.
We should form a very false idea of the motions of the small
intestines during digestion, if we judged of them by those which
these intestines exhibit in an animal recently killed. In this case, it
is not the annular fibres only that enter into action, so as to
exhibit, by their successive contractions, a vermicular motion. The
longitudinal fibres act also in a very conspicuous manner, and
produce a rolling of the intestinal circumvolutions, which change
their relations at every instant. These motions are never more
evident than when the whole mass of intestines is removed from
a living animal.
The motions of the large intestines have nearly the same
characters as those of the small intestines, like these last, they
are not always in the same direction, but push the substances
which are contained in their cavity, sometimes towards the ileum
and sometimes towards the anus. But by means of this motion,
these substances which have already the character of feces, can
never re-enter the small intestines. The cause that prevents their
return is different from that which prevents the return into the
stomach of the substances contained in the duodenum. The
obstacle in this case, we have said, is produced by the contraction
of the contractile rings, which are found at the extremity of the
two cavities; in the other, it is produced by a cause purely
mechanical, by the arrangement of the ileo-cecal valve. Hence it
follows, that if the mode of contraction of the different parts of
the intestinal canal be perverted by any cause, it might happen
that their contraction towards the pylorus would not take place
when the duodenum was affected with its anti-peristaltic motion,
and then the substances contained in it, pushed by the
contraction of the annular fibres, would re-enter the stomach. At
the coecum, on the contrary, as the obstacle is purely mechanical,
so long as the ileo-cecal valve is not broken, it will present an
insurmountable obstacle to the return of the feces into the small
intestines.
The motions of the large intestines, sufficient to carry the feces
into the rectum, would not, in a state of health, be powerful
enough to expel them entirely, by overcoming the resistance
which the sphincter constantly presents; in expelling the feces,
the contraction of the intestine is assisted by the pressure which
arises from the lowering of the diaphragm, and by the contraction
of the abdominal muscles.
We have just pointed out the motions which carry the alimentary
mass along the intestines. We may see that they have but little
resemblance among them. The only character that is common to
them is that of not being under the influence of the will. Yet there
is an exception to this in some individuals who possess the faculty
of ruminating. (The will is seen exerting itself on the production
of other sensible organic motions. Bayle could stop at will the
pulsation of his heart.) If we examine the motions of the digestive
tube when it is free of aliments, we see their difference in a
manner not less striking. The œsophagus exhibits those alternate
motions that we have described; a very powerful contraction of
its inferior third, and then suddenly the most complete relaxation.
In the stomach we see only some undulations, that go irregularly
from one orifice to another. In the intestines, these motions
exhibit nearly the same regularity, but the groove formed by the
contraction of the annular fibres is deeper, and the undulatory
motion is not so slow. If a stimulating medicine is introduced into
the stomach, these contractions become more evident, and the
motions more rapid; but they always preserve the same
character. The contraction takes place progressively, and never in
the sudden manner of a muscle of locomotion. Of all the
substances which can be used to ascertain these motions, there
is no one whose action is more efficacious than veratrine, a new
vegetable alkali extracted from the veratrum sabadilla. If the
external parietes of the digestive tube be excited by any stimulus,
by touching it with the finger, by a puncture, or by the galvanic
fluid, there is in the œsophagus a sudden contraction of the
longitudinal and circular fibres, which narrows the organ and
shortens it at the same time; the relaxation takes place
instantaneously and in as striking a manner. In the stomach, no
motion is perceived in the direction of its length; we see only an
annular contraction, which is developed slowly at the excited
point, and which is usually not transmitted to the neighbouring
parts. In the intestines, the excitement produces a very decided
contraction, and very often in the neighbouring parts a kind of
peristaltic motion; but this motion is always slow and does not at
all resemble the sudden contraction of the œsophagus.
The difference between the motions of the œsophagus and those
of the other parts of the intestinal canal is very remarkable in
birds. In them the œsophagus appears to be entirely
membranous; and yet it contracts like a muscle of locomotion;
whilst the stomach, which has red muscles very similar to the
locomotive muscles, has slow, gradual vermicular motions, like all
the canal which is below it.
There exists finally between the motions of the intestinal canal a
difference relative to the manner in which they terminate. Those
of the intestines, but little sensible during life, acquire at the
moment of death a very great intensity; whilst those of the
œsophagus, before so distinct, cease immediately, and in the
most complete manner.
[32] It is not the dartos that contracts in the motions of the
scrotum, it is the skin itself that produces that vermicular motion
that is observed in this part. This motion can be produced by
stimuli of very different kinds; by the impression of cold, by
pinching the skin or by fear. I have seen these motions so great in
a man on whom I was about to operate for hydrocele, that I was
obliged to wait for a long time for fear of wounding the testicle,
which, by those motions, ascended and descended precipitately.
[33] It might be thought from this expression, that Bichat
supposed that the great arteries influenced the course of the
blood by an active contraction analogous to the muscular
contraction; but this was not his opinion. He only wished to say,
that the blood continued to move in the great arteries solely by
the influence of the heart. This contraction of the great arterial
trunks has been heretofore maintained by many anatomists, and
is even at present by some. There are at the present day three
principal theories relative to the circulation.
In the first, it is contended that all the parts of the arterial system
are irritable, and that they contract like the muscular texture;
many even add that they can dilate spontaneously, as takes place
every instant in the heart. According to this supposition, the
arteries alone would be able to continue the course of the blood.
In the second opinion, which is that of Harvey, and which is still
adopted, more particularly by the English physiologists, it is
affirmed on the contrary, that the arteries are not contractile in
any point; that if they do contract in certain cases, it is in virtue
of that property common to all the solids, by which they return
upon themselves, when the cause that has distended them
ceases to act. The partisans of this opinion conclude that the
arteries have not and cannot have any influence upon the motion
of the blood which runs through them, and that the heart is the
principal, and as it were, the sole agent of the circulation.
Finally the third opinion, that which now prevails most generally
in France, consists in a union of the two preceding ones; the
trunks and principal arterial branches are considered as incapable
of acting upon the blood; but this property is attributed to the
small arteries, and it is thought to be very great in the last
divisions of these vessels. Thus, in this mixed opinion, the blood
is carried by the sole influence of the heart in all the arteries of a
considerable size; it is moved in part by the influence of the heart
and in part by that of the parietes in the smaller arteries, and
finally it is moved by the sole action of the parietes in the last
arterial divisions. This action of the small vessels is also described
as the principal cause of the course of the blood in the veins.
In a question of this nature our opinion should be determined by
experiments alone. This presents many points for elucidation.
The first and the easiest to be decided is to ascertain if the
arteries are or are not irritable. The problem was in some
measure resolved in relation to the great arteries by the
experiments of Haller and his disciples, by Bichat himself, and by
those which M. Nysten has made upon man. For the purpose of
being more perfectly convinced, I have sought, by all the known
means, to develop the irritability of the arterial parietes; I have
successively subjected them to the action of pricking instruments,
of caustics and of galvanism, and I have never perceived any
thing which resembled a phenomenon of irritability; and as those
who maintain the irritability of the arteries pretend that if we do
not perceive the contractions, it is because the experiments are
made on too small animals, in whom the effects are but slightly
apparent in consequence of the small diameter of these canals, I
have repeated the experiment on large animals, on horses and
asses, and I have never observed any other motions than the
communicated motions.
As the great arteries show no contraction, we ought to believe
that the small ones would not; but as among the physiologists
who reject the irritability of the arterial trunks, some like Haller,
do not speak of the branches, others accord to them contractility,
it becomes necessary to test this question by experiment; now
these small vessels, like the larger ones, remain perfectly
immoveable under the action of the scalpel, caustics and a
stream of galvanic fluid.
Irritability does not exist then in the large or the small arteries.
Respecting the last arterial divisions, as the vessels which form
them are so small that they cannot come under the cognizance of
the senses, at least in a state of health, no one can affirm or deny
that they are irritable. Yet from analogy we ought to conclude,
that they have no sensible motion. In cold-blooded animals, in
fact, it is easy to see the blood circulating in these vessels, and
even passing into the veins; now the vessels themselves appear
to be completely immoveable.
As the arteries cannot act upon the blood by contracting in the
manner of muscles, must we conclude that they have no action
upon this fluid, and that they are in relation to it nearly like
inflexible canals? I am very far from thinking so. If in fact the
arteries had no influence upon the blood, this fluid, moved by the
sole impulse of the heart, would, from its incompressibility, be
alternately in motion and at rest. This is indeed what Bichat
thought, and what he has advanced in his other works; it is what
has been since maintained in a more formal manner by Dr.
Johnson of London. It is however very easy to prove that it is not
in this way that the blood is moved in these vessels. Open a large
artery in a living animal, and the blood will escape in a continuous
jet, but by jerks; open a small artery, and the blood will flow out
in a continuous and uniform jet. The same phenomena take place
in man if the arteries are opened, either by accident or in surgical
operations. The heart being unable to produce a continuous flow,
since its action is intermittent, it must be then that the arteries
act upon the blood; this action can only be the disposition which
they have to contract, and even to obliterate their cavity entirely.
Bichat thought that his tendency to narrowing was not sufficient
in the arteries to expel the blood contained in their cavity. He
maintains that the vessel does not contract upon itself only when
the blood has ceased to distend it. If it were so, the arteries
would be equivalent to inflexible canals, and the course of the
arterial blood would not be continuous; but we can easily
demonstrate that the force with which the arteries contract is
more than sufficient to drive out the blood that they contain.
When two ligatures are applied at the same time and at some
centimetres distant upon two points of an artery which furnishes
no branches, we have a portion of artery in which the blood is
subjected only to the influence of the parietes. If we make in this
portion of the vessel a small opening, almost all the blood that it
contains is immediately thrown out, and the artery is much
contracted. This experiment has been known for a long time, and
uniformly succeeds. The following is one of my own, and places,
it seems to me, the phenomenon in a very clear light. I laid bare
the crural artery and vein of a dog to a certain extent; I passed
under these vessels, near the trunk, a string, which I afterwards
drew tightly at the posterior part of the thigh, so that all the
arterial blood should come to the limb by the crural artery, and all
the venous blood return to the trunk by the crural vein; I then
applied a ligature upon the artery, and this vessel was very soon
completely empty in the part below the ligature.
It is then satisfactorily proved that the force with which the
arteries contract upon themselves is sufficient to expel the blood
they contain. But what is the nature of this contraction? We have
proved that it cannot be attributed to irritability. Every thing leads
to the belief that it should be referred to the very great elasticity
which the arterial parietes enjoy, an elasticity that is brought into
action, when the heart forces a certain quantity of blood into the
cavity of these vessels. This property of the arteries being known,
it is easy to conceive how the principal agent of the arterial
motion, being alternate, the course of fluid is yet continuous. The
elasticity of the arterial parietes is similar to that of the reservoir
of air in certain pumps with an alternate action, and which
notwithstanding throw out the fluid in a continuous manner.
It is not enough to know the kind of influence which the
contraction of the arteries has on the motion of the arterial blood;
it is necessary to know if this contraction does not influence in a
sensible manner the course of the blood in the veins. This is
elucidated by the following experiment. Lay bare, as in the
preceding experiment, the crural artery and vein of a dog; tie the
limb strongly, taking care not to include these vessels; afterwards
tie the crural vein, and make a small opening in it below the
ligature, of one or two lines in length; the blood flows out in a
continuous jet. If the artery be compressed, so as to intercept the
course of blood in it, the jet still continues a short time; but it is
seen sensibly to diminish, as the artery is becoming empty. It at
length ceases entirely when the artery is completely emptied; and
though the vein remains distended with blood along its whole
extent, it does not flow out at the small wound. If the
compression be taken off of the artery, the blood enters it with
force, and almost at the same instant it begins again to flow from
the opening in the vein, and the jet is reestablished as before. If
we check the course of the blood in the artery, there is but a
feeble jet from the vein; it is the same if the passage of this fluid
is alternately intercepted and permitted.
I make the same phenomenon evident in another way; I
introduce into the crural artery the extremity of a syringe filled
with water at the temperature of 30 degrees of the centigrade
thermometer; I push the piston slowly, and soon the blood goes
out by the opening in the vein, at first alone and afterwards
mixed with water, and it forms a jet the more considerable in
proportion to the force with which the piston is pushed.
To prove, as we have done, that the heart maintains an evident
influence on the course of the blood in the capillary vessels, is not
to advance that these vessels have no action on the motion of
this fluid. Many physiological phenomena, on the contrary, prove
that the capillaries can aid with more or less facility the passage
of the blood, and consequently sensibly influence its course.
[34] Under no circumstance does the stomach rise up, as Bichat
calls it. We have, in a preceding note, explained the ordinary
motions of this viscus, in a state of vacuity, during digestion and
under the influence of an internal or external stimulus. None of
these motions are sufficient to produce that sudden and energetic
expulsion which characterizes vomiting. The opinion that the
stomach rises up in vomiting originated in a time of ignorance,
and we ought not to be astonished that it should find advocates
even in our day. This has not however been uniformly adopted;
Bayle and P. Chirac opposed it by experiments; Senac, Van
Swieten and Duverney declared themselves against it; but Haller,
by adopting it, suddenly changed the views and removed the
uncertainty of a great number of physiologists, who, not taking
the labour of making experiments for themselves, loved to repose
on the faith of a celebrated name. In physiology the opinions of
Haller are certainly entitled to very great weight; this is because
this wise observer, before announcing them as a general
proposition, was accustomed to repeat many times the
experiments on which he founded them; but in this case he did
not sufficiently question the use of the stomach in vomiting.
He has made four experiments only, less for the purpose of
satisfying himself that the phenomenon existed, than to see it
such as he supposed it. It is very difficult, even for the best mind,
to divest itself in observing, of the ideas previously received
without examination. It may then be believed, that Haller in this
way saw but superficially. These considerations determined me
some years since, to satisfy myself of what takes place in
vomiting, and of the part which the stomach performs in it. I shall
relate briefly the experiments which I tried on the subject. The
first was made on a dog of middling size, whom I had made to
swallow six grains of emetic. When this medicine had excited
nausea, I cut through the linea alba opposite the stomach, and
introduced my finger into the abdomen. At each nausea, I felt it
very powerfully compressed above by the liver, which the
diaphragm pushed down, and below by the intestines, which
were compressed by the abdominal muscles. The stomach also
appeared to me to be compressed; but instead of feeling it
contract, it appeared to me, on the contrary, to increase in size.
The nauseas became more frequent, and the more marked
efforts, which precede vomiting, appeared. Vomiting finally took
place, and then I felt my finger pressed with a force truly
extraordinary. The stomach rid itself of a part of the aliments it
contained; but I distinguished no sensible contraction in it. The
nausea having ceased for a short time, I enlarged the opening in
the linea alba, for the purpose of observing the stomach. As soon
as the incision was enlarged, the stomach presented itself at it,
and made an effort to come out of the abdomen; but I prevented
it with my hand. The nauseas returned in a few minutes, and I
was not a little surprized to see the stomach filled with air, as
they came on. In a very little time the organ had become three
times its former size; vomiting soon followed this dilatation, and it
was evident to all who were present, that the stomach had been
compressed without having experienced the least contraction in
its fibres. This organ rid itself of air and of a portion of aliments;
but, immediately after the exit of these substances, it was flaccid,
and it was not till after some minutes, that gradually contracting,
it became nearly of the same dimensions as it was before the
vomiting. A third vomiting took place, and we saw again the same
series of phenomena.
For the purpose of ascertaining whence the air came, which,
during the nauseas, distended the stomach, I applied a ligature
on the stomach near the pylorus, so as to close the
communication which exists between this organ and the small
intestines, and I made the dog swallow six grains more of emetic
in powder. At the end of half an hour the vomiting returned,
accompanied by the same phenomena. The distension of the
stomach by air was at least as marked as in the preceding
experiment; besides there was no appearance of contraction of
the stomach, and we could not even clearly distinguish its
peristaltic motion. The animal having been killed some moments
after, in an experiment which had no relation to vomiting, we
examined the abdomen. We saw that the stomach was of
considerable size; its texture was flaccid and not all contracted;
the ligature, at the pylorus, was not displaced, and the air had
not been able to pass this way.
Having repeated this experiment and uniformly obtained the
same results, I thought it right to conclude with Chirac and
Duverney, that the mechanical pressure, exerted on the stomach
by the diaphragm and the abdominal muscles, is much concerned
in the production of vomiting; now, if it were so, by removing this
pressure from the stomach, vomiting would be prevented;
experiment confirmed this conjecture.
I injected into the vein of a dog four grains of an emetic dissolved
in two ounces of common water, (in this way vomiting is
produced quicker and more certainly;) I afterwards made an
opening in the abdomen, and when the first efforts of vomiting
began, I quickly drew out the whole of the stomach, which did
not prevent the efforts of vomiting from continuing. The animal
made precisely the same efforts as if he had vomited; but nothing
came from the stomach; this organ remained completely
immoveable. I wished then to see what would be the effect of
pressure made on the stomach; for this purpose, I placed my
right hand on the anterior face of this organ, and my left hand on
the posterior face. The pressure was hardly commenced when the
efforts of vomiting, that is to say, the contraction of the
diaphragm and the abdominal muscles powerfully recommenced.
I suspended the pressure; the abdominal muscles and diaphragm
soon suspended their contractions. I renewed the pressure; the
contractions of the muscles began again; then I suspended it;
they ceased; and seven or eight times in succession. The last
time, I made a strong and continued pressure; this produced a
real vomiting. A part of the substances contained in the stomach
was thrown off. I repeated this experiment on another dog; I
observed the same facts; only I remarked moreover that the
contractions of the diaphragm and the abdominal muscles can be
produced by merely drawing by the œsophagus.
In the experiment just related, the emetic substance was
introduced into the veins, and we have already remarked, that
the effects were quicker and more certain than if the same
substance had been introduced into the stomach. This alone
should make us suspect that vomiting is not owing, as is
generally believed, to the impression of the emetic on the mucous
membrane of the stomach; for, in this case, its action ought to
have been more prompt when it was placed directly in contact
with this membrane, than when it arrived at it with the blood
after having passed through the lungs and the four cavities of the
heart. For the purpose of elucidating this question and of seeing if
the contractions of the muscles were the result of the impression
produced on the stomach, or if they were excited more directly by
the emetic substance mixed with the blood, I made the following
experiment:
I opened the abdomen of a dog, and having brought the stomach
out at the opening, I tied with care the vessels that went to this
viscus, and I removed the whole of it (I ascertained in some of
the preceding experiments that a dog can live eight and forty
hours after his stomach has been removed.) I made a suture in
the abdominal parietes; then, having laid bare the crural vein, I
injected into its cavity a solution of two grains of emetic in an
ounce and a half of water. I had hardly finished the injection
when the dog began to have nausea, and he soon made all the
efforts that an animal does when he vomits. These efforts
appeared to me to be even more violent and longer continued
than in ordinary vomiting. The dog remained quiet about a
quarter of an hour; I then renewed the injection, and I forced
two grains more of emetic into the crural vein; this was followed
with the same efforts of vomiting. I repeated the experiment
many times and always with the same success; but this
experiment suggested to me another, which I performed in the
following way: I took a dog of good size, from whom I removed
the stomach, as I had done in the preceding experiment; I
introduced into the abdomen a hog’s bladder, to the neck of
which I had fixed, by threads, a canula of gum elastic; I put the
end of this canula into the extremity of the œsophagus, and I
fixed it there also by threads, so that the bladder resembled
somewhat the stomach, and was, like it, in communication with
the œsophagus. I introduced into the bladder about a pint of
common water; this distended it, but did not fill it completely. A
suture was made in the wound of the abdomen, and four grains
of emetic were injected into the jugular vein. Nausea soon
appeared, and was followed with real efforts of vomiting; finally,
after some minutes, the animal vomited up abundantly the water
from the bladder.
It followed evidently from the preceding experiments, that the
abdominal muscles and the diaphragm concurred to produce
vomiting; but it remained to be ascertained, what was the part of
the diaphragm in the production of this phenomenon, and what
was that of the abdominal muscles.
If the diaphragm received only diaphragmatic nerves, it would be
easy to resist the contraction of this muscle by dividing these
nerves; but it also receives filaments from dorsal pairs, and these
filaments are sufficient to support its contractions. Yet experiment
shows us, that the diaphragmatic nerves being cut, the
contraction of the diaphragm is very evidently diminished in
power, and it may be said, without much hazard of mistake, that
this muscle loses, by this division, three quarters of its contractile
force. It was then useful to see what influence the division of
these nerves would have on the production of this phenomenon. I
made this division in the neck of a dog of three years old, and I
afterwards injected into the jugular vein three grains of emetic;
there was only a very feeble vomiting; another injection of
emetic, a quarter of an hour after, excited no vomiting. I opened
the abdomen and endeavoured to produce vomiting by
compressing the stomach. The compression, though very
powerful and long continued, excited no effort of vomiting; it did
not even appear to produce nausea. I thought that this
circumstance might be owing to the idiosyncrasy of the animal;
but having many times since repeated this experiment, I have
never obtained any other result.
In order to understand what part the abdominal muscles by their
contractions take in vomiting, we ought to observe what takes
place when these muscles are unable to act. There is but one way
of coming at this, which is, to separate these muscles from their
attachments at the sides of the linea alba; this we have done on
many animals; we have detached successively the external
oblique, the internal oblique and the transversalis, leaving on the
anterior face of the abdomen only the peritoneum. When these
muscles are thus removed, we can see very distinctly through the
peritoneum, all that takes place in this cavity; we distinguish, for
example, perfectly the peristaltic motion of the stomach and the
intestines; and if the stomach contracts it will be easy to see it.
The abdominal muscles being thus detached, I injected three
grains of emetic into the jugular vein, and also immediately
nausea and vomiting took place by the contraction of the
diaphragm alone. It was curious to see, in the convulsive
contraction of this muscle, the whole intestinal mass pushed
downwards, and pressing strongly against the peritoneum, which
was ruptured in some places. In this case, the linea alba, formed
by a very strong fibrous texture, is the only part which resists the
pressure of the viscera; its existence then is indispensable to the
action of vomiting; perhaps it performs an analogous office in the
ordinary state. This experiment proves that vomiting can be
produced by the efforts of the diaphragm alone; this is also
confirmed by the following experiment:
I detached, as above, the abdominal muscles and laid bare the
peritoneum; I afterwards divided the diaphragmatic nerves, and
injected an emetic into the veins. The animal had some nausea,
but nothing more. Though I repeated many times the injection of
the emetic, I never was able to produce any sensible effort of
vomiting.
From the different experiments that we have just related, and
from the facts that we made known in a preceding note relative
to the motions of the œsophagus, we may conclude, without any
hazard,
1st. That vomiting can take place without any contraction of the
stomach.
2d. That the pressure exerted immediately on the stomach by the
diaphragm and abdominal muscles, appears to be sufficient to
produce vomiting, when the occlusion of the inferior part of the
œsophagus offers no obstacle to it.
3d. That the convulsive contraction of the diaphragm and
abdominal muscles, in vomiting from tartarized antimony and
emetic substances properly so called, is the result of a direct
action of these substances on the nervous system and
independent of the impression felt by the stomach.
[35] The motions of the iris cannot be attributed to an active
expansion of an erectile texture; they are owing to the
contractions of two muscular layers, one of which is radiated and
enlarges the opening of the pupil, the other is orbicular and
contracts it.
The motions of the iris, like all those which have muscular
contraction for their cause, can be excited for a considerable time
after death by the galvanic fluid. During life, the motions of the
pupil are produced in man, by the more or less vivid impression
of light on the retina. But they are beyond the influence of the
will; in birds on the contrary, they appear to be entirely subjected
to it. In these animals, we can even after death, and on an eye
entirely detached from the body, produce the motions of the iris
by pricking the optic nerve.
[36] When a patient dies after having for a long time been
deprived of solid and liquid nourishment, it is not rare to find in
him the stomach and intestines considerably lessened in their two
dimensions, the internal cavity almost entirely effaced, the length
being hardly a third of what it was before the disease. We truly
say then with Bichat that is a contraction from a want of
extension. But that this mode of contractility is as he says
perfectly independent of life and owing only to the arrangement
of parts, is what cannot be admitted. If it were so in fact, by
emptying the stomach after death, we might produce a
contraction similar to that which is produced during life. Now
experiment shows us, that this does not take place. The stomach
when emptied remains flaccid, and does not contract in any
perceptible degree.
[37] We know that the organs are nourished, that the glands
secrete, we know that certain vessels absorb (whether they be
the lymphatics or not,) but we do not know, that all this is
produced by a partial oscillatory movement in each fibre, in each
molecule. No one can be certain that this movement takes place,
because no one has seen it.
[38] Why invent a new word, when we have that of elasticity,
which expresses for all bodies whether organic or inorganic, that
tendency to resume their usual form and size, when the cause
that made them change them is no longer in exercise?
[39] Bichat here unites three sorts of motion which have no
relation between them; the systole of the cavities of the heart
should be considered as a really active dilatation. The increase of
size of the corpora cavernosa, which is an effect purely passive of
the accumulation of blood in those parts, and which can be
produced after death by artificially accelerating the circulation in
them; and finally, the motion of the iris, a motion evidently
produced by a muscular contraction, excitable by galvanism or
pricking the nerve.
[40] Without denying the influence which the capillary systems of
the different organs have on the circulation, we have shown that
even in the veins the action of the heart is felt and modifies the
course of the blood.
 CHAPTER VIII.

OF THE ORIGIN AND DEVELOPMENT OF THE ANIMAL LIFE.

If there be any circumstance, which establishes a real line of

demarcation between the two lives, this circumstance undoubtedly is
the mode and epoch of their origin. The organic life is active from
the very first moment of our existence; the animal life begins after
birth only; for without external excitants the latter is as necessarily
condemned to inaction, as without the fluids of the œconomy, which
are its internal excitants, the former would become extinct. But the
subject, on which we are now engaged deserves a more particular
discussion, and in the first place let us examine, in what manner the
animal life, which for some time is absolutely null, is born as it were
and developed.

I. In the fœtus the first order of the functions of the animal life
is not as yet in action.

The instant, at which the fœtus begins to exist, is nearly that of its
conception; but this existence, the sphere of which is every day
enlarged, is not the same as that, which the child is destined to
enjoy after birth.
The state, in which the fœtus exists while in the womb, has been
compared to that of a profound sleep. Such comparison is inexact.
In a state of sleep the animal life is only in part suspended. In the
fœtus it has not commenced. We have seen in fact, that this life is
made up of the simultaneous or distinct exercise of the senses, of
the nerves, of the brain, of the organs of locomotion, and the voice.
Now in these different functions every thing in such state is inactive.
Every sensation supposes the action of external bodies upon our
own, together with the perception of such action; a perception which
takes place by virtue of the sensibility of the system, which is either
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