LYMPHATIC AND LACTEAL SYSTEM. 



217 



structures. To support the Hunterian theory 

 the lymphatic was required to be present with 

 every molecule of the organization, there with 

 open mouth (for imbibition in the living body 

 was not admitted as possible) to remove the 

 old material in order to make room for the new, 

 which was supposed to be deposited by the open 

 mouths of capillary arteries. Now, although 

 physiologists no longer admit that the arteries 

 any where terminate by open mouths, but 

 consider all nutrition to take place by the 

 transudation of the liquor sanguinis through 

 the delicate tunics of the capillary blood- 

 vessels, and although venous absorption, as well 

 as lymphatic, is acknowledged to take place, 

 consequently that the ubiquity of the lym- 

 phatic ceases to be a matter of necessity, still 

 it appears to me that physiologists have not 

 yet shaken off the old impression, that every 

 particle of the organization must have its lym- 

 phatic vessel, and I cannot help thinking that 

 the continuance of this impression is mislead- 

 ing us in our notions of the arrangement of 

 the system. 



There are also some additional anatomical 

 considerations which have had their weight in 

 leading me to the opinion that the lymphatic 

 system is less extensive than is generally sup- 

 posed. It is not, I believe, known to anato- 

 mists that the lymphatic vessels admit readily 

 of dissection in their uninjected state ; these 

 vessels do not easily give way under traction, 

 and by using the forceps to hold them, and a 

 blunt but pointed instrument to detach them 

 from the surrounding cellular membrane, to 

 which they are but loosely attached, they may 

 be dissected with equal facility as the cuta- 

 neous nerves, for which they are not unfre- 

 quently mistaken by the young dissector. I 

 have in this way several times dissected the 

 lymphatics of the upper extremity, from the 

 glands in the axilla to the fingers, and in the 

 lower, from the inguinal glands to the toes. 

 In proceeding thus to trace these vessels, scarcely 

 a single lateral branch can be detected in the 

 leg and thigh, by which the supposed universal 

 net-work of the surface of the skin could have 

 been connected with the rest of the system. 

 When the subcutaneous lymphatic vessels are 

 injected with quicksilver, every anatomist must 

 have remarked the absence of lateral branches ; 

 this has always been accounted for by sup- 

 posing a valve at the termination of each late- 

 ral branch into the larger longitudinal vessels; 

 but in dissecting these vessels in their unin- 

 jected state, the lateral branches if present 

 ought to be met with, which is not the case. I 

 am fully aware that Haase, and other inves- 

 tigators, have succeeded in getting the injection 

 to pass in a retrograde direction from the sub- 

 cutaneous lymphatics of the lower extremity 

 into a net-woik of vessels of small extent situ- 

 ated close to the surface of the skin : this has 

 occurred to myself on two occasions, in the 

 skin over the tibia, and in the inguinal region, 

 but in both these instances it was in a portion 

 of skin presenting a cicatrix ; the net-work was 

 circumscribed, and left the impression on my 

 mind of an abnormal rather than of a normal 



condition of these vessels. The entire pro- 

 fession have adopted the notion that the pro- 

 cess of ulceration is effected by the lymphatic 

 vessels, consequently that, as every structure 

 may ulcerate, so it must have its lymphatic 

 vessel. But I may be permitted to ask patho- 

 logists to consider, whether they are not still 

 influenced by the Hunterian theory, viz. that 

 the countless open mouths of the lymphatics 

 (which modern anatomists do not allow them 

 to possess) effect the removal of the textures 

 disappearing by ulceration, rather than by the 

 few facts and observations bearing upon this 

 important question. I would ask whether the 

 occasional instances, of inflamed lymphatics 

 containing pus, being found leading from an 

 ulcerated surface, are sufficient to establish the 

 opinion, that the whole process is effected by 

 this set of vessels; or whether the occurrence 

 is not more satisfactorily accounted for, by the 

 supposition that the ulcerative process has im- 

 plicated a lymphatic vessel, and that the pus 

 has entered the vessel by an opening thus 

 effected in its paries, or that the pus has been 

 formed in the lymphatic itself, as the result of 

 inflammation affecting its interior; more par- 

 ticularly when it is borne in mind, that the pus 

 globule is much too large to have entered these 

 vessels by imbibition, and that open mouths are 

 denied to them. The parts of the body in 

 which I have seen pus in the lymphatics, have 

 been on the surface of the lung, on the mu- 

 cous membrane of the intestines, on the penis 

 when ulcers had occurred in these organs, also 

 in the subcutaneous lymphatics after suppura- 

 tion and sloughing of the cellular tissue, situ- 

 ations in which every anatomist has seen lym- 

 phatics, and where the ulcerative or sloughing 

 processes might readily have effected an open- 

 ing into them. 



The lymphatic, or absorbent glands, called 

 also conglobate glands by Sylvius, and lym- 

 phatic ganglia by Chaussier, are small fleshy 

 bodies of a flattened form, rounded or oval in 

 outline, varying from the size of a millet-seed 

 to that of an almond ; so situated in various 

 parts of the body as to intercept the lymphatic 

 vessels in their course towards the trunks of the 

 system. They are generally clustered together, 

 but occasionally are found single or isolated. 

 The isolated glands are usually very small ; 

 the large ones clustered together. The lym- 

 phatic glands are well protected from pressure. 

 In the limbs they are principally situated in 

 the cellular spaces at the flexures of the joints, 

 and enjoy the same protection as the main 

 bloodvessels, close to which they are generally 

 located. The loose cellular tissue in which they 

 are for the most part imbedded, allows them 

 great freedom of motion, by which they are 

 enabled to elude pressure. 



The lymphatic glands are most developed in 

 childhood, least so in old age, and are interme- 

 diate in this respect in adult life. They are 

 not found in Amphibia and Fishes, and in 

 Birds only in the cervical region : intricate 

 plexuses of large lymphatic vessels occur fre- 

 quently in those animals which are destitute of 

 lymphatic glands. 



