CHAPTER IV.

PHYSIOLOGICAL ANATOMY.

THE DIGESTIVE ORGANS.

_Digestion_ signifies the act of separating or distributing, hence its

application to the process by which food is made available for nutritive

purposes. The organs of digestion are the Mouth, Teeth, Tongue, Salivary

Glands, Pharynx, Esophagus, the Stomach and the Intestines, with their

glands, the Liver, Pancreas, Lacteals, and the Thoracic Duct.

[Illustration: Fig. 26.

A view of the lower jaw. _1_. The body.

_2, 2_. Rami, or branches. _3, 3_. Processes of

the lower jaw. _m_. Molar teeth. _b_. Bicuspids,

_c_. Cuspids. _i_. Incisors.]

The _Mouth_ is an irregular cavity, situated between the upper and the

lower jaw, and contains the organs of mastication. It is bounded by the

lips in front, by the cheeks at the sides, by the roof of the mouth and

teeth of the upper jaw above, and behind and beneath by the teeth of the

lower jaw, soft parts, and palate. The soft palate is a sort of pendulum

attached only at one of its extremities, while the other involuntarily

opens and closes the passage from the mouth to the pharynx. The interior

of the mouth, as well as other portions of the alimentary canal, is

lined with a delicate tissue, called _mucous membrane_.

The _Teeth_ are firmly inserted in the alveoli or sockets, of the upper

and the lower jaw. The first set, twenty in number, are temporary, and

appear during infancy. They are replaced by permanent teeth, of which

there are sixteen in each jaw; four incisors, or front teeth, four

cuspids, or eye teeth, four bicuspids, or grinders, and four molars, or

large grinders. Each tooth is divided into the crown, body, and root.

The _crown_ is the grinding surface; the _body_, the part projecting

from the jaw, is the seat of sensation and nutrition; the _root_ is that

portion of the tooth which is inserted in the alveolus. The teeth are

composed of dentine, or ivory, and enamel. The ivory forms the greater

portion of the body and root, while the enamel covers the exposed

surface. The small white cords communicating with the teeth are the

nerves.

The _Tongue_ is a flat oval organ, the base of which is attached to the

os hyoides, while the apex, the most sensitive part of the body, is

free. Its surface is covered with a membrane, which, at the sides and

lower part, is continuous with the lining of the mouth. On the lower

surface of the tongue, this membrane is thin and smooth, but on the

upper side it is covered with numerous papillae, which, in structure,

are similar to the sensitive papillae of the skin.

[Illustration: Fig. 27.

The salivary glands. The largest one, near the ear, is the

parotid gland. The next below it is the submaxillary gland.

The one under the tongue is the sublingual gland.]

The _Salivary Glands_ are six in number, three on each side of the

mouth. Their function is to secrete a fluid called _saliva_, which aids

in mastication. The largest of these glands, the _Parotid_, is situated

in front and below the ear; its structure, like that of all the salivary

glands, is cellular. The _Submaxillary_ gland is circular in form, and

situated midway between the angle of the lower jaw and the middle of the

chin. The _Sublingual_ is a long flattened gland, and, as its name

indicates, is located below the tongue, which when elevated, discloses

the saliva issuing from its porous openings.

The _Pharynx_ is nearly four inches in length, formed of muscular and

membranous cells, and situated between the base of the cranium and the

esophagus, in front of the spinal column. It is narrow at the upper

part, distended in the middle, contracting again at its junction with

the esophagus. The pharynx communicates with the nose, mouth, larynx,

and esophagus.

The _Esophagus_, a cylindrical organ, is a continuation of the pharynx,

and extends through the diaphragm to the stomach. It has three coats:

first, the muscular, consisting of an exterior layer of fibers running

longitudinally, and an interior layer of transverse fibers; second, the

cellular, which is interposed between the muscular and the mucous coat;

third, the mucous membrane, or internal coat, which is continuous with

the mucous lining of the pharynx.

[Illustration: Fig. 28.

A representation of the interior of the stomach.

_1_. The esophagus. _2_. Cardiac orifice opening into

the stomach. _6_. The middle or muscular coat.

_7_. The interior or mucous coat. _10_. The beginning

of the duodenum. _11_. The pyloric orifice.]

The _Stomach_ is a musculo-membranous, conoidal sac, communicating with

the esophagus by means of the cardiac orifice (see Fig. 28). It is

situated obliquely with reference to the body, its base lying at the

left side, while the apex is directed toward the right side. The stomach

is between the liver and spleen, subjacent to the diaphragm, and

communicates with the intestinal canal by the pyloric orifice. It has

three coats. The peritoneal, or external coat is composed of compact,

cellular tissue, woven into a thin, serous membrane, and assists in

keeping the stomach in place. The middle coat is formed of three layers

of muscular fibers: in the first, the fibres run longitudinally; in the

second, in a circular direction; and in the third, they are placed

obliquely to the others. The interior, or mucous coat, lines this organ.

The stomach has a soft, spongy appearance, and, when not distended, lies

in folds. During life, it is ordinarily of a pinkish color. It is

provided with numerous small glands, which secrete the gastric fluid

necessary for the digestion of food. The lining membrane, when divested

of mucus, has a wrinkled appearance. The arteries, veins, and

lymphatics, of the stomach are numerous.

[Illustration: Fig. 29.

Small and large intestines. _1, 1, 2, 2_.

Small intestine. _3_. Its termination in the

large intestine. _4_. Appendix vermiformis.

_5_. Caecum. _6_. Ascending colon.

_7_. Transverse colon. _8_. Descending colon.

_9_. Sigmoid flexure of colon. _10_. Rectum.]

The _Intestines_ are those convoluted portions of the alimentary canal

into which the food is received after being partially digested, and in

which the separation and absorption of the nutritive materials and the

removal of the residue take place. The coats of the intestines are

analogous to those of the stomach, and are, in fact, only extensions of

them. For convenience of description, the intestines may be divided into

the _small_ and the _large_. The small intestine is from twenty to

twenty-five feet in length, and consists of the Duodenum, Jejunum, and

Ileum. The _Duodenum_, so called because its length is equal to the

breadth of twelve fingers, is the first division of the small intestine.

If the mucous membrane of the duodenum be examined, it will be found

thrown into numerous folds, which are called _valvulæ conniventes_, the

chief function of which appears to be to retard the course of the

alimentary matter, and afford a larger surface for the accommodation of

the absorbent vessels. Numerous _villi_, minute thread-like projections,

will be found scattered over the surface of these folds, set side by

side, like the pile of velvet. Each _villus_ contains a net-work of

blood-vessels, and a lacteal tube, into which the ducts from the liver

and pancreas open, and pour their secretions to assist in the conversion

of the chyme into chyle. The _Jejunum_, so named because it is usually

found empty after death, is a continuation of the duodenum, and is that

portion of the alimentary canal in which the absorption of nutritive

matter is chiefly effected. The _Ileum_, which signifies something

rolled up, is the longest division of the small intestine. Although

somewhat thinner in texture than the jejunum, yet the difference is

scarcely perceptible. The large intestine is about five feet in length,

and is divided into the Caecum, Colon, and Rectum. The _Caecum_ is about

three inches in length. Between the large and the small intestine is a

valve, which prevents the return of excrementitious matter that has

passed into the large intestine. There is attached to the cæcum an

appendage about the size of a goose-quill, and three inches in length,

termed the _appendix vermiformis_. The _Colon_ is that part of the large

intestine which extends from the cæcum to the rectum, and which is

divided into three parts, distinguished as the ascending, the

transverse, and the descending.

[Illustration: Fig. 30.

Villi of the small intestine greatly

magnified.]

[Illustration: Fig. 31.

A section of the Ileum, turned inside out,

so as to show the appearance and arrangement

of the villi on an extended surface.]

The _Rectum_ is the terminus of the large intestine. The intestines are

abundantly supplied with blood-vessels. The arteries of the small

intestine are from fifteen to twenty in number. The large intestine is

furnished with three arteries, called the _colic arteries_. The

_ileo-colic artery_ sends branches to the lower part of the ileum, the

head of the colon, and the appendix vermiformis. The _right colic

artery_ forms arches, from which branches are distributed to the

ascending colon. The _colica media_ separates into two branches, one of

which is sent to the right portion of the transverse colon, the other to

the left. In its course, the _superior hemorrhoidal artery_ divides into

two branches, which enter the intestine from behind, and embrace it on

all sides, almost to the anus.

The _Thoracic Duct_ is the principal trunk of the absorbent system, and

the canal through which much of the chyle and lymph is conveyed to the

blood. It begins by a convergence and union of the lymphatics on the

lumbar vertebræ, in front of the spinal column, then passes upward

through the diaphragm to the lower part of the neck, thence curves

forward and downward, opening into the subclavian vein near its junction

with the left jugular vein, which leads to the heart.

[Illustration: Fig. 32.

_c, c_. Right and left subclavian veins. _b_.

Inferior vena cava. _a_. Intestines. _d_. Entrance

of the thoracic duct into the left

subclavian vein. _4_. Mesenteric glands,

through which the lacteals pass to the

thoracic duct.]

[Illustration: Fig. 33.

The inferior surface of the liver. 1. Right lobe.

2. Left lobe. 3. Gall-bladder.]

The _Liver_, which is the largest gland in the body, weighs about four

pounds in the adult, and is located chiefly on the right side,

immediately below the diaphragm. It is a single organ, of a dark red

color, its upper surface being convex, while the lower is concave. It

has two large lobes, the right being nearly four times as large as the

left. The liver has two coats, the _serous_, which is a complete

investment, with the exception of the diaphragmatic border, and the

depression for the gall-bladder, and which helps to suspend and retain

the organ in position; and the _fibrous_, which is the inner coat of the

liver, and forms sheaths for the blood-vessels and excretory ducts. The

liver is abundantly supplied with arteries, veins, nerves, and

lymphatics. Unlike the other glands of the human body, it receives two

kinds of blood; the arterial for its nourishment, and the venous, from

which it secretes the bile. In the lower surface of the liver is lodged

the gall-bladder, a membranous sac, or reservoir, for the bile. This

fluid is not absolutely necessary to the digestion of food, since this

process is effected by other secretions, nor does bile exert any special

action upon, starchy or oleaginous substances, when mixed with them at a

temperature of 100° F. Experiments also show that in some animals there

is a constant flow of bile, even when no food has been taken, and there

is consequently no digestion to be performed. Since the bile is formed

from the venous blood, and taken from the waste and disintegration of

animal tissue, it would appear that it is chiefly an excrementitious

fluid. It does not seem to have accomplished its function when

discharged from the liver and poured into the intestine, for there it

undergoes various alterations previous to re-absorption, produced by its

contact with the intestinal juices. Thus the bile, after being

transformed in the intestines, re-enters the blood under a new form, and

is carried to some other part of the system to perform its mission.

The _Spleen_ is oval, smooth, convex on its external, and irregularly

concave on its internal, surface. It is situated on the left side, in

contact with the diaphragm and stomach. It is of a dark red color,

slightly tinged with blue at its edges. Some physiologists affirm that

no organ receives a greater quantity of blood, according to its size,

than the spleen. The structure of the spleen and that of the mesenteric

glands are similar, although the former is provided with a scanty supply

of lymphatic vessels, and the chyle does not pass through it, as through

the mesenteric glands. The _Pancreas_ lies behind the stomach, and

extends transversely across the spinal column to the right of the

spleen. It is of a pale, pinkish color, and its secretion is analogous

to that of the salivary glands; hence it has been called the _Abdominal

Salivary Gland_.

[Illustration: Fig. 34.

Digestive organs. _3_. The tongue. _7_. Parotid

gland. _8_. Sublingual gland. _5_. Esophagus. _9_.

Stomach. _10_. Liver. _11_. Gall-bladder, _14_. Pancreas.

_13, 13_. The duodenum. The small and large intestines

are represented below the stomach.]

Digestion is effected in those cavities which we have described as parts

of the alimentary canal. The food is first received into the mouth,

where it is masticated by the teeth, and, after being mixed with mucus

and saliva, is reduced to a mere pulp; it is then collected by the

tongue, which, aided by the voluntary muscles of the throat, carries the

food backward into the pharynx, and, by the action of the involuntary

muscles of the pharynx and esophagus, is conveyed to the stomach. Here

the food is subjected to a peculiar, churning movement, by the alternate

relaxation and contraction of the fibers which compose the muscular wall

of the stomach. As soon as the food comes in contact with the stomach,

its pinkish color changes to a bright red; and from the numerous tubes

upon its inner surface is discharged a colorless fluid, called the

_gastric juice_, which mingles with the food and dissolves it. When the

food is reduced to a liquid condition, it accumulates in the pyloric

portion of the stomach. Some distinguished physiologists believe that

the food is kept in a gentle, unceasing, but peculiar motion, called

_peristaltic_, since the stomach contracts in successive circles. In the

stomach the food is arranged in a methodical manner. The undigested

portion is detained in the upper, or cardiac extremity, near the

entrance of the esophagus, by contraction of the circular fibers of the

muscular coat. Here it is gradually dissolved, and then carried into the

pyloric portion of the stomach. From this, then, it appears, that the

dissolved and undissolved portions of food occupy different parts of the

stomach. After the food has been dissolved by the gastric fluid, it is

converted into a homogeneous, semi-fluid mass, called _chyme_. This

substance passes from the stomach through the pyloric orifice into the

duodenum, in which, by mixing with the bile and pancreatic fluid, its

chemical properties are again modified, and it is then termed _chyle_,

which has been found to be composed of three distinct parts, a

reddish-brown sediment at the bottom, a whey-colored fluid in the

middle, and a creamy film at the top. Chyle is different from chyme in

two respects: First, the alkali of the digestive fluids, poured into the

duodenum, or upper part of the small intestine, neutralizes the acid of

the chyme; secondly, both the bile and the pancreatic fluid seem to

exert an influence over the fatty substances contained in the chyme,

which assists the subdivision of these fats into minute particles. While

the chyle is propelled along the small intestine by the peristaltic

action, the matter which it contains in solution is absorbed in the

usual manner into the vessels of the villi by the process called

_osmosis_. The fatty matters being subdivided into very minute

particles, but not dissolved, and consequently incapable of being thus

absorbed by osmosis, pass bodily through the epithelial lining of the

intestine into the commencement of the lacteal tubes in the villi. The

digested substances, as they are thrust along the small intestines,

gradually lose their albuminoid, fatty, and soluble starchy and

saccharine matters, and pass through the ileo-caecal valve into the

cæcum and large intestine. An acid reaction takes place here, and they

acquire the usual fæcal smell and color, which increases as they

approach the rectum. Some physiologists have supposed that a second

digestion takes place in the upper portion of the large intestine. The

lacteals, filled with chyle, pass into the mesenteric glands with which

they freely unite, and afterward enter the _receptaculum chyli_, which

is the commencement of the thoracic duct, a tube of the size of a

goose-quill, which lies in front of the backbone. The lymphatics, the

function of which is to secrete and elaborate lymph, also terminate in

the _receptaculum chyli_, or receptacle for the chyle. From this

reservoir the chyle and lymph flow into the thoracic duct, through which

they are conveyed to the left subclavian vein, there to be mingled with

venous blood. The blood, chyle, and lymph, are then transmitted directly

to the lungs.

The process of nutrition aids in the development and growth of the body;

hence it has been aptly designated a "perpetual reproduction." It is the

process by which every part of the body assimilates portions of the

blood distributed to it. In return, the tissues yield a portion of the

material which was once a component part of their organization. The body

is constantly undergoing waste as well as repair. One of the most

interesting facts in regard to the process of nutrition in animals and

plants is, that all tissues originate in cells. In the higher types of

animals, the blood is the source from which the cells derive their

constituents. Although the alimentary canal is more or less complicated

in different classes of animals, yet there is no species, however low in

the scale of organization, which does not possess it in some form.[2]

The little polyp has only one digestive cavity, which is a pouch in the

interior of the body. In some animals circulation is not distinct from

digestion, in others respiration and digestion are performed by the same

organs; but as we rise in the scale of animal life, digestion and

circulation are accomplished in separate cavities, and the functions of

nutrition become more complex and distinct.

* * * * *

The People's Common Sense Medical Adviser in Plain English or, Medicine Simplified, 54th ed., One Million, Six Hundred and Fifty Thousand · 第 4 / 34 章