On the proximate cause of death after the spontaneous introduction of air into the veins. With some remarks on the treatment of that accident / [John Eric Erichsen].

  • Erichsen, John Eric, 1818-1896
Date:
[1844]
Catalogue details

Licence: Public Domain Mark

Credit: On the proximate cause of death after the spontaneous introduction of air into the veins. With some remarks on the treatment of that accident / [John Eric Erichsen]. Source: Wellcome Collection.

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    with the precautions necessary to avoid distension of the pulmo¬ nary heart, does not produce any other consecutive phenomenon beyond a muscular weakness, which ceases in a few days.” * The only argument adduced by Marchal de Calvi in support of his opi¬ nion is, that the action of the heart is arrested sooner by expired than by pure atmospheric air. The reason of this difference is, no doubt, that one is blown in, whilst the other gains admittance slowly and spontaneously. The rapidity of death being invaria¬ bly in the direct ratio of the rapidity and force with which the air is introduced. We now come to the consideration of the fourth class of opi¬ nions, viz. that death is occasioned by the arrest of the circulation in the lungs. It has been shown that death does not occur from overdistension of the right auricle or ventricle, or from the nox¬ ious influence on the heart of the carbonic acid, eliminated from the venous blood, or indeed from any cause that affects that organ primarily; nor is it occasioned by the irritation of the air on the brain. There will now, I think, be but little difficulty in proving that the primary cause of the fatal event is the arrest of the blood in the capillaries of the lungs, the consequence of which is that an insufficient quantity is sent to the nervous centres, the due per¬ formance of whose functions is necessary for the maintenance of respiration and animal life. The effect of the injection of certain substances, such as mer¬ cury, oil, or purulent matter into the veins, resembles very closely that of air. Death in these cases ensuing either very shortly after the foreign matter has gained admittance into the venous system, in consequence of its being unable to pass through the capillaries of the lungs, and thus arresting the general circulation ; or else, if the animal survive the immediate effects of the experiment, it will probably die in a few days of pneumonia; which disease, as Nysten has shown, is very apt to supervene in those dogs that are not immediately killed by injecting air into their veins. The anatomical evidence in support of the opinion that the presence of air in the capillaries of the lungs arrests the circulation through these organs, will be found in the fact, that, although the right ca¬ vities may be full of bloody froth, it is very seldom met with in the left side of the heart, or if so, but in very small quantity, merely a few stray bubbles,—in the pulmonary artery being, as far as it can be traced, filled with bloody froth,—in the lungs being always in an exsanguine condition,—and in the pulmonary veins and left side of the heart, and arterial system, being nearly, if not entirely empty of blood, whilst the venous system is gorged as far as the vence cavce or right auricle, where the presence of air prevents the farther entry of blood. From the analogy, then, afforded by * Recherches de Physiologique, &c., pp. 93.